From the Department of Orthopaedic Surgery, Warren Alpert Medical School/Brown University, Providence, RI.
J Am Acad Orthop Surg. 2022 Jun 15;30(12):e842-e851. doi: 10.5435/JAAOS-D-21-01253. Epub 2022 Mar 15.
Ossification of the ligamentum flavum (OLF) is an uncommon but potentially serious spinal condition which can cause progressive compression of the spinal canal with associated devastating neurologic compromise. Although debate exists regarding the exact etiology of OLF, overexpression of genes and transcription factors centered around the Notch and Wnt signaling pathways because of increased mechanical stress seems to be related. There are many clinical and radiographic presentations of OLF; however, progressive myelopathy is the most commonly encountered. Radiographic analysis may reveal isolated OLF or OLF combined with ossification of other areas of the spine, such as disk, posterior longitudinal ligament, and dura. When surgery is necessary for OLF, several surgical strategies exist including open laminectomy with excision, endoscopic decompression, Bridge Crane resection, en block resection, and combined anterior and posterior approaches. Resection may be complicated by dural adhesion or dural ossification, and postoperative neurologic deficits are not uncommon.
黄韧带骨化（OLF）是一种不常见但潜在严重的脊柱疾病，可导致椎管进行性受压，并伴有相关的毁灭性神经功能障碍。尽管关于 OLF 的确切病因存在争议，但由于机械应力增加，围绕 Notch 和 Wnt 信号通路的基因和转录因子的过度表达似乎与之相关。OLF 有许多临床和影像学表现；然而，进行性脊髓病是最常见的。放射学分析可能显示孤立的 OLF 或 OLF 与脊柱其他区域的骨化（如椎间盘、后纵韧带和硬脑膜）相结合。当 OLF 需要手术时，存在几种手术策略，包括开放性椎板切除术切除、内镜减压、Bridge Crane 切除术、整块切除术和前后联合入路。切除可能会因硬脑膜粘连或硬脑膜骨化而变得复杂，术后神经功能缺损并不少见。
