A reappraisal of the diagnosis in cervical disc disease: the posterior longitudinal ligament perforated or not.

Abstract:

:Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy.

journal_name

Neuroradiology

journal_title

Neuroradiology

authors

Isu T,Iwasaki Y,Miyasaka K,Abe H,Tashiro K,Ito T

doi

10.1007/BF00548195

subject

Has Abstract

pub_date

1986-01-01 00:00:00

pages

215-20

issue

3

eissn

0028-3940

issn

1432-1920

journal_volume

28

pub_type

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