Nakamura H
Department of Orthopaedic Surgery, Kagoshima University, Faculty of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1994 Sep;68(9):725-36.
Progression of ossification of the posterior longitudinal ligament (OPLL) was evaluated in relation to that of ossification of the anterior longitudinal ligament (OALL). The subjects of this study were 68 patients with OPLL in the cervical spine. 47 of them underwent conservative treatment, and the remaining 21 underwent decompression surgery of the cervical spine (involving 11 cases of laminectomy and 10 of an enlargements of the spinal canal). All 68 patients were followed up for more than 5 years. Most of the continuous and most of the mixed types of OPLL exhibited advancement of the stage at the final examination, and showed much progression of OALL during the follow-up period. The progression of OALL tended to be more advanced in those cases in which the progression of OPLL was advanced. In most of the operated cases, OPLL was highly progressed after surgery in both the longitudinal direction and in the thickness, regardless of the ossification type. There was also evidence of progression of OALL in these patients, at each level of the cervical spine, with particularly advanced progression at the lower levels with a higher rate than in the conservative cases. These results indicate that the progressions of OPLL and OALL are closely correlated, and that the same precipitating factors may therefore be involved in both OPLL and OALL. A marked progression of the ossification after surgery suggested that local factors of the cervical spine played an important role in the progression.
评估了后纵韧带骨化（OPLL）与前纵韧带骨化（OALL）的进展情况。本研究的对象为68例颈椎OPLL患者。其中47例接受了保守治疗，其余21例接受了颈椎减压手术（包括11例椎板切除术和10例椎管扩大术）。所有68例患者均随访超过5年。大多数连续型和混合型OPLL在最终检查时显示分期进展，并在随访期间显示OALL有明显进展。OPLL进展程度较高的病例中，OALL的进展往往更明显。在大多数手术病例中，无论骨化类型如何，术后OPLL在纵向和厚度上均有高度进展。这些患者在颈椎的每个节段也有OALL进展的证据，在较低节段进展尤为明显，且进展率高于保守治疗病例。这些结果表明，OPLL和OALL的进展密切相关，因此两者可能涉及相同的促发因素。手术后骨化的明显进展表明颈椎的局部因素在进展中起重要作用。
