What is ligament ossification?
What is ligament ossification?
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.
What is ossification of the spine?
Ossification of the posterior longitudinal ligament of the spine (OPLL) is a condition that is characterized by the calcification of the soft tissues that connect the bones of the spine, which may lead to compression of the spinal cord.
Can OPLL be cured?
OPLL can be treated via an anterior (ie, corpectomy and fusion) or posterior (ie, laminectomy and fusion or laminoplasty) approach, or both. The optimal approach is dictated by the classification and extent of OPLL, cervical spine sagittal alignment, severity of stenosis, and history of previous surgery.
Is OPLL a disability?
T-OPLL is a rare but has a high disability rate disease, which results in intractable myelopathy and radiculopathy, the prevalence of T-OPLL in individuals of Japanese ethnicity is 1.6–1.9%, and the mean age of onset is > 40 years old [1, 2].
What causes ossification?
HO occurs after other injuries, too. HO has been known to occur in cases of traumatic brain injury, stroke, poliomyelitis, myelodysplasia, carbon monoxide poisoning, spinal cord tumors, syringomyelia, tetanus, multiple sclerosis, post total hip replacements, post joint arthroplasty, and after severe burns.
Who gets OPLL?
OPLL is traditionally thought to be more common in Japan with a prevalence of 2 to 4% as compared with 0.01 to 2% in non-Asian populations. Among patients with myelopathy, the prevalence of OPLL is 27% in Japan and 20 to 23% in the United States.
What happens during ossification?
The cartilage cells die out and are replaced by osteoblasts clustered in ossification centres. Bone formation proceeds outward from these centres. This replacement of cartilage by bone is known as endochondral ossification.
Is OPLL a rare disease?
1,2 The association of OPLL with ankylosing spondylitis (AS) is rare; however, this might be relatively common in Japan and its incidence is reported to be 2%.
What causes OPLL?
OPLL is a multifactorial condition caused by ectopic hyperostosis and calcification of the posterior longitudinal ligament. Familial inheritance and genetic factors have been implicated in the etiology of OPLL. The cervical spine is most commonly affected followed by the thoracic spine.
Can OPLL cause paralysis?
Ossification of the posterior longitudinal ligament (OPLL) can cause severe and irreversible paralysis in not only the cervical spine but also the thoracolumbar spine.
How is ossification treated?
Usually, treatment will include gentle range of motion of the joints and some physical therapy. Your doctor may also prescribe medications to slow down or stop the abnormal growth of bone. When HO severely affects your movement or causes excruciating pain, surgery may be needed.
Can Opll cause paralysis?
Which is the most common type of ossification?
Endochondral ossification involves the replacement of hyaline cartilage with bony tissue. Most of the bones of the skeleton are formed in this manner. These bones are called endochondral bones.
Is Opll hereditary?
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.
What is surgery paralysis?
General anesthesia is designed to temporarily cause paralysis, which relaxes the muscles and makes surgery easier for the doctors, but it also means a patient can’t move or talk.
How long is recovery time for neck surgery?
Usually, you will have to remain in the hospital for around two days following this surgery. Further recovery will happen over the next four to six weeks, after which you can return to light activities. Full recovery takes around two to three months.
What is the ossification process?
Bone formation, also called ossification, process by which new bone is produced. Soon after the osteoid is laid down, inorganic salts are deposited in it to form the hardened material recognized as mineralized bone. The cartilage cells die out and are replaced by osteoblasts clustered in ossification centres.
How is OPLL treated?
What is the function of the posterior longitudinal ligament?
The posterior longitudinal ligament runs in the spinal canal attaching to the vertebral bodies and vertebral discs and tightens with cervical flexion.
What is OPLL disease?
OPLL is a calcification of the soft tissues that connect the spinal bones which results in a narrowing of the spinal canal and compression of the cervical spinal cord. The cause of OPLL is unclear at this point, but we know people of Asian heritage especially Japanese have a higher likelihood of developing OPLL.
What is the meaning of ossification?
Ossification: The process of creating bone, that is of transforming cartilage (or fibrous tissue) into bone. “Os” is a synonym for “bone.” The Latin word “os” means “bone” as does the related Greek word “osteon.”
Where is the posterior longitudinal ligament located?
The posterior longitudinal ligament (PLL) is a long and important ligament located immediately posterior to the vertebral bodies (to which it attaches loosely) and intervertebral discs (to which it is firmly attached). It extends from the back of the sacrum inferiorly and gradually broadens as it ascends.
What is thickening of the posterior longitudinal ligament?
Introduction. Although ossification of the posterior longitudinal ligament (OPLL) is a well-known disorder that leads to myelopathy, hypertrophy of the posterior longitudinal ligament (HPLL) is a rare pathological condition. HPLL is defined by thickening of the PLL that compresses the dural tube.
What is an example of ossification?
Intramembranous ossification is the process of bone development from fibrous membranes. It is involved in the formation of the flat bones of the skull, the mandible, and the clavicles. Ossification begins as mesenchymal cells form a template of the future bone.
Where is the ossification of the posterior longitudinal ligament?
Posterior longitudinal ligament (running vertically in the center) in the thoracic region. Ossification of the posterior longitudinal ligament ( OPLL) is a process of fibrosis, calcification, and ossification of the posterior longitudinal ligament of the spine, that may involve the spinal dura.
Do you need surgery for posterior longitudinal ligament?
Conclusion: Anterior, posterior, or circumferential surgery may be warranted to treat patients with cervical OPLL, and must be based on careful patient selection, and both MR and CT documentation of the full extent of OPLL. Keywords: Cervical spine, neurodiagnostic testing, ossification posterior longitudinal ligament, surgery, patient selection
Where does the ossification of the PLL occur?
It is the hypertrophy and ossification that may cause myelopathy secondary to direct spinal cord compression or ischemia. The PLL extends along the posterior surface of the vertebral bodies from the clivus to the sacrum.
Which is better anterior or posterior ossification surgery?
The optimal approach is dictated by the classification and extent of OPLL, cervical spine sagittal alignment, severity of stenosis, and history of previous surgery. Anterior surgery is associated with superior outcomes when OPLL occupies >50% to 60% of the canal, despite increased technical difficulty and higher complication rates.
What causes ossification of ligaments?
Ossification of the posterior longitudinal ligament most commonly occurs in the cervical spine (neck). 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.
What is flowing ossification?
Flowing ossifications are seen in diffuse idiopathic skeletal hyperostosis (DISH). They are defined as heterotopic ossifications involving the anterior longitudinal ligament, paraspinal connective tissues and annulus fibrosus of at least four contiguous vertebral bodies and are originally described on lateral radiographs of the spine.
What is posterior ligament?
Posterior cruciate ligament. The posterior cruciate ligament (PCL) is one of four ligaments that hold the knee in place and provide added stability. More specifically, the PCL helps to ensure proper alignment of the femur and tibia, also called the thighbone and shinbone. Ligaments are fibrous tissue that usually connect bones.
What are the ligaments of the spine?
Three of the more important ligaments in the spine are the Ligamentum Flavum, Anterior Longitudinal Ligament and the Posterior Longitudinal Ligament. The Ligamentum Flavum forms a cover over the dura mater: a layer of tissue that protects the spinal cord. The Anterior Longitudinal Ligament attaches to the front (anterior) of each vertebra.