• Katsuyuki Sasaki, Toru Doi, Tomohisa Inoue, Keiichiro Tozawa, Hiroyuki Nakarai, Yuichi Yoshida, Yusuke Ito, Nozomu Ohtomo, Ryuji Sakamoto, Koji Nakajima, Kosei Nagata, Naoki Okamoto, Hideki Nakamoto, So Kato, Yuki Taniguchi, Yoshitaka Matsubayashi, Ken Okazaki, Sakae Tanaka, and Yasushi Oshima.
• Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan.
• Spine. 2024 Apr 15; 49 (8): E100E106E100-E106.

Study DesignA prospective, single-center, observational study.ObjectiveTo explore the association between serum levels of bone turnover markers and ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine.Summary Of Background DataThe relationship between bone turnover markers, such as N-terminal propeptide of type I procollagen (PINP) or tartrate-resistant acid phosphate 5b (TRACP-5b), and OPLL has previously been examined. However, the correlation between these markers and thoracic OPLL, which is more severe than cervical-only OPLL, remains unclear.MethodsThis prospective study included 212 patients from a single institution with compressive spinal myelopathy and divided them into those without OPLL (Non-OPLL group, 73 patients) and those with OPLL (OPLL group, 139 patients). The OPLL group was further subdivided into cervical OPLL (C-OPLL, 92 patients) and thoracic OPLL (T-OPLL, 47 patients) groups. Patients' characteristics and biomarkers related to bone metabolism, such as calcium, inorganic phosphate (Pi), 25-hydroxyvitamin D, 1α,25 dihydroxyvitamin D, PINP, and TRACP-5b, were compared between the Non-OPLL and OPLL groups, as well as the C-OPLL and T-OPLL groups. Bone metabolism biomarkers were also compared after adjusting for age, sex, body mass index, and the presence of renal impairment using propensity score-matched analysis.ResultsThe OPLL group had significantly lower serum levels of Pi and higher levels of PINP versus the Non-OPLL group as determined by propensity score-matched analysis. The comparison results between the C-OPLL and T-OPLL groups using a propensity score-matched analysis showed that T-OPLL patients had significantly higher concentrations of bone turnover markers, such as PINP and TRACP-5b, compared with C-OPLL patients.ConclusionsIncreased systemic bone turnover may be associated with the presence of OPLL in the thoracic spine, and bone turnover markers such as PINP and TRACP-5b can help screen for thoracic OPLL.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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