TY - JOUR
T1 - Prevalence and Distribution of Diffuse Idiopathic Skeletal Hyperostosis on Whole-spine Computed Tomography in Patients with Cervical Ossification of the Posterior Longitudinal Ligament
AU - Nishimura, Soraya
AU - Nagoshi, Narihito
AU - Iwanami, Akio
AU - Takeuchi, Ayano
AU - Hirai, Takashi
AU - Yoshii, Toshitaka
AU - Takeuchi, Kazuhiro
AU - Mori, Kanji
AU - Yamada, Tsuyoshi
AU - Seki, Shoji
AU - Tsuji, Takashi
AU - Fujiyoshi, Kanehiro
AU - Furukawa, Mitsuru
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 - Yamazaki, Masashi
AU - Watanabe, Kota
AU - Matsumoto, Morio
AU - Nakamura, Masaya
AU - Okawa, Atsushi
AU - Kawaguchi, Yoshiharu
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Study Design: This was a retrospective multicenter study. Objective: To clarify the progression of diffuse idiopathic skeletal hyperostosis (DISH) using whole-spine computed tomography in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: DISH and cervical OPLL frequently coexist, and can cause ankylosing spinal fractures due to biomechanical changes and fragility of the affected vertebrae. The epidemiology and pathophysiology of DISH occurring with cervical OPLL are unclear. Materials and Methods: We used whole-spine computed tomography to determine the prevalence of DISH in 234 patients with a diagnosis of cervical OPLL based on plain cervical radiographs. We established a novel system for grading the progression of DISH based on a cluster analysis of the DISH distribution along the spine. We calculated the correlation coefficient between this grading system and patient age. Results: The prevalence of DISH in patients with cervical OPLL was 48.7%. Patients with DISH were significantly older than those who did not have DISH (67.3 vs. 63.4 y; P=0.005). Cluster analysis classified the DISH distribution into 6 regions, based on the levels affected: C2-C5, C3-T1, C6-T5, T3-10, T8-L2, and T12-S1. DISH was observed most frequently at T3-T10. We defined a system for grading DISH progression based on the number of regions involved, from grade 0 to 6. DISH was distributed at T3-T10 in >60% of the grade 1 patients, whereas most patients with DISH at the cervical or lumbar spine were grade 4 or 5. There was a weak but significant correlation between the DISH grade and patient age. Conclusions: DISH was present in nearly half of the patients with cervical OPLL. DISH was more common in older patients. DISH developed at the thoracic level and progressed into the cervical and/or lumbar spine with age. Level of Evidence: Level III.
AB - Study Design: This was a retrospective multicenter study. Objective: To clarify the progression of diffuse idiopathic skeletal hyperostosis (DISH) using whole-spine computed tomography in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: DISH and cervical OPLL frequently coexist, and can cause ankylosing spinal fractures due to biomechanical changes and fragility of the affected vertebrae. The epidemiology and pathophysiology of DISH occurring with cervical OPLL are unclear. Materials and Methods: We used whole-spine computed tomography to determine the prevalence of DISH in 234 patients with a diagnosis of cervical OPLL based on plain cervical radiographs. We established a novel system for grading the progression of DISH based on a cluster analysis of the DISH distribution along the spine. We calculated the correlation coefficient between this grading system and patient age. Results: The prevalence of DISH in patients with cervical OPLL was 48.7%. Patients with DISH were significantly older than those who did not have DISH (67.3 vs. 63.4 y; P=0.005). Cluster analysis classified the DISH distribution into 6 regions, based on the levels affected: C2-C5, C3-T1, C6-T5, T3-10, T8-L2, and T12-S1. DISH was observed most frequently at T3-T10. We defined a system for grading DISH progression based on the number of regions involved, from grade 0 to 6. DISH was distributed at T3-T10 in >60% of the grade 1 patients, whereas most patients with DISH at the cervical or lumbar spine were grade 4 or 5. There was a weak but significant correlation between the DISH grade and patient age. Conclusions: DISH was present in nearly half of the patients with cervical OPLL. DISH was more common in older patients. DISH developed at the thoracic level and progressed into the cervical and/or lumbar spine with age. Level of Evidence: Level III.
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U2 - 10.1097/BSD.0000000000000701
DO - 10.1097/BSD.0000000000000701
M3 - Article
C2 - 30113323
AN - SCOPUS:85052805264
SN - 2380-0186
VL - 31
SP - E460-E465
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
IS - 9
ER -