Association of Estrogen Receptor 2(ESR 2) Gene Polymorphisms with Ossification of the Posterior Longitudinal Ligament of the Spine

STUDY DESIGN: Genetic screening of the estrogen receptor 2 (ESR2) genes in patients with ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE: We studied the relationships between ESR2 gene polymorphisms and OPLL to understand the pathophysiology of OPLL. SUMMARY OF LITERATURE REVIEW: The OPLL has a strong genetic component. Several familial surveys and human leukocyte antigen (HLA) haplotype studies reveal that genetic background is an important component in the occurrence of OPLL and a large number of gene analysis studies were utilized to clarify the susceptible gene for OPLL, including COL11A2, BMP-2, TNF-alpha, NPPS, leptin receptor, transforming growth factor (TGF)-beta, Retinoic X receptor, ER, IL-1, PTH, and VDR have been performed. MATERIALS AND METHOD: Genomic deoxyribonucleic acid (DNA) samples obtained from 164 patients (93 men and 71 women) with OPLL and 219 control subjects, without the disease (105 men and 114 women) were amplified by polymerase chain reaction, and polymorphism genotypes were determined by the restriction endonuclease digestion. The distribution of genotypes was compared between the patients with the disease and the control subjects. RESULTS: The polymorphism of ESR2 [rs1256049, exon6, Val328Val, p=0.018, odd ratio (OR)=2.41, 95 confidence interval (CI)=1.15-5.02 in the recessive model] only showed statistically significant association between the control and the OPLL groups. The rest SNPs of ESR2 did not show any significant differences between the control and the OPLL groups. CONCLUSIONS: Estrogen receptor 2 (ESR2) gene polymorphisms (rs 1256049) was associated with OPLL. In future studies, we will perform target SNP chip between OPLL and candidate gene.

Influence of different operations on BMP-2,BMP-7 in rat posterior longitudinal ligament / 中国矫形外科杂志

[Objective]To discuss the initiating and developing mechanism of OPLL,and the influence of different operations on happening and developing of OPLL.[Method]We subgroup healthy adult S-D rats into groups,did operation on C 3~6 level.The first group:laminectomy;the second group:laminectomy and muscle cutting;the third group:muscle cutting only;the fourth group:exposure only;contrasting group:no treatment.We got the tissue of posterior longitudinal,ligament at 1,2,4,and 8 weeks post-operation and quantify BMP-2 and BMP-7 by PCR method.[Result]BMP-2,BMP-7 increased significantly in the 1st,2nd and 3rd group compared with the contrastinggroup;BMP-2,BMP-7 of only exposure group had no significant difference compared with the contrasting group.[Conclusion]BMP-2 and BMP-7 play important roles in the early stage of OPLL,they could be the on-setting factors of OPLL.BMP-7 may play an important roles in the later ossification period.

Anterior Decompression and Interbody Fusion for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Case Report

The authors describe a case of a 41-year-old woman who developed clumsiness and decreased sensation of both hands due to ossification of the posterior longitudinal ligament(OPLL) of the cervical spine. The central part of the vertebral body and ossified area of the posterior longitudinal ligament was removed and the defect was filled with iliac bone graft. The operative result was excellent and the brief review about OPLL was made.

Anterior Decompression and Interbody Fusion for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Case Report

The authors describe a case of a 41-year-old woman who developed clumsiness and decreased sensation of both hands due to ossification of the posterior longitudinal ligament(OPLL) of the cervical spine. The central part of the vertebral body and ossified area of the posterior longitudinal ligament was removed and the defect was filled with iliac bone graft. The operative result was excellent and the brief review about OPLL was made.

Clinical Evaluation of Cervical Ossification of the Posterior Longitudinal Ligament

The authors treated 32 patients with Ossification of the Posterior Longitudinal Ligament(OPLL). Seventeen of these patient had surgery during the past 1 year between 1987 and 1988. In this study we present a radiological and clinical analysis of these cases with a literature review. We also discuss a clinical system of grading, different types of radiological patterns, the indication of surgical treatment and the choice of operative methods. 1) The incidence of the cervical OPLL was about 5.4% in our annual study, which was based on the cervical CT and CTM. 2) The highest incidence was in patients 50-60 years of age and male: female ratio was about 3:1. 3) The highest incidence was in C5, C6 and C4 levels of cervical spine and two and three level involvement was prominent. 4) The pattern of OPLL was devided into a continuous type (21%), a multiple segmented type(48%), a mixed type(25%), a localized type(6%). 5) Absolute diameter did not always parallel the extent of spinal cord signs as did the percentage of spinal canal narrowing. 6) In cases of a clinical grading of more than III, surgery must be considered. In grade II, surgery is indicative if conservative management failed to improve the clinical symptoms. 7) For the evaluation of the cervical OPLL, the CT-Scan of CT metrizamide myelography was more useful method. 8) Cervical Corpectomy and fusion with or without bone cement were found to be advisable in Cases of cervical OPLL.