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Ossification of the posterior longitudinal ligament

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

75-year-old Asian patient presenting post fall with head strike.

Patient Data

Age: 75 years
Gender: Male

CT Cervical spine

ct

The craniocervical junction is intact. Normal spinal alignment preserved. Vertebral bodies have normal height and alignment. Multilevel degenerative changes with prominent marginal osteophytes. There is ossification of the posterior longitudinal ligament of the spine from C2 to C6 causing moderate canal stenosis at those levels; the ossification is fused from C2 to C3 and discontinuous on the remaining segments. Disc-osteophyte complexes cause moderate to severe foraminal stenosis bilaterally at C3/4, C4/5, C5/6, and C6/7. Ossification of the nuchal ligament from C4 to C6. No overt cervical lymphadenopathy or soft tissue mass lesions. Scarring noted within the right lung apex.

Case Discussion

Imaging features of ossification of the posterior longitudinal ligament (OPLL) along the cervical spine causing a diffuse moderate canal stenosis. Also, there is ossification of the nuchal ligament from C4 to C6, which has been described as associated with OPLL. 

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