Abstract
Background: This study investigated how diffuse idiopathic skeletal hyperostosis (DISH) influences clinical characteristics in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Although DISH is considered unlikely to promote neurologic dysfunction, this relationship remains unclear. Methods: Patient data were prospectively collected from 16 Japanese institutions. In total, 239 patients with cervical OPLL were enrolled who had whole-spine computed tomography images available. The primary outcomes were visual analog scale pain scores and the results of other self-reported clinical questionnaires. Correlations were sought between clinical symptoms and DISH using the following grading system: 1, DISH at T3-T10; 2, DISH at both T3–10 and C6–T2 and/or T11–L2; and 3, DISH beyond the C5 and/or L3 levels. Results: DISH was absent in 132 cases, grade 1 in 23, grade 2 in 65, and grade 3 in 19. There were no significant correlations between DISH grade and clinical scores. However, there was a significant difference in the prevalence of neck pain (but not in back pain or low back pain) among the three grades. Interestingly, DISH localized in the thoracic spine (grade 1) may create overload at the cervical spine and lead to neck pain in patients with cervical OPLL. Conclusion: This study is the first prospective multicenter cross-sectional comparison of subjective outcomes in patients with cervical OPLL according to the presence or absence of DISH. The severity of DISH was partially associated with the prevalence of neck pain.
Highlights
Ossification of the spinal ligaments impairs spinal mobility and occasionally leads to a spinal disorder [1,2]
diffuse idiopathic skeletal hyperostosis (DISH) was was throughout largely ignored ignored by clinicians the it isitnow known that largely cliniciansand andresearchers researchersuntil until the is known can can sometimes result in specific symptoms, including backback painpain sometimes result in specific symptoms, including stiffness reduced range of articular motion
This study is the first prospective multicenter cross-sectional comparison of subjective outcomes in patients with cervical OPLL according to the presence or absence of DISH
Summary
Ossification of the spinal ligaments impairs spinal mobility and occasionally leads to a spinal disorder [1,2]. Diffuse idiopathic skeletal hyperostosis (DISH), which is defined as ossification of the anterior longitudinal ligament bridging at least four vertebral segments of the thoracolumbar spine [4,5], has been recognized as a pathological feature in patients predisposed to ossification and often coincides with the presence of OPLL [6,7,8,9,10]. The Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), established a nationwide patient registry to prospectively collect the clinical and radiologic data, including whole-spine computed tomography (CT). Influences clinical characteristics in patients with cervical ossification of the posterior longitudinal ligament (OPLL). DISH localized in the thoracic spine (grade 1) may create overload at the cervical spine and lead to neck pain in patients with cervical OPLL. Conclusion: This study is the first prospective multicenter cross-sectional comparison of subjective outcomes in patients with cervical OPLL according to the presence or absence of DISH. The severity of DISH was partially associated with the prevalence of neck pain
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