Key Points about Ossification of Posterior Longitudinal Ligament (OpLL)

  • It is an uncommon condition that affects people of Asian descent. It occurs when the posterior longitudinal ligament becomes rigid and less flexible.
  • The cause is unknown, but genetics, lifestyle, and hormonal factors play a role.
  • Symptoms of OpLL progress very slowly and include numbness, tingling, and mild pain in the arms or legs.
  • OPLL can be diagnosed in a clinic visit with your doctor with a physical exam and diagnostic imaging such as X-ray, MRI, or CT scan.
  • While most patients with OPLL can be treated with medications, physical therapy, or lifestyle changes, some may require surgery.

Overview

Ossification of the posterior longitudinal ligament (OLL) occurs when the posterior longitudinal ligament becomes thicker and less flexible. 

The posterior longitudinal ligament runs the length of the spine and stabilizes the bones of the spinal cord.

OPLL is most common in the cervical spine.

Ossification of Posterior Longitudinal Ligament (OpLL) causes

While the cause of OpLL is not fully understood, lifestyle, environmental, and hormonal factors play a role.

Ossification of Posterior Longitudinal Ligament (OpLL) symptoms

Initially, OPLL patients do not experience symptoms. As the disease progresses, you may experience symptoms such as:

  • Mild pain in the arms or legs.
  • Numbness.
  • Tingling.
  • An unpleasant sensation to touch.

Ossification of Posterior Longitudinal Ligament (OpLL) complications

If left untreated, OpLL could lead to loss of mobility and independence.

Ossification of Posterior Longitudinal Ligament (OpLL) risk factors

There are a variety of factors that increase your risk of developing Ossification of Posterior Longitudinal Ligament (OpLL) including:

  • Gender — Men are more likely to develop OpLL.
  • Age — People in their 50’s and 60’s are most likely to develop OpLL.
  • Ancestry — People of Asian descent, especially Japanese, are most likely to develop OpLL.

Ossification of Posterior Longitudinal Ligament (OpLL) prevention

Although OpLL cannot be prevented in most cases, recent research shows a correlation between sleep patterns and the incidence rate of developing OpLL. Practicing good sleep habits during your middle-aged years has shown to decrease the likelihood of developing OpLL later in life.

Ossification of Posterior Longitudinal Ligament (OpLL) diagnosis

Your doctor can diagnose OpLL during a clinic visit. He or she will take a full medical history, perform a physical exam, and order diagnostic testing such as:

  • X-ray — An X-ray can produce images of the bones to see if you have a bone spur, narrowing in the disc space, vertebral fracture or collapse.
  • CT scan — A CT scan can produce detailed images of the bones and soft tissues.
  • MRI — A magnetic resonance imaging scan can produce detailed images of bones and soft tissues in the body without using radiation.

Ossification of Posterior Longitudinal Ligament (OpLL) treatment

In mild cases of Ossification of Posterior Longitudinal Ligament, nonsurgical methods can help relieve your symptoms. Nonsurgical treatments for OpLL include

  • Medications — Pain medications, anti-inflammatory medications, or non-steroidal anti-inflammatory drugs can help relieve your symptoms.
  • Physical therapy or strengthening exercises.
  • Lifestyle or activity level modifications.

As the disease progresses or the patient starts having trouble walking or shows signs of spinal cord compression, surgery may be necessary. Surgery used to treat OpLL include:

  • Anterior cervical discectomy with fusion.
  • Anterior cervical corpectomy with fusion.
  • Laminectomy.
  • Laminectomy and fusion.
  • Laminoplasty.
  • Combined anterior and posterior approach.

When to Seek Care

If you have any symptoms of OpLL, schedule a visit with your doctor right away. Your doctor will evaluate your case and develop a customized treatment plan for your case. Because severe cases of OpLL can lead to loss of mobility, early intervention is essential.

Next Steps 

Before your doctor's appointment, take notes on your symptoms, when they are most severe, any family history of spine disorders, and any questions you have for the doctor.

If you have been diagnosed with Ossification Of Posterior Longitudinal Ligament (OpLL), follow your doctor’s treatment and recovery instructions closely. 

If your symptoms change or worsen, call your doctor right away.