颈椎后纵韧带骨化合并硬膜囊骨化的CT影像特点及临床意义

目的探讨颈椎后纵韧带骨化合并硬膜囊骨化的CT影像特点及临床意义。方法前路手术治疗21倒颈椎后纵韧带骨化患者,术前均行CT三维重建检查,明确后纵韧带骨化诊断及骨化物类型。术中5例患者被证实合并硬膜囊骨化．其中3例手术切除骨化物时造成硬膜囊缺损而出现脑脊液漏,另2例采用骨化物漂浮法减压。结果4例患者的CT横断面影像具有典型的双影征,矢状面成像表现为分层结构。3例脑脊液漏患者经非手术治疗均得以痊愈。随访1～3年,合并硬膜囊骨化患者的神经功能平均恢复率低于其他患者。结论CT三维影像有助于患者术前硬膜囊骨化的诊断,这对前路手术治疗后纵韧带骨化具有重要意义。

CT characteristics and clinical meanings of associated dural ossification in ossification of posterior longitudinal ligament of cervical spine

Objective To discuss the CT characteristics and clinical meanings of associated dural ossification in ossifica- tion of posterior longitudinal ligament of cervical spine.Methods Twenty-one patients with ossification of posterior longitudi- nal ligament were treated by anterior decompression surgery.The diagnosis and types of ossification were confirmed by three- dimensional reconstruction computed tomography before surgery.Five patients were identified associated with dural ossification during surgery.The dura mater of three patients had defects and developed leak of cerebrospinal fluid after excising ossifica- tion,and ossification floating was performed for other two patients.Results Four of five patients with dural ossification exhib- ited a typical computed tomographic double-layer sign on cross-sectional views and laminated construction on sagittal views. The leak of cerebrospinal fluid of the three patients all stopped after conservative treatments.After a follow-up period of one to three years,the average recovery rate of the patients with dural ossification was lower than that of those without dural ossfica- tion.Conclusion Three-dimensional reconstruction computed tomography is helpful to diagnose associated dural ossification, and it is of importance to anterior decompression surgery in the patients with ossification of posterior longitudinal ligament.