Neurosurgery Resident Medical College of Georgia North Augusta, SC, US
Disclosure(s):
Christopher Carr, MD, MPH: No financial relationships to disclose
Introduction: Ossification of the posterior longitudinal ligament (OPLL) results from endochondral ossification of the PLL and occurs most frequently in the cervical spine. OPLL patients may be at higher risk for spinal cord injury after trauma. Though the pathogenesis remains poorly understood, OPLL has been poorly characterized outside Asian populations. We aimed to examine the prevalence and characteristics of cervical spine OPLL at our southern, public, Level 1 Trauma and Advanced Comprehensive Stroke Center.
Methods: We used a novel free-text search methodology to identify patients with computed tomography (CT) reports including “ossification/calcification of the posterior longitudinal ligament” who presented from August 2020 through January 2023. We collected demographic, clinical, and radiological variables. We classified patients into circumscribed, segmental, mixed, and continuous OPLL groups and measured spinal stenosis for the mixed and continuous groups.
Results: Of 17091 CT scans performed in the emergency department, 412 (2.4%) patients met inclusion criteria. 254/412 (61.7%) were male. 200/412 (48.5%) were African-American. 191/412 (46.4%) were Caucasian, 6/412 (1.5%) were Asian, and 4/412 (1.0%) were Hispanic. There were 84/412 (20.4%) circumscribed, 200/412 (48.5%) segmental, 37/412 (9.0%) mixed, and 91/412 (22.1%) continuous OPLL patients. Mean minimal spinal canal diameter was 13.7mm with 7.3mm left for the spinal cord once accounting for OPLL (53.3% stenosis) for the mixed group and 13.5mm with 8.1mm left for the spinal cord (60.6% stenosis) for the continuous OPLL group. Patients with OPLL diagnosed by CTA had increased prevalence of hypertension and diabetes.
Conclusion : We report prevalence of OPLL in a southern, rural cohort. To our knowledge, this association has not been reported previously. Further investigation is needed to determine any novel associated genetic or environmental risk factors for OPLL.