后纵韧带骨化症患者中弥漫性特发性骨肥厚的严重程度与其他脊柱韧带骨化之间的关联

Association between Severity of Diffuse Idiopathic Skeletal Hyperostosis and Ossification of Other Spinal Ligaments in Patients with Ossification of the Posterior Longitudinal Ligament.

作者信息

Nishimura Soraya, Hirai Takashi, Nagoshi Narihito, Yoshii Toshitaka, Hashimoto Jun, Mori Kanji, Maki Satoshi, Katsumi Keiichi, Takeuchi Kazuhiro, Ushio Shuta, Furuya Takeo, Watanabe Kei, Nishida Norihiro, Kaito Takashi, Kato Satoshi, Nagashima Katsuya, Koda Masao, Nakashima Hiroaki, Imagama Shiro, Murata Kazuma, Matsuoka Yuji, Wada Kanichiro, Kimura Atsushi, Ohba Tetsuro, Katoh Hiroyuki, Watanabe Masahiko, Matsuyama Yukihiro, Ozawa Hiroshi, Haro Hirotaka, Takeshita Katsushi, Matsukura Yu, Inose Hiroyuki, Yamazaki Masashi, Watanabe Kota, Matsumoto Morio, Nakamura Masaya, Okawa Atsushi, Kawaguchi Yoshiharu

机构信息

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.

Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan.

出版信息

J Clin Med. 2021 Oct 13;10(20):4690. doi: 10.3390/jcm10204690.

DOI:10.3390/jcm10204690

PMID:34682814

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8539272/

Abstract

BACKGROUND

Although diffuse idiopathic skeletal hyperostosis (DISH) is known to coexist with the ossification of spinal ligaments (OSLs), details of the radiographic relationship remain unclear.

METHODS

We prospectively collected data of 239 patients with symptomatic cervical ossification of the posterior longitudinal ligament (OPLL) and analyzed the DISH severity on whole-spine computed tomography images, using the following grades: grade 0, no DISH; grade 1, DISH at T3-T10; grade 2, DISH at both T3-T10 and C6-T2 and/or T11-L2; and grade 3, DISH beyond C5 and/or L3. Ossification indices were calculated as the sum of vertebral and intervertebral levels with OSL for each patient.

RESULTS

DISH was found in 107 patients (44.8%), 65 (60.7%) of whom had grade 2 DISH. We found significant associations of DISH grade with the indices for cervical OPLL (r = 0.45, < 0.0001), thoracic ossification of the ligamentum flavum (OLF; r = 0.41, < 0.0001) and thoracic ossification of the supra/interspinous ligaments (OSIL; r = 0.53, < 0.0001). DISH grade was also correlated with the index for each OSL in the whole spine (OPLL: r = 0.29, < 0.0001; OLF: r = 0.40, < 0.0001; OSIL: r = 0.50, < 0.0001).

CONCLUSION

The DISH grade correlated with the indices of OSL at each high-prevalence level as well as the whole spine.

摘要

背景

虽然已知弥漫性特发性骨肥厚（DISH）与脊柱韧带骨化（OSL）共存，但影像学关系的细节仍不清楚。

方法

我们前瞻性收集了239例有症状的颈椎后纵韧带骨化（OPLL）患者的数据，并使用以下分级在全脊柱计算机断层扫描图像上分析DISH的严重程度：0级，无DISH；1级，T3-T10有DISH；2级，T3-T10和C6-T2及/或T11-L2均有DISH；3级，C5以上和/或L3以上有DISH。计算每个患者的骨化指数，即椎体和椎间层面出现OSL的总和。

结果

107例患者（44.8%）发现有DISH，其中65例（60.7%）为2级DISH。我们发现DISH分级与颈椎OPLL指数（r = 0.45，P < 0.0001）、胸椎黄韧带骨化（OLF；r = 0.41，P < 0.0001）以及胸椎棘上/棘间韧带骨化（OSIL；r = 0.53，P < 0.0001）之间存在显著相关性。DISH分级还与全脊柱各OSL指数相关（OPLL：r = 0.29，P < 0.0001；OLF：r = 0.40，P < 0.0001；OSIL：r = 0.50，P < 0.