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Ossification of the posterior longitudinal ligament (OPLL) is a process of fibrosis, calcification, and ossification of the posterior longitudinal ligament of the spine, that may involve the spinal dura. [1]
The posterior longitudinal ligament contains a higher density of nociceptors than many ligaments, so can cause back pain. [1] It may ossify, particularly around cervical vertebrae. [1] The posterior longitudinal ligament has a high density of vasomotor fibres, allowing for increased blood flow to respond to damage to the ligament. [1]
In the spine, there is bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to partial or complete fusion of adjacent vertebrae. The facet and sacroiliac joints tend to be uninvolved. The thoracic spine is the most common level involved. [2]
To treat myelopathy and ossified posterior longitudinal ligament (OPLL), there are two approaches that can expand the spinal canal. These approaches are the anterior approach which is a direct removal of the cord compressing lesion, or a posterior approach which is an indirect decompression of the spinal cord.
The anterior longitudinal ligament and posterior longitudinal ligament are both illustrated in this image; the anterior longitudinal ligament is to the far left, while the posterior longitudinal ligament is left of the center. The longitudinal ligaments are two sets of ligaments that run along the spine. These are:
The supraspinous ligament becomes taut when the spine is fully flexed. [4] The supraspinous ligament, along with the posterior longitudinal ligament, interspinous ligaments and ligamentum flavum, help to limit hyperflexion of the vertebral column.
Mutations in this gene have been associated with Generalized arterial calcification of infancy, ossification of the posterior longitudinal ligament of the spine (OPLL), Hypophosphatemic rickets autosomal recessive 2 (ARHR2), and insulin resistance.
The anterior longitudinal ligament is a ligament that extends across the anterior/ventral aspect of the vertebral bodies and intervertebral discs the spine. It may be partially cut to treat certain abnormal curvatures in the vertebral column , such as kyphosis .