Radiographic Predictors for the Development of Myelopathy in Patients With Ossification of the Posterior Longitudinal Ligament A Multicenter Cohort Study

被引：92

作者：

Matsunaga, Shunji ^{[1
]}

Nakamura, Kozo ^{[2
]}

Seichi, Atsushi ^{[2
]}

Yokoyama, Toru ^{[3
]}

Toh, Satoshi ^{[3
]}

Ichimura, Shoichi ^{[4
]}

Satomi, Kazuhiko ^{[4
]}

Endo, Kenji ^{[5
]}

Yamamoto, Kengo ^{[5
]}

Kato, Yoshiharu ^{[6
]}

Ito, Tatsuo ^{[6
]}

Tokuhashi, Yasuaki ^{[7
]}

Uchida, Kenzo ^{[8
]}

Baba, Hisatoshi ^{[8
]}

Kawahara, Norio ^{[9
]}

Tomita, Katsuro ^{[9
]}

Matsuyama, Yukihiro ^{[10
]}

Ishiguro, Naoki ^{[10
]}

Iwasaki, Motoki ^{[11
]}

Yoshikawa, Hideki ^{[11
]}

Yonenobu, Kazuo ^{[12
]}

Kawakami, Mamoru ^{[13
]}

Yoshida, Munehito ^{[13
]}

Inoue, Shinsuke ^{[14
]}

Tani, Toshikazu ^{[14
]}

Kaneko, Kazuo ^{[15
]}

Taguchi, Toshihiko ^{[15
]}

Imakiire, Takanori

Komiya, Setsuro ^{[16
]}

机构：

[1] Imakiire Gen Hosp, Dept Orthopaed Surg, Kagoshima 8928502, Japan

[2] Univ Tokyo, Fac Med, Dept Orthopaed Surg, Tokyo 113, Japan

[3] Hirosaki Univ, Grad Sch Med, Dept Orthopaed Surg, Aomori, Japan

[4] Kyorin Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[5] Tokyo Med Univ, Dept Orthopaed Surg, Tokyo, Japan

[6] Tokyo Womens Med Univ, Dept Orthopaed Surg, Tokyo, Japan

[7] Nihon Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[8] Univ Fukui, Fac Med, Dept Orthopaed & Rehabil Med, Fukui 910, Japan

[9] Kanazawa Univ, Fac Med Sci, Dept Orthopaed Surg, Kanazawa, Ishikawa, Japan

[10] Nagoya Univ, Sch Med, Dept Orthopaed Surg, Aichi, Japan

[11] Osaka Univ, Grad Sch Med, Dept Orthopaed Surg, Osaka, Japan

[12] Natl Hosp Osaka S Med Ctr, Dept Orthopaed Surg, Osaka, Japan

[13] Wakayama Med Univ, Dept Orthopaed Surg, Wakayama, Japan

[14] Kochi Med Sch, Dept Orthopaed Surg, Kochi, Japan

[15] Yamaguchi Grad Univ, Sch Med, Dept Orthopaed Surg, Yamaguchi, Japan

[16] Kagoshima Univ, Dept Orthopaed Surg, Grad Sch Med & Dent Sci, Korimoto, Kagoshima, Japan

来源：

SPINE | 2008年 / 33卷 / 24期

关键词：

OPLL; myelopathy; CT; dynamic factor;

D O I：

10.1097/BRS.0b013e31817f988c

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. A multicenter cohort study was performed retrospectively. Objective. To identify radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligaments (OPLL). Summary of Background Data. The pathomechanism of myelopathy in the OPLL remains unknown. Some patients with large OPLL have not exhibited myelopathy for a long periods of time. Predicting the course of future neurologic deterioration in asyptomatic patients with OPLL is difficult at their initial visit. Methods. A total of 156 OPLL patients from 16 spine institutes with an average of 10.3 years of follow-up were reviewed. Subjects underwent a plain roentgenogram, computed tomography (CT), and magnetic resonance imaging of the cervical spine during the followup. The trauma history of the cervical spine, maximum percentage of spinal canal stenosis in a plain roentgenogram and CT, range of motion of the cervical spine, and axial ossified pattern in magnetic resonance imaging or CT were reviewed in relation to the existence of myelopathy. Results. All 39 patients with greater than 60% spinal canal stenosis on the plain roentgenogram exhibited myelopathy. Of 117 patients with less than 60% spinal canal stenosis, 57 (49%) patients exhibited myelopathy. The range of motion of the cervical spine was significantly larger in patients with myelopathy than in those of without it. The axial ossified pattern could be classified into 2 types: a central type and a lateral deviated type. The incidence of myelopathy in patients with less than 60% spinal canal stenosis was significantly higher in the lateral deviated-type group than in the central-type group. Fifteen patients of 156 subjects developed trauma-induced myelopathy. Of the 15 patients, 13 had mixed-type OPLL and 2 had segmental-type OPLL. Conclusion. Static and dynamic factors were related to the development of myelopathy in OPLL.

引用

页码：2648 / 2650

页数：3

共 2 条

[1]

MATSUNAGA S, 1994, CLIN ORTHOP RELAT R, P168

[2] Radiological pathogenesis of cervical myelopathy in 60 consecutive patients with cervical ossification of the posterior longitudinal ligament [J].

Morio, Y ;

Nagashima, H ;

Teshima, R ;

Nawata, K .

SPINAL CORD, 1999, 37 (12) :853-857

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