颈椎后纵韧带骨化症的研究进展

颈椎后纵韧带骨化(ossification of the posterior longitudinal ligament of cervical spine,OPLL)是指因颈椎后纵韧带骨化对脊髓、神经根产生压迫,从而导致的一组神经功能损伤症候群,是导致颈椎病的重要原因之一。后纵韧带骨化是一种罕见的板层骨沉积病理过程,可导致脊髓受压。虽然研究发现OPLL的发生发展与多种遗传和环境因素有关,但对其病理生理学的认识还很不清楚。无症状的患者可以保守治疗,神经根病或脊髓病患者应考虑手术减压,虽然手术可以对神经、脊髓进行减压,减缓OPLL进展,但也有可能导致硬脊膜撕裂、神经损伤、轴性疼痛及C₅神经根麻痹等相关并发症,治疗方式的选择一直是困扰医师的难题,不同治疗方式对预后的影响不同,OPLL的形态和大小以及位置对选择手术入路和技术有重要意义,而神经功能、影像学分型等也可指导治疗方式的选择。关于颈椎OPLL治疗仍需深入研究流行病学、病理解剖和病理生理学、临床表现、影像学表现等。本文分析关于OPLL的病因、历史、表现和管理的现有文献,进一步归纳总结以便更好地理解OPLL,并为OPLL患者的治疗提供建议。 

Advances in the study of ossification of posterior longitudinal ligaments of the cervical spine

Ossification of the posterior longitudinal ligament of cervical spine(OPLL) refers to a group of neurological impairment syndromes caused by ossification of the posterior longitudinal ligament of cervical vertebra, which compresses the spinal cord and nerve root, and is one of the important causes of cervical spondylosis. Ossification of the posterior longitudinal ligament is a rare pathological process of lamellar bone deposition that can lead to spinal cord compression. Although studies have found that the occurrence and development of OPLL are related to a variety of genetic and environmental factors, the understanding of its pathophysiology is still unclear. Asymptomatic patients can be treated conservatively, nerve root or surgical decompression should be considered in patients with spinal cord disease can be carried out on the nerve, spinal cord decompression surgery, slow progress in OPLL, but is also likely to be dural tear, nerve damage and axial pain related complications, such as the choice of treatment has been a problem in the physician, the influence of different treatments on prognosis, different shape and size, and location of OPLL is important to the choice of surgical approach and technique, and nerve function, image credits can also guide the choice of treatment. The epidemiology, pathological anatomy and pathophysiology, clinical manifestations and imaging manifestations of cervical OPLL treatment still need to be further studied. In this review, our goal is to address the existing literature on the etiology, history, presentation, and management of OPLL, to make generalizations to better understand OPLL, and to provide our recommendations for the treatment of OPLL patients.