Imaging Grading System for the Diagnosis of Dural Ossification Based on 102 Segments of TOLF CT Bone-window Data

Overview

Journal Sci Rep

Specialty Science

Date 2017 Jun 9

PMID 28592849

Citations 9

Authors

Sheng-Yuan Zhou

Bo Yuan

Xiong-Sheng Chen

Xue-Bin Li

Wei Zhu

Lian-Shun Jia

Affiliations

Soon will be listed here.

Abstract

Thoracic ossification of the ligamentum flavum (TOLF) complicated with dural ossification (DO) is a severe clinical disease. The diagnosis of DO preoperatively remains challenging. The current study retrospectively analyzed imaging features of 102 segments with TOLF from 39 patients and proposed a grading system for evaluating DO risk. Logistic regression results showed that unilateral spinal canal occupational rate (UCOR), tram track signs, and C-signs were all risk factors for DO (odds ratios of 5.393, 19.734 and 72.594, respectively). In validation analyses for the TOLF-DO grading system, sensitivity was 76.0% (19/25), specificity was 91.0% (70/77), and Youden's index was 0.66. Thus, implementation of the TOLF-DO grading system has the potential to improve the diagnosis of DO.

Citing Articles

CDUNeXt: efficient ossification segmentation with large kernel and dual cross gate attention.

Xia H, Wang C, Li Z, Zhang Y, Hu S, Zhai J Sci Rep. 2024; 14(1):31018.

PMID: 39730708 PMC: 11681111. DOI: 10.1038/s41598-024-82199-9.

Imaging signs for preoperative diagnosis of dural ossification in patients with thoracic ossification of the ligamentum flavum: a blind, randomized diagnostic accuracy study.

Chen G, Tao L, Chen Z, Li W, Song C, Zhong W Quant Imaging Med Surg. 2024; 14(2):1466-1476.

PMID: 38415144 PMC: 10895093. DOI: 10.21037/qims-23-634.

Prevalence, diagnosis, and impact on clinical outcomes of dural ossification in the thoracic ossification of the ligamentum flavum: a systematic review.

Zhao Y, Xiang Q, Jiang S, Wang L, Lin J, Sun C Eur Spine J. 2023; 32(4):1245-1253.

PMID: 36877368 DOI: 10.1007/s00586-023-07625-4.

Three-dimensional imaging analysis for the diagnosis of dural ossification in thoracic ossification of the ligamentum flavum: a multicenter study.

Yan C, Ling S, Zhao T, Tan Y, Liu T, Shen J Quant Imaging Med Surg. 2023; 13(1):417-427.

PMID: 36620130 PMC: 9816743. DOI: 10.21037/qims-22-418.

The Essence of Clinical Practice Guidelines for Ossification of Spinal Ligaments, 2019: 6. Diagnosis of OLF.

Koda M Spine Surg Relat Res. 2021; 5(5):334-335.

PMID: 34708169 PMC: 8502511. DOI: 10.22603/ssrr.2021-0116.

References

Yang Z, Xue Y, Zhang C, Dai Q, Zhou H . Surgical treatment of ossification of the ligamentum flavum associated with dural ossification in the thoracic spine. J Clin Neurosci. 2012; 20(2):212-6. DOI: 10.1016/j.jocn.2012.02.028. View

Ando K, Imagama S, Ito Z, Hirano K, Muramoto A, Kato F . Predictive factors for a poor surgical outcome with thoracic ossification of the ligamentum flavum by multivariate analysis: a multicenter study. Spine (Phila Pa 1976). 2013; 38(12):E748-54. DOI: 10.1097/BRS.0b013e31828ff736. View

Miyakoshi N, Shimada Y, Suzuki T, Hongo M, Kasukawa Y, Okada K . Factors related to long-term outcome after decompressive surgery for ossification of the ligamentum flavum of the thoracic spine. J Neurosurg. 2003; 99(3 Suppl):251-6. DOI: 10.3171/spi.2003.99.3.0251. View

Trivedi P, Behari S, Paul L, Banerji D, Jain V, Chhabra D . Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien). 2001; 143(8):775-82. DOI: 10.1007/s007010170031. View

Epstein N . Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2003; 2(6):436-49. DOI: 10.1016/s1529-9430(02)00394-7. View

Wang W, Kong L, Zhao H, Dong R, Li J, Jia Z . Thoracic ossification of ligamentum flavum caused by skeletal fluorosis. Eur Spine J. 2006; 16(8):1119-28. PMC: 2200777. DOI: 10.1007/s00586-006-0242-5. View

Li F, Chen Q, Xu K . Surgical treatment of 40 patients with thoracic ossification of the ligamentum flavum. J Neurosurg Spine. 2006; 4(3):191-7. DOI: 10.3171/spi.2006.4.3.191. View

Hida K, Iwasaki Y, Koyanagi I, Abe H . Bone window computed tomography for detection of dural defect associated with cervical ossified posterior longitudinal ligament. Neurol Med Chir (Tokyo). 1997; 37(2):173-5; discussion 175-6. DOI: 10.2176/nmc.37.173. View

Sun X, Chen Z, Qi Q, Guo Z, Sun C, Li W . Diagnosis and treatment of ossification of the ligamentum flavum associated with dural ossification: clinical article. J Neurosurg Spine. 2011; 15(4):386-92. DOI: 10.3171/2011.5.SPINE10748. View

10.

Wang T, Yin C, Wang D, Li S, Chen X . Surgical Technique for Decompression of Severe Thoracic Myelopathy due to Tuberous Ossification of Ligamentum Flavum. Clin Spine Surg. 2017; 30(1):E7-E12. DOI: 10.1097/BSD.0000000000000213. View

11.

Seichi A, Nakajima S, Takeshita K, Kitagawa T, Akune T, Kawaguchi H . Image-guided resection for thoracic ossification of the ligamentum flavum. J Neurosurg. 2003; 99(1 Suppl):60-3. DOI: 10.3171/spi.2003.99.1.0060. View

12.

Muthukumar N . Dural ossification in ossification of the ligamentum flavum: a preliminary report. Spine (Phila Pa 1976). 2009; 34(24):2654-61. DOI: 10.1097/BRS.0b013e3181b541c9. View

13.

Shiokawa K, Hanakita J, Suwa H, Saiki M, Oda M, Kajiwara M . Clinical analysis and prognostic study of ossified ligamentum flavum of the thoracic spine. J Neurosurg. 2001; 94(2 Suppl):221-6. DOI: 10.3171/spi.2001.94.2.0221. View

14.

Epstein N . Anterior approaches to cervical spondylosis and ossification of the posterior longitudinal ligament: review of operative technique and assessment of 65 multilevel circumferential procedures. Surg Neurol. 2001; 55(6):313-24. DOI: 10.1016/s0090-3019(01)00464-5. View

15.

Epstein N . Identification of ossification of the posterior longitudinal ligament extending through the dura on preoperative computed tomographic examinations of the cervical spine. Spine (Phila Pa 1976). 2001; 26(2):182-6. DOI: 10.1097/00007632-200101150-00013. View

16.

Chen X, Yang H, Wang G, Gu Y, Pan W, Dong R . Surgery for thoracic myelopathy caused by ossification of the ligamentum flavum. J Clin Neurosci. 2009; 16(10):1316-20. DOI: 10.1016/j.jocn.2008.12.025. View

17.

Epstein N . Wound-peritoneal shunts: part of the complex management of anterior dural lacerations in patients with ossification of the posterior longitudinal ligament. Surg Neurol. 2009; 72(6):630-4. DOI: 10.1016/j.surneu.2009.05.002. View

18.

Kuh S, Kim Y, Cho Y, Jin B, Kim K, Yoon Y . Contributing factors affecting the prognosis surgical outcome for thoracic OLF. Eur Spine J. 2005; 15(4):485-91. PMC: 3489313. DOI: 10.1007/s00586-005-0903-9. View

19.

Nishiura I, Isozumi T, Nishihara K, Handa H, Koyama T . Surgical approach to ossification of the thoracic yellow ligament. Surg Neurol. 1999; 51(4):368-72. DOI: 10.1016/s0090-3019(98)00051-2. View

20.

Sun J, Zhang C, Ning G, Li Y, Li Y, Wang P . Surgical strategies for ossified ligamentum flavum associated with dural ossification in thoracic spinal stenosis. J Clin Neurosci. 2014; 21(12):2102-6. DOI: 10.1016/j.jocn.2014.02.027. View