Yoshizawa T, Naitoh Y, Yoshida M, Yabuki T, Kanazawa I
Department of Neurology, University of Tsukuba.
Rinsho Shinkeigaku. 1991 Jul;31(7):720-4.
We reported a case of cervical myelopathy due to hypertrophy of the posterior longitudinal ligament (HPLL). A 56-year-old man who developed spastic gait and urinary disturbance was admitted to our hospital. Neurological examination disclosed muscle weakness and hyperreflexia in all extremities, and superficial sensory disturbance below Th 4. Neither plain films nor tomograms of the neck showed ossification of the posterior longitudinal ligament (OPLL). However, myelography, myelo-CT and MR scan revealed HPLL and anterior compression of the cervical cord at C2-C6. From these findings, we diagnosed this case as cervical myelopathy due to HPLL. Clinical symptoms were relieved by posterior decompressive laminoplasty. HPLL has been preserved. During the following four years, ossification has not emerged into the hypertrophic region of posterior longitudinal ligament. This case suggests that HPLL may be a novel clinical category of compression myelopathy. Further observation will be needed.
我们报告了一例因后纵韧带肥厚(HPLL)导致的脊髓型颈椎病病例。一名出现痉挛性步态和排尿障碍的56岁男性入住我院。神经系统检查发现四肢肌肉无力和反射亢进,以及T4以下的浅感觉障碍。颈部的X线平片和断层扫描均未显示后纵韧带骨化(OPLL)。然而,脊髓造影、脊髓CT和磁共振扫描显示C2 - C6水平存在HPLL并对颈髓产生前方压迫。根据这些发现,我们将该病例诊断为因HPLL导致的脊髓型颈椎病。通过后路减压椎板成形术,临床症状得到缓解。HPLL得以保留。在接下来的四年里,后纵韧带肥厚区域未出现骨化。该病例提示HPLL可能是压迫性脊髓病的一种新的临床类型。需要进一步观察。