Risk Management and Healthcare Policy (May 2022)
Clinical Risk Factors for Thoracic Ossification of the Ligamentum Flavum: A Cross-Sectional Study Based on Spinal Thoracic Three-Dimensional Computerized Tomography
Abstract
Hao Zhang,1,* Nian Deng,2,* Lu Zhang,3 Lei Zhang,4 Chao Wang1 1Department of Spine Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 2Department of Orthopaedics, The Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), Qingdao, People’s Republic of China; 3Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 4Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University, Jinan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chao Wang, Department of Spine Surgery, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao, 266000, People’s Republic of China, Email [email protected] Lei Zhang, Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 266000, People’s Republic of China, Email [email protected]: Inconsistent results of the clinical risk factors associated with thoracic ossification of the ligamentum flavum (TOLF) have been reported in limited previous studies.Purpose: This retrospective study aimed to investigate the potential risk factors for TOLF by a retrospective cross-sectional study, which may provide valuable experience for further clinical and pathophysiological research.Methods: A total of 2247 asymptomatic participants, who underwent spinal thoracic three-dimensional computerized tomography (3D-CT) scans at our institution from January 2016 to December 2019, were enrolled in this study according to the screening criteria. Demographic information such as age, sex, height, weight, body mass index (BMI), smoking and drinking history, diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) were recorded. Laboratory results included serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), uric acid (UA), creatinine (Cr), calcium, and phosphorus. Participants were divided into TOLF group and non-TOLF group in accordance with the thoracic 3D-CT manifestation.Results: TOLF was observed in 153 (6.81%) asymptomatic participants. Comparison of demographic data and laboratory examinations between the two groups showed that participants in the TOLF group were older, had a higher BMI, as well as higher levels of DBP. In addition, there was no significant difference in sex, drinking, tobacco use, SBP, TC, TG, PP, and levels of LDL-C, HDL-C, sUA, sCr, calcium, and phosphorus between the two groups. Furthermore, dichotomous logistic regression analyses revealed that age (OR = 1.018, p = 0.041) and BMI (OR = 1.090, p < 0.001) were risk factors for TOLF.Conclusion: Our study reveals that age and BMI are clinical risk factors for the development of TOLF, while age cannot be identified as an independent risk factor for female in subgroup analysis.Keywords: ossification of the ligamentum flavum, risk factor, body mass index, uric acid, triglyceride
