下颈椎不稳对颈椎后纵韧带骨化症早期发病的影响

目的探讨下颈椎不稳与颈椎后纵韧带骨化症(OPLL)早期发病的关系。方法对76例OPLL患者及30例正常人行颈椎X线摄片、CT及MRI检查。在颈椎屈曲/伸展侧位片上测量全颈椎活动范围、椎体水平移位及成角程度,根据MRIT2加权像观察脊髓内高信号变化,并与临床资料对比分析。结果OPLL患者颈椎屈伸范围比正常人明显减小(P<0.01),下颈椎不稳发生率比正常人明显增高(P<0.01)。OPLL合并下颈椎不稳的患者,神经系统受损程度和脊髓受压程度不平行,产生重于影像学表现的临床症状。结论下颈椎不稳加速OPLL症的发生和发展。

Effect of lower cervical instability on the onset of cervical ossification of the posterior longitudinal ligament

Objective To evaluate the effect of lower cervical instability on the onset of cervical ossification of the posterior longitudinal ligament(OPLL).Methods 76 patients with cervical OPLL and 30 healthy volunteers were analyzed for the range of motion of the cervical spine and horizontal displacements and angular displacements on lateral dynamic radiographs. Intramedullary high intensity lesions were observed on T2 weighted MRI.Clinical symptoms were studied, and factors relating to the onset of myelopathy were discussed clinically and radiographically.Result The range of flexion and extension of patients with cervical OPLL was smaller than the volunteers and the frequence of lower cervical instability was heigher than the latter(P< 0.01).Clinical severity of myelopathy in the patients with cervical OPLL and with lower cervical instability was not proportional to the degree of spinal cord compression.Conclusion Lower cervical instability may accelerate the onset and development of OPLL.