后纵韧带肥厚(Hypertrophy of Posterior Longitudinal Ligament)MRI病例图片影像诊断分析

脊椎   2010-11-29

【临床病史】:43岁患者出现步态障碍和背痛,既往有甲状腺机能减低和风湿性关节炎。43-year-old patient with hypothyroidism and rheumatoid arthritis presenting with gait disturbances and back pain.

【影像图片】MRI图像

后纵韧带肥厚.jpg

【影像表现】

【影像诊断】:Hypertrophy of Posterior Longitudinal Ligament 后纵韧带肥厚

【诊断要点】

  • No ossification/calcification 无骨化/钙化
  • Controversial evolution to OPLL 是否会进展至后纵韧带骨化尚有争议
  • Amyloid deposition in long term hemodialysis patients 长期的血透病人可以有类淀粉样沉积
  • Reported in patients with Mucopolysacchridosis 在粘多糖患者中有报道
  • Causes myelopathy and gait disturbances 可以引起脊椎病或行走障碍
  • Two types : Primary and secondary (to disc degenerative changes ) 两种类型:原发性和继发性(椎间盘变性性改变)
  • Abnormal thickening of the posterior longitudinal ligament (PLL) greater than 3.5 mm without any ossified fragments. 后纵韧带异常增厚超过3.5mm,不伴有任何的骨化成分
  • Associations reported between OPLL and hypothyroidism as well as Rheumatoid Arthritis. 在后纵韧带骨化与甲状腺功能减低和风湿性关节炎之间有相关的报道。

【讨论】:Suggested Reading

Matsumoto T, Yoshida M, Yamada H, et al. Lumbar Canal Stenosis Caused by Hypertrophy of the Posterior Longitudinal Ligament: Case Report. Spine 2001;26:E576-9.

Mizuno J, Nakagawa H, Hashizume Y. Cervical amyotrophy caused by hypertrophy of the posterior longitudinal ligament. Spinal Cord 2002;40:484-8.

(参考来源:,AJNR June 28, 2010,作者:freemanpyw译)
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