弥漫性特发性骨肥厚症中后纵韧带及黄韧带骨化导致的胸上段脊髓病：病例报告及文献复习。
Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literature review.
机构信息
Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, People's Republic of China.
出版信息
Eur Spine J. 2011 Jul;20 Suppl 2(Suppl 2):S195-201. doi: 10.1007/s00586-010-1538-z. Epub 2010 Aug 10.
Abstract
A rare case of a 44-year-old Chinese male with diffuse idiopathic skeletal hyperostosis (DISH) and simultaneous ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) at T1-2 causing thoracic myelopathy is reported herein. Posterior decompression without extirpating the OPLL was performed at T1-2. Postoperatively, symptoms were greatly improved, with remaining hyperreflexia and Grade 4/5 muscle strength in the lower extremities. The Japanese Orthopedic Association score improved from 5 preoperatively to 9 at final follow-up. The presence of a cyst due to leakage of cerebrospinal fluid was confirmed by MRI at day 27, but it resolved after conservative management. The clinical manifestation of DISH, the relationship among DISH, OPLL, and OLF, and management of thoracic myelopathy due to OPLL and OLF were reviewed.
摘要
本文报道了 1 例罕见病例，一名 44 岁的中国男性患有弥漫性特发性骨肥厚（DISH），同时在 T1-2 存在后纵韧带骨化（OPLL）和黄韧带骨化（OLF），导致胸髓病。在 T1-2 行后路减压术，不切除 OPLL。术后症状明显改善，下肢反射亢进，肌力 4/5 级。日本骨科协会评分从术前的 5 分提高到最终随访时的 9 分。第 27 天 MRI 证实存在因脑脊液漏引起的囊肿，但经保守治疗后缓解。回顾了 DISH 的临床表现、DISH、OPLL 和 OLF 之间的关系，以及 OPLL 和 OLF 引起的胸髓病的治疗。
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