Prabhu Rudra Mangesh, Rathod Tushar N, Mohanty Shubhranshu S, Hadole Bhushan S, Marathe Nandan A, Rai Abhishek K
Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Department of Orthopaedics, Seth G.S Medical College and K.E.M Hospital, Mumbai, India.
Surg Neurol Int. 2022 Apr 22;13:158. doi: 10.25259/SNI_247_2022. eCollection 2022.
Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder that mostly involves the cervical spine. It is more prevalent in East Asian countries. Patients typically present with the gradual onset of myelopathy, while about 5% show rapid progression.
A 51-year-old diabetic and hypertensive male presented with a left-sided hemiparesis following trivial trauma. The first diagnosis was a stroke, but the subsequent workup proved negative. Subsequently, the MRI and CT studies demonstrated significant cord compression due to OPLL extending from C2 to C7. There was also a heterogeneous hyperintense intramedullary cord signal indicative of edema/myelomalacia in the retro- odontoid region. The CT also diagnosed C2-C7 diffuse idiopathic skeletal hyperostosis.
Patients with cervical myelopathy due to OPLL rarely present about 5% of the time with the acute onset of neurological deficit following minor trauma. Certainly, one must consider high cervical OPLL as responsible for hemiparesis in a patient whose brain MR has ruled out a stroke.
后纵韧带骨化（OPLL）是一种主要累及颈椎的进行性疾病。在东亚国家更为常见。患者通常表现为脊髓病逐渐起病，约5%的患者病情进展迅速。
一名51岁患有糖尿病和高血压的男性，在轻微外伤后出现左侧偏瘫。最初诊断为中风，但随后的检查结果为阴性。随后，MRI和CT检查显示，由于OPLL从C2延伸至C7，导致脊髓明显受压。齿突后区域脊髓内还存在不均匀的高信号，提示水肿/脊髓软化。CT还诊断出C2 - C7弥漫性特发性骨肥厚。
因OPLL导致的颈椎脊髓病患者，约5%的情况下在轻微外伤后会急性出现神经功能缺损。当然，对于脑MRI已排除中风的偏瘫患者，必须考虑高位颈椎OPLL是病因。
