Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
J Bone Miner Metab. 2020 Jan;38(1):63-69. doi: 10.1007/s00774-019-01026-8. Epub 2019 Jul 9.
Although ossification of the posterior longitudinal ligament (OPLL) commonly develops in the cervical spine, it also occurs, albeit less commonly, in the thoracic spine. However, data are scarce regarding the characteristics of patients with thoracic OPLL. In the current study, we performed a cross-sectional study on a total of 133 patients with OPLL to clarify the clinical characteristics of patients with thoracic OPLL compared with those of patients with cervical OPLL. The subjects were divided into four groups according to the main region of OPLL and treatment type: C-OPLL-C, cervical OPLL treated conservatively; C-OPLL-S, cervical OPLL treated via surgery; T-OPLL-C, thoracic OPLL treated conservatively; and T-OPLL-S, thoracic OPLL treated via surgery. Symptoms developed at an earlier age in the T-OPLL-S group than in the C-OPLL groups. Current body mass index (BMI), maximum lifetime BMI, and BMI at the age of 20 years were significantly higher in the T-OPLL-S group than in the C-OPLL groups. Yearly weight gain from the age of 20 years to the age at which maximum body weight was attained was significantly greater in the T-OPLL-S group than in the C-OPLL groups. The T-OPLL group showed a higher rate of co-existence of OPLL at other regions or ossification of the ligamentum flavum compared to the C-OPLL groups. Our findings demonstrate that severe obesity, early-onset of symptoms, and diffuse ossification of spinal ligaments are distinct features of patients with myelopathy caused by thoracic OPLL.
尽管后纵韧带骨化症（OPLL）通常在颈椎中发展，但它也在胸椎中发生，尽管不太常见。然而，关于胸椎 OPLL 患者特征的数据却很少。在目前的研究中，我们对总共 133 例 OPLL 患者进行了一项横断面研究，以阐明与颈椎 OPLL 患者相比，胸椎 OPLL 患者的临床特征。根据 OPLL 的主要区域和治疗类型，将患者分为四组：C-OPLL-C，保守治疗的颈椎 OPLL；C-OPLL-S，手术治疗的颈椎 OPLL；T-OPLL-C，保守治疗的胸椎 OPLL；和 T-OPLL-S，手术治疗的胸椎 OPLL。T-OPLL-S 组的症状比 C-OPLL 组更早出现。T-OPLL-S 组的当前体重指数（BMI）、最大终生 BMI 和 20 岁时 BMI 均明显高于 C-OPLL 组。T-OPLL-S 组从 20 岁到达到最大体重的年龄之间的每年体重增加量明显大于 C-OPLL 组。T-OPLL 组与 C-OPLL 组相比，其他区域的 OPLL 或黄韧带骨化共存的发生率更高。我们的研究结果表明，严重肥胖、症状早发和脊柱韧带弥漫性骨化是胸椎 OPLL 引起的脊髓病患者的明显特征。
