Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-

Toshitaka Yoshii, Takashi Hirai, Akio Iwanami, Narihito Nagoshi, Kazuhiro Takeuchi, Kanji Mori, Tsuyoshi Yamada, Shoji Seki, Takashi Tsuji, Kanehiro Fujiyoshi, Mitsuru Furukawa, Soraya Nishimura, Kanichiro Wada, Masao Koda, Takeo Furuya, Yukihiro Matsuyama, Tomohiko Hasegawa, Katsushi Takeshita, Atsushi Kimura, Masahiko Abematsu & 15 others Hirotaka Haro, Tetsuro Ohba, Masahiko Watanabe, Hiroyuki Katoh, Kei Watanabe, Hiroshi Ozawa, Haruo Kanno, Shiro Imagama, Kei Ando, Shunsuke Fujibayashi, Morio Matsumoto, Masaya Nakamura, Masashi Yamazaki, Atsushi Okawa, Yoshiharu Kawaguchi

Research output: Contribution to journalArticle

Abstract

Background: Previous studies have shown that patients with cervical ossification of the posterior longitudinal ligament (OPLL) often have co-existing ossification of the nuchal ligament (ONL). However, no studies have focused on ONL and its relevance to the severity of OPLL or ossification of other spinal ligaments, such as anterior longitudinal ligament (OALL), ligamentum flavum (OLF), and supraspinous/interspinous ligament (OSIL). Methods: In this multicenter study, we investigated ossification of the spinal ligaments in the whole spine computed tomography (CT) images of 233 cervical OPLL patients. The severity of ossification was evaluated using ossification index for each spinal ligament, calculated as the sum of the level of ossification. We compared the severity of ossification in each spinal ligament between patients with ONL and those without ONL. Furthermore, we investigated how the number of segments, where ONL exists, affects the severity of ossification in each spinal ligament. Results: One hundred thirty patients (55.8%) had co-existing ONL in the cervical OPLL patients included in this study. The ONL (+) group included more male and aged patients. The cervical ossification indexes of OPLL and OALL were higher in ONL (+) patients than in ONL (−) patients. The thoracolumbar ossification indexes of OALL and OSIL were also higher in ONL (+) patients. Logistic regression analysis revealed that age, gender and cervical OA-index were independent factors correlating to the existence of ONL. In the cervical spine, both the ossification indexes of OALL and OPLL increased as the levels of ONL increased. Similarly, in the thoracolumbar spine, both the ossification indexes of OALL and OSIL were increased as the levels of cervical ONL increased. In the multiple regression analysis, cervical OA-index and thoracolumbar OSI-index showed significant correlation with the number of ONL levels. Conclusions: Co-existence of ONL in cervical OPLL patients was associated with the severity of spinal hyperostosis especially in cervical OPLL, OALL, thoracolumbar OALL and OSIL.

LanguageEnglish
Pages35-41
Number of pages7
JournalJournal of Orthopaedic Science
Volume24
Issue number1
DOIs
Publication statusPublished - 01-01-2019
Externally publishedYes

Fingerprint

Ossification of Posterior Longitudinal Ligament
Ligaments
Osteogenesis
Spine
Tomography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Yoshii, Toshitaka ; Hirai, Takashi ; Iwanami, Akio ; Nagoshi, Narihito ; Takeuchi, Kazuhiro ; Mori, Kanji ; Yamada, Tsuyoshi ; Seki, Shoji ; Tsuji, Takashi ; Fujiyoshi, Kanehiro ; Furukawa, Mitsuru ; Nishimura, Soraya ; Wada, Kanichiro ; Koda, Masao ; Furuya, Takeo ; Matsuyama, Yukihiro ; Hasegawa, Tomohiko ; Takeshita, Katsushi ; Kimura, Atsushi ; Abematsu, Masahiko ; Haro, Hirotaka ; Ohba, Tetsuro ; Watanabe, Masahiko ; Katoh, Hiroyuki ; Watanabe, Kei ; Ozawa, Hiroshi ; Kanno, Haruo ; Imagama, Shiro ; Ando, Kei ; Fujibayashi, Shunsuke ; Matsumoto, Morio ; Nakamura, Masaya ; Yamazaki, Masashi ; Okawa, Atsushi ; Kawaguchi, Yoshiharu. / Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-. In: Journal of Orthopaedic Science. 2019 ; Vol. 24, No. 1. pp. 35-41.
@article{e43c25c5b9df4d109da5ae762ee65493,
title = "Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-",
abstract = "Background: Previous studies have shown that patients with cervical ossification of the posterior longitudinal ligament (OPLL) often have co-existing ossification of the nuchal ligament (ONL). However, no studies have focused on ONL and its relevance to the severity of OPLL or ossification of other spinal ligaments, such as anterior longitudinal ligament (OALL), ligamentum flavum (OLF), and supraspinous/interspinous ligament (OSIL). Methods: In this multicenter study, we investigated ossification of the spinal ligaments in the whole spine computed tomography (CT) images of 233 cervical OPLL patients. The severity of ossification was evaluated using ossification index for each spinal ligament, calculated as the sum of the level of ossification. We compared the severity of ossification in each spinal ligament between patients with ONL and those without ONL. Furthermore, we investigated how the number of segments, where ONL exists, affects the severity of ossification in each spinal ligament. Results: One hundred thirty patients (55.8{\%}) had co-existing ONL in the cervical OPLL patients included in this study. The ONL (+) group included more male and aged patients. The cervical ossification indexes of OPLL and OALL were higher in ONL (+) patients than in ONL (−) patients. The thoracolumbar ossification indexes of OALL and OSIL were also higher in ONL (+) patients. Logistic regression analysis revealed that age, gender and cervical OA-index were independent factors correlating to the existence of ONL. In the cervical spine, both the ossification indexes of OALL and OPLL increased as the levels of ONL increased. Similarly, in the thoracolumbar spine, both the ossification indexes of OALL and OSIL were increased as the levels of cervical ONL increased. In the multiple regression analysis, cervical OA-index and thoracolumbar OSI-index showed significant correlation with the number of ONL levels. Conclusions: Co-existence of ONL in cervical OPLL patients was associated with the severity of spinal hyperostosis especially in cervical OPLL, OALL, thoracolumbar OALL and OSIL.",
author = "Toshitaka Yoshii and Takashi Hirai and Akio Iwanami and Narihito Nagoshi and Kazuhiro Takeuchi and Kanji Mori and Tsuyoshi Yamada and Shoji Seki and Takashi Tsuji and Kanehiro Fujiyoshi and Mitsuru Furukawa and Soraya Nishimura and Kanichiro Wada and Masao Koda and Takeo Furuya and Yukihiro Matsuyama and Tomohiko Hasegawa and Katsushi Takeshita and Atsushi Kimura and Masahiko Abematsu and Hirotaka Haro and Tetsuro Ohba and Masahiko Watanabe and Hiroyuki Katoh and Kei Watanabe and Hiroshi Ozawa and Haruo Kanno and Shiro Imagama and Kei Ando and Shunsuke Fujibayashi and Morio Matsumoto and Masaya Nakamura and Masashi Yamazaki and Atsushi Okawa and Yoshiharu Kawaguchi",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jos.2018.08.009",
language = "English",
volume = "24",
pages = "35--41",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",
number = "1",

}

Yoshii, T, Hirai, T, Iwanami, A, Nagoshi, N, Takeuchi, K, Mori, K, Yamada, T, Seki, S, Tsuji, T, Fujiyoshi, K, Furukawa, M, Nishimura, S, Wada, K, Koda, M, Furuya, T, Matsuyama, Y, Hasegawa, T, Takeshita, K, Kimura, A, Abematsu, M, Haro, H, Ohba, T, Watanabe, M, Katoh, H, Watanabe, K, Ozawa, H, Kanno, H, Imagama, S, Ando, K, Fujibayashi, S, Matsumoto, M, Nakamura, M, Yamazaki, M, Okawa, A & Kawaguchi, Y 2019, 'Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-', Journal of Orthopaedic Science, vol. 24, no. 1, pp. 35-41. https://doi.org/10.1016/j.jos.2018.08.009

Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-. / Yoshii, Toshitaka; Hirai, Takashi; Iwanami, Akio; Nagoshi, Narihito; Takeuchi, Kazuhiro; Mori, Kanji; Yamada, Tsuyoshi; Seki, Shoji; Tsuji, Takashi; Fujiyoshi, Kanehiro; Furukawa, Mitsuru; Nishimura, Soraya; Wada, Kanichiro; Koda, Masao; Furuya, Takeo; Matsuyama, Yukihiro; Hasegawa, Tomohiko; Takeshita, Katsushi; Kimura, Atsushi; Abematsu, Masahiko; Haro, Hirotaka; Ohba, Tetsuro; Watanabe, Masahiko; Katoh, Hiroyuki; Watanabe, Kei; Ozawa, Hiroshi; Kanno, Haruo; Imagama, Shiro; Ando, Kei; Fujibayashi, Shunsuke; Matsumoto, Morio; Nakamura, Masaya; Yamazaki, Masashi; Okawa, Atsushi; Kawaguchi, Yoshiharu.

In: Journal of Orthopaedic Science, Vol. 24, No. 1, 01.01.2019, p. 35-41.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study-

AU - Yoshii, Toshitaka

AU - Hirai, Takashi

AU - Iwanami, Akio

AU - Nagoshi, Narihito

AU - Takeuchi, Kazuhiro

AU - Mori, Kanji

AU - Yamada, Tsuyoshi

AU - Seki, Shoji

AU - Tsuji, Takashi

AU - Fujiyoshi, Kanehiro

AU - Furukawa, Mitsuru

AU - Nishimura, Soraya

AU - Wada, Kanichiro

AU - Koda, Masao

AU - Furuya, Takeo

AU - Matsuyama, Yukihiro

AU - Hasegawa, Tomohiko

AU - Takeshita, Katsushi

AU - Kimura, Atsushi

AU - Abematsu, Masahiko

AU - Haro, Hirotaka

AU - Ohba, Tetsuro

AU - Watanabe, Masahiko

AU - Katoh, Hiroyuki

AU - Watanabe, Kei

AU - Ozawa, Hiroshi

AU - Kanno, Haruo

AU - Imagama, Shiro

AU - Ando, Kei

AU - Fujibayashi, Shunsuke

AU - Matsumoto, Morio

AU - Nakamura, Masaya

AU - Yamazaki, Masashi

AU - Okawa, Atsushi

AU - Kawaguchi, Yoshiharu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Previous studies have shown that patients with cervical ossification of the posterior longitudinal ligament (OPLL) often have co-existing ossification of the nuchal ligament (ONL). However, no studies have focused on ONL and its relevance to the severity of OPLL or ossification of other spinal ligaments, such as anterior longitudinal ligament (OALL), ligamentum flavum (OLF), and supraspinous/interspinous ligament (OSIL). Methods: In this multicenter study, we investigated ossification of the spinal ligaments in the whole spine computed tomography (CT) images of 233 cervical OPLL patients. The severity of ossification was evaluated using ossification index for each spinal ligament, calculated as the sum of the level of ossification. We compared the severity of ossification in each spinal ligament between patients with ONL and those without ONL. Furthermore, we investigated how the number of segments, where ONL exists, affects the severity of ossification in each spinal ligament. Results: One hundred thirty patients (55.8%) had co-existing ONL in the cervical OPLL patients included in this study. The ONL (+) group included more male and aged patients. The cervical ossification indexes of OPLL and OALL were higher in ONL (+) patients than in ONL (−) patients. The thoracolumbar ossification indexes of OALL and OSIL were also higher in ONL (+) patients. Logistic regression analysis revealed that age, gender and cervical OA-index were independent factors correlating to the existence of ONL. In the cervical spine, both the ossification indexes of OALL and OPLL increased as the levels of ONL increased. Similarly, in the thoracolumbar spine, both the ossification indexes of OALL and OSIL were increased as the levels of cervical ONL increased. In the multiple regression analysis, cervical OA-index and thoracolumbar OSI-index showed significant correlation with the number of ONL levels. Conclusions: Co-existence of ONL in cervical OPLL patients was associated with the severity of spinal hyperostosis especially in cervical OPLL, OALL, thoracolumbar OALL and OSIL.

AB - Background: Previous studies have shown that patients with cervical ossification of the posterior longitudinal ligament (OPLL) often have co-existing ossification of the nuchal ligament (ONL). However, no studies have focused on ONL and its relevance to the severity of OPLL or ossification of other spinal ligaments, such as anterior longitudinal ligament (OALL), ligamentum flavum (OLF), and supraspinous/interspinous ligament (OSIL). Methods: In this multicenter study, we investigated ossification of the spinal ligaments in the whole spine computed tomography (CT) images of 233 cervical OPLL patients. The severity of ossification was evaluated using ossification index for each spinal ligament, calculated as the sum of the level of ossification. We compared the severity of ossification in each spinal ligament between patients with ONL and those without ONL. Furthermore, we investigated how the number of segments, where ONL exists, affects the severity of ossification in each spinal ligament. Results: One hundred thirty patients (55.8%) had co-existing ONL in the cervical OPLL patients included in this study. The ONL (+) group included more male and aged patients. The cervical ossification indexes of OPLL and OALL were higher in ONL (+) patients than in ONL (−) patients. The thoracolumbar ossification indexes of OALL and OSIL were also higher in ONL (+) patients. Logistic regression analysis revealed that age, gender and cervical OA-index were independent factors correlating to the existence of ONL. In the cervical spine, both the ossification indexes of OALL and OPLL increased as the levels of ONL increased. Similarly, in the thoracolumbar spine, both the ossification indexes of OALL and OSIL were increased as the levels of cervical ONL increased. In the multiple regression analysis, cervical OA-index and thoracolumbar OSI-index showed significant correlation with the number of ONL levels. Conclusions: Co-existence of ONL in cervical OPLL patients was associated with the severity of spinal hyperostosis especially in cervical OPLL, OALL, thoracolumbar OALL and OSIL.

UR - http://www.scopus.com/inward/record.url?scp=85054405561&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054405561&partnerID=8YFLogxK

U2 - 10.1016/j.jos.2018.08.009

DO - 10.1016/j.jos.2018.08.009

M3 - Article

VL - 24

SP - 35

EP - 41

JO - Journal of Orthopaedic Science

T2 - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

IS - 1

ER -