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
N1 - Publisher Copyright:
© 2018 The Japanese Orthopaedic Association
PY - 2019/1
Y1 - 2019/1
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.
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U2 - 10.1016/j.jos.2018.08.009
DO - 10.1016/j.jos.2018.08.009
M3 - Article
C2 - 30243519
AN - SCOPUS:85054405561
SN - 0949-2658
VL - 24
SP - 35
EP - 41
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
IS - 1
ER -