• Alex M Hollenberg and Addisu Mesfin.
• Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA.
• World Neurosurg. 2020 Nov 1; 143: e581-e589.

ObjectiveWe sought to evaluate the influence of trauma-induced spinal cord injury (SCI) on the operative management of cervical ossification of the posterior longitudinal ligament (OPLL) in a North American cohort.MethodsA retrospective chart review was performed for all patients who underwent surgical management for OPLL in an academic medical center between November 2006 and July 2019. Patients were categorized into 1 of 2 groups and compared on the basis of their initial presentation: 1) SCI with OPLL or 2) cervical myelopathy (CM) with OPLL. Patient characteristics were collected. OPLL classification and K-line measurements were performed. Surgical approach, levels fused/decompressed, blood loss, postoperative length of stay, surgical complications, and neurologic outcome were recorded.ResultsAmong the 28-patient cohort, 12 were in the SCI with OPLL group and 16 were in the CM with OPLL group. The most common type of OPLL in both groups was segmental (n = 21, 75%). The average levels fused/decompressed (P = 0.0176), estimated blood loss (P = 0.0204), and postoperative length of stay (P = 0.0003) were all significantly higher in the SCI with OPLL group. There were significantly more anterior-only surgical approaches performed in the CM with OPLL group (P = 0.0159). The motor score at admission (P = 0.0005) and at latest follow-up (P = 0.0003) for the SCI with OPLL group was significantly lower than the CM with OPLL group.ConclusionsPatients with SCI complicated by OPLL had worse preoperative and postoperative neurologic motor scores as compared with patients in the CM with OPLL group. Most of the patients in our cohort showed neurologic improvement.Copyright © 2020 Elsevier Inc. All rights reserved.

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