Scholarlink

Purpose <p>Patients with ossification of the posterior longitudinal ligament (OPLL) may require lumbar surgery due to ossified lesions and degenerative changes. However, risk stratification for lumbar intervention remains underexplored. We aimed to identify predictors of lumbar surgery in patients with OPLL.</p> Methods <p>We retrospectively analyzed 178 OPLL patients who underwent whole-spine computed tomography (CT) (2007–2023). Patients were classified according to whether they underwent lumbar surgery. CT obtained prior to lumbar surgery or during conservative follow-up was reviewed. Imaging parameters, including ossification distribution and degenerative changes, were compared between groups and analyzed using multivariable logistic regression to identify independent predictors.</p> Results <p>Lumbar surgery was performed in 70 (39.3%) patients. The surgery group exhibited higher body mass index and greater prevalence of thoracolumbar ankylosis, thoracic and lumbar OPLL, lumbar ossification of the ligamentum flavum (OLF), and intervertebral disc (IVD) gas. Multivariable analysis identified lumbar OLF (OR, 6.49; 95% CI, 2.60–16.25) and lumbar IVD gas (OR, 5.75; 95% CI, 2.37–13.97) as independent risk factors. Coexisting OPLL and OLF at the same level was associated with younger surgical age and greater neurological severity.</p> Conclusions <p>Using whole-spine CT, we demonstrated that patients requiring lumbar surgery frequently exhibited a diffuse whole-spine ossification phenotype, characterized by thoracolumbar OPLL and ankylosis. Lumbar OLF and IVD gas were identified as independent risk factors; notably, lumbar OLF reflects this generalized ossification tendency, whereas disc gas indicates mechanical stress and degeneration. These findings support whole-spine CT–based risk stratification and longitudinal monitoring in patients with OPLL.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Whole-spine CT predictors of lumbar surgery in patients with ossification of the posterior longitudinal ligament

  • 期刊论文

  • 发表日期：

    2026年7月13日

查看全文
  • Yoshinao Koike,
  • Tsutomu Endo,
  • Yukitoshi Shimamura,
  • Masahiro Kanayama,
  • Ryo Fujita,
  • Yuichi Hasegawa,
  • Shotaro Fukada,
  • Masahiko Takahata,
  • Ken Kadoya,
  • Hideki Sudo,
  • Katsuhisa Yamada,
  • M Alaa Terkawi,
  • Huohuo Xue,
  • Misaki Ishii,
  • Norimasa Iwasaki

摘要

Purpose

Patients with ossification of the posterior longitudinal ligament (OPLL) may require lumbar surgery due to ossified lesions and degenerative changes. However, risk stratification for lumbar intervention remains underexplored. We aimed to identify predictors of lumbar surgery in patients with OPLL.

Methods

We retrospectively analyzed 178 OPLL patients who underwent whole-spine computed tomography (CT) (2007–2023). Patients were classified according to whether they underwent lumbar surgery. CT obtained prior to lumbar surgery or during conservative follow-up was reviewed. Imaging parameters, including ossification distribution and degenerative changes, were compared between groups and analyzed using multivariable logistic regression to identify independent predictors.

Results

Lumbar surgery was performed in 70 (39.3%) patients. The surgery group exhibited higher body mass index and greater prevalence of thoracolumbar ankylosis, thoracic and lumbar OPLL, lumbar ossification of the ligamentum flavum (OLF), and intervertebral disc (IVD) gas. Multivariable analysis identified lumbar OLF (OR, 6.49; 95% CI, 2.60–16.25) and lumbar IVD gas (OR, 5.75; 95% CI, 2.37–13.97) as independent risk factors. Coexisting OPLL and OLF at the same level was associated with younger surgical age and greater neurological severity.

Conclusions

Using whole-spine CT, we demonstrated that patients requiring lumbar surgery frequently exhibited a diffuse whole-spine ossification phenotype, characterized by thoracolumbar OPLL and ankylosis. Lumbar OLF and IVD gas were identified as independent risk factors; notably, lumbar OLF reflects this generalized ossification tendency, whereas disc gas indicates mechanical stress and degeneration. These findings support whole-spine CT–based risk stratification and longitudinal monitoring in patients with OPLL.