Ossification of the Posterior Longitudinal Ligament: Pathophysiology, Diagnosis, and Management. Issue 17 (1st September 2022)

• Record Type: Journal Article
• Authors: Le, Hai V.; Wick, Joseph B.; Van, Benjamin W.; Klineberg, Eric O.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 30:Issue 17(2022)
• Page Start: 820
• Page End: 830
• Publication Date: 2022-09-01
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-22-00049
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Ossification of the posterior longitudinal ligament (OPLL) occurs as heterotopic bone forms in the posterior longitudinal ligament, resulting in neural compression, myelopathy, and radiculopathy. OPLL is most commonly observed in East Asian populations, with prevalence rates of 1.9% to 4.3% reported in Japan. OPLL rates are lower in North American and European patients, with reported prevalence of 0.1% to 1.7%. Patients typically develop symptoms due to OPLL in their cervical spines. The etiology of OPLL is multifactorial, including genetic, metabolic, and anatomic factors. Asymptomatic or symptomatic patients with OPLL can be managed nonsurgically, whereas patients with neurologic symptoms may require surgical decompression from an anterior, posterior, or combined approach. Surgical treatment can provide notable improvement in neurologic function. Surgical decision making accounts for multiple factors, including patient comorbidities, neurologic status, disease morphology, radiographic findings, and procedure complication profiles. In this study, we review OPLL epidemiology and pathophysiology, clinical features, radiographic evaluation, management, and complications.