Persistent chest pain or vague back pain

Introduction Patients with ossification of the posterior longitudinal ligament of the thoracic spine complained of persistent back pain and its history can last from several months to several years. All 12 patients treated with anterior surgery reported by Kenji Hannai complained of persistent chest pain or blurred back pain. The posterior longitudinal ligament ossification of the thoracic spine (OPLL) is not a common disease worldwide, but it is not uncommon in some countries in the Far East to ossify the posterior longitudinal ligament, resulting in paralysis of the limbs and hospital visits. It is generally thought to be caused by heterotopic ossification of chondrocytes, but some scholars believe that it is related to fibrocartilage and intramembranous bone. Some scholars believe that degenerated intervertebral disc can affect the formation of ossification of posterior longitudinal ligament.

Cause

(1) Causes of the disease

The cause is not yet clear.

(two) pathogenesis

As with other parts of the posterior longitudinal ligament ossification, the pathogenesis of thoracic OPLL is not yet clear. It is generally thought to be caused by heterotopic ossification of chondrocytes, but some scholars believe that it is related to fibrocartilage and intramembranous bone. Some scholars believe that degenerated intervertebral disc can affect the formation of ossification of posterior longitudinal ligament.

an examination

an examination:

1. X-ray examination: lateral thoracic or tomographic X-ray film, often found ossified posterior longitudinal ligament with high density shadow, can be continuous or isolated.

2. Myelography: It can show the range of bone formation, which has great significance for determining the range of decompression.

3. CT examination: has a clear diagnostic significance, and can measure the rate of spinal stenosis. CT three-dimensional reconstruction can not only show the extent and shape of the bone, but also the degree of spinal cord compression.

4. MRI examination: It can show the extent of spinal cord compression and so on.

Differential diagnosis

Chest pain is a common clinical symptom, and there are many reasons, and the location and severity of chest pain are not necessarily consistent with the location and severity of the lesion. Trauma, inflammation, tumors and certain physical and chemical factors caused by tissue damage stimulate the intercostal nerve, phrenic nerve, spinal nerve root and vagus nerve are distributed in the esophagus, bronchus, lung, pleura, heart and aorta nerve shoots, can cause Chest pain.

Overworked, gallbladder inflammation or gallstones, cold and cold, lack of blood can also cause back pain.

Clinical manifestations:

1. Back pain: OPLL-induced thoracic lesions can only occur after a short period of time from onset to complete onset. However, some patients only complained of persistent back pain when they visited the hospital, and their medical history lasted for several months to several years. All 12 patients treated with anterior surgery reported by Kenji Hannai complained of persistent chest pain or blurred back pain.

2. Lower extremity spasm: It can be caused by mild exercise and severe to severe lower extremity, and can be accompanied by different degrees of sensation.

3. Abnormal urination function: depending on the degree of lesions, there may be dysfunction and incontinence.

4. Unstable walking: the lower limbs are weak, and there is a feeling of stepping on the air or a feeling of walking on the cotton.

Complications: Complicated with complete paralysis of the lower extremities.

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