Takashi Hirai, Toshitaka Yoshii, Shuta Ushio, Jun Hashimoto, Kanji Mori, Satoshi Maki, Keiichi Katsumi, Narihito Nagoshi, Kazuhiro Takeuchi, Takeo Furuya, Kei Watanabe, Norihiro Nishida, Soraya Nishimura, Kota Watanabe, Takashi Kaito, Satoshi Kato, Katsuya Nagashima, Masao Koda, Kenyu Ito, Shiro Imagama, Yuji Matsuoka, Kanichiro Wada, Atsushi Kimura, Tetsuro Ohba, Hiroyuki Katoh, Masahiko Watanabe, Yukihiro Matsuyama, Hiroshi Ozawa, Hirotaka Haro, Katsushi Takeshita, Morio Matsumoto, Masaya Nakamura, Masashi Yamazaki, Masato Yuasa, Hiroyuki Inose, Atsushi Okawa, Yoshiharu Kawaguchi
Journal of clinical medicine 9(12) 2020年12月15日
This study aimed to clarify whether ossification predisposition influences clinical symptoms including pain, restriction of activities of daily living, and quality of life in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Cervical ossification predisposition potentially causes neurologic dysfunction, but the relationship between clinical symptoms and radiologic severity of OPLL has not yet been investigated. Data were prospectively collected from 16 institutions across Japan. We enrolled 239 patients with cervical OPLL. The primary outcomes were patient-reported outcomes, including visual analog scale (VAS) pain scores and other questionnaires. Whole-spine computed tomography images were obtained, and correlations were investigated between clinical symptoms and radiologic findings, including the distribution of OPLL, the sum of the levels where OPLL was present (OP-index), and the canal narrowing ratio (CNR) grade. The cervical OP-index was Grade 1 in 113 patients, Grade 2 in 90, and Grade 3 in 36. No significant correlations were found between radiologic outcomes and VAS pain scores. The cervical OP-index was associated with lower extremity function, social dysfunction, and locomotive function. The CNR grade was not correlated with clinical symptoms, but Grade 4 was associated with lower extremity dysfunction. Thickness and extension of ossified lesions may be associated with lower extremity dysfunction in cervical OPLL.