Ossification of the thoracic posterior longitudinal ligament in a fixed population. Radiological and neurological manifestations.

Ono, Masato; Russell, W. A.; Kudo, Shouji; Kuroiwa, Yuki; Takamori, Masaharu; Motomura, Satoru; Murakami, Junji

doi:10.1148/radiology.143.2.7071349

Cited by 50 publications

(29 citation statements)

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“…A Japanese study, based on a ®xed population sample, revealed that the prevalence of thoracic OPLL was 0.6%, and that patients were nearly always asymptomatic. 17 In OPLL, proton density MR imaging demonstrated ossi®ed lesions with high sensitivity. 18 High signal intensity seen on T1 weighted images within ossi®ed lesions indicates the presence of fatty marrow and corresponds with a radiolucent area within the ossi®ed lesions seen on conventional tomograms.…”

Section: Radiological ®Ndingsmentioning

confidence: 99%

Surgical treatment for thoracic spinal stenosis

Choe

Chung

et al. 2001

Spinal Cord

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Objectives: To describe the underlying causes, surgical results and prognostic factors in thoracic stenosis causing myelopathy. Methods: The underlying causes and surgical results were analyzed retrospectively in 28 cases of thoracic spinal stenosis which caused myelopathy. Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was performed in 24 cases, anterior decompression in ®ve cases, and combined decompression in one case. Ossi®cation of ligamentum¯avum was found in 18 cases, facet hypertrophy in 13, ossi®cation of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively 16 patients improved and four patients worsened. Follow-up ranged from 2 months to 5 years and 8 months). Statistical analysis was performed using a w 2 test to investigate the relationship between subjects. Multivariant analysis (general linear model) was used to determine the factors which in¯uence surgical outcome. Results: There were neurological improvements in 16 patients, in whom Nurick grade changed from 3.3 preoperatively to 1.8 postoperatively. Eight patients showed no signi®cant change in functional grade and four patients deteriorated after decompressive laminectomy. The group of which initial symptom duration was less than 2 years showed better results (P=0.006). The group with sucient decompression and no additional proximal stenosis had better treatment outcome (P=0.005, P=0.002). Conclusion: Chronic severe myelopathy caused by thoracic spinal stenosis can be reversible with appropriate decompression. Surgical outcome was dependent on initial symptom duration, sucient decompression and presence of additional proximal stenosis.

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Section: Radiological ®Ndingsmentioning

confidence: 99%

Surgical treatment for thoracic spinal stenosis

Choe

Chung

et al. 2001

Spinal Cord

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“…Although OPLL is considered a rare disease in Western countries [2], it is a major disorder in Asia and often causes severe myelopathy or spinal cord injury. The prevalence of OPLL in Japanese populations has been reported to range from 1.9% to 4.3% [3], compared with only 0.1% to 1.3% in the United States [4–6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Distribution of Ossified Lesions in the Whole Spine of Patients with Cervical Ossification of the Posterior Longitudinal Ligament A Multicenter Study (JOSL CT study)

et al. 2016

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Ossification of the posterior longitudinal ligament (OPLL) can cause severe and irreversible paralysis in not only the cervical spine but also the thoracolumbar spine. To date, however, the prevalence and distribution of OPLL in the whole spine has not been precisely evaluated in patients with cervical OPLL. Therefore, we conducted a multi-center study to comprehensively evaluate the prevalence and distribution of OPLL using multi-detector computed tomography (CT) images in the whole spine and to analyze what factors predict the presence of ossified lesions in the thoracolumbar spine in patients who were diagnosed with cervical OPLL by plain X-ray. Three hundred and twenty-two patients with a diagnosis of cervical OPLL underwent CT imaging of the whole spine. The sum of the levels in which OPLL was present in the whole spine was defined as the OP-index and used to evaluate the extent of ossification. The distribution of OPLL in the whole spine was compared between male and female subjects. In addition, a multiple regression model was used to ascertain related factors that affected the OP-index. Among patients with cervical OPLL, women tended to have more ossified lesions in the thoracolumbar spine than did men. A multiple regression model revealed that the OP-index was significantly correlated with the cervical OP-index, sex (female), and body mass index. Furthermore, the prevalence of thoracolumbar OPLL in patients with a cervical OP-index ≥ 10 was 7.8 times greater than that in patients with a cervical OP-index ≤ 5. The results of this study reveal that the extent of OPLL in the whole spine is significantly associated with the extent of cervical OPLL, female sex, and obesity.

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“…Mice deficient in TNALP (Akp2 À/À ) display poor mineralization, primarily from the inability of the initial mineral crystal to form within the matrix-vesicle membrane, leading to severe hypophosphatasia [93], similar to the deactivating mutations seen in human hypophosphatasia (OMIM #146300) [94]. The NPP1-knockout mice (Enpp1 À/À ; tip-toe walking mouse, or tww/tww) [95,96] exhibit soft-tissue calcification and mineralization leading to progressive postnatal ankylosis of intervertebral disc, peripheral joint hyperostosis, arterial and cartilage calcification and increase bone formation due to deficiency of ePPi similar to the human mutations seen in the posterior longitudinal ligament [97]. Despite the different mechanism of supplying ePPi, the mutant ank mice (ank/ank), due to truncation mutation of the C-terminal domain leading to loss of function of the pyrophosphate transporter, exhibit a similar hypermineralized phenotype to the Enpp1 À/À mice.…”

Section: Normal and Pathological Mineralizationmentioning

confidence: 87%