PurposeTo analyze the significance of ossification index of cervical posterior longitudinal ligament as a risk factor for thoracic OPLL (ossification of the posterior longitudinal ligament) in patients with cervical OPLL. MethodsWe retrospectively analyzed the clinical data of cervical OPLL patients in Changzheng hospital, who received chest CT scans for screening of COVID-19, and included 87 patients into this study. According to the radiographic evidence, 87 patients were divided into CT group(cervical OPLL combined with thoracic OPLL)and C group(cervical OPLL group). We measured the cervical OS index (ossification index), and analyzed the relationship between thoracic OPLL and cervical OS index. ResultsThere was no difference of age、sex、duration of symptoms、comorbidity between the 2 groups(P>0.05). The mean cervical OS index was higher in the CT group than in the C group (8 ± 2 VS 3 ± 2,P<0.001). ConclusionsPatients with cervical OS index >8 was considered as “high risk” of tandem OPLL, while with value ≤ 4 was considered as “low risk”. Index between 5 and 8 were considered as “middle risk”. This study demonstrated that the cervical OS index may be used as an indicator of thoracic OPLL in patients with cervical OPLL, with a high diagnostic accuracy.