Tanaka H, Nakamura K, Kurokawa T, Kobayashi M, Machida H, Izuka T, Hoshino Y, Tsuyama N, Hatsuyama Y
Nihon Seikeigeka Gakkai Zasshi. 1981 Jul;55(7):635-45.
Many studies of the pathogenesis of ossification of posterior longitudinal ligaments (OPLL) have been reported, and both general and local factors have been pointed out. In case a longitudinal ligament is affected by both the general and local OPLL factors for many years, the shape and size of the cervical vertebral bodies and the arrangement of the cervical spinal column might be affected. The relation between OPLL and disc degeneration, the morphology of the facet joint and the change of longitudinal ligament tension has been reported by many authors. But the relation between OPLL and the shape, size and arrangement of cervical vertebral bodies has not been reported. We selected X-ray films of the lateral view of cervical spines which had been taken at our hospital since 1975. The subjects consisted of 190 cases in Group I and 189 cases in Group II. Half of Group I had OPLL, of which 71 were males and 24 females. The other half of Group I was composed of 95 cases (CS) of cervical spondylosis of the same sex and age distribution. Group II comprised 189 cases, all males aged 49 yrs. Of them, 41 were OPLL cases, 102 CS, and 46 normal subjects. The X-ray films of Group II were taken during medical examinations. The height, antero-posterior diameter of the cervical vertebral bodies and the antero-posterior diameter of the cervical spinal canals were measured and examined for kyphosis between the two neighbouring cervical vertebral bodies, disc space narrowing and Barsony ossification. The height and antero-posterior diameter of the cervical vertebral bodies were compared among the following groups. 1) the 3 groups divided according to age (-49,50-59,60-75 yrs.), 2) segmental type with non-segmental type, 3) OPLL only at C3 and C4 with OPLL only at C5, C6, and C7. The results were as follows: The cervical vertebral bodies of OPLL were taller and wider than those of CS. Cervical vertebral bodies of the older group were shorter and wider than those of the younger groups in both OPLL and CS. THe relative height (C3 = I) of OPLL group was very close to Normal group. The cervical vertebral bodies of non-segmental type were taller but not wider than those of segmental type of OPLL group. The C3 and C4 vertebral bodies with OPLL only at C3 and C4 were taller, but not wider than those with OPLL only at C5, C6 and C7. The antero-posterior diameter of cervical spinal canal of OPLL was narrower than CS group. The above data indicate the following: 1) With advance in age, cervical vertebral bodies become lower and wider. 2) The cervical vertebral body of OPLL is taller and wider than that of CS. 3) The level of OPLL and the type of OPLL have a relation to the height of cervical vertebral body. 4) The cervical vertebral bodies which have OPLL are wider than non-OPLL. But the level and the type of OPLL have no relation with the A-P diameter of the cervical vertebral body.
许多关于后纵韧带骨化症(OPLL)发病机制的研究已有报道,其中既指出了一般因素,也指出了局部因素。如果纵韧带多年来同时受到OPLL的一般因素和局部因素影响,颈椎椎体的形状和大小以及颈椎柱的排列可能会受到影响。许多作者报道了OPLL与椎间盘退变、小关节形态以及纵韧带张力变化之间的关系。但OPLL与颈椎椎体的形状、大小和排列之间的关系尚未见报道。我们选取了我院自1975年以来拍摄的颈椎侧位X线片。研究对象包括I组190例和II组189例。I组一半患者患有OPLL,其中男性71例,女性24例。I组另一半由95例(CS)性别和年龄分布相同的颈椎病患者组成。II组包括189例,均为49岁男性。其中,41例为OPLL患者,102例为CS患者,46例为正常受试者。II组的X线片是在体检时拍摄的。测量颈椎椎体的高度、前后径以及颈椎管的前后径,并检查相邻两个颈椎椎体之间的后凸、椎间隙变窄和巴尔索尼骨化情况。比较了以下几组颈椎椎体的高度和前后径。1)根据年龄(-49岁、50 - 59岁、60 - 75岁)分为3组;2)节段型与非节段型;3)仅C3和C4有OPLL的与仅C5、C6和C7有OPLL的。结果如下:OPLL患者的颈椎椎体比CS患者的更高、更宽。在OPLL和CS患者中,老年组的颈椎椎体比年轻组的更短、更宽。OPLL组的相对高度(C3 = 1)与正常组非常接近。OPLL组非节段型的颈椎椎体更高,但不比节段型的更宽。仅C3和C4有OPLL的C3和C4椎体比仅C5、C6和C7有OPLL的更高,但不比其更宽。OPLL患者颈椎管的前后径比CS组更窄。上述数据表明:1)随着年龄增长,颈椎椎体变低、变宽。2)OPLL患者的颈椎椎体比CS患者的更高、更宽。3)OPLL的节段水平和类型与颈椎椎体高度有关。4)有OPLL的颈椎椎体比无OPLL的更宽。但OPLL的节段水平和类型与颈椎椎体的前后径无关。