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).
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).
复制标题
纵向韧带宫颈骨化患者的整个脊柱中骨化病变的患病率和分布（JOSL CT研究）。
DOI：
10.1371/journal.pone.0160117
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Kawaguchi Y
中科院分区：
文献类型：
--
作者：
Hirai T;Yoshii T;Iwanami A;Takeuchi K;Mori K;Yamada T;Wada K;Koda M;Matsuyama Y;Takeshita K;Abematsu M;Haro H;Watanabe M;Watanabe K;Ozawa H;Kanno H;Imagama S;Fujibayashi S;Yamazaki M;Matsumoto M;Nakamura M;Okawa A;Kawaguchi Y
后纵韧带骨化不仅会导致颈椎，也会导致胸腰椎严重且不可逆的瘫痪。然而，到目前为止，颈椎关节外翻在整个脊柱中的患病率和分布尚未得到准确的评估。因此，我们进行了一项多中心研究，利用全脊柱的多探测器计算机断层扫描（CT）图像综合评估OPLL的患病率和分布，并分析在x线平片诊断为颈椎OPLL的患者中，哪些因素可以预测胸腰椎存在骨化病变。322例诊断为颈椎OPLL的患者接受了全脊柱CT成像。整个脊柱中存在的OPLL水平的总和被定义为op指数，用于评估骨化程度。比较男性和女性受试者全脊柱OPLL的分布。此外，采用多元回归模型确定影响op指数的相关因素。在颈椎OPLL患者中，女性在胸腰椎的骨化病变多于男性。多元回归模型显示，op指数与宫颈op指数、性别（女性）、体重指数显著相关。此外，颈op指数≥10的患者发生胸腰椎OPLL的几率是颈op指数≤5的患者的7.8倍。本研究的结果显示，全脊柱的后纵韧带损伤程度与颈椎后纵韧带损伤程度、女性性别和肥胖程度显著相关。
Ossification of the posterior longitudinal ligament (OPLL) can cause severe and irreversible paralysis in not only the cervical spine but also the thoracolumbar spine. To date, however, the prevalence and distribution of OPLL in the whole spine has not been precisely evaluated in patients with cervical OPLL. Therefore, we conducted a multi-center study to comprehensively evaluate the prevalence and distribution of OPLL using multi-detector computed tomography (CT) images in the whole spine and to analyze what factors predict the presence of ossified lesions in the thoracolumbar spine in patients who were diagnosed with cervical OPLL by plain X-ray. Three hundred and twenty-two patients with a diagnosis of cervical OPLL underwent CT imaging of the whole spine. The sum of the levels in which OPLL was present in the whole spine was defined as the OP-index and used to evaluate the extent of ossification. The distribution of OPLL in the whole spine was compared between male and female subjects. In addition, a multiple regression model was used to ascertain related factors that affected the OP-index. Among patients with cervical OPLL, women tended to have more ossified lesions in the thoracolumbar spine than did men. A multiple regression model revealed that the OP-index was significantly correlated with the cervical OP-index, sex (female), and body mass index. Furthermore, the prevalence of thoracolumbar OPLL in patients with a cervical OP-index ≥ 10 was 7.8 times greater than that in patients with a cervical OP-index ≤ 5. The results of this study reveal that the extent of OPLL in the whole spine is significantly associated with the extent of cervical OPLL, female sex, and obesity.