Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: Etiology, Clinical Presentation, and Management

Abstract

» Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic condition that results in ectopic bone formation and calcification of the posterior longitudinal ligament.» OPLL can present in any race/ethnicity but historically has been reported in the East Asian population.» OPLL predisposes patients to spinal cord injury in the setting of minor trauma.» Asymptomatic patients typically can be managed nonoperatively. Surgical treatment is reserved for patients presenting with myelopathy and worsening radiculopathy that has not responded to conservative treatment.» The decision to use anterior, posterior, or combined anterior-posterior approaches should be an individualized decision that considers the degree of OPLL pathology, K-line imaging findings, and other patient-specific risk factors.