Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Toyama, Japan.
Sci Rep. 2020 Mar 26;10(1):5532. doi: 10.1038/s41598-020-62278-3.
Ossification of the posterior longitudinal ligament (OPLL) can occur throughout the entire spine and can sometimes lead to spinal disorder. Although patients with OPLL sometimes develop physical limitations because of pain, the characteristics of pain and effects on activities of daily living (ADL) have not been precisely evaluated in OPLL patients. Therefore, we conducted a multi-center prospective study to assess whether the symptoms of cervical OPLL are different from those of cervical spondylosis (CS). A total of 263 patients with a diagnosis of cervical OPLL and 50 patients with a diagnosis of CS were enrolled and provided self-reported outcomes, including responses to the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), JOA Back Pain Evaluation Questionnaire (JOABPEQ), visual analog scale (VAS), and SF-36 scores. The severity of myelopathy was significantly correlated with each domain of the JOACMEQ and JOABPEQ. There was a negative correlation between the VAS score for each domain and the JOA score. There were significantly positive correlations between the JOA score and the Mental Health, Bodily Pain, Physical Functioning, Role Emotional, and Role Physical domains of the SF-36. One-to-one matching resulted in 50 pairs of patients with OPLL and CS. Although there was no significant between-group difference in scores in any of the domains of the JOACMEQ or JOABPEQ, the VAS scores for pain or numbness in the buttocks or limbs were significantly higher in the CS group; however, there was no marked difference in low back pain, chest tightness, or numbness below the chest between the two study groups. The scores for the Role Physical and Body Pain domains of the SF-36 were significantly higher in the OPLL group than in the CS group, and the mean scores for the other domains was similar between the two groups. The results of this study revealed that patients with OPLL were likely to have neck and low back pain and restriction in ADL. No specific type of pain was found in patients with OPLL when compared with those who had CS.
后纵韧带骨化症（OPLL）可发生于整个脊柱，并可能导致脊柱功能障碍。尽管 OPLL 患者有时会因疼痛而出现身体活动受限，但 OPLL 患者的疼痛特征及其对日常生活活动（ADL）的影响尚未得到准确评估。因此，我们进行了一项多中心前瞻性研究，以评估颈椎 OPLL 的症状是否与颈椎病（CS）不同。共纳入 263 例颈椎 OPLL 患者和 50 例 CS 患者，记录患者的自我报告结果，包括日本骨科协会（JOA）颈椎脊髓病评估问卷（JOACMEQ）、JOA 背痛评估问卷（JOABPEQ）、视觉模拟评分（VAS）和 SF-36 评分。脊髓病的严重程度与 JOACMEQ 和 JOABPEQ 的各个领域均显著相关。每个领域的 VAS 评分与 JOA 评分呈负相关。JOA 评分与 SF-36 的心理健康、躯体疼痛、身体机能、情绪角色和身体角色领域呈显著正相关。1:1 配对后，OPLL 组和 CS 组各有 50 对患者。虽然 JOACMEQ 或 JOABPEQ 的各个领域的评分在两组间均无显著差异，但 CS 组的臀部或四肢疼痛或麻木的 VAS 评分显著更高；然而，两组间的腰痛、胸闷或胸部以下麻木之间无明显差异。SF-36 的身体角色和躯体疼痛领域评分在 OPLL 组显著高于 CS 组，而其他领域的平均评分在两组间相似。本研究结果表明，OPLL 患者可能出现颈部和腰部疼痛以及 ADL 受限。与 CS 患者相比，OPLL 患者没有特定类型的疼痛。
