Satoshi Saito, Abstract Co-Author: Nothing to Disclose

Tetsuo Nakayama MD, Abstract Co-Author: Nothing to Disclose

Shigeru Ehara MD, Presenter: Nothing to Disclose

The objectives of this study are to elucidate the pattern of imaging features of the traumatic injury to the cervical spine with the ossification of posterior longitudinal ligament and to correlate clinically.

This is a retrospective analysis of the cases with cervical spine trauma associated with the ossification of posterior longitudinal ligament during a 2-year period in one institution. Inclusion criteria were documentation of the traumatic change in the cervical spine and ossification of posterior longitudinal ligament on CT and/or MR imaging. Correlation with clinical history including the injury mechanism, neurological findings and clinical course was performed. The patterns of cervical spine injury on CT and MR imaging were analyzed in regard to the levels and types of injuries.

The patients included in this study were 10 men and two women (age 44-85, median 68). The mechanism of injuries were fall from height 5, fall at home (not highter than 1 meter) 5, traffic accident 1 and other accident (hit by fallen tree) 1. Spinal cord injury was identified in 10 of 12 cases, including central cord syndrome in 1 case. Fractures of the cervical vertebrae were noted in 5 cases, occured just above or below the ankylosed segment in 4 cases and occurred at the center of the ankylosed segment in 1 case. The all the fractures were shear type transverse fracture involving the anterior and posterior elements. The level of paresis was relatively low (Frankel C) in 10 cases, and the degree of fracture displacement was mild in all 5 cases.

Cervical Spine injury in patients with the ossification of posterior longitudinal ligament occurs due to relatively minor trauma. Fractures often occur at the margin of the ankylosed segment, and fracture displacement is relatively mild. Since the imaging findings are relatively subtle, CT and MR imaging features are important for detecting such traumatic changes.

Subtle traumatic changes in patients with the ossification of posterior longitudinal ligament can be only detected by CT and MR imaging.

Saito, S, Nakayama, T, Ehara, S, Cervical Spine Trauma in Patients with the Ossification of Posterior Longitudinal Ligament (OPLL): Imaging Features with Clinical Correlation.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11020128.html