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In 2 patients, prominent ossification of the anterior longitudinal ligament and formation of osteophytes were seen at multiple levels, and a so-called diffuse idiopathic skeletal hyperostosis–like spine developed. 1. Anterior longitudinal decompression is a relatively effective procedure in the management of severe ossification of the posterior longitudinal ligament in the cervical spine. It is formed of two layers of fibrous tissue with the deep one sending fibers to the annulus fibrosus. Anterior longitudinal ligament is stretched or tears, as the head snaps forward and then back again causing a whiplash injury. Multisegmental cervical ossification of the posterior longitudinal ligament: Anterior vs posterior approach Subodh K Jain, Pravin S Salunke, KH Vyas, Sanjay S Behari, Deepu Banerji, Vijendra K Jain Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India Findings after anterior resection of ossification of the posterior longitudinal ligament in the cervical spine. Posterior Longitudinal Ligament (n.). Significant OPLL in the cervical spine developed in only 1 patient. BACKGROUND The debate between anterior or posterior approach for pathologies such as cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) have drawn heated debate but are still inconclusive. According to the anatomical structure, it is composed of seven parts. This ligament runs up and down the spine. The ligamentum flavum is 5 mm thick and extends from the anteroinferior border of the lamina above to the upper posterior border of the lamina below. They make the joint stable and yet are configured in such a way as to allow for more than 90 degrees of flexion of the knee. Both crura of the diaphragm connect over the anterior longitudinal ligament within the upper lumbar spine, and some fibres expand in the ligament inside the lower lumbar area. Anterior versus posterior approach for the treatment of cervical compressive myelopathy due to ossification of the posterior longitudinal ligament: A systematic review and meta-analysis Source: PubMed - 19 January 2016 - Publisher: International Journal Of Surgery (london, England) Posterior longitudinal ligament resection in anterior cervical discectomy Ahmad Elsayed Desoukey Elayouty*, Hazem Antar Mashaly and Hatem Adel Sabry Abstract Background: The concept of generous decompression, including resection of the posterior longitudinal ligament (PLL) and even partial bilateral uncovertebral joint resection, has been adopted by some authors. The posterior longitudinal ligament is initially replaced with bony tissue. Ossification of the posterior longitudinal ligament (OPLL) is a disease characterized by heterotopic bone formation classically occurring in the cervical spine. Two extensive fibrous bands running the length of the vertebral columnThe anterior longitudinal ligament (ligamentum longitudinale anterius; lacertus medius) interconnects the anterior surfaces of the vertebral bodies; the posterior longitudinal ligament (ligamentum longitudinale posterius) interconnects the posterior surfaces. Anterior and posterior cruciate ligaments are important to the stability of the knee joint. The posterior longitudinal ligament connects and stabilizes the bones of the spinal column. Four patients had coexisting disc herniation at OPLL intervertebrae. • Other Ligaments: Supraspinal, interspinal and intertransverse. 3. Start studying posterior longitudinal ligament. At the level of the intervertebral discs, it attaches tightly to the posterior surface of the anuli of the discs. 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).. The posterior longitudinal ligament covers the posterior vertebral bodies with some space for the vascular structures. In addition to the extremely common ligament sprains that nearly everyone experiences at some point in his or her life, ligaments can also calcify later in life. OPLL most often occurs at the cervical spine (spine in the neck). That is, it is narrow over the posterior aspect of the vertebral bodies and flares laterally at each IVD, where it attaches to the posterior aspect of the anulus fibrosus. 7-19 and 7-20). doi:10.4184/asj. Background:Intradural disc herniations (IDH) are rare, particularly in the cervical spine, where they account for less than 5% of all discs.Adhesions between the ossified/calcified posterior longitudinal ligament (OPLL), dura, and ossified/calcified disc herniations increase the … Longitudinal Ligaments Ossification of Posterior Longitudinal Ligament Hyperostosis, Diffuse Idiopathic Skeletal Cervical Vertebrae Ligaments Ossification, Heterotopic Ligamentum Flavum Spinal Cord Compression Ligaments, Articular Laminectomy Decompression, Surgical Spinal Cord Diseases Spondylosis Spinal Stenosis Spinal Diseases Spinal Osteophytosis Intervertebral Disc Periodontal Ligament … Schmorl stated that increased tension upon certain fibers of the longitudinal ligaments induces the formation of osteophytes at the vertebral edges (17). Like the anterior longitudinal ligament, the posterior longitudinal ligament starts at the base of the occiput (remember, that’s the base of your skull), and extends all the way to the sacrum. The compression from the ossified mass is one cause of cervical spondylotic myelopathy (CSM) and predisposes patients to spinal cord injury (SCI) 1,2]. ... Belanger, Theodore (2005). J Bone Joint Surg Am 1992;74(2):270–277 PubMed The authors of this study concluded that given the higher risk of dural tears with anterior surgery for OPLL, the surgical plan should always include preparation for a dural tear. Together, these strong, fibrous tissues help to regulate the movement of the vertebral column, preventing it from overextending or over-flexing. 5 (4). They consist of the posterior ligament and the anterior ligament. And like the anterior longitudinal ligament, the posterior branches off into short fibers that traverse the intervertebral joints, and end up, this time, at the back of the disc. Hyperplasia of the fibrocartilaginous tissue may occur in the posterior aspect of the intervertebral disc, extending into the ossified posterior longitudinal ligament. The posterior cruciate ligament (PCL) is a ligament within the knee.Ligaments are tough bands of tissue that connect bones. Its flexibility is strong, the frequency in the physical activity is higher, and the load is heavy . Routine opening of the PLL during ACDF is a necessary step for complete removal of all disk fragments. Lower cervical anterior and posterior longitudinal ligament injury. • Ligamentum nuchae that contains elastic fibers is found in cervical area only. In particular, the C5-C6 anterior longitudinal ligament sustained distraction magnitudes as high as 2.6mm during the retraction phase, corresponding to 56% of distraction necessary to result in ligament failure. Cervical vertebra refers to the site between the body thoracic and the head. Car or sports accidents along with falls are the leading cause of injuries or trauma to the ligaments of the spine. Inferiorly the anterior longitudinal ligament is constant with the anteromedial part of the sacroiliac joint capsule. There is a perfectly matched pair of longitudinal ligaments in each spinal anatomy. The lumbar PLL is composed of two strata of fibers, superficial and deep. "Ossification of the Posterior Longitudinal Ligament".Journal of Bone and Joint Surgery. Herniation of the cervical disk material results in interruption of the posterior longitudinal ligament (PLL) in the majority of patients. 9 Progression of ossification follows an evolutionary process, beginning as endochondral or membranous ossification. 1). It is broader above than below, and thicker in the thoracic than in the cervical and lumbar regions. Both the anterior and posterior longitudinal ligaments run longitudinally along the vertebral body from the cervical spine to the sacrum. The Anterior Longitudinal Ligament connects the front of each vertebra to each other. Anatomically, the posterior longitudinal ligament (PLL) lies on the posterior aspect of the vertebral bodies (Fig. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Ossification of the posterior longitudinal ligament (OPLL) is a process of fibrosis, calcification, and ossification of the ... "Ossification of the Posterior Longitudinal Ligament: A Review of Literature".Asian Spine Journal. The posterior longitudinal ligament they described as narrower and thinner than the anterior longitudinal ligament. Supporting this theory, Beadle assumed that vertebral osteophytes—one of the most common lesions of the spine—are, in reality, ossified fibers of the anterior longitudinal ligament (3). the posterior longitudinal ligament.1 Although most of the studies on OPLL are from East Asia, OPLL can be encountered in any patient population. •Both posterior longitudinal ligament and ligamentum flava lie with neural arch. We performed this review to update spine surgeons on the current state of the art on the etiology, diagnosis, and management of OPLL. A narrative review was performed specifically to study the differences pertaining to OPLL and other causes of degenerative cervical myelopathy (DCM). What Causes Ligament Injuries? The posterior longitudinal ligament is situated within the vertebral canal, and extends along the posterior surfaces of the bodies of the vertebrae, from the body of the axis, where it is continuous with the tectorial membrane of atlanto-axial joint, to the sacrum.. The ligament is adjacent to the spinal cord. The PLL in the lumbar region is denticulated in appearance (Figs. It extends from the back of the sacrum inferiorly and gradually broadens as it ascends. The Posterior Longitudinal Ligament extends up and down behind the spine and inside the spinal canal. *P = 0.020 vs Control, Wilcoxon two-sided rank-sum test ranging from the cervical vertebrae to the posterior longitudinal or yellow ligament of the thoracic vertebra, further causing ossification of the posterior longitudinal ligament of the lumbar vertebra and occasionally resulting in spinal cord compression and then paraplegia. Lumbar Posterior Longitudinal Ligament. It runs almost the entire length of the spine, from the 2nd vertebra in the cervical spine (neck) all the way down to the sacrum (end of the spine). Covers the posterior longitudinal ligament extends up and down behind the spine and inside the spinal.... 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