Evaluation of locomotive syndrome in patients with ossification of the posterior longitudinal ligament at cervical spine presenting mild symptoms.

Abstract

Mild cervical ossification of the posterior longitudinal ligament (OPLL) is often asymptomatic or minimally symptomatic; however, its impact on physical function remains unclear. Locomotive syndrome (LS), a condition involving a decline in mobility due to musculoskeletal disorders, may help predict early functional impairments beyond neurological deficits. This study aimed to assess the severity of LS in patients with mild OPLL using the locomotive syndrome risk test battery. This cross-sectional study included 37 patients with mild OPLL (Japanese Orthopaedic Association score ≧16 points) and 73 propensity score-matched controls with no major comorbidities. All participants underwent three LS assessments: the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25). LS stages were defined according to the Japanese Orthopaedic Association criteria. Group comparisons were performed using Student's t-test and the Chi-Square test. The OPLL group demonstrated significantly lower two-step and stand-up test scores (P < 0.05) and higher GLFS-25 scores (P = 0.0102) than controls. A significantly higher proportion of the OPLL group was classified as having LS stage 2 (32.4 % vs. 15.1 %, P = 0.0017), indicating more advanced locomotor dysfunction. Patients with mild cervical OPLL and preserved neurological function exhibited greater LS severity and subjective disabilities. The GLFS-25 effectively captured functional and psychosocial burden not reflected in traditional neurological scores, suggesting the need for early screening and mindful diagnostic communication.