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)

BMC Musculoskelet Disord

et al. 2016

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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.

Section: Methodssupporting

confidence: 58%

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

Mori

BMC Musculoskelet Disord

et al. 2016

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“…A retrospective multicenter study that included patients with cervical OPLL reported that OPLL was also present in the thoracolumbar spine in 17.8% of cases and in the lumbar spine in 12.1% 20 . Furthermore, it has been documented that the prevalence of OPLL in the thoracolumbar spine increases with the number of cervical levels affected by OPLL 1,2 . Similarly, patients with CS often have low back pain as well.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Ushio

et al. 2020

Sci Rep

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Ossification of the posterior longitudinal ligament (OPLL) can occur throughout the entire spine and can sometimes lead to spinal disorder. Although patients with OPLL sometimes develop physical limitations because of pain, the characteristics of pain and effects on activities of daily living (ADL) have not been precisely evaluated in OPLL patients. Therefore, we conducted a multi-center prospective study to assess whether the symptoms of cervical OPLL are different from those of cervical spondylosis (CS). A total of 263 patients with a diagnosis of cervical OPLL and 50 patients with a diagnosis of CS were enrolled and provided self-reported outcomes, including responses to the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), JOA Back Pain Evaluation Questionnaire (JOABPEQ), visual analog scale (VAS), and SF-36 scores. The severity of myelopathy was significantly correlated with each domain of the JOACMEQ and JOABPEQ. There was a negative correlation between the VAS score for each domain and the JOA score. There were significantly positive correlations between the JOA score and the Mental Health, Bodily Pain, Physical Functioning, Role Emotional, and Role Physical domains of the SF-36.

“…In this study, we categorized patients with cervical OPLL into three groups according to the number of segments at which cervical OPLL could be confirmed. In a previous study [ 6 ], we demonstrated that this classification could predict not only the presence but also the degree of hyperostosis in the whole spine. Therefore, we investigated whether there was a correlation between this classification system and the prevalence of ossified lesions at each segment in the thoracolumbar spine.…”

Section: Discussionmentioning

confidence: 83%

“…We also defined the sum of the levels at which OPLL was present in the cervical spine as the cervical OP index. Using a previously reported method [ 6 ], we divided patients into three groups according to their cervical OP index values, namely, grade 1 (≤5), grade 2 (6–9), and grade 3 (≥10). The physical and radiologic data were compared between the male and female patient populations.…”

Section: Methodsmentioning

confidence: 99%

Distribution of ossified spinal lesions in patients with severe ossification of the posterior longitudinal ligament and prediction of ossification at each segment based on the cervical OP index classification: a multicenter study (JOSL CT study)

BMC Musculoskelet Disord

Nagoshi

et al. 2018

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BackgroundIn patients with ossification of the posterior longitudinal ligament (OPLL) in the cervical spine, it is well known that the thoracic ossified lesions often coexist with the cervical lesions and can cause severe myelopathy. However, the prevalence of OPLL at each level of the thoracic and lumbar spinal segments is unknown. The aims of this study were to investigate how often OPLL occurs at each level in the thoracolumbar spine in patients with a radiological diagnosis of cervical OPLL and to identify the spinal levels most likely to develop ossification.MethodsData were collected from 20 institutions in Japan. Three hundred and twenty-two patients with a diagnosis of cervical OPLL were included. The OPLL index (OP index), defined as the sum of the vertebral body and intervertebral disc levels where OPLL is present, was used to determine disease severity. An OP index ≥20 was defined as severe OPLL. The prevalence of OPLL at each level of the thoracic and lumbar spinal segments was calculated.ResultsWomen were more likely to have ossified lesions in the thoracolumbar spine than men. Severe OPLL was significantly more common in women than in men (20% vs. 4.5%). For thoracic vertebral OPLL, the most frequently affected was the T1 segment in both men and women, followed by the T1/2 and T3/4 intervertebral levels in men and women, respectively. Ossified lesions were frequently seen at the intervertebral and vertebral levels around the cervicothoracic and thoracolumbar junctions in men with severe OPLL, whereas OPLL was more diffusely distributed in the thoracic spine in women with severe OPLL.ConclusionThoracolumbar OPLL occurred most often at T1 in men and at T3/4 in women. In severe OPLL cases, although ossified lesions were frequently seen at the intervertebral and vertebral levels around the cervicothoracic and thoracolumbar junctions in men, OPLL could be observed more diffusely in the thoracic spine in women.