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一例胸腰段黄韧带骨化及磁共振成像

[A case of ossified yellow ligaments (ossified ligamenta flava) of the thoraco-lumbar region and magnetic resonance imaging].

作者信息

Yatsuzuka H, Kitajima T, Taguchi Y, Sakai H, Nakamura N

出版信息

No Shinkei Geka. 1986 Aug;14(9):1121-5.

PMID:3095673
Abstract

A Case of ossified yellow ligaments in thoraco-lumbar region is reported. A 47-year-old-male complained low back pain with suddenness in August, 1984. One month later, he noticed dyesthesia on his right lower extremity and gait disturbance. These symptoms progressed slowly. In June, 1985, he admitted to The Jikei University Hospital. On neurological examinations, he was noticed an intermittent claudication, spastic paraparesis and stocking type sensory loss in his lower extremities. Plain lumbar X-ray films showed ossified yellow ligaments (OYL) in the posterior half of the spinal canal from the level of 10th thoracic to second lumbar vertebrae. Magnetic resonance imaging disclosed marked indentations of the spinal cord at the same level. The wide laminectomy was carried out and OYL were removed totally in gentle manner. Postoperative course was uneventful. His sensory disorders improved remarkably and he gained good muscle strength in his lower extremities, but a considerable spasticity remained still. OYL is closely related to the developmental canal stenosis, the spondylosis and the other degenerative disorders such as ossification of posterior longitudinal ligaments. This allows more complicated neurological signs and symptoms in the case of OYL. When OYL is suggested, it is recommended to performed whole spinal radiological survey. The surgical consideration should be done. From this point of view, MRI would be a most useful weapon.

摘要

报告了一例胸腰段黄韧带骨化病例。一名47岁男性于1984年8月突然出现腰痛。一个月后,他注意到右下肢感觉异常和步态障碍。这些症状进展缓慢。1985年6月,他入住东京慈惠会医科大学医院。神经学检查发现他下肢有间歇性跛行、痉挛性截瘫和袜套样感觉丧失。腰椎X线平片显示从第10胸椎至第2腰椎水平的椎管后半部有黄韧带骨化(OYL)。磁共振成像显示同一水平脊髓有明显受压。进行了广泛的椎板切除术,并以轻柔的方式完全切除了黄韧带骨化。术后过程顺利。他的感觉障碍明显改善,下肢肌力恢复良好,但仍有相当程度的痉挛。黄韧带骨化与发育性椎管狭窄、脊椎关节病以及其他退行性疾病如后纵韧带骨化密切相关。这使得黄韧带骨化病例出现更复杂的神经体征和症状。当怀疑有黄韧带骨化时,建议进行全脊柱放射学检查。应进行手术评估。从这个角度来看,磁共振成像将是最有用的工具。

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