Progression Analysis of Ossification and Bone Metabolism in Patients with Cervical Ossification of the Posterior Longitudinal Ligament

DOI
  • Katsumi Keiichi
    Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital
  • Watanabe Kei
    Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital
  • Hirano Toru
    Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital
  • Ohashi Masayuki
    Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital
  • Yamazaki Akiyoshi
    Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital
  • Mizouchi Tatsuki
    Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital
  • Ishikawa Yuya
    Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital
  • Sato Masayuki
    Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital
  • Izumi Tomohiro
    Department of Orthopaedic Surgery, Niigata Minami Hospital
  • Kawashima Hiroyuki
    Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital

Bibliographic Information

Other Title
  • 頚椎後縦靭帯骨化症の骨化進展と骨代謝動態の解析

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Abstract

<p>Introduction: In the previous study, we established a method for three-dimensional analysis of computed tomography (CT) of cervical ossification of the posterior longitudinal ligament (OPLL) to identify the risk factors for the progression of ossification. The aim of this study was to establish biomarkers predicting progression of ossification by considering bone metabolism.</p><p>Methods: In this study, 44 OPLL patients, who underwent imaging examinations and bone metabolism tests in our hospital or related facilities, were included. The subjects consisted of 26 men and 18 women with the mean age of 61 years.</p><p>Bone metabolism was measured using complete blood count, biochemical parameters, electrolyte, 25-hydroxyvitamin D (25OHD), intact parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), procollagen type 1 amino-terminal propeptide (P1NP), tartrate-resistant acid phosphatase 5b (TRACP-5b), sclerostin and Dickkopf-related protein 1 (Dkk-1), and bone mineral density. Progression of ossification was measured using the three-dimensional analysis of the volume of ossification to calculate the annual rate of increase. Based on the previous findings of the annual rate of increase (7.5%/year) in patients with cervical OPLL after laminoplasty, in the present study, the progression group (P group) was defined as those with an annual rate of increase of ≥8%, whereas the nonprogression group (N group) was defined as those with an annual rate of increase of <8%. Univariate and multivariate analyses were used to identify related factors.</p><p>Results: The mean annual rate of increase was 5.0% per year. Univariate analysis identified age (P group, 50.0 years; N group, 63.9 years), BMI (P group, 30.4 kg/m2; N group, 24.8 kg/m2), serum phosphorus level (P group, 2.7 mg/dL; N group, 3.1 mg/dL), and TRACP-5b level (P group, 303.6 mU/dL; N group, 468.3 mU/dL) as significant factors (all, p < 0.05), whereas multivariate analysis identified age as the only significant factor (p < 0.05).</p><p>Conclusions: In our previous studies, younger age and obesity were identified as significant risk factors for progression of ossification. Hence, the present study's results are consistent with our previous findings. In addition, univariate analysis also identified serum phosphorus and TRACP-5b as related factors. Both factors are closely related to bone metabolism and easy to measure. Future studies are required to evaluate the factors as possible biomarkers for the progression of OPLL ossification.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 12 (9), 1167-1173, 2021-09-20

    The Japanese Society for Spine Surgery and Related Research

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