Characteristics of the cervical spine and cervical cord injuries in older adults with cervical ossification of the posterior longitudinal ligament

Scientific Reports, 2023 · DOI: https://doi.org/10.1038/s41598-023-29877-2 · Published: February 11, 2023

Simple Explanation

This study investigates cervical spinal cord injury (CSCI) in older adults, specifically focusing on those with ossification of the posterior longitudinal ligament (OPLL). The goal was to understand the characteristics of OPLL and whether it affects neurological outcomes after CSCI. Researchers compared older adults with CSCI who also had OPLL to those who did not, looking at factors like injury type, neurological severity, and recovery. They used statistical methods to account for other variables that could influence outcomes. The findings suggest that while OPLL might worsen initial neurological symptoms after a spinal cord injury in older adults, it doesn't necessarily lead to poorer long-term neurological improvement.

Study Duration

2010–2020

Participants

1512 patients aged ≥ 65 years diagnosed with CSCI

Evidence Level

Retrospective cohort study

Key Findings

1
The prevalence of OPLL in older adults with CSCI was found to be 22.0% in the study population.
2
Older adults with both CSCI and OPLL were more likely to be male, have a higher BMI, have a history of smoking, experience low-energy trauma, and have diabetes mellitus.
3
While patients with OPLL showed worse neurological findings at the time of injury, OPLL was not associated with a poorer neurological improvement after CSCI.

Research Summary

This study examined the characteristics and impact of ossification of the posterior longitudinal ligament (OPLL) on cervical spinal cord injury (CSCI) outcomes in older adults. The research involved a retrospective analysis of 1512 patients aged 65 years and older. The study revealed that 22% of older adults with CSCI also had OPLL. These patients tended to be male and have factors such as higher BMI, smoking history, and diabetes. The key finding was that although OPLL might exacerbate neurological symptoms at the time of injury, it did not significantly hinder neurological improvement following CSCI in older adults.

Practical Implications

Clinical Management

Clinicians should be aware of the higher prevalence of OPLL in older male patients with CSCI who have certain risk factors like higher BMI and smoking history.

Prognosis Counseling

Despite potentially worse initial neurological findings, older CSCI patients with OPLL can be reassured that their long-term neurological improvement may not be negatively affected by OPLL.

Future Research

Further prospective studies are needed to standardize treatment protocols and comprehensively evaluate the relationship between OPLL morphology, spinal canal diameter, and cord compression.

Study Limitations

1
Sampling bias due to retrospective data collection from medical records.
2
Lack of evaluation of ossification type and detailed OPLL characteristics (length, thickness).
3
Non-standardized treatment protocols across different facilities in the multicenter study.

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