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Prevalence and progression of radiographic ossification of the posterior longitudinal ligament and associated factors in the Japanese population: a 3-year follow-up of the ROAD study

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Abstract

Summary

The prevalence of radiographic cervical ossification of the posterior longitudinal ligament (OPLL) in 1,562 Japanese from a population-based cohort was 1.9 %. The presence of OPLL showed a significant association with the femoral neck bone mineral density (BMD), presence of diffuse idiopathic skeletal hyperostosis (DISH) and plasma pentosidine levels. Only one new case of radiographic OPLL was detected, but OPLL progressed in all affected subjects.

Introduction

The purpose of this study was to clarify the prevalence and progression of radiographic OPLL and the associated factors, using the population-based cohort Research on Osteoarthritis/osteoporosis Against Disability (ROAD).

Methods

In the ROAD study, 1,690 participants underwent X-ray examination of the entire spine and both knees. Radiographic OPLL, lumbar spondylosis, knee osteoarthritis and DISH were diagnosed by a single, well-experienced orthopaedic surgeon. An interviewer-administered questionnaire and tests for anthropometric measurements were administered, and the BMDs of the lumbar spine and proximal femur were determined. A new OPLL case was considered if heterotopic ossification in the posterior longitudinal ligament was absent at baseline but present during follow-up. Progression was defined as an increase in the maximum length or width of the ossification at follow-up over that at baseline.

Results

Radiographic OPLL was detected in 30 (17 men, 13 women) of 1,562 individuals who underwent X-ray examination of the cervical spine (prevalence = 1.9 %). Its prevalence was significantly higher in men than in women (p = 0.007), but no association with age was observed. In a logistic regression analysis, OPLL showed a significant association with the femoral neck BMD, presence of DISH and plasma pentosidine levels. Only one new case of radiographic OPLL was detected, but OPLL progressed in all affected subjects.

Conclusion

This population-based study clarified the prevalence of radiographic OPLL in the Japanese population as well as its progression. OPLL showed significant association with plasma pentosidine levels, BMD and DISH.

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Acknowledgments

This work was supported by Grants-in-Aid for Scientific Research B23390172 and B20390182 to NY, C20591737 to TA and C20591774 to SM; grants for Young Scientists A18689031 to HO; Collaborating Research with NSF 08033011-00262 (Director, NY) from the Ministry of Education, Culture, Sports, Science and Technology and H17-Men-eki-009 (Director, KN), H18-Choujyu-037 (Director, TN), H20-Choujyu-009 (Director, NY), H23-Choujyu-002 (Director, TA), H23-Nanchi-Ippan-032 (Director, YT) and H25-Choujyu-007 (Director, NY) from the Ministry of Health, Labour and Welfare in Japan. This study was also supported by grants from the Japan Osteoporosis Society (NY, SM, HO and TA) and research aid from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006-1 and 2010-2, Director, HK). The authors wish to thank Dr. Takako Nojiri and Mr. Kazuhiro Hatanaka from the Gobo Public Health Centre; Dr. Naoki Hirabayashi of the Kawakami Clinic, Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Kumiko Shinou, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, Ms. Ikuyo Ueyama, Mrs. Michiko Mori, Mrs. Hisayo Sugimoto and other members of the public office in Hidakagawa Town; Dr. Shinji Matsuda of the Shingu Public Health Centre and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mr. Shoichi Shimoichi, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji and other members of the public office in Taiji Town for their assistance in locating and scheduling participants for examinations. We also thank Ms. Kyoko Yoshimura, Mrs. Toki Sakurai and Mrs. Saeko Sahara for their assistance with data reduction and administration.

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Authors and Affiliations

  1. Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    N. Yoshimura & H. Oka

  2. Department of Orthopedic Surgery, Wakayama Medical University, 811-1 Kimidera, Wakayama, Wakayama, 641-8509, Japan

    K. Nagata, M. Yoshida, Y. Enyo, R. Kagotani, H. Hashizume, H. Yamada, Y. Ishimoto & M. Teraguchi

  3. Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    S. Muraki & T. Akune

  4. Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    S. Tanaka & H. Kawaguchi

  5. Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Y. Toyama

  6. National Rehabilitation Center for Persons with Disabilities, 1, Namiki 4-chome, Tokorozawa, Saitama, 359-8555, Japan

    K. Nakamura

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  1. N. Yoshimura
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Correspondence to N. Yoshimura.

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Yoshimura, N., Nagata, K., Muraki, S. et al. Prevalence and progression of radiographic ossification of the posterior longitudinal ligament and associated factors in the Japanese population: a 3-year follow-up of the ROAD study. Osteoporos Int 25, 1089–1098 (2014). https://doi.org/10.1007/s00198-013-2489-0

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