摘要
作者对１９例颈椎后纵韧带骨化症（ＯＰＬＬ）合并胸椎黄韧带骨化症（ＯＬＦ）的诊断问题进行了分析。其临床特点主要为：仅有下肢上运动神经元损害症状、体征而无或仅既往有上肢神经损害症状、体征，或经颈椎手术后上肢神经损害症状、体征明显减轻或消失而下肢症状、体征加重。影像学上，当Ｘ线平片发现累及多个节段尤其是下颈椎的连续型。混合型ＯＰＬＬ及合并ＤＩＳＨ病（弥漫性特发性骨质增生）时要高度怀疑有颈椎ＯＰＬＬ合并胸椎ＯＬＦ的可能。确定诊断以Ｘ线侧位平片为简单、经济的筛选方法。ＭＲＩ结合ＣＴ，全脊髓造影加ＣＴＭ是确定胸椎黄韧带骨化范围、程度、部位以及了解脊髓受压程度的最佳方法。
AbstractThe diaRnosis of l9 patients with myelopathy dueto ossification of the posterior longitudinal ligament(OPLL)of the cervical spine associated with ossifica-tion of the ligamentum flavum(OLF)of thoracic spinewere reviewed.The characteristic profile is a patientwith myelopathic symptoms and signs on the lowerlimbs,with or without a history of myelopathic symp-toms on the upper limbs;or after posterior decompres-son of the cervical spine,the myelopathic symptomsand signs recovered on the upper limbs but progressedon the lower limbs,OLF of the thoracic spine shouldbe highly suspected when multi-level continuous typeor combined type of OPLL which especially involvedthe lower cervical spine appears on the plain X-rayfilm.The first choice to screen OLF of the thoracicspine is a plain lateral roentoenogram and tomographyof the thoracic spine,which is simple and economic.For further confirmation of the diagnosis,MRI com-bined with CT scan or myelogram with CTM is thebest method to demonstrate the distribution ,locationand extent of OLF in the thoracic spine as well as thedegree of compression of the spinal cord.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1995年第9期575-577,共3页
Chinese Journal of Orthopaedics
