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学科主题: 临床医学
题名:
Investigation of ossification in the posterior longitudinal ligament using micro-focus X-ray CT scanning and histological examination
作者: Fukutake, Katsunori1; Ishiwatari, Takao2; Takahashi, Hiroshi1; Tsuchiya, Kazuaki1; Okubo, Yoichiro2; Shinozaki, Minoru2; Tochigi, Naobumi2; Wakayama, Megumi2; Nemoto, Tetsuo2; Shibuya, Kazutoshi2,3; Wada, Akihito1
关键词: Ossification of the posterior longitudinal ligament ; Micro-focus X-ray CT ; Mechanisms of ossification
刊名: DIAGNOSTIC PATHOLOGY
发表日期: 2015-11-21
DOI: 10.1186/s13000-015-0440-8
卷: 10
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Pathology
研究领域[WOS]: Pathology
关键词[WOS]: BODY-MASS INDEX ; CERVICAL-SPINE ; RICKETS
英文摘要:

Background: Ossification in the posterior longitudinal ligament (PLL) correlates with changes of enthesis during the early stages of development, but this issue remains controversial, as little is known regarding the details of this process. The aim of the present study was to elucidate part of the ossification mechanism. Thus, in the present study, we observed and evaluated minute ossifications in the PLL that did not exhibit symptoms of ossification of the posterior longitudinal ligament (OPLL).

Methods: The subjects in the present study were derived from serial autopsy cases from January 2009 to December 2013 at Toho University Omori Medical Center, Japan. Minute ossifications in the PLL from autopsy subjects without any history of OPLL were screened as high-density areas using micro-focus X-ray CT, and the foci were histologically examined. Subsequently, we conducted both micro-focus X-ray CT image analysis and histological examination, and evaluated the correlation between these findings and putative predictive factors reported in previous studies.

Results: A total of 103 individuals among the 267 subjects involved in the present study were analyzed within the study period. There were no cases involving OPLL identification prior to death, and no subjects presented with neurological symptoms of myelopathy. The incidence of cases involving high-density areas greater than 0.1 mm(2) in the PLL was 46.6 %, half of which revealed mature bone structures inside this area. Thus, the high-density areas comprised three types: a continuous posterior-annular fibrosus type (23 cases), an isolated posterior-annular fibrosus type (11 cases), and a posterior-vertebral type (29 cases). However, a positive correlation was observed between the proportion of high-density areas, age (Pearson r = 0.265, p < 0.01), and HbA1c (Pearson r = 0.294, p < 0.01). Histological examination confirmed that these high-density areas involved calcification with or without mature bone formation.

Conclusions: We evaluated minute foci of calcification with and without ossification in the PLL from 103 cadavers, generating the following observations:

1. Minute calcification foci greater than 0.1 mm(2) were observed in the PLL of 48 cases (46.6 %), half of which revealed mature bone structures inside this area (23.3 %).

2. The proportion of minute calcification foci observed in the present study was correlated with age and glucose tolerance, suggesting changes in the OPLL in the early stage.

3. Three different mechanisms of ossification were suggested: The two structures developed behind the disc might reflect the elongation of enthesis or rupture of annular fibrosus, while the remaining structure developed behind the vertebral body might reflect a dystrophic calcification-based bony metaplasia sequence.

语种: 英语
项目资助者: Japan Agency for Medical Research and development, AMED
WOS记录号: WOS:000364999300001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57407
Appears in Collections:北京大学第一临床医学院_皮肤性病科_期刊论文

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作者单位: 1.Toho Univ, Sch Med, Dept Surg Pathol, Ota Ku, Tokyo 1438541, Japan
2.Toho Univ, Omori Med Ctr, Dept Orthoped Surg, Ota Ku, Tokyo 1438541, Japan
3.Peking Univ, Hosp 1, Dept Dermatol, Beijing 100871, Peoples R China

Recommended Citation:
Fukutake, Katsunori,Ishiwatari, Takao,Takahashi, Hiroshi,et al. Investigation of ossification in the posterior longitudinal ligament using micro-focus X-ray CT scanning and histological examination[J]. DIAGNOSTIC PATHOLOGY,2015,10.
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