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

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

doi:10.1038/s41598-021-93602-0

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.

Highlights

Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease
In the multivariate regression analysis, a higher neck visual analog scale (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
These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function

Summary

Introduction

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; cervical spine function may decrease over time. 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. Because OPLL is a progressive disease, the bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; cervical spine function and quality of life (QOL) may decrease over time. In 2007, the JOA established a self-administered questionnaire, the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), as a new outcome measurement tool for patients with cervical myelopathy, which included measurements of cervical spine function such as neck pain, stiff neck, disability, and QOL (Supplemental Table 2)[7]

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