Ossification of Posterior Longitudinal Ligament (OPLL)

Causes of ossification of posterior longitudinal ligament

The exact cause of OPLL is unknown, but it typically occurs when the soft tissues on the spine calcify and narrow the spinal canal. This causes the compression on the nerves in the cervical spinal cord. Research has shown links to hereditary factors, the environment and an individual’s lifestyle.

Risk factors for ossification of posterior longitudinal ligament

There are a variety of factors that lead to ossification of posterior longitudinal ligament including:

• Race — people of Asian descent are more likely to develop OPLL
• Gender — men are more often diagnosed with ossification of posterior longitudinal ligament
• Diabetes — people who suffer from diabetes are more likely to develop OPLL
• Age — OPLL typically occurs in men who are in their 50s and 60s

Symptoms of ossification of posterior longitudinal ligament

At onset, most patients do not experience symptoms from ossification of posterior longitudinal ligament.

Mild symptoms associated with OPLL include:

• Pain
• Numbness in the hands
• Tingling in the hands

As the condition worsens, symptoms gradually intensify. Symptoms of moderate to severe ODLL include:

• Difficulty walking and with bowel and bladder control (symptoms of myelopathy)
• Pain, tingling and numbness in the neck, shoulder, arm or hand (symptoms of cervical radiculopathy)

Diagnosis for ossification of posterior longitudinal ligament

Ossification of posterior longitudinal ligament is diagnosed in a physical exam and with diagnostic imaging. If you have symptoms of OPLL, your Mercy Health spine specialist may order:

• X-ray
• MRI (magnetic resonance imaging) scan
• CT (computed tomography) scan

Treatment for ossification of posterior longitudinal ligament

Your spine doctor will work with you to develop a treatment plan most appropriate for your case. If you have mild to moderate ossification of posterior longitudinal ligament that is not progressing, conservative treatments can be effective. 

Nonsurgical treatments for OPLL include:

• Medications — nonsteroidal anti-inflammatory (NSAIDS) medications are effective in relieving arm pain caused by ossification of posterior longitudinal ligament.
• Activity modification — some patients will experience symptom relief by adjusting their activity level or activities that are causing pain.
• Physical therapy— exercises, as a part of physical therapy, can help relieve the pain associated with OPLL.

If nonsurgical treatments are not successful, you may need spine surgery to prevent any loss of neurological function. Your Mercy Health spine team will evaluate your case and develop the most appropriate treatment plan for you. 

Surgical treatment options may include:

Anterior cervical discectomy and fusion (ACDF)
An anterior cervical discectomy and fusion is a spinal surgery where your spine surgeon will remove a herniated or degenerative disc in the cervical spine (neck). After the disc is removed, your surgeon will fuse the bones of the spine together to stabilize the spine.

Anterior cervical corpectomy with fusion
A anterior cervical corpectomy with fusion is a spinal surgery that is performed to remove bone spurs that are putting pressure on the spinal cord and nerves.

Laminectomy
A spinal surgical procedure where the spine surgeon removes a portion of the lamina (a vertebral bone that helps cover the spinal cord and nerves).

Laminectomy and fusion 
A laminectomy with a spinal fusion is a two-part procedure where a laminectomy is performed followed by a spinal fusion where the vertebrae are fused together to stabilize the spine.

Laminoplasty
A laminoplasty is a spinal surgical procedure where your spine surgeon creates space for the spinal cord and nerve roots. This helps reduce the pressure on the spinal cord. A spinal fusion is not performed with a laminoplasty.