Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum
ABSTRACT Purpose There are many causes of thoracic ossification of the ligamentum flavum (TOLF), of which mechanical stress factors have gained increasing attention. This study aimed to explore the potential pathogenesis of TOLF by comparing spinal sagittal alignment parameters between patients with...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.70061 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850112339371622400 |
|---|---|
| author | Zixuan Xu Lei Yuan Siyu Zhou Xinhu Guo Shuai Jiang Longjie Wang Guanghui Chen Yuanyu Hu Junbo Qi Zhaoqing Guo Qiang Qi Weishi Li Chuiguo Sun |
| author_facet | Zixuan Xu Lei Yuan Siyu Zhou Xinhu Guo Shuai Jiang Longjie Wang Guanghui Chen Yuanyu Hu Junbo Qi Zhaoqing Guo Qiang Qi Weishi Li Chuiguo Sun |
| author_sort | Zixuan Xu |
| collection | DOAJ |
| description | ABSTRACT Purpose There are many causes of thoracic ossification of the ligamentum flavum (TOLF), of which mechanical stress factors have gained increasing attention. This study aimed to explore the potential pathogenesis of TOLF by comparing spinal sagittal alignment parameters between patients with TOLF and an asymptomatic population. Methods We retrospectively included patients who underwent surgical treatment for thoracic myelopathy caused by OLF at Peking University Third Hospital from 2012 to 2022. Sagittal alignment parameters measured by picture archiving and communication system were compared between the TOLF group and a control group with independent t‐test, Wilcoxon rank‐sum test, and Chi‐Squared test. Patients with caudal insertion of OLF above the T10 level were categorized into Group 1, while those with caudal insertion below the T10 level were categorized into Group 2. Sagittal alignment parameters were then compared among these two groups and the control group. Results Compared with the control group, the OLF group exhibited less lumbar lordosis (44.46° ± 11.41° vs. 52.55° ± 9.70°, p < 0.001), greater thoracolumbar curvature, greater PI‐LL mismatch, and greater SVA imbalance. In patients with caudal insertion of the OLF above the T10 level, PI, PT, and LL were smaller compared to the control group. Patients with caudal insertion below the T10 level had smaller LL, greater thoracolumbar kyphosis, more severe SVA imbalance, and more severe PI‐LL mismatch. Conclusion Patients with TOLF have a straighter spine. Mechanical stress plays a more significant role in the development of TOLF in patients with caudal lesions below the T10 level. In patients with TOLF not involving the thoracolumbar segment, factors other than mechanical stress, such as endocrine factors, may play a more crucial role in the development of TOLF. |
| format | Article |
| id | doaj-art-581530bca7fb4d678ddb0451e5a61b0b |
| institution | OA Journals |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-581530bca7fb4d678ddb0451e5a61b0b2025-08-20T02:37:24ZengWileyOrthopaedic Surgery1757-78531757-78612025-07-011771956196410.1111/os.70061Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum FlavumZixuan Xu0Lei Yuan1Siyu Zhou2Xinhu Guo3Shuai Jiang4Longjie Wang5Guanghui Chen6Yuanyu Hu7Junbo Qi8Zhaoqing Guo9Qiang Qi10Weishi Li11Chuiguo Sun12Department of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaDepartment of Orthopedics Peking University Third Hospital Beijing ChinaABSTRACT Purpose There are many causes of thoracic ossification of the ligamentum flavum (TOLF), of which mechanical stress factors have gained increasing attention. This study aimed to explore the potential pathogenesis of TOLF by comparing spinal sagittal alignment parameters between patients with TOLF and an asymptomatic population. Methods We retrospectively included patients who underwent surgical treatment for thoracic myelopathy caused by OLF at Peking University Third Hospital from 2012 to 2022. Sagittal alignment parameters measured by picture archiving and communication system were compared between the TOLF group and a control group with independent t‐test, Wilcoxon rank‐sum test, and Chi‐Squared test. Patients with caudal insertion of OLF above the T10 level were categorized into Group 1, while those with caudal insertion below the T10 level were categorized into Group 2. Sagittal alignment parameters were then compared among these two groups and the control group. Results Compared with the control group, the OLF group exhibited less lumbar lordosis (44.46° ± 11.41° vs. 52.55° ± 9.70°, p < 0.001), greater thoracolumbar curvature, greater PI‐LL mismatch, and greater SVA imbalance. In patients with caudal insertion of the OLF above the T10 level, PI, PT, and LL were smaller compared to the control group. Patients with caudal insertion below the T10 level had smaller LL, greater thoracolumbar kyphosis, more severe SVA imbalance, and more severe PI‐LL mismatch. Conclusion Patients with TOLF have a straighter spine. Mechanical stress plays a more significant role in the development of TOLF in patients with caudal lesions below the T10 level. In patients with TOLF not involving the thoracolumbar segment, factors other than mechanical stress, such as endocrine factors, may play a more crucial role in the development of TOLF.https://doi.org/10.1111/os.70061mechanical stresspathogenesissagittal alignmentthe thoracic ossification of the ligamentum flavum |
| spellingShingle | Zixuan Xu Lei Yuan Siyu Zhou Xinhu Guo Shuai Jiang Longjie Wang Guanghui Chen Yuanyu Hu Junbo Qi Zhaoqing Guo Qiang Qi Weishi Li Chuiguo Sun Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum Orthopaedic Surgery mechanical stress pathogenesis sagittal alignment the thoracic ossification of the ligamentum flavum |
| title | Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum |
| title_full | Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum |
| title_fullStr | Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum |
| title_full_unstemmed | Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum |
| title_short | Potential Influence of Sagittal Parameters in the Pathogenesis of Patients With the Thoracic Ossification of the Ligamentum Flavum |
| title_sort | potential influence of sagittal parameters in the pathogenesis of patients with the thoracic ossification of the ligamentum flavum |
| topic | mechanical stress pathogenesis sagittal alignment the thoracic ossification of the ligamentum flavum |
| url | https://doi.org/10.1111/os.70061 |
| work_keys_str_mv | AT zixuanxu potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT leiyuan potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT siyuzhou potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT xinhuguo potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT shuaijiang potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT longjiewang potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT guanghuichen potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT yuanyuhu potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT junboqi potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT zhaoqingguo potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT qiangqi potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT weishili potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum AT chuiguosun potentialinfluenceofsagittalparametersinthepathogenesisofpatientswiththethoracicossificationoftheligamentumflavum |