Wang Zhiwei, Sun Yanqing, Tang Yifan, Yuan Bo, Zhou Shengyuan, Chen Xiongsheng, Jia Lianshun
Spine Center, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Spine Center, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
World Neurosurg. 2018 Jul;115:e172-e177. doi: 10.1016/j.wneu.2018.03.222. Epub 2018 Apr 9.
Ossification of the posterior longitudinal ligament (OPLL) is a 3-dimensional (3D) disease that causes cervical myelopathy. The conventional 2-dimensional (2D) measurement of OPLL has limitations in estimating cord compression and myelopathy. In this study, we attempted to use 3D computed tomography (CT) and magnetic resonance imaging (MRI) to measure the 3D occupying ratio of OPLL and investigate its significance in the assessment of spinal cord myelopathy.
Three-dimensional CT and MRI were performed in 50 patients with cervical OPLL at a neutral position before surgery. MRI was done to determine the extent of spinal cord compression. The CT data were saved in DICOM format and analyzed using Mimics 17.0. Then a 3D model of OPLL was semiautomatically segmented at a specific threshold. The following data were measured: diameter of the spinal canal, thickness of the OPLL, and 3D volume of the OPLL and spinal canal. The Japanese Orthopedic Association (JOA) score was used to assess the cervical spinal cord function.
Pearson correlation analysis showed that both the occupying ratio and the 3D occupying ratio were significantly and negatively correlated with the JOA score. Multiple linear regression analysis indicated that only the 3D occupying ratio showed a significantly negative correlation with the JOA score, whereas age, sex, and the occupying ratio were insignificantly associated with the JOA score.
The 3D occupying ratio of OPLL is a reliable indicator for assessing the severity of spinal cord myelopathy. MRI provides more details about cord compression, making the measurement more accurate and objective.
后纵韧带骨化（OPLL）是一种导致颈椎脊髓病的三维（3D）疾病。传统的二维（2D）OPLL测量在估计脊髓压迫和脊髓病方面存在局限性。在本研究中，我们尝试使用三维计算机断层扫描（CT）和磁共振成像（MRI）来测量OPLL的三维占位率，并研究其在评估脊髓型颈椎病中的意义。
对50例颈椎OPLL患者在术前中立位进行三维CT和MRI检查。通过MRI确定脊髓压迫程度。CT数据以DICOM格式保存，并使用Mimics 17.0进行分析。然后在特定阈值下对OPLL的三维模型进行半自动分割。测量以下数据：椎管直径、OPLL厚度以及OPLL和椎管的三维体积。采用日本骨科学会（JOA）评分评估颈椎脊髓功能。
Pearson相关分析表明，占位率和三维占位率均与JOA评分呈显著负相关。多元线性回归分析表明，只有三维占位率与JOA评分呈显著负相关，而年龄、性别和占位率与JOA评分无显著相关性。
OPLL的三维占位率是评估脊髓型颈椎病严重程度的可靠指标。MRI提供了更多关于脊髓压迫的细节，使测量更加准确和客观。
