☆ 4.7 Article

Lumbar ossification of the ligamentum flavum reflects a strong ossification tendency of the entire spinal ligament

SCIENTIFIC REPORTS (2023)

Journal

SCIENTIFIC REPORTS

Volume 13, Issue 1, Pages -

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NATURE PORTFOLIO

DOI: 10.1038/s41598-023-27650-z

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Abstract

Patients with lumbar ossification of the ligamentum flavum (OLF) may have a high risk of developing concomitant ossification of the entire spinal ligament, and the etiology is still unclear. This study investigated the propensity for spinal ligament ossification in asymptomatic individuals with lumbar OLF. The results showed that subjects with more lumbar OLF were more likely to have multilevel thoracic OLF and coexisting ossification of the posterior longitudinal ligament (OPLL).

Patients with ossification of the ligamentum flavum (OLF) in the lumbar spine may be at high risk of developing concomitant ossification of the entire spinal ligament, but the etiology remains unclear. We investigated the propensity for spinal ligament ossification in asymptomatic subjects with lumbar OLF using the data of 595 Japanese individuals receiving medical check-ups, including computed tomography (CT) scanning. The severity of OLF (total number of intervertebral segments with OLF) of the entire spine on CT was quantified using an OLF index. Subjects with OLF were grouped according to this index: localized OLF (n = 138), intermediate OLF (n = 70), and extensive OLF (n = 31). The proportion of subjects with lumbar OLF increased with increasing OLF index (localized 13.7%, intermediate 41.4%, and extensive 70.9%). Multiple regression analysis found that lumbar OLF index was associated with thoracic OLF index, and co-existence of ossification of the posterior longitudinal ligament (OPLL) of the thoracic and lumbar spine. This study showed that subjects with more multilevel lumbar OLF were more likely to develop multilevel thoracic OLF and to have coexisting OPLL. Patients with lumbar OLF may be a distinctive subgroup with a strong tendency to ossification of the entire spinal ligament.

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Ossified Ligamentum Flavum: Epidemiology, Treatment, and Outcomes

Alan H. Daniels, Christopher L. McDonald, Bryce A. Basques, Eren O. Kuris

Summary: Ossification of the ligamentum flavum (OLF) is a spinal condition that can potentially cause compression of the spinal canal and neurological damage. The exact cause is debated but is likely related to gene overexpression and signaling pathways. Progressive myelopathy is the most common symptom, and radiographic analysis can show ossification in different areas. Surgical treatment options exist but may result in complications and postoperative neurological deficits.

JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS (2022)