胸椎黄韧带骨化症骨桥形成的特点及其意义

The feature and significance of the formation of osseous bridge in ossification of the thoracic ligamentum flavum

目的 探讨胸椎黄韧带骨化症患者椎体骨桥形成的特点及其意义。方法 分析手术治疗的 5 0例胸椎黄韧带骨化症中骨桥形成 2 8例 (占 5 4 % )的临床表现及影像学资料。结果 ①骨桥与黄韧带骨化位置的关系 :骨桥与骨化黄韧带紧邻者 15例 ;其中 ,4例在某些节段可见黄韧带骨化与骨桥发生于同一间隙 ,间隔一个椎间隙的 10例、间隔 2个椎间隙的 1例、间隔 3个椎间隙的 2例。②骨桥形成的节段 :形成于一个椎间隙的 14例、2个椎间隙的 7例、3个椎间隙的 5例、5个和 7个椎间隙的各 1例。③骨桥形成的特点是在椎间形成高密度的连续骨化影。这种表现主要发生在与黄韧带骨化节段相邻的部位。结论 骨桥形成在胸椎黄韧带骨化症中出现是退变的一种表现形式 ;

Objective To explore the clinical feature and the pathologic signficance of osseous bridge in ossification of the thoracic ligamentum flavum.Methods 50 cases of ossification of ligamentum flavum were surgically treated, among which 28 cases (54%) had the osseous bridge formation. The data of clinical manifestation and image feature were analysed. Results ①With regard to the relationship between the osseous bridge and the ossified ligamentum flavum, 15 cases were at the neighbouring position , 4 cases were at the same level in some segments, 10 cases spanned one intervertebral space, 1 case spanned two intervertebral spaces, 2 cases spanned three intervertebral spaces.② Regarding the segments of osseous bridge, 14 cases were formed in one intervertebral space, 7 cases in two intervertebral spaces, 5 cases in three intervertebral spaces, the other two in five and seven intervertebral spaces respectively. ③ It seems that the characteristic process of the formation of osseous bridge was to form high-density and successive ossified image in the intervertebral space, which located at the neighbouring site of the ossified ligamentum flavum. There were only 4 cases, in which both of the thoracic ligamentum flavum and osseous bridge were in the same intervertebral space.Conclusion The occurrence of osseous bridge in the ossification of ligamentum flavum may be explained as the degenerative process indicating that the ossification of the thoracic ligamatum flavum may be the degenerative part of the spine.