後縦靭帯骨化症による脊髄障害の病理(<特集>頚椎 OPLL)

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Compression of the spinal cord was marked at the level of the intervertebral disk, and the spinal cord was strikingly flattened anteroposteriorly. Intensive damage was seen in the gray matter as compared to the white matter. The white matter showed demyelination and axon loss with status spongiosus, which was more marked in the posterolateral than in the anterior column. The cross-sectional shape of the spinal cord at the most severely affected segment was classified into two categories : boomerang and triangular. A triangular-shaped spinal cord with a taransverse area less than 60% of normal in more than one segment appeared to be associated with severe and irreversible pathological changes in case of OPLL. The most seriously damaged parts of the spinal cord showed tissue necrosis and cavity formation that extended from the central parts of the gray matter to the ventral parts of the posterior column. Venous congestion and subsequent necrosis seemed to play a significant role in the pathogenesis of spinal cord cysts secondary to chronic compression. The spinal nerve roots that showed marked demyelination and axon loss were damaged by ossification where the anterior nerve roots emerge from the spinal cord and where the roots penetrate the dura. As cause of compression myelopathy, hypertrophy of the PLL and ossification of the dura mater were also important. Aberrant peripheral nerve bundles and peripheral type remyelination were observed in severely damaged parts of the spinal cord.
日本脊髄外科学会の論文
1997-06-16

後縦靭帯骨化症による脊髄障害の病理(<特集>頚椎 OPLL)

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