Prevalence and related clinical factors of thoracic ossification of the ligamentum flavum – A CT-based cross-sectional study-

Publication date: Available online 17 August 2017
Source:The Spine Journal
Author(s): Sang-Il Kim, Kee-Yong Ha, Jin-Woo Lee, Young-Hoon Kim
Background TextThoracic ossification of the ligamentum flavum (TOLF) is an uncommon pathology but it may sometimes grow and cause serious neurologic manifestations. Little has been demonstrated yet about the epidemiology and etiology of TOLFPurposeTo estimate the prevalence and clinical characteristics of TOLFDesignCross-sectional studyPatient SampleAll individuals who had undergone chest computed tomography (CT) for the evaluation of pulmonary disease or for medical examination for one year at our instituteOutcome MeasuresPresence of TOLF and the association of these findings with thoracic kyphosis (TK), ossification of posterior longitudinal ligament (OPLL), space available for cord (SAC), age, gender, body mass index (BMI), and diabetes.MethodsPrevalence and distribution of TOLF, TK and concurrent OPLL were analyzed on CT scans. Through reviews of their medical records, clinical characteristics including age, gender, BMI, and diabetes were investigated. Logistic regression analysis was performed to determine the risk factors of TOLF.ResultsA total of 4999 individuals (2929 males and 2070 females) were included for the analysis. TOLF was found in 1090 individuals (674 males and 416 females). A single TOLF lesion was noted in 592 individuals and multiple lesions were noted in 498 individuals. The most commonly involved level was T10-T11. Distribution of TOLF showed two peaks, and the highest peak was at the lower thoracic spine (T10-12) and the second highest peak was at T3-T5. TK was 31.5°±9.5) in the TOLF group and 29.7°±8.9 in the non-TOLF group (P<0.001). Space available for cord/anteroposterior canal diameter ratio in TOLF level was 0.882. Logistic regression analysis showed that gender and TK were significantly associated with TOLF.ConclusionsIncidental TOLF was found in 21.8% of the study cohort. Gender and TK were related to TOLF.



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