Ossification of the posterior longitudinal ligament: a review

Abstract

<jats:p>Ossification of the posterior longitudinal ligament (OPLL) is most commonly found in men, the elderly, and Asian patients. There are many diseases associated with OPLL, such as diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and other spondyloarthropathies. Several factors have been reported to be associated with OPLL formation and progression, including genetic, hormonal, environmental, and lifestyle factors. However, the pathogenesis of OPLL is still unclear. Most symptomatic patients with OPLL present with neurological deficits such as myelopathy, radiculopathy, and/or bowel and bladder symptoms. There are some reports of asymptomatic OPLL. Both static and dynamic factors are related to the development of myelopathy. Plain radiography, CT, and MR imaging are used to evaluate OPLL extension and the area of spinal cord compression. Management of OPLL continues to be controversial. Each surgical technique has some advantages and disadvantages, and the choice of operation should be made case by case, depending on the patient's condition, level of pathology, type of OPLL, and the surgeon's experience. In this paper, the authors attempt to review the incidence, pathology, pathogenesis, natural history, clinical presentation, classification, radiological evaluation, and management of OPLL.</jats:p>

Cervical curvature, spinal cord MRIT2 signal, and occupying ratio impact surgical approach selection in patients with ossification of the posterior longitudinal ligament

“…Because cervical spine curvature may be altered by surgery, patients with preoperative instability of the cervical spine and patients presenting with kyphosis are not suitable for posterior surgery. For these patients, posterior fixation is generally necessary to avoid kyphosis progress following posterior surgery [19][20][21], increasing risks to patients.…”

Loss of equilibrative nucleoside transporter 1 in mice leads to progressive ectopic mineralization of spinal tissues resembling diffuse idiopathic skeletal hyperostosis in humans

“…(5) Although often misdiagnosed, DISH and OPLL are distinct from degenerative disc disease, osteoarthritis, and ankylosing spondylitis. (6) DISH is typically diagnosed using radiographs of the thoracic spine or chest, which demonstrate: (1) flowing calcifications along the anterolateral aspect of at least four contiguous vertebral bodies; (2) preservation of intervertebral disc height (in contrast to degenerative disc disease); and (3) absence of bony ankylosis of facet joints and absence of sacroiliac erosion, sclerosis, or fusion (in contrast to ankylosing spondylitis).…”

Association of transforming growth factor-beta 1 gene polymorphism with genetic susceptibility to ossification of the posterior longitudinal ligament in Korean patients

“…Abnormalities of bone metabolism play an important role in the occurrence of OPLL (Matsui et al, 1996). Both environmental and genetic factors are believed to contribute to individual susceptibility to OPLL (Saetia et al, 2011). Many research groups have investigated the associations between specific polymorphisms of bone metabolism-related genes and genetic susceptibility to OPLL (Kamiya et al, 2001;Kawaguchi et al, 2003;Tsukahara et al, 2005;Kobashi et al, 2008;Wang et al, 2008;Liu et al, 2010).…”