Is surgical treatment effective for different forms of spinal cord compression?

Degenerative Cervical Myelopathy (DCM) is the most common cause of injury to the spinal cord in the elderly population worldwide and, with an aging population globally, it is likely to become even more common. As such, a thorough understanding of optimal treatment for this condition is vital.

The term DCM actually encompasses a number of different conditions that cause compression of the spinal cord. One of these conditions is known as ossification of the posterior longitudinal ligament (OPLL) in which there is a thickening of the bone around the posterior longitudinal ligament, a ligament situated within the vertebral canal. Although many patients with OPLL do not have symptoms, the excess bone growth can put pressure on the spinal cord and cause symptoms including mild pain and numbness in the arms and/or legs or even complete numbness in the extremities. For those who have symptoms, surgery may be recommended and the aim of this study was to compare whether surgery for those with OPLL is as successful as for those with other forms of DCM. Surgery for DCM involved the surgical decompression of the spinal cord.

In this study, 479 patients undergoing surgery for DCM were enrolled. After surgery, outcomes were assessed for all patients in terms of function and quality of life. The outcomes of patients with OPLL, of which there were 135 (28.2% of the whole sample of patients), were compared to those with other forms of DCM.

Overall, it was found that outcomes for patients with OPLL were similar to those with other forms of DCM. There was a trend towards patients with OPLL encountering more surgery-related complications but this was not statistically significant. As such, surgical decompression for OPLL is a viable and useful treatment, just as it is for other forms of DCM.

Madeleine O’Higgins, PhD
Krembil Research Institute, Toronto Western Hospital, University Health Network
Toronto, Canada



Comparison of Outcomes of Surgical Treatment for Ossification of the Posterior Longitudinal Ligament Versus Other Forms of Degenerative Cervical Myelopathy: Results from the Prospective, Multicenter AOSpine CSM-International Study of 479 Patients.
Nakashima H, Tetreault L, Nagoshi N, Nouri A, Arnold P, Yukawa Y, Toyone T, Tanaka M, Zhou Q, Fehlings MG.
J Bone Joint Surg Am. 2016 Mar 2


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