Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Ossification of the Transverse Ligament of the Atlas on CT: Frequency and Associated Findings

CT를 이용한 환추횡인대 골화증의 빈도와 연관 소견

  • Sukwoo Son (Department of Radiology, Hanyang University College of Medicine, Guri Hospital) ;
  • Jeong Ah Ryu (Department of Radiology, Hanyang University College of Medicine, Guri Hospital) ;
  • Tae Yeob Kim (Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital) ;
  • Sungjun Kim (Department of Radiology, Yonsei University School of Medicine, Gangnam Severance Hospital) ;
  • Seunghun Lee (Department of Radiology, Hanyang University College of Medicine, Seoul Hospital)
  • 손석우 (한양대학교 의과대학 구리병원 영상의학과) ;
  • 류정아 (한양대학교 의과대학 구리병원 영상의학과) ;
  • 김태엽 (한양대학교 의과대학 구리병원 내과) ;
  • 김성준 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 이승훈 (한양대학교 의과대학 서울병원 영상의학과)
  • Received : 2019.03.16
  • Accepted : 2019.09.05
  • Published : 2020.05.01
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Abstract

Purpose To determine the frequency of ossification of the transverse ligament of the atlas (OTLA) and to investigate the associated findings on cervical spine CT and plain radiography. Materials and Methods We reviewed 5201 CT scans of the cervical spine of 3975 consecutive patients over an 11-year period for the presence of OTLA and compared them with those of age- and sex-matched controls. The frequency and associated findings of OTLA were investigated and statistically correlated. Results The overall frequency of OTLA was 1.1% (45 of 3975 patients) and increased with age (p < 0.005). The frequency of OTLA in patients over 80 years was 12%. The space available for the spinal cord (SAC) was smaller in patients with OTLA (p < 0.005). Mineralization of the complex of the anterior atlantooccipital membrane and Barkow ligament, ossification of the ligamentum flavum, and kyphosis of the cervical spine positively correlated to the presence of OTLA (p < 0.005). Conclusion OTLA was associated with age, SAC narrowing, cervical kyphosis, and ossification of other cervical ligaments and may be associated with degenerative spondylosis, systemic hyperostotic status, or mechanical stress or instability.

목적 경추 전산화단층촬영(cervical spine CT; 이하 C-spine CT)과 일반촬영을 이용하여 환추횡인대골화증(ossification of the transverse ligament of the atlas; 이하 OTLA)과 연관된 영상 소견에 대하여 알아보았다. 대상과 방법 11년간 3975명의 환자에게서 촬영한 5201개의 C-spine CT를 분석하여 OTLA의 유무를 확인하였고, 이를 대조군과 비교하여 그 빈도와 연관된 영상 소견의 통계학적 유의성을 확인하였다. 결과 3975명 중 45명에서 OTLA가 확인되었다(1.1%). 그 빈도는 나이에 따라 증가하는 소견을 보였으며(p < 0.005), 80세 이상인 환자의 12%에서 관찰되었다. 척수 공간(space available for spinal cord; 이하 SAC)은 OTLA 환자군에서 유의하게 작은 것으로 확인되었으며(p < 0.005), 전방환추후두막(anterior atlantooccipital membrane)-Barkow 인대 복합체의 광물질침착(mineralization), 황색인대골화증(ossification of ligamentum flavum), 경추후만증 또한 유의미한 양의 상관관계를 보였다(p < 0.005). 결론 OTLA는 환자의 나이, SAC 협소, 경추후만증, 다른 경추인대의 골화증과 연관되어 퇴행성 척추병증, 전신적인 골 과잉 상태, 혹은 기계적 스트레스나 불안정성에 관련이 있을 것으로 생각된다.

Keywords

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