Ossification of the posterior longitudinal ligament (OPLL) with compressive myelopathy

Case contributed by Ammar Haouimi
Diagnosis certain

Presentation

Quadriparesis.

Patient Data

Age: 45 years
Gender: Male
This study is a stack
Sagittal
non-contrast
This study is a stack
Axial
non-contrast
This study is a stack
Sagittal
bone window
This study is a stack
Coronal
bone window
This study is a stack
Axial bone
window
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Info

Extensive ossification of the posterior longitudinal ligament, extending from C2 down up to C4 and with a lesser degree from C5 to T1 level. Marked narrowing of the spinal canal between C2 and C4, measuring 6 mm in sagittal diameter at C4. Also, there is ossification of the anterior longitudinal ligament as well as the alar and transverse ligaments.

This study is a stack
Sagittal
T1
This study is a stack
Sagittal
T2
This study is a stack
Sagittal
STIR
This study is a stack
Axial
T2
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Info

In addition to the ossification of the previously described ligaments, there is compression of the spinal cord mainly at the C3-C4 level with increased STIR and T2 cord signal in keeping with compressive myelopathy.

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