Ossification Of Posterior Longitudinal Ligament
Ossification of the posterior longitudinal ligament (OPLL) is a medical condition that results in the calcification of the tissues (ligaments) that joint the vertebrae. This problem most commonly affects the neck or the cervical region of the spine. The calcification leads to loss of space between the vertebrae and narrowing of the spinal canal. This condition may lead to some neurologic symptoms in the later stages although it is largely asymptomatic in the initial phase.

Causes

  • The genetic makeup of the person may predispose him/her to the development of this condition. The highest incidence of OPLL has been observed in the Asians.
  • Men are at a greater risk of developing OPLL compared to women
  • Degeneration or herniation of the inter-vertebral discs
  • People suffering from non-insulin dependent diabetes are likely to develop OPLL
  • Past history of having mild neck sprains
  • Long working hours and workers who have late night shifts
  • Men who are middle aged or old
  • Having a BMI (body mass index) of 40 or more

Symptoms

  • The symptoms generally develop gradually and the initial stages may be characterized by mild pain in the back or neck
  • Tingling sensation in upper and lower extremities
  • Unsteady gait due to loss of control over the lower extremities
  • Quadriplegia may be seen in later stages
  • The person may appear clumsy while doing basic manual tasks
  • Numbness may be reported in hands- Parasthesia
  • Discomfort in the hands and arms

Diagnosis

  • Details of the patient’s medical, family history, lifestyle, dietary habits may be taken down
  • Thorough physical examination to check for loss of sensation and coordination in the extremities may be conducted
  • X-ray imaging may be required in most cases to assess the changes in bone structure and exact location of calcification
  • MRI and CT scan may be required to analyze the severity of damage to the surrounding soft tissues besides the posterior ligament
  • The patient may be put under regular observation using the above mentioned techniques in the initial stages of OPLL. This helps in keeping a tab on the progress of the condition

Treatment

  • Prescription of pain killers, anti inflammatory medicines, antidepressants, topical agents and anticonvulsants
  • The patient may be advised bed rest. No activity that pressurizes or causes stress to the spine should be done
  • Use of supportive devices such as back brace, neck collar may be recommended to keep the spine stable

Advanced stages of OPLL are treated through surgical methods. A part of the vertebral bone may be removed or fused to relieve the spinal compression and create space. The aim is to stabilize the spinal cord