Scola R H, Werneck L C, Iwamoto F M, Cabral N L, Maegawa G H, Rogacheski E
Departamento de Clínica Médica, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Brasil.
Arq Neuropsiquiatr. 1998 Sep;56(3A):480-5. doi: 10.1590/s0004-282x1998000300021.
Ossification of the posterior longitudinal ligament (OPLL) is an uncommon cause of compressive myelopathy in the Caucasian population. A case of spastic paraparesis in a Caucasian man whose radiological investigation showed OPLL is presented. The radiographs of the cervical spine showed a strip of bony density posterior to the vertebral bodies, extending from C2 to T1. Computerized tomography (CT) and CT myelography showed OPLL at the same level. Magnetic resonance showed an area of increased signal on T2-weighted sequences at C7-T1 level suggestive of myelomalacia. The patient underwent an open-door laminoplasty (C2 to C7) with improvement of the paraparesis. OPLL should be included in the differential diagnosis of cervical myelopathy. It can be easily detected by plain radiographs and CT of the cervical spine. A review of the clinical and radiological features and the treatment of OPLL is presented.
后纵韧带骨化(OPLL)是白种人群中导致压迫性脊髓病的罕见原因。本文报告了1例白种男性痉挛性截瘫病例,其影像学检查显示存在OPLL。颈椎X线片显示椎体后方有一条骨密度带,从C2延伸至T1。计算机断层扫描(CT)及CT脊髓造影显示相同节段存在OPLL。磁共振成像显示C7 - T1节段T2加权序列上信号增强区域,提示存在脊髓软化。该患者接受了开门式椎板成形术(C2至C7),截瘫症状得到改善。OPLL应纳入颈椎脊髓病的鉴别诊断。通过颈椎X线平片和CT可轻易检测到。本文对OPLL的临床和影像学特征及治疗进行了综述。