Progression Of Ossification Of The Anterior Longitudinal Ligament Associated With Diffuse Idiopathic Skeletal Hyperostosis By Age: A Study Of Computed Tomography Findings Over 5 Years

Study Design:Observational study.Objective:To investigate whether the progression of anterior longitudinal ligament ossification varies by age among patients with diffuse idiopathic skeletal hyperostosis (DISH).Methods:Of the patients who underwent computed tomography (CT) of the thoracic to pelvic region at least twice from 2009 to 2018, 191 who underwent CT at an interval of 5 years and 0 months to 5 years and 2 months were enrolled (87 men and 104 women). Sex, age at the time of the first CT scan, the presence/absence of DISH, level of complete vertebral body fusion associated with DISH, and extent of ligament ossification using the modified Mata scoring system were investigated.Results:DISHs were detected in 53 (27.7%) of 191 patients. The score of ligament ossification increased over time in 35 (66%) of 53 patients; 93 intervertebral spaces were affected. The percentage of completely fused intervertebral spaces increased by 6.7% from 31.3% to 38.0% over time. The increase in score for all intervertebral spaces in individual patients was significantly greater in the <= 70 years old group (2.7 +/- 2.8 points, n = 28) than in the >= 71 years old group (1.2 +/- 1.4 points; n = 25; P = .028). The mean age of patients with a recorded score that increased by >= 1 point was 67.4 years and that of patients without any change in the score was 73.3 years (P = .036). Thus, patients with recorded changes in the score were younger.Conclusion:During the approximately 5-year period, ossification progressed more in younger patients than in older patients.