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Posterior longitudinal ligament in the spinal posterior longitudinal ligament behind the vertebral body, narrow and tough. Long as the spinal ligaments, starting from the axis and axis vertebrae and the coverage continued with film, issued sacrum. And the intervertebral disc and vertebral body upper and lower edge of the tight junction, combined with the vertebral body is more loose, restricted the role of spinal flexion over. The very length and anterior longitudinal ligament, vertebral body compared with the relatively narrow part of the fine paste, but the disc at the wide, posterior longitudinal ligament may limit excessive flexion and prevent spinal disc prolapse back role. Further ing: 1
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Cervical posterior longitudinal ligament calcification ossification of posterior longitudinal ligament, the formation of spinal lesions, the spinal cord easy to pressure to produce clinical signs of spinal cord compression. Disease is more common in Asians, rare in Caucasians, especially the highest incidence of the Japanese, followed by China. The incidence of the disease increases with age, there is a growing tendency of women in male patients the incidence rate of more than 2 times. The incidence of cervical can, but the neck 5, the neck 4, 6 neck and neck for up to 7, while the direction of the vertical and horizontal direction. Because of the posterior longitudinal ligament and ossification have calcium deposits, so that the sagittal diameter of cervical spinal canal decreases, the spinal cord can produce different levels of direct pressure and stimulation, and the ossification of the posterior longitudinal ligament anterior spinal artery can also be oppressive, resulting in arterial insufficiency in the ditch, causing the center of the spinal cord damage. At the same time, due to the ossification of posterior longitudinal ligament (especially continuous), with make ossification of the cervical spine segmental stability in the region does not move, suffering from Day activity completely disappeared, and so is bound to increase the area of cervical ossification of the adjacent segments of non- compensatory activities, and accelerate the process of degeneration, resulting in adjacent segmental cervical spine instability, significant osteophyte proliferation of intervertebral disc degeneration and salient, often cause clinical symptoms or new symptoms of the direct cause of also in the treatment of choice in particular, the focus of surgical therapy. Ossification of cervical posterior longitudinal ligament cause is unclear, may be related to trauma, chronic fatigue, inflammation, cervical disc degeneration, genetic and other factors. In addition some patients cervical OPLL, there are yellow ligament of thoracic and lumbar spine ligament or ossification of the patellar tendon and other organizations, with more parts of the body's tendency to ossification. Wu Hao of Neurosurgery, Xuanwu Hospital, BeijingOssification of cervical posterior longitudinal ligament compared with the occurrence and development of the slow, early do not have any clinical symptoms. When the ossification of the block to a certain degree of thickening caused by widening the narrow cervical spinal canal, or OPLL though not serious, but the original developmental spinal stenosis, can cause blood vessels to the spinal cord or spinal cord compression, so the emergence symptoms in middle-aged more than age. Ligament calcification due to the scope of the nerve root canal is not affected, so little clinical radicular symptoms, but mainly for the cervical spinal canal stenosis. Most of the symptoms in patients with spinal cord compression occurs when to the hospital and is characterized by symptoms of spinal cord compression of different degrees of chronic progressive spastic quadriplegia, often starting from the lower extremity symptoms, after months of January or upper extremity symptoms, but also the first symptoms of upper extremity symptoms or limb. Performance of both upper arm acids, hemp, swelling, Shen, weakness, decreased flexibility of the hand, decreased grip strength, muscle atrophy was moderate or mild, pain reduction, Hoffman's sign was positive. Lower limb can be a double lower extremity numbness, weakness, cramps, difficulty lifting, mopping the floor and the line or the trembling instability, there is a sense of stepping Cotton, who adductor muscle spasm was significantly scissor gait, severe cases are not self-ups and turn over, lower extremity increased muscle tone, muscle weakness, knife being positive, physiological effects, or hyperthyroidism active, pathological reflex positive, can have deep and superficial hypoesthesia. Sphincter dysfunction, urinary problems or incontinence, bowel dysfunction, often abdominal distension, chest and abdomen often belted sense. Precisely because of the slow onset of the disease, more disease unknowingly, the initial obvious symptoms, are often not taken seriously, but due to injuries or accidents can be sudden increase, the occurrence of quadriplegia. Our department has treated many cases of the disease has been diagnosed in patients refusing surgery, due to accidentally fall or car emergencies such as sudden deceleration, leading to limb paralysis, posterior single door giving our department after surgery, the need for rehabilitation Division long-term rehabilitation, long period of hospitalization, medical and costly, to the huge loss of family and society.Cervical posterior longitudinal ligament calcification treatment:
Ossification of posterior longitudinal ligament, including conservative treatment and surgical treatment of surgery. For the symptoms slightly and older who have organic diseases, can be used non-surgical therapy. Commonly used continuous skull traction, bed rest, cervical collar fixed, physiotherapy and drug therapy. For intermittent cervical traction and massage therapy, reports have caused the symptoms get worse, should be carefully selected.
For symptoms, image data of patients diagnosed, surgery should be considered.
Cervical posterior longitudinal ligament calcification anterior and posterior surgery the implementation of two ways, sometimes in patients with severe anterior surgery. Purpose is to remove the ossification of the posterior longitudinal ligament of spinal cord compression, expansion of the spinal canal, to maintain spinal stability.
Anterior: theory, implementation of the posterior longitudinal ligament ossification anterior surgery should be a direct lift the removal of ligament lesions of spinal cord compression, but because of technical reasons, the long segment of the posterior longitudinal ligament ossification Surgeons had to choose posterior surgery. Anterior cervical surgery also includes lesions of OPLL excision and floating and French. By floating method, the first removal of vacuum within the disc, and then rongeur bite than some of the vertebrae and removed using a micro drill bit grinding vertebral bone, so that yellow and white blocks of the gradual ossification of the posterior longitudinal ligament was significantly the surgical field, and ossification of the lesion was surrounded entirely free floating softening, decompression spinal CSF pulsation under the expansion of ossification of the lesion can gradually move forward to achieve the purpose of decompression. Decompression zone to be implanted in iliac bone. Anterior technically demanding, difficult and risky surgery. Our department is currently done without anterior severe complications.
Posterior approach: laminoplasty, a unilateral open the door, and bilateral open surgery, the decompression degree of neurological recovery, spinal stability and degree of cervical flexion deformity, etc. laminectomy and laminoplasty between no significant difference, while cervical arthroplasty can increase spinal stability and prevent anti-cervical flexion deformity, and can control the ossification of cervical posterior longitudinal ligament lesion development. Laminoplasty important technical aspect in maintaining the structural stability after spine position during surgery to maintain spinal cord decompression effect.



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