title: 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).
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Yoshii
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Iwanami
authors.affiliation: Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama, Okayama, 701-1154, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 53 Honcho, Hirosaki, Aomori, 036-8203, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Kanichiro
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-0856, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Koda
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
authors.affiliation: Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine and Dental Science, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima, 890-8520, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Abematsu
authors.affiliation: Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi, 409-3898, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Haro
authors.affiliation: Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata, Niigata, 951-8520, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro Miyaginoku, Sendai, 983-8512, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ozawa
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Kanno
authors.affiliation: Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-0065, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo Ward, Kyoto, Kyoto, 606-8507, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Fujibayashi
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okawa
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.|Working group of the CT study, Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL), Tokyo, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Kawaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology / Q000473:pathology*; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology / Q000473:pathology*; D012737:Sex Factors