An Seong Bae, Lee Jong Joo, Kim Tae Woo, Lee Nam, Shin Dong Ah, Yi Seong, Kim Keung Nyun, Yoon Do Heum, Ha Yoon
Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.
Department of Neurosurgery, Prime Hospital, Busan, Korea.
Quant Imaging Med Surg. 2019 Jun;9(6):952-959. doi: 10.21037/qims.2019.05.26.
To compare the differences between the one-dimensional (1D) length, two-dimensional (2D) area, and three-dimensional (3D) volume occupying ratios, and to assess the difference between the central and peripheral types of ossification of the posterior longitudinal ligament (OPLL).
In total, 60 patients were included in this study, and 1D and 2D occupying ratios were obtained using Centricity PACS (GE Healthcare), while a 3D model was created using MIMICS (Materialise, Leuven, Belgium). Clinical symptoms were measured preoperatively by the modified Japanese Orthopedic Association (JOA) score, short-form health survey (SF-36), and neck disability index. The increased signal intensity (ISI) in T2-weighted MRI was divided into three groups: grade 0, none; grade1, limited to one disc level; or grade2, beyond one disc level. The axial view of spinal canal in CT was vertically divided into three equal parts. Then, the OPLL was categorized by central and peripheral type according to the location of most protruded tip.
The 1D, 2D, and 3D occupying ratios had a significantly negative relationship with JOA score (r=-0.503; -0.506; -0.516, respectively). There was little difference in the JOA score between the central and peripheral types (17.15 17.12, P=0.785). The relationship with MR ISI, according to the central and peripheral type, showed no significant difference. In each multiple regression analysis, the 1D, 2D, and 3D occupying ratios were determined to have more influence on the JOA score (Beta: -0.364, -0.411, -0.462, respectively) than age, sex, most severe level, OPLL type, location type, and MR ISI.
There was no difference between 1D, 2D, and 3D occupying ratios in reflecting the JOA score in cervical OPLL. Also, it is sufficient to reflect the occupying ratio in the clinical outcome without distinguishing between central and peripheral type.
比较一维（1D）长度、二维（2D）面积和三维（3D）体积占有率之间的差异，并评估后纵韧带骨化（OPLL）中央型和外周型之间的差异。
本研究共纳入60例患者，使用Centricity PACS（GE医疗）获得1D和2D占有率，同时使用MIMICS（Materialise，比利时鲁汶）创建3D模型。术前通过改良日本骨科协会（JOA）评分、简短健康调查问卷（SF-36）和颈部功能障碍指数评估临床症状。T2加权磁共振成像（MRI）中的信号强度增加（ISI）分为三组：0级，无；1级，限于一个椎间盘水平；或2级，超过一个椎间盘水平。CT中椎管的轴位视图垂直分为三个相等部分。然后，根据最突出尖端的位置将OPLL分为中央型和外周型。
1D、2D和3D占有率与JOA评分呈显著负相关（r分别为-0.503、-0.506、-0.516）。中央型和外周型之间的JOA评分差异不大（17.15对17.12，P = 0.785）。根据中央型和外周型，与MRI ISI的关系无显著差异。在每项多元回归分析中，确定1D、2D和3D占有率对JOA评分的影响（β分别为-0.364、-0.411和-0.462）大于年龄性别、最严重程度、OPLL类型、位置类型和MRI ISI。
在反映颈椎OPLL的JOA评分方面，1D、2D和3D占有率之间没有差异。此外，在不区分中央型和外周型的情况下，足以反映临床结果中的占有率。
