Central Cord Syndrome Developed in Patients with Ossification of the Posterior Longitudinal Ligament: Clinical Features and Functional Outcomes

ABSTRACT

OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) is a degenerative disorder of the spine which is related to cervical compressive myelopathy. We studied patients with central cord syndrome (CCS) to explore the implication of OPLL on clinical features and functional outcomes of CCS. METHOD: A retrospective study was conducted on 26 patients with CCS between 1998 and 2003. Demographic characteristics, mechanisms of injury, neurological impairments, main functional outcomes, and complications were identified. Clinical features and outcomes were compared between OPLL and non-OPLL group. RESULTS: Twenty patients with CCS had OPLL (12/17 with traumatic and 8/9 with non-traumatic CCS). The initial ASIA motor score of OPLL and non-OPLL patients was 67.8 and 65.3 and, at discharge, 82.8 and 78.5. There were no significant differences in gait, bladder management, length of stay, discharge disposition, and major complications between OPLL and non-OPLL group. Among OPLL patients, non- traumatic CCS patients showed higher ASIA motor score at discharge and had a tendency of better functional outcome than traumatic CCS patients. CONCLUSION: OPLL was commonly observed in CCS patients. Mechanism of injury rather than the presence of OPLL was a significant determinant of clinical features or functional outcomes of CCS.