Objective: This study has been centred in state of Rajasthan (India), to consolidate the significance of high fluoride consumption and endemicity in causing OPLL and tries to identify fluorosis as a predictor of operative as well as post-operative outcome.

Material and Methods: A single centre retrospective cohort study. Case records of clinico-radiologically diagnosed patients of OPLL were retrospectively evaluated who were managed during 3-year duration (2019-2022). Patients were grouped into Group A: endemic zone; ground water consumption, Group B: endemic zone; purified water consumption and Group C: patients from non-endemic region. Nurick grade and modified Japanese Orthopedic Association (mJOA) score were used for clinical evaluation. Demographic, clinical, radiological, management and urinary fluoride were evaluated preoperatively, at discharge and after 3 months. 

Results: Of the total operated 28 patients, 23 belonged to fluorosis endemic zone whereas 5 were from non-endemic zone. Group A showed deterioration in Nurick as well as mJOA scores p value <0.05 in follow up period. Group C patients showed the best improvement post operatively followed by Group B. Fluorosis had an impact as an independent variable for clinical outcome, but it was not found to be clinically significant.

Conclusion: Early outcomes of OPLL with fluorosis appear to have higher risk of deterioration after surgery in comparison to those who are from non-endemic zone or having no fluorosis.

Soumya Ranjan Rana, MS, MCh, is a highly skilled neurosurgeon at Sunshine Hospital, Bhubaneswar, dedicated to delivering exceptional patient-centered care with trust, compassion, and professionalism. With extensive experience as a consultant neurosurgeon and over 1,000 successful surgeries to his credit, he specializes in stereotactic and functional neurosurgery, endovascular procedures, epilepsy surgery, endoscopic skull base surgery, neurotrauma, neurovascular interventions, and minimally invasive as well as endoscopic spine surgery. His commitment to clinical excellence and compassionate care has earned him recognition as a trusted expert in advanced neurosurgical treatment.