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Usefulness of digital tomosynthesis in diagnosing cervical ossification of the posterior longitudinal ligament: a comparative study with other imaging modalities

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Abstract

Purpose

The diagnosis and classification of ossification of the posterior longitudinal ligament (OPLL) can be difficult with radiography alone; therefore, computed tomography (CT) is also usually performed. There are many reports on the usefulness of digital tomosynthesis (DTS) for image analysis in orthopedics. This study aimed to compare the accuracy of DTS with radiography and CT for the diagnosis and classification of cervical OPLL (C-OPLL).

Materials and methods

We included 31 patients with OPLL and 30 with cervical spondylotic myelopathy. The patients' cervical spine radiography, DTS, and CT images were each evaluated twice by three specialists and three residents.

Results

In the intra-observer reliability study, there was one observer with a fair level of kappa values for radiography and DTS among three residents. The kappa values for CT were the best for all observers. In the inter-observer reliability study, the interclass correlation coefficient (ICC) values were high for both diagnosis and classification by specialists at the almost perfect level for all three imaging modalities. On the other hand, the ICC values for both diagnosis and classification for radiography by the residents were lower than those for DTS and CT.

Conclusions

This study revealed that DTS may be an alternative to CT for the diagnosis and classification of C-OPLL by specialists. Caution should be exercised in diagnosing and classifying C-OPLL using radiography and DTS by residents, and the use of CT is recommended.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan

    Toru Asari, Kanichiro Wada, Gentaro Kumagai, Eiji Sasaki, Rino Okano, Tetsushi Oyama, Manami Tsukuda, Kento Ota & Yasuyuki Ishibashi

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  1. Toru Asari
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  2. Kanichiro Wada
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  3. Gentaro Kumagai
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  4. Eiji Sasaki
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  5. Rino Okano
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  6. Tetsushi Oyama
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  7. Manami Tsukuda
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  8. Kento Ota
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  9. Yasuyuki Ishibashi
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Correspondence to Toru Asari.

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Ethical approval

This study was approved by the ethics committee of the Hirosaki University Graduate School of Medicine (IRB number: 2019–1038).

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Asari, T., Wada, K., Kumagai, G. et al. Usefulness of digital tomosynthesis in diagnosing cervical ossification of the posterior longitudinal ligament: a comparative study with other imaging modalities. Eur Spine J 31, 3470–3476 (2022). https://doi.org/10.1007/s00586-022-07430-5

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  • DOI: https://doi.org/10.1007/s00586-022-07430-5

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