Skip to main content
Top

08-06-2024 | Original Article

Ossification of the posterior longitudinal ligament is linked to heterotopic ossification of the ankle/foot tendons

Authors: Tsutomu Endo, Masahiko Takahata, Yoshinao Koike, Ryo Fujita, Daisuke Yoneoka, Masahiro Kanayama, Ken Kadoya, Tomoka Hasegawa, Mohamad Alaa Terkawi, Katsuhisa Yamada, Hideki Sudo, Taku Ebata, Misaki Ishii, Norimasa Iwasaki

Published in: Journal of Bone and Mineral Metabolism

Login to get access

Abstract

Introduction

Systemic osteogenesis has been speculated to be involved in the pathogenesis of ossification of the posterior longitudinal ligament (OPLL). Our purpose was to compare the radiologic prevalence and severity of heterotopic ossification in foot tendons of Japanese patients with OPLL and to determine their association with systemic heterotopic ossification.

Materials and methods

Clinical and radiographic data of 114 patients with OPLL were collected from 2020 to 2022. Control data were extracted from a medical database of 362 patients with ankle radiographs. Achilles and plantar tendon ossification were classified as grades 0–4, and the presence of osteophytes at five sites in the foot/ankle joint was assessed by radiography. Factors associated with the presence and severity of each ossification were evaluated by multivariable logistic regression and linear regression analysis.

Results

The prevalence of Achilles and plantar tendon ossification (grade ≥ 2) was 4.0–5.5 times higher in patients with OPLL (40–56%) than in the controls (10–11%). The presence of Achilles tendon ossification was associated with OPLL, age, and coexisting plantar tendon ossification, and was most strongly associated with OPLL (standardized regression coefficient, 0.79; 95% confidence interval, 1.34–2.38). The severity of Achilles and plantar tendon ossification was associated with the severity of ossification of the entire spinal ligament.

Conclusions

The strong association of foot tendon ossification with OPLL suggests that patients with OPLL have a systemic osteogenesis background. These findings will provide a basis for exploring new treatment strategies for OPLL, including control of metabolic abnormalities.
Appendix
Available only for authorised users
Literature
21.
go back to reference Tamam C, Yildirim D, Tamam M, Mulazimoglu M, Ozpacaci T (2011) Bilateral Achilles tendon ossification: diagnosis with ultrasonography and single photon emission computed tomography/computed tomography case report. Med Ultrason 13:320–322PubMed Tamam C, Yildirim D, Tamam M, Mulazimoglu M, Ozpacaci T (2011) Bilateral Achilles tendon ossification: diagnosis with ultrasonography and single photon emission computed tomography/computed tomography case report. Med Ultrason 13:320–322PubMed
28.
go back to reference Morris KL, Giacopelli JA, Granoff D (1990) Classifications of radiopaque lesions of the tendo achillis. J Foot Surg 29:533–542PubMed Morris KL, Giacopelli JA, Granoff D (1990) Classifications of radiopaque lesions of the tendo achillis. J Foot Surg 29:533–542PubMed
32.
go back to reference Kawaguchi Y, Kitajima I, Nakano M et al (2019) Increase of the serum FGF-23 in ossification of the posterior longitudinal ligament. Glob Spine J 9:492–498CrossRef Kawaguchi Y, Kitajima I, Nakano M et al (2019) Increase of the serum FGF-23 in ossification of the posterior longitudinal ligament. Glob Spine J 9:492–498CrossRef
33.
go back to reference Horing F (1908) Über tendinitis ossificans traumatica. Münch Med Wochenschr 55:674–675 Horing F (1908) Über tendinitis ossificans traumatica. Münch Med Wochenschr 55:674–675
34.
go back to reference Kumai T, Benjamin M (2002) Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol 29:1957–1964PubMed Kumai T, Benjamin M (2002) Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol 29:1957–1964PubMed
35.
go back to reference Malhotra CM, Lally EV, Buckley WM (1986) Ossification of the plantar fascia and peroneus longus tendons in diffuse idiopathic skeletal hyperostosis (DISH). J Rheumatol 13:215–218PubMed Malhotra CM, Lally EV, Buckley WM (1986) Ossification of the plantar fascia and peroneus longus tendons in diffuse idiopathic skeletal hyperostosis (DISH). J Rheumatol 13:215–218PubMed
41.
Metadata
Title
Ossification of the posterior longitudinal ligament is linked to heterotopic ossification of the ankle/foot tendons
Authors
Tsutomu Endo
Masahiko Takahata
Yoshinao Koike
Ryo Fujita
Daisuke Yoneoka
Masahiro Kanayama
Ken Kadoya
Tomoka Hasegawa
Mohamad Alaa Terkawi
Katsuhisa Yamada
Hideki Sudo
Taku Ebata
Misaki Ishii
Norimasa Iwasaki
Publication date
08-06-2024
Publisher
Springer Nature Singapore
Published in
Journal of Bone and Mineral Metabolism
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-024-01518-2
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare