Degenerative ligamentum flavum hypertrophy

Introduction

Introduction to degenerative ligamentum flavum Cervical spondylosis generally has cervical vertebrae hyperplasia, normal curvature variation and cervical disc herniation. Mainly due to cervical degenerative lesions and compression of the nerve (dural sac) caused by local metabolic cycle is blocked. It depends on what nerves are actually oppressed. It can be divided into cervical type with neck symptoms, nerve roots with nerve root involvement, spinal cord type of limb movement and sensory disturbance, and vertebral artery type caused by sympathetic nerve stimulation around the vertebral artery. And the esophagus type that has swallowing discomfort or difficulty in the esophagus. The main reactions are pain, dizziness, vomiting, hand numbness, insomnia, and reflex pain. If you do not pay close attention to treatment, the disease will further develop, and may also lead to irregular rhythm, decreased vision, facial paralysis or upper limb muscle atrophy and other serious consequences. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: spinal stenosis

Cause

Degenerative ligamentum flavum hypertrophy

Damage (40%):

When the lumbar vertebrae degenerate, the stress on the ligamentum flavum is very high, and the elastic fibers will be denatured or broken. The long-term damage and repair process will inevitably cause fibrosis of the ligamentum flavum, which will eventually lead to calcification of the ligamentum flavum.

Other factors (30%):

The etiology or pathogenesis of hypertrophy of the ligamentum flavum is unclear and may be related to factors such as chronic degeneration, trauma, inflammation, and metabolic disorders.

Prevention

Degenerative ligamentum flavum hypertrophy prevention

Encourage young and middle-aged people to strengthen physical exercise to delay the process of degeneration of the spine. The elderly should also carry out appropriate physical exercise and strengthen the prevention and treatment of osteoporosis, which is very beneficial to delay the hypertrophy of degenerative ligamentum flavum.

Complication

Degenerative ligamentum flavum hypertrophy Complications

The end result of degenerative ligamentum flavum hypertrophy is the stenosis of the spinal canal, especially the stenosis at the beginning of the lateral crypt, leading to compression of the cauda equina and compression of the nerve roots. The degeneration of hypertrophic ligaments of the ligamentum flavum decreased, the compensatory capacity of collagen fibers increased, the fiber arrangement was disordered, and the obvious degeneration and calcification occurred. The collagen content increased significantly, which was the main reason for the hypertrophy of the ligamentum flavum.

Symptom

Degenerative ligamentum flavum hypertrophy symptoms Common symptoms Lower lumbar pain Yellow ligaments hypertrophy Hand numb neck fear of flexion, fear of dizziness, dizziness, spinal nerve compression, insomnia, intermittent claudication

Degenerative ligamentum flavum is more common in the elderly, with a long course of disease, and may have an acute aggravation process. Occurs between the lumbar 4 ~ lumbar 5 lamina, so that the cauda equina and nerve roots are oppressed. The nerve root can be affected bilaterally or unilaterally. Clinical symptoms are similar to those of lumbar spinal stenosis. Often the lower back pain is mainly relieved or disappeared after rest, and there may be neurogenic intermittent claudication.

Examine

Degenerative examination of hypertrophic ligamentum flavum

The disease is often characterized by severe symptoms and light signs. The tenderness of the spinous process was obvious in the lesion segment, and the lumbar overextension test was positive. It was an important sign of the disease, and the straight leg elevation test was often negative. Patients with longer course of disease may have sensory and abnormal muscle strength. When the lesion is located in the 3 and 4 gaps of the waist, the lumbar 4 nerve root is compressed, the anterior side of the calf is numb, the quadriceps muscle strength is reduced, and the knee reflex is weakened; when the lesion is located in the lumbar 4 and 5 gap, the lateral part of the calf or the foot of the foot is included. There are numbness on the back, occasionally the foot is drooping, and the tendon reflex is generally normal; when the waist 5, 1 gap is involved, the posterior lateral part of the calf and the lateral three-toed foot are numb, and the tendon reflex generally weakens or disappears.

Diagnosis

Diagnosis and diagnosis of degenerative ligamentum flavum

Differential diagnosis

The clinical manifestations of lumbar spinal stenosis caused by degenerative ligamentum flavum hypertrophy and lumbar disc herniation and lumbar spinal stenosis are similar to those of cauda equina and nerve root compression diseases. It is impossible to make a correct diagnosis based solely on clinical manifestations. Its diagnosis mainly relies on imaging diagnostic techniques such as CT and MRI, especially the important opinions of MRI on its diagnosis. MRI has multi-directional and multi-parametric imaging features, which makes the ligamentum flavum show its unique characteristics on MRI images. The diagnosis of ligamentum flavum is better than other imaging methods.

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