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Hesni S, Baxter D, Saifuddin A. The imaging of cervical spondylotic myeloradiculopathy. Skeletal Radiol 2023; 52:2341-2365. [PMID: 37071191 DOI: 10.1007/s00256-023-04329-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/12/2023] [Accepted: 03/20/2023] [Indexed: 04/19/2023]
Abstract
This review provides a detailed description of the imaging features of cervical spondylotic myelopathy and radiculopathy, with a focus on MRI. Where relevant, we will outline grading systems of vertebral central canal and foraminal stenosis. Whilst post-operative appearances of the cervical spine are outside the scope of this paper, we will touch on imaging features recognised as predictors of clinical outcome and neurological recovery. This paper will serve as a reference for both radiologists and clinicians involved in the care of patients with cervical spondylotic myeloradiculopathy.
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Affiliation(s)
- Susan Hesni
- Department of Radiology, Royal National Orthopaedic Hospital (RNOH), Stanmore, UK.
| | - David Baxter
- Department of Surgery, Royal National Orthopaedic Hospital (RNOH), Stanmore, UK
| | - Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital (RNOH), Stanmore, UK
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Park J, Cho YE, Kim KH, Shin S, Kim S, Lim CH, Chung SY, Park YG. Correlation Between the Severity of Multifidus Fatty Degeneration and the Size of Ossification of Posterior Longitudinal Ligament at Each Spinal Level. Neurospine 2023; 20:921-930. [PMID: 37798986 PMCID: PMC10562234 DOI: 10.14245/ns.2346506.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the correlation between ossification of the posterior longitudinal ligament (OPLL) size and multifidus fatty degeneration (MFD), hypothesizing that larger OPLL sizes are associated with worse MFD. METHODS One hundred four patients with cervical OPLL who underwent surgery were screened. OPLL occupying diameter and area ratios, the severity of MFD using the Goutallier classification, and range of motion (ROM) of cervical flexion-extension (ΔCobb) were measured. Correlation analyses between OPLL size, MFD severity, and ΔCobb were conducted. MFD severity was compared for each OPLL type using one-way analysis of variance. RESULTS The final clinical data from 100 patients were analyzed. The average Goutallier grade of C2-7 significantly correlated with the average OPLL diameter and area occupying ratios, and OPLL involved vertebral level (r = 0.58, p < 0.01; r = 0.40, p < 0.01; r = 0.47, p < 0.01, respectively). The OPLL size at each cervical level significantly correlated with MFD of the same or 1-3 adjacent levels. ΔCobb angle was negatively correlated with the average Goutallier grade (r = -0.31, p < 0.01) and average OPLL occupying diameter and area ratios (r = -0.31, p < 0.01; r = -0.35, p < 0.01, respectively). Patients with continuous OPLL exhibited worse MFD than those with segmental OPLL (p < 0.01). CONCLUSION OPLL size is clinically correlated with MFD and cervical ROM. OPLL at one spinal level affects MFD at the same and 1-3 adjacent spinal levels. The worsening severity of MFD is associated with the longitudinal continuity of OPLL.
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Affiliation(s)
- Jinyoung Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Eun Cho
- Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hyun Kim
- Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sanghoon Shin
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sungjun Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chae Hwan Lim
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Young Chung
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Ghil Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Nakajima M, Koido M, Guo L, Terao C, Ikegawa S. A novel CCDC91 isoform associated with ossification of the posterior longitudinal ligament of the spine works as a non-coding RNA to regulate osteogenic genes. Am J Hum Genet 2023; 110:638-647. [PMID: 36990086 PMCID: PMC10119134 DOI: 10.1016/j.ajhg.2023.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common intractable disease that causes spinal stenosis and myelopathy. We have previously conducted genome-wide association studies for OPLL and identified 14 significant loci, but their biological implications remain mostly unclear. Here, we examined the 12p11.22 locus and identified a variant in the 5' UTR of a novel isoform of CCDC91 that was associated with OPLL. Using machine learning prediction models, we determined that higher expression of the novel CCDC91 isoform was associated with the G allele of rs35098487. The risk allele of rs35098487 showed higher affinity in the binding of nuclear proteins and transcription activity. Knockdown and overexpression of the CCDC91 isoform in mesenchymal stem cells and MG-63 cells showed paralleled expression of osteogenic genes, including RUNX2, the master transcription factor of osteogenic differentiation. The CCDC91 isoform directly interacted with MIR890, which bound to RUNX2 and decreased RUNX2 expression. Our findings suggest that the CCDC91 isoform acts as a competitive endogenous RNA by sponging MIR890 to increase RUNX2 expression.
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Affiliation(s)
- Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo 108-8639, Japan
| | - Masaru Koido
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan; Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 108-8639, Japan
| | - Long Guo
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo 108-8639, Japan; Department of Laboratory Animal Science, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an 710061, China
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan.
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo 108-8639, Japan.
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4
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Kwon WK, Ham CH, Moon HJ, Kim JH, Park YK. Radiologic risk factors associated with development of myelopathy in patients with ossification of the posterior longitudinal ligament of the cervical spine. Clin Neurol Neurosurg 2023; 227:107668. [PMID: 36924696 DOI: 10.1016/j.clineuro.2023.107668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 01/25/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
STUDY DESIGN Retrospective Cohort Study OBJECTIVE: Myelopathy following ossification of the posterior longitudinal ligament (OPLL) is one of the devastating clinical features in these patients, while we still know little about which factors are associated with development of myelopathy. We evaluated the difference of radiologic measurements between OPLL patients with or without myelopathy and searched for the clinical significance with emphasis on the impact of dynamic motion. METHODS 305 patients diagnosed of OPLL were enrolled for retrospective review. They were divided into two groups according to the coexistence of radiographic evidence of myelopathy. Demographic data as well as radiologic measures including the presence of disc degeneration (DD), anterior-posterior diameter (APD) of central canal, canal compromise (CC) ratio, global and segmental range of motion (gROM and sROM), OPLL type (morphologic classification) and K-line were collected. RESULTS APD (odds ratio (OR); 0.411), CC ratio (OR; 1.100) and sROM (OR; 1.371) were significantly associated with the presence of myelopathy in the multivariate analysis. While the statistically significant factors were same in OPLLs with CC larger than 50%, presence of DD (OR; 4.509) and sROM (OR; 1.295) were significantly associated with myelopathy but not the CC itself in OPLLs with CC smaller than 50%. CONCLUSIONS We discovered that the APD, CC ratio and sROM had significant association with development of myelopathy in OPLLs. And the presence of dynamic factors had significant association with myelopathy in OPLLs with smaller CC ratios. This observation and its clinical significance on development of myelopathy might enhance our understanding of OPLL.
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Affiliation(s)
- Woo-Keun Kwon
- Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Hwa Ham
- Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hong Joo Moon
- Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Joo Han Kim
- Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youn-Kwan Park
- Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
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Magomedov SS, Mytyga PG. [Repeated cervical laminoplasty for progressive ossification of posterior longitudinal ligament: a case report]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:90-95. [PMID: 36763559 DOI: 10.17116/neiro20238701190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Posterior longitudinal ligament ossification is a progressive disease resulting in severe multilevel spinal stenosis with myelopathy. Decompression via anterior or posterior approach is the main treatment option. Decompressive laminoplasty is currently considered the most effective and safest method. This procedure provides favorable outcomes with low trauma and short surgery time. Redo surgeries are rare and most often performed within 2 years after primary laminoplasty. The most common causes are progressive spinal stenosis following posterior longitudinal ligament ossification, insufficient primary decompression and progressive cervical spine kyphosis. Considering few data on redo laminoplasty, we present a patient with progressive ossification of posterior longitudinal ligament who underwent redo surgery at the same level in 10 years after primary laminoplasty.
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Affiliation(s)
- Sh Sh Magomedov
- Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg, Russia
| | - P G Mytyga
- Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg, Russia
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Bai X, Levental M, Karaplis AC. Burosumab Treatment for Autosomal Recessive Hypophosphatemic Rickets Type 1 (ARHR1). J Clin Endocrinol Metab 2022; 107:2777-2783. [PMID: 35896139 PMCID: PMC9516063 DOI: 10.1210/clinem/dgac433] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Autosomal recessive hypophosphatemic rickets (ARHR) are rare, heritable renal phosphate-wasting disorders that arise from overexpression of the bone-derived phosphaturic hormone fibroblast growth factor 23 (FGF23) leading to impaired bone mineralization (rickets and osteomalacia). Inactivating mutations of Dentin matrix protein 1 (DMP1) give rise to ARHR type 1 (ARHR1). Short stature, prominent bowing of the legs, fractures/pseudofractures, and severe enthesopathy are prominent in this patient population. Traditionally, treatment consists of oral phosphate replacement and the addition of calcitriol but this approach is limited by modest efficacy and potential renal and gastrointestinal side effects. OBJECTIVE The advent of burosumab (Crysvita), a fully humanized monoclonal antibody to FGF23 for the treatment of X-linked hypophosphatemia and tumor-induced osteomalacia, offers a unique opportunity to evaluate its safety and efficacy in patients with ARHR1. RESULTS Monthly administration of burosumab to 2 brothers afflicted with the disorder resulted in normalization of serum phosphate, healing of pseudofracture, diminished fatigue, less bone pain, and reduced incapacity arising from the extensive enthesopathy and soft tissue fibrosis/calcification that characterizes this disorder. No adverse effects were reported following burosumab administration. CONCLUSION The present report highlights the beneficial biochemical and clinical outcomes associated with the use of burosumab in patients with ARHR1.
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Affiliation(s)
- Xiuying Bai
- Lady Davis Institute for Medical Research, CIUSSS de Centre-Ouest-de-l’île-de-Montréal, Jewish General Hospital, McGill University, Montréal, Quebec, H3T 1E2, Canada
| | - Mark Levental
- Department of Radiology, CIUSSS de Centre-Ouest-de-l’île-de-Montréal, Jewish General Hospital, McGill University, Montréal, Quebec, H3T 1E2, Canada
| | - Andrew C Karaplis
- Correspondence: Andrew C. Karaplis, MD, PhD, Lady Davis Institute for Medical Research, 3755 Cote Steve Catherine, Montreal, QC, H3T 1E2, Canada.
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Small extracellular vesicle-mediated miR-320e transmission promotes osteogenesis in OPLL by targeting TAK1. Nat Commun 2022; 13:2467. [PMID: 35513391 PMCID: PMC9072352 DOI: 10.1038/s41467-022-29029-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/24/2022] [Indexed: 12/22/2022] Open
Abstract
Ossification of the posterior longitudinal ligament (OPLL) is an emerging spinal disease caused by heterotopic ossification of the posterior longitudinal ligament. The pathological mechanism is poorly understood, which hinders the development of nonsurgical treatments. Here, we set out to explore the function and mechanism of small extracellular vesicles (sEVs) in OPLL. Global miRNA sequencings are performed on sEVs derived from ligament cells of normal and OPLL patients, and we have showed that miR-320e is abundantly expressed in OPLL-derived sEVs compare to other sEVs. Treatment with either sEVs or miR-320e significantly promote the osteoblastic differentiation of normal longitudinal ligament cells and mesenchymal stem cells and inhibit the osteoclastic differentiation of monocytes. Through a mechanistic study, we find that TAK1 is a downstream target of miR-320e, and we further validate these findings in vivo using OPLL model mice. Together, our data demonstrate that OPLL ligament cells secrete ossification-promoting sEVs that contribute to the development of ossification through the miR-320e/TAK1 axis. The pathological mechanisms that lead to Ossification of the posterior longitudinal ligament (OPLL) are unclear. Here, the authors show that OPLL ligament cells produce small extracellular vesicles that induce ossification via miR-320e/TAK1 signaling in mice and human posterior longitudinal ligament cells.
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Lee CH, Kim KT, Kim CH, Lee EY, Lee SG, Seo ME, Kim JH, Chung CK. Unveiling the genetic variation of severe continuous/mixed-type ossification of the posterior longitudinal ligament by whole-exome sequencing and bioinformatic analysis. Spine J 2021; 21:1847-1856. [PMID: 34273568 DOI: 10.1016/j.spinee.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/16/2021] [Accepted: 07/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is known as a rare, complex genetic disease, its complexity being partly because OPLL is diagnosed by radiological findings regardless of clinical or genetic evaluations. Although many genes associated with susceptibility have been reported, the exact causative genes are still unknown. PURPOSE We performed an analysis using next-generation sequencing and including only patients with a clear involved phenotype. STUDY DESIGN/SETTING This was a case control study. PATIENT SAMPLE A total of 74 patients with severe OPLL and 26 healthy controls were included. OUTCOME MEASURES Causal single-nucleotide variant (SNV), gene-wise variant burden (GVB), and related pathway METHOD: We consecutively included the severe OPLL patients with continuous-/mixed-type and an occupying ratio of ≥ 40%, and performed whole-exome sequencing (WES) and bioinformatic analysis. Then, a validation test was performed for candidate variations. Participants were divided into 4 groups (rapidly-growing OPLL, growing rate ≥ 2.5%/y; slow-growing, < 2.5%/y; uncertain; and control). RESULTS WES was performed on samples from 74 patients with OPLL (rapidly-growing, 33 patients; slow-growing, 37; and uncertain, 4) with 26 healthy controls. Analysis of 100 participants identified a newly implicated SNV and 4candidate genes based on GVB. The GVB of CYP4B1 showed a more deleterious score in the OPLL than the control group. Comparison between the rapidly growing OPLL and control groups revealed seven newly identified SNVs. We found significant association for 2 rare missense variants; rs121502220 (odds ratio [OR] = infinite; minor allele frequency [MAF] = 0.034) in NLRP1 and rs13980628 (OR= infinite; MAF = 0.032) in SSH2. The 3 genes are associated with inflammation control and arthritis, and SSH2 and NLRP1 are also related to vitamin D modulation. CONCLUSIONS Identification of unique variants in novel genes such as CYP4B1 gene may induce the development of OPLL. In subgroup analysis, NLRP1 and SSH2 genes coding inflammation molecules may related with rapidly-growing OPLL.
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Affiliation(s)
- Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul; Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam
| | - Ki Tae Kim
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul; Department of Laboratory Medicine, Korea University Anam Hospital, Seoul
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul; Department of Neurosurgery, Seoul National University College of Medicine
| | - Eun Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine
| | - Sang Gu Lee
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Seongnam
| | - Myung-Eui Seo
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul
| | - Ju Han Kim
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital, Seoul; Department of Neurosurgery, Seoul National University College of Medicine; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, The Republic of Korea.
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Sun XF, Wang Y, Sun JC, Xu XM, Kong QJ, Chen Y, Yang HS, Liu Y, Guo YF, Shi GD, Chen XS, Chen DY, Shen Y, Hao DJ, Shen HX, Zhu QS, Yuan W, Jia LS, Shi JG. Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020. J Orthop Surg (Hong Kong) 2021; 28:2309499020975213. [PMID: 33355038 DOI: 10.1177/2309499020975213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL). METHOD Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement. RESULTS Cervical OPLL can cause various degrees of neurological symptoms, an it's thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article. CONCLUSION In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.
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Affiliation(s)
- Xiao-Fei Sun
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yuan Wang
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Jing-Chuan Sun
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Xi-Ming Xu
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Qing-Jie Kong
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yu Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Hai-Song Yang
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yang Liu
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yong-Fei Guo
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Guo-Dong Shi
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Xiong-Sheng Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - De-Yu Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yong Shen
- Department of Spine Surgery, Hebei Medical University, The Third Hospital, Shijiazhuang, China
| | - Ding-Jun Hao
- Department of Spine Surgery, Xi'an Jiaotong University and Xi'an Medical College, Xi'an Honghui Hospital, Xi 'an, China
| | - Hong-Xing Shen
- Department of Spine Surgery, Shanghai Jiaotong University, Renji Hospital, Shanghai, China
| | - Qing-San Zhu
- Department of Spine Surgery, Jilin University, The First Bethune Hospital, Changchun, China
| | - Wen Yuan
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Lian-Shun Jia
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Jian-Gang Shi
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
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Zhang B, Chen G, Gao X, Chen Z. Potential Link between Ossification of Nuchal Ligament and the Risk of Cervical Ossification of Posterior Longitudinal Ligament: Evidence and Clinical Implication from a Meta-Analysis of 8429 Participants. Orthop Surg 2021; 13:1055-1066. [PMID: 33719181 PMCID: PMC8126919 DOI: 10.1111/os.12938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/09/2020] [Accepted: 12/27/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of the present paper was to evaluate the strength and the magnitude of the association between ossification of the nuchal ligament (ONL) and the risk of cervical ossification of the posterior longitudinal ligament (COPLL) and to determine whether there is a direct association or whether COPLL is a consequence of shared risk factors. METHODS Medline, Web of Science, Cochrane Library, and Embase databases were searched for studies evaluating the association of COPLL-ONL published before July 2020. Eligible studies were selected based on certain inclusion and exclusion criteria. Two investigators independently conducted the quality assessment and extracted the data, including study designs, countries, patients' age, gender, body mass index (BMI), and the risk of COPLL between individuals with and without ONL. A meta-analysis of homogenous data, a sensitivity analysis, a publication bias assessment, and a subgroup analysis were performed using Stata 12.0 software. RESULTS A total of 10 cohort studies involving 8429 participants were incorporated into this analysis. Pooled results demonstrated a statistically significant association between the presence of ONL and the increased COPLL risk (odds ratio [OR] 3.84; 95% confidence interval [CI] 2.68-5.52, P < 0.001). Furthermore, subgroup analyses indicated that this association was independent of study design (6.36-fold in case-control studies vs 3.22-fold in cross-sectional studies), sex (6.33-fold in male-female ratio >2.5 vs 2.91-fold in male-female ratio <2.5), age (4.28-fold in age ≥55 years vs 3.45-fold in age <55 years), and BMI (3.88-fold in BMI ≥ 25 kg/m2 vs 2.43-fold in BMI < 25 kg/m2 ), which also indicated that obese, older male patients with ONL had a higher risk of OPLL. Moreover, combined two articles revealed that patients with larger-type ONL had a significantly higher risk of long-segment COPLL compared with controls (OR 1.86; 95% CI 1.41-2.47, P < 0.001). CONCLUSION This is the first meta-analysis to demonstrate a strong and steady association between ONL and higher risk of COPLL. This association was independent of sex, age, and BMI. Considering that ONL is generally asymptomatic and easily detectable on X-ray, our findings implied that ONL might serve as an early warning sign of the onset of COPLL and provide clinicians an opportunity for early detection and early intervention.
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Affiliation(s)
- Baoliang Zhang
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Guanghui Chen
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Xingshuai Gao
- Orthopaedic Department, Zhongshan Jishuitan Orthopaedic Hospital, Zhongshan, China
| | - Zhongqiang Chen
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
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Nakajima T, Ikeya M. Development of pluripotent stem cell-based human tenocytes. Dev Growth Differ 2020; 63:38-46. [PMID: 33270251 DOI: 10.1111/dgd.12702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
Human pluripotent stem cells (PSCs) are used as a platform for therapeutic purposes such as cell transplantation therapy and drug discovery. Another motivation for studying PSCs is to understand human embryogenesis and development. All cell types that make up the body tissues develop through defined trajectories during embryogenesis. For example, paraxial mesoderm is considered to differentiate into several cell types including skeletal muscle cells, chondrocytes, osteocytes, dermal fibroblasts, and tenocytes. Tenocytes are fibroblast cells that constitute the tendon. The step-wise narrowing fate decisions of paraxial mesoderm in the embryo have been modeled in vitro using PSCs; however, deriving tenocytes from human-induced PSCs and their application in cell therapy have long been challenging. PSC-derived tenocytes can be used for a source of cell transplantation to treat a damaged or ruptured tendon due to injury, disorder, or aging. In this review, we discuss the latest research findings on the use of PSCs for studying the biology of tenocyte development and their application in therapeutic settings.
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Affiliation(s)
- Taiki Nakajima
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan.,Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Makoto Ikeya
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
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Sugita D, Nakajima H, Kokubo Y, Takeura N, Yayama T, Matsumine A. Cyclic tensile strain facilitates ossification of the cervical posterior longitudinal ligament via increased Indian hedgehog signaling. Sci Rep 2020; 10:7231. [PMID: 32350355 PMCID: PMC7190672 DOI: 10.1038/s41598-020-64304-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 04/15/2020] [Indexed: 11/29/2022] Open
Abstract
The pathomechanisms of initiation and progression of ossification of the posterior longitudinal ligament (OPLL) are unclear. Indian hedgehog (Ihh) and related signaling molecules are key factors in normal enchondral ossification. The purpose of this study is to investigate the contribution of mechanical strain to OPLL and the relationship of Ihh with OPLL. Sections of the posterior longitudinal ligament (PLL) were obtained from 49 patients with OPLL and from 7 patients without OPLL. Cultured PLL cells were subjected to 24 hours of cyclic tensile strain. To identify differentially expressed genes associated with cyclic tensile strain, microarray analysis was performed. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis identified upregulation of various genes, particularly of the Hedgehog signaling pathway; Ihh and related genes had increased expression compared with controls after 24-hour cyclic tensile strain. In immunoblotting analysis, Ihh, Runx2, Sox9, Gli2, Gli3, and smoothened (SMO) had significantly increased expression after 6- or 12-hour cyclic tensile strain. OPLL samples were strongly immunopositive for Ihh, Sox9, Runx2, Gli2, Gli3, and SMO in the ossification front of OPLL. These results suggest that cyclic tensile strain induces abnormal activation of Ihh and related signaling molecules, and this might be important in the ossification process in OPLL.
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Affiliation(s)
- Daisuke Sugita
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Yasuo Kokubo
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Takeura
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Takafumi Yayama
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukiwachou, Otsu, Shiga, 520-2192, Japan
| | - Akihiko Matsumine
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
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Wang P, Teng Z, Liu X, Liu X, Kong C, Lu S. A new single nucleotide polymorphism affects the predisposition to thoracic ossification of the posterior longitudinal ligament. J Orthop Surg Res 2019; 14:438. [PMID: 31831033 PMCID: PMC6909598 DOI: 10.1186/s13018-019-1481-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 11/20/2019] [Indexed: 01/13/2023] Open
Abstract
Background Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is one of the common factors that cause thoracic spinal stenosis, which results in intractable myelopathy and radiculopathy. Our previous study first reported rs201153092A site mutation in the collagen 6A1 (COL6A1) gene as a potentially pathogenic locus for T-OPLL. We aimed to determine whether the rs201153092A site mutation causes abnormal expression of the COL6A1 in Han Chinese patients with T-OPLL and whether this locus is also associated with cervical-OPLL. Methods Peripheral blood was collected from a total of 60 patients with T-OPLL disease (30 patients carrying the rs201153092A site mutation in COL6A1 and 30 wild-type patients) and 400 northern Chinese individuals (200 cervical-OPLL patients and 200 control subjects) using the Sequenom system. The expression of COL6A1 was analyzed by enzyme-linked immunosorbent assay, reverse transcription-quantitative polymerase chain reaction, and Western blotting. Results rs201153092A mutation resulted in markedly increased COL6A1 gene expression levels in peripheral blood samples. The allele frequency and genotype frequency results showed that this locus is no difference between cervical-OPLL patients and controls. Conclusions The rs201153092A site mutation of COL6A1 can significantly increase the expression of COL6A1. The COL6A1 gene rs201153092A site polymorphism is a potential pathogenic mutation in T-OPLL disease, which may be only associated with the occurrence of T-OPLL.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng, Beijing, 100053, People's Republic of China
| | - Ze Teng
- Department of Radiology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, 100021, People's Republic of China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Chao Kong
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng, Beijing, 100053, People's Republic of China
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng, Beijing, 100053, People's Republic of China.
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Wang P, Teng Z, Liu X, Liu X, Kong C, Lu S. The COL6A1 rs201153092 single nucleotide polymorphism, associates with thoracic ossification of the posterior longitudinal ligament. Mol Med Rep 2019; 21:191-200. [PMID: 31939624 PMCID: PMC6896296 DOI: 10.3892/mmr.2019.10846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/30/2019] [Indexed: 01/13/2023] Open
Abstract
Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is one of the most common factors that causes thoracic spinal stenosis, resulting in intractable myelopathy and radiculopathy. Our previous study reported that the rs201153092 polymorphism present in the collagen 6A1 (COL6A1) gene was a potentially pathogenic locus for the development of T-OPLL. The present study aimed to determine whether the rs201153092 mutation causes abnormal expression of COL6A1 in Han Chinese patients with T-OPLL, and to examine the effects of this mutation on osteogenesis by establishing a model of osteogenic differentiation. COL6A1 gene mutant and wild-type mouse 3T3-E1 embryonic osteoblast models were constructed to induce the differentiation of these cells into osteoblasts. The potential of the mutation site to induce abnormal expression of the COL6A1 gene and osteogenic markers was assessed via reverse transcription-quantitative PCR and western blot analyses. The results demonstrated that the rs201153092A mutation site resulted in significantly increased COL6A1 gene expression levels in the OPLL tissues obtained following clinical surgery. This mutation was shown to play an important role in the development of T-OPLL by regulating the overexpression of the COL6A1 gene and significantly increasing the expression levels of osteogenic markers. The findings of the present study suggested that the rs201153092A mutant variant could increase the expression levels of COL6A1 and consequently play a role in the pathogenesis of T-OPLL.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Ze Teng
- Department of Radiology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, P.R. China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Chao Kong
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
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IL17RC affects the predisposition to thoracic ossification of the posterior longitudinal ligament. J Orthop Surg Res 2019; 14:210. [PMID: 31291973 PMCID: PMC6621948 DOI: 10.1186/s13018-019-1253-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 07/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Thoracic ossification of the posterior longitudinal ligament (T-OPLL) can cause thoracic spinal stenosis, which results in intractable myelopathy and radiculopathy. The etiology of T-OPLL is unknown and the condition is difficult to treat surgically. Whole-genome sequencing identified a genetic variant at rs199772854 of the interleukin 17 receptor C (IL17RC) gene as a potentially pathogenic locus associated with T-OPLL. We aimed to determine whether the rs199772854A site mutation causes abnormal expression of the IL17RC in Han Chinese patients with T-OPLL and predict the possible pathogenic mechanisms of T-OPLL. Analyses were performed to determine whether IL17RC is involved in the pathogenicity of T-OPLL. Methods Peripheral blood and OPLL tissue were collected from a total of 72 patients with T-OPLL disease (36 patients carrying the rs199772854A site mutation in IL17RC and 36 wild-type patients). The expression of IL17RC was analyzed by enzyme-linked immunosorbent assay, reverse transcription-quantitative polymerase chain reaction, immunohistochemistry, and Western blotting. Results rs199772854A mutation resulted in markedly increased IL17RC gene expression levels in peripheral blood samples and the OPLL tissue obtained following clinical surgery (P < 0.05). Conclusions The results suggest that the rs199772854A site mutation of IL17RC can significantly increase the expression of IL17RC. The IL17RC gene rs199772854A site polymorphism is a potential pathogenic mutation in T-OPLL disease, which may be associated with the occurrence of T-OPLL.
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Wang P, Liu X, Kong C, Liu X, Teng Z, Ma Y, Yong L, Liang C, He G, Lu S. Potential role of the IL17RC gene in the thoracic ossification of the posterior longitudinal ligament. Int J Mol Med 2019; 43:2005-2014. [PMID: 30864693 PMCID: PMC6443333 DOI: 10.3892/ijmm.2019.4130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 03/04/2019] [Indexed: 11/06/2022] Open
Abstract
The thoracic ossification of the posterior longitudinal ligament (T-OPLL) can cause thoracic spinal stenosis, which results in intractable myelopathy and radiculopathy. Our previous whole-genome sequencing study first reported rs199772854 in the interleukin 17 receptor C (IL17RC) gene as a potentially pathogenic loci for T-OPLL. The aim of the present study was to examine the effects of the IL17RC gene rs199772854A site mutation on osteogenesis by establishing a model of osteogenic differentiation. IL17RC gene mutation site and wild-type site mouse embryonic osteoblast (3T3-E1) models were constructed in order to induce the differentiation of the cells into osteoblasts. Whether the mutation site causes the abnormal expression of the IL17RC gene and osteogenic markers was analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis. The IL17RC gene rs199772854A site mutation was demonstrated to play a biological role through the overexpression of its own gene, and also to significantly increase the expression levels of osteogenic markers. Furthermore, the mutation upregulated the expression of the key proteins, tumor necrosis factor receptor (TNFR)-associated factor 6 (TRAF6) and nuclear factor (NF)-κB, in the interleukin (IL)-17 signaling axis. On the whole, the findings of this study suggest that the IL17RC gene rs199772854A loci mutation propels mouse embryonic osteoblasts towards osteogenic differentiation and may play an important role in the pathogenesis of T-OPLL. The IL17RC gene may promote osteogenesis through the IL-17 signaling pathway and may thus be involved in the process of ectopic osteogenesis in T-OPLL.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Chao Kong
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Ze Teng
- Department of Radiology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, P.R. China
| | - Yunlong Ma
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Lei Yong
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Chen Liang
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Guanping He
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
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17
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Du JJ, Chen YF, Peng Y, Li XJ, Ma W. Calcification of the intervertebral disc and ossification of posterior longitudinal ligament in children. BMC Musculoskelet Disord 2018; 19:316. [PMID: 30185184 PMCID: PMC6124007 DOI: 10.1186/s12891-018-2227-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 08/09/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND IDC in children, first reported by Baron in 1924, is very rare. OPLL of the cervical spine mainly affect people ages 50-70 years. The coexistence of IDC and OPLL in children is very rare, only six cases with 3 to 24 months' follow-up were reported to date. CASE PRESENTATION A 6-year-old boy presented with complains of neck pain at July 2007. The boy was treated by conservative treatment and observed up for 9 years. Neck pain greatly improved after a one-month conservative treatment and never recur. Laboratory tests revealed elevated ESR and CRP at admission and found nothing abnormal at 19-month and 9-year follow-up. Computed tomography and magnetic resonance imaging revealed IDC at C2/3, C3/4 and OPLL at C3/4 at admission and found minor calcification at C2/3 remained but calcification at C3/4 and OPLL at C3/4 completely disappeared at 19-month and 9-year follow-up. Nineteen months after initial diagnosis, restoration of T2-weighted signal intensity of C2/3 and C3/4 discs was observed through MRI. Loss of T2-weighted signal intensity of C2/3 disc and decrease of T2-weighted signal intensity of C3/4 disc was observed at 9-year follow-up. CONCLUSIONS IDC with OPLL in children is very rare. Conservative treatments are recommended with affirmative short-term and long-term clinical effects. More intensive observation with long-term follow-ups may be needed to warrant the clinical effects.
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Affiliation(s)
- Jun-Jie Du
- Department of Orthopaedics, Air Force General Hospital of PLA, 30 Fucheng Road, Beijing, 100142, People's Republic of China.
| | - Yu-Fei Chen
- Department of Orthopaedics, Air Force General Hospital of PLA, 30 Fucheng Road, Beijing, 100142, People's Republic of China.
| | - Ye Peng
- Department of Orthopaedics, Air Force General Hospital of PLA, 30 Fucheng Road, Beijing, 100142, People's Republic of China
| | - Xiao-Jie Li
- Department of Orthopaedics, Air Force General Hospital of PLA, 30 Fucheng Road, Beijing, 100142, People's Republic of China
| | - Wei Ma
- Department of Orthopaedics, Air Force General Hospital of PLA, 30 Fucheng Road, Beijing, 100142, People's Republic of China
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18
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Boody BS, Lendner M, Vaccaro AR. Ossification of the posterior longitudinal ligament in the cervical spine: a review. INTERNATIONAL ORTHOPAEDICS 2018; 43:797-805. [PMID: 30116867 DOI: 10.1007/s00264-018-4106-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/08/2018] [Indexed: 01/20/2023]
Abstract
Ossification of the posterior longitudinal ligament (OPLL) is a rare pathologic process of lamellar bone deposition that can result in spinal cord compression. While multiple genetic and environmental factors have been related to the development of OPLL, the pathophysiology remains poorly understood. Asymptomatic patients may be managed conservatively and patients with radiculopathy or myelopathy should be considered for surgical decompression. Multiple studies have demonstrated the morphology and size of the OPLL as well as the cervical alignment have significant implications for the appropriate surgical approach and technique. In this review, we aim to address all the available literature on the etiology, history, presentation, and management of OPLL in an effort to better understand OPLL and give our recommendations for the treatment of patients presenting with OPLL.
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Affiliation(s)
- Barrett S Boody
- Rothman Institute, 125 S. 9th St. 10th Floor, Philadelphia, PA, 19107, USA
| | - Mayan Lendner
- Rothman Institute, 125 S. 9th St. 10th Floor, Philadelphia, PA, 19107, USA.
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19
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Wang P, Liu X, Zhu B, Ma Y, Yong L, Teng Z, Liang C, He G, Liu X. Association of IL17RC and COL6A1 genetic polymorphisms with susceptibility to ossification of the thoracic posterior longitudinal ligament in Chinese patients. J Orthop Surg Res 2018; 13:109. [PMID: 29764467 PMCID: PMC5952594 DOI: 10.1186/s13018-018-0817-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/19/2018] [Indexed: 11/23/2022] Open
Abstract
Background In our previous whole-genome sequencing study of 30 unrelated northern Chinese Han patients, we identified six single nucleotide polymorphisms (SNPs) in the interleukin 17 receptor C (IL17RC) and collagen type VI α1 chain (COL6A1) genes that were potentially associated with thoracic ossification of the posterior longitudinal ligament (T-OPLL). To determine whether these six SNPs are associated with susceptibility to T-OPLL in the northern Chinese Han population, we performed a case-control association study to confirm specific susceptible loci in the expanded samples. Methods The six SNPs in the IL17RC and COL6A1 genes were analyzed in 200 northern Chinese individuals (100 patients and 100 control subjects) using the Sequenom system. Results The genotype distributions and allele frequencies of each SNP in the control and patient groups were compared. rs201153092, rs13051496, rs199772854, rs76999397, and rs189013166 showed potential pathogenic loci for T-OPLL in the northern Chinese Han population, whereas rs151158105 did not. At the genotype level, the differences in the genotype frequencies of rs201153092, rs13051496, rs199772854, rs76999397, and rs189013166 between T-OPLL cases and controls reached statistical significance. Conclusions To the best of our knowledge, this is the first association study of susceptibility genes in Han Chinese patients with T-OPLL. The results revealed five SNPs in the IL17RC and COL6A1 genes that represented potentially pathogenic mutations in patients with T-OPLL.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Bin Zhu
- The Center for Pain Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| | - Yunlong Ma
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Lei Yong
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Ze Teng
- Department of Radiology, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Chen Liang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Guanping He
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, People's Republic of China.
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Wang P, Liu X, Zhu B, Ma Y, Yong L, Teng Z, Wang Y, Liang C, He G, Liu X. Identification of susceptibility loci for thoracic ossification of the posterior longitudinal ligament by whole-genome sequencing. Mol Med Rep 2017; 17:2557-2564. [PMID: 29207129 DOI: 10.3892/mmr.2017.8171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/22/2017] [Indexed: 11/06/2022] Open
Abstract
Ossification of the posterior longitudinal ligament (OPLL) is a myelopathy commonly observed in the cervical spine. By contrast, thoracic OPLL (T‑OPLL) is rare but more severe. Previous studies have identified several polymorphisms in osteogenic genes that are associated with the occurrence and development of cervical OPLL. However, few genetic studies have evaluated T‑OPLL. The present study aimed to identify the genetic factors for OPLL by performing whole‑genome sequencing (WGS) in 30 unrelated northern Chinese Han patients with T‑OPLL. Using bioinformatics analyses and damaging‑variant prediction algorithms, two deleterious variants [c.1534G>A(p.Gly512Ser)/collagen, type VI, α1 (COL6A1)] and [c.2275C>A(p.Leu759Ile)/inteleukin-17 receptor C (IL17RC)] were identified in seven unrelated patients. These two mutations resulted in markedly increased gene expression levels in peripheral blood samples. To the best of our knowledge, this is the first report to describe the use of WGS analysis of T‑OPLL in the northern Chinese Han population. The results revealed two novel potentially pathogenic mutations in patients with T‑OPLL.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Bin Zhu
- Center for Pain Medicine, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Yunlong Ma
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Lei Yong
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Ze Teng
- Department of Radiology, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Yongqiang Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Chen Liang
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Guanping He
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P.R. China
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Association of miR-146a, miR-149, miR-196a2, and miR-499 Polymorphisms with Ossification of the Posterior Longitudinal Ligament of the Cervical Spine. PLoS One 2016; 11:e0159756. [PMID: 27454313 PMCID: PMC4959720 DOI: 10.1371/journal.pone.0159756] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
Background Ossification of the posterior longitudinal ligament (OPLL) of the spine is considered a multifactorial and polygenic disease. We aimed to investigate the association between four single nucleotide polymorphisms (SNPs) of pre-miRNAs [miR-146aC>G (rs2910164), miR-149T>C (rs2292832), miR-196a2T>C (rs11614913), and miR-499A>G (rs3746444)] and the risk of cervical OPLL in the Korean population. Methods The genotypic frequencies of these four SNPs were analyzed in 207 OPLL patients and 200 controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Findings For four SNPs in pre-miRNAs, no significant differences were found between OPLL patients and controls. However, subgroup analysis based on OPLL subgroup (continuous: continuous type plus mixed type, segmental: segmental and localized type) showed that miR-499GG genotype was associated with an increased risk of segmental type OPLL (adjusted odds ratio = 4.314 with 95% confidence interval: 1.109–16.78). In addition, some allele combinations (C-T-T-G, G-T-T-A, and G-T-C-G of miR-146a/-149/-196a2/-499) and combined genotypes (miR-149TC/miR-196a2TT) were associated with increased OPLL risk, whereas the G-T-T-G and G-C-C-G allele combinations were associated with decreased OPLL risk. Conclusion The results indicate that GG genotype of miR-499 is associated with significantly higher risks of OPLL in the segmental OPLL group. The miR-146a/-149/-196a2/-499 allele combinations may be a genetic risk factor for cervical OPLL in the Korean population.
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Chen X, Guo J, Cai T, Zhang F, Pan S, Zhang L, Wang S, Zhou F, Diao Y, Zhao Y, Chen Z, Liu X, Chen Z, Liu Z, Sun Y, Du J. Targeted next-generation sequencing reveals multiple deleterious variants in OPLL-associated genes. Sci Rep 2016; 6:26962. [PMID: 27246988 PMCID: PMC4887887 DOI: 10.1038/srep26962] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 05/10/2016] [Indexed: 01/12/2023] Open
Abstract
Ossification of the posterior longitudinal ligament of the spine (OPLL), which is characterized by ectopic bone formation in the spinal ligaments, can cause spinal-cord compression. To date, at least 11 susceptibility genes have been genetically linked to OPLL. In order to identify potential deleterious alleles in these OPLL-associated genes, we designed a capture array encompassing all coding regions of the target genes for next-generation sequencing (NGS) in a cohort of 55 unrelated patients with OPLL. By bioinformatics analyses, we successfully identified three novel and five extremely rare variants (MAF < 0.005). These variants were predicted to be deleterious by commonly used various algorithms, thereby resulting in missense mutations in four OPLL-associated genes (i.e., COL6A1, COL11A2, FGFR1, and BMP2). Furthermore, potential effects of the patient with p.Q89E of BMP2 were confirmed by a markedly increased BMP2 level in peripheral blood samples. Notably, seven of the variants were found to be associated with the patients with continuous subtype changes by cervical spinal radiological analyses. Taken together, our findings revealed for the first time that deleterious coding variants of the four OPLL-associated genes are potentially pathogenic in the patients with OPLL.
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Affiliation(s)
- Xin Chen
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Jun Guo
- Beijing Anzhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing Institute of Heart, Lung &Blood Vessel Disease, Beijing, China
| | - Tao Cai
- Beijing Anzhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing Institute of Heart, Lung &Blood Vessel Disease, Beijing, China
| | - Fengshan Zhang
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Shengfa Pan
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Li Zhang
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Shaobo Wang
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Feifei Zhou
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Yinze Diao
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Yanbin Zhao
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Zhen Chen
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Xiaoguang Liu
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Zhongqiang Chen
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Zhongjun Liu
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Yu Sun
- Orthopaedic Department, Institute of Spinal Surgery, Peking University Third Hospital, Beijing, China
| | - Jie Du
- Beijing Anzhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing Institute of Heart, Lung &Blood Vessel Disease, Beijing, China
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Maeda Y, Yamamoto K, Yamakawa A, Aini H, Takato T, Chung UI, Ohba S. The H2 blocker famotidine suppresses progression of ossification of the posterior longitudinal ligament in a mouse model. RMD Open 2015; 1:e000068. [PMID: 26509067 PMCID: PMC4612692 DOI: 10.1136/rmdopen-2015-000068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/03/2015] [Accepted: 04/24/2015] [Indexed: 12/13/2022] Open
Abstract
Background Ossification of the posterior longitudinal ligament (OPLL) of the spine is a common human myelopathy that leads to spinal cord compression. No disease-modifying drug for OPLL has been identified, whereas surgery and conservative management have been established. Objectives To evaluate the therapeutic potential of the H2 blocker famotidine for ectopic ossification in the cervical spine in an OPLL mouse model. Methods The H2 blocker famotidine was orally administered to Enpp1ttw/ttw mice, a model of OPLL, at either 4 or 15 weeks of age. Radiological and survival rate analyses were performed to assess the effects of famotidine on OPLL-like lesions and mortality in Enpp1ttw/ttw mice. Results Oral administration of famotidine suppressed the progression of OPLL-like ectopic ossification and reduced mortality in Enpp1ttw/ttw mice when administration began at 4 weeks of age, early in the development of ossification. Conclusions This study points to the use of famotidine as a disease-modifying drug for ectopic ossification of spinal soft tissue, including OPLL.
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Affiliation(s)
- Yujiro Maeda
- Department of Sensory and Motor System Medicine, The University of Tokyo Graduate School of Medicine, Tokyo , Japan ; Division of Clinical Biotechnology , The University of Tokyo Graduate School of Medicine , Tokyo , Japan
| | - Kenichi Yamamoto
- Department of Sensory and Motor System Medicine, The University of Tokyo Graduate School of Medicine, Tokyo , Japan ; Division of Clinical Biotechnology , The University of Tokyo Graduate School of Medicine , Tokyo , Japan
| | - Akira Yamakawa
- Division of Clinical Biotechnology , The University of Tokyo Graduate School of Medicine , Tokyo , Japan
| | - Hailati Aini
- Department of Bioengineering , The University of Tokyo Graduate School of Engineering , Tokyo , Japan
| | - Tsuyoshi Takato
- Department of Sensory and Motor System Medicine, The University of Tokyo Graduate School of Medicine, Tokyo , Japan
| | - Ung-Il Chung
- Division of Clinical Biotechnology , The University of Tokyo Graduate School of Medicine , Tokyo , Japan ; Department of Bioengineering , The University of Tokyo Graduate School of Engineering , Tokyo , Japan
| | - Shinsuke Ohba
- Division of Clinical Biotechnology , The University of Tokyo Graduate School of Medicine , Tokyo , Japan ; Department of Bioengineering , The University of Tokyo Graduate School of Engineering , Tokyo , Japan
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