Association Between Deep Posterior Cervical Paraspinal Muscle Morphology and Clinical Features in Patients With Cervical Ossification of the Posterior Longitudinal Ligament

Toru Doi; Nozomu Ohtomo; Fumihiko Oguchi; Keiichiro Tozawa; Hiroyuki Nakarai; Koji Nakajima; Ryuji Sakamoto; Naoki Okamoto; Hideki Nakamoto; So Kato; Yuki Taniguchi; Yoshitaka Matsubayashi; Hiroyuki Oka; Ko Matsudaira; Sakae Tanaka; Yasushi Oshima

doi:10.1177/2192568221989655

Association Between Deep Posterior Cervical Paraspinal Muscle Morphology and Clinical Features in Patients With Cervical Ossification of the Posterior Longitudinal Ligament

Global Spine J. 2023 Jan;13(1):8-16. doi: 10.1177/2192568221989655. Epub 2021 Jan 28.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, 13143The University of Tokyo, Tokyo, Japan.
² Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, 26307The University of Tokyo, Tokyo, Japan.

Abstract

Study design: A retrospective observational study.

Objective: To clarify the association of the paraspinal muscle area and composition with clinical features in patients with cervical ossification of the posterior longitudinal ligament (OPLL).

Methods: Consecutive patients with cervical OPLL who underwent cervical magnetic resonance imaging (MRI) before surgery were reviewed. The cross-sectional area (CSA) and fatty infiltration ratio (FI%) of deep posterior cervical paraspinal muscles (multifidus [MF] and semispinalis cervicis [SCer]) were examined. We assessed the association of paraspinal muscle measurements with the clinical characteristics and clinical outcomes, such as Neck Disability Index (NDI) score. Moreover, we divided the patients into 2 groups according to the extent of the ossified lesion (segmental and localized [OPLL-SL] and continuous and mixed [OPLL-CM] groups) and compared these variables between the 2 groups.

Results: 49 patients with cervical OPLL were enrolled in this study. The FI% of the paraspinal muscles was significantly associated with the number of vertebrae (ρ = 0.283, p = 0.049) or maximum occupancy ratio of OPLL (ρ = 0.397, p = 0.005). The comparative study results indicated that the NDI score was significantly worse (OPLL-SL, 22.9 ± 13.7 vs. OPLL-CM, 34.4 ± 13.7) and FI% of SCer higher (OPLL-SL, 9.1 ± 1.7% vs. OPLL-CM, 11.1 ± 3.7%) in the OPLL-CM group than those in the OPLL-SL group.

Conclusions: Our results suggest that OPLL severity may be associated with fatty infiltration of deep posterior cervical paraspinal muscles, which could affect neck disability in patients with cervical OPLL.

Keywords: Neck Disability Index; cervical; fatty infiltration; multifidus; neck pain; ossification of the posterior longitudinal ligament; paraspinal muscle; semispinalis cervicis.