Analysis of Hypertrophy of the Posterior Longitudinal Ligament of the Cervical Spine, on the Basis of Clinical and Experimental Studies

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1091-1098 ◽  
Author(s):  
Junichi Mizuno ◽  
Hiroshi Nakagawa ◽  
Yoshio Hashizume
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Anterior Approach ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Cord Compression ◽  
Intervertebral Discs ◽  
Decompression Surgery ◽  
Resonance Imaging

ABSTRACT OBJECTIVE The goal of this study was to elucidate the pathophysiological features and treatment of hypertrophy of the posterior longitudinal ligament (HPLL) of the cervical spine. HPLL is defined as a pathological thickening of the posterior longitudinal ligament (PLL), causing spinal cord compression. Incomplete decompression via removal of only coexisting herniated intervertebral discs or spondylotic spurs might be performed, resulting in unsatisfactory surgical outcomes, when the PLL becomes abnormally thickened and contributes to myelopathy. METHODS Patients with HPLL who underwent cervical decompression surgery were selected. Medical records and radiographs were retrospectively reviewed, to obtain data on the pre- and postoperative clinical conditions of the patients. Autopsy cases with HPLL proven by low-energy x-ray examinations were chosen for assessment of the pathological characteristics. RESULTS Seventeen men and three women with HPLL underwent treatment via an anterior approach, with direct removal of HPLL. Nineteen patients developed myelopathy, whereas one patient developed radiculopathy. Radiologically, all HPLL cases exhibited coexisting herniated intervertebral discs and 10 exhibited small segmental ossifications of the PLL. Magnetic resonance imaging or computed tomographic myelography revealed extensive cord compression across the vertebral endplate level. The average preoperative Benzel modified Japanese Orthopaedic Association score was 10.8, and the average postoperative score was 13.2. Histological examinations revealed thickening of the PLL with proliferation of chondrocytes, together with various degenerative changes. CONCLUSION Patients with HPLL can benefit from an anterior approach with direct removal of the HPLL and associated herniated intervertebral discs or ossification of the PLL. Cervical polytomography, computed tomography, and magnetic resonance imaging are useful in establishing a diagnosis of HPLL.

scholarly journals Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

2013 ◽  
Vol 46 (3) ◽  
pp. 173-177 ◽  
Author(s):  
Cristiano Gonzaga de Souza ◽  
Emerson Leandro Gasparetto ◽  
Edson Marchiori ◽  
Paulo Roberto Valle Bahia
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Correct Diagnosis ◽  
Cord Compression ◽  
Intervertebral Discs ◽  
University Hospital ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Radiographic Findings ◽  
Vertebral Bodies

Spondylodiscitis represents 2%–4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis.

The use of flexion-extension magnetic resonance imaging for evaluating signal intensity changes of the cervical spinal cord

2009 ◽  
Vol 10 (4) ◽  
pp. 366-373 ◽  
Author(s):  
Kern H. Guppy ◽  
Mark Hawk ◽  
Indro Chakrabarti ◽  
Amit Banerjee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Resonance Imaging ◽  
Flexion Extension ◽  
Dynamic Mr

The authors present 2 cases involving patients who presented with myelopathy. Magnetic resonance imaging of the cervical spine showed spinal cord signal changes on T2-weighted images without any spinal cord compression. Flexion-extension plain radiographs of the spine showed no instability. Dynamic MR imaging of the cervical spine, however, showed spinal cord compression on extension. Compression of the spinal cord was caused by dynamic anulus bulging and ligamentum flavum buckling. This report emphasizes the need for dynamic MR imaging of the cervical spine for evaluating spinal cord changes on neutral position MR imaging before further workup for other causes such as demyelinating disease.

Reliability of Magnetic Resonance Imaging in Predicting Disc Material Posterior to the Posterior Longitudinal Ligament in the Cervical Spine

Spine ◽  
1998 ◽  
Vol 23 (22) ◽  
pp. 2468-2471 ◽  
Author(s):  
S. Craig Humphreys ◽  
Scott D. Hodges ◽  
Desmond L. Fisher ◽  
Jason C. Eck ◽  
Laurie A. Covington
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Posterior Longitudinal Ligament ◽  
Resonance Imaging ◽  
Disc Material

Management of The Cervical Spine Tuberculosis

2018 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Sabri Ibrahim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Spinal Tuberculosis ◽  
Intervertebral Disk ◽  
Posterior Fixation ◽  
Resonance Imaging ◽  
Vertebral Bodies ◽  
Intervertebral Disk Space ◽  
Developed Nations

Tuberculosis of the cervical spine is a rare clinical condition (10%), most commonly affected lower thoracic region (40-50% of the cases). Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Characteristically, there is a destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. For the diagnosis of spinal tuberculosis, magnetic resonance imaging is more sensitive than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates an involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Anti-tuberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. The quality of debridement and bony fusion is optimal when the anterior approach is used. Posterior fixation is the best means of achieving reduction followed by stable sagittal alignment over time. With early diagnosis and early treatment, the prognosis is generally good.

Intradural Dirofilariasis in a Dog with Chronic Cervical Pain

2017 ◽  
Vol 53 (1) ◽  
pp. 59-63
Author(s):  
Kathleen Ann Bonawandt ◽  
Jason M. Berg ◽  
Richard J. Joseph ◽  
Joseph D. Stefanacci
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Spinal Pain ◽  
Resonance Imaging ◽  
Male Adult ◽  
Normal Limits ◽  
History Of ◽  
C2 Vertebra ◽  
Intradural Extramedullary

ABSTRACT A 7 yr old female spayed Yorkshire terrier was referred to the author's institute for a 5 mo history of recurrent cervical spinal pain. Neurologic examination did not reveal any deficits. Hematologic and serum analyses were within normal limits. Thoracic radiographs that incorporated the cervical spine did not show structural abnormalities. Magnetic resonance imaging of the cervical spine demonstrated a contrast enhancing, intradural extramedullary lesion at the level of the C2 vertebra. Hemilaminectomy was performed, during which a long, narrow nematode was visualized upon opening of the dura mater. The parasite was alive when removed during surgery, and the dog recovered with complete resolution of symptoms. The parasite was submitted and confirmed as a male adult Dirofilaria immitis. This is a novel case of an intradural D. immitis infection in the dog with a magnetic resonance imaging description of spinal D. immitis.

Sign in / Sign up

Export Citation Format

Share Document