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 ImagamaKazuma 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

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1 Citation (Scopus)

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.

Original languageEnglish
Article number4137
JournalJournal of Clinical Medicine
Volume10
Issue number18
DOIs
Publication statusPublished - 2021 Sep

Keywords

  • Cervical spine
  • Clinical findings
  • Computed tomography
  • Diffuse idiopathic skeletal hyperostosis
  • Ossification of the posterior longitudinal ligament
  • Pain
  • Patient-reported outcomes
  • Whole spine

ASJC Scopus subject areas

  • Medicine(all)

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