Bone strength of the proximal femur in healthy subjects with ossification of the posterior longitudinal ligament

Doi, T.; Hirai, S.; Kaneko, M.; Ohashi, S.; Nakajima, K.; Oguchi, F.; Kato, S.; Taniguchi, Y.; Matsubayashi, Y.; Hayashi, N.; Tanaka, S.; Oshima, Y.

Affiliations

¹Department of Orthopaedic Surgery, University of Tokyo Hospital, Tokyo, Japan

²Department of Orthopaedic Surgery, Kanto Rosai Hospital, Kawasaki, Japan

³Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, Sagamihara, Japan

⁴Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan

Abstract and keywords

Summary: We compared the bone strength measured via quantitative computed tomography-based finite element method (QCT/FEM) between healthy adults with and without ossification of the posterior longitudinal ligament (OPLL). No statistically significant difference was observed in the bone strength between healthy adults with and without OPLL. Hyperostosis of the posterior longitudinal ligament in OPLL may not be associated with the systemic bone strength.

Introduction: Although patients with OPLL have been reportedly associated with increased level of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), little is known about the bone strength in OPLL subjects. The aim of this study is to investigate the bone strength measured via QCT/FEM in healthy subjects with OPLL using the medical check-up data, including whole-body CT scans.

Methods: We examined 796 participants (529 men and 267 women) who underwent CT scans in a single health center between January 2008 and May 2009. We identified OPLL in whole spine and divided the subjects into two groups: non-OPLL and OPLL groups. We calculated the predicted bone strength (PBS) of the proximal femur using QCT/FEM and examined the bone mineral status of the calcaneus using quantitative ultrasound (QUS). We compared the PBS and the QUS parameters between the non-OPLL and OPLL groups.

Results: Seventy-four subjects (9.3%; 57 men and 17 women) were diagnosed with OPLL in the whole spine. The OPLL group was significantly older than the non-OPLL group. No statistically significant difference was observed in the PBS and the QUS parameters between the non-OPLL and OPLL groups in both sexes. Furthermore, no statistically significant difference was noted in the PBS and the QUS parameters between two groups in age- and gender-matched analysis.

Conclusions: Our results suggest that hyperostosis of the posterior longitudinal ligament in OPLL may not be associated with bone strength and bone mineral status at the extremities.

Keywords: Bone mineral density; Dual-energy X-ray absorptiometry (DXA); Ossification of the posterior longitudinal ligament (OPLL); Predicted bone strength (PBS); Quantitative computed tomography-based finite element method (QCT/FEM); Quantitative ultrasound (QUS)

Links

DOI: 10.1007/s00198-019-05253-7

PubMed: 31814062

WoS: 000501516200001

History

Received: 2019-06-19

Accepted: 2019-12-01

Online: 2019-12-09

Cited Works (4)

Year	Entry
2016	Farr JN, Khosla S. Determinants of bone strength and quality in diabetes mellitus in humans. Bone. January 2016;82:28-34.
2012	Dall’Ara E, Pahr D, Varga P, Kainberger F, Zysset P. QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA. Osteoporos Int. February 2012;23(2):563-572.
2001	NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. February 14, 2001;285(6):785-795.
2007	Bessho M, Ohnishi I, Matsuyama J, Matsumoto T, Imai K, Nakamura K. Prediction of strength and strain of the proximal femur by a CT-based finite element method. J Biomech. 2007;40(8):1745-1753.