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Ossification of Posterior Longitudinal Ligament (OPLL)
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Ossification of posterior longitudinal ligament (OPLL)
            • Definitions

              • Ossification within spinal posterior longitudinal ligament (PLL)

            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

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Fehlings MG et al: Cervical spondylotic myelopathy: current state of the art and future directions. Spine (Phila Pa 1976). 38(22 Suppl 1):S1-8, 2013
                                                2. Li H et al: A systematic review of complications in cervical spine surgery for ossification of the posterior longitudinal ligament. Spine J. 11(11):1049-57, 2011
                                                3. Saetia K et al: Ossification of the posterior longitudinal ligament: a review. Neurosurg Focus. 30(3):E1, 2011
                                                4. Shin JH et al: Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes. Neurosurg Focus. 30(3):E8, 2011
                                                5. 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
                                                6. 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
                                                7. 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
                                                8. Shiraishi T et al: Cervical peridural calcification in patients undergoing long-term hemodialysis. Report of two cases. 100(3 Suppl): 284-6, 2004
                                                9. 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
                                                10. Epstein N: Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2(6):436-49, 2002
                                                11. Epstein NE et al: In vitro characteristics of cultured posterior longitudinal ligament tissue. Spine. 27(1):56-8, 2002
                                                12. Matsunaga S et al: J Neurosurg. 96(2 Suppl):168-72, 2002
                                                13. Matsunaga S et al: Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament. J Neurosurg. 97(2 Suppl):172-5, 2002
                                                14. 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
                                                15. Matsunaga S et al: Quality of life in elderly patients with ossification of the posterior longitudinal ligament. Spine. 26(5):494-8, 2001
                                                16. 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
                                                17. 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
                                                18. Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
                                                19. 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
                                                20. Epstein NE: Ossification of the posterior longitudinal ligament in evolution in 12 patients. Spine. 19(6):673-01, 1994
                                                21. Epstein NE: The surgical management of ossification of the posterior longitudinal ligament in 43 north americans. Spine. 19(6):664-72, 1994
                                                22. 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
                                                23. 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

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Ossification of posterior longitudinal ligament (OPLL)
                                                          • Definitions

                                                            • Ossification within spinal posterior longitudinal ligament (PLL)

                                                          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

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Fehlings MG et al: Cervical spondylotic myelopathy: current state of the art and future directions. Spine (Phila Pa 1976). 38(22 Suppl 1):S1-8, 2013
                                                                                              2. Li H et al: A systematic review of complications in cervical spine surgery for ossification of the posterior longitudinal ligament. Spine J. 11(11):1049-57, 2011
                                                                                              3. Saetia K et al: Ossification of the posterior longitudinal ligament: a review. Neurosurg Focus. 30(3):E1, 2011
                                                                                              4. Shin JH et al: Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes. Neurosurg Focus. 30(3):E8, 2011
                                                                                              5. 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
                                                                                              6. 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
                                                                                              7. 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
                                                                                              8. Shiraishi T et al: Cervical peridural calcification in patients undergoing long-term hemodialysis. Report of two cases. 100(3 Suppl): 284-6, 2004
                                                                                              9. 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
                                                                                              10. Epstein N: Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2(6):436-49, 2002
                                                                                              11. Epstein NE et al: In vitro characteristics of cultured posterior longitudinal ligament tissue. Spine. 27(1):56-8, 2002
                                                                                              12. Matsunaga S et al: J Neurosurg. 96(2 Suppl):168-72, 2002
                                                                                              13. Matsunaga S et al: Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament. J Neurosurg. 97(2 Suppl):172-5, 2002
                                                                                              14. 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
                                                                                              15. Matsunaga S et al: Quality of life in elderly patients with ossification of the posterior longitudinal ligament. Spine. 26(5):494-8, 2001
                                                                                              16. 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
                                                                                              17. 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
                                                                                              18. Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
                                                                                              19. 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
                                                                                              20. Epstein NE: Ossification of the posterior longitudinal ligament in evolution in 12 patients. Spine. 19(6):673-01, 1994
                                                                                              21. Epstein NE: The surgical management of ossification of the posterior longitudinal ligament in 43 north americans. Spine. 19(6):664-72, 1994
                                                                                              22. 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
                                                                                              23. 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