RF90#220
Rapid Fire
Association of Dyslipidemia with the Development of Symptomatic Ossification of the Posterior Longitudinal Ligament
Shotaro Fukada1,2,3, Tsutomu Endo2, Yoshinao Koike2,3, Kota Suda3, Hiroaki Sakai3, Miki Komatsu3, Yuki Takeuchi3, Naoya Okada3, Yoshiki Shirai3, Masahiro Kanayama1, Norimasa Iwasaki2, 1. Spine Center, Hakodate Central General Hospital, Japan, 2. Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Japan, 3. Hokkaido Spinal Cord Injury Center, Japan
Background: Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease characterized by ectopic bone formation in the spinal ligament, causing spinal canal stenosis and severe myelopathy. OPLL is the major cause of myelopathy in middle-aged to older populations in East Asia and predominantly affects the cervical spine, but the details of the factors involved in OPLL remain unclear. Recently, it has been suggested that metabolic abnormalities, including obesity and visceral fat, are closely associated with OPLL, but the prevalence of dyslipidemia in OPLL patients is not known.
Objective: To clarify the association between dyslipidemia and the development of symptomatic OPLL. Methods The study included 92 patients with symptomatic OPLL and 246 control subjects without spinal ligament ossification, based on CT scans. They were also classified by dyslipidemia status according to Japanese guidelines. Clinical data and fasting blood tests were compared, and risk factors for OPLL were analyzed using multivariate logistic regression.
Results: Dyslipidemia prevalence was 35.4% in the non-ossified group, 71.7% in OPLL group. The proportion of OPLL was significantly higher in the dyslipidemia (+) group (P < 0.001). The mean body mass index (BMI) of the OPLL group was significantly higher than that of the control group (27.2 kg/m2 and 23.0 kg/m2). Multivariate logistic regression analysis revealed that dyslipidemia was associated with the development of OPLL (regression coefficient, 0.80; 95% confidence interval, 0.11−1.50). Additional risk factors included age, BMI, and diabetes mellitus.
Conclusion: Dyslipidemia is highly prevalent in symptomatic OPLL patients and may contribute to its development. We demonstrated a novel association between dyslipidemia and symptomatic OPLL development using serum data. This suggests that visceral fat obesity or abnormal lipid metabolism are associated with the mechanisms of onset and exacerbation of OPLL as well as focal mechanical irritation due to being overweight. Further research is needed to clarify the causal relationship between lipid metabolism and ectopic ligament ossification.