Observation About Cervical Posterior Longitudinal Ligament Degeneration Of Cervical Spondylitic Myelopathy

Background and objectiveCervical spondylitic myelopathy is the most common kind of cervical degeneration diseases and it’s pathological basis is degenerative intervertebral disc. Through a series of pathophysiological changes, it will cause adjacent vertebral osteophyte formation, which lead to oppression of spinal cord and its affiliated vascular structure. Cervical spondylitic myelopathy disease is one of the most common type and serious of cervical vertebra disease to the health of old people, and results in different degree of spinal cord dysfunction. It will cause proliferous, hypertrophy, cartilage ossification, and dural sac adhesions of cervical Posterior longitudinal ligament with stretching, friction and degeneration of the posterior longitudinal ligament. Research shows that Cervical posterior longitudinal ligament hypertrophy is an important factors of chronic compressive cervical spinal cord. More and more evidence shows that Cervical posterior longitudinal ligament hypertrophy and Ossification of the posterior longitudinal ligament has a close correlation. But the sequential research of Cervical posterior longitudinal ligament hypertrophyt and Ossification of the posterior longitudinal ligament is still rare. This study is based on the spondylitic myelopathy after longitudinal ligament degeneration on the basis of clinical characteristics. Study degeneration and development characteristics of the Posterior Longitudinal Ligament in order to provide relevant parameters for the clinical diagnosis and treatment and to improve the safety and efficacy of surgery.Methods:Choose the patients who have treated in the Orthopedics of the First Affiliated Hospital of Zhengzhou university between January2010and October2012. Clinical data by screening (relatively perfect) randomly selected60patients with cervical spondylosis set as observation group. Over the same period hospitalized patients randomly selected60patients who did not have cervical spondylosis patients set as control group. Observation group of patients:male36, female24cases, at age21-76years old, average52.4years old,18cases of combined cervical posterior longitudinal ligament hypertrophy,24cases of combined Ossification of the posterior longitudinal ligament, A total of42cases. The control group:28cases of male,32cases of female, aged16-71years old, average47.6years old. The imaging data of observation group and control group patients were analyzed with PACS Version5.0. We use statistical SPSS17.0processing software to analysis the qualitative and quantitative data obtained, using the single factor analysis of variance, chi-square, and Pearson correlation analysis, and P<0.05for the difference is statistically significant.Results:1. Cervical posterior longitudinal ligament degeneration located in the center of the vertebral canal (56.8%) with partial side abusers (43.2%), and segmental degeneration occurs in C4and C5as the increasing incidence of a disease of the age.2. Compared with the control group, the target in observation group such as distance of the edge of vertebral body which is apart from the recent spine, cervical spinal cord transverse diameter of the sagittal diameter of vertebral sagittal diameter measures, difference has statistical significance (P values were less than0.05), two way in different gender comparison, results showed that there was no statistically significant difference (P value were greater than0.05).3. Compared with the control group, the target in observation group such as SAC、DSR and cervical vertebra tube, the differences were statistically significant (all P values<0.05). The results of two genders in different group in comparison show that there was no statistically significant difference (P value were greater than0.05), index of observation group were significantly less than the control group.4. DSR, SAC, edge of vertebral osteophyte nearest distance of spine and spinal cord area/spinal canal area have obvious correlation, the correlation between the DSR and spinal cord area/spinal canal area is the highest.Conclusion:1. Cervical posterior longitudinal ligament degeneration occurs the part for C4,5with many segmental type midline, Significantly the degeneration of the thickness and width, and longitudinal ligament degeneration after the merger with C3is more mixed. We should focus on preoperative intraoperative longitudinal ligament after dealing with myelopathic type cervical vertebra disease. Age and longitudinal ligament degeneration of cervical spine after occurrence is closely related, according to this analysis, the older you get, the greater morbidity of Posterior longitudinal ligament.2.DSR, SAC, edge of vertebral osteophyte nearest distance of spine, spinal cord area/spinal canal area have obvious correlation, and the DSR in prompt stenosis degree has the closest correlation. The distance of the edge of vertebral body that apart from the recent spines can serve as an evaluation index of spinal canal stenosis in order to predict whether the ossification of the posterior longitudinal ligament occur. If the distance of the edge of the vertebral body is less than13, it may prompt osteophytosis or ossification of the posterior longitudinal ligament. We should observe wether there exists proliferation or hypertrophy of posterior longitudinal ligament, in order to remove to pathological changes if necessary.