Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: a CT-based multicenter cross-sectional study

Abstract

BackgroundSupra/interspinous ligaments connect adjacent spinous processes and act as a stabilizer of the spine. As with other spinal ligaments, it can become ossified. However, few report have discussed ossification supra/interspinous ligaments (OSIL), so its epidemiology remains unknown. We therefore aimed to investigate the prevalence and distribution of OSIL in symptomatic patients with cervical ossification of the posterior longitudinal ligament (OPLL).MethodsThe participants of our study were symptomatic patients with cervical OPLL who were diagnosed by standard radiographs of the cervical spine. The whole spine CT data as well as clinical parameters such as age and sex were obtained from 20 institutions belong to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL). The prevalence and distribution of OSIL and the association between OSIL and clinical parameters were reviewed. The sum of the levels involved by OPLL (OP-index) and OSIL (OSI-index) as well as the prevalence of ossification of the nuchal ligament (ONL) were also investigated.ResultsA total of 234 patients with a mean age of 65 years was recruited. The CT-based evidence of OSIL was noted in 68 (54 males and 14 females) patients (29%). The distribution of OSIL showed a significant thoracic preponderance. In OSIL-positive patients, single-level involvement was noted in 19 cases (28%), whereas 49 cases (72%) presented multi-level involvement. We found a significant positive correlation between the OP-index grade and OSI-index. ONL was noted at a significantly higher rate in OSIL-positive patients compared to negative patients.ConclusionsThe prevalence of OSIL in symptomatic patients with cervical OPLL was 29%. The distribution of OSIL showed a significant thoracic preponderance.

Increase of the Serum FGF-23 in Ossification of the Posterior Longitudinal Ligament

“…The previous studies used a similar index for evaluating the factors related to severe spinal ossification and where spinal ossification exists. 16,17,32,33 The results revealed that severe ossification was found more frequently in females than in males, and >50% of patients with cervical OPLL have spinal ossification in other regions such as the thoracic and lumbar spine. The current study demonstrated a negative correlation between serum Pi and the OS index, indicating the total ossification index (the OP + OF + OA indexes); however, the correlations were very weak.…”

“…8 The OP (OPLL) index was used. 16,17 This index is determined by the sum of the levels of vertebral bodies and intervertebral discs in which OPLL is present. We also applied the same index for ossification of the ligamentum flavum (the OF index) and for ossification of the anterior longitudinal ligament (the OA index), both of which were described in previous studiess.…”

Associations between Clinical Symptoms and Degree of Ossification in Patients with Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multi-Institutional Cross-Sectional Study

“…Various studies on OPLL have described numerous issues, such as the efficacy of surgical treatments [ 2 , 3 , 4 , 5 , 6 , 7 ], clinical courses [ 8 , 9 ], and epidemiologic data [ 10 , 11 ]. Recent studies have demonstrated multiple ossified lesions in patients with ossification predisposition [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. A retrospective multicenter study [ 12 ] showed that more than 55% of patients with cervical OPLL also had OPLL at the thoracic and/or lumbar spine.…”

Clinical characteristics in patients with ossification of the posterior longitudinal ligament: A prospective multi-institutional cross-sectional study

“…Although researchers have investigated several issues related to ossification, including prevalence [1][2][3] , distribution of the ossified lesions [1][2][3][4][5][6] , and neurologic outcomes after surgical treatment [7][8][9][10] , there has been no study documenting in detail the subjective symptoms and self-reported ability to perform activities of daily living (ADL) in patients with OPLL. The aims of this study were to investigate the relationship between severity of pain and neurologic status in patients with OPLL and to identify whether there are any specific clinical symptoms in patients with cervical OPLL that are not present in those with cervical spondylosis (CS), which often leads to myelopathy similar to that occurring in cervical OPLL.…”