Epidemiological survey of ossification of the ligamentum flavum in thoracic spine: CT imaging observation of 993 cases
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ORIGINAL ARTICLE
Epidemiological survey of ossification of the ligamentum flavum in thoracic spine: CT imaging observation of 993 cases Ning Lang • Hui Shu Yuan • Hong Lei Wang • Jing Liao • Man Li • Fu Xin Guo • Shan Shi • Zhong Qiang Chen
Received: 2 August 2011 / Revised: 7 August 2012 / Accepted: 22 August 2012 / Published online: 15 September 2012 Ó Springer-Verlag 2012
Abstract Objective To investigate the characteristics of epidemiological distribution of the ossification of the ligamentum flavum (OLF) in the thoracic spine including the incidence, segmental distribution, and shape. Methods Chest spiral computed tomography scans of 993 cases (male 506, female 487, mean age 60 years, range 5–102 years) who presented due to chest symptoms were analyzed with axial slices combined with sagittal slices. The conditions of OLF in the thoracic spine, including segments, thickness, location, and dural sac compression, were recorded. Prevalence was standardized according to the ‘‘Age Structure of Population in Beijing 2008’’. Results Among the population investigated, the standardized prevalence rate was 63.9 %. The standardized prevalence rate for males (68.5 %) was higher than that for females (59.0 %). The highest prevalence rate of OLF was in the 50–59 years age group (79.2 %); however, high density originated it can be found in individuals aged 10–19 years. The comparison of different thoracic segments showed that T10–11 (44.0 %) and T11–12 (41.6 %) had the highest prevalence rates.
Ning Lang and Hui Shu Yuan contributed equally to this work. N. Lang H. S. Yuan H. L. Wang J. Liao M. Li F. X. Guo S. Shi Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, People’s Republic of China Z. Q. Chen (&) Department of Orthopaedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, People’s Republic of China e-mail: [email protected]
Conclusion The prevalence of ossification of the ligamentum flavum was highest in the 50–59 years group, but also occurred in early years. OLF occurs more frequently in the lower than in the upper and middle thoracic regions and its prevalence increases with aging. Keywords Ossification Ligamentum flavum Thoracic Epidemiology
Introduction Ossification of the ligamentum flavum (OLF) was first reported by Polgar in 1920 [1]. OLF occurs mainly in the Asian population [2–8] and there are only a few reports in the Caucasian, African, and Arabic racial groups [9–14]. OLF is one of the commonest causes of thoracic spinal stenosis and spinal cord compression, which can cause serious neurological symptoms or even paraplegia. Currently, the etiology and epidemiological characteristics of OLF are unknown and epidemiological investigations using diagnostic imaging methods have rarely been performed [3, 15]. Diagnostic methods were lateral radiographs [15] or MRI scans [3], but there are many factors that can contribute to local spinal bone overlaps in the lateral chest radiograph, whic
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