Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Tanida, Atsushi; Kamimura, Atsushi; Tanishima, Shinji; Mihara, Tokumitsu; Takeda, Chikako; Nagashima, Hideki

doi:10.1038/scsandc.2016.32

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…It is possible that DM angiopathy, therefore, interferes with nutrient delivery to other organs, including the spinal cord. Several studies mention possible spinal cord ischemia in patients with DM [18-20]. Mawad et al [21] evaluated 24 patients who developed signs and symptoms of spinal cord ischemia or infarction following thoracoabdominal aortic aneurysm surgery using MRI.…”

Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

et al. 2019

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Study Design Multicenter, prospective study. Purpose To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. Overview of Literature To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. Methods The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. Results JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group ( p <0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. Conclusions Poor glycemic control might prevent postoperative functional recovery of the spinal cord.

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Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

et al. 2019

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“…Table 1 highlights the cases with OPLL that showed an acute presentation and a rapid progression. [8,5,7] In the present report, following trivial trauma, our patient presented with an acute left hemiparesis and anterior cord compression from C2 to C7 attributed to OPLL (i.e., once the brain MR ruled out a stroke).…”

Section: Discussionmentioning

confidence: 53%

A case of cervical OPLL and DISH mimicking stroke

Prabhu

Rathod²,

Mohanty³

et al. 2022

Surgical Neurology International

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Background: Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder that mostly involves the cervical spine. It is more prevalent in East Asian countries. Patients typically present with the gradual onset of myelopathy, while about 5% show rapid progression. Case Description: A 51-year-old diabetic and hypertensive male presented with a left-sided hemiparesis following trivial trauma. The first diagnosis was a stroke, but the subsequent workup proved negative. Subsequently, the MRI and CT studies demonstrated significant cord compression due to OPLL extending from C2 to C7. There was also a heterogeneous hyperintense intramedullary cord signal indicative of edema/myelomalacia in the retro- odontoid region. The CT also diagnosed C2–C7 diffuse idiopathic skeletal hyperostosis. Conclusion: Patients with cervical myelopathy due to OPLL rarely present about 5% of the time with the acute onset of neurological deficit following minor trauma. Certainly, one must consider high cervical OPLL as responsible for hemiparesis in a patient whose brain MR has ruled out a stroke.

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“…In addition, external mechanical compression on spinal cord may further damage blood supply of the spinal cord and further affect the functional recovery potential of the injured spinal cord. [23] The recovery potential of spinal cord artery and other compressed vessels after decompression is limited, and atherosclerosis may aggravate this pathological change, which may be one of the reasons why the recovery ratio of spinal cord function in carotid atherosclerosis group is lower than that in noncarotid atherosclerosis group. This study found that the severity of carotid atherosclerosis was not related to the postoperative recovery rate of patients with CSM.…”

Section: Discussionmentioning

confidence: 99%

“…Atherosclerosis or plaque will result in increased vascular fragility, decreased vascular elasticity, lumen stenosis and hemodynamic changes of spinal artery, which affect blood supply to the spinal cord. In addition, external mechanical compression on spinal cord may further damage blood supply of the spinal cord and further affect the functional recovery potential of the injured spinal cord [23] . The recovery potential of spinal cord artery and other compressed vessels after decompression is limited, and atherosclerosis may aggravate this pathological change, which may be one of the reasons why the recovery ratio of spinal cord function in carotid atherosclerosis group is lower than that in noncarotid atherosclerosis group.…”

Section: Discussionmentioning

confidence: 99%

The influence of carotid atherosclerosis on surgical outcomes of patients with cervical spondylotic myelopathy

Liu

Wang

et al. 2022

Medicine

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The appearance of atherosclerosis in the carotid artery may be suggest the possibility of atherosclerosis in the spinal cord artery, which can cause spinal cord ischemia and further lead to neural element damage.According to the inclusion and exclude standard, there are 137 patients with cervical spondylotic myelopathy (CSM) incorporating retrospective analysis. These patients were consecutively admitted into The Second Hospital-Cheeloo College of Medicine-Shandong University from January 2016 to December 2018 and have accepted surgical treatment. All patients were examined by color Doppler ultrasound to detect carotid atherosclerosis before surgery. All patients were divided into 2 groups according to the presence or absence of carotid atherosclerosis: carotid atherosclerosis group (n = 88) and noncarotid atherosclerosis group (n = 49). All patients were followed up for at least 12 months after surgery. Demographic and surgery-related data were collected and analyzed to identify potential factors that affect the surgical outcomes in CSM.The average age of carotid atherosclerosis group (51 males and 37 females), and noncarotid atherosclerosis group (24 males and 25 females) were 62.02 ± 10.34 years (range, 38-85 years) and 49.61 ± 10.28 years (range, 26-67 years), respectively.In carotid atherosclerosis group: pre and postoperative modify Japanese Orthopedic Association Scores (mJOA score) were 11.58 ± 1.82 and 14.36 ± 1.64; the recovery rate of mJOA score was 45.57% ± 13.28%. In noncarotid atherosclerosis group: pre and postoperative mJOA score were 12.00 ± 2.11 and 15.04 ± 1.70; the recovery rate of mJOA score was 53.90% ± 13.22%. Univariate logistic regression analysis demonstrated that gender (P = .004), age ≥65 years (P = .001), duration of symptoms ≥12 months (P = .040), smoking history (P < .001), preoperative mJOA score 11 (P = .007) and carotid atherosclerosis (P = .004) were related to poor surgical outcomes. Multivariate logistic regression analysis showed significant correlations between poor surgical outcomes and age ≥65 years (P = .047), smoking history (P = .010), preoperative mJOA score 11 (P = .008) or carotid atherosclerosis (P = .047).Carotid atherosclerosis may be a risk factor for poor surgical outcomes in CSM.

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Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Cited by 4 publications

References 33 publications

Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

A case of cervical OPLL and DISH mimicking stroke

The influence of carotid atherosclerosis on surgical outcomes of patients with cervical spondylotic myelopathy

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