Association between Basal Ganglia Calcification and Cervical Spine Ossification Disorders: A Retrospective Cross-Sectional Study

Objective Basal ganglia calcification (BGC) is a common incidental finding on brain computed tomography (CT) and may indicate a tendency toward systemic calcification. The relationship between BGC and cervical spine ossification disorders remains unexplored. This study aimed to investigate the association between BGC and cervical ossification of the posterior longitudinal ligament (OPLL) and diffuse idiopathic skeletal hyperostosis (DISH). Methods This retrospective cross-sectional study analyzed patients who underwent both brain CT and cervical spine CT at Chungbuk National University Hospital from March 2023 to March 2025. BGC presence was evaluated on brain CT, while OPLL and DISH were assessed on cervical spine CT. Logistic regression analysis was performed to determine associations, adjusting for age and sex. Results Among 1,911 included patients, those with BGC (n = 298, 15.7%) demonstrated significantly higher prevalence of both OPLL (33.2% vs. 9.9%; p < 0.001) and DISH (18.0% vs. 6.7%; p < 0.001) than those without BGC. After adjusting for age and sex, BGC remained significantly associated with OPLL (adjusted odds ratio [OR], 4.41; 95% confidence interval [CI], 3.27-5.95; p < 0.001) and DISH (adjusted OR, 2.79; 95% CI, 1.92-4.06; p < 0.001). Conclusion Incidental BGC is associated with a significantly increased risk of cervical OPLL and DISH. Brain CT scans revealing BGC may warrant evaluation of the cervical spine.