颈椎后纵韧带骨化症临床表现与影像学特点相关性研究

摘要

Objective To explore the relationship of the radiological characteristics and clinical symptoms of ossification of the posterior longitudinal ligament (OPLL) of cervical spine. Methods 200 OPLL patients were recruited into this study. The data of JOA scores of the OPLL patients were collected. The stenotic rate of the cervical spine canal was calculated by the sagittal plane CT. The sorts and ossificated cervicle were also identified by the images. Results The stenotic rate of the cervical spine canal was 19.8％ to 60.3％ with average 42.9％,the JOA scores was 4 to 15, averaged 10. Linear regression showed the stenotic rate of the cervical spine canal was negatively correlated with the JOA scores (P＜0.01). There were 94 cases for segmental-type, 46 for mixed-type, 23 for continuous-type and 37 for focal-type. The third and fourth cervical vertebrae were susceptible to ossify. Conclusion The higher the OPLL occupation ratio, the worse the clinical OPLL symptoms. The OPLL patients following clinical symptoms with spinal cord oppression are more likely the segmental-type.%目的 探讨颈椎后纵韧带骨化症(OPLL)临床表现与影像学特点之间的相关性.方法 2008年9月～2010年11月多中心搜集200例OPLL患者的影像学资料及临床特点(JOA评分),参照颈椎正中矢状位CT计算OPLL椎管占位率,同时对OPLL患者进行分型及观察骨化椎体情况.对OPLL占位率与JOA评分数据进行相关分析.结果 OPLL椎管占位率为19.8%～60.3%,平均42.9%;JOA评分4～15分,平均10分.线性回归显示,OPLL椎管占位率与JOA评分呈负相关(P<0.01).节段型94例,混合型46例,连续型23例,局灶型37例,C3和C4椎体骨化次数最多.结论 OPLL的临床表现与椎管占位率有密切关系,椎管占位率越大,临床症状越严重.C3、C4为最常见骨化椎体,有脊髓压迫症状的OPLL以节段型常见.