後縱韌帶的骨化

OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT

李瑶華(Lee, Y. W.) ； 衛優遊(Wei, Y. Y.)

《中華放射線醫學雜誌》 4卷1期 (1979/03) Pp. 37-42

摘要

後縱韌帶的骨化是引起神經壓迫症狀的眾多原因之一，從X光片上可見具有很特徵性的變化，即在椎體後緣有帶狀或小棒狀的鈣化，從側面X光片上不難辯認，這種X光片上所見的鈣化，經病理學檢查，證明確實是一種韌帶的骨化現象，其發生的部位是在頸椎和細椎後緣，而以頸椎後緣之發生較多。這種病變多見於日本人，歐美人士少，台大醫院放射線科從1093例頸椎X光片中，發現14例有後縱韌帶的骨化發生率的1.3%，與日本人的發生率接近。後縱韌帶骨化發生在男女的比例為1.8:1，發生年齡則以50-59歲為最高峯，佔了64%，最年輕患者21歲，最老患者79歲，14個後縱韌帶骨化病例中，13人有神經根變(rediculopathy)或脊髓病變(myelopathy)或兩者兼有。其症狀可能因後縱韌帶骨化引起，或是合併有頸椎退化症之故，也有不引起症狀的。後縱韌帶骨化的患者併發頸椎退化症(spondylosis)，頸韌帶骨化(calcification of nuchal ligament)及強直性脊椎骨增生(ankylosing spinal hyperostosis)的情形比一般人高，可能與年齡有關，但與其他全身性疾病的關係不大。

並列摘要

Ossification of the posterior longitudinal ligament, one of the causes of spinal cord compression, is characterized roentgenographically by the presence of a longitudinal rod-like or band-like density along the posterior margin of the vertebral body. It is easy to recognize on the film of lateral projection of the spine, such calcification is proved to be the definite ossification of the posterior longitudinal ligament through many operated or autopsied patients reported previously. Ossification of the posterior longitudinal ligament appears to be more common among Japanese, and less frequent in Caucasian. One thousand and ninty-three cases of cervical spine were selected randomly in the Department of Radiology of National Taiwan University Hospital and 14 cases showed definite calcification of the posterior longitudinal ligament. The incidence is about 1.3%, close to the incidence of Japanese. The ratio of male to female was 1.8: 1. The ages ranged from 21 to 79 years old with the peak incidence in the sixth decade. Neurological manifestation as radiculopathy, myelopathy or both were found in 13 out of 14 cases. It may be that the presence of ossification of the posterior longitudinal ligament as well as cervical spondylosis. But it does not necessarily cause neurological syndrome. The most frequent site of OPLL is in the cervical spine. The combination of cervical spondylosis, calcified nuchal ligament and ankylosing spinal hyperostosis with ossification of the posterior longitudinal ligament are found more common than the general population. There is no significant relation-ship between OPLL and other systemic disease.