Clinical progression of ossification of the ligamentum flavum in thoracic spine: a 10- to 11-year follow-up study

Fan, Tianqi; Sun, Chuiguo; Chen, Guanghui; Jiang, Shuai; Li, Weishi; Chen, Zhongqiang

doi:10.1007/s00586-022-07468-5

Cited by 6 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Particularly, the neurological signs of the dorsal column in the spinal cord also had a low rate of improvement because the dorsal column had been directly compressed by the OLF. Significant improvements can be attained with timely diagnosis and treatment, as demonstrated in previous reports (Table 4) [53][54][55][56][57][58]. Patients with prolonged disease duration, other spinal diseases, or intramedullary high signals on sagittal T2-weighted images tend to have a worse prognosis [51,58].…”

Section: Clfmentioning

confidence: 66%

The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature

Nishikawa,

Yoshimura,

Naito

et al. 2023

JCM

View full text Add to dashboard Cite

Introduction: We report our experience regarding the clinical features and pathological findings of the calcification of the ligamentum flavum (CLF) and ossification of the ligamentum flavum (OLF) in the spine. In addition, we reviewed the previous studies on CLF and OLF to enhance the understanding of these conditions. Materials and Methods: We compared the clinical, radiological, and histopathological features of CLF and OLF. Results: In CLF, a computed tomography (CT) scan showed egg-shaped or speck-like calcification in the ligamentum flavum. Magnetic resonance (MR) imaging demonstrated spinal cord compression due to a thickened ligamentum flavum, which appeared as a low-intensity mass. Pathological findings demonstrated fused islands of calcification resembling sand-like calcification. In OLF, CT showed beak-like ossification extending into the intervertebral foramen. MR imaging demonstrated spinal cord compression by a low-intensity mass. Pathological findings revealed laminar ossification of LF with chondrocytes near the calcification and laminar hyaline cartilage. Conclusions: CLF and OLF appear to be distinct entities based on their clinical, neuroradiological, histopathological, and pathogenetic features. We suggest that the causes of CLF include both metabolic and dystrophic factors, while the pathogenesis of OLF is characterized by enchondral ossification induced by a genetic cascade triggered by shearing/tension stress.

show abstract

Section: Clfmentioning

confidence: 66%

The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature

Nishikawa,

Yoshimura,

Naito

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…First described as a clinical condition in the 1920s, 33 OLF has since been reported as an important cause of thoracic spinal myelopathy. [34][35][36][37] Reports focused on OLF are increasing outside of East Asia as reported case numbers continue to climb. 38,39 Some reports have indicated that a range of factors including genetics, metabolic abnormalities, inflammation, and mechanical stress contribute to TOLF incidence and progression.…”

Section: Discussionmentioning

confidence: 99%

“…First described as a clinical condition in the 1920s, 33 OLF has since been reported as an important cause of thoracic spinal myelopathy 34–37 . Reports focused on OLF are increasing outside of East Asia as reported case numbers continue to climb 38,39 .…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

View full text Add to dashboard Cite

Study Design. Systematic review and meta-analysis. Objective. This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF). Summary of Background Data. The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF. Methods. The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF. Results. This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up，functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95,4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 2.99 (2.77,3.22) , and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.41 (3.17,3.64) . Conclusions. These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.

show abstract

“…It manifests predominately through the calcification of paravertebral cartilage and fibrous tissue, thereby inducing a pathological transformation process that involves various biological constituents [ 2 , 3 ]. Several factors, including age, gender, ethnicity, and genetics, play significant roles in determining the incidence and severity of OLF [ 4 , 5 ]. Ligamentum flavum (LF) is an integral part of the spine; hence, any abnormality in its structure poses risks to other components of the spinal cord, nerve roots, and vertebral arteries [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

KLF5 promotes the ossification process of ligamentum flavum by transcriptionally activating CX43

Guo,

Yang,

Liu

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

Background Ossification of ligamentum flavum (OLF) is a prevalent degenerative spinal disease, typically causing severe neurological dysfunction. Kruppel-like factor 5 (KLF5) plays an essential role in the regulation of skeletal development. However, the mechanism KLF5 plays in OLF remains unclear, necessitating further investigative studies. Methods qRT-PCR, immunofluorescent staining and western blot were used to measure the expression of KLF5. Alkaline Phosphatase (ALP) staining, Alizarin red staining (ARS), and the expression of Runt-related transcription factor 2 (RUNX2), osteopontin (OPN), and osteocalcin (OCN) were used to evaluate the osteogenic differentiation. Luciferase activity assay and ChIP-PCR were performed to investigate the molecular mechanisms. Results KLF5 was significantly upregulated in OLF fibroblasts in contrast to normal ligamentum flavum (LF) fibroblasts. Silencing KLF5 diminished osteogenic markers and mineralized nodules, while its overexpression had the opposite effect, confirming KLF5’s role in promoting ossification. Moreover, KLF5 promotes the ossification of LF by activating the transcription of Connexin 43 (CX43), and overexpressing CX43 could reverse the suppressive impact of KLF5 knockdown on OLF fibroblasts’ osteogenesis. Conclusion KLF5 promotes the OLF by transcriptionally activating CX43. This finding contributes significantly to our understanding of OLF and may provide new therapeutic targets.

show abstract

Clinical progression of ossification of the ligamentum flavum in thoracic spine: a 10- to 11-year follow-up study

Cited by 6 publications

References 30 publications

The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature

The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

KLF5 promotes the ossification process of ligamentum flavum by transcriptionally activating CX43

Contact Info

Product

Resources

About