Evidence map›Paper›PMID 34911374›Full record

ArticleGlobal spine journal2023

Preoperative Magnetic Resonance Imaging Signal Intensity Classification Is Associated With Clinical Presentation and Surgical Outcomes in Myelopathy Caused by Thoracic Ossification of Ligamentum Flavum: A Multicenter Study.

Chao Zhang, Shengdong Yang, Lin Wang, Nan Wang, Zhenyong Ke, Peng Liu, Chengmin Zhang, Chuang Xiong, Runhan Zhao, Hao Liang and 1 more

Open access · goldAbstract read
In one paragraph

Article in Global spine journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Open posterior approach versus endoscopic approach for thoracic ligamentum flavum ossification: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Pooled it
  2. Review
  3. Article
  4. Costs of revision operations for distal junctional kyphosis following thoracic posterior spinal fusion for adolescent idiopathic scoliosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
    Article
  5. Review
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Chao ZhangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Shengdong YangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Lin WangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Nan WangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Zhenyong KeDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.ORCID 0000-0002-4335-8315
Peng LiuDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.ORCID 0000-0002-6678-2266
Chengmin ZhangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Chuang XiongDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Runhan ZhaoDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Hao LiangDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Xiaoji LuoDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.ORCID 0000-0002-3783-9438
The Affiliated Yongchuan Hospital of Chongqing Medical University · CNArmy Medical University · CNDalian Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective Cohort Study.

objectivesTo explore whether classification of the increased signal intensity (ISI) on magnetic resonance imaging (MRI) correlates with clinical presentations and outcomes in symptomatic thoracic ossification of ligamentum flavum (T-OLF) patients.

methodsAll patients with symptomatic T-OLF who underwent laminectomy at four institutions were reviewed. The ISI on preoperative T2-weighted MRI was divided into 3 groups, Grade 0, none; Grade 1, light (obscure); and Grade 2, intense (bright). Neurological function before surgery and at follow-up was evaluated by the revised Japanese Orthopedic Association (JOA) score. Patients' demographics, clinical manifestations, and surgical outcomes were compared.

resultsA total of 94 patients were involved. Preoperative MRI showed 32 patients in Grade 0, 39 patients in Grade 1, and 23 patients in Grade 2. Low extremities numbness, weakness, and clinical signs were less frequent in Grade 0 patients. The grade of ISI was correlated with the duration of symptoms and cord compression. Grade 0 patients had a better preoperative JOA score than those with ISI changes, while Grade 2 patients showed worse neurological recovery, longer duration of operation, more intraoperative blood loss, and a higher incidence of perioperative complications.

conclusionThe classification of ISI is an effective parameter for preoperatively assessing cord compression, clinical severity, and surgical outcomes in T-OLF patients. Grade 0 patients have relatively mild neurological impairment but are more likely to be misdiagnosed. Grade 2 indicates the worst clinical impairment and neurological recovery, and implies a risky and challenging surgery.

Indexed as

ossification of ligamentum flavumseverity of symptomssurgical outcomesT2 hyperintensitythoracic myelopathy

Identifiers

PMID34911374
PMCPMC10556922
OpenAlexW4200320420

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.