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Relationship of preoperative intramedullary MRI signal intensity and dynamic factors with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament.
Clin Neurol Neurosurg. 2018 11; 174:117-122.CN

Abstract

OBJECTIVE

We aimed to analyze the relationship of preoperative signal intensity on magnetic resonance imaging (MRI) and dynamic factor with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL).

PATIENTS AND METHODS

We retrospectively reviewed the records of 29 patients (20 males and 9 females) who underwent double-door laminoplasty for cervical OPLL. T2-weighted MRI was performed preoperatively. To assess the high-signal changes of the spinal cord, signal intensity was classified as grade 0 (low signal, no changes), grade 1 (medium signal, mild changes), and grade 2 (bright signal, pronounced changes). The following factors were analyzed for their relationship with surgical outcome, expressed as the Japanese Orthopedic Association (JOA) score recovery rate: pre- and postoperative C2-C7 range of motion (ROM), segmental ROM, C2-C7 lordotic angle, and spinal cord occupying ratio, as well as disease duration.

RESULTS

Disease duration was significantly longer in patients with pronounced high-signal changes on preoperative MRI (P < 0.05 for grade 2 vs. grade 1 or 0). The mean preoperative JOA score and JOA score recovery rate were significantly lower in patients with pronounced high-signal changes on preoperative MRI (P < 0.05 for grade 2 vs. grade 1 or 0). Preoperatively, segmental ROM was significantly smaller in patients with no MRI signal intensity changes (P < 0.05 for grade 0 vs. grade 1 or 2). Additionally, preoperative segmental ROM was negatively correlated with JOA score recovery rate (R=-0.470, P = 0.01) and positively correlated with high-signal changes on preoperative MRI (R = 0.460, P = 0.012). On multivariate analysis, preoperative segmental ROM was negatively associated with JOA score recovery rate (odds ratio, - 0.407; P = 0.046).

CONCLUSION

Given its negative correlation with JOA score recovery rate and positive correlation with high-signal changes on preoperative MRI, higher preoperative segmental ROM may be associated with spinal cord damage due to repeated minor trauma, predicting poor surgical outcome of laminoplasty in cervical OPLL.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan. Electronic address: masashim@oita-u.ac.jp.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30236637

Citation

Miyazaki, Masashi, et al. "Relationship of Preoperative Intramedullary MRI Signal Intensity and Dynamic Factors With Surgical Outcomes of Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament." Clinical Neurology and Neurosurgery, vol. 174, 2018, pp. 117-122.
Miyazaki M, Ishihara T, Notani N, et al. Relationship of preoperative intramedullary MRI signal intensity and dynamic factors with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament. Clin Neurol Neurosurg. 2018;174:117-122.
Miyazaki, M., Ishihara, T., Notani, N., Kanezaki, S., Abe, T., & Tsumura, H. (2018). Relationship of preoperative intramedullary MRI signal intensity and dynamic factors with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament. Clinical Neurology and Neurosurgery, 174, 117-122. https://doi.org/10.1016/j.clineuro.2018.09.018
Miyazaki M, et al. Relationship of Preoperative Intramedullary MRI Signal Intensity and Dynamic Factors With Surgical Outcomes of Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament. Clin Neurol Neurosurg. 2018;174:117-122. PubMed PMID: 30236637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of preoperative intramedullary MRI signal intensity and dynamic factors with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament. AU - Miyazaki,Masashi, AU - Ishihara,Toshinobu, AU - Notani,Naoki, AU - Kanezaki,Shozo, AU - Abe,Tetsutaro, AU - Tsumura,Hiroshi, Y1 - 2018/09/11/ PY - 2018/07/09/received PY - 2018/08/27/revised PY - 2018/09/09/accepted PY - 2018/9/22/pubmed PY - 2019/11/22/medline PY - 2018/9/22/entrez KW - Cervical laminoplasty KW - Cervical ossification of the posterior longitudinal ligament KW - Dynamic factor KW - Intramedullary high-signal change KW - MRI SP - 117 EP - 122 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 174 N2 - OBJECTIVE: We aimed to analyze the relationship of preoperative signal intensity on magnetic resonance imaging (MRI) and dynamic factor with surgical outcomes of laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL). PATIENTS AND METHODS: We retrospectively reviewed the records of 29 patients (20 males and 9 females) who underwent double-door laminoplasty for cervical OPLL. T2-weighted MRI was performed preoperatively. To assess the high-signal changes of the spinal cord, signal intensity was classified as grade 0 (low signal, no changes), grade 1 (medium signal, mild changes), and grade 2 (bright signal, pronounced changes). The following factors were analyzed for their relationship with surgical outcome, expressed as the Japanese Orthopedic Association (JOA) score recovery rate: pre- and postoperative C2-C7 range of motion (ROM), segmental ROM, C2-C7 lordotic angle, and spinal cord occupying ratio, as well as disease duration. RESULTS: Disease duration was significantly longer in patients with pronounced high-signal changes on preoperative MRI (P < 0.05 for grade 2 vs. grade 1 or 0). The mean preoperative JOA score and JOA score recovery rate were significantly lower in patients with pronounced high-signal changes on preoperative MRI (P < 0.05 for grade 2 vs. grade 1 or 0). Preoperatively, segmental ROM was significantly smaller in patients with no MRI signal intensity changes (P < 0.05 for grade 0 vs. grade 1 or 2). Additionally, preoperative segmental ROM was negatively correlated with JOA score recovery rate (R=-0.470, P = 0.01) and positively correlated with high-signal changes on preoperative MRI (R = 0.460, P = 0.012). On multivariate analysis, preoperative segmental ROM was negatively associated with JOA score recovery rate (odds ratio, - 0.407; P = 0.046). CONCLUSION: Given its negative correlation with JOA score recovery rate and positive correlation with high-signal changes on preoperative MRI, higher preoperative segmental ROM may be associated with spinal cord damage due to repeated minor trauma, predicting poor surgical outcome of laminoplasty in cervical OPLL. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/30236637/Relationship_of_preoperative_intramedullary_MRI_signal_intensity_and_dynamic_factors_with_surgical_outcomes_of_laminoplasty_for_cervical_ossification_of_the_posterior_longitudinal_ligament_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(18)30380-9 DB - PRIME DP - Unbound Medicine ER -