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Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)

Background: The purpose of this study was to clarify the clinical features of ossification of the posterior longitudinal ligament (OPLL) and extreme ossification at multiple sites. Methods: This prospective study involved patients with a diagnosis of cervical OPLL at 16 institutions in Japan. Patien...

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Autores principales: Hirai, Takashi, Yoshii, Toshitaka, Hashimoto, Jun, Ushio, Shuta, Mori, Kanji, Maki, Satoshi, Katsumi, Keiichi, Nagoshi, Narihito, Takeuchi, Kazuhiro, Furuya, Takeo, Watanabe, Kei, Nishida, Norihiro, Nishimura, Soraya, Watanabe, Kota, Kaito, Takashi, Kato, Satoshi, Nagashima, Katsuya, Koda, Masao, Nakashima, Hiroaki, Imagama, Shiro, Murata, Kazuma, Matsuoka, Yuji, Wada, Kanichiro, Kimura, Atsushi, Ohba, Tetsuro, Katoh, Hiroyuki, Watanabe, Masahiko, Matsuyama, Yukihiro, Ozawa, Hiroshi, Haro, Hirotaka, Takeshita, Katsushi, Matsumoto, Morio, Nakamura, Masaya, Egawa, Satoru, Matsukura, Yu, Inose, Hiroyuki, Okawa, Atsushi, Yamazaki, Masashi, Kawaguchi, Yoshiharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267168/
https://www.ncbi.nlm.nih.gov/pubmed/35806979
http://dx.doi.org/10.3390/jcm11133694
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author Hirai, Takashi
Yoshii, Toshitaka
Hashimoto, Jun
Ushio, Shuta
Mori, Kanji
Maki, Satoshi
Katsumi, Keiichi
Nagoshi, Narihito
Takeuchi, Kazuhiro
Furuya, Takeo
Watanabe, Kei
Nishida, Norihiro
Nishimura, Soraya
Watanabe, Kota
Kaito, Takashi
Kato, Satoshi
Nagashima, Katsuya
Koda, Masao
Nakashima, Hiroaki
Imagama, Shiro
Murata, Kazuma
Matsuoka, Yuji
Wada, Kanichiro
Kimura, Atsushi
Ohba, Tetsuro
Katoh, Hiroyuki
Watanabe, Masahiko
Matsuyama, Yukihiro
Ozawa, Hiroshi
Haro, Hirotaka
Takeshita, Katsushi
Matsumoto, Morio
Nakamura, Masaya
Egawa, Satoru
Matsukura, Yu
Inose, Hiroyuki
Okawa, Atsushi
Yamazaki, Masashi
Kawaguchi, Yoshiharu
author_facet Hirai, Takashi
Yoshii, Toshitaka
Hashimoto, Jun
Ushio, Shuta
Mori, Kanji
Maki, Satoshi
Katsumi, Keiichi
Nagoshi, Narihito
Takeuchi, Kazuhiro
Furuya, Takeo
Watanabe, Kei
Nishida, Norihiro
Nishimura, Soraya
Watanabe, Kota
Kaito, Takashi
Kato, Satoshi
Nagashima, Katsuya
Koda, Masao
Nakashima, Hiroaki
Imagama, Shiro
Murata, Kazuma
Matsuoka, Yuji
Wada, Kanichiro
Kimura, Atsushi
Ohba, Tetsuro
Katoh, Hiroyuki
Watanabe, Masahiko
Matsuyama, Yukihiro
Ozawa, Hiroshi
Haro, Hirotaka
Takeshita, Katsushi
Matsumoto, Morio
Nakamura, Masaya
Egawa, Satoru
Matsukura, Yu
Inose, Hiroyuki
Okawa, Atsushi
Yamazaki, Masashi
Kawaguchi, Yoshiharu
author_sort Hirai, Takashi
collection PubMed
description Background: The purpose of this study was to clarify the clinical features of ossification of the posterior longitudinal ligament (OPLL) and extreme ossification at multiple sites. Methods: This prospective study involved patients with a diagnosis of cervical OPLL at 16 institutions in Japan. Patient-reported outcome measures, including responses on the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOA-CMEQ), JOA Back Pain Evaluation Questionnaire (JOA-BPEQ), and visual analog scale pain score, were collected to investigate clinical status. In each patient, the sum of the levels at which OPLL was located (OP index) was evaluated on whole-spine computed tomography, along with ossification of other spinal ligaments including the anterior longitudinal ligament (OALL), ligament flavum (OLF), supra- and intraspinous ligaments (SSL), and diffuse idiopathic skeletal hyperostosis (DISH). The distribution of OP index values in the study population was investigated, and the clinical and radiologic characteristics of patients in the top 10% were assessed. Results: In total, 236 patients (163 male, 73 female; mean age 63.5 years) were enrolled. Twenty-five patients with OP index ≥ 17 were categorized into a high OP index group and the remainder into a moderate/low OP index group. There were significantly more women in the high OP index group. Patients in the high OP index group also had significantly poorer scores for lower extremity function and quality of life on the JOA-CMEQ and in each domain but not for body pain on the JOA-BPEQ compared with those in the moderate/low OP index group. Patients in the high OP index group had more OALL in the cervical spine and more OLF and SSL in the thoracic spine. The prevalence of DISH was also significantly higher in the high OP index group. In the high OP index group, interestingly, OPLL was likely to be present adjacent to DISH in the cervicothoracic and thoracolumbar spine, especially in men, and often coexisted with DISH in the thoracic spine in women. Conclusion: This prospective cohort registry study is the first to demonstrate the clinical and radiologic features of patients with OPLL and a high OP index. In this study, patients with a high OP index had poorer physical function in the lumbar spine and lower extremities and were also predisposed to extreme ossification of spinal ligaments other than the OPLL.
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spelling pubmed-92671682022-07-09 Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study) Hirai, Takashi Yoshii, Toshitaka Hashimoto, Jun Ushio, Shuta Mori, Kanji Maki, Satoshi Katsumi, Keiichi Nagoshi, Narihito Takeuchi, Kazuhiro Furuya, Takeo Watanabe, Kei Nishida, Norihiro Nishimura, Soraya Watanabe, Kota Kaito, Takashi Kato, Satoshi Nagashima, Katsuya Koda, Masao Nakashima, Hiroaki Imagama, Shiro Murata, Kazuma Matsuoka, Yuji Wada, Kanichiro Kimura, Atsushi Ohba, Tetsuro Katoh, Hiroyuki Watanabe, Masahiko Matsuyama, Yukihiro Ozawa, Hiroshi Haro, Hirotaka Takeshita, Katsushi Matsumoto, Morio Nakamura, Masaya Egawa, Satoru Matsukura, Yu Inose, Hiroyuki Okawa, Atsushi Yamazaki, Masashi Kawaguchi, Yoshiharu J Clin Med Article Background: The purpose of this study was to clarify the clinical features of ossification of the posterior longitudinal ligament (OPLL) and extreme ossification at multiple sites. Methods: This prospective study involved patients with a diagnosis of cervical OPLL at 16 institutions in Japan. Patient-reported outcome measures, including responses on the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOA-CMEQ), JOA Back Pain Evaluation Questionnaire (JOA-BPEQ), and visual analog scale pain score, were collected to investigate clinical status. In each patient, the sum of the levels at which OPLL was located (OP index) was evaluated on whole-spine computed tomography, along with ossification of other spinal ligaments including the anterior longitudinal ligament (OALL), ligament flavum (OLF), supra- and intraspinous ligaments (SSL), and diffuse idiopathic skeletal hyperostosis (DISH). The distribution of OP index values in the study population was investigated, and the clinical and radiologic characteristics of patients in the top 10% were assessed. Results: In total, 236 patients (163 male, 73 female; mean age 63.5 years) were enrolled. Twenty-five patients with OP index ≥ 17 were categorized into a high OP index group and the remainder into a moderate/low OP index group. There were significantly more women in the high OP index group. Patients in the high OP index group also had significantly poorer scores for lower extremity function and quality of life on the JOA-CMEQ and in each domain but not for body pain on the JOA-BPEQ compared with those in the moderate/low OP index group. Patients in the high OP index group had more OALL in the cervical spine and more OLF and SSL in the thoracic spine. The prevalence of DISH was also significantly higher in the high OP index group. In the high OP index group, interestingly, OPLL was likely to be present adjacent to DISH in the cervicothoracic and thoracolumbar spine, especially in men, and often coexisted with DISH in the thoracic spine in women. Conclusion: This prospective cohort registry study is the first to demonstrate the clinical and radiologic features of patients with OPLL and a high OP index. In this study, patients with a high OP index had poorer physical function in the lumbar spine and lower extremities and were also predisposed to extreme ossification of spinal ligaments other than the OPLL. MDPI 2022-06-27 /pmc/articles/PMC9267168/ /pubmed/35806979 http://dx.doi.org/10.3390/jcm11133694 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hirai, Takashi
Yoshii, Toshitaka
Hashimoto, Jun
Ushio, Shuta
Mori, Kanji
Maki, Satoshi
Katsumi, Keiichi
Nagoshi, Narihito
Takeuchi, Kazuhiro
Furuya, Takeo
Watanabe, Kei
Nishida, Norihiro
Nishimura, Soraya
Watanabe, Kota
Kaito, Takashi
Kato, Satoshi
Nagashima, Katsuya
Koda, Masao
Nakashima, Hiroaki
Imagama, Shiro
Murata, Kazuma
Matsuoka, Yuji
Wada, Kanichiro
Kimura, Atsushi
Ohba, Tetsuro
Katoh, Hiroyuki
Watanabe, Masahiko
Matsuyama, Yukihiro
Ozawa, Hiroshi
Haro, Hirotaka
Takeshita, Katsushi
Matsumoto, Morio
Nakamura, Masaya
Egawa, Satoru
Matsukura, Yu
Inose, Hiroyuki
Okawa, Atsushi
Yamazaki, Masashi
Kawaguchi, Yoshiharu
Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title_full Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title_fullStr Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title_full_unstemmed Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title_short Clinical Characteristics of Patients with Ossification of the Posterior Longitudinal Ligament and a High OP Index: A Multicenter Cross-Sectional Study (JOSL Study)
title_sort clinical characteristics of patients with ossification of the posterior longitudinal ligament and a high op index: a multicenter cross-sectional study (josl study)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267168/
https://www.ncbi.nlm.nih.gov/pubmed/35806979
http://dx.doi.org/10.3390/jcm11133694
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