Jones M D, Pais M J, Omiya B
Department of Radiological Sciences, University of California, Irvine, Medical Center, Orange.
Radiol Clin North Am. 1988 Nov;26(6):1213-34.
The common phenomenon of osteophyte formation about the vertebral margins and on the vertebral bodies in certain instances connotes underlying disk degeneration. The classification and mechanism of formation of these bony excrescences are not totally clear in all instances, but there is frequent association with degenerative disk change. Distorted alignment of the spinal column as in scoliosis, and functional demands on the spine, play major roles in these abnormalities. The true degree of anatomic abnormality is greater than can be appreciated on the radiographs. Syndesmophytes are vertically orientated outgrowths of trabecular bone forming in the outer margins of the annulus fibrosus and related to repeated episodes of inflammation and repair. They are classically seen in ankylosing spondylitis and colonic spondyloarthropathy. Bulky paravertebral excrescences are more likely to be found in psoriatic arthritis and Reiter's syndrome. Other bony excrescences in the spine were also discussed. OPLL is a progressive disease that can result in severe radicular and myelopathic symptoms. Although OPLL appears to have an unexplained predilection for Asians, it affects all races. Classically diagnosed on lateral radiographs of the cervical spine, it is best imaged with CT. Proper evaluation of the extent of the entire ossified mass and its effect on the spinal cord is crucial in the planning of adequate therapy.
在某些情况下，椎体边缘和椎体上骨赘形成的常见现象意味着潜在的椎间盘退变。这些骨质增生的分类和形成机制在所有情况下并不完全清楚，但常与椎间盘退变改变相关。脊柱排列扭曲如脊柱侧弯以及对脊柱的功能需求，在这些异常情况中起主要作用。解剖学异常的真实程度大于X线片上所能观察到的。韧带骨赘是在纤维环外缘形成的垂直排列的小梁骨生长物，与反复的炎症和修复发作有关。典型地见于强直性脊柱炎和结肠性脊柱关节病。粗大的椎旁骨质增生更可能见于银屑病关节炎和赖特综合征。还讨论了脊柱中的其他骨质增生。后纵韧带骨化症是一种可导致严重神经根和脊髓病症状的进行性疾病。虽然后纵韧带骨化症似乎对亚洲人有无法解释的偏好，但它影响所有种族。典型地通过颈椎侧位X线片诊断，最好用CT成像。在规划适当的治疗时，正确评估整个骨化肿块的范围及其对脊髓的影响至关重要。
