Prevalence, Distribution, and Morphology of Thoracic Ossification of the Yellow Ligament in Japanese

Mori, Kanji; Kasahara, Toshiyuki; Mimura, Tomohiro; Nishizawa, Kazuya; Murakami, Yoshitaka; Matsusue, Yoshitaka; Imai, Shunsuke

doi:10.1097/brs.0b013e31829e018b

Cited by 86 publications

(90 citation statements)

References 24 publications

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“…We also found that the prevalence of OLF in men was higher than in women at most segments, which was in line with most of the literature. 12,15,18,36 This finding may be due to heavier physical activity in men, which causes heavier stress on the ligamentum flavum. However, in some studies, the prevalence rates were reported to be higher in women than in men.…”

Section: Discussionmentioning

confidence: 91%

“…Thus, when the ligamentum flavum is replaced by a mature bone, its osseous morphology should be V-shaped or a part of V shape on CT images. 12 Although thoracic OLF has been reported in several Asian countries, such as Japan, [11][12][13][14] China 3,4,[15][16][17][18][19] and South Korea, [20][21][22] and also in Caucasian and Caribbean ethnic groups, [23][24][25][26][27][28] extensive studies on thoracic OLF including a large number of patients have not yet been reported in the literature. This is partly due to the relatively low mean prevalence of thoracic OLF, which was reported as 3.8% in China and as 6.2% for Japanese men and 4.8% for Japanese women.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum: a retrospective analysis of 85 cases

Ren

Zhao

et al. 2015

Spinal Cord

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Study design: A retrospective comparative study. Objectives: To describe the clinical features and radiological findings, to assess the safety and effectiveness of posterior decompressive laminectomy and resection of the ossification of the ligamentum flavum (OLF), and to determine which presurgical and surgical variables were most closely related to postsurgical prognosis of thoracic myelopathy (TM) caused by OLF in China. Methods: Eighty-five patients with the diagnosis of TM caused by OLF received surgical treatment from July 1998 to May 2012. Clinical data were collected from medical and operative records. Correlations between the surgical outcome and various factors were also analyzed. Results: All cases were followed up for a mean of 49.2 months (range, 24-190 months) postoperatively. The mean Japanese Orthopaedic Association score was 3.8 points preoperatively and 8.2 points at the final follow-up, yielding a mean recovery rate of 63.0%. Postoperative complications included transient neurological deficits (9 cases), persistent neurological deficits (4 cases), dural tears (17 cases), cerebrospinal fluid leakage (9 cases), wound dehiscence (2 cases) and wound infection (3 cases). The OLF level (middle thoracic), preoperative duration of symptoms, intramedullary signal change on T2WI and preoperative severity of myelopathy were important predictors of surgical outcome. Conclusions: Biomechanical and anatomical factors may have a key role in thoracic OLF progression. Posterior decompressive laminectomy and resection of the OLF can be considered an effective, reliable and safe alternative procedure. The OLF level, preoperative duration of symptoms, intramedullary signal change on T2WI and preoperative severity of myelopathy were confirmed and significantly correlated with the surgical outcome.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum: a retrospective analysis of 85 cases

Ren

Zhao

et al. 2015

Spinal Cord

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“…Our findings are those of symptomatic cervical OPLL patients only and cannot be generalized to the general population. Although CT allows more precise evaluation of the ossification of spinal ligaments compared to radiography [20, 21], much higher radiation dose of CT makes it ethically impossible to perform an observational epidemiological population study using CT scan. In addition, we [13, 20, 21] and others [22] have reported that patients with symptomatic cervical OPLL frequently had tandem ossifications at the thoracolumbar region, which sometimes required additional surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Although CT allows more precise evaluation of the ossification of spinal ligaments compared to radiography [20, 21], much higher radiation dose of CT makes it ethically impossible to perform an observational epidemiological population study using CT scan. In addition, we [13, 20, 21] and others [22] have reported that patients with symptomatic cervical OPLL frequently had tandem ossifications at the thoracolumbar region, which sometimes required additional surgeries. It is therefore important to evaluate the whole spine so as not to overlook the latent risk of tandem ossifications in the thoracolumbar region when we treat patients with cervical OPLL [13, 20–22].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: a CT-based multicenter cross-sectional study

Mori

Yoshii

Hirai

et al. 2016

BMC Musculoskelet Disord

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BackgroundSupra/interspinous ligaments connect adjacent spinous processes and act as a stabilizer of the spine. As with other spinal ligaments, it can become ossified. However, few report have discussed ossification supra/interspinous ligaments (OSIL), so its epidemiology remains unknown. We therefore aimed to investigate the prevalence and distribution of OSIL in symptomatic patients with cervical ossification of the posterior longitudinal ligament (OPLL).MethodsThe participants of our study were symptomatic patients with cervical OPLL who were diagnosed by standard radiographs of the cervical spine. The whole spine CT data as well as clinical parameters such as age and sex were obtained from 20 institutions belong to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL). The prevalence and distribution of OSIL and the association between OSIL and clinical parameters were reviewed. The sum of the levels involved by OPLL (OP-index) and OSIL (OSI-index) as well as the prevalence of ossification of the nuchal ligament (ONL) were also investigated.ResultsA total of 234 patients with a mean age of 65 years was recruited. The CT-based evidence of OSIL was noted in 68 (54 males and 14 females) patients (29%). The distribution of OSIL showed a significant thoracic preponderance. In OSIL-positive patients, single-level involvement was noted in 19 cases (28%), whereas 49 cases (72%) presented multi-level involvement. We found a significant positive correlation between the OP-index grade and OSI-index. ONL was noted at a significantly higher rate in OSIL-positive patients compared to negative patients.ConclusionsThe prevalence of OSIL in symptomatic patients with cervical OPLL was 29%. The distribution of OSIL showed a significant thoracic preponderance.

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“…In general, progressive transverse myeloplegia is a symptom of compressive myelopathy due to OLF [1]. In addition to pyramidal tract disorders, problems in the posterior funiculus have often been reported to occur due to compression of the posterior side of the spinal cord [2].…”

Section: Discussionmentioning

confidence: 99%

Four Cases of Thoracic Ossification of the Ligamentum Flavum with Acute Progressive Myelopathy

Hisatsugu¹,

Yokokura²

2017

J Clin Exp Orthop

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Background: Spinal cord paralysis symptoms due to ossification of the ligamentum flavum (OLF) often proceed slowly, and few reports have described acute progression of paralysis without any clear trauma that resulted in difficulty in walking. Here, we report 4 cases of thoracic OLF in which the patients had acute progression of myelopathy, and all had good recovery of paralysis after early decompressive surgery.

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Prevalence, Distribution, and Morphology of Thoracic Ossification of the Yellow Ligament in Japanese

Abstract: The prevalence of thoracic OYL in Japanese was 36%. A further study disclosing the association between clinical manifestations and size and/or morphology of OYL is warranted.

Cited by 86 publications

References 24 publications

Clinical characteristics and surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum: a retrospective analysis of 85 cases

Clinical characteristics and surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum: a retrospective analysis of 85 cases

Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: a CT-based multicenter cross-sectional study

Four Cases of Thoracic Ossification of the Ligamentum Flavum with Acute Progressive Myelopathy

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