Factors associated with bone metabolism in patients with cervical ossification of the posterior longitudinal ligament accompanied with diffuse idiopathic skeletal hyperostosis

Abstract

Introduction: Diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL) are both characterized as ossification in paravertebral ligaments and sometimes present simultaneously, however, the bone metabolism in patients with cervical OPLL accompanying/not accompanying DISH has not well been studied. Thus, a retrospective analysis was performed to understand any differences in bone metabolism in these patients.Methods: Male patients who underwent surgery for OPLL were divided into two groups based on the presence or absence of DISH (OD and O group, respectively). Patients with cervical spondylosis comprised the control group (CS group). Bone mineral density (BMD) and bone metabolism factors were compared among the groups.Results: The OD and O groups had significantly higher body mass indexes (BMIs) than did the CS group. Morphologically, the number of continuous type of OPLL was high in the OD group whereas that of segmental type was higher in the O group. The OD and O group had greater BMD than the CS group. Both TRACP-5b and P1NP were tended to be lower in the OD group whereas Ca and P concentrations were similar level among the groups. Intact parathyroid hormone in OD group was significantly higher than CS group.Discussion: Patients with OPLL accompanying DISH had significantly higher BMD whereas they tend to be lower in bone turnover. Significantly higher i-PTH levels was found in the OD group and would be the characteristic blood marker, but further research on the relationship between DISH and PTH was necessary.

Femur Bone Mineral Density and Pentosidine Level Distinguish Ankylosing Spinal Disorder Patients with and without Sacroiliac Ankylosis

“…Although the precise definition of AS in elderly is unclear, ASD with SJA resembles AS because 21 out of 31 patients in the ASD with SJA group were applied with the modified New York diagnostic criteria. also reported a significantly higher BMD of the femur neck among patients with DISH matched for age, sex, and BMI than the general population 10,15) . In addition, ASD without SJA completely matched DISH according to Resnick's definition.…”

“…Patients with AS reportedly have low BMDs of the lumbar spine, whereas patients with DISH have high BMDs of the lumbar spine 9,10,[15][16][17][18] . The T and Z scores of the lumbar spine were higher in the ASD group than those in the non-ASD group.…”

Trabecular bone score and bone turnover markers in men with DISH: Data from the Camargo Cohort study

“…Nevertheless, serum PINP levels were similar in DISH and NDISH subjects, which is in line with a recent study on 49 men that underwent surgery for ossification of the posterior longitudinal ligament in cervical spine (OPLL). The authors observed that PINP levels were not significantly different in subjects with OPLL associated with DISH, compared to those with cervical spondylosis [41].…”

“…Regarding to bone resorption markers, we have observed no differences in serum CTX levels in subjects with or without DISH. In this sense, serum levels of tartrate-resistant acid phosphatase 5b (TRAP-5b), another biomarker of bone resorption, have been assessed in a recent report, but no differences between DISH and NDISH subjects were found [41]. With regard to the physiologic regulators of bone turnover, DISH has been related to reduced DKK-1 levels, a protein that inhibits osteogenesis induced by the Wnt/b-catenin pathway [18,19].…”

Molecular and Genetic Mechanisms of Spinal Stenosis Formation: Systematic Review

“…Progressive ectopic ossification of the posterior longitudinal ligament (OPLL) is a disorder resulting in SS. Patients with OPLL typically develop various neurological symptoms ranging from discomfort to severe myelopathy due to compression of the spinal cord and nerve roots [ 23 , 24 ]. OPLL occurs 70% of the time in the cervical spine, 15% in the thoracic spine, and 15% in the lumbar spine [ 25 ].…”