Clinical characteristics in patients with ossification of the posterior longitudinal ligament: A prospective multi-institutional cross-sectional study.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
26 03 2020
26 03 2020
Historique:
received:
19
07
2019
accepted:
05
03
2020
entrez:
29
3
2020
pubmed:
29
3
2020
medline:
15
12
2020
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 32218490
doi: 10.1038/s41598-020-62278-3
pii: 10.1038/s41598-020-62278-3
pmc: PMC7099083
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5532Références
Hirai, T. et al. Prevalence and Distribution of Ossified Lesions in the Whole Spine of Patients with Cervical Ossification of the Posterior Longitudinal Ligament A Multicenter Study (JOSL CT study). PLoS One 11, e0160117 (2016).
doi: 10.1371/journal.pone.0160117
Kawaguchi, Y. et al. Ossification of the posterior longitudinal ligament in not only the cervical spine, but also other spinal regions: analysis using multidetector computed tomography of the whole spine. Spine 38, E1477–1482 (2013).
doi: 10.1097/BRS.0b013e3182a54f00
Mori, K. et al. Prevalence, distribution, and morphology of thoracic ossification of the posterior longitudinal ligament in Japanese: results of CT-based cross-sectional study. Spine 39, 394–399 (2014).
doi: 10.1097/BRS.0000000000000153
Fujimori, T. et al. Prevalence, Concomitance, and Distribution of Ossification of the Spinal Ligaments: Results of Whole Spine CT Scans in 1500 Japanese Patients. Spine 41, 1668–1676 (2016).
doi: 10.1097/BRS.0000000000001643
Mori, K. et al. Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: a CT-based multicenter cross-sectional study. BMC Musculoskelet. Disord. 17, 492 (2016).
doi: 10.1186/s12891-016-1350-y
Yoshii, T. et al. Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament -A multi-center CT study. J. Orthop. Sci. 24, 35–41 (2019).
doi: 10.1016/j.jos.2018.08.009
Matsumoto, M. et al. Outcomes of fusion surgery for ossification of the posterior longitudinal ligament of the thoracic spine: a multicenter retrospective survey: clinical article. J. Neurosurg. Spine 15, 380–385 (2011).
doi: 10.3171/2011.6.SPINE10816
Sakai, K. et al. Five-year follow-up evaluation of surgical treatment for cervical myelopathy caused by ossification of the posterior longitudinal ligament: a prospective comparative study of anterior decompression and fusion with floating method versus laminoplasty. Spine 37, 367–376 (2012).
doi: 10.1097/BRS.0b013e31821f4a51
Yoshii, T. et al. Anterior Cervical Corpectomy and Fusion Using a Synthetic Hydroxyapatite Graft for Ossification of the Posterior Longitudinal Ligament. Orthopedics 40, e334–e339 (2017).
doi: 10.3928/01477447-20161208-02
Yoshii, T. et al. Anterior decompression with fusion versus posterior decompression with fusion for massive cervical ossification of the posterior longitudinal ligament with a ≥50% canal occupying ratio: a multicenter retrospective study. Spine J. 16, 1351–1357 (2016).
doi: 10.1016/j.spinee.2016.07.532
Hirabayashi, K. et al. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 8, 693–699 (1983).
doi: 10.1097/00007632-198310000-00003
Fukui, M. et al. JOA Back Pain Evaluation Questionnaire (JOABPEQ)/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The report on the development of revised versions. April 16, 2007. The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation. J. Orthop. Sci. 14, 348–365 (2009).
doi: 10.1007/s00776-009-1337-8
Jenkinson, C., Coulter, A. & Wright, L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ 306, 1437–1440 (1993).
doi: 10.1136/bmj.306.6890.1437
Tsukimoto, H. A case report—autopsy of syndrome of compression of the spinal cord owing to ossification with spinal canal of cervical spine. Arch. Jap Clin. 29, 1003–7 (1960).
Sasaki, E. et al. Prevalence and symptom of ossification of posterior longitudinal ligaments in the Japanese general population. J. Orthop. Sci. 19, 405–411 (2014).
doi: 10.1007/s00776-014-0552-0
Kumagai, G. et al. Association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population. J. Orthop. Sci. 19, 390–397 (2014).
doi: 10.1007/s00776-014-0549-8
Hashizume, H. et al. Japanese orthopaedic association back pain evaluation questionnaire (JOABPEQ) as an outcome measure for patients with low back pain: reference values in healthy volunteers. J. Orthop. Sci. 20, 264–280 (2015).
doi: 10.1007/s00776-014-0693-1
Nakajima H, et al. Multicenter cross-sectional study of the clinical features and types of treatment of spinal cord-related pain syndrome. J Orthop Sci in press (2019)
Takenaka, S. et al. Neurological manifestations of thoracic myelopathy. Arch. Orthop. Trauma. Surg. 134, 903–912 (2014).
doi: 10.1007/s00402-014-2000-1
Hirai, T. et al. Distribution of ossified spinal lesions in patients with severe ossification of the posterior longitudinal ligament and prediction of ossification at each segment based on the cervical OP index classification: a multicenter study (JOSL CT study). BMC Musculoskelet. Disord. 19, 107 (2018).
doi: 10.1186/s12891-018-2009-7
Yamada, T. et al. Clinical Outcomes of Cervical Spinal Surgery for Cervical Myelopathic Patients with Coexisting Lumbar Spinal Canal Stenosis (Tandem Spinal Stenosis) A retrospective analysis of 297 cases. Spine 43, E234–241 (2018).
doi: 10.1097/BRS.0000000000002289
Fujimori, T., Le, H., Ziewacz, J. E., Chou, D. & Mummaneni, P. V. Is there a difference in range of motion, neck pain, and outcomes in patients with ossification of posterior longitudinal ligament versus those with cervical spondylosis, treated with plated laminoplasty? Neurosurg. Focus. 35, E9 (2013).
doi: 10.3171/2013.4.FOCUS1394
Hirai, T. et al. Presence of anterior compression of the spinal cord after laminoplasty inhibits upper extremity motor recovery in patients with cervical spondylotic myelopathy. Spine 37, 377–384 (2012).
doi: 10.1097/BRS.0b013e31821fd396
Fujiyoshi, T. et al. Static versus dynamic factors for the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament. J. Clin. Neurosci. 17, 320–324 (2010).
doi: 10.1016/j.jocn.2009.06.023
Kawaguchi, Y. et al. More Than 20 Years Follow-up After En Bloc Cervical Laminoplasty. Spine 41, 1570–1579 (2016).
doi: 10.1097/BRS.0000000000001579
Choi, B. W. & Hum, T. W. Significance of Intramedullary High Signal Intensity on Magnetic Resonance Imaging in Patients with Cervical Ossification of the Posterior Longitudinal Ligament. Clin. Orthop. Surg. 7, 465–9 (2015).
doi: 10.4055/cios.2015.7.4.465
Chang, H., Song, K. J., Kim, H. Y. & Choi, B. W. Factors related to the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament. J. Bone Jt. Surg. Br. 94, 946–9 (2012).
doi: 10.1302/0301-620X.94B7.29018
Nishimura, S. et al. Prevalence and Distribution of Diffuse Idiopathic Skeletal Hyperostosis on Whole-spine Computed Tomography in Patients With Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Study. Clin. Spine Surg. 31, E460–E465 (2018).
doi: 10.1097/BSD.0000000000000701