三种术式治疗长节段颈椎后纵韧带骨化症的多中心研究
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摘要
目的：对比分析颈前路椎体次全切、骨化灶切除或部分切除、钛网植骨融合内固定术，后路单开门减压椎管成形、椎体侧块内固定术，后路单开门椎管成形术三种手术治疗长节段颈椎后纵韧带骨化症（Cervical Ossification of the Posterior Longitudinal Ligament，OPLL）的手术效果及并发症，探讨治疗长节段OPLL的较优手术方式，为临床治疗提供参考。
方法：回顾分析2006年1月至2011年1月间在暨南大学附属第一医院、湘雅医学院附属第二医院、南华大学附属第三医院手术治疗54例颈椎长节段OPLL患者，其中男24例，女30例，年龄41-78岁，平均65.4岁，行颈前路椎体次全切、骨化灶切除或部分切除、钛网植骨融合内固定术者20例（前路组），后路单开门减压椎管成形、椎体侧块内固定术者26例（后路内固定组），后路单开门椎管成形术者8例（后路无内固定组）。平均随访时间2.4年(6月-5年)。所有患者术前均常规进行颈椎X线正侧位、CT平扫及MRI检查。术后1周、1年随访行颈椎X线正侧位片检查，部分患者加行CT矢状位重建检查。术后疗效采用日本骨科学会JOA评分系统进行评价，同时计算早期及终末JOA改善率,JOA改善率=（术后评分-术前评分）/（17-术前评分）×100%。采用SPSS13.O统计分析软件统计学分析术前术后JOA改善率情况，P<0.05差异具有显著性。观察三组患者术后恢复情况，同时分析影响手术效果的因素。
结果：前路组、后路内固定组、后路无内固定组三种手术治疗后术后1周时JOA改善率分别为51.04%、70.87%、65.73%，各组两两比较，两组后路手术之间JOA改善率无明显差异，但都优于前路；术后1年左右时，三组病例JOA改善率分别为75.87%、78.90%、76.94%，各组两两比较，均无明显差异。治疗后前路组并发症有脑脊液漏1例，喉返神经损伤1例，血肿形成1例，颈动脉窦损伤1例；后路内固定组1例患者术中并发脑脊液漏，1例患者术后出现C5神经根症状；后路无内固定组有2例患者出现轴索症状，1例患者术后1年查发现椎板继发关门。
结论：1、治疗长节段颈椎后纵韧带骨化症采用前路椎体次全切钛网植骨融合内固定术、后路单开门椎管成形内固定术、后路单开门椎管成形术三种术式均可获得较好的疗效。
2、术后短期内后路单开门椎管成形内固定术、后路单开门椎管成形术术后JOA改善率优于前路椎体次全切钛网植骨融合内固定术；术后1年左右三种术式的术后JOA改善率无明显差异。
3、前路椎体次全切钛网植骨融合内固定术、后路单开门椎管成形内固定术、后路单开门椎管成形术三种术式治疗长节段颈椎后纵韧带骨化症比较，颈后路单开门椎管成形内固定术具有并发症少，风险小，安全有效的特点，是治疗该病的一种较好方法。
OBJECTIVE:To discuss and analyze three kinds of surgical (Anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implantfusion;Posterior open-door laminoplasty,decompression,bone graft and internalfixation;Posterior open-door laminoplasty) treatments effect on long-segment cervicalossification of the posterior longitudinal ligament.It could provide a reference foroperative select.
METHODS: It was a retrospective analysis of the54cases of ossification of theposterior longitudinal ligament of clinical data，that was collected in the The first hospitalaffiliated Jinan university,Second Xiangya Hospital, The Affiliated Hospital of NanhuaUniversity during the time Jan.2006-Jan.2010.Age of41to78years，average65.5yearsold,which involved24men and30women.20cases undergoing anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implant fusion asgroup A,26receiving posterior open-door laminoplasty,decompression,bone graft andinternal fixation as group B,and8undergoing posterior open-door laminoplasty withoutinternal fixation as group C.Patients were followed up for6months to5years,2.4yearson average.Lateral cervical spine X-ray,CT scan and MRI examinations were routinelytaken preoperatively.Results of operations according to JOA scoring system,which wasformulated by Japanese Orthopaedic Association,were evaluated.Neurological functionwas evaluated on preoperatively,and lw,ly postoperatively,and the improvementrates were also calculated.The data was evaluated by SPSS l3.0analysis software.The difference was statistical significance when P<0.05. Surgical complications and factorsaffecting the surgical results were also recorded.
Results:1week after treatment,the mean amelioration rate was51.04%in groupA,70.87%in group B,65.73%in group C.There was1case with dural tear in group A,there have significant difference between anterior and posterior approach,and but therewas no significant difference between Group B and Group C.1year after treatment,themean amelioration rate was75.87%in group A,78.90%in group B,76.94%in group C,there was no significant difference between each Group.There was1case with duraltear in group A,1case of recurrent laryngeal nerve temporary palsy occurred,1casehad Hematoma,and1case got Carotid sinus injury; In group B,1case had dural tear,1case had C5nerve root palsy; In group C, posterior axis of symptoms occurred in2cases,1case of Lamina secondary closed.
Conclusion:1.Use anterior cervical corpectomy,removal or partial removal ofossification foci,interbody implant fusion and posterior open-door laminoplasty,decompression,bone graft and internal fixation and posterior open-door laminoplastytreat long-segment OPLL, three procedures are given a good effect;2.Short-termfollow-up to improve the rate of anterior and posterior surgical procedure have differencebetween anterior and posterior approach,but1year after treatment, the amelioration ratewas no significant difference between each methods;3. For long-segmentOPLL,posterior open-door laminoplasty, decompression,bone graft and internal fixationwith few complications,it safe and effective.
方法：回顾分析2006年1月至2011年1月间在暨南大学附属第一医院、湘雅医学院附属第二医院、南华大学附属第三医院手术治疗54例颈椎长节段OPLL患者，其中男24例，女30例，年龄41-78岁，平均65.4岁，行颈前路椎体次全切、骨化灶切除或部分切除、钛网植骨融合内固定术者20例（前路组），后路单开门减压椎管成形、椎体侧块内固定术者26例（后路内固定组），后路单开门椎管成形术者8例（后路无内固定组）。平均随访时间2.4年(6月-5年)。所有患者术前均常规进行颈椎X线正侧位、CT平扫及MRI检查。术后1周、1年随访行颈椎X线正侧位片检查，部分患者加行CT矢状位重建检查。术后疗效采用日本骨科学会JOA评分系统进行评价，同时计算早期及终末JOA改善率,JOA改善率=（术后评分-术前评分）/（17-术前评分）×100%。采用SPSS13.O统计分析软件统计学分析术前术后JOA改善率情况，P<0.05差异具有显著性。观察三组患者术后恢复情况，同时分析影响手术效果的因素。
结果：前路组、后路内固定组、后路无内固定组三种手术治疗后术后1周时JOA改善率分别为51.04%、70.87%、65.73%，各组两两比较，两组后路手术之间JOA改善率无明显差异，但都优于前路；术后1年左右时，三组病例JOA改善率分别为75.87%、78.90%、76.94%，各组两两比较，均无明显差异。治疗后前路组并发症有脑脊液漏1例，喉返神经损伤1例，血肿形成1例，颈动脉窦损伤1例；后路内固定组1例患者术中并发脑脊液漏，1例患者术后出现C5神经根症状；后路无内固定组有2例患者出现轴索症状，1例患者术后1年查发现椎板继发关门。
结论：1、治疗长节段颈椎后纵韧带骨化症采用前路椎体次全切钛网植骨融合内固定术、后路单开门椎管成形内固定术、后路单开门椎管成形术三种术式均可获得较好的疗效。
2、术后短期内后路单开门椎管成形内固定术、后路单开门椎管成形术术后JOA改善率优于前路椎体次全切钛网植骨融合内固定术；术后1年左右三种术式的术后JOA改善率无明显差异。
3、前路椎体次全切钛网植骨融合内固定术、后路单开门椎管成形内固定术、后路单开门椎管成形术三种术式治疗长节段颈椎后纵韧带骨化症比较，颈后路单开门椎管成形内固定术具有并发症少，风险小，安全有效的特点，是治疗该病的一种较好方法。
OBJECTIVE:To discuss and analyze three kinds of surgical (Anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implantfusion;Posterior open-door laminoplasty,decompression,bone graft and internalfixation;Posterior open-door laminoplasty) treatments effect on long-segment cervicalossification of the posterior longitudinal ligament.It could provide a reference foroperative select.
METHODS: It was a retrospective analysis of the54cases of ossification of theposterior longitudinal ligament of clinical data，that was collected in the The first hospitalaffiliated Jinan university,Second Xiangya Hospital, The Affiliated Hospital of NanhuaUniversity during the time Jan.2006-Jan.2010.Age of41to78years，average65.5yearsold,which involved24men and30women.20cases undergoing anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implant fusion asgroup A,26receiving posterior open-door laminoplasty,decompression,bone graft andinternal fixation as group B,and8undergoing posterior open-door laminoplasty withoutinternal fixation as group C.Patients were followed up for6months to5years,2.4yearson average.Lateral cervical spine X-ray,CT scan and MRI examinations were routinelytaken preoperatively.Results of operations according to JOA scoring system,which wasformulated by Japanese Orthopaedic Association,were evaluated.Neurological functionwas evaluated on preoperatively,and lw,ly postoperatively,and the improvementrates were also calculated.The data was evaluated by SPSS l3.0analysis software.The difference was statistical significance when P<0.05. Surgical complications and factorsaffecting the surgical results were also recorded.
Results:1week after treatment,the mean amelioration rate was51.04%in groupA,70.87%in group B,65.73%in group C.There was1case with dural tear in group A,there have significant difference between anterior and posterior approach,and but therewas no significant difference between Group B and Group C.1year after treatment,themean amelioration rate was75.87%in group A,78.90%in group B,76.94%in group C,there was no significant difference between each Group.There was1case with duraltear in group A,1case of recurrent laryngeal nerve temporary palsy occurred,1casehad Hematoma,and1case got Carotid sinus injury; In group B,1case had dural tear,1case had C5nerve root palsy; In group C, posterior axis of symptoms occurred in2cases,1case of Lamina secondary closed.
Conclusion:1.Use anterior cervical corpectomy,removal or partial removal ofossification foci,interbody implant fusion and posterior open-door laminoplasty,decompression,bone graft and internal fixation and posterior open-door laminoplastytreat long-segment OPLL, three procedures are given a good effect;2.Short-termfollow-up to improve the rate of anterior and posterior surgical procedure have differencebetween anterior and posterior approach,but1year after treatment, the amelioration ratewas no significant difference between each methods;3. For long-segmentOPLL,posterior open-door laminoplasty, decompression,bone graft and internal fixationwith few complications,it safe and effective.
引文
1、 Kim TJ,Bae KW,Uhm WS,et al.Prevalence of ossification of the posterior longitudinalligament of the cervical spine[J].Joint Bone Spine,2008;75(4):471-474
2、 Yan L,Zhao WG,Li JJ,et al.Linkage of three polymorphisms on chromosome20p12toossification of the posteriorlongitudinal ligament of spine and its severity in Han Chinesepatients[J].Chin Med J(Engl),2010,123(17):2341-2346.
3、 Wang MY, Thambuswamy M. Ossification of the posterior longitudinal ligament in non-Asians:demographic, clinical, and radiographic findings in43patients[J].Neurosurg Focus,2011,30:E4.
4、 Kim TJ,Bae KW,Uhm WS,et al.Prevalence of ossification of the posterior longitudinalligament of the cervical spine[J].Joint Bone Spine.2008,75(4):471-474.
5、 Inamasu J,Guiot B,Sachs D.Ossification of the posterior longitud inalligament:an update onits biology,epidemiology,and natural history[J],Neurosurg,2006,6:1027-1039
6、 Mizuno J,Nakagawa H.Ossified posterior longitudinal ligament:management strategies andoutcomes[J],Spine,2006,3:282-288
7、 Hirabayashi K，Miyakawa J,Satomi K，et al.Operative results and postoperative progressionof ossification among the patients with ossification of cervical posterior longitudinalligaments[J].Spine,1981,6:354-364
8、 Matsuyama Y,Kawakami N,Yanase M,et al.Cervical myelopathy due to OPLL:clinicalevaluation by MRI and intraoperative spinal sonography[J],J Spinal DisordTech,2004,3:401-404
9、 Wang JC，McDonough PW，Endow KK，et al.The effect of cervical plating on single levelanterior cervical discectomy and fusion[J].J Spinal Disord,1999,(6):467-47
10、 Kobashi G,WashioM,OkamotoK,et al.High body mass index after age20anddiabetesmellitus are independent risk factors for ossification of the posterior longitudinalligament of the spine in Japanese subjects:a case control study inmultiplehospitals[J],Spine,2004,9:1006-1101
11、 Murakami M,Seichi A,Chikuda H,et al.Long-term follow-up of the progression ofossification of the posterior longitudinal ligament[J].J Neurosurg Spine,2010;12(5):577-579
12、 Hale J.J.,Gruson K.I.,Spivak J.M.Laminoplasty:a review of its role in compressivecervical myelopathy[J].Spine J,2006;6(6Suppl):289S-298S.
13、 Sakou T,MiyazakiA,Tomimura K,et al.Ossification of the posterior longitudinalligament of the cervical spine:subtotal vertebrectomy as a treatment[J].Clin Orthop RelatRes,1979,(140):58-65
14、 Kriangsak,Dosang,Sangkook Lee,et al.Ossification of the posterior longitudinalligament: a review[J].Neurosurgical Focus,2011,30(3):1-16
15、 Motokil,Shin yao,Akira M.Surgical strategy for cervical myelopathy due to ossificationof the posterior longitudinal ligament[J].spine,2007,32(6):647-653.
16、 Chen Y,Chen D,Wang X,et al.Anterior corpectomy and fusion for severe ossification ofposterior longitudinal ligament in the cervical spine[J].Int Orthop.2009,33(2):477-482
17、 Ogawa Y.Updates on ossification of posterior longitudinal ligament. Clinical results andproblems of posterior decompression for OPLL of the cervical spine[J].Clin Calcium.2009Oct,19(10):1493-8
18、 Iwasaki M,Okuda SY,Miyauchi A,et al.Surgical Strategy for Cervical Myelopathy dueto Ossification of the Posterior Longitudinal Ligament:Part2:Advantages of anteriordecompression and fusion over laminoplasty[J].Spine,2007,32:647-653
19、李忠海,赵杰,张海龙,等.二期前后路手术治疗颈椎后纵韧带骨化症的疗效分析[J].中国骨与关节损伤杂志,2009,24(11):964-967.
20、李阳,袁文,张颖,等.伴脊髓高信号改变的颈椎后纵韧带骨化症手术治疗及疗效分析[J].中国矫形外科杂志,2010,18(1):38-41.
21、倪斌.再谈颈椎后纵韧带骨化灶手术入路选择[J].脊椎外科杂志,2009,7(5):319-320.
22、 Yamazaki A,Homma T,Uchiyama S,et al.Morphologic limitations of posteriordecompression by midsagittal splitting method for myelopathy caused by ossification of theposterior longitudinal ligament in the cervical spine[J].Spine(Phila Pa1976).1999;24(1):32-34.
23、 Fujiyoshi T,Yamazaki M,Kawabe J,et al.A new concept formaking decisions regardingthe surgical approach for cervical ossification of the posterior longitudinal ligament:theK-line[J].Spine.2008;33(26):E990-E993.
24、 Morio Y,Teshima R,Nagashima H,et al.Correlation between operative outcomes ofcervical compression mylopathy and MRI of the spinal cord[J].Spine.2001;26:1238-1245
25、 Tsukamoto,N.,T.Maeda,H.Miura,et al.Repetitive tensile stress to rat caudal vertebraeinducing cartilage formation in the spinal ligaments:a possible role of mechanical stress inthe development of ossification of the spinal ligaments[J].J NeurosurgSpine,2006.5(3):234-42.
26、 Doyle A.M.,Nerem T.Ahsan,Human mesenchymal stem cells form multicellularstructures in response to applied cyclic strain[J].Ann Biomed Eng,2009.37(4):783-93.
27、 Sakai,Okawa,Takahashi,et al.Five-year Follow-up Evaluation of Surgical Treatment forCervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: AProspective Comparative Study of Anterior Decompression and Fusion With FloatingMethod Versus Laminoplasty[J].Spine.2012,37(5):367–376
28、 T Fujiyoshi,M Yamazaki,H Konishi,etal.The Outcome of Posterior DecompressionSurgery for Patients with Cervical Myelopathy Due to the K-line(-)-Type OPLL:Laminoplasty vs Posterior Decompression with Instrumented Fusion[J].Spine.2009,Affiliated Society Meeting Abstracts.P40.
29、 Hale JJ,Gruson KI,Spivak JM.Laminoplasty:a review of its role in compressive cervicalmyelopathy[J].Spine J.2006;6(6Suppl):289S-298S.
30、 Nakanishi K,Tanaka N,Nishikawa K,et al.Positive effect of posterior instrumentationafter surgical posterior decompression for ex-tensive cervicothoracic ossification of theposterior longitudinal ligament[J].Spine,2005,30(13):E382-E386．
31、 Kazuhiro Chiba,Yuto Ogawa,Ken Ishii,et al.Long-term results of Expansive Open-DoorLaminoplasty for Cervieal myeloPathy—Average14-Year Follow-upStudy[J].Spine,2006,1(26):2998-3005
32、孙宇.关于轴性症状[J].中国脊柱脊髓杂志,2008,18(4):289
33、 Nakase H,Park YS,Kimura,et al.Complications and long-term follow-up results intitanium mesh cage reconstruction after cervical corpectomy[J].J Spina DisordTech,2006,19:353-357.
34、 Haller,Iwanik,Shen.Clinically Relevant Anatomy of Recurrent Laryngeal Nerve[J]Spine,2012,37(2):97-100
35、 Okamoto K,Kobashi G,Washio M,et al.Japan Collaborative Epidemiologieal StudyGroup for Evaluation of Ossifieation of the Posterior Longitudinal Ligament of theSpine(OPLL) Risk.Dietary habits and risk of OPLL;findings from a case-control study inJapan[J].J Bone Miner Metab (2004)22:612-61
36、 Yokosuka K,ParkJ S,Jimbo K,et al.Immunohistoehemieal demonstration of advancedglyeation end Products and the effeets of advanced glycation end Produets in ossifiedligament tissues in vitro[J].Spine(2007)15:337-339。
37、田纪伟,王雷,董双海,等.颈椎后纵韧带骨化症手术并发症探讨[J].中国矫形外科杂志,2007,15(15):1139-1142
38、 Kawaguchi Y,Kanamori M,Ishiara H,et al.Preventive measures for axial symptomsfollowing cervieal laminoplasty[J].J Spinal Disord Tech,2003,16:497-501.
39、曾岩，党耕盯，马庆军，颈椎前路术后融合节段曲度变化与轴性症状和神经功能的相关性研究[J],中国脊柱脊髓杂志,2004,14(9):520-523
40、 Sakaura H,Hosono N,Mukai Y,et al.C5palsy after decompression surgery for cervicalmyelopathy.Spine,2003,28(21):2447-2451
41、 Hirabayashi.S, Yamamoto. H, Shiboi. R et al.Anatomical analyses and thoughts on thecause of postoperative C5palsy[J]. The Japanese Society for Spine Surgery and RelatedResearch,2009,20:868–873
42、 Hironobu Sakaura, Noboru Hosono,Yoshihiro Mukai,et al.Segmental Motor ParalysisAfter Cervieal Laminoplasty:a prospective study [J].Spine,2006,31(23):2684-2688
43、 Matsumoto, Watanabe, Hosogane,et al.Impact of Lamina Closure on Long-termOutcomes of Open-door Laminoplasty in Patients with Cervical Myelopathy-Minimum5-year Follow-up Study[J].Spine,2012,37(6):245-251
44、元虎，陈继良，郑光彬，等.改良Z型椎管扩大成形术治疗颈椎后纵韧带骨化症[J]..中国矫形外科杂志,2008,16（7）:504-506
45、 Thakar S,M Ch,Vedantam A,et al.Correlation between change in graft height and changein segmental angle following central corpectomy for cervieal spondylotic myelopathy[J].JNeurosurg Spine,2008,9(2):158-166
46、Kim TJ,Bae KW,Uhm WS,et al.Prevalence of ossification of the posterior longitudinalligament of the cervical spine[J].Joint Bone Spine.2008;75(4):471-474.
47、Holly LT，Moftakhar P，Khoo LT，et al.Surgical outeomes of elderly patients with cervicalspondylotic myelopathy[J].Surg Neurol[J],2008,69(3):233-240.
48、Baba H,Imura S,Kawahara N,et al.Osteoplastic laminoplasty for cervical myeloradiculopathysecondary to ossification of the posterior longitudinal ligament[J]. IntOrthop.1995,19(1):40-45.
49、Mizuno J,Nakagawa H,Inoue T,et al.Clinicopathological study of"snake-eye appearance"incompressive myelopathy of the cervical spinal cord[J].J Neurosurg.2003;99(suppl2):162-168.
50、Mitsuru Y,Ken N,Michiya,et al.Long-term surgical outcome and risk factors in patients withcervical myelopathy and a change in signal intensity of intramedullary spinal cord onmagnetic resonance imaging[J], J Neurosurg Spine,2010,12:59–65.
51、Ashwin A, Rajasekaran, Ajoy P. Comparison of prognostic value of different MRIclassifications of signal intensity change in cervical spondylotic myelopathy[J]. The SpineJournal,2010,10(6):475-485
52、Chikuda, Seichi, Takeshita, et al.Acute Cervical Spinal Cord Injury Complicated byPreexisting Ossification of the Posterior Longitudinal Ligament: A MulticenterStudy[J].Spine,2011,36(18):1453-1458
53、Aditya，Ashish，Vedantam.Association of magnetic resonance imaging signal changes andoutcome prediction after surgery for cervical spondylotic myelopathy[J].Journal ofNeurosurgery Spine,2011,15(6):660-666
54、Kim DY, Park YS, Jeong.Anterior Cervical Disc Herniation Presenting as Instability andMinimal Dysphagia: A Case Report[J]. Korean J Spine,2010,7(4):272-275
55、Mochizuki M,Aiba A,Hashimoto M,et al.Cervical myelopathy in patients with ossification ofthe posterior longitudinal ligament[J].J Neurosurg Spine.2009;10(2):122-128.
56、Matsunaga S,Nakamura K,Seichi A,et al.Radiographic predictors for the development ofmyelopathy in patients with ossification of the posterior longitudinal ligament:a multicentercohort study[J].Spine.2008;33(24):2648-2650.57、 Choi S,Lee SH,Lee JY,et al.Factors affecting prognosis of patients who underwentcorpectomy and fusion for treatment of cervical ossification of the posterior longitudinalligament:analysis of47patients[J].J Spinal Disord Tech,2005,18(4):309-314.
58、Toshikatsu O, Kazuhito E, Masumi O,et al. Chronic Right Lower Abdominal Pain Due toLumbar Ossification of the Posterior Longitudinal Ligament[J]. Am J Gastroenterol,2012,107:142-143
59、Do-Sung Yoo, Sang-Bok Lee,Pil-Woo,et al.Spinal cord injury in cervical spinalstenosis byminor trauma[J].World Neurosurgery,2010,73(1):50-52
60、Mizuno J,Nakagawa H.Ossified Posterior longitudinal ligament:managemen strategies andoutcomes[J].Spine,2006:6(6)282-28
61、 Mastunaga s.Sakou T.Ossifieation of the Posterior longitudinal ligaments:prevalence,Presentation,and natural history:ClarkCR(ed)The cervieal spine，4th end.2005[C],PhiladelPhia.2005:1091-1098.
62、 Yonenobu.Is Surgery Indicated for Asymptomatic or Mildly Myelopathic Patients WithSignificant Ossification of the Posterior Longitudinal Ligament?[J]. Spine,2012;37(5):E315-317.
63、 Epstein N.Diagnosis and surgical management of cervical ossification of the posteriorlongitudinal ligament[J].Spine.2002,2(6):436-449.
64、 Azuma,Kato, Taguchi.Etiology of Cervical Myelopathy Induced by Ossification of thePosterior Longitudinal Ligament: Determining the Responsible Level of OPLL Myelopathy byCorrelating Static Compression and Dynamic Factors[J]. Journal of Spinal Disorders&Techniques,2010,23(3):166-169
65、 Fujiwara N, Takeshita K.Updates on ossification of posterior longitudinal ligament.Quality of life (QOL) of patients with OPLL[J].Clin Calcium.2009,19(10):1449-1456.
1、Sakou T, Taketomi E, Matsunaga S,et al.Genetic study of ossification of the posteriorlongitudinal ligament in the cervical spine with human leukocyte antigenhaplotype[J].Spine,1991,16:1249–1252,
2、Inamasu J,Guiot BH,Sachs DC.Ossification of the posterior longitudinal ligament:an updateon its biology,epidemiology,and natural history[J]. Neurosurgery,2006,58(6):1027-1039
3、McAfee PC, Regan JJ, Bohlman HH.Cervical cord compression from ossification of theposterior longitudinal ligament in non-orientals[J].J Bone Joint Surg Br,1987,69:569–575,
4、Nakama S, Ihara T, Sugamata M,et al.An ultrastructural study on the ligamentum flavum ofthe cervical spine in patients with ossification of the posterior longitudinal ligament[J].Med MolMorphol,2006,39:198–202,
5、Murakami M,Seichi A,Chikuda H,et al. Long-term follow-up of the progression ofossification of the posterior longitudinal ligament[J].J Neurosurg Spine,2010,12(5):577-579
6、Tanabe J, Sarin H, Kindt G.Familial ossification of the posterior longitudinal ligament (OPLL)in the thoracic spine:case report[J].Surg Neurol,2002,58:403–405
7、Furushima K,Shimo-Onoda K,Maeda S,et al.Large-scale screening for candidate genes ofossification of the posterior longitudinal ligament of the spine[J].J Bone Miner Res,2002,17:128–137
8、Tahara M, Aiba A, Yamazaki M,et al.The extent of ossification of posterior longitudinalligament of the spine associated with nucleotide pyrophosphatase gene and leptin receptor genepolymorphisms[J].Spine,2005,30:877–881
9、Maeda S, Ishidou Y, Koga H,et al.Functional impact of human collagen alpha2(XI) genepolymorphism in pathogenesis of ossification of the posterior longitudinal ligament of thespine[J]. J Bone Miner Res,2001,16:948–957
10、Maeda S, Koga H, Matsunaga S, et al.Gender-specific haplotype association of collagenalpha2(XI) gene in ossification of the posterior longitudinal ligament of the spine[J].J HumGenet,2001,46:1–4
11、Horikoshi T, Maeda K, Kawaguchi Y,et al.A large-scale genetic association study ofossification of the posterior longitudinal ligament of the spine[J].Hum Genet,2006,119:611–616
12、Tanaka T, Ikari K, Furushima K,et al.Genomewide linkage and linkage disequilibriumanalyses identify COL6A1, on chromosome21, as the locus for ossification of the posteriorlongitudinal ligament of the spine[J].Am J Hum Genet,2003,73:812–822
13、Kong Q, Ma X, Li F,et al.COL6A1polymorphisms associated with ossification of theligamentum flavum and ossification of the posterior longitudinal ligament[J]. Spine,2007,32:2834–2838
14、Tsukahara S,Miyazawa N,Akagawa H,et al.COL6A1,the candidate gene for ossification ofthe posterior longitudinal ligament,is associated with diffuse idiopathic skeletal hyper-ostosis inJapanese[J].Spine,2005,30(20):2321-2324.
15、Yan L,Zhao WG,Li JJ,et al.Linkage of three polymorphisms on chromosome20p12toossification of the posterior longitudinal ligament of spine and its severity in Han Chinesepatients[J].Chin Med J(Engl),2010,123(17):2341-2346.
16、Okawa A, Ikegawa S, Nakamura I,et al.Mapping of a gene responsible for twy (tip-toewalking Yoshimura), a mouse model of ossification of the posterior longitudinal ligament of thespine (OPLL)[J].Mamm Genome,1998,9:155–156
17、Okawa A, Nakamura I, Goto S,et al.Mutation in Npps in a mouse model of ossification ofthe posterior longitudinal ligament of the spine[J].Nat Genet,1998,19:271–273
18、Koshizuka Y,Kawaguchi H,Ogata N,et al.Nucleotide pyrophosphatase gene polymorphismassociated with ossification of the posterior longitudinal ligament of the spine[J].J Bone MinerRes,2002,17(1):138-144.
19、Tahara M, Aiba A, Yamazaki M, et al.The extent of ossification of posterior longitudinalligament of the spine associated with nucleotide pyrophosphatase gene and leptin receptor genepolymorphisms[J].Spine,2005,30:877–881
20、Kobashi G, Ohta K, Washio M, et al.FokI variant of vitamin D receptor gene and factorsrelated to atherosclerosis associated with ossification of the posterior longitudinal ligament of thespine: a multihospital case-control study[J].Spine,2008,33:E553–E558
21、Inoue I, Ikeda R, Tsukahara S.Current topics in pharmacological research on bonemetabolism: promyelotic leukemia zinc finger (PLZF) and tumor necrosisfactor-alpha-stimulated gene6(TSG-6) identified by gene expression analysis play roles in thepathogenesis of ossification of the posterior longitudinal ligament[J].J Pharmacol Sci,2006,100:205–210
22、Kishiya M, Sawada T, Kanemaru K,et al.A functional RNAi screen for Runx2-regulatedgenes associated with ectopic bone formation in human spinal ligaments[J]. J Pharmacol Sci,2008,106:404–414
23、Liu Y, Zhao Y, Chen Y,et al.RUNX2polymorphisms associated with OPLL and OLF in theHan population[J].Clin Orthop Relat Res,2010,468:3333–3341
24、Yonemori K, Imamura T, Ishidou Y,et al.Bone morphogenetic protein receptors and activinreceptors are highly expressed in ossified ligament tissues of patients with ossification of theposterior longitudinal ligament[J].Am J Pathol,1997,150:1335–1347
25、Kon T, Yamazaki M, Tagawa M,et al.Bone morphogenetic protein-2stimulatesdifferentiation of cultured spinal ligament cells from patients with ossification of the posteriorlongitudinal ligament[J].Calcif Tissue Int,1997,60:291–296
26、Wang H, Yang ZH, Liu DM,et al.Association between two polymorphisms of the bonemorphogenetic protein-2gene with genetic susceptibility to ossification of the posteriorlongitudinal ligament of the cervical spine and its severity[J].Chin Med J (Engl),2008,121:1806–1810
27、Wang H, Liu D, Yang Z,et al.Association of bone morphogenetic protein-2genepolymorphisms with susceptibility to ossification of the posterior longitudinal ligament of thespine and its severity in Chinese patients[J].Eur Spine J,2008,17:956–964,
28、Yuan Ren,Jie Feng,Zhi-zhong Liu,et al.A New Haplotype in BMP4Implicated inOssification of the Posterior Longitudinal Ligament (OPLL) in a Chinese Population.Journal ofOorthopaedic Research,2012,10:748-756
29、Kamiya M, Harada A, Mizuno M,et al.Association between a polymorphism of thetransforming growth factor-beta1gene and genetic susceptibility to ossification of the posteriorlongitudinal ligament in Japanese patients[J].Spine,2001,26:1264–1267
30、Kawaguchi Y, Furushima K, Sugimori K,et al.Association between polymorphism of thetransforming growth factor-beta1gene with the radiologic characteristic and ossification of theposterior longitudinal ligament[J].Spine,2003,28:1424–1426
31、Eun JP, Ma TZ, Lee WJ,et al.Comparative analysis of serum proteomes to discoverbiomarkers for ossification of the posterior longitudinal ligament[J].Spine,2007,32:728–734
32、Matsui H, Yudoh K, Tsuji H.Significance of serum levels of type I procollagen peptide andintact osteocalcin and bone mineral density in patients with ossification of the posteriorlongitudinal ligaments[J].Calcif Tissue Int,1996,59:397–400
33、Ito K, Matsuyama Y, Yukawa Y, et al.Analysis of interleukin-8, interleukin-10, and tumornecrosis factoralpha in the cerebrospinal fluid of patients with cervical spondyloticmyelopathy[J].J Spinal Disord Tech,2008,21:145–147
34、DH Kim,YS Jeong,J Chon,et al.Association between interleukin15receptor, alpha(IL15RA) polymorphism and Korean patients with ossification of the posterior longitudinalligament[J].Cytokine,2011,55(3):343-346
35、Horikoshi T, Maeda K, Kawaguchi Y,et al.A large-scale genetic association study ofossification of the posterior longitudinal ligament of the spine[J].Hum Genet,2006,119:611–616
36、Kishiya M, Sawada T, Kanemaru K,et al.A functional RNAi screen for Runx2-regulatedgenes associated with ectopic bone formation in human spinal ligaments[J].J Pharmacol Sci,2008,106:404–414
37、P Lencel, S Delplace, P Pilet,et al.Cell-specific effects of TNF-α and IL-1β on alkalinephosphatase: implication for syndesmophyte formation and vascular calcification[J].LaboratoryInvestigation,2011,91:1434-1442
38、Kobashi G, Washio M, Okamoto K, et al.High body mass index after age20and diabetesmellitus are independent risk factors for ossification of the posterior longitudinal ligament of thespine in Japanese subjects: a case-control study in multiple hospitals[J].Spine,2004,29:1006–1010
39、Li H, Liu D, Zhao CQ,et al.Insulin potentiates the proliferation and bone morphogeneticprotein-2-induced osteogenic differentiation of rat spinal ligament cells via extracellularsignal-regulated kinase and phosphatidylinositol3-kinase[J]. Spine,2008,33:2394–2402
40、Goel A, Pareikh S.Limited oblique corpectomy for treatment of ossified posteriorlongitudinal ligament[J].Neurol India,2005,53:280–282
41、KimiakiY, Jin S, Kotaro J,et al.mmunohistochemical demonstration of advanced glycationend products and the effects of advanced glycation enfproducts in ossification ligament tissues InVitro [J].Spine,2007,32:337-339
42、Li H， Jiang LS， Dai LY. High glucose potentiates collagen synthesis and bonemorphogenetic protein-2-induced early osteoblast gene expression in rat spinal ligamentcells[J].Endocrinology,2010,151(1):63-74.
43、Li,H.,D.Liu,C.Q.Zhao,et al.Insulin potentiates the proliferation and bone morphogeneticprotein-2-induced osteogenic differentiation of rat spinal ligament cells via extracellularsignal-regulated kinase and phosphatidylinositol3-kinase[J].Spine(Phila Pa1976),2008,33(22):2394-402
44、Hirai N, Ikata T, Murase M,et al.Bone mineral density of the lumbar spine in patients withossification of the posterior longitudinal ligament of the cervical spine[J]. J Spinal Disord,1995,8:337–341
45、Yamauchi T, Taketomi E, Matsunaga S, Sakou T: Bone mineral density in patients withossification of the posterior longitudinal ligament in the cervical spine[J]. J Bone Miner Metab,199917:296–300
46、Morio Y, Yamamoto K, Kishimoto H,et al.Bone mineral density of the radius in patientswith ossification of the cervical posterior longitudinal ligament. A longitudinal study[J].Spine,1993,18:2513–2516
47、Aita I, Ohno A, Amagai H,et al.Histomorphometric study of iliac bones in cervicalmyelopathy with ossification of the posterior longitudinal ligament[J].J OrthopSci,1998,3:324–329
48、Yamada K, Inui K, Iwamoto M,et al.High serum levels of menatetrenone in male patientswith ossification of the posterior longitudinal ligament[J].Spine,2003,28:1789–1793
49、Yonemori K, Imamura T, Ishidou Y,et al.Bone morphogenetic protein receptors and activinreceptors are highly expressed in ossified ligament tissues of patients with ossification of theposterior longitudinal ligament[J].Am J Pathol,1997,150:1335–1347
50、Sawada T,Kishiya,Kanemaru,et al.Possible role of extracellular nucleotides in ectopicossification of human spinal ligaments[J].J Pharmacol Sci,2008.106(1):152-61
51、Furukawa K: Current topics in pharmacological research on bone metabolism: molecularbasis of ectopic bone formation induced by mechanical stress. J PharmacolSci,2006,100:201–204
52、Ohishi H, Furukawa K, Iwasaki K,et al.Role of prostaglandin I2in the gene expressioninduced by mechanical stress in spinal ligament cells derived from patients with ossification ofthe posterior longitudinal ligament[J].J Pharmacol Exp Ther,2003,305:818–824
53、Tanno M, Furukawa KI, Ueyama K,et al.Uniaxial cyclic stretch induces osteogenicdifferentiation and synthesis of bone morphogenetic proteins of spinal ligament cells derivedfrom patients with ossification of the posterior longitudinal ligaments[J].Bone,2003,33:475–484
54、Iwasaki K, Furukawa KI, Tanno M,et al.Uni-axial cyclic stretch induces Cbfa1expressionin spinal ligament cells derived from patients with ossification of the posterior longitudinalligament[J].Calcif Tissue Int,2004,74:448–457
55、Iwasawa T, Iwasaki K, Sawada T,et al.Pathophysiological role of endothelin in ectopicossification of human spinal ligaments induced by mechanical stress[J].Calcif Tissue Int,2006,79:422–430
56、Sawada T, Kishiya M, Kanemaru K,et al.Possible role of extracellular nucleotides in ectopicossification of human spinal ligaments[J].J Pharmacol Sci,2008,106:152–161
57、Iwasawa T,IwasakiK,Sawada T,et al.Pathophysiological role of endothelin in ectopicossification of human spinal ligaments induced bymechanical stress [J].CalcifTissue Int,2006,79(6):422-430
58、Chen J,Wang X,Wang C,et al.Rotational stress:role in development of ossification ofposterior longitudinal ligament and ligamentum flavum[J].Med Hypotheses,2011,76(1):73-76.
59、HS Yang,XH Lu,DY Chen,et al.Mechanical strain induces Cx43expression in spinalligament fibroblasts derived from patients presenting ossification of the posterior longitudinalligament[J].European Spine Journal,2011,20(9):1459-1465
60、Okamoto K, Kobashi G, Washio M,et al.Dietary habits and risk of ossification of theposterior longitudinal ligaments of the spine (OPLL);findings from a case-control study inJapan[J].J Bone Miner Metab,2004,22:612–617
61、Kobashi G, Ohta K, Washio M,et al.FokI variant of vitamin D receptor gene and factorsrelated to atherosclerosis associated with ossification of the posterior longitudinal ligament of thespine: a multihospital case-control study[J].Spine,2008,33:E553–E558
62、Washio M, Kobashi G, Okamoto K,et al.Sleeping habit and other life styles in the prime oflife and risk for ossification of the posterior longitudinal ligament of the spine (OPLL): acase-control study in Japan[J]. J Epidemiol,2004,14:168–173
2、 Yan L,Zhao WG,Li JJ,et al.Linkage of three polymorphisms on chromosome20p12toossification of the posteriorlongitudinal ligament of spine and its severity in Han Chinesepatients[J].Chin Med J(Engl),2010,123(17):2341-2346.
3、 Wang MY, Thambuswamy M. Ossification of the posterior longitudinal ligament in non-Asians:demographic, clinical, and radiographic findings in43patients[J].Neurosurg Focus,2011,30:E4.
4、 Kim TJ,Bae KW,Uhm WS,et al.Prevalence of ossification of the posterior longitudinalligament of the cervical spine[J].Joint Bone Spine.2008,75(4):471-474.
5、 Inamasu J,Guiot B,Sachs D.Ossification of the posterior longitud inalligament:an update onits biology,epidemiology,and natural history[J],Neurosurg,2006,6:1027-1039
6、 Mizuno J,Nakagawa H.Ossified posterior longitudinal ligament:management strategies andoutcomes[J],Spine,2006,3:282-288
7、 Hirabayashi K，Miyakawa J,Satomi K，et al.Operative results and postoperative progressionof ossification among the patients with ossification of cervical posterior longitudinalligaments[J].Spine,1981,6:354-364
8、 Matsuyama Y,Kawakami N,Yanase M,et al.Cervical myelopathy due to OPLL:clinicalevaluation by MRI and intraoperative spinal sonography[J],J Spinal DisordTech,2004,3:401-404
9、 Wang JC，McDonough PW，Endow KK，et al.The effect of cervical plating on single levelanterior cervical discectomy and fusion[J].J Spinal Disord,1999,(6):467-47
10、 Kobashi G,WashioM,OkamotoK,et al.High body mass index after age20anddiabetesmellitus are independent risk factors for ossification of the posterior longitudinalligament of the spine in Japanese subjects:a case control study inmultiplehospitals[J],Spine,2004,9:1006-1101
11、 Murakami M,Seichi A,Chikuda H,et al.Long-term follow-up of the progression ofossification of the posterior longitudinal ligament[J].J Neurosurg Spine,2010;12(5):577-579
12、 Hale J.J.,Gruson K.I.,Spivak J.M.Laminoplasty:a review of its role in compressivecervical myelopathy[J].Spine J,2006;6(6Suppl):289S-298S.
13、 Sakou T,MiyazakiA,Tomimura K,et al.Ossification of the posterior longitudinalligament of the cervical spine:subtotal vertebrectomy as a treatment[J].Clin Orthop RelatRes,1979,(140):58-65
14、 Kriangsak,Dosang,Sangkook Lee,et al.Ossification of the posterior longitudinalligament: a review[J].Neurosurgical Focus,2011,30(3):1-16
15、 Motokil,Shin yao,Akira M.Surgical strategy for cervical myelopathy due to ossificationof the posterior longitudinal ligament[J].spine,2007,32(6):647-653.
16、 Chen Y,Chen D,Wang X,et al.Anterior corpectomy and fusion for severe ossification ofposterior longitudinal ligament in the cervical spine[J].Int Orthop.2009,33(2):477-482
17、 Ogawa Y.Updates on ossification of posterior longitudinal ligament. Clinical results andproblems of posterior decompression for OPLL of the cervical spine[J].Clin Calcium.2009Oct,19(10):1493-8
18、 Iwasaki M,Okuda SY,Miyauchi A,et al.Surgical Strategy for Cervical Myelopathy dueto Ossification of the Posterior Longitudinal Ligament:Part2:Advantages of anteriordecompression and fusion over laminoplasty[J].Spine,2007,32:647-653
19、李忠海,赵杰,张海龙,等.二期前后路手术治疗颈椎后纵韧带骨化症的疗效分析[J].中国骨与关节损伤杂志,2009,24(11):964-967.
20、李阳,袁文,张颖,等.伴脊髓高信号改变的颈椎后纵韧带骨化症手术治疗及疗效分析[J].中国矫形外科杂志,2010,18(1):38-41.
21、倪斌.再谈颈椎后纵韧带骨化灶手术入路选择[J].脊椎外科杂志,2009,7(5):319-320.
22、 Yamazaki A,Homma T,Uchiyama S,et al.Morphologic limitations of posteriordecompression by midsagittal splitting method for myelopathy caused by ossification of theposterior longitudinal ligament in the cervical spine[J].Spine(Phila Pa1976).1999;24(1):32-34.
23、 Fujiyoshi T,Yamazaki M,Kawabe J,et al.A new concept formaking decisions regardingthe surgical approach for cervical ossification of the posterior longitudinal ligament:theK-line[J].Spine.2008;33(26):E990-E993.
24、 Morio Y,Teshima R,Nagashima H,et al.Correlation between operative outcomes ofcervical compression mylopathy and MRI of the spinal cord[J].Spine.2001;26:1238-1245
25、 Tsukamoto,N.,T.Maeda,H.Miura,et al.Repetitive tensile stress to rat caudal vertebraeinducing cartilage formation in the spinal ligaments:a possible role of mechanical stress inthe development of ossification of the spinal ligaments[J].J NeurosurgSpine,2006.5(3):234-42.
26、 Doyle A.M.,Nerem T.Ahsan,Human mesenchymal stem cells form multicellularstructures in response to applied cyclic strain[J].Ann Biomed Eng,2009.37(4):783-93.
27、 Sakai,Okawa,Takahashi,et al.Five-year Follow-up Evaluation of Surgical Treatment forCervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: AProspective Comparative Study of Anterior Decompression and Fusion With FloatingMethod Versus Laminoplasty[J].Spine.2012,37(5):367–376
28、 T Fujiyoshi,M Yamazaki,H Konishi,etal.The Outcome of Posterior DecompressionSurgery for Patients with Cervical Myelopathy Due to the K-line(-)-Type OPLL:Laminoplasty vs Posterior Decompression with Instrumented Fusion[J].Spine.2009,Affiliated Society Meeting Abstracts.P40.
29、 Hale JJ,Gruson KI,Spivak JM.Laminoplasty:a review of its role in compressive cervicalmyelopathy[J].Spine J.2006;6(6Suppl):289S-298S.
30、 Nakanishi K,Tanaka N,Nishikawa K,et al.Positive effect of posterior instrumentationafter surgical posterior decompression for ex-tensive cervicothoracic ossification of theposterior longitudinal ligament[J].Spine,2005,30(13):E382-E386．
31、 Kazuhiro Chiba,Yuto Ogawa,Ken Ishii,et al.Long-term results of Expansive Open-DoorLaminoplasty for Cervieal myeloPathy—Average14-Year Follow-upStudy[J].Spine,2006,1(26):2998-3005
32、孙宇.关于轴性症状[J].中国脊柱脊髓杂志,2008,18(4):289
33、 Nakase H,Park YS,Kimura,et al.Complications and long-term follow-up results intitanium mesh cage reconstruction after cervical corpectomy[J].J Spina DisordTech,2006,19:353-357.
34、 Haller,Iwanik,Shen.Clinically Relevant Anatomy of Recurrent Laryngeal Nerve[J]Spine,2012,37(2):97-100
35、 Okamoto K,Kobashi G,Washio M,et al.Japan Collaborative Epidemiologieal StudyGroup for Evaluation of Ossifieation of the Posterior Longitudinal Ligament of theSpine(OPLL) Risk.Dietary habits and risk of OPLL;findings from a case-control study inJapan[J].J Bone Miner Metab (2004)22:612-61
36、 Yokosuka K,ParkJ S,Jimbo K,et al.Immunohistoehemieal demonstration of advancedglyeation end Products and the effeets of advanced glycation end Produets in ossifiedligament tissues in vitro[J].Spine(2007)15:337-339。
37、田纪伟,王雷,董双海,等.颈椎后纵韧带骨化症手术并发症探讨[J].中国矫形外科杂志,2007,15(15):1139-1142
38、 Kawaguchi Y,Kanamori M,Ishiara H,et al.Preventive measures for axial symptomsfollowing cervieal laminoplasty[J].J Spinal Disord Tech,2003,16:497-501.
39、曾岩，党耕盯，马庆军，颈椎前路术后融合节段曲度变化与轴性症状和神经功能的相关性研究[J],中国脊柱脊髓杂志,2004,14(9):520-523
40、 Sakaura H,Hosono N,Mukai Y,et al.C5palsy after decompression surgery for cervicalmyelopathy.Spine,2003,28(21):2447-2451
41、 Hirabayashi.S, Yamamoto. H, Shiboi. R et al.Anatomical analyses and thoughts on thecause of postoperative C5palsy[J]. The Japanese Society for Spine Surgery and RelatedResearch,2009,20:868–873
42、 Hironobu Sakaura, Noboru Hosono,Yoshihiro Mukai,et al.Segmental Motor ParalysisAfter Cervieal Laminoplasty:a prospective study [J].Spine,2006,31(23):2684-2688
43、 Matsumoto, Watanabe, Hosogane,et al.Impact of Lamina Closure on Long-termOutcomes of Open-door Laminoplasty in Patients with Cervical Myelopathy-Minimum5-year Follow-up Study[J].Spine,2012,37(6):245-251
44、元虎，陈继良，郑光彬，等.改良Z型椎管扩大成形术治疗颈椎后纵韧带骨化症[J]..中国矫形外科杂志,2008,16（7）:504-506
45、 Thakar S,M Ch,Vedantam A,et al.Correlation between change in graft height and changein segmental angle following central corpectomy for cervieal spondylotic myelopathy[J].JNeurosurg Spine,2008,9(2):158-166
46、Kim TJ,Bae KW,Uhm WS,et al.Prevalence of ossification of the posterior longitudinalligament of the cervical spine[J].Joint Bone Spine.2008;75(4):471-474.
47、Holly LT，Moftakhar P，Khoo LT，et al.Surgical outeomes of elderly patients with cervicalspondylotic myelopathy[J].Surg Neurol[J],2008,69(3):233-240.
48、Baba H,Imura S,Kawahara N,et al.Osteoplastic laminoplasty for cervical myeloradiculopathysecondary to ossification of the posterior longitudinal ligament[J]. IntOrthop.1995,19(1):40-45.
49、Mizuno J,Nakagawa H,Inoue T,et al.Clinicopathological study of"snake-eye appearance"incompressive myelopathy of the cervical spinal cord[J].J Neurosurg.2003;99(suppl2):162-168.
50、Mitsuru Y,Ken N,Michiya,et al.Long-term surgical outcome and risk factors in patients withcervical myelopathy and a change in signal intensity of intramedullary spinal cord onmagnetic resonance imaging[J], J Neurosurg Spine,2010,12:59–65.
51、Ashwin A, Rajasekaran, Ajoy P. Comparison of prognostic value of different MRIclassifications of signal intensity change in cervical spondylotic myelopathy[J]. The SpineJournal,2010,10(6):475-485
52、Chikuda, Seichi, Takeshita, et al.Acute Cervical Spinal Cord Injury Complicated byPreexisting Ossification of the Posterior Longitudinal Ligament: A MulticenterStudy[J].Spine,2011,36(18):1453-1458
53、Aditya，Ashish，Vedantam.Association of magnetic resonance imaging signal changes andoutcome prediction after surgery for cervical spondylotic myelopathy[J].Journal ofNeurosurgery Spine,2011,15(6):660-666
54、Kim DY, Park YS, Jeong.Anterior Cervical Disc Herniation Presenting as Instability andMinimal Dysphagia: A Case Report[J]. Korean J Spine,2010,7(4):272-275
55、Mochizuki M,Aiba A,Hashimoto M,et al.Cervical myelopathy in patients with ossification ofthe posterior longitudinal ligament[J].J Neurosurg Spine.2009;10(2):122-128.
56、Matsunaga S,Nakamura K,Seichi A,et al.Radiographic predictors for the development ofmyelopathy in patients with ossification of the posterior longitudinal ligament:a multicentercohort study[J].Spine.2008;33(24):2648-2650.57、 Choi S,Lee SH,Lee JY,et al.Factors affecting prognosis of patients who underwentcorpectomy and fusion for treatment of cervical ossification of the posterior longitudinalligament:analysis of47patients[J].J Spinal Disord Tech,2005,18(4):309-314.
58、Toshikatsu O, Kazuhito E, Masumi O,et al. Chronic Right Lower Abdominal Pain Due toLumbar Ossification of the Posterior Longitudinal Ligament[J]. Am J Gastroenterol,2012,107:142-143
59、Do-Sung Yoo, Sang-Bok Lee,Pil-Woo,et al.Spinal cord injury in cervical spinalstenosis byminor trauma[J].World Neurosurgery,2010,73(1):50-52
60、Mizuno J,Nakagawa H.Ossified Posterior longitudinal ligament:managemen strategies andoutcomes[J].Spine,2006:6(6)282-28
61、 Mastunaga s.Sakou T.Ossifieation of the Posterior longitudinal ligaments:prevalence,Presentation,and natural history:ClarkCR(ed)The cervieal spine，4th end.2005[C],PhiladelPhia.2005:1091-1098.
62、 Yonenobu.Is Surgery Indicated for Asymptomatic or Mildly Myelopathic Patients WithSignificant Ossification of the Posterior Longitudinal Ligament?[J]. Spine,2012;37(5):E315-317.
63、 Epstein N.Diagnosis and surgical management of cervical ossification of the posteriorlongitudinal ligament[J].Spine.2002,2(6):436-449.
64、 Azuma,Kato, Taguchi.Etiology of Cervical Myelopathy Induced by Ossification of thePosterior Longitudinal Ligament: Determining the Responsible Level of OPLL Myelopathy byCorrelating Static Compression and Dynamic Factors[J]. Journal of Spinal Disorders&Techniques,2010,23(3):166-169
65、 Fujiwara N, Takeshita K.Updates on ossification of posterior longitudinal ligament.Quality of life (QOL) of patients with OPLL[J].Clin Calcium.2009,19(10):1449-1456.
1、Sakou T, Taketomi E, Matsunaga S,et al.Genetic study of ossification of the posteriorlongitudinal ligament in the cervical spine with human leukocyte antigenhaplotype[J].Spine,1991,16:1249–1252,
2、Inamasu J,Guiot BH,Sachs DC.Ossification of the posterior longitudinal ligament:an updateon its biology,epidemiology,and natural history[J]. Neurosurgery,2006,58(6):1027-1039
3、McAfee PC, Regan JJ, Bohlman HH.Cervical cord compression from ossification of theposterior longitudinal ligament in non-orientals[J].J Bone Joint Surg Br,1987,69:569–575,
4、Nakama S, Ihara T, Sugamata M,et al.An ultrastructural study on the ligamentum flavum ofthe cervical spine in patients with ossification of the posterior longitudinal ligament[J].Med MolMorphol,2006,39:198–202,
5、Murakami M,Seichi A,Chikuda H,et al. Long-term follow-up of the progression ofossification of the posterior longitudinal ligament[J].J Neurosurg Spine,2010,12(5):577-579
6、Tanabe J, Sarin H, Kindt G.Familial ossification of the posterior longitudinal ligament (OPLL)in the thoracic spine:case report[J].Surg Neurol,2002,58:403–405
7、Furushima K,Shimo-Onoda K,Maeda S,et al.Large-scale screening for candidate genes ofossification of the posterior longitudinal ligament of the spine[J].J Bone Miner Res,2002,17:128–137
8、Tahara M, Aiba A, Yamazaki M,et al.The extent of ossification of posterior longitudinalligament of the spine associated with nucleotide pyrophosphatase gene and leptin receptor genepolymorphisms[J].Spine,2005,30:877–881
9、Maeda S, Ishidou Y, Koga H,et al.Functional impact of human collagen alpha2(XI) genepolymorphism in pathogenesis of ossification of the posterior longitudinal ligament of thespine[J]. J Bone Miner Res,2001,16:948–957
10、Maeda S, Koga H, Matsunaga S, et al.Gender-specific haplotype association of collagenalpha2(XI) gene in ossification of the posterior longitudinal ligament of the spine[J].J HumGenet,2001,46:1–4
11、Horikoshi T, Maeda K, Kawaguchi Y,et al.A large-scale genetic association study ofossification of the posterior longitudinal ligament of the spine[J].Hum Genet,2006,119:611–616
12、Tanaka T, Ikari K, Furushima K,et al.Genomewide linkage and linkage disequilibriumanalyses identify COL6A1, on chromosome21, as the locus for ossification of the posteriorlongitudinal ligament of the spine[J].Am J Hum Genet,2003,73:812–822
13、Kong Q, Ma X, Li F,et al.COL6A1polymorphisms associated with ossification of theligamentum flavum and ossification of the posterior longitudinal ligament[J]. Spine,2007,32:2834–2838
14、Tsukahara S,Miyazawa N,Akagawa H,et al.COL6A1,the candidate gene for ossification ofthe posterior longitudinal ligament,is associated with diffuse idiopathic skeletal hyper-ostosis inJapanese[J].Spine,2005,30(20):2321-2324.
15、Yan L,Zhao WG,Li JJ,et al.Linkage of three polymorphisms on chromosome20p12toossification of the posterior longitudinal ligament of spine and its severity in Han Chinesepatients[J].Chin Med J(Engl),2010,123(17):2341-2346.
16、Okawa A, Ikegawa S, Nakamura I,et al.Mapping of a gene responsible for twy (tip-toewalking Yoshimura), a mouse model of ossification of the posterior longitudinal ligament of thespine (OPLL)[J].Mamm Genome,1998,9:155–156
17、Okawa A, Nakamura I, Goto S,et al.Mutation in Npps in a mouse model of ossification ofthe posterior longitudinal ligament of the spine[J].Nat Genet,1998,19:271–273
18、Koshizuka Y,Kawaguchi H,Ogata N,et al.Nucleotide pyrophosphatase gene polymorphismassociated with ossification of the posterior longitudinal ligament of the spine[J].J Bone MinerRes,2002,17(1):138-144.
19、Tahara M, Aiba A, Yamazaki M, et al.The extent of ossification of posterior longitudinalligament of the spine associated with nucleotide pyrophosphatase gene and leptin receptor genepolymorphisms[J].Spine,2005,30:877–881
20、Kobashi G, Ohta K, Washio M, et al.FokI variant of vitamin D receptor gene and factorsrelated to atherosclerosis associated with ossification of the posterior longitudinal ligament of thespine: a multihospital case-control study[J].Spine,2008,33:E553–E558
21、Inoue I, Ikeda R, Tsukahara S.Current topics in pharmacological research on bonemetabolism: promyelotic leukemia zinc finger (PLZF) and tumor necrosisfactor-alpha-stimulated gene6(TSG-6) identified by gene expression analysis play roles in thepathogenesis of ossification of the posterior longitudinal ligament[J].J Pharmacol Sci,2006,100:205–210
22、Kishiya M, Sawada T, Kanemaru K,et al.A functional RNAi screen for Runx2-regulatedgenes associated with ectopic bone formation in human spinal ligaments[J]. J Pharmacol Sci,2008,106:404–414
23、Liu Y, Zhao Y, Chen Y,et al.RUNX2polymorphisms associated with OPLL and OLF in theHan population[J].Clin Orthop Relat Res,2010,468:3333–3341
24、Yonemori K, Imamura T, Ishidou Y,et al.Bone morphogenetic protein receptors and activinreceptors are highly expressed in ossified ligament tissues of patients with ossification of theposterior longitudinal ligament[J].Am J Pathol,1997,150:1335–1347
25、Kon T, Yamazaki M, Tagawa M,et al.Bone morphogenetic protein-2stimulatesdifferentiation of cultured spinal ligament cells from patients with ossification of the posteriorlongitudinal ligament[J].Calcif Tissue Int,1997,60:291–296
26、Wang H, Yang ZH, Liu DM,et al.Association between two polymorphisms of the bonemorphogenetic protein-2gene with genetic susceptibility to ossification of the posteriorlongitudinal ligament of the cervical spine and its severity[J].Chin Med J (Engl),2008,121:1806–1810
27、Wang H, Liu D, Yang Z,et al.Association of bone morphogenetic protein-2genepolymorphisms with susceptibility to ossification of the posterior longitudinal ligament of thespine and its severity in Chinese patients[J].Eur Spine J,2008,17:956–964,
28、Yuan Ren,Jie Feng,Zhi-zhong Liu,et al.A New Haplotype in BMP4Implicated inOssification of the Posterior Longitudinal Ligament (OPLL) in a Chinese Population.Journal ofOorthopaedic Research,2012,10:748-756
29、Kamiya M, Harada A, Mizuno M,et al.Association between a polymorphism of thetransforming growth factor-beta1gene and genetic susceptibility to ossification of the posteriorlongitudinal ligament in Japanese patients[J].Spine,2001,26:1264–1267
30、Kawaguchi Y, Furushima K, Sugimori K,et al.Association between polymorphism of thetransforming growth factor-beta1gene with the radiologic characteristic and ossification of theposterior longitudinal ligament[J].Spine,2003,28:1424–1426
31、Eun JP, Ma TZ, Lee WJ,et al.Comparative analysis of serum proteomes to discoverbiomarkers for ossification of the posterior longitudinal ligament[J].Spine,2007,32:728–734
32、Matsui H, Yudoh K, Tsuji H.Significance of serum levels of type I procollagen peptide andintact osteocalcin and bone mineral density in patients with ossification of the posteriorlongitudinal ligaments[J].Calcif Tissue Int,1996,59:397–400
33、Ito K, Matsuyama Y, Yukawa Y, et al.Analysis of interleukin-8, interleukin-10, and tumornecrosis factoralpha in the cerebrospinal fluid of patients with cervical spondyloticmyelopathy[J].J Spinal Disord Tech,2008,21:145–147
34、DH Kim,YS Jeong,J Chon,et al.Association between interleukin15receptor, alpha(IL15RA) polymorphism and Korean patients with ossification of the posterior longitudinalligament[J].Cytokine,2011,55(3):343-346
35、Horikoshi T, Maeda K, Kawaguchi Y,et al.A large-scale genetic association study ofossification of the posterior longitudinal ligament of the spine[J].Hum Genet,2006,119:611–616
36、Kishiya M, Sawada T, Kanemaru K,et al.A functional RNAi screen for Runx2-regulatedgenes associated with ectopic bone formation in human spinal ligaments[J].J Pharmacol Sci,2008,106:404–414
37、P Lencel, S Delplace, P Pilet,et al.Cell-specific effects of TNF-α and IL-1β on alkalinephosphatase: implication for syndesmophyte formation and vascular calcification[J].LaboratoryInvestigation,2011,91:1434-1442
38、Kobashi G, Washio M, Okamoto K, et al.High body mass index after age20and diabetesmellitus are independent risk factors for ossification of the posterior longitudinal ligament of thespine in Japanese subjects: a case-control study in multiple hospitals[J].Spine,2004,29:1006–1010
39、Li H, Liu D, Zhao CQ,et al.Insulin potentiates the proliferation and bone morphogeneticprotein-2-induced osteogenic differentiation of rat spinal ligament cells via extracellularsignal-regulated kinase and phosphatidylinositol3-kinase[J]. Spine,2008,33:2394–2402
40、Goel A, Pareikh S.Limited oblique corpectomy for treatment of ossified posteriorlongitudinal ligament[J].Neurol India,2005,53:280–282
41、KimiakiY, Jin S, Kotaro J,et al.mmunohistochemical demonstration of advanced glycationend products and the effects of advanced glycation enfproducts in ossification ligament tissues InVitro [J].Spine,2007,32:337-339
42、Li H， Jiang LS， Dai LY. High glucose potentiates collagen synthesis and bonemorphogenetic protein-2-induced early osteoblast gene expression in rat spinal ligamentcells[J].Endocrinology,2010,151(1):63-74.
43、Li,H.,D.Liu,C.Q.Zhao,et al.Insulin potentiates the proliferation and bone morphogeneticprotein-2-induced osteogenic differentiation of rat spinal ligament cells via extracellularsignal-regulated kinase and phosphatidylinositol3-kinase[J].Spine(Phila Pa1976),2008,33(22):2394-402
44、Hirai N, Ikata T, Murase M,et al.Bone mineral density of the lumbar spine in patients withossification of the posterior longitudinal ligament of the cervical spine[J]. J Spinal Disord,1995,8:337–341
45、Yamauchi T, Taketomi E, Matsunaga S, Sakou T: Bone mineral density in patients withossification of the posterior longitudinal ligament in the cervical spine[J]. J Bone Miner Metab,199917:296–300
46、Morio Y, Yamamoto K, Kishimoto H,et al.Bone mineral density of the radius in patientswith ossification of the cervical posterior longitudinal ligament. A longitudinal study[J].Spine,1993,18:2513–2516
47、Aita I, Ohno A, Amagai H,et al.Histomorphometric study of iliac bones in cervicalmyelopathy with ossification of the posterior longitudinal ligament[J].J OrthopSci,1998,3:324–329
48、Yamada K, Inui K, Iwamoto M,et al.High serum levels of menatetrenone in male patientswith ossification of the posterior longitudinal ligament[J].Spine,2003,28:1789–1793
49、Yonemori K, Imamura T, Ishidou Y,et al.Bone morphogenetic protein receptors and activinreceptors are highly expressed in ossified ligament tissues of patients with ossification of theposterior longitudinal ligament[J].Am J Pathol,1997,150:1335–1347
50、Sawada T,Kishiya,Kanemaru,et al.Possible role of extracellular nucleotides in ectopicossification of human spinal ligaments[J].J Pharmacol Sci,2008.106(1):152-61
51、Furukawa K: Current topics in pharmacological research on bone metabolism: molecularbasis of ectopic bone formation induced by mechanical stress. J PharmacolSci,2006,100:201–204
52、Ohishi H, Furukawa K, Iwasaki K,et al.Role of prostaglandin I2in the gene expressioninduced by mechanical stress in spinal ligament cells derived from patients with ossification ofthe posterior longitudinal ligament[J].J Pharmacol Exp Ther,2003,305:818–824
53、Tanno M, Furukawa KI, Ueyama K,et al.Uniaxial cyclic stretch induces osteogenicdifferentiation and synthesis of bone morphogenetic proteins of spinal ligament cells derivedfrom patients with ossification of the posterior longitudinal ligaments[J].Bone,2003,33:475–484
54、Iwasaki K, Furukawa KI, Tanno M,et al.Uni-axial cyclic stretch induces Cbfa1expressionin spinal ligament cells derived from patients with ossification of the posterior longitudinalligament[J].Calcif Tissue Int,2004,74:448–457
55、Iwasawa T, Iwasaki K, Sawada T,et al.Pathophysiological role of endothelin in ectopicossification of human spinal ligaments induced by mechanical stress[J].Calcif Tissue Int,2006,79:422–430
56、Sawada T, Kishiya M, Kanemaru K,et al.Possible role of extracellular nucleotides in ectopicossification of human spinal ligaments[J].J Pharmacol Sci,2008,106:152–161
57、Iwasawa T,IwasakiK,Sawada T,et al.Pathophysiological role of endothelin in ectopicossification of human spinal ligaments induced bymechanical stress [J].CalcifTissue Int,2006,79(6):422-430
58、Chen J,Wang X,Wang C,et al.Rotational stress:role in development of ossification ofposterior longitudinal ligament and ligamentum flavum[J].Med Hypotheses,2011,76(1):73-76.
59、HS Yang,XH Lu,DY Chen,et al.Mechanical strain induces Cx43expression in spinalligament fibroblasts derived from patients presenting ossification of the posterior longitudinalligament[J].European Spine Journal,2011,20(9):1459-1465
60、Okamoto K, Kobashi G, Washio M,et al.Dietary habits and risk of ossification of theposterior longitudinal ligaments of the spine (OPLL);findings from a case-control study inJapan[J].J Bone Miner Metab,2004,22:612–617
61、Kobashi G, Ohta K, Washio M,et al.FokI variant of vitamin D receptor gene and factorsrelated to atherosclerosis associated with ossification of the posterior longitudinal ligament of thespine: a multihospital case-control study[J].Spine,2008,33:E553–E558
62、Washio M, Kobashi G, Okamoto K,et al.Sleeping habit and other life styles in the prime oflife and risk for ossification of the posterior longitudinal ligament of the spine (OPLL): acase-control study in Japan[J]. J Epidemiol,2004,14:168–173