CT Manifestations of Ossification of Posterior Longitudinal Ligament in the Cervical Spine_West China Medical Journal

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Department of Radiology, Yantai Port Hospital, Yantai, Shandong 264002, P.R.China;

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Keywords：

頸椎; 椎管狹窄; 后縱韌帶骨化; 體層攝影術; X線計算機

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【摘要】目的 探討頸椎后縱韌帶骨化癥(OPLL)的CT表現及其診斷價值。方法回顧性分析2004年11月-2009年10月收治的6 480例頸椎患者的CT圖像資料，觀察后縱韌帶骨化塊的形態、位置及與椎管的關系，計算椎管狹窄率。結果 6 480例頸椎CT圖像中，37例發現OPLL，占0.57%（37/6 480）。頸椎后縱韌帶骨化塊表現為點狀、條狀、線狀、平板狀、山丘狀、蕈傘狀及花邊狀，呈現局限型、節段型、連續型、混合型特點。C4、C5及C6為頸椎后縱韌帶骨化常見位置。骨化塊平均厚度為4.12 mm，骨化塊致椎管矢狀徑狹窄率為10.20%～49.18%，多位于椎管前方中間位置。椎管狹窄率 gt;34.10%，臨床癥狀明顯。結論 CT檢查能較好地顯示頸椎后縱韌帶骨化塊的特征及椎管的狹窄程度，是臨床醫生選擇手術方案和術后評估預后的一種較好方法。
【Abstract】 Objective To study the CT manifestations of ossification of posterior longitudinal ligament (OPLL) and to evaluate diagnostic value. Methods Retrospective analysis was made on the cervical spine CT images of 6 480 cases, and 37 cases of OPLL were found. The shape, location of the ossification pieces and the sagital diameter of cervical spinal canal and the stenotic rate were observed and measured. Results The ossified pieces were manifested as dots, belts, lines, boards, mounds, mushrooms and flower margins in shape. They were continuous, segmental, solitary or mixed. OPLL usually was found at C4, C5 and C6. The average thickness of the ossified pieces was 4.12 mm. The spinal stenotic rate ranged from 10.20% to 49.18% due to OPLL. The ossified pieces were often found at the middle of the back edge of cervical vertebrae bodies. There were obvious symptoms when the stenotic rate of sagital diameter of cervical spinal canal was over 34.10%. Conclusion CT is an optimal modality for diagnosis of OPLL of cervical spine and cervical spinal stenosis, and may help the clinicians to select or valuate operation project.

Citation： XU Kai. CT Manifestations of Ossification of Posterior Longitudinal Ligament in the Cervical Spine. West China Medical Journal, 2010, 25(9): 1664-1666. doi: Copy

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1. 徐恩多. 局部解剖學[M]. 北京: 人民衛生出版社, 1993: 168-172.
2. Ohishi H, Furukawa K, Iwasaki K, et al. Role of prostaglandin I2 in the gene expression induced by mechanical stress in spinal ligament cells derived from patients with ossification of the posterior longitudinal ligament[J]. J Pharmacol Exp Ther, 2003, 305(3): 818-824.
3. Ramos-Remus C, Russell AS, Gomez-Vargas A, et al. Ossification of the posterior longitudinal ligament in three geographically and genetically different populations of ankylosing spondylitis and other spondyloarthropathies[J]. Ann Rheum Dis, 1998, 57(7): 429-433.
4. 李蘭貴, 蘇凱, 張玉琴. 頸椎后縱韌帶骨化癥的影像學表現[J]. 實用放射學雜志, 2004, 20(2): 140-143.
5. Li H, Jiang LS, Dai LY. A review of prognostic factors for surgical outcome of ossification of the posterior longitudinal ligament of cervical spine[J]. Eur Spine J, 2008, 17(10): 1277-1288.
6. Yang DY, Wang YC, Lee CS, et al. Ossification of the posterior cervical longitudinal ligament[J]. Acta Neurochir (Wien), 1992, 115(1-2): 15-19.
7. Hanai K, Adachi H, Ogasawara H. Axial transverse tomography of the cervical spine narrowed by ossification of the posterior longitudinal ligament[J]. J Bone Joint Surg Br, 1977, 59-B(4): 481-484.
8. Yamashita Y, Takahashi M, Matsuno Y, et al. Spinal cord compression due to ossification of ligaments: MR imaging[J]. Radiology, 1990, 175(3): 843-848.

West China Medical Journal

CT Manifestations of Ossification of Posterior Longitudinal Ligament in the Cervical Spine

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