Ossified Posterior Longitudinal Ligament

Ono, Katsuhiko; Ōta, Hiroshi; Tada, Kazuya; Hamada, Hirofumi; Takaoka, Kunio

doi:10.1097/00007632-197706000-00005

Cited by 127 publications

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“…However, postoperative results have varied, as reported by Ono et a1 (2) in their series of 40 patients: no improvement was obtained in 11 cases and the situation worsened in 7. Anterior decompression with interbody fusion appears to produce better results than posterior decompressive laminectomy (5).…”

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confidence: 87%

“…Myelopathy occurs as a late complication of OPLL, usually after the age of SO years (2). Although there is a correlation between the volume of the OPLL and the development of neurologic complications (2-4), other mechanisms are also involved.…”

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confidence: 99%

“…The autopsy disclosed a disc herniation which had completely crossed the OPLL at the C6-C7 level. Ono et a1 reported a case in which the autopsy revealed a C3-C4 disc herniation associated with an interruption of the OPLL, but fracture was not mentioned (2).…”

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confidence: 99%

“…OPLL may occur alone or in association with AS (I) or DISH (2,7). Fractures observed after minimal trauma in patients with DISH often occur at the C6-C7 level and include an anterior lesion, often crossing the vertebral body and a fracture of the posterior arch, which is easily visualized on sagittal MRI (8).…”

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confidence: 99%

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Cervical cord compression complicating fractured ossification of the posterior longitudinal ligament: comment on the article by Olivieri et al

Chary‐Valckenaere

Blum

Pourel

1997

Arthritis & Rheumatism

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confidence: 87%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Cervical cord compression complicating fractured ossification of the posterior longitudinal ligament: comment on the article by Olivieri et al

Chary‐Valckenaere

Blum

Pourel

1997

Arthritis & Rheumatism

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“…In our patient, the cause of cervical myelopathy was OPLL. This is a condition of unclear etiopathogenesis, which is more frequent in the Japanese population (3)(4)(5) and in patients with DISH (6). It has also been observed in patients with AS (7)(8)(9)(10)(11).…”

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confidence: 99%

Cervical myelopathy caused by ossification of the posterior longitudinal ligament in ankylosing spondylitis

Olivieri

Fiandra

Muscat

et al. 1996

Arthritis & Rheumatism

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Ossification of the posterior longitudinal ligament in ankylosing spondylitis

Olivieri

Trippi

Gemignani

et al. 1988

Arthritis & Rheumatism

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Arthritis and Rheumatism, Yagan et a1 (1) reported a case of ossification of the posterior longitudinal ligament (PLL) in a patient with HLA-B27 positive ankylosing spondylitis (AS). We have recently seen a similar case, which we report here.The patient was a 39-year-old man with a 13-year history of inflammatory low back pain and stiffness, and decreasing range of motion of the lumbar spine. In the past few years, his symptoms had extended to the cervical spine. There was no history of urethritis, diarrhea, psoriasis, peripheral arthritis, uveitis, conjunctivitis, or cardiac symptoms.Physical examination disclosed dorsal kyphosis, forward craning of the cervical spine, and severe restriction of motion of both the cervical and the lumbar spine, in all directions. Chest expansion was reduced to 1.5 cm.Laboratory evaluation revealed an erythrocyte sedimentation rate (Westergren) of 39 m d h o u r , a C-reactive protein level of 3.2 mg/dl (normal <0.5), and a serum IgA level of 626 mg/dl (normal 50-350). HLA typing was positive for the B27 antigen.Radiographic examination of the pelvis showed ankylosis of both sacroiliac joints, erosions, and irregular periosteal new bone formation ("whiskering") at the ischial tuberosities, together with osteitis of the symphysis pubis. Radiographs of the lumbar and the dorsal spine showed squaring of the vertebral bodies and apophyseal joint sclerosis and ankylosis. Cervical spine radiographs (Figure 1) demonstrated squaring of the vertebral bodies, marginal syndesmophytes, apophyseal joint sclerosis and fusion, and ossification of the PLL extending from Cl to C6. A radiolucent line was visible between the posterior aspect of the vertebral bodies and the ossified PLL.PLL ossification is an uncommon condition with an unclear etiology. It is most frequently reported in Japanese people (2,3). In 1978, Resnick et a1 (4) reported finding PLL ossification in 50% of 74 North American patients who had diffuse idiopathic skeletal hyperostosis (DISH), and suggested that there was an association between the 2 conditions.The report by Yagan et al in 1983 (1) described the first case of PLL ossification in a patient with a clear diagnosis of B27 positive AS. That patient also had an ossification of the anterior longitudinal ligament of the cervical spine, similar to that seen in DISH. Although the patient showed no other signs of DISH in the thoracic or the lumbar spine, the authors wondered "whether the ossification of the anterior longitudinal ligament of cervical spine-similar to that seen in diffuse idiopathic skeletal hyperostosis-contributed to the development of PLL ossification in the patient's neck." Unlike their patient, ours showed no signs of DISH in the cervical, lumbar, or dorsal spine.This report confirms the hypothesis by Yagan et a1 that PLL ossification and AS may coexist in a patient.

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Ossified Posterior Longitudinal Ligament

Cited by 127 publications

References 0 publications

Cervical cord compression complicating fractured ossification of the posterior longitudinal ligament: comment on the article by Olivieri et al

Cervical cord compression complicating fractured ossification of the posterior longitudinal ligament: comment on the article by Olivieri et al

Cervical myelopathy caused by ossification of the posterior longitudinal ligament in ankylosing spondylitis

Ossification of the posterior longitudinal ligament in ankylosing spondylitis

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