Clinical characteristics in patients with ossification of the posterior longitudinal ligament: A prospective multi-institutional cross-sectional study

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

doi:10.1038/s41598-020-62278-3

Abstract

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.

Highlights

Ossification of the posterior longitudinal ligament (OPLL) can occur throughout the entire spine and can sometimes lead to spinal disorder
Researchers have investigated several issues related to ossification, including prevalence[1,2,3], distribution of the ossified lesions[1,2,3,4,5,6], and neurologic outcomes after surgical treatment[7,8,9,10], there has been no study documenting in detail the subjective symptoms and self-reported ability to perform activities of daily living (ADL) in patients with OPLL
The aims of this study were to investigate the relationship between severity of pain and neurologic status in patients with OPLL and to identify whether there are any specific clinical symptoms in patients with cervical OPLL that are not present in those with cervical spondylosis (CS), which often leads to myelopathy similar to that occurring in cervical OPLL

Summary

Introduction

Ossification of the posterior longitudinal ligament (OPLL) can occur throughout the entire spine and can sometimes lead to spinal disorder. 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. Researchers have investigated several issues related to ossification, including prevalence[1,2,3], distribution of the ossified lesions[1,2,3,4,5,6], and neurologic outcomes after surgical treatment[7,8,9,10], there has been no study documenting in detail the subjective symptoms and self-reported ability to perform activities of daily living (ADL) in patients with OPLL

Objectives

Methods

Conclusion