In his latest installment to the Total Spine series of instructional videos, Dr. Paul McCormick describes retropleural thoracotomy, a surgical technique used to treat complex spinal conditions of the thoracic and lumbar spine. “Retropleural thoracotomy is an important...
Ossification of the Posterior Longitudinal Ligament (OPLL)
Ossification: process of changing into a bone or bone-like substance
Ossification of the posterior longitudinal ligament (OPLL) is a condition in which a flexible structure known as the posterior longitudinal ligament becomes thicker and less flexible.
The posterior longitudinal ligament connects and stabilizes the bones of the spinal column. It runs almost the entire length of the spine, from the 2nd vertebra in the cervical spine (neck) all the way down to the sacrum (end of the spine). The ligament is adjacent to the spinal cord.
OPLL most often occurs at the cervical spine (spine in the neck).
Here at The Spine Hospital at the Neurological Institute of New York, we specialize in treating OPLL.
OPLL typically begins with no or mild symptoms. Mild symptoms may include mild pain, tingling, and/or numbness in the hands. OPLL can also cause dysesthesia, an unpleasant sensation that accompanies touch. Sometimes an unpleasant sensation may be present without any touch.
As OPLL progresses, symptoms typically become more severe. If the ligament takes up valuable space within the spinal canal as it thickens, it may compress (squeeze) the spinal cord, producing myelopathy. Symptoms of myelopathy (spinal cord compression) include difficulty walking and difficulty with bowel and bladder control. OPLL may also cause radiculopathy, or compression of a nerve root. Symptoms of cervical radiculopathy include pain, tingling, or numbness in the neck, shoulder, arm, or hand.
The majority of cases will include a slow progression of symptoms, but in some cases, symptoms may suddenly become worse after a mild injury.
|Causes and Risk Factors|
The causes of OPLL are not fully understood. Genetic, hormonal, environmental, and lifestyle factors seem to play a role.
OPLL is usually detected in men in their 50’s and 60’s. It is most common in individuals with Asian, especially Japanese, ancestry.
|Tests and Diagnosis|
If a patient presents with symptoms associated with OPLL, the doctor may order the following diagnostic procedures:
When symptoms are mild and not progressive, OPLL can be addressed with nonoperative measures. Nonoperative treatments may include pain medications, anti-inflammatory medications, anticonvulsants, non-steroidal anti-inflammatory drugs (NSAIDs) and topical opioids.
The surgeon will determine the best treatment for each patient and situation. Treatment decisions will depend on a variety of factors, such as the degree of myelopathy, spinal deformity, and the number of segments involved.
|Preparing for Your Appointment|
Drs. Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine and Patrick C. Reid are experts in treating OPLL. They can also offer you a second opinion.
Helpful Surgery Overviews
Dr. McCormick will choose the treatment method specific to each patient and situation. Some of the condition’s treatment options may be listed below.
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