Continuing Education Column Ossification of Posterior Longitudinal Ligament(OPLL) of Cervical Spine Ki Hong Cho, M.D. Department of Neurosurgery Ajou

Size: px

Start display at page:

Download "Continuing Education Column Ossification of Posterior Longitudinal Ligament(OPLL) of Cervical Spine Ki Hong Cho, M.D. Department of Neurosurgery Ajou"

기성 한
5 years ago
Views:

1 Ossification of Posterior Longitudinal Ligament(OPLL) of Cervical Spine Ki Hong Cho, M.D. Department of Neurosurgery Ajou University College of Medicine & Hospital E mail : khcho54@ajou.ac.kr Abstract The most common and neurologically important enthesopathy that is caused by inflammation of tendinous and ligamentous attatchments to bone is ossification of posterior longitudinal ligament (OPLL). The OPLL can occur at the posterior surface of the spinal vertebral bodies from the foramen magnum to the sacrum; however, the cervical portion of the vertebra is mainly affected. The cervical OPLL is originally thought to occur only in individuals of Japanese descent; however the advances in its diagnosis by using computed tomography and magnetic resonance imaging have led to more frequent identification of the disease in other Asians and whites as well. The cervical OPLL is a surgically treatable cause of myelopathy and various surgical approaches including anterior and posterior approach have been introduced. Although the indications of surgical treatment have been defined, the selection of the most effective operation remains controversial. Keywords : Enthesopathy; Ossification of posterior longitudinal ligament; Surgical treatment 781

2 A B C D 782

3 783

4 784

5 785

6 786

7 A B C 787

8 A B A A B C 788

9 789

10 A B 790

11 791

12 plasty with an extended foraminotomy for cervical myelopathy. Neurosurgery 1995 ; 37 : Seichi A, Takeshita K, Ohishi I, Kawaguchi H, Akune T, Nakamura K, et al. Long term results of double door lami- noplasty for cervical stenotic myelopathy. Spine 2001 ; 26 : 11. Tsukimoto H. A case report : Autopsy of syndrome of compression of spinal cord owing to ossification within spinal canal of cervical spine. Arch Jpn Chir 1960 ; 29 : Hosoda Y, Yoshimura Y, Higaki S. A new breed of mouse showing multiple osteochondral lesions twy mouse. Ryumachi 1981; 21(Suppl) : Nakamura I, Ikegawa S, Okawa A, Okuda S, Koshizuka Y, Nakamura Y, et al. Association of the human NPPS gene with ossification of the posterior longitudinal ligament of the spine (OPLL). Hum Genet 1999 ; 104 : Youmans JR. Youmans Neurological surgery, 4ed. Philadelphia : WB Saunders, 1996 : Abe H, Tsuru M, Ito T, Iwasaki Y, Koiwa M. Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine. J Neurosurg 1981 ; 55 : Rozario RA, Levine H, Stein BA. Cervical myelopathy and radiculopathy secondary to ossification of posterior longitudinal ligament. Surg Neurol 1978 ; 10 : Hirabayashi K, Toyama Y, Chiba K. Expensive laminoplasty for myelopathy in ossification of the longitudinal ligament. Clin Orthop 1999 ; 359 : Keiji K, Teiji T, Takashi Y. Spinous process splitting lamino Yonenobu K, Fuji T, Ono K, Okada K, Yamamoto T, Harada N. Choice of surgical treatment for multisegmental cervical spondylotic myelopathy. Spine 1985 ; 10 : Hanai K, Inouye Y, Kawai K, Tago k, Itoh Y. Anterior decompression for myelopathy resulting from ossification of posterior longitudinal ligament. J Bone Joint Surg [Br] 1982 ; 64 : Hoshi K, Kurokawa T, Nakamura K, Hoshino Y, Saita K, Miyshi K. Expansive cervical laminoplasties. observations on comparative changes in spinous process lengths following longitudinal laminal divisions using autogenous bone or hydroxyapatite spacers. Spinal Cord 1996 ; 34 : Chiba K, Toyama Y, Watanabe M, Maruiwa H, Matsumoto M, Hirabayashi K. Impact of longitudinal distance of the cervical spine on the results of expansive open door laminoplasty. Spine 2000 ; 25 : Edwards II CC, Heller JG, Silcox III DH. T saw laminoplasty for the management of cervical spondylotic myelopathy Clinical and radiographic outcome. Spine 2000 ; 25 : Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open door laminoplasty for cervical spinal stenotic myelopathy. Spine 1983 ; 8 : Kazuo Yonenobu, Takenori Oda. Posterior approach to the degenerative cervical spine. Eur Spine J 2003 ; (Suppl 2) :

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R