Evaluation of the Ossification of the Cervical Posterior Longitudinal Ligament Utilizing X-Ray, CT and MR Imaging
Journal Title: Orthopedics Research and Traumatology – Open Journal - Year 2017, Vol 2, Issue 1
Abstract
Background: Cervical ossification of posterior longitudinal ligament (OPLL) is a common disease among the elderly population of East Asian countries. Cervical OPLL is often misdiagnosed in lateral radiography or magnetic resonance imaging (MRI). The present study analyzes the diagnostic accuracy of cervical OPLL in lateral radiography and MRI compared to computed tomography (CT). Methods and Materials: A total of 60 Japanese patients who were clinically diagnosed with cervical OPLL by CT imagining were considered in this study. Firstly, a lateral radiograph was checked identifying a high-density structure along the posterior aspect of vertebral bodies as OPLL. Secondly, a T2 weighted MRI sagittal image was obtained which delineated a thick low-signal posterior longitudinal ligament as OPLL. Thirdly, a cervical CT investigated vertebral bodies in which OPLL was present. Subsequently, lateral radiographs and MRIs were compared to the CT scans. The diagnostic accuracy in lateral radiograph and MRI were evaluated and causes of misdiagnosis were postulated. Results: Diagnostic accuracy utilizing lateral radiograph and MRI were 20% (12/60) and 25% (15/60), respectively. Only 5 out of the 60 cases displayed evidence of OPLL in all three modalities. Regarding each vertebral level, accuracy using lateral radiograph and MRI of each C2-C7 was C2 (88.8% and 100%), C3 (88.8% and 100%), C4 (79.5% and 97.9%), C5 (95.5% and 110.6%), C6 (42.5% and 70.2%) and C7 (23.8% and 66.6%). Conclusions: Diagnosing cervical OPLL using lateral radiograph is prone to underestimation; whereas, diagnosis via MRI is prone to overestimation. If severe spondylosis, facet joints, and pedicle shadows occur, they can hinder the detection of OPLL in the lateral radiograph. Regarding the MRI-based diagnosis, it would be difficult to distinguish ossifications from ligament hypertrophy. However, the use of X-ray and MRI present an accurate diagnostic tool for cervical OPLL at the levels of C2, C3, C4 and C5.
Authors and Affiliations
Yuko Kobashi
Keywords
Related Articles
- EP ID EP552452
- DOI 10.17140/ORTOJ-2-109
- Views 136
- Downloads 0
Isokinetic Muscle Strength in Recreational Athletes with Partial ACL Lesions Treated with Surgical Reconstruction
Background: Surgery that spares the intact portion of the ACL seems to be more favorable. This surgical technique has a positive effect on joint stability, joint position sense and functional scores in patients with part...
Halo-Vesting in Preschool Aged Children with Synchondrosis Fracture: A Case Series which Explores the Current Techniques Associated with this Procedure
Upper cervical spine injuries are the most common form of spinal cord trauma that occur in preschool children. Among such injuries, odontoid synchondrosis fractures are the most frequently observed, though relatively few...
Evaluation of the Ossification of the Cervical Posterior Longitudinal Ligament Utilizing X-Ray, CT and MR Imaging
Background: Cervical ossification of posterior longitudinal ligament (OPLL) is a common disease among the elderly population of East Asian countries. Cervical OPLL is often misdiagnosed in lateral radiography or magnetic...
Coaching Orthopaedic Surgeons: Can Visiting Professors be a Valuable Surgical Coach?
Much has been discussed about coaching on different fields and medical training has not been left aside. Atul Gawande’s article in The New Yorker back in 2002 was an eye opener for many regarding the fact that surgeons n...
Muscle Pedicle Graft in Avascular Necrosis Femoral Head
Aims: To assess the effectiveness of muscle pedicle graft in avascular necrosis (AVN) head femur in Grade 1 and Grade 2 AVN of femoral head grade 1 and grade 2 as head sparing procedure. Method: The pixel count in Tc-99...