Department of Orthopaedics, Shanghai Changzheng Hospital, Fengyang Road No. 415, Shanghai, 200003, China.
Sci Rep. 2017 Jun 7;7(1):2983. doi: 10.1038/s41598-017-03178-x.
Thoracic ossification of the ligamentum flavum (TOLF) complicated with dural ossification (DO) is a severe clinical disease. The diagnosis of DO preoperatively remains challenging. The current study retrospectively analyzed imaging features of 102 segments with TOLF from 39 patients and proposed a grading system for evaluating DO risk. Logistic regression results showed that unilateral spinal canal occupational rate (UCOR), tram track signs, and C-signs were all risk factors for DO (odds ratios of 5.393, 19.734 and 72.594, respectively). In validation analyses for the TOLF-DO grading system, sensitivity was 76.0% (19/25), specificity was 91.0% (70/77), and Youden's index was 0.66. Thus, implementation of the TOLF-DO grading system has the potential to improve the diagnosis of DO.
黄韧带骨化（TOLF）合并硬脊膜骨化（DO）是一种严重的临床疾病。术前 DO 的诊断仍然具有挑战性。本研究回顾性分析了 39 例患者 102 个 TOLF 节段的影像学特征，并提出了一种评估 DO 风险的分级系统。Logistic 回归结果表明，单侧椎管占位率（UCOR）、轨道征和 C 征均为 DO 的危险因素（比值比分别为 5.393、19.734 和 72.594）。在 TOLF-DO 分级系统的验证分析中，该系统的灵敏度为 76.0%（19/25），特异性为 91.0%（70/77），约登指数为 0.66。因此，实施 TOLF-DO 分级系统有可能提高 DO 的诊断率。
