Obesity and calcification of the ligaments of the spine: a comprehensive CT analysis of the entire spine in a random trauma population

Chaput, Christopher D.; Siddiqui, Mehdi; Rahm, Mark

doi:10.1016/j.spinee.2019.03.003

Cited by 36 publications

(25 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Histopathologically, it has been proposed that HLF and OLF, in its essence, are the process of fibrosis and endochondral osteogenesis of ligamentum fibroblasts under numerous external stimuli (Yayama et al, 2007;Sun et al, 2020). Extensive evidence has shown that genetic background (Hou et al, 2014;, mechanical stress (Hayashi et al, 2017;Shunzhi et al, 2017), aging and gender (Safak et al, 2010;Moon et al, 2015;Kim et al, 2018), endocrine and metabolic abnormalities (Dario et al, 2015;Shemesh et al, 2018;Chaput et al, 2019), local inflammation, and angiogenesis (Zhang K. et al, 2017;Sun et al, 2018;Yang et al, 2018a;Jezek et al, 2020) are potential predisposing factors in the development of HLF/OLF. In addition, intrinsic alterations in multiple cellular activities, growth factors, and molecular mediators have been implicated in this intricate process (Chao et al, 2016;Qu et al, 2016a;Sidon et al, 2019;Ye et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Dysregulation of MicroRNAs in Hypertrophy and Ossification of Ligamentum Flavum: New Advances, Challenges, and Potential Directions

et al. 2021

View full text Add to dashboard Cite

Pathological changes in the ligamentum flavum (LF) can be defined as a process of chronic progressive aberrations in the nature and structure of ligamentous tissues characterized by increased thickness, reduced elasticity, local calcification, or aggravated ossification, which may cause severe myelopathy, radiculopathy, or both. Hypertrophy of ligamentum flavum (HLF) and ossification of ligamentum flavum (OLF) are clinically common entities. Though accumulated evidence has indicated both genetic and environmental factors could contribute to the initiation and progression of HLF/OLF, the definite pathogenesis remains fully unclear. MicroRNAs (miRNAs), one of the important epigenetic modifications, are short single-stranded RNA molecules that regulate protein-coding gene expression at posttranscriptional level, which can disclose the mechanism underlying diseases, identify valuable biomarkers, and explore potential therapeutic targets. Considering that miRNAs play a central role in regulating gene expression, we summarized current studies from the point of view of miRNA-related molecular regulation networks in HLF/OLF. Exploratory studies revealed a variety of miRNA expression profiles and identified a battery of upregulated and downregulated miRNAs in OLF/HLF patients through microarray datasets or transcriptome sequencing. Experimental studies validated the roles of specific miRNAs (e.g., miR-132-3p, miR-199b-5p in OLF, miR-155, and miR-21 in HLF) in regulating fibrosis or osteogenesis differentiation of LF cells and related target genes or molecular signaling pathways. Finally, we discussed the perspectives and challenges of miRNA-based molecular mechanism, diagnostic biomarkers, and therapeutic targets of HLF/OLF.

show abstract

Section: Introductionmentioning

confidence: 99%

Dysregulation of MicroRNAs in Hypertrophy and Ossification of Ligamentum Flavum: New Advances, Challenges, and Potential Directions

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Obesity is one of characteristics of DISH. Recently, Chaput et al30 conducted CT-based survey of 214 trauma patients who were under 50 years of age and revealed that ossification of the anterior longitudinal ligament was associated with increased adiposity. Further, they suggested that obesity may play a more important role in spinal ossification than in age-related degeneration.…”

mentioning

confidence: 99%

Metabolic Syndrome is a Predisposing Factor for Diffuse Idiopathic Skeletal Hyperostosis

Okada

Ishihara²,

Azuma

et al. 2021

Neurospine

View full text Add to dashboard Cite

Objective Diffuse idiopathic skeletal hyperostosis (DISH) causes spinal ankylosis, which can result in patients suffering specific spinal fractures that lead to a reduction in the activities of daily life in older patients. Currently, DISH is associated with diabetes mellitus and cardiovascular disease; however, the association between DISH and metabolic syndrome has not been established. The purpose of this study was to investigate a potential association between DISH and metabolic syndrome. Methods We retrospectively reviewed clinical data from consecutive subjects undergoing the musculoskeletal health medical checkups, and enrolled 327 subjects (174 men and 153 women; mean, 63.4 ± 13.7-years). Subjects who had spinal ankylosis at least 4 contiguous vertebral bodies were classified as the DISH group (n = 39) while the others were part of the non-DISH group (n = 288). The definition of the metabolic syndrome comes from diagnostic criteria used by the Japanese Society for Internal Medicine. Age, sex, body max index (BMI), hematological evaluation, blood pressure, presence of metabolic syndrome, the visceral fat area on abdominal computed tomography, and spinal epidural lipomatosis (SEL) on magnetic resonance imaging were evaluated. Results Compared to the non-DISH group, in the DISH group, mean age (DISH group, 74.3 years; non-DISH group, 1.9 years; p < 0.001), male prevalence were higher (DISH group, 82.1%; non-DISH group, 49.3%; p < 0.001), and BMI was greater (DISH group, 24.8; non-DISH group, 23.0; p = 0.006). the metabolic syndrome was more frequently observed in DISH group (28.9%) than in the non-DISH group (16.0%) (p = 0.045). The visceral fat area was significantly larger in the DISH group than in the non-DISH group (DISH group, 130.7 ± 58.2 cm 2 ; Non-DISH group, 89.0 ± 48.1 cm 2 ; p < 0.001). The prevalence of SEL was similar between the 2 groups (10.3% in the DISH group vs. 8.7% in the nonDISH group; p = 0.464). Poisson regression analysis revealed that the metabolic syndrome was significantly associated with DISH with odds ratio of 2.0 (95% confidence interval, 1.0–3.7; p = 0.004). Conclusion Metabolic syndrome was significantly associated with DISH. Our data showed metabolic syndrome is potentially related to DISH.

show abstract

“…Interestingly, we found three cases with idiopathic hypercalcemia or skeletal fluorosis presenting continuous long-segment ossification, which revealed hypercalcemia and skeletal fluorosis might contribute to the development of diffuse ossification. [30][31][32] Moreover, previous studies found diabetes mellitus, hyperinsulinism, obesity, hemochromatosis, X-linked hypophosphatemia, and hypoparathyroidism were associated with the spinal ligament ossification, [33][34][35][36] so clinicians should pay more attention to these metabolism-related factors.…”

Section: Discussionmentioning

confidence: 99%

Cervical Ossification of Ligamentum Flavum: Elaborating an Underappreciated but Occasional Contributor to Myeloradiculopathy in Aging Population Based on Synthesis of Individual Participant Data

Zhang¹,

Chen²,

Chen³

et al. 2021

CIA

View full text Add to dashboard Cite

Purpose: Cervical ossification of ligamentum flavum (COLF) is a rare clinical entity which can occasionally contribute to severe myeloradiculopathy. Many orthopedists are unfamiliar with or underestimate this pathology. Therefore, a comprehensive research is obligatory to reappraise the epidemiological, radiological, clinical and histopathological characteristics of COLF-myeloradiculopathy based on synthesis of individual patient data. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, EMBASE, Scopus and Web of Science databases were searched for studies discussing COLF-myeloradiculopathy from the inception to December 2020. Results: A total of 94 cases from 54 studies were identified. The annual publications demonstrated a steady increase, and most reports were from Japan and China. The mean age was 58.76±13.39 years and nearly 60% of cases occurred in the 55-64 and 65-74 years age group. The male-female ratio was 1.4:1. Most cases belonged to East Asian population (60.64%). COLF predominately appeared in the lower cervical and cervicothoracic spine (76.60%) and mainly affected C4-5 (23.29%) and C5-6 (21.23%). Single-segment type ossification accounted for 62.76 and 45.45% of ossification lesions distributed bilaterally. The majority of COLF (81.1%) were spontaneous, and motor disturbance (76.4%), spinal ataxia (62.5%) and sensory disturbance (58.9%) were the most common manifestations. Histopathologically, it's a metaplastic process of endochondral ossification with the formation of mature lamellar bone which was distinguished from calcification of ligamentum flavum. About 21.28% of concurrent COLF and COPLL cases were identified as a separated group, with unique characteristics. Conclusion: COLF is an underappreciated but potentially growing pathogeny of myeloradiculopathy in aging population, though its distinct epidemiological, radiological, clinical and histopathological features are not fully supported by current evidence. However, our findings will provide several referential data for future researches to shed light on COLF.

show abstract

Obesity and calcification of the ligaments of the spine: a comprehensive CT analysis of the entire spine in a random trauma population

Cited by 36 publications

References 41 publications

Dysregulation of MicroRNAs in Hypertrophy and Ossification of Ligamentum Flavum: New Advances, Challenges, and Potential Directions

Dysregulation of MicroRNAs in Hypertrophy and Ossification of Ligamentum Flavum: New Advances, Challenges, and Potential Directions

Metabolic Syndrome is a Predisposing Factor for Diffuse Idiopathic Skeletal Hyperostosis

Cervical Ossification of Ligamentum Flavum: Elaborating an Underappreciated but Occasional Contributor to Myeloradiculopathy in Aging Population Based on Synthesis of Individual Participant Data

Contact Info

Product

Resources

About