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경추 뒤세로인대골화증 환자에서 컴퓨터단층촬영 및 자기공명영상

Cervical Spine CT and MRI Findings in a Patient with Ossification of the Posterior Longitudinal Ligament

Article information

J Korean Neurol Assoc. 2015;33(1):67-68
Publication date (electronic) : February 1, 2015
doi : http://dx.doi.org/10.17340/jkna.2015.1.19
Sang Bub Lee, MD, Chang Beom Bae, MD, Dong Kuck Lee, MD
Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Korea
이상법, 배창범, 이동국
대구가톨릭대학교 의과대학 신경과학교실
Address for correspondence: Dong Kuck Lee, MD Department of Neurology, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea Tel: +82-53-650-4267 Fax: +82-53-654-9786 E-mail: dklee@cu.ac.kr
received : August 15, 2014 , rev-recd : October 1, 2014 , accepted : October 1, 2014 .
Keywords: Ossification of the posterior longitudinal ligament

61세 남자가 수년간의 경부통증 및 어깨관절 근력약화로 내원하였다. 생체징후는 정상이며 특이한 과거력은 없었다. 신경학적진찰에서 우측 어깨 굽힘 및 바깥회전시 근력저하(MRC grade 3)가 있었으나 감각이상 및 근위축은 없었다. 우측 어깨관절의 수동운동 제한은 없었다. 양측 상하지의 심부건 반사는 정상이었으며 Hoffmann징후는 보이지 않았다. 자기공명영상에서는 골화종괴를 뚜렷하게 확인할 수 없었으나 컴퓨터단층촬영에서 제 2경추에서부터 제 5경추까지 경추체 후방에 연속형의 경추후종인대의 골화가 보였다(Fig.). 이는 척추관협착 및 압박성 척수병증(compressive myelopathy)을 유발할 수 있다[1]. 저자들의 환자에서도 척수 압박 부위에 신호강도 증가부위가 보여 이는 척수 부종이 있음을 시사한다(Fig.) [2].

Figure.

(A) The sagittal T2-weighted MRI shows bandlike low or no signal intensity of mass like lesion (white arrow) compressing spinal cord and short linear high signal intensity lesion (open arrow) posterior to C3-4 vertebral bodies. (B) The axial T2-weighted MRI shows focal rounded low or no signal intensity posterior to C2-3 vertebral bodies. (C) The sagittal reconstruction CT scan shows a long strip of ossification (white arrow) posterior to the C1-C3 vertebral bodies. White arrows in figure A and C indicate same level of vertebral bodies.

References

1. Chang H. Ossification of posterior longitudinal ligament. J Korean Soc Spine Surg 2006;13:153–162.
2. Matsunaga S, Sakou T, Taketomi E, Yamaguchi M, Okano T. The natural course of myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine. Clin Orhop Relat Res 1994;305:168–177.

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Copyright © 2015 Korean Neurological Association

Figure.

Figure.

(A) The sagittal T2-weighted MRI shows bandlike low or no signal intensity of mass like lesion (white arrow) compressing spinal cord and short linear high signal intensity lesion (open arrow) posterior to C3-4 vertebral bodies. (B) The axial T2-weighted MRI shows focal rounded low or no signal intensity posterior to C2-3 vertebral bodies. (C) The sagittal reconstruction CT scan shows a long strip of ossification (white arrow) posterior to the C1-C3 vertebral bodies. White arrows in figure A and C indicate same level of vertebral bodies.