Endo Tsutomu, Koike Yoshinao, Hisada Yuichiro, Fujita Ryo, Suzuki Ryota, Tanaka Masaru, Tsujimoto Takeru, Shimamura Yukitoshi, Hasegawa Yuichi, Kanayama Masahiro, Yamada Katsuhisa, Iwata Akira, Sudo Hideki, Ishii Misaki, Iwasaki Norimasa, Takahata Masahiko
Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan.
Global Spine J. 2023 Jun;13(5):1325-1331. doi: 10.1177/21925682211031514. Epub 2021 Oct 6.
Retrospective cross-sectional study.
There is insufficient data on the clinical features of ossification of the ligamentum flavum (OLF) of the thoracic spine and the risk of progression of ossified lesions. The link between obesity and ossification of the posterior longitudinal ligament (OPLL), which frequently coexists with OLF, has been demonstrated. However, the link between obesity and OLF has not been recognized. We aimed to determine the prevalence of obesity in thoracic OLF and whether the severity of OLF is associated with the degree of obesity.
A total of 204 symptomatic Japanese subjects with thoracic OLF and 136 subjects without spinal ligament ossification as controls were included. OLF subjects were divided into 3 groups: 1) localized OLF (OLF <2-intervertebral regions); 2) multilevel OLF (OLF ≥3-intervertebral regions); and 3) OLF + OPLL. The severity of OLF was quantified using the OLF index using computed tomography imaging of the entire spine.
The proportion of severely obese subjects (BMI ≥ 30 kg/m) was significantly higher both in the multilevel OLF group (25.5%) and the OLF + OPLL group (44.3%) than in the localized OLF group (3.6%) and the control group (1.4%) ( < 0.01). BMI, age, and coexistence of cervical OPLL and lumbar OLF were associated with thoracic OLF index in the multiple regression analysis.
Our findings demonstrated that obesity is a distinct feature of multilevel OLF in the thoracic spine and that the severity of OLF is associated with the degree of obesity.
回顾性横断面研究。
关于胸椎黄韧带骨化（OLF）的临床特征以及骨化病变进展风险的数据不足。肥胖与常与OLF共存的后纵韧带骨化（OPLL）之间的关联已得到证实。然而，肥胖与OLF之间的关联尚未得到认识。我们旨在确定胸椎OLF中肥胖的患病率，以及OLF的严重程度是否与肥胖程度相关。
共纳入204例有症状的日本胸椎OLF患者和136例无脊柱韧带骨化的受试者作为对照。OLF患者分为3组：1）局限性OLF（OLF＜2个椎间区域）；2）多节段OLF（OLF≥3个椎间区域）；3）OLF+OPLL。使用全脊柱计算机断层扫描成像，通过OLF指数对OLF的严重程度进行量化。
多节段OLF组（25.5%）和OLF+OPLL组（44.3%）中重度肥胖受试者（BMI≥30kg/m²）的比例显著高于局限性OLF组（3.6%）和对照组（1.4%）（P＜0.01）。在多元回归分析中，BMI、年龄以及颈椎OPLL和腰椎OLF的共存与胸椎OLF指数相关。
我们的研究结果表明，肥胖是胸椎多节段OLF的一个显著特征，且OLF的严重程度与肥胖程度相关。
