Keiichi Katsumi

Niigata University Medical and Dental Hospital

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Kei Watanabe

Niigata University Medical and Dental Hospital

Masayuki Ohashi

Niigata University

Tôru Hirano

Niigata University Medical and Dental Hospital

Toshitaka Yoshii

Tokyo Medical and Dental University

Takashi Kaito

Osaka University

Shiro Imagama

Nagoya University

Takeo Furuya

Chiba University

Atsushi Kimura

Jichi Medical University

Naoto Endo

Tsubame Rosai Hospital

Masashi Yamazaki

University of Tsukuba

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Research Organization of Information and Systems

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Open Evidence

Niigata University

Kitasato University

Japan Agency for Medical Research and Development

Niigata University Medical and Dental Hospital

Keio University

Chiba University

Nagoya University

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The Impact of Ossification Spread on Cervical Spine Function in Patients With Ossification of The Posterior Longitudinal Ligament

Research Square (Research Square) (2021)

Keiichi Katsumi Takashi Hirai Toshitaka Yoshii Satoshi Maki Kanji Mori

Abstract Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cervical spine function and quality of life (QOL) in patients with cervical OPLL. In total, 238 patients (162 men, 76 women; mean age, 63.9 years) were enrolled from 16 institutions. Each patient underwent whole spine computed tomography and was evaluated cervical spine function and QOL using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). In the multivariate regression analysis, a higher neck VAS score and a larger number of bridge formations of OPLL in the whole spine were significant predictors of adverse outcomes related to cervical spine function. This is the first prospective multicenter study to reveal the impact of ossification spread on cervical spine function. These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function.

Posterior longitudinal ligament

Anterior longitudinal ligament

10.21203/rs.3.rs-216266/v1

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Citations (0)

Three-dimensional morphological analysis of cervical foraminal stenosis using dynamic flexion-extension computed tomography images

Journal of Orthopaedic Science (2019)

Tatsuki Mizouchi Keiichi Katsumi Tomohiro Izumi Akiyoshi Yamazaki Hirokazu Shoji

Foraminotomy

Facet (psychology)

Foramen

10.1016/j.jos.2019.11.002

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Citations (3)

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson’s disease: what is the impact of Parkinson’s disease on surgical outcome?

BMC Musculoskeletal Disorders (2019)

Kei Watanabe Keiichi Katsumi Masayuki Ohashi Yohei Shibuya Tomohiro Izumi

To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction. Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 patients with PD (mean age, 76 years; 3 men and 23 women) with thoracolumbar OVF who underwent spinal fusion with a minimum of 2 years of follow-up were included (PD group). Surgical invasion, perioperative complications, radiographic sagittal alignment, mechanical failure (MF) related to instrumentation, and clinical outcomes were evaluated. A control group of 296 non-PD patients (non-PD group) matched for age, sex, distribution of surgical procedures, number of fused segments, and follow-up period were used for comparison. The PD group showed higher rates of perioperative complications (p < 0.01) and frequency of delirium than the non-PD group (p < 0.01). There were no significant differences in the degree of kyphosis correction, frequency of MF, visual analog scale of the symptoms, and improvement according to the Japanese Orthopaedic Association scoring system between the two groups. However, the PD group showed a higher proportion of non-ambulators and dependent ambulators with walkers at the final follow-up (p < 0.01). A similar surgical strategy can be applicable to patients with PD with OVF in the thoracolumbar junction. However, physicians should pay extra attention to intensive perioperative care to prevent various adverse events and implement a rehabilitation regimen to regain walking ability.

Kyphosis

Sports medicine

10.1186/s12891-019-2473-8

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Citations (21)

Machine Learning Approach in Predicting Clinically Significant Improvements After Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament

Spine (2021)

Satoshi Maki Takeo Furuya Toshitaka Yoshii Satoru Egawa Kenichiro Sakai

A retrospective analysis of prospectively collected data.This study aimed to create a prognostic model for surgical outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) using machine learning (ML).Determining surgical outcomes helps surgeons provide prognostic information to patients and manage their expectations. ML is a mathematical model that finds patterns from a large sample of data and makes predictions outperforming traditional statistical methods.Of 478 patients, 397 and 370 patients had complete follow-up information at 1 and 2 years, respectively, and were included in the analysis. A minimal clinically important difference (MCID) was defined as an acquired Japanese Orthopedic Association (JOA) score of ≥2.5 points, after which a ML model that predicts whether MCID can be achieved 1 and 2 years after surgery was created. Patient background, clinical symptoms, and imaging findings were used as variables for analysis. The ML model was created using LightGBM, XGBoost, random forest, and logistic regression, after which the accuracy and area under the receiver-operating characteristic curve (AUC) were calculated.The mean JOA score was 10.3 preoperatively, 13.4 at 1 year after surgery, and 13.5 at 2 years after surgery. XGBoost showed the highest AUC (0.72) and high accuracy (67.8) for predicting MCID at 1 year, whereas random forest had the highest AUC (0.75) and accuracy (69.6) for predicting MCID at 2 years. Among the included features, total preoperative JOA score, duration of symptoms, body weight, sensory function of the lower extremity sub-score of the JOA, and age were identified as having the most significance in most of ML models.Constructing a prognostic ML model for surgical outcomes in patients with OPLL is feasible, suggesting the potential application of ML for predictive models of spinal surgery.Level of Evidence: 4.

Posterior longitudinal ligament

10.1097/brs.0000000000004125

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Citations (12)

Bone Mineral Density After Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis at a Minimum 20-Year Follow-up

Spine Deformity (2017)

Masayuki Ohashi Tôru Hirano Kei Watanabe Keiichi Katsumi Hirokazu Shoji

Osteopenia

10.1016/j.jspd.2017.09.002

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Citations (14)

Predictive biomarkers of ossification progression and bone metabolism dynamics in patients with cervical ossification of the posterior longitudinal ligament

European Spine Journal (2023)

Keiichi Katsumi Kei Watanabe Akiyoshi Yamazaki Tôru Hirano Masayuki Ohashi

Sclerostin

Bone remodeling

Posterior longitudinal ligament

10.1007/s00586-023-07565-z

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Citations (1)

Posterior instrumented fusion suppresses the progression of ossification of the posterior longitudinal ligament: a comparison of laminoplasty with and without instrumented fusion by three-dimensional analysis

European Spine Journal (2015)

Keiichi Katsumi Tomohiro Izumi Ito T Tôru Hirano Kei Watanabe

Laminoplasty

Posterior longitudinal ligament

10.1007/s00586-015-4328-9

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Citations (50)

Response to “Letter to the editor regarding the article ‘Multimodal Deep Learning-based Radiomics Approach for Predicting Surgical Outcomes in Patients with Cervical Ossification of the Posterior Longitudinal Ligament’“

Spine (2025)

Satoshi Maki Takeo Furuya Keiichi Katsumi Hideaki Nakajima Kazuya Honjoh

Multimodal therapy

10.1097/brs.0000000000005296

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Citations (0)

Predicting Factors at Skeletal Maturity for Curve Progression and Low Back Pain in Adult Patients Treated Nonoperatively for Adolescent Idiopathic Scoliosis With Thoracolumbar/Lumbar Curves

Spine (2018)

Masayuki Ohashi Kei Watanabe Tôru Hirano Kazuhiro Hasegawa Keiichi Katsumi

Study Design. A retrospective, long-term follow-up study. Objective. We aimed to clarify the predicting factors at skeletal maturity for future curve progression and low back pain (LBP) in adolescent idiopathic scoliosis (AIS) with thoracolumbar/lumbar (TL/L) curve. Summary of Background Data. TL/L curves are likely to progress after skeletal maturity and cause LBP. Methods. Of 147 patients treated nonoperatively for AIS with TL/L curve, 56 (55 females; average age at the time of survey, 39.5 ± 7.1 years; average follow-up duration after maturity, 24.9 ± 6.9 years) completed questionnaires, including the visual analogue scale (VAS) for LBP and Oswestry disability index (ODI). Forty-nine patients underwent a radiological examination, and 48 underwent lumbar magnetic resonance imaging (MRI). Results. The mean Cobb angle of the TL/L curve increased from 37.3° ± 7.5° to 47.8° ± 12.6° (0.41° ± 0.39° per year). The factors at skeletal maturity that were associated with the annual progression of the TL/L curve included a cranially located apical vertebra, and great apical vertebral translation and L3 tilt. In addition, the VAS for LBP was positively correlated with L4 tilt, and the ODI was positively correlated with L4 tilt and apical vertebral rotation. Multivariate analyses and receiver-operating characteristic curves demonstrated that L3 tilt at skeletal maturity independently predicted a curve progression ≥0.5° per year (odds ratio [OR], 1.17), while L4 tilt at skeletal maturity independently predicted a VAS ≥3 cm (OR, 1.20) and ODI ≥21% (OR, 1.25) in adulthood, with a cutoff value of approximately 16° for each factor. Moreover, lumbar disc degeneration on MRI was associated with L4 tilt at skeletal maturity and LBP in adulthood. Conclusion. Great L3 and L4 tilt at skeletal maturity, especially those >16°, are predictors of future curve progression and LBP in adulthood, respectively. For adolescent patients with these risk factors, periodic follow-ups into adulthood should be considered. Level of Evidence: 4

Oswestry Disability Index

Cobb angle

Pelvic tilt

10.1097/brs.0000000000002716

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Citations (37)

The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament

Journal of Neurosurgery Spine (2014)

Keiichi Katsumi Akiyoshi Yamazaki Kei Watanabe Tôru Hirano Masayuki Ohashi

Cervical radiculopathy of the C2–4 spinal nerves is a rare condition and is poorly documented in terms of clinical symptoms, hindering its detection during initial patient screening based on imaging diagnostics. The authors describe in detail the clinical symptoms and successful surgical treatment of a patient diagnosed with isolated C-4 radiculopathy. This 41-year-old man suffered from sleep disturbance because of pain behind the right ear, along the right clavicle, and at the back of his neck on the right side. The Jackson and Spurling tests were positive, with pain radiating to the area behind the patient's ear. Unlike in cases of radiculopathy involving the C5–8 spinal nerves, no loss of upper-extremity motor function was seen. Magnetic resonance imaging showed foraminal stenosis at the C3–4 level on the right side, and multiplanar reconstruction CT revealed a beak-type ossification of the posterior longitudinal ligament in the foraminal region at the same level. In the absence of intracranial lesions or spinal cord compressive lesions, the positive Jackson and Spurling tests and the C3–4 foraminal stenosis were indicative of isolated C-4 radiculopathy. Microscopic foraminotomy was performed at the C3–4 vertebral level and the ossified lesion was resected. The patient's symptoms completely resolved immediately after surgery. To the authors' knowledge, this report is the first to describe the symptomatic features of isolated C-4 radiculopathy, in a case in which the diagnosis has been confirmed by both radiological findings and surgical outcome. Based on this case study, the authors conclude that the characteristic symptoms of C-4 radiculopathy are the presence of pain behind the ear and in the clavicular region in the absence of upper-limb involvement.

Posterior longitudinal ligament

Foraminotomy

Neck pain

10.3171/2014.2.spine13500

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Citations (2)