Prevalence and Natural Course of Transverse Ligament of the Atlas Calcification in Asymptomatic Healthy Individuals

Anno, Masato; Oshima, Yasushi; Taniguchi, Yuki; Matsubayashi, Yoshitaka; Kato, So; Soma, Kazuhito; Oka, Hiroyuki; Hayashi, Naoto; Tanaka, Sakae

doi:10.1097/brs.0000000000002744

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…Periodontoid calci cation is a radiological signs de ned by the radiographic calci cations in a crown-like con guration around the odontoid process, which is usually detected by CT scans. Calci cation can develop anywhere around the odontoid process, whereas it tended to be usually located in the transverse ligament of the atlas (TLA) [12] . Calci ed lesion around the odontoid process caused by CPPD disease is a cause of acute in ammatory neck pain and stiffness, which is typically known as the crowned dens syndrome [13] (CDSyn).…”

Section: Disscussionmentioning

confidence: 99%

Coexistence of Crowned Dens Sign and Calcification of Ligamentum Flavum in the cervical Spine: coincidence or association?

Meng

Pan

Zhang

et al. 2023

Preprint

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Background: Calcification of the cervical ligamentum flavum(CLF) and periodontoid calcification are two rare diseases in the orthopaedic clinic. Only few reports have described these coexisting conditions. Objectives: We present our cases of cervical radiculomyelopathy caused by CLF combined with or without periodontoid calcification, and the relationship between the two clinical conditions are briefly discussed on the review of data of the literature. Methods: We retrospectively reviewed 33 patients with CLF. In our case series, the clinical and radiological characteristics of patients are described and analyzed. The calcification surrounding the dens is termed as crowned dens sign(CDSign) in our study. And the relationship between the two conditions of CLF and CDSign are discussed. Results:There were 28 women and 5 men aged between 56 and 86 years. Neurological symptoms and neck pain were presented in most patients. Calcification sites on axial CT images were described in 33 cases with 81 levels, C4-5 and C5-6 were attacked most frequently, and multiple- rather than single-level involvement could be observed in our series. CDSign was identified in 26 cases, and the the prevalence were 79%. Following evaluation, 23 patients received posterior surgery, and 8 patients underwent anterior cervical surgery. Conclusions: The coexistence of CDSign and CLF is an uncommon phenomenon. The association of these two diseases is stronger than a coincidence. It is possible that the coexistence of CLF with CDSign may be a rare form of the cervical manifestation of calcium pyrophosphate dihydrate (CPPD) deposition disease.

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Section: Disscussionmentioning

confidence: 99%

Coexistence of Crowned Dens Sign and Calcification of Ligamentum Flavum in the cervical Spine: coincidence or association?

Meng

Pan

Zhang

et al. 2023

Preprint

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“…Anno 등( 26 )은 최근 건강한 1136명의 C-spine CT를 이용하여 환추횡인대 석회화의 유병률을 분석하였고 이는 약 3.5%로 나타났다. 이는 본 연구에서 OTLA의 유병률(1.1%)보다 높은 결과이지만 본 연구에서는 모든 연령을 대상으로 한 반면, 해당 연구에서는 대상군을 40세 이상으로 설정하였고 본 연구에서는 OTLA 유무의 기준을 180 HU로 설정하였으나 해당 연구에서는 이보다 낮은 환추횡인대 고음영 소견 또한 양성으로 간주하였기 때문으로 생각된다.…”

Section: 고찰unclassified

“…하지만 해당 연구에서의 환추횡인대 석회화의 유병률은 본 연구에서의 OTLA와 마찬가지로 나이가 증가함에 있어 그 빈도가 증가하는 소견을 보였다. 또한 본 연구에서 50세 미만의 환자는 OTLA가 발견되지 않았고 오직 50세 이상의 환자들에게서만 발견이 되었는데, Anno 등( 26 )의 연구에서도 99.2%의 환추횡인대 석회화가 50세 이상에서 발견되었으며 이를 통해 OTLA나 환추횡인대 석회화가 퇴행성 변화와도 관련이 있을 것으로 생각해볼 수 있다.…”

Section: 고찰unclassified

Ossification of the Transverse Ligament of the Atlas on CT: Frequency and Associated Findings

손

류

김

et al. 2020

J Korean Soc Radiol

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목적 경추 전산화단층촬영(cervical spine CT; 이하 C-spine CT)과 일반촬영을 이용하여 환추횡인대골화증(ossification of the transverse ligament of the atlas; 이하 OTLA)과 연관된 영상 소견에 대하여 알아보았다. 대상과 방법 11년간 3975명의 환자에게서 촬영한 5201개의 C-spine CT를 분석하여 OTLA의 유무를 확인하였고, 이를 대조군과 비교하여 그 빈도와 연관된 영상 소견의 통계학적 유의성을 확인하였다. 결과 3975명 중 45명에서 OTLA가 확인되었다(1.1%). 그 빈도는 나이에 따라 증가하는 소견을 보였으며( p < 0.005), 80세 이상인 환자의 12%에서 관찰되었다. 척수 공간(space available for spinal cord; 이하 SAC)은 OTLA 환자군에서 유의하게 작은 것으로 확인되었으며( p < 0.005), 전방환추후두막(anterior atlantooccipital membrane)-Barkow 인대 복합체의 광물질침착(mineralization), 황색인대골화증(ossification of ligamentum flavum), 경추후만증 또한 유의미한 양의 상관관계를 보였다( p < 0.005). 결론 OTLA는 환자의 나이, SAC 협소, 경추후만증, 다른 경추인대의 골화증과 연관되어 퇴행성 척추병증, 전신적인 골 과잉 상태, 혹은 기계적 스트레스나 불안정성에 관련이 있을 것으로 생각된다.

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Prevalence and Natural Course of Transverse Ligament of the Atlas Calcification in Asymptomatic Healthy Individuals

Abstract: 3.

Cited by 2 publications

References 11 publications

Coexistence of Crowned Dens Sign and Calcification of Ligamentum Flavum in the cervical Spine: coincidence or association?

Coexistence of Crowned Dens Sign and Calcification of Ligamentum Flavum in the cervical Spine: coincidence or association?

Ossification of the Transverse Ligament of the Atlas on CT: Frequency and Associated Findings

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