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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

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)

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

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

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Abstract

Background

In 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.

Methods

Data 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.

Results

Women 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.

Conclusion

Thoracolumbar 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.
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Metadata
Title
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)
Authors
Takashi Hirai
Toshitaka Yoshii
Narihito Nagoshi
Kazuhiro Takeuchi
Kanji Mori
Shuta Ushio
Akio Iwanami
Tsuyoshi Yamada
Shoji Seki
Takashi Tsuji
Kanehiro Fujiyoshi
Mitsuru Furukawa
Soraya Nishimura
Kanichiro Wada
Takeo Furuya
Yukihiro Matsuyama
Tomohiko Hasegawa
Katsushi Takeshita
Atsushi Kimura
Masahiko Abematsu
Hirotaka Haro
Tetsuro Ohba
Masahiko Watanabe
Hiroyuki Katoh
Kei Watanabe
Hiroshi Ozawa
Haruo Kanno
Shiro Imagama
Kei Ando
Shunsuke Fujibayashi
Masao Koda
Masashi Yamazaki
Morio Matsumoto
Masaya Nakamura
Atsushi Okawa
Yoshiharu Kawaguchi
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2009-7

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