Kadoya S, Nakamura T, Ohashi M, Hirose G, Tada A
No Shinkei Geka. 1979 Jan;7(1):63-70.
Ossification of the posterior longitudinal spinal ligament (OPLL) was characterized by calcified longitudinal band along the posterior margin of vertebrae, but it has not been possible to know how the cord is compressed within the narrowed spinal canal. Our neuroradiological studies based on CT-view of the 15 cases of OPLL suffering from various degree of myelopathy revealed: 1) Computed tomography precisely delineated shape of OPLL, which was quite polymorphic, like mushroom, irregular cubic and round. OPLL ranged more than two vertebrae was not uniform, but exhibited different configuration at each level. 2) OPLL at lower cervical and higher thoracic regions was difficult to diagnose by conventional lateral roentgenograms, but CT-scan demonstrated clearly whole extent of OPLL. 3) obliteration ratio of the affected spinal canal was calculated on CT-scan. Cases showing severe myelopathy, such as quadriparesis and neurogenic bladder, presented spinal canal stenosis of more than 30%. Spondylosis were concomittant roentgenographic findings on 13 cases of OPLL (87%). However, spondylotic changes responsible to the myelopathy were seen on only three cases. In these case, the obliteration ratio by ossificated ligament was lower than 26%. On conclusion, computed tomographic views of OPLL gave us more detailed information about the stenotic spinal canal and found to be essential examination when considering operative intervention.
后纵韧带骨化（OPLL）的特征是沿椎体后缘有钙化的纵行条带，但目前尚无法了解脊髓在狭窄椎管内是如何受压的。我们对15例患有不同程度脊髓病的OPLL患者进行CT检查的神经放射学研究显示：1）计算机断层扫描能精确描绘出OPLL的形态，其形态非常多样，如蘑菇状、不规则立方体状和圆形。跨越两个以上椎体的OPLL并不均匀，而是在每个层面呈现出不同的形态。2）下颈椎和上胸椎区域的OPLL通过传统的侧位X线片很难诊断，但CT扫描能清晰显示OPLL的全貌。3）在CT扫描上计算受累椎管的狭窄率。表现为严重脊髓病的病例，如四肢瘫痪和神经源性膀胱，椎管狭窄超过30%。13例OPLL患者（87%）同时有脊柱退变的X线表现。然而，仅3例患者发现与脊髓病相关的脊柱退变改变。在这些病例中，骨化韧带导致的狭窄率低于26%。总之，OPLL的计算机断层扫描图像为我们提供了关于狭窄椎管的更详细信息，并且发现它是考虑手术干预时必不可少的检查。
