Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
J Orthop Sci. 2020 Sep;25(5):746-750. doi: 10.1016/j.jos.2019.09.018. Epub 2019 Oct 29.
Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by heterotopic bone formation in the posterior longitudinal ligament of the spine. We know that the size and distribution of the ossified lesions in patients with OPLL are different in each case. However, the characteristics of the patients with radiologically severe cervical OPLL remain unknown.
The participants of our study were symptomatic patients with cervical OPLL who were diagnosed by standard radiographs of the cervical spine. Whole-spine CT data and demographic data such as age and sex were obtained from 20 institutions belonging to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. According to the number of the levels involved by OPLL, we stratified the patients into two subgroups: severe group (S-group) and non-severe group (NS-group) to delineate the characteristics of radiologically severe patients with cervical OPLL. We also evaluated the most compressed level and the degree of occupying ratio of cervical spinal canal by OPLL at the most compressed level.
A total of 234 patients with a mean age of 65 years were recruited. The S-group consisted of 48 patients (21%, 12 females and 36 males) and the NS-group consisted of 92 patients (79%, 22 females and 70 males). The mean age of males in the S-group (68 years old) was significantly higher than that of males in the NS-group (64 years old); however there was no significant difference in the mean age in females between the S-group (69 years old) and the NS-group (66 years old). No significant difference of body mass index, ossification of the nuchal ligament-positivity and presence of diabetes mellitus were found between the S- and the NS-group.
It is likely that the manner of extension of cervical OPLL is different between male and female patients.
脊柱后纵韧带骨化症（OPLL）的特征是脊柱后纵韧带中有异位骨形成。我们知道，OPLL 患者的骨化病变的大小和分布在每个病例中都不同。然而，放射学上严重的颈椎 OPLL 患者的特征尚不清楚。
我们的研究对象是通过颈椎标准影像学诊断为有症状的颈椎 OPLL 患者。从属于日本多中心脊柱韧带骨化研究组织的 20 个机构获得了全脊柱 CT 数据和年龄、性别等人口统计学数据。根据 OPLL 受累的节段数，我们将患者分为两组：严重组（S 组）和非严重组（NS 组），以描绘放射学上严重的颈椎 OPLL 患者的特征。我们还评估了最受压水平的 OPLL 以及最受压水平的颈椎椎管占有率程度。
共纳入 234 名平均年龄为 65 岁的患者。S 组包括 48 名患者（21%，12 名女性和 36 名男性），NS 组包括 92 名患者（79%，22 名女性和 70 名男性）。S 组男性的平均年龄（68 岁）明显高于 NS 组男性（64 岁）；然而，S 组女性的平均年龄（69 岁）与 NS 组女性的平均年龄（66 岁）之间没有显著差异。S 组和 NS 组之间的体重指数、项韧带骨化阳性和糖尿病的存在没有显著差异。
颈椎 OPLL 在男性和女性患者中的扩展方式可能不同。
