颈椎后纵韧带骨化的发生和病因学研究  

Development and pathogenesis of OPLL of the cervical spine

作　　者：黄红云[1] 冯涛[1] 崔月汉[1] 刘宗惠[1] 王亚奇[1] 修波[1] 关颖鹏 罗毅[1] 

机构地区：[1]海军总医院神经外科,北京100037

出　　处：《中华神经外科杂志》1999年第5期272-274,共3页Chinese Journal of Neurosurgery

摘　　要：目的　阐述颈椎后纵韧带骨化（ Ｏ Ｐ Ｌ Ｌ） 的发生和病因学。方法　取２０ 例新鲜颈椎标本（１０ 例３０ 岁以下， １０ 例６０ 岁以上） 拍 Ｘ 线平片后， 后纵韧带切片行光镜和电镜检查。１０ 例颈椎 Ｏ Ｐ Ｌ Ｌ和２８ 例颈椎病患者术前行 Ｘ 线平片和 Ｃ Ｔ 检查， 术中取后纵韧带行组织学检查。结果　年轻标本的 Ｘ 线平片和光镜 检查以及老年标本的 Ｘ 线平片检查均未见后纵韧带骨化， 但老年标本在光镜检查中发现４ 例后纵韧带有骨化灶； ６ 例未发现骨化者， 在电镜检查中５ 例有钙化小泡和（ 或） 钙化小体。１０ 例 Ｏ Ｐ Ｌ Ｌ 患者的光镜， Ｘ 线平片和（ 或） Ｃ Ｔ 检查中后纵韧带均呈骨化状。２８ 例颈椎病患者的 Ｘ 线平片或 Ｃ Ｔ 检查均未见后纵韧带骨化， 但在光镜检查中发现１０ 例后纵韧带呈小灶状骨化。其他患者有１６ 例在电镜检查中发现钙化小泡和 （ 或） 钙化小体。结论　这些研究结果提示颈椎 Ｏ Ｐ Ｌ Ｌ并不是一种独立疾病过程， 而是颈椎病的一种特殊表现。就象颈椎病一样， 它的发生和病因学可能是老化后内分泌和代谢平衡失调， 加之颈椎的局部活动等多因素综合作用的结果。Objective To elucidate the development and pathogenesis of ossification of the posterior longirudinal ligament (OPLL) of the cervical spine.Methods X ray films of the cervical spine were taken in 20 fresh male cadaveric spine specimens (10 specimens<30 years, 10>60 years).The posterior longitudinal ligament (PLL)was then sectioned for light microscopic and electron microscopic examination. In 38 patients with OPLL and cervical spondylotic myelopathy, preoperative routine cervical x rays and CT scans were examined. During operation, the PLL was removed in 28 patients(53 67 years, mean 60 years) with cervical spondylosis and 10 patients (53 76 years,mean 61 years) with OPLL. The specimens of PLL were examined histologically under light and electron microscopy.Results In the cadaver specimens there was no ossification on x ray films and microscopic sections in the young specimens, also no ossification on the x ray films in the old specimens. But there were foci of ossification on microscopic sections in 4 of the old specinens and calcific vesicles and /or bodies on electron microscopic sections in 5 of the old specimens without ossification seen under light microscopy. In the operative specimens 10 patients with OPLL showed OPLL on the microscopic sections of the PLL and on x ray films and/or CT scans of the cervical spine. No patient with cervical spondylosis had OPLL on the x ray films or CT scans of the cervical spine, but 10 showed foci of ossification on the microscopic sections of the PLL. Sixteen patients without ossification on light microscopic sections had calcific vesicles and /or bodies on electron microscopy. Conclusion These results suggest that OPLL is not a separate disease process, but a variant of cervical spondylosis. As in cervical spondylosis, its development and pathogenesis are likely due to multiple endocrine and metabolic changes that occur with aging and as well as the local effects of chronic movement of the cervical spine.

关 键 词：OPLL 颈椎病 发生 病因学 

分 类 号：R681.55[医药卫生—骨科学]