{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:34:17Z","timestamp":1772109257447,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,7,20]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Stenotic thoracic ligamentum flavum hypertrophy can cause leg and\/or low back pain similar to that caused by lumbar spinal stenosis. However, the thoracic spine may occasionally be overlooked in patients with leg and\/or low back pain. An accurate understanding of the prevalence of stenotic thoracic ligamentum flavum hypertrophy and its associated factors is necessary.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this prevalence study, we reviewed whole-spine MRI scans of patients who visited the pain clinic complaining of leg and\/or low back pain between 2010 and 2019. We analyzed the overall prevalence and prevalence according to the age group, sex, grade of lumbar disc degeneration, and thoracic level. In addition, we identified factors independently associated with stenotic thoracic ligamentum flavum hypertrophy occurrence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1896 patients, the overall prevalence of stenotic thoracic ligamentum flavum hypertrophy was 9.8% (185\/1896), with the highest prevalence observed in the \u226580-year-old age group among all age groups (15.9%, 14\/88). The region with the highest prevalence was the T10\/11 level (3.0%, 57\/1896). Multivariable logistic regression analysis revealed that when compared with the &lt;50-year-old age group, all other age groups were significantly associated with stenotic thoracic ligamentum flavum hypertrophy (p&lt;0.01). In addition, grade 5 of lumbar disc degeneration was significantly associated with stenotic thoracic ligamentum flavum hypertrophy (p=0.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Given the possibility for missed stenotic thoracic ligamentum flavum hypertrophy to potentially result in neurological complications, extending lumbar spine MRI covering the lower thoracic region may be considered for patients over 50 years of age with suspected severe lumbar disc degeneration.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2023-104692","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T13:25:56Z","timestamp":1690550756000},"page":"326-331","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of and factors associated with stenotic thoracic ligamentum flavum hypertrophy"],"prefix":"10.1136","volume":"49","author":[{"given":"Chan-Sik","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-9986","authenticated-orcid":false,"given":"Hyungtae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sehee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju Hwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea"},{"name":"Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Republic of Korea"},{"name":"Wonkwang Institute of Science, Wonkwang University School of Medicine, Iksan, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koun","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Seung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeon-Dong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea"},{"name":"Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Republic of Korea"},{"name":"Wonkwang Institute of Science, Wonkwang University School of Medicine, Iksan, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"2025101113053540000_49.5.326.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5921"},{"key":"2025101113053540000_49.5.326.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06520-6"},{"key":"2025101113053540000_49.5.326.3","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/BSD.0000000000000081","article-title":"Clinical features of thoracic spinal stenosis-associated myelopathy: a retrospective analysis of 427 cases","volume":"29","author":"Hou","year":"2016","journal-title":"Clin Spine Surg"},{"key":"2025101113053540000_49.5.326.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0919-7"},{"key":"2025101113053540000_49.5.326.5","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20883"},{"key":"2025101113053540000_49.5.326.6","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/00007632-199103000-00005","article-title":"Thoracic myelopathy caused by ossification of the ligamentum flavum. 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