Ossification of the Posterior Longitudinal Ligament
Ossification of the Posterior Longitudinal Ligament
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DOI：
10.1093/med/9780190887773.003.0009
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
T. Vogel;Hansen Deng;P. Mummaneni
中科院分区：
文献类型：
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作者：
T. Vogel;Hansen Deng;P. Mummaneni
脊髓型颈椎病或神经根型颈椎病患者可能会发生后纵韧带骨化（OPLL）。轻微的创伤可能会加重症状，导致脊髓型颈椎病迅速进展。识别是关键，计算机断层扫描是诊断 OPLL 的首选成像方式。手术时间取决于症状的严重程度和进展。前路和后路入路都可以接受，但通常首选后路入路。术中神经监测的使用可以帮助外科医生采取纠正措施，以减少或预防永久性神经功能缺损。对于 65 岁以下症状轻微且根管严重受损的患者，可考虑进行预防性手术。
Ossification of the posterior longitudinal ligament (OPLL) may occur in patients presenting with cervical myelopathy or cervical radiculopathy. Mild trauma may aggravate symptoms, resulting in a rapid progression of cervical myelopathy. Recognition is key and utilization of computed tomography is the preferred imaging modality for diagnosing OPLL. Timing of surgery is dependent on severity and progression of symptoms. Anterior and posterior approaches are acceptable, but generally the posterior approach is preferred. The use of intraoperative neuromonitoring may assist the surgeon in taking corrective actions to reduce or prevent permanent neurological deficits. Prophylactic surgery may be considered in mildly symptomatic patients less than 65 years old with a high degree of canal compromise.