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posterior longitudinal ligament pain

The PLL firmly attaches to the superior and inferior bony end plates of all lumbar vertebrae, and also firmly attaches to the superior aspect of the S1 segment. Ossification of spinal ligaments is recognized as a musculoskeletal disorder that often leads to neurological dysfunction. The PLL extends along the posterior surface of the vertebral bodies from the clivus to the sacrum. ; Chou, D.; Mummaneni, P.V. (Yukihiro Matsuyama), K.W. Hypertrophy of the PLL (HPLL) is a distinct condition that is a pathologic thickening of the PLL, and HPLL may or may not be a precursor to OPLL. 2018 Feb;110:11-16. doi: 10.1016/j.wneu.2017.10.105. The cervical OP-index was Grade 1 in 113 patients, Grade 2 in 90, and Grade 3 in 36. The lumbar posterior longitudinal ligament is much thinner, both in width and thickness, than its anterior counterpart; therefore, the main opposition to flexion of the lumbar spine comes from the ligamentum flavum (Panjabi & White 1990). Laminoplasty is a common surgical treatment for OPLL. Thickness and extension of ossified lesions may be associated with lower extremity dysfunction in cervical OPLL. The primary outcomes were patient-reported outcomes, including visual analog scale (VAS) pain scores and other questionnaires. Roentgenographic findings of the developmental process of cervical osteophytes causing dysphagia. Ossification of the posterior longitudinal ligament (OPLL) is commonly seen in oriental populations, and its cause remains obscure. With the continuous development of human society and more needs of people health, sports activities are more and more indepth into people's lives. (Kanichiro Wada), A.K., T.O., H.K., H.O., and Y.K. OPLL is found primarily in the middle or lower cervical spine of middle-aged and elderly men (almost 3.5:1 more than women) of Japanese origin, living in Japan (Yamada et al., 2003). The posterior longitudinal ligament is narrow over the middle of the vertebral bodies and expands over the disks and vertebral endplates (Fig. The superficial fibers form a distinct midline band that spans several vertebral levels. 5-23) and occasionally occurs in the lumbar region. The ligaments are seen from C7 to L5; some were segmental, others were multi-segmental, and the density of the ligaments is more than previously thought. OPLL presents clinically with signs of myelopathy such as lower extremity weakness, hyperreflexia, or gait and balance abnormalities.38 The C4, C5, and C6 levels are most often affected, and the most calcification typically centers around C5.39 Radiographically, OPLL presents in four different types: (1) localized ossification of one vertebral level, (2) segmental ossification of multiple vertebral levels that are disconnected, (3) continuous ossification that connects between multiple levels, and (4) mixed ossification that is a combination of different types.38,46 Furthermore, ossification within the spinal column of a single level can be classified as central, localized to the middle of the PLL, or laterally deviated, where ossification occurs in the lateral parts of the PLL.39 Planar x-ray has limited usefulness in terms of diagnosing OPLL. Sakai, K.; Okawa, A.; Takahashi, M.; Arai, Y.; Kawabata, S.; Enomoto, M.; Kato, T.; Hirai, T.; Shinomiya, K. Five-year follow-up evaluation of surgical treatment for cervical myelopathy caused by ossification of the posterior longitudinal ligament: A prospective comparative study of anterior decompression and fusion with floating method versus laminoplasty. We excluded patients who had undergone anterior decompression surgery or posterior OPLL surgery. Does ossification of the posterior longitudinal ligament progress after laminoplasty? This work was supported by Health and Labour Science Research grants (201610008B) and by a grant from the Japan Agency for Medical Research and Development (16ek0109136h0002). The posterior longitudinal ligament unites the posterior sides of the vertebral bodies. Informed consent was obtained from all patients before enrollment in the study. Find support for a specific problem on the support section of our website. Rapid Progression of Ossification of the Posterior Longitudinal Ligament … The lateral expansions are thin, and the central portion of the ligament is thick. Yoshii, T.; Hirai, T.; Iwanami, A.; Nagoshi, N.; Takeuchi, K.; Mori, K.; Yamada, T.; Seki, S.; Tsuji, T.; Fujiyoshi, K.; et al. performed the statistical analyses. But the ossification can extend from the C3 vertebra and lower levels to the posterior aspect of the C2 vertebra. The symptoms usually correlate with the thickness of ligament ossification and residual canal size,30,31 and the location and extent of OPLL determine the type of neurologic symptoms. A number of possible etiological factors have been incriminated that possibly initiate the formation and growth of OPLL and maturation of clinical symptoms. Ligaments limiting nutation include the sacrospinous, sacrotuberous, anterior capsule, anterior sacroiliac ligament, anterior longitudinal ligament, interosseous ligament, and the short posterior ligaments [1] p62-65 [2] p55-60 and the lower bands of the iliolumbar ligament [3] p545 [4] p52 [5] p45-46. (Kazuhiro Takeuchi), T.F., K.W. This is demonstrated in the illustration below as a torn interspinous ligament; a thinned ligamentum flavum; torn capsular ligaments; and a torn posterior longitudinal ligament. For example, your anterior longitudinal ligament (see below for details) is located in front of your vertebral bodies. Introduction Low back pain (LBP) is the most common cause for chronic or permanent impairment in adults under the age of 65 years, and the most common cause of activity limitations in persons under the age of 45 years 1 . acquired the funding. 7-19 and 7-20). The analysis was performed independently by 6 senior spine surgeons (S.U., K.M., S.M., K.K., N.N., and K.T.) You seem to have javascript disabled. This study demonstrated that the degree of body pain based on a VAS score was not associated with the OP-index or CNR in OPLL patients. (Kei Watanabe), N.N. ; Guyatt, G.H. The functions of the posterior longitudinal ligament are to prevent hyperflexion and to support the posterior aspects of the anterior vertebral column. Of particular interest is the observation that data on load-deformation values for the anterior longitudinal ligament are similar to those data obtained from the ligamentum flavum, suggesting that the two major stabilizing ligaments are balanced in their design (Panjabi & White 1990). Ossification of the posterior longitudinal ligament (OPLL)OPLL is a condition in which the flexible structure of the posterior longitudinal ligament becomes thicker and less flexible. Grades 1, 2, and Ans ( Third Edition ), M.M.,,! 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