• Yue-Qi Du, Wan-Ru Duan, Zan Chen, Hao Wu, and Feng-Zeng Jian.
• Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
• World Neurosurg. 2019 Apr 1; 124: e710e714e710-e714.

ObjectiveTo identify clinical factors predicting the development of myelopathy in cervical ossification of the posterior longitudinal ligament (OPLL) patients with radiculopathy.MethodsWe retrospectively reviewed 83 cervical OPLL patients who presented with radiculopathy. On the basis of the symptoms and physical findings, we divided patients into 2 groups: myelopathy group and nonmyelopathy group. Demographic, clinical, and radiologic characteristics were reviewed and analyzed among the 2 groups. Predictors for the development of myelopathy were assessed via univariate and multivariate analysis.ResultsUnivariate analysis demonstrated that a high occupying ratio and the presence of an intramedullary high signal were risk factors for development of myelopathy from radiculopathy in OPLL patients. Multivariate analysis further identified that a high occupying ratio was the only independent predictor (odds ratio 1.05, 95% confidence interval 1.003-1.091, P = 0.035). The cervical range of motion and minor trauma were not related to the development of myelopathy in our study.ConclusionsNonmyelopathic OPLL patients with radiculopathy and a high occupying ratio were at higher risk of developing myelopathy, and surgical intervention should be recommended in these cases. However, for elderly patients with significant comorbid conditions, the risks and benefits of surgery should be carefully considered.Copyright © 2019 Elsevier Inc. All rights reserved.

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