ArticleFrontiers in molecular biosciences2026
Association and predictive value of systemic immune-inflammation index and body mass index in cervical ossification of the posterior longitudinal ligament.
Article in Frontiers in molecular biosciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Cervical ossification of the posterior longitudinal ligament (C-OPLL) is a common cause of cervical myelopathy. While mechanical and metabolic factors have been implicated in its pathogenesis, the role of systemic inflammation remains unclear. This research aimed to explore the link between inflammation-related biomarkers and C-OPLL and their predictive ability. Methods: A total of 442 patients (211 C-OPLL, 231 controls) were enrolled in this study. We collected demographic data, comorbidities, and preoperative blood parameters. The calculation of Systemic immune-inflammation index (SII) and other inflammatory indices was performed. Independent risk factors were identified through multivariate logistic regression. Subgroup and interaction analyses assessed the combined effect of body mass index (BMI) and SII on C-OPLL. Results: Patients with C-OPLL showed significantly higher BMI and SII levels than controls (all p < 0.05). Multivariate logistic regression analysis indicated that SII (odds ratio [OR]: 1.121; 95% confidence interval [CI]: 1.101-1.210; P < 0.01) and BMI (OR: 1.412; 95% CI: 1.251-1.594; P < 0.01) were independent predictors of C-OPLL. The AUC for SII on the ROC curve was 0.82. The SII demonstrated a sensitivity of 73.0% and a specificity of 80.5% at a cutoff of 464.2, derived from the current dataset using Youden index analysis. Subgroup analyses consistently showed a positive association between SII and C-OPLL, with no significant interactions detected. A significant synergistic effect was observed between obesity and high SII (P = 0.038). Obese patients with high SII had the highest prevalence of C-OPLL (63.1%) and the greatest risk (OR = 6.23, compared with normal-weight individuals with low SII). Both SII and BMI were independently associated with C-OPLL. Conclusion: These findings suggest that metabolic burden and systemic inflammatory activation may be involved in C-OPLL pathogenesis. Inflammation-based measures such as SII could therefore complement risk stratification, though further research is needed.
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