Ossification of the posterior longitudinal ligament

Definition

Hardening of the ligaments supporting the cervical spinal column (neck)

Ligaments support the movement of the spinal column and prevent dislocation. The anterior longitudinal ligaments support the anterior side and the posterior longitudinal ligaments support the posterior side of the spinal column. Hardened and thickened posterior longitudinal ligaments may compress the nerve in the spinal canal. It usually happens on the cervical spine (neck), but also rarely on the thoracic spine.

Symptoms

Starts with mild neck pain and numbness on hands and arms.

  • 1.Discomfort by continuous dull pain on the neck
  • 2.Numbness on the chest if severe
  • 3.Numbness, pain, decrease of sensation, and muscle weakness of legs. Gait disability, paralysis or urinary disability if severe.
  • 4.Suddenly developed symptoms after trauma

Cause

Genetic factor is the most important.

  • While no specific cause is found, genetic factor is considered to be important. There are many cases where other family members have the disease as well, suggesting that genetic/racial factors may have a role. Other conditions such as trauma, diabetes, obesity, immune disease, or ankylosing spondylitis, may affect the disease development.
  • This is exacerbated by environmental factors.

  • Extended use of computer or Smartphone, A long driving, Use of high pillow, forward head posture
  • Treatment

    Early diagnosis is important while it progress chronically and slowly

    Diagnosis : X-ray, myelography, CT, MRI

    Non-surgical treatment

    • Bed rest
    • Medication
    • Cervical brace
    • Traction

    Surgical treatment

    Patients with myelopathy, such as gait disability or difficulty in delicate manual movement

    • Microscopic laminectomy
    • Microscopic Corpectomy&removal of OPLL