The results showed that lnc-KRT18-1, TSPEAR, CLIC2, ANKRD33B, TWIST2, C19orf73, TBX19, TWIST2, LOC101926975, and ABLIM1 had the highest number of interactions, which revealed the vital roles of these genes in the pathogenesis of OPLL (Figure 5). Here, TSPEAR is linked to ossification of the posterior longitudinal ligament of the spine.