Journal of Clinical Medicine (Sep 2021)
Associations between Clinical Findings and Severity of Diffuse Idiopathic Skeletal Hyperostosis in Patients with Ossification of the Posterior Longitudinal Ligament
- Takashi Hirai,
- Soraya Nishimura,
- Toshitaka Yoshii,
- Narihito Nagoshi,
- Jun Hashimoto,
- Kanji Mori,
- Satoshi Maki,
- Keiichi Katsumi,
- Kazuhiro Takeuchi,
- Shuta Ushio,
- Takeo Furuya,
- Kei Watanabe,
- Norihiro Nishida,
- Kota Watanabe,
- Takashi Kaito,
- Satoshi Kato,
- Katsuya Nagashima,
- Masao Koda,
- Hiroaki Nakashima,
- Shiro Imagama,
- Kazuma Murata,
- 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,
- Yu Matsukura,
- Hiroyuki Inose,
- Atsushi Okawa,
- Yoshiharu Kawaguchi
Affiliations
- Takashi Hirai
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Soraya Nishimura
- Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan
- Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Narihito Nagoshi
- Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan
- Jun Hashimoto
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Ōtsu 520-2192, Japan
- Satoshi Maki
- Department of Orthopedic Surgery, School of Medicine, Chiba University Graduate, Chiba 260-0856, Japan
- Keiichi Katsumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata 951-8520, Japan
- Kazuhiro Takeuchi
- National Hospital Organization Okayama Medical Center, Department of Orthopedic Surgery, Okayama 701-1192, Japan
- Shuta Ushio
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Takeo Furuya
- Department of Orthopedic Surgery, School of Medicine, Chiba University Graduate, Chiba 260-0856, Japan
- Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata 951-8520, Japan
- Norihiro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Kota Watanabe
- Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan
- Takashi Kaito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
- Satoshi Kato
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-1192, Japan
- Katsuya Nagashima
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
- Masao Koda
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
- Hiroaki Nakashima
- Department of Orthopedics, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
- Shiro Imagama
- Department of Orthopedics, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
- Kazuma Murata
- Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku, Tokyo 160-8402, Japan
- Yuji Matsuoka
- Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku, Tokyo 160-8402, Japan
- Kanichiro Wada
- Department of Orthopaedic Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
- Atsushi Kimura
- Department of Orthopedics, Jichi Medical University, Shimotsuke 329-0498, Japan
- Tetsuro Ohba
- Department of Orthopedic Surgery, University of Yamanashi, Chuo 409-3898, Japan
- Hiroyuki Katoh
- Department of Orthopedic Surgery, Surgical Science, School of Medicine, Tokai University, Isehara 259-1193, Japan
- Masahiko Watanabe
- Department of Orthopedic Surgery, Surgical Science, School of Medicine, Tokai University, Isehara 259-1193, Japan
- Yukihiro Matsuyama
- Department of Orthopedic Surgery, School of Medicine, Hamamatsu University, Hamamatsu 431-3125, Japan
- Hiroshi Ozawa
- Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Japan
- Hirotaka Haro
- Department of Orthopedic Surgery, University of Yamanashi, Chuo 409-3898, Japan
- Katsushi Takeshita
- Department of Orthopedics, Jichi Medical University, Shimotsuke 329-0498, Japan
- Morio Matsumoto
- Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan
- Masaya Nakamura
- Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan
- Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
- Yu Matsukura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Hiroyuki Inose
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan
- Yoshiharu Kawaguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan
- DOI
- https://doi.org/10.3390/jcm10184137
- Journal volume & issue
-
Vol. 10,
no. 18
p. 4137
Abstract
Background: This study investigated how diffuse idiopathic skeletal hyperostosis (DISH) influences clinical characteristics in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Although DISH is considered unlikely to promote neurologic dysfunction, this relationship remains unclear. Methods: Patient data were prospectively collected from 16 Japanese institutions. In total, 239 patients with cervical OPLL were enrolled who had whole-spine computed tomography images available. The primary outcomes were visual analog scale pain scores and the results of other self-reported clinical questionnaires. Correlations were sought between clinical symptoms and DISH using the following grading system: 1, DISH at T3-T10; 2, DISH at both T3–10 and C6–T2 and/or T11–L2; and 3, DISH beyond the C5 and/or L3 levels. Results: DISH was absent in 132 cases, grade 1 in 23, grade 2 in 65, and grade 3 in 19. There were no significant correlations between DISH grade and clinical scores. However, there was a significant difference in the prevalence of neck pain (but not in back pain or low back pain) among the three grades. Interestingly, DISH localized in the thoracic spine (grade 1) may create overload at the cervical spine and lead to neck pain in patients with cervical OPLL. Conclusion: This study is the first prospective multicenter cross-sectional comparison of subjective outcomes in patients with cervical OPLL according to the presence or absence of DISH. The severity of DISH was partially associated with the prevalence of neck pain.
Keywords
- cervical spine
- clinical findings
- computed tomography
- diffuse idiopathic skeletal hyperostosis
- ossification of the posterior longitudinal ligament
- pain
