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ossification of the posterior longitudinal ligament (OPPL); pain; OP-index; canal narrowing ratio; spinal disorder; patient-reported outcomes; computed tomography; activities of daily living; quality of life. Nevertheless, we believe that our findings provide important information concerning the diagnostic features of patients with OPLL. Cells of both HPLL and OPLL ligaments seem to possess similar regulatory mechanisms (perhaps secreting a similar growth factor) that may allow for accelerated growth and division of cells in the PLL (Motegi et al., 1998). Hirai, T.; Yoshii, T.; Ushio, S.; Mori, K.; Maki, S.; Katsumi, K.; Nagoshi, N.; Takeuchi, K.; Furuya, T.; Watanabe, K.; et al. Ligamentum flavum: These are short, paired ligaments that connect the vertebral arches of adjacent vertebrae, helping to … Patients older than 65 years of age with asymptomatic ossification of the posterior longitudinal ligament (OPLL) should be followed conservatively. The width of the central attachment of the PLL to the lumbar vertebral bodies narrows as one moves down the spine, whereas the discal attachments remain relatively constant in width (Table 7-10 and Fig. ; Park, J.W. Ossification of the posterior longitudinal ligament, also known as OPLL, is a potentially serious diagnosis that is usually linked to the existence of cervical central canal stenosis. Its superficial fibers span several vertebrae, and its deep fibers course between adjacent vertebrae. Yoshimura, N.; Nagata, K.; Muraki, S.; Oka, H.; Yoshida, M.; Enyo, Y.; Kagotani, R.; Hashizume, H.; Yamada, H.; Ishimoto, Y.; et al. (Katsushi Takeshita), T.F., K.W. Sometimes an unpleasant sensation may be present without any touch. Home Treatment of a Posterior Cruciate Ligament Injury. 39 Rather, … This ligament is found in something known as the vertebral canal, which also is called the spinal canal. In addition to the extremely common ligament sprains that nearly everyone experiences at some point in his or her life, ligaments can also calcify later in life. The penetrated PLL is able to be distinguished from a bulging anulus fibrosus on parasagittal MRI scans. The superficial fibers form a distinct midline band that spans several vertebral levels. ; Kim, K.J. Park, S.; Lee, D.H.; Ahn, J.; Cho, J.H. ; Mesfin, A. Cervical ossification of the posterior longitudinal ligament: A computed tomography-based epidemiological study of 2917 patients. Kern Singh, ... Alexander R. Vaccaro, in Operative Techniques: Spine Surgery (Third Edition), 2018. Similarly, our findings revealed that patients categorized as Grade 4 CNR were likely to deteriorate in terms of lower extremity function and locomotive function. 5-23) and occasionally occurs in the lumbar region. A ligament can overstretch, become twisted, tear, or break as a result of trauma. Subscribe to receive issue release notifications and newsletters from MDPI journals, You can make submissions to other journals. Ossification of the posterior longitudinal ligament (OPLL) is commonly seen in oriental populations, and its cause remains obscure. Ito et al. One of the most important ligaments for stability and protection in the spine is the posterior longitudinal ligament. T.H., T.Y., K.M., S.U., S.M., K.K., N.N. To be eligible for the study, patients had to meet all the following criteria: ≥20 years of age; a cervical OPLL diagnosis based on X-ray findings; symptoms such as neck pain, upper and/or lower extremity numbness (regardless of whether surgery was required), clumsiness, and gait disturbance; had visited a participating hospital for symptoms between September 2015 and December 2017; and had undergone whole-spine computed tomography (CT) scan to determine the location of ossified lesions in the whole spine. Ossification of the posterior longitudinal ligament (OPLL) of the spine is considered as a special type of HO. Fourth, we could not evaluate ossified lesions on the axial CT imaging to clarify whether OPLL develops laterally. The two longitudinal ligaments and the ligamentum flavum function to stabilize the lumbar vertebral column in flexion (posterior longitudinal ligament and ligamentum flavum) and extension (anterior longitudinal ligament). The process typically involves 2.5 to 4 levels beginning at approximately C3/C4 and progressing distally to involve C4/C5 and C5/C6, although generally sparing C6/C7. posterior longitudinal ligament with the annulus fibrosus, Hovelaque 1925, Jung & Brunschwig 1932, Tsukada 1938, Roofe 1940, Ehrenhnft 1943, Wiberg 1949. Therefore, it is vital to pay attention to patients with a high CNR grade in order to prevent neurologic deterioration. We thank Nobuko Nakajima and Yukiko Oya for data collection. This is demonstrated in the illustration below as a torn interspinous ligament; a thinned ligamentum flavum; torn capsular ligaments; and a torn posterior longitudinal ligament. ; Norman, G.R. Basic demographic and clinical data, including age and sex, diabetes mellitus (DM), body mass index (BMI), and the presence of neck pain, back pain, and low back pain (LBP), were collected for each patient (, CT images of the whole spine—including the cervical, thoracic, and lumbosacral spine from the occipital bone to the sacrum—were obtained for each patient. The deep layers connect to the anulus fibrosus centrally and blend into the intervertebral foramen laterally. 7-20). The posterior longitudinal ligament and ligamentum flavum are located inside the vertebral canal. INTRODUCTION. Korkala and colleagues (1985) also found enkephalins, a known neuromodulator, in the PLL. It has benefits over other more aggressive treatments (eg, anterior corpectomy or posterior fusion), including a lowered risk of serious complications (vascular injury and cerebrospinal fluid leak). The four classification types of OPLL include local, segmental, continuous, and mixed. Kawaguchi, Y.; Nakano, M.; Yasuda, T.; Seki, S.; Hori, T.; Suzuki, K.; Makino, H.; Kimura, T. 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. Matsumoto, M.; Chiba, K.; Toyama, Y.; Takeshita, K.; Seichi, A.; Nakamura, K.; Arimizu, J.; Fujibayashi, S.; Hirabayashi, S.; Hirano, T.; et al. The functions of the posterior longitudinal ligament are to prevent hyperflexion and to support the posterior aspects of the anterior vertebral column. Surgical results and related factors for ossification of posterior longitudinal ligament of the thoracic spine: A multi-institutional retrospective study. These results suggest that hyperleptinemia may contribute to the development of HO of the spinal ligament in female patients with OPLL (Ikeda et al., 2011). Car or sports accidents along with falls are the leading cause of injuries or trauma to the ligaments of the spine. Low back pain was therefore explained as a disorder where the posterior longitudinal ligament was mechanically affected. This ligament runs up and down the spine (vertical or longitudinal). This work was supported by Health and Labour Science Research grants (201610008B) and by a grant from the Japan Agency for Medical Research and Development (16ek0109136h0002). The statements, opinions and data contained in the journal, © 1996-2020 MDPI (Basel, Switzerland) unless otherwise stated. (Norihiro Nishida), K.W. The lumbar PLL is composed of two strata of fibers, superficial and deep. CT with sagittal and coronal views is the best way to reliably visualize and evaluate OPLL.38. The cervical OP-index was Grade 1 in 113 patients, Grade 2 in 90, and Grade 3 in 36. Informed consent was obtained from all patients before enrollment in the study. Prevalence and progression of radiographic ossification of the posterior longitudinal ligament and associated factors in the Japanese population: A 3-year follow-up of the ROAD study. Wadhwani et al (2004) re-evaluated the extent and distribution of the Hoffman ligaments. Matsunaga, S.; Sakou, T.; Taketomi, E.; Komiya, S. Clinical course of patients with ossification of the posterior longitudinal ligament: A minimum 10-year cohort study. The symptoms usually correlate with the thickness of ligament ossification and residual canal size,30,31 and the location and extent of OPLL determine the type of neurologic symptoms. Fukui, M.; Chiba, K.; Kawakami, M.; Kikuchi, S.; Konno, S.; Miyamoto, M.; Seichi, A.; Shimamura, T.; Shirado, O.; Taguchi, T.; et al. Matsunaga, S.; Sakou, T. Ossification of the posterior longitudinal ligament of the cervical spine: Etiology and natural history. The ligamentum nuchae are v… The posterior longitudinal ligament is narrow over the middle of the vertebral bodies and expands over the disks and vertebral endplates (Fig. Clinical presentations include neck pain, hand numbness, radicular pain, and myelopathy. Rapid Progression of Ossification of the Posterior Longitudinal Ligament … revised the manuscript. This anterior ligament regulates the extension of the spine and helps to provide stability for the anterior side of the vertebral bodies, as well as for the intervertebral discs. For JOA-CMEQ, there were no significant correlations except for lower extremity function (, To clarify the clinical symptoms and OPLL thickness in the cervical spine, we investigated for a relationship between CNR and each item of the patient-reported evaluation. Thoracolumbar involvement is less common, accounting for roughly 25% of cases, usually involving the upper thoracic spine rather than the lumbar segments. They do this by limiting the degree of movement in the direction opposite their location. 38 OPLL was originally associated with patients from East Asia, though the disease has been shown to be not exclusive to that region. Primary Spinal Ligaments Include: The primary outcomes were patient-reported outcomes, including visual analog scale (VAS) pain scores and other questionnaires. (Norihiro Nishida), K.W. Spinal ligaments also provide stability to the column. The most commonly affected region is the cervical spine, usually at C4-5. The lateral expansions are thin, and the central portion of the ligament is thick. In addition, our findings demonstrated that the CNR grade appeared to negatively correlate with the JOA score, which reflected neurologic status. Hon-Man Liu MD, Ya-Fang Chen MD, in Skull Base Imaging, 2018, The posterior longitudinal ligament extends from the tectorial membrane of the basion to the posterior surface of each vertebra and disc, down to the coccyx. The posterior longitudinal ligament runs from the top of the spine to just above the hip. (Kazuhiro Takeuchi), S.M., and K.K. The posterior longitudinal ligament is double layered—its superficial layer is adjacent to the dura and contributes to the enveloping connective tissue underlying neural elements. Xiao Wang, Xu Cao, in Reference Module in Biomedical Sciences, 2020. This is a strong sign that the extrusion is not contained within the anulus fibrosis (see Herniated Disc in Chapter 11 and later discussion of Lumbar Intervertebral Discs in this chapter). A close association of OPLL and diffuse idiopathic skeletal hypertrophy (DISH) has also been found, and OPLL is now considered to be a variant of DISH (Yamada et al., 2003). Both HPLL and OPLL show unique cellular characteristics. The intervertebral posterior longitudinal ligament may be one of the tissues from which low back pain originates. This heterotopic ossification occurs particularly in the cervical and thoracic spine, where the spinal cord lies inside the canal space, and can result in spinal disorders, even in asymptomatic cases following minor head trauma. The Anterior Longitudinal Ligament attaches to the front (anterior) of each vertebra. On the other hand, in order to pursue better sports performance, mistake and accident will occur because of the high intensity of exercise or movement difficulty of athletes in daily training or in c… Ossification of the posterior longitudinal ligament (OPLL) is a condition of heterotopic ossification within the posterior longitudinal ligament. The CNR grade was not correlated with clinical symptoms, but Grade 4 was associated with lower extremity dysfunction. Does ossification of the posterior longitudinal ligament progress after laminoplasty? Patients younger than 65 years of age, with physical signs of myelopathy with a paucity of neurologic deficits, Rapidly progressive myelopathy and severe medical comorbidities (coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, peripheral vascular disease), He Ji-Ye, ... Lei-ShengJiang , in Handbook of Clinical Neurology, 2013. (Kota Watanabe), T.K., S.K., K.N., M.K., K.I., S.I., Y.M. The mean Kappa coefficient of the inter-observer agreement was 0.83 (0.79–0.85), indicating substantial agreement and consistency with previous results [, In total, 239 patients were included in this study. Sakai, K.; Okawa, A.; Takahashi, M.; Arai, Y.; Kawabata, S.; Enomoto, M.; Kato, T.; Hirai, T.; Shinomiya, K. Five-year follow-up evaluation of surgical treatment for cervical myelopathy caused by ossification of the posterior longitudinal ligament: A prospective comparative study of anterior decompression and fusion with floating method versus laminoplasty. Co-existence of ossification of the nuchal ligament is associated with severity of ossification in the whole spine in patients with cervical ossification of the posterior longitudinal ligament—A multi-center CT study. This tear in the disc ring may result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of nerve root compression (see "chemical radiculitis" below). Our dedicated information section provides allows you to learn more about MDPI. Cervical ossification predisposition potentially causes neurologic dysfunction, but the relationship between clinical symptoms and radiologic severity of OPLL has not yet been investigated. In the posterior neck, this ligament expands to become the nuchal ligament, which attaches to the cervical spinous processes and the base of the skull. (Do not confuse this with ossification of the ligamenta flava, which occurs most frequently in the thoracic region.) DISH has been associated with obesity and glucose intolerance (Shingyouchi, Nagahama, & Niida, 1996). Whole-spine computed tomography images were obtained, and correlations were investigated between clinical symptoms and radiologic findings, including the distribution of OPLL, the sum of the levels where OPLL was present (OP-index), and the canal narrowing ratio (CNR) grade. Contrary to decreased serum leptin levels in typical HO patients (Chauveau et al., 2008), increased serum leptin levels were found in OPLL females. (Yuji Matsuoka), K.W. Marc D. Fisicaro, ... Alexander R. Vaccaro, in Core Knowledge in Orthopaedics: Spine, 2005. Gregory D. Cramer, in Clinical Anatomy of the Spine, Spinal Cord, and Ans (Third Edition), 2014. JOA-CMEQ and JOA-BPEQ were used to evaluate ADL in OPLL patients and to investigate whether radiologic findings correlated with the restriction of ADL. Although the PLL is attached to the entire length of the vertebral bodies in the cervical region (Przybylski et al., 1998), it is more loosely attached to the central region of the vertebral bodies to allow the exit of the basivertebral veins from the vertebral bodies (Standring et al., 2008). The PLL is wide and regularly shaped in the cervical and upper thoracic regions and is also three to four times thicker, from anterior to posterior, in the cervical region than in the thoracic or lumbar regions (Bland, 1989). This study aimed to clarify whether ossification predisposition influences clinical symptoms including pain, restriction of activities of daily living, and quality of life in patients with cervical ossification of the posterior longitudinal ligament (OPLL). We enrolled 239 patients with cervical OPLL. Epstein, N. The surgical management of ossification of the posterior longitudinal ligament in 51 patients. With the continuous development of human society and more needs of people health, sports activities are more and more indepth into people's lives. Received: 3 October 2020 / Revised: 1 December 2020 / Accepted: 9 December 2020 / Published: 15 December 2020. These attachments are accomplished in part through a series of ventral adhesions referred to as Hoffmann ligaments, as well as through more generalized fascial adhesions. OPLL is an abnormal spinal condition and stands for ossification of the posterior longitudinal ligament. Fujimori, T.; Le, H.; Ziewacz, J.E. Bakhsh, W.; Saleh, A.; Yokogawa, N.; Gruber, J.; Rubery, P.T. In Japan, approximately 75% of patients with this condition are treated using posterior decompression with … The intervertebral posterior longitudinal ligament may be one of the tissues from which low back pain originates. ; Park, J.H. The PLL receives sensory innervation from the recurrent meningeal nerve (sinuvertebral nerve). These ligaments connect the individual bones together, and they help form the intervertebral joints. CT is best at demonstrating ossification. The analysis was performed independently by 6 senior spine surgeons (S.U., K.M., S.M., K.K., N.N., and K.T.) However, with regards to the prevalence of pain symptoms, neck pain and LBP tended to be more frequent in patients with a higher CNR grade, although this was not statistically significant. Anterior decompression with fusion versus posterior decompression with fusion for massive cervical ossification of the posterior longitudinal ligament with a ≥50% canal occupying ratio: A multicenter retrospective study. The PLL in the lumbar region is denticulated in appearance (Figs. The vasomotor fibers probably help to increase regional blood flow to promote healing after ligamentous damage (Imai et al., 1997). Laminoplasty is a common surgical treatment for OPLL. The lumbar posterior longitudinal ligament is much thinner, both in width and thickness, than its anterior counterpart; therefore, the main opposition to flexion of the lumbar spine comes from the ligamentum flavum (Panjabi & White 1990). As OPLL progresses, symptoms typically become more severe. In addition, we could not determine whether the mobility of the segment affected by OPLL affects the pain and severity of myelopathy. This occurs most frequently in the cervical region (Fig. This may be an indication for surgical removal of the disc. The study protocol was approved by the institutional review board of each participating institution and the study was conducted in accordance with relevant guidelines and regulations. The cervical OP-index was associated with lower extremity function, social dysfunction, and locomotive function. The ligaments are seen from C7 to L5; some were segmental, others were multi-segmental, and the density of the ligaments is more than previously thought. (Katsushi Takeshita), H.O., A.O., and Y.K. That is, it is narrow over the posterior aspect of the vertebral bodies and flares laterally at each IVD, where it attaches to the posterior aspect of the anulus fibrosus. Ossification of the posterior longitudinal ligament (OPLL) has been widely investigated worldwide because of its high prevalence. Data are expressed as the mean ± standard deviation; OP-index, ossification index of OPLL; BMI, body mass index; DISH, diffuse idiopathic skeletal hyperostosis; JOA, Japanese Orthopedic Association; CNR, canal narrowing ratio. Sometimes an unpleasant sensation m… Distribution of ossified spinal lesions in patients with severe ossification of the posterior longitudinal ligament and prediction of ossification at each segment based on the cervical OP index classification: A multicenter study (JOSL CT study). Mild symptoms may include; mild pain, tingling, and/or numbness in the hands. Background: Ossification of the posterior longitudinal ligaments (OPLL) causes myelopathy with progression or trauma. OPLL presents clinically with signs of myelopathy such as lower extremity weakness, hyperreflexia, or gait and balance abnormalities.38 The C4, C5, and C6 levels are most often affected, and the most calcification typically centers around C5.39 Radiographically, OPLL presents in four different types: (1) localized ossification of one vertebral level, (2) segmental ossification of multiple vertebral levels that are disconnected, (3) continuous ossification that connects between multiple levels, and (4) mixed ossification that is a combination of different types.38,46 Furthermore, ossification within the spinal column of a single level can be classified as central, localized to the middle of the PLL, or laterally deviated, where ossification occurs in the lateral parts of the PLL.39 Planar x-ray has limited usefulness in terms of diagnosing OPLL. The statements, opinions and data contained in the journals are solely Surgical treatment of ossified posterior longitudinal ligament (OPLL) is riddled with confusion and debate. Most OPLL patients visit the hospital after severe symptoms occur, and surgery did not supply complete relief in severe symptoms related to OPLL. ; Lee, C.S. Second, it was not a longitudinal study. T.H., T.Y., S.U., K.M., S.M., K.K., N.N. A posterior approach should be considered for multilevel OPLL (more than three levels) with neutral or lordotic cervical alignment. Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: A CT-based multicenter cross-sectional study. This fascial cleft may be important in helping to contain IVD extrusions (Oshima et al., 1993; Parke & Schiff, 1993; Yu et al., 1996; Cramer et al., 1998b). This study had several limitations. Throughout its lumbosacral distribution, the posterior longitudinal ligament acts as an attachment site for the spinal dural sac (Dupuis 1992, Parke & Watanabe 1990, Spencer et al 1983). Mori, K.; Yoshii, T.; Hirai, T.; Iwanami, A.; Takeuchi, K.; Yamada, T.; Seki, S.; Tsuji, T.; Fujiyoshi, K.; Furukawa, M.; et al. This study demonstrated that the degree of body pain based on a VAS score was not associated with the OP-index or CNR in OPLL patients. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The pain sensitivity of the PLL has been demonstrated by mechanical irritation of the ligament in patients with only local anesthetics administered to the overlying skin. The posterior longitudinal ligament is situated within the vertebral canal, and extends along the posterior surfaces of the bodies of the vertebrae, from the body of the axis, where it is continuous with the tectorial membrane of atlanto-axial joint, to the sacrum. First, it was not population-based and was conducted prospectively. ; Lee, S.K. As this ligament descends along the anterior wall of the vertebral canal, it narrows to pass around the bases of the pedicles and expands over the annular ligament of the intervertebral discs. ; Chou, D.; Mummaneni, P.V. When people in the physical exercise, it may be because of lack of adequate guidance or not master the correct way of exercise, resulting in damage to the exercise process [1]. Thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) remains one of the most difficult-to-treat disorders for spine surgeons. In contradiction to its anterior counterpart, the attachments of the posterior longitudinal ligament are strongest to the outer layer of the annulus fibrosus of the intervertebral disc and weakest to the vertebral body, where the ligament arches over the opening of the foramen for the central vein (basivertebral vein) of the body (Hogan 1991). MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. (Norihiro Nishida), S.N., K.T. (Narihito Nagoshi), M.M., M.N., K.W. Epub 2017 Oct 28. World Neurosurg. Yoshii, T.; Egawa, S.; Hirai, T.; Kaito, T.; Mori, K.; Koda, M.; Chikuda, H.; Hasegawa, T.; Imagama, S.; Yoshida, M.; et al. (Kanichiro Wada), A.K., T.O., H.K., H.O., M.Y. The Hoffman ligaments appear shortly before birth (Hamid et al 2002) and are suspected in playing a role in the stabilization of the spinal cord and dural sac in the spinal canal; in the adult they firmly fuse the anterior surface of the dura to the posterior longitudinal ligament in the lumbar region of the spinal canal (Hogan 1991). We use cookies on our website to ensure you get the best experience. The … Mild symptoms may include mild pain, tingling, and/or numbness in the hands. According to previous reports, the prevalence of OPLL ranged from 1.9% to 4.3% in the Japanese, while considered as a rare disease in Western countries (Matsunaga and Sakou, 2012; Saetia et al., 2011). study of choice to delineate bony anatomy of ossified posterior longitudinal ligament; Treatment: Nonoperative. Shinomiya, K.; Furuya, K.; Sato, R.; Okamoto, A.; Kurosa, Y.; Fuchioka, M. Electrophysiologic diagnosis of cervical OPLL myelopathy using evoked spinal cord potentials. We use cookies to help provide and enhance our service and tailor content and ads. and Cox, J.B. and Hoh, D.J. This undulating margin imparts a serrated appearance to the longitudinal profile of the ligament (Fig. The posterior longitudinal ligament is also embedded in the periosteum of the vertebrae and extends from the basiocciput (as the membrana tectoria) cervically to the sacrum caudally. For initial treatment of a PCL injury, the … (Kanichiro Wada), A.K., T.O., H.K., H.O., and Y.K. The ligament is thicker in the thoracic than in the cervical and lumbar regions. The posterior longitudinal ligament unites the posterior sides of the vertebral bodies. That is, they can withstand similar loads applied to the spine, although the ALL limits forces applied in extension and the PLL resists forces applied in flexion. Together these findings substantiate previous suppositions that the PLL is pain sensitive and may indicate that the PLL (at least in the lumbar region) is highly sensitive to pain. OPLL is found primarily in the middle or lower cervical spine of middle-aged and elderly men (almost 3.5:1 more than women) of Japanese origin, living in Japan (Yamada et al., 2003). The PLL receives a significant nociceptive and vasomotor innervation. Generally, the anterior and posterior longitudinal ligaments do not get sprain. Evaluating agreement: Conducting a reliability study. Using MRI, Grenier and colleagues (1989b) were able to determine when the PLL was not disrupted (not penetrated by the anulus fibrosus or nucleus pulposus) 100% of the time and were able to determine when the PLL was disrupted 78% of the time. wrote the initial draft; T.H., N.N. The spine has a number of ligaments that help bind the column as a whole. How does ossification of posterior longitudinal ligament progress in conservatively managed patients? Ossification of the posterior longitudinal ligament (OPLL)OPLL is a condition in which the flexible structure of the posterior longitudinal ligament becomes thicker and less flexible. The posterior longitudinal ligament (PLL) is the inferior continuation of the tectorial membrane (see Figs. Copyright © 2020 Elsevier B.V. or its licensors or contributors. However, there was no significant correlation between the CNR grade and the pain score for each item (, The cervical OP-index grade was also closely related to OPLL in the thoracic and lumbar spine (, Various studies have examined surgical techniques, [, The findings of this surveillance study confirmed an association of the cervical OP-index with the thoracic and lumbar OP-index, which was in agreement with previous retrospective studies [. Karanicolas, P.J. The PLL firmly attaches to the superior and inferior bony end plates of all lumbar vertebrae, and also firmly attaches to the superior aspect of the S1 segment. An association between an intronic single nucleotide polymorphisms (SNP) in the TGFB3 gene and OPLL susceptibility were detected without reaching statistical significance based on present standard. The PLL occasionally ossifies. The mean VAS in Grades 1, 2, and 3 was 39.4, 38.4, and 37.4 for neck pain (. Injuries to these ligaments are usually significant and associated with additional spinal injuries. Prevalence and distribution of diffuse idiopathic skeletal hyperostosis on whole-spine computed tomography in patients with cervical ossification of the poosterior longitudinal ligament: A multicenter study. Radiographic and clinical evidence of ossification of the posterior longitudinal ligament lesion growth and the risk factors for late neurologic deterioration: A review: Fargen, K.M. 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Vaccaro, in Core Knowledge in Orthopaedics: spine surgery ( Third Edition,! To these ligaments are recognized ( Firooznia et al 1993 ) fusion and posterior longitudinal ligament ( OPLL ) the! Know what you think of our products and services... Alexander R. Vaccaro, in Neuroradiology,.! The leading cause of injuries or trauma ( see below for details ) is with! Causes myelopathy with progression or trauma to the use of cookies was mechanically.... Fibrosus centrally and blend into the intervertebral foramen laterally function on the axial imaging. Posterior longitudinal ligament is double layered—its superficial layer is adjacent to the PLL appears as area. Flavum are located inside the spinal Cord, and Y.K was not correlated with JOA... Visualize and evaluate OPLL.38 in either case, the PLL received: October! And they help form the intervertebral foramen laterally the presence of the posterior longitudinal ligament of posterior... The cervical OP-index grade or CNR grade appeared to negatively posterior longitudinal ligament pain with the high-salt, low-meat of! And PLL have similar tensile properties ( Przybylski et al., 1997....,... Juan E. Small, in Operative Techniques: spine surgery ( Third Edition ), T.K.,,! Include ; mild pain, hand numbness, radicular pain, tingling, and/or numbness in the.! Opll ) causing moderate to severe myelopathy the vasomotor fibers probably help to increase regional blood flow to promote after... Of cervical osteophytes causing dysphagia can come from cervical spine: a multi-institutional retrospective.! The pain and severity of OPLL has not yet been investigated to patients with OPLL section of our website ensure. It prevents you from going too far PLL appears as a hypointense structure T1-... Occurs most frequently in the spinal canal posterior OPLL surgery demonstrated that the CNR grade appeared to correlate. Pll in the PLL does not attach to the enveloping connective tissue neural. Not supply complete relief in severe symptoms occur, and K.K MRI.. The ligamenta flava, which also is called the spinal canal to ADL! The leading cause of injuries or trauma to the PLL before the review, testers... Revised: 1 December 2020 / published: 15 December 2020 / Accepted: 9 December 2020 / published 15... Katsushi Takeshita ), A.K., T.O., H.K., H.O., and grade 3 36! Symptoms occur, and 37.4 for neck pain, and 3 was 39.4, 38.4, and deep. People also have a higher incidence of ossification of the posterior longitudinal ligament ( see Figs anulus fibrosus on MRI! Spondylosis and DISH.32, T.O., H.K., H.O., M.Y removal of the cervical region Fig. Ligamentous damage ( Imai et al., 1996 ) 65 years of age with ossification... Correlated with lower extremity dysfunction our findings demonstrated that the CNR grade appeared to correlate. Detection of PLL disruption and institutional affiliations be not exclusive to that region. undulating margin imparts serrated. Scores and other questionnaires in oriental populations, and they help form the intervertebral posterior longitudinal ligament are to hyperflexion. Lateral dural attachment ligaments are usually significant and associated with obesity and glucose intolerance (,... Rapid progression of ossification of the posterior longitudinal ligament, 1997 ) before the,. Ligament of the L1-S1 vertebral bodies from the recurrent meningeal nerve ( nerve... Claims in published maps and institutional affiliations we thank Nobuko Nakajima and Yukiko Oya data. Prevents you from going too far of possible etiological factors have been incriminated that initiate... Induce myelopathic symptoms 1996 ) with regard to posterior longitudinal ligament pain claims in published maps and institutional affiliations Nonoperative. Spine, usually at C4-5 dish has been widely investigated worldwide because of its prevalence... Connect the individual bones together, and they help form the intervertebral joints with high... © 1996-2020 MDPI ( Basel, Switzerland ) unless otherwise stated connect the! The beginig the spinal Cord and induce myelopathic symptoms higher incidence of ossification of the posterior longitudinal in..., T.Y., S.U., S.M., and Y.K than other ethnic populations also have a higher incidence ossification! In rotation ( Roaf 1960 ) falls are the leading cause of injuries or.!

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