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Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. Clinical, neuroradiological and neurophysiological study on 9 cases

The Italian Journal of Neurological Sciences volume 13, pages 767–780 (1992)Cite this article

Abstract

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is considered to be uncommon in western countries, although widely known and studied in Japan. We report on 9 cases of OPLL cervical myelopathy, investigated by x-ray films and cervical CT and by somatosensory evoked potentials. The patients reported spastic tetraparesis, sensory disorders of the limbs and, in one case, sphincter incontinence. Neuroradiological examinations showed that the posterior columns of the spinal cord were more affected than the roots. Our data suggest that OPLL is more frequent in the West than has so far been reported and that combined radiological and neurophysiological investigation ensures correct diagnosis and accurate assessment of the cord impairment.

Sommario

L'Ossificazione del Legamento Longitudinale Posteriore (OPLL) a livello cervicale è una metaplasia considerata di rara osservazione presso le popolazioni occidentali mentre nella popolazione giapponese risulta largamente conosciuta e studiata. Vengono presentati 9 casi di mielopatia cervicale attribuibili a tale patologia, studiati mediante, Rx e TAC cervicale e valutazione neurofisiologica (Potenziali Evocati Somato-Sensitivi).

All'osservazione i pazienti riferivano tetraparesi spastica, disturbi sensitivi agli arti, incontinenza sfinterica in 1 caso. I reperti neurofisologici hanno mostrato una prevalente compromissione dei cordoni posteriori midollari rispetto a danni radicolari. Dai dati raccolti si può concludere che tale patologia è in Occidente più frequente di quanto finora riportato e che lo studio associato radiologico, e neurofisologico permette una corretta diagnosi ed una valida quantificazione della sofferenza midollare.

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Affiliations

  1. Divistone di Neurologia, Ospedali Riuniti di Pietra e Finale Ligure, 17027, Pietra Ligure SV

    Conte L. Del, Tassinari T., Trucco M. & Badino R.

  2. Servizio di Radiologia, Ospedali Riuniti di Pietra e Finale Ligure, 17027, Pietra Ligure SV

    Serrato O.

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Del Conte, L., Tassinari, T., Trucco, M. et al. Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. Clinical, neuroradiological and neurophysiological study on 9 cases. Ital J Neuro Sci 13, 767–780 (1992). https://doi.org/10.1007/BF02229163

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  • DOI: https://doi.org/10.1007/BF02229163

Key Words

  • Myelopathy
  • ossification of the posterior longitudinal ligament
  • somatosensory evoked potentials
  • computed tomography