Clinical imaging study and meta-analysis of ossification of the ligamentum flavum

Abstract

目的 探討黃韌帶骨化(ossification ofligamentum flavum,OLF)的臨床流行病學特征,評估OLF在普通人群中的發病率、形態和分布特點.進行相關OLF流行病學研究的meta分析.方法 對1736名中國南方人進行脊柱的臨床影像學研究,分別進行MRI T2加權的矢狀位成像,OLF定義為一椎管后方的低信號區,并在CT上證實.根據OLF累及的節段分為單一型、連續型和非連續型;根據矢狀位T2加權像上OLF的形態學特征分為三角形、圓形和鳥喙形三種.檢索Ovid Medline、PubMed、Embase和中國生物文獻數據庫(1980年1月至2010年1月),搜集全部有關OLF的流行病學研究.結果 共有66例志愿者發現有脊柱OLF,其中女52例,男14例.根據該研究新的分型,單一型45例(68.2%),連續型11例(16.7%),非連續型10例(15.2%);形態學上,92個OLF中,17個(18.5%)為三角形,75個(81.5%)為圓形骨化物.納入研究的OLF流行病學研究共有4篇.結論 OLF在中國南方人群中的患病率約為3.8%(66/1736),發生率與年齡和性別相關;31.8%的多節段OLF和15.2%的非連續型OLF均提示全脊柱MR檢查的必要性. Objective To study the clinical epidemiology of ossification of ligamentum flavum(OLF)and evaluate its characteristics of prevalence,morphology,and distribution in a common population.Some factors associated with its occurrence were analyzed by meta-analysis.Methods A total of 1736 southern Chinese volunteers were recruited by open invitation.T2 weighted MRI sequences of whole spine in all participants were obtained.OLF was identified as an area of low signal intensity located in the posterior part of the spinal canal,and subsequently confirmed by CT scan.The distribution of OLF was classified into three types:isolated type,continuous type and non-continuous type.The morphology of the lesion was classified into triangular,round and beak shapes based on the pattern of ossification on T2 weighted sagittal MRIs.Literatures about OLF were searched in Ovid Medline,PubMed,Embase and Chinese BioMedical Literature Database from January 1980 to January 2010.Results OLF was identified in 66 volunteers including 52 females and 14 males.According to the new classification of the study,there were 45 cases of single type (68.2%),11 cases of continuous type(16.7%)and 10 cases of non-continuous type(15.2%).In 92 OLF,there were 17 triangular shape(18.5%)and 75 rounded shape according to morphological classification.A literature review showed that there were only 4 reports related to the prevalence of OLF.Conclusion This study demonstrated that morbidity rate of OLF is about 3.8% in southern Chinese population.The incidence is related to age and gender.It is necessary to perform whole spine MRI examination to detect the multiple level and noncontinous type.