Ossification in the region of the posterior longitudinal ligament as a cause of cervical myelopathy.

Bakay, Louis; Cares, Herbert L.; Smith, Richard J.H.

doi:10.1136/jnnp.33.2.263

Cited by 60 publications

(15 citation statements)

References 9 publications

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“…Apesar de sido descrita por Key em 1838 na Inglaterra, apenas na década de 60, com a publicação de diversos estudos no Japão, a OLLP foi caracterizada como uma entidade clínica própria 5,6 . No Japão a prevalência radiográfica de OLLP em adultos é de 2% e aumenta para 3,7% naqueles com mais de 50 anos de idade 1,4 .…”

Section: Discussionunclassified

“…Como nem sempre a OLLP é visualizada na radiografia simples, esses dados podem estar subestimados. Contudo, é importante salientar que o achado de OLLP em radiografias não implica na ocorrência de mielopatia ou qualquer outro distúrbio clínico aparente, podendo ser totalmente assintomática 6 . A incidência de casos de OLLP sintomáticos não é conhecida nos países ocidentais e no Japão é estimada em 19 casos por milhão de pessoas 1 e corresponde a 20% das indicações de cirurgia em pacientes com mielopatia cervical 7 .…”

Section: Discussionunclassified

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Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

Scola

Werneck

Iwamoto

et al. 1998

Arq. Neuro-Psiquiatr.

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RESUMO -A ossificação do ligamento longitudinal posterior (OLLP) é causa incomum de mielopatia compressiva na população caucasiana. É relatado o caso de um paciente do sexo masculino com um quadro de paraparesia espástica, cuja investigação radiológica mostrou OLLP. O raio-X de coluna cervical mostrou imagem laminar, vertical, com densidade óssea, posterior aos corpos vertebrais, que se estendia de C2 a T1. A tomografia computadorizada (TC) e a mielotomografia mostravam OLLP causando compressão medular ântero-posterior no segmento descrito. Na ressonância magnética, observou-se área de hiperintensidade em T2 no segmento C7-T1, compatível com mielomalácia. O paciente foi submetido a laminoplastia tipo "open-door", com melhora do quadro parético dos membros inferiores. A OLLP deve entrar no diagnóstico diferencial das mielopatias cervicais, sendo facilmente diagnosticada através de radiografias e TC da coluna cervical. São revisados os aspectos clínicos e radiológicos e o tratamento da OLLP. PALAVRAS-CHAVE: ossificação do ligamento longitudinal posterior, mielopatia cervical, tomografia computadorizada, ressonância magnética.Ossification of the posterior longitudinal ligament in the cervical spine: case report ABSTRACT -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.KEY WORDS: ossification of the posterior longitudinal ligament, cervical myelopathy, computerized tomography, magnetic resonance.A ossificação do ligamento longitudinal posterior (OLLP) é causa frequente e bem estudada de mielopatia cervical no Japão 1,2 . A maior série de OLLP existente na literatura foi publicada pelo Ministério da Saúde do Japão, com 2125 casos 1,3 e estima-se que mais de 3% da população japonesa

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Section: Discussionunclassified

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

Scola

Werneck

Iwamoto

et al. 1998

Arq. Neuro-Psiquiatr.

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“…The symptoms of cervical myeloradiculopathy arising from OPLL vary and operation must be considered for patients with progression or impending paresis [6,8,13,14,15]. Direct removal of the ossified lesion by the anterior approach is essential for the best neurological outcome.…”

Section: Discussionmentioning

confidence: 99%

Anterior decompression and fusion for cervical myeloradiculopathy secondary to ossification of the posterior ligament

Baba

Furusawa

Tanaka

et al. 1994

International Orthopaedics

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The authors reviewed 85 patients who had undergone anterior decompression and cervical fusion for myeloradiculopathy due to ossification of the posterior longitudinal ligament. There were 72 males and 13 females; the average follow up was for 8.3 years. Sixteen patients (group I) underwent one vertebra subtotal spondylectomy with fusion, 58 (group II) two vertebra subtotal spondylectomy, and 11 (group III) three vertebra subtotal spondylectomy. Neurological recovery was assessed on the grading system of the Japanese Orthopaedic Association. The patients in group I had an average improvement of 75%, in group II 72% and in group III 23%. The severity of compromise of the spinal cord did not affect the postoperative improvement. Duration of disease, previous injury and advanced neurological symptoms all affected neurological recovery. Spondylectomy of at most two vertebrae, with fusion, is recommended for ossification of the posterior longitudinal ligament. If there is more extensive involvement laminoplasty may be indicated.

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“…Ossification of the posterior longitudinal ligament (OPLL) of the cervical spine is one of the main causes of myeloradiculopathy in Asian populations, especially in Japan [1][2][3][4]. Accurate determination of the size of OPLL and the nature of its growth in terms of length and thickness is important because these factors crucially relate to spinal canal stenosis and can cause myelopathy [5].…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluation of volume change in ossification of the posterior longitudinal ligament of the cervical spine using computed tomography

et al. 2013

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Background Two-dimensional imaging is not adequate for evaluating ossification of the posterior longitudinal ligament (OPLL). This study was designed to evaluate the accuracy of a novel computed tomography (CT)-based three-dimensional (3D) analysis method that we had devised to measure volume changes in OPLL. Subjects and methods Twenty OPLL patients (12 male and 8 female; mean age 63.6 years) who were being followed conservatively were examined twice with an interval of at least 1 year between the two scans. The mean interval was 22 (range 12-45) months. A 3D model was created with DICOM data from CT images, using the MIMICS Ò software to calculate the volume. The mean ossification volume was determined from two measurements. Since ossification size varies widely, evaluation of change in volume is generally affected by the original size. Therefore, the change in ossification volume between the first and second CT examinations was calculated as the annual rate of progression. Results The type of OPLL was classified as continuous in 3 patients, segmented in 3, and mixed in 14. The mean ossification volume was 1,831.68 mm 3 at the first examination and 1,928.31 mm 3 at the second, showing a significant mean increase in ossification volume. The mean annual rate of lesion increase was 3.33 % (range 0.08-7.79 %). Conclusion The 3D method used allowed detailed OPLL classification and quantification of change in the ossified volume. Thus, this method appears to be very useful for quantitative evaluation of OPLL with only minimal measurement error.

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Ossification in the region of the posterior longitudinal ligament as a cause of cervical myelopathy.

Cited by 60 publications

References 9 publications

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

Anterior decompression and fusion for cervical myeloradiculopathy secondary to ossification of the posterior ligament

Three-dimensional evaluation of volume change in ossification of the posterior longitudinal ligament of the cervical spine using computed tomography

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