Musculoskeletal ImagingPosterior longitudinal ligament
1. Anatomya spinal ligament that extends behind the intervertebral discs and vertebral bodies within the vertebral canal from the axis and membrana tectoria to the sacrum. This ligament is strung like a bow over the central concave portion of the vertebral body. Also, see posterior longitudinal ligament.
2. Pathology
A specific disorder, ossification of the posterior longitudinal ligament or OPLL, with variable clinical manifestations, may occur. Patients may exhibit cord signs, manifested by dominant motor and sensory disturbances in the lower extremity; segmental signs, represented by dominant motor and sensory disturbances in the upper extremity; and cervicobrachialgia, which causes no obvious neurologic deficits but is associated with pain in the neck, shoulder and arm.
The radiographic features of OPLL are characteristic. The cervical spine (and rarely the thoracic and lumbar spine) reveals a dense, ossified strip of variable thickness along the posterior margins of the vertebral bodies and the intervertebral discs (Fig.1). Conventional tomography, CT and MR imaging provide additional diagnostic information.
Because of its coexistence in patients with diffuse idiopathic skeletal hyperostosis DISH , a common cause and pathogenesis are suspected to exist for these two conditions.
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Lateral radiograph of the cervical spine demonstrates longitudinally orientated ossification posterior to the vertebral bodies of C2 and C3 resulting in narrowing of the spinal canal (arrow).
(Courtesy of Louis Santini, MD, Danville, PA)
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Posterior longitudinal ligament, Fig.1 | |