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The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament.

ABSTRACT: Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cervical spine function and quality of life (QOL) in patients with cervical OPLL. In total, 238 patients (162 men, 76 women; mean age, 63.9 years) were enrolled from 16 institutions. Each patient underwent whole spine computed tomography and was evaluated for cervical spine function and QOL using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). In the multivariate regression analysis, a higher neck VAS score and a larger number of bridge formations of OPLL in the whole spine were significant predictors of adverse outcomes related to cervical spine function. This is the first prospective multicenter study to reveal the impact of ossification spread on cervical spine function. These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function.

SUBMITTER: Katsumi K

PROVIDER: S-EPMC8275804 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament.

Katsumi Keiichi K Hirai Takashi T Yoshii Toshitaka T Maki Satoshi S Mori Kanji K Nagoshi Narihito N Nishimura Soraya S Takeuchi Kazuhiro K Ushio Shuta S Furuya Takeo T Watanabe Kei K Nishida Norihiro N Watanabe Kota K Kaito Takashi T Kato Satoshi S Nagashima Katsuya K Koda Masao M Ito Kenyu K Imagama Shiro S Matsuoka Yuji Y Wada Kanichiro K Kimura Atsushi A Ohba Tetsuro T Katoh Hiroyuki H Matsuyama Yukihiro Y Ozawa Hiroshi H Haro Hirotaka H Takeshita Katsushi K Watanabe Masahiko M Matsumoto Morio M Nakamura Masaya M Yamazaki Masashi M Okawa Atsushi A Kawaguchi Yoshiharu Y

Scientific reports 20210712 1

Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cerv ...[more]

PMID: 34253758

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Project description:The ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is commonly observed in degenerative changes of the cervical spine. Early detection of cervical OPLL and prevention of postoperative complications are of utmost importance. We gathered data from 775 patients who underwent cervical spine surgery at the First Affiliated Hospital of Guangxi Medical University, collecting a total of 84 variables. Among these patients, 144 had cervical OPLL, while 631 did not. They were randomly divided into a training cohort and a validation cohort. Multiple machine learning (ML) methods were employed to screen the variables and ultimately develop a diagnostic model. Subsequently, we compared the postoperative outcomes of patients with positive and negative cervical OPLL. Initially, we compared the advantages and disadvantages of various ML methods. Seven variables, namely Age, Gender, OPLL, AST, UA, BMI, and CHD, exhibited significant differences and were used to construct a diagnostic nomogram model. The area under the curve (AUC) values of this model in the training and validation groups were 0.76 and 0.728, respectively. Our findings revealed that 69.2% of patients who underwent cervical OPLL surgery eventually required elective anterior surgery, in contrast to 86.8% of patients who did not have cervical OPLL. Patients with cervical OPLL had significantly longer operation times and higher postoperative drainage volumes compared to those without cervical OPLL. Interestingly, preoperative cervical OPLL patients demonstrated significant increases in mean UA, age, and BMI. Furthermore, 27.1% of patients with cervical anterior longitudinal ligament ossification (OALL) also exhibited cervical OPLL, whereas this occurrence was only observed in 6.9% of patients without cervical OALL. We developed a diagnostic model for cervical OPLL using the ML method. Our findings indicate that patients with cervical OPLL are more likely to undergo posterior cervical surgery, and they exhibit elevated UA levels, higher BMI, and increased age. The prevalence of cervical anterior longitudinal ligament ossification was also significantly higher among patients with cervical OPLL.

Dataset Information

The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament.

Publications

The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament.

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