Inamasu Joji, Guiot Bernard H
Department of Neurosurgery, University of South Florida College of Medicine, Tampa, Florida 33606, USA.
J Neurosurg Spine. 2006 Aug;5(2):133-9. doi: 10.3171/spi.2006.5.2.133.
Ossification of the ligamentum flavum (OLF) is a pathological condition that affects the ligament and causes slowly progressive myeloradiculopathy in adults. Although OLF has been regarded as endemic to East Asian countries, studies from outside these areas have increasingly been reported. Because of long-standing compression of the spinal cord by OLF, a patient's functional prognosis may not always be favorable, and attempts have been made in recent studies to identify clinical factors that are predictive of the surgical outcome of patients with thoracic OLF.
The authors conducted a review of the literature published in the English, Japanese, and Korean languages. They examined studies in which correlation between clinical factors and outcome was statistically evaluated. The clinical factors included sex, age, level of the ossified ligamentum flavum, number of segments affected by OLF, coexisting ossification of the posterior longitudinal ligament (OPLL) or other spinal disorders, preoperative duration of symptoms, preoperative neurological score, computed tomography (CT)-based classification, and the presence of intramedullary high signal intensity on T2-weighted magnetic resonance images.
The clinical factors that are unlikely to be predictive of outcome include sex, age, level of the ossified lesion, number of OLF-affected segments, coexisting OPLL, CT classification, and the presence of high signal intensity. It is unclear whether the preoperative duration of symptoms or neurological score is predictive of outcome because the results have been inconsistent among the studies. Analysis of the more recent literature, however, suggests that these two factors are predictive of outcome. The use of a neurological score should be standardized so that compilation and comparison of data can be facilitated.
黄韧带骨化（OLF）是一种影响韧带并导致成人缓慢进行性脊髓神经根病的病理状况。尽管OLF一直被认为是东亚国家的地方病，但来自这些地区以外的研究报告越来越多。由于OLF对脊髓的长期压迫，患者的功能预后可能并不总是良好，最近的研究试图确定可预测胸椎OLF患者手术结果的临床因素。
作者对以英文、日文和韩文发表的文献进行了综述。他们审查了对临床因素与结果之间的相关性进行统计学评估的研究。临床因素包括性别、年龄、骨化黄韧带的节段水平、受OLF影响的节段数、并存的后纵韧带骨化（OPLL）或其他脊柱疾病、术前症状持续时间、术前神经学评分、基于计算机断层扫描（CT）的分类以及T2加权磁共振图像上髓内高信号强度的存在情况。
不太可能预测结果的临床因素包括性别、年龄、骨化病变的节段水平、受OLF影响的节段数、并存的OPLL、CT分类以及高信号强度的存在情况。术前症状持续时间或神经学评分是否能预测结果尚不清楚，因为各研究结果不一致。然而，对最新文献的分析表明，这两个因素可预测结果。应规范神经学评分的使用，以便于数据的汇总和比较。
