Wang Hongli, Zou Fei, Jiang Jianyuan, Lu Feizhou, Chen Wenjun, Ma Xiaosheng, Xia Xinlei, Wang Lixun
From the Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
Spine (Phila Pa 1976). 2014 Dec 15;39(26 Spec No.):B7-11. doi: 10.1097/BRS.0000000000000430.
A retrospective clinical data analysis.
This study was conducted to investigate the correlation between ossification of the nuchal ligament (ONL) and pathological changes of the cervical spine in patients with cervical spondylosis.
ONL can usually be found in cervical spondylosis. Thus, it is important to find the correlation between ONL and pathological changes of the cervical spine in patients with cervical spondylosis.
The medical records of 100 patients with cervical spondylosis with the local type of ONL (ONL group) and 50 patients with cervical spondylosis only (control group) were reviewed. Data analysis included patients' sex, age, location of ONL, maximum cord compression level, osteophyte height ratio, and grade of cervical intervertebral disc degeneration. Radiological features were evaluated by lateral plain radiography and magnetic resonance imaging.
In total, 69.0% of subjects in the ONL group had ONL located at the maximum cord compression level; there was no difference based on sex (P = 0.248). The value of the osteophyte height ratio was higher at the ONL level than at its superior and inferior adjacent segments (P < 0.001). The osteophyte height ratio was also significantly different at the C4-C5 (P < 0.001) and C5-C6 (P = 0.008) levels between the ONL group and the control group. There was a significant difference in distribution of intervertebral disc degeneration grading between the ONL level and superior adjacent segments (P = 0.028), as well as inferior adjacent segments (P = 0.049). The distribution of intervertebral disc degeneration grading at the C5-C6 level between patients whose location of ONL and maximum cord compression level were both at C5-C6 and patients whose maximum cord compression level was at C5-C6 in the control group was also significantly different (P = 0.035).
The location of ONL commonly corresponds to the most stenotic level of the spinal canal. The location of ONL also correlates with the level of osteophyte formation and intervertebral disc degeneration, indicating that ONL has correspondence to instability-related cervical pathological changes in cervical spondylosis.
回顾性临床数据分析。
本研究旨在探讨颈椎病患者项韧带骨化（ONL）与颈椎病理改变之间的相关性。
ONL在颈椎病患者中较为常见。因此，找出ONL与颈椎病患者颈椎病理改变之间的相关性很重要。
回顾了100例具有局部型ONL的颈椎病患者（ONL组）和50例单纯颈椎病患者（对照组）的病历。数据分析包括患者的性别、年龄、ONL位置、脊髓最大受压水平、骨赘高度比以及颈椎间盘退变程度。通过颈椎侧位X线平片和磁共振成像评估影像学特征。
ONL组中，69.0%的受试者ONL位于脊髓最大受压水平；基于性别无差异（P = 0.248）。ONL水平处的骨赘高度比值高于其相邻上、下节段（P < 0.001）。ONL组与对照组在C4 - C5（P < 0.001）和C5 - C6（P = 0.008）水平的骨赘高度比值也有显著差异。ONL水平与相邻上节段（P = 0.028）以及相邻下节段（P = 0.049）之间的椎间盘退变分级分布存在显著差异。ONL位置和脊髓最大受压水平均在C5 - C6的患者与对照组中脊髓最大受压水平在C5 - C6的患者在C5 - C6水平的椎间盘退变分级分布也有显著差异（P = 0.035）。
ONL的位置通常与椎管最狭窄水平相对应。ONL的位置还与骨赘形成水平和椎间盘退变相关，表明ONL与颈椎病中与不稳定相关的颈椎病理改变存在对应关系。
