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[Clinical analysis of ossified thoracic ligaments and thoracic disc hernia]
[Clinical analysis of ossified thoracic ligaments and thoracic disc hernia]
- Source :
- Neurologia medico-chirurgica. 31(13)
- Publication Year :
- 1991
-
Abstract
- Thoracic lesions present several clinical problems, particularly in their diagnosis and treatment, compared with cervical or lumbar lesions. Since 1983, 18 cases of thoracic space lesions, excluding spinal tumors or trauma have been experienced: nine cases of ossification of yellow ligament (OYL), five of ossification of posterior longitudinal ligament (OPLL), and four of disc hernia (DH). In these 18 patients, problems of clinical manifestations, neuroradiological examination, and surgical approaches are analyzed and discussed. As clinical manifestations, there was a preponderant occurrence in males in the OYL group, while in the OPLL group all the patients were females. OYL and DH occurred at lower thoracic levels. Thirteen of the 18 patients showed combined lesions either in the cervical or in the lumbar regions, such as cervical OPLL, cervical spondylosis, lumbar DH, and lumbar canal stenosis. In the neuroradiological examinations diagnosis of the upper thoracic lesions was difficult. Computed tomography (CT) scan with intrathecal metrizamide injection seemed essential for examination of ossified thoracic lesions. However, because CT imaging of the entire spine is impractical, efficient use of this examination requires previous localization of the offending vertebral level from either the neurological findings or other neuroradiological examinations such as myelography. Magnetic resonance imaging seemed most useful for ruling out the thoracic compressing lesions. As for surgical approaches, posterior decompression was effective for OYL and the anterior approach was useful for OPLL and DH. In patients with “tandem lesions, ” neurological and neuroradiological findings played an important role in deciding the responsible site.
- Subjects :
- Male
medicine.medical_specialty
Thoracic Vertebrae
Lumbar
medicine
Cervical spondylosis
Posterior longitudinal ligament
Humans
Hernia
Myelography
Aged
Ligaments
medicine.diagnostic_test
Ossification
business.industry
Ossification, Heterotopic
Magnetic resonance imaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Surgery
medicine.anatomical_structure
Ligament
Female
Neurology (clinical)
Radiology
medicine.symptom
business
Tomography, X-Ray Computed
Intervertebral Disc Displacement
Subjects
Details
- ISSN :
- 04708105
- Volume :
- 31
- Issue :
- 13
- Database :
- OpenAIRE
- Journal :
- Neurologia medico-chirurgica
- Accession number :
- edsair.doi.dedup.....b1322f2a7b6750f2ef89470e6013de71