Conservative treatment of ossification of the posterior longitudinal ligament in the cervical spine

Abstract

Introduction The pathology of Ossification of the posterior longitudinal ligament (OPLL) is progressive stenosis of the spinal canal [1], which may cause compression myelopathy, radiculopathy, or both. Thus, it is usually recommended that patients with OPLL undergo immediate surgical treatment; conservative treatment is not commonly applied initially [2]. Surgical decompression is also recommended to prevent trauma-induced aggravation of myelopathy or spinal cord injury [3,4] by accidental external force. However, even among patients with large amounts of OPLL, cases have been observed with no incidence of myelopathy or with only mild myelopathy that improved or remained unchanged for a long period after the application of conservative treatment [1,5,6]. Because the indications and role of conservative treatment in OPLL are still obscure, it is important to understand both the natural course of OPLL and the pathology of the myelopathy resulting from OPLL so indications for conservative treatment can be extrapolated. © 2006 Springer.