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Risk of Ossification of the Posterior Longitudinal Ligament (OPLL) following gout diagnosis: a nationwide cohort study
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DOI：10.1007/s00264-026-06788-1.png)
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Abstract
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Study design Population-based retrospective cohort study. Objectives To assess the longitudinal association between incident gout and risk of incident cervical ossification of the posterior longitudinal ligament (OPLL). Methods Using National Health Insurance Service data linked to health screening records (2002-2013), adults aged 20-79 years with incident gout were identified (>= 2 primary diagnoses of ICD-10 M10.0/M10.9 within 30 days) after a two year washout. Controls without gout were propensity score-matched 1:20. Incident cervical OPLL was defined as ICD-10 M48.82 with cervical CT or MRI within 30 days. Participants were followed from index date to OPLL, death, or December 31, 2013. Cox proportional hazards models estimated adjusted hazard ratios (HRs); sensitivity analyses used a stricter OPLL definition (>= 2 diagnoses > 30 days apart). Results The matched cohort included 5,977 gout patients and 119,540 controls (478,828 person-years). OPLL developed in 17 (0.28%) gout patients versus 162 (0.14%) controls, yielding incidence rates of 0.75 vs 0.36 per 1,000 person-years (incidence rate ratio 2.11; 95% CI, 1.28-3.47). Gout was associated with increased OPLL risk in the fully adjusted model (HR 2.13; 95% CI, 1.27-3.56). Findings were consistent under the stricter definition (incidence rate ratio 2.29; 95% CI, 1.26-4.17). Conclusions In this nationwide cohort, incident gout was independently associated with more than a twofold higher risk of incident cervical OPLL.
Keywords:
Gout
Ossification of the Posterior Longitudinal Ligament
Inflammation
Incidence
Cohort Studies
Retrospective Studies
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