Pathology of Spinal Cord Lesions Caused by Ossification of the Posterior Longitudinal Ligament

Spinal cord lesions are included in the diagnosis of multiple sclerosis (MS), yet spinal cord MRI is not mandatory for diagnosis according to the latest revisions of the McDonald Criteria. We investigated the distribution of spinal cord lesions in MS patients and examined how it influences the fulfillment of the 2017 McDonald Criteria. Seventy-four patients with relapsing-remitting MS were examined with brain and entire spinal cord MRI. Sixty-five patients received contrast. The number and anatomical location of MS lesions were assessed along with the Expanded Disability Status Scale (EDSS). A Chi-square test, Fischer’s exact test, and one-sided McNemar’s test were used to test distributions. MS lesions were distributed throughout the spinal cord. Diagnosis of dissemination in space (DIS) was increased from 58/74 (78.4%) to 67/74 (90.5%) when adding cervical spinal cord MRI to brain MRI alone (p = 0.004). Diagnosis of dissemination in time (DIT) was not significantly increased when adding entire spinal cord MRI to brain MRI alone (p = 0.04). There was no association between the number of spinal cord lesions and the EDSS score (p = 0.71). MS lesions are present throughout the spinal cord, and spinal cord MRI may play an important role in the diagnosis and follow-up of MS patients.

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Comprehensive Expression Profiles of CircRNAs, LncRNAs, and mRNAs in PBMCs from Patients with Ossification of the Posterior Longitudinal Ligament

Molecular Omics ◽

10.1039/d1mo00060h ◽

2021 ◽

Author(s):

Ning Jiang ◽

Kuibo Zhang ◽

Jie Shang ◽

Bin Wang ◽

Junlong Zhong ◽

...

Keyword(s):

Spinal Cord ◽

Expression Profiles ◽

Posterior Longitudinal Ligament ◽

Spinal Disease ◽

Ectopic Ossification

Ossification of the posterior longitudinal ligament (OPLL), one of spinal disease causing to myelopathy, is characterized by the ectopic ossification and narrowing the spinal cord. However, the pathogenesis of OPLL...

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Alterations in Neuron Innervation Associated with Spinal Cord Lesions

Journal of Neuroscience Nursing ◽

10.1097/01376517-198104000-00002 ◽

1981 ◽

Vol 13 (2) ◽

pp. 48-52

Author(s):

Delycia Feustel

Keyword(s):

Spinal Cord ◽

Spinal Cord Lesions

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Factors for a Good Surgical Outcome in Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Thoracic Ossification of the Posterior Longitudinal Ligament: Prospective Single-Center Study

Operative Neurosurgery ◽

10.1093/ons/opx043 ◽

2017 ◽

Vol 13 (6) ◽

pp. 661-669 ◽

Cited By ~ 10

Author(s):

Shiro Imagama ◽

Kei Ando ◽

Kazuyoshi Kobayashi ◽

Tetsuro Hida ◽

Kenyu Ito ◽

...

Keyword(s):

Spinal Cord ◽

Surgical Outcomes ◽

Ligamentum Flavum ◽

Posterior Longitudinal Ligament ◽

Neurophysiological Monitoring ◽

Posterior Decompression ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Estimated Blood Loss ◽

Significant Factors

Abstract BACKGROUND Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE To identify factors for good surgical outcomes with prospective and comparative study. METHODS Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score. Preoperative, intraoperative, and postoperative findings were compared in the 2 groups, and significant factors for a good outcome were analyzed. RESULTS Patients with a good outcome (76%) had significantly lower nonambulatory rate and positive prone and supine position tests preoperatively; lower rates of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level, thoracic spinal cord alignment difference, and spinal canal stenosis on preoperative magnetic resonance imaging; lower estimated blood loss; higher rates of intraoperative spinal cord floating and absence of deterioration of intraoperative neurophysiological monitoring; and lower rates of postoperative complications (P < .0005). In multivariate logistic regression analysis, negative prone and supine position test (odds ratio [OR]: 17.00), preoperative ambulatory status (OR: 6.05), absence of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level (OR: 5.84), intraoperative spinal cord floating (OR: 4.98), and lower estimated blood loss (OR: 1.01) were significant factors for a good surgical outcome. CONCLUSION This study demonstrated that early surgery is recommended during these positive factors. Appropriate surgical planning based on preoperative thoracic spinal cord alignment difference, as well as sufficient spinal cord decompression and reduction of complications using intraoperative ultrasonography and intraoperative neurophysiological monitoring, may improve surgical outcomes.

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