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Review article
Uncorrected Proof. Available online 31 March 2025
Ossification of posterior longitudinal ligament of the cervical spine: A review article
Osificación del ligamento longitudinal posterior de la columna cervical: artículo de revisión
Shengyu Cuia,b,c,d,1, Jinze Lia,b,c,d,1, Xiaoxu Yue, Hongyu Zhaof,
Corresponding author
zhaocmu1974abc@21cn.com

Corresponding author at: Department of Neurosurgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China.
, Fengzeng Jiana,b,c,d
a Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
b Spine Center, China International Neuroscience Institute (CHINA-INI), Beijing, China
c Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
d Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Xuanwu Hospital, Capital Medical University, Beijing, China
e Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
f Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Table 1. Summary of the surgical approaches to ossification of the posterior longitudinal ligament (OPLL) of the cervical spine and its main features.
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Abstract

This article reviews the literature on the status of cervical OPLL in recent years, and reviews the etiology, clinical manifestations, imaging features, treatment and prognosis. Evidence was collected through PubMed and Google Scholar databases. After screening, weight removal and irrelevant articles, 57 articles were finally included in the review. Imaging is the only way to confirm the diagnosis, and CT and MRI are used to assess the patient's ossified material and spinal cord compression. Because there are hundreds of surgical approaches to cervical OPLL, each with advantages and disadvantages, clinicians must develop a personalized surgical plan based on the patient’s preoperative relevant factors to maximize prognosis. Clinicians should also actively follow up on discharged patients, carefully analyze cases with a poor prognosis, and summarize their experiences.

Keywords:
Ossification of posterior longitudinal ligament (OPLL)
Bone morphogenetic proteins
The posterior longitudinal ligament
Cervical vertebra
Review
Resumen

Este artículo realiza un análisis crítico de la literatura científica reciente sobre la osificación del ligamento longitudinal posterior cervical (OPLL), examinando su etiología, manifestaciones clínicas, hallazgos imagenológicos, abordajes terapéuticos y factores pronósticos. La selección de estudios se efectuó mediante una búsqueda sistemática en las bases de datos PubMed y Google Scholar. Tras aplicar criterios de inclusión/exclusión, eliminar duplicados y artículos de baja relevancia metodológica, se integraron 57 publicaciones en esta revisión. Los estudios de imagen —particularmente la tomografía computarizada (TC) y la resonancia magnética (RM)— constituyen herramientas diagnósticas fundamentales para evaluar la extensión de la osificación y el grado de compresión medular. Dada la amplia variedad de técnicas quirúrgicas disponibles para el manejo del OPLL cervical, cada una con indicaciones específicas y perfiles de riesgo-beneficio diferenciados, se enfatiza la necesidad de diseñar estrategias quirúrgicas personalizadas basadas en factores clínicos, radiológicos y características individuales del paciente, con el fin de optimizar los resultados funcionales. Adicionalmente, se subraya la importancia del seguimiento posoperatorio proactivo y el análisis retrospectivo de casos con evolución desfavorable para refinar los protocolos clínicos.

Palabras clave:
Osificación del ligamento longitudinal posterior cervical (OPLL)
Proteínas morfogenéticas óseas (BMP)
Compresión medular cervical
Diagnóstico por imagen
Revisión sistemática

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