Ossification of the posterior longitudinal ligament

Case contributed by Dr Fakhry Mahmoud Ebouda


40 years old woman of Asian decent. She has pain in the right upper limb and parathesia with numbness in the left hand.

Patient Data

Age: 40 years.
Gender: Female

The lateral plain film shows ossification along the posterior C3 and C6 vertebral bodies. Plain Xr is less sensitive than CT and MRI in detection and identification of OPLL.

MRI shows thickening and ossification of the posterior longitudinal ligament from about C3 through C7. Spinal stenosis is noted with demonstration of ventral cord indentation at C3 to C7.Hypertrophied posterior neural arch element indents the posterior subarachnoid space.

Case Discussion

Ossification of the posterior longitudinal ligament (OPLL)  is typically an entity seen in patients of asian descent, although it is seen in all ethnicities. It is characterized by, as the name suggests, ossification of the posterior longitudinal ligament.  As can be seen in this case MRI and CT are very sensitive and specific studies for this disease with findings sometimes being subtle on plain films. This typically seen in the mid cervical spine and results central canal stenosis, predisposing the patient to cord injury from minor trauma.Its incidence in  cervical - 75%


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Case information

rID: 32764
Published: 13th Dec 2014
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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