Ossification of the posterior longitudinal ligament: a review of literature. Analysis of demographics, risk factors, clinical presentation, and surgical treatment modalities for the ossified posterior longitudinal ligament. Kalb S, Martirosyan NL, Perez-Orribo L et-al. Ossification of the posterior longitudinal ligament and ligamentum flavum: imaging features. Ossification of posterior longitudinal ligaments: evaluation with MRI. Ossification of the posterior longitudinal ligament: a review. Magnetic resonance imaging findings in ossification of the posterior longitudinal ligament of the cervical spine. Spinal cord compression due to ossification of ligaments: MR imaging. Yamashita Y, Takahashi M, Matsuno Y et-al. laminectomy and fusion and laminoplasty) may be better tolerated in older patients 8. plated multilevel anterior discectomy and fusion, anterior cervical corpectomy with fusion) may provide more direct decompression and best improve myelopathy, although may cause greater soft-tissue morbidity. Surgical options can include an anterior, posterior or combined approach. Management can range from conservative to surgical removal. T2-weighted sequences are considered the most effective in the evaluation of spinal cord compression due to both the ossification and abnormal signal intensity of the spinal cord 5. However, hypertrophy of the ligament without ossification can also have this appearance. Ossification of the posterior longitudinal ligament appears hypointense on T1 and T2-weighted images. ![]() The ossification appears confluent with but often thicker and denser than cortical bone of the vertebral body. Ossification can appear continuous (spanning multiple segments), segmental (discontinuous along vertebral bodies), and/or localized (spanning just the disc level). CTĬT is the best modality to depict ossification of the posterior longitudinal ligament and is often obtained for this purpose in cases of cervical spinal stenosis. Localized/focal/circumscribed: mainly located posterior to a disc spaceĬontinuous ossification of the posterior longitudinal ligament is visible as linear density posterior to the vertebral body cortex, within the ventral spinal canal. Mixed: a combination of continuous and segmental types Segmental: one or several separate lesions behind the vertebral bodies The most commonly used classification is that proposed by the Investigation Committee for Ossification of the Spinal Ligaments, part of the Japanese Ministry of Health, Labor and Welfare 12,13:Ĭontinuous: a long lesion extending over several vertebral bodies This typically seen in the mid cervical spine and results in central canal stenosis, predisposing the patient to cord injury from minor trauma: OPLL is often associated with several other entities:ĭiffuse idiopathic skeletal hyperostosis (DISH)ĭISH may be seen in up to 12% of elderly male Caucasians, with OPLL seen in about half of these, suggesting the incidence among Caucasians may be higher than the figures above. The exact pathogenesis of OPLL is unclear 3. If present, symptoms usually manifest in the 4 th-6 th decades of life 7,8. ![]() Patients may be asymptomatic, or have evidence of radiculopathy and/or myelopathy 11. The disorder is recognized as the leading cause of cervical myelopathy in Japan. The incidence is higher in East Asian populations (2.4%) compared to Caucasians (0.2-0.7%). OPLL is twice as common in men compared with women. There is a recognized greater prevalence in males and in the elderly 3.
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