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Ossification of Posterior Longitudinal Ligament (OPLL), Cervical Spine
Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Ossification of posterior longitudinal ligament (OPLL)

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Chen LF et al: Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study. Neurosurg Focus. 40(6):E4, 2016
                                            2. Chen Y et al: Roles of the Endoplasmic Reticulum Stress Transducer OASIS in Ossification of the Posterior Longitudinal Ligament. Clin Spine Surg. ePub, 2016
                                            3. Fujimori T et al: Prevalence, Concomitance, and Distribution of Ossification of the Spinal Ligaments: Results of Whole Spine CT Scans in 1500 Japanese Patients. Spine (Phila Pa 1976). ePub, 2016
                                            4. Ito K et al: MRI Signal Intensity Classification in Cervical Ossification of the Posterior Longitudinal Ligament -Predictor Of Surgical Outcomes. Spine (Phila Pa 1976). ePub, 2016
                                            5. Kawaguchi Y et al: Characteristics of ossification of the spinal ligament; incidence of ossification of the ligamentum flavum in patients with cervical ossification of the posterior longitudinal ligament - Analysis of the whole spine using multidetector CT. J Orthop Sci. ePub, 2016
                                            6. Tauchi R et al: Cervical Myeloradiculopathy due to Ossification of the Posterior Longitudinal Ligament with versus without Diffuse Idiopathic Spinal Hyperostosis. Global Spine J. 6(4):350-6, 2016
                                            7. Fujimori T et al: Three-dimensional measurement of intervertebral range of motion in ossification of the posterior longitudinal ligament: are there mobile segments in the continuous type? J Neurosurg Spine. 17(1):74-81, 2012
                                            8. Jeon TS et al: Analysis of demographics, clinical, and radiographical findings of ossification of posterior longitudinal ligament of the cervical spine in 146 Korean patients. Spine (Phila Pa 1976). 37(24):E1498-503, 2012
                                            9. Matsunaga S et al: Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history. Spine (Phila Pa 1976). 37(5):E309-14, 2012
                                            10. Wu JC et al: Conservatively treated ossification of the posterior longitudinal ligament increases the risk of spinal cord injury: a nationwide cohort study. J Neurotrauma. 29(3):462-8, 2012
                                            11. Matsunaga S et al: Radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligament: a multicenter cohort study. Spine (Phila Pa 1976). 33(24):2648-50, 2008
                                            12. Inamasu J et al: Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history. Neurosurgery. 58(6):1027-39; discussion 1027-39, 2006
                                            13. Matsunaga S et al: Clinical course of patients with ossification of the posterior longitudinal ligament: a minimum 10-year cohort study. J Neurosurg. 100(3 Suppl):245-8, 2004
                                            14. Shiraishi T et al: Cervical peridural calcification in patients undergoing long-term hemodialysis. Report of two cases. 100(3 Suppl): 284-6, 2004
                                            15. Kamizono J et al: Occupational recovery after open-door type laminoplasty for patients with ossification of the posterior longitudinal ligament. Spine. 28(16):1889-92, 2003
                                            16. Epstein N: Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2(6):436-49, 2002
                                            17. Epstein NE et al: In vitro characteristics of cultured posterior longitudinal ligament tissue. Spine. 27(1):56-8, 2002
                                            18. Matsunaga S et al: J Neurosurg. 96(2 Suppl):168-72, 2002
                                            19. Matsunaga S et al: Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament. J Neurosurg. 97(2 Suppl):172-5, 2002
                                            20. Epstein NE: Identification of ossification of the posterior longitudinal ligament extending through the dura on preoperative computed tomographic examinations of the cervical spine. Spine. 26(2):182-6, 2001
                                            21. Matsunaga S et al: Quality of life in elderly patients with ossification of the posterior longitudinal ligament. Spine. 26(5):494-8, 2001
                                            22. Sakou T et al: Recent progress in the study of pathogenesis of ossification of the posterior longitudinal ligament. J Orthop Sci. 5(3):310-5, 2000
                                            23. Yamauchi T et al: Bone mineral density in patients with ossification of the posterior longitudinal ligament in the cervical spine. J Bone Miner Metab. 17(4):296-300, 1999
                                            24. Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
                                            25. Koga H et al: Genetic mapping of ossification of the posterior longitudinal ligament of the spine. Am J Hum Genet. 62(6):1460-7, 1998
                                            26. Epstein NE: Ossification of the posterior longitudinal ligament in evolution in 12 patients. Spine. 19(6):673-01, 1994
                                            27. Epstein NE: The surgical management of ossification of the posterior longitudinal ligament in 43 north americans. Spine. 19(6):664-72, 1994
                                            28. Matsunaga S et al: The natural course of myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine. Clin Orthop. (305):168-77, 1994
                                            29. Epstein N: The surgical management of ossification of the posterior longitudinal ligament in 51 patients. J Spinal Disord. 6(5):432-54; discussion 454-5, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Ossification of posterior longitudinal ligament (OPLL)

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nonvascular Interventions

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Chen LF et al: Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study. Neurosurg Focus. 40(6):E4, 2016
                                                                                      2. Chen Y et al: Roles of the Endoplasmic Reticulum Stress Transducer OASIS in Ossification of the Posterior Longitudinal Ligament. Clin Spine Surg. ePub, 2016
                                                                                      3. Fujimori T et al: Prevalence, Concomitance, and Distribution of Ossification of the Spinal Ligaments: Results of Whole Spine CT Scans in 1500 Japanese Patients. Spine (Phila Pa 1976). ePub, 2016
                                                                                      4. Ito K et al: MRI Signal Intensity Classification in Cervical Ossification of the Posterior Longitudinal Ligament -Predictor Of Surgical Outcomes. Spine (Phila Pa 1976). ePub, 2016
                                                                                      5. Kawaguchi Y et al: Characteristics of ossification of the spinal ligament; incidence of ossification of the ligamentum flavum in patients with cervical ossification of the posterior longitudinal ligament - Analysis of the whole spine using multidetector CT. J Orthop Sci. ePub, 2016
                                                                                      6. Tauchi R et al: Cervical Myeloradiculopathy due to Ossification of the Posterior Longitudinal Ligament with versus without Diffuse Idiopathic Spinal Hyperostosis. Global Spine J. 6(4):350-6, 2016
                                                                                      7. Fujimori T et al: Three-dimensional measurement of intervertebral range of motion in ossification of the posterior longitudinal ligament: are there mobile segments in the continuous type? J Neurosurg Spine. 17(1):74-81, 2012
                                                                                      8. Jeon TS et al: Analysis of demographics, clinical, and radiographical findings of ossification of posterior longitudinal ligament of the cervical spine in 146 Korean patients. Spine (Phila Pa 1976). 37(24):E1498-503, 2012
                                                                                      9. Matsunaga S et al: Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history. Spine (Phila Pa 1976). 37(5):E309-14, 2012
                                                                                      10. Wu JC et al: Conservatively treated ossification of the posterior longitudinal ligament increases the risk of spinal cord injury: a nationwide cohort study. J Neurotrauma. 29(3):462-8, 2012
                                                                                      11. Matsunaga S et al: Radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligament: a multicenter cohort study. Spine (Phila Pa 1976). 33(24):2648-50, 2008
                                                                                      12. Inamasu J et al: Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history. Neurosurgery. 58(6):1027-39; discussion 1027-39, 2006
                                                                                      13. Matsunaga S et al: Clinical course of patients with ossification of the posterior longitudinal ligament: a minimum 10-year cohort study. J Neurosurg. 100(3 Suppl):245-8, 2004
                                                                                      14. Shiraishi T et al: Cervical peridural calcification in patients undergoing long-term hemodialysis. Report of two cases. 100(3 Suppl): 284-6, 2004
                                                                                      15. Kamizono J et al: Occupational recovery after open-door type laminoplasty for patients with ossification of the posterior longitudinal ligament. Spine. 28(16):1889-92, 2003
                                                                                      16. Epstein N: Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2(6):436-49, 2002
                                                                                      17. Epstein NE et al: In vitro characteristics of cultured posterior longitudinal ligament tissue. Spine. 27(1):56-8, 2002
                                                                                      18. Matsunaga S et al: J Neurosurg. 96(2 Suppl):168-72, 2002
                                                                                      19. Matsunaga S et al: Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament. J Neurosurg. 97(2 Suppl):172-5, 2002
                                                                                      20. Epstein NE: Identification of ossification of the posterior longitudinal ligament extending through the dura on preoperative computed tomographic examinations of the cervical spine. Spine. 26(2):182-6, 2001
                                                                                      21. Matsunaga S et al: Quality of life in elderly patients with ossification of the posterior longitudinal ligament. Spine. 26(5):494-8, 2001
                                                                                      22. Sakou T et al: Recent progress in the study of pathogenesis of ossification of the posterior longitudinal ligament. J Orthop Sci. 5(3):310-5, 2000
                                                                                      23. Yamauchi T et al: Bone mineral density in patients with ossification of the posterior longitudinal ligament in the cervical spine. J Bone Miner Metab. 17(4):296-300, 1999
                                                                                      24. Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
                                                                                      25. Koga H et al: Genetic mapping of ossification of the posterior longitudinal ligament of the spine. Am J Hum Genet. 62(6):1460-7, 1998
                                                                                      26. Epstein NE: Ossification of the posterior longitudinal ligament in evolution in 12 patients. Spine. 19(6):673-01, 1994
                                                                                      27. Epstein NE: The surgical management of ossification of the posterior longitudinal ligament in 43 north americans. Spine. 19(6):664-72, 1994
                                                                                      28. Matsunaga S et al: The natural course of myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine. Clin Orthop. (305):168-77, 1994
                                                                                      29. Epstein N: The surgical management of ossification of the posterior longitudinal ligament in 51 patients. J Spinal Disord. 6(5):432-54; discussion 454-5, 1993