Ossification of the ligamentum flavum
Introduction
Introduction to ossification of ligamentum flavum With the extensive development of spinal surgery, cervical vertebral tract ossification of the cervical vertebrae, thoracic vertebrae and lumbar vertebrae are not uncommon in clinical observations. Especially after the advanced techniques of CT and MRI, the diagnosis rate and discovery The rate is obviously improved, and there are many cases of compression or stimulation of the spinal cord. In severe cases, surgical resection is needed. Cervical ligamentum flavum ossification has been discussed in a special section. basic knowledge The proportion of sickness: 0.004% - 0.009% Susceptible people: no specific population Mode of infection: non-infectious Complications:
Cause
Causes of ossification of the ligamentum flavum
Cause:
Whether the ossification of the ligamentum flavum and the calcification of the ligamentum flavum is the same disease, or two different diseases, the opinions are not uniform, especially for the cases that occur in the cervical vertebrae, the claim is that the two diseases believe that: the former is more Found in men, in addition to the spine, other parts of the body without ossification, and easy to adhere to the dura mater and lamina; while the latter is more common in women, other parts of the body can be found calcification, and does not adhere to the dura mater and lamina, No continuity, claiming that the two are the same disease patients think: the basic pathological changes of the two are similar, and calcification is very rare, so it should be regarded as the different stages of development of the same lesion, the author believes that from clinical diagnosis and treatment From the point of view, the two do not necessarily need to be distinguished, especially in the current situation of their own opinions, the clinician should still be based on the principle that the patient can relieve the pain.
Prevention
Prevention of ossification of ligamentum flavum
1, the affected joints should be protected, reduce joint load, reduce weight, pay attention to rest, avoid long-term weight and poor posture, use a cane, walker and so on.
2, usually pay attention to the affected joints to keep warm, you can use hot water bags, hot towels and other hot compresses, as much as possible to avoid air conditioning, electric fans directly to the joints.
Complication
Yellow ligament ossification complications Complications
Severe cases can be complicated.
Symptom
Symptoms of ossification of the ligamentum flavum Common symptoms Sensory disorder, easy to fall, muscle tension, hypertonic ligament ossification
In the early stage, the sagittal diameter of the spinal canal can be free of any symptoms; however, the development of the sagittal diameter of the spinal canal is prone to spinal cord compression, which is as follows:
1. The first symptomatic disorder occurs, mainly because the pressure is from the posterior aspect of the spinal canal. The severity and extent of the pressure is proportional to the degree of the lesion and the course of the disease, and inversely proportional to the size of the sagittal diameter of the spinal canal.
2. The dyskinesia occurs more than 2 to 3 months after the former, and the muscles of the lower limbs are increased, and it is easy to fall, and the weakness and the easy to fall are early, and in severe cases, paralysis occurs.
3. The local symptoms of the vertebral nodes are often not obvious. In a few cases, there may be neck pain or chest pain, waist pain, and may be accompanied by symptoms of sensory disturbances such as restricted or increased numbness when the activity is limited.
Examine
Examination of ossification of the ligamentum flavum
1. Imaging examination
(1) X-ray plain film: the ossification (calcification) of the ligamentum flavum can be displayed on the lateral and oblique slices. The neck is 5-6, the neck 45 and the thoracic segment are more common. The lumbar vertebrae are thick and dense due to bones. It is often difficult to show. In severe cases, the ossified ligamentum flavum can be found in the spinal canal. Most of these cases are complicated with spinal stenosis, cervical spondylosis or other diseases of the thoracic and lumbar spine. Therefore, the vertebral body can be found on the X-ray film. The ratio of the sagittal diameter of the body to the spinal canal and the absolute value of the sagittal diameter of the spinal canal are smaller than normal. In addition, there are many spur formations in the intervertebral space.
(2) Tomography and CT examination: The shape and location of the ossified yellow ligament can be clearly displayed, which is clearer than the former.
(3) Others: MRI and myelography and other examinations are helpful for diagnosis, especially for those with lesions involving nerves. MRI should be performed routinely.
2. Electrophysiological examination
For patients with spinal cord compression symptoms, evoked potential or electromyography may be used as appropriate, not only as a basis for adjuvant diagnosis, but also for the exclusion of the spinal cord itself.
Diagnosis
Diagnosis and differentiation of ossification of ligamentum flavum
According to clinical manifestations, X-ray lateral and oblique, tomography and CT, MRI and electrophysiological examination can establish a diagnosis.
