What movement does the posterior longitudinal ligament prevent?
hyperflexionThe posterior longitudinal ligament runs along the posterior (or back) surface of the vertebral bodies (posterior means toward the back of the body). This ligament is situated within the vertebral canal, and it prevents hyperflexion, which is when bend your spine too far forward.
What is the function of the two longitudinal ligaments of the spine?
Function. Limit extension of the vertebral column and reinforce the intervertebral disc.
What is the main function of anterior and posterior longitudinal ligaments in vertebral column?
The ligamentum flavum, anterior longitudinal ligament (ALL), and posterior longitudinal ligament (PLL) allow the flexion and extension of the spine while keeping the bones aligned.
Does posterior longitudinal ligament prevent hyperflexion?
Posterior longitudinal ligament Compared to the anterior longitudinal ligament, this ligament is much narrower, relatively weaker. It resists hyperflexion of the vertebral column and helps prevent posterior herniation of the nucleus pulposus of an IV disc.
What does the posterior longitudinal ligament limit?
Limits flexion of the vertebral column and reinforces the intervertebral disc.
Where does the posterior longitudinal ligament start?
The posterior longitudinal ligament extends from the tectorial membrane of the basion to the posterior surface of each vertebra and disc, down to the coccyx.
What are anterior and posterior longitudinal ligaments?
The Anterior Longitudinal Ligament attaches to the front (anterior) of each vertebra. This ligament runs up and down the spine (vertical or longitudinal). The Posterior Longitudinal Ligament runs up and down behind (posterior) the spine and inside the spinal canal.
What is the function of the Y of Bigelow ligament?
Description. The iliofemoral ligament (Y-ligament; ligament of Bigelow) is a band of great strength which lies in front of the joint; it is intimately connected with the capsule, and serves to strengthen it in this situation.
What supplies the posterior longitudinal ligament?
Blood Supply and Lymphatics Posterior arteries supply the posterior part of the spinal cord, and the anterior portion receives supply from the anterior spinal artery.
What ligament prevents knee hyperflexion?
The anterior cruciate ligament (ACL)
What ligament is responsible for preventing hyperextension?
It is the posterior cruciate ligament (PCL) that prevents the femur from sliding forward along the tibia. The ACL is the most important ligament to prevent hyperextension of the knee.
What ligament prevents hyperflexion of the hip?
Iliofemoral ligamentIliofemoral ligament – attaches to the anterior iliac spine and acetabular rim (os coxa) and to the intertrochanteric line (femur); it is very strong, and prevents hyperextension of the hip joint when standing.
What are 2 Functions of ligaments?
Hold bones together. Make sure that joints don't twist. Stabilize muscles and bones. Strengthen joints.
What is the annular ligament and its main function?
The annular ligament stabilizes the radial head within the radial notch of the ulna as it rotates during supination and pronation of the forearm.
What is the function of the transverse ligament?
It functions to prevent anterior displacement of the C1 (atlas) over C2 (axis), the main stabilizer for the odontoid process preventing it from posterior migration.
What is the function of Uterosacral ligaments?
The uterosacral ligaments are thick bands of connective tissue that help support your uterus. They travel from the base of your uterus to your lower spine.
What is the treatment for OPLL?
When symptoms are mild and not progressive, OPLL can be addressed with nonoperative measures. Nonoperative treatments may include pain medications, anti-inflammatory medications, anticonvulsants, non-steroidal anti-inflammatory drugs (NSAIDs), and topical opioids.
What is the term for a ligament that becomes thicker and less flexible?
Ossification of the posterior longitudinal ligament (OPLL) is a condition in which a flexible structure known as the posterior longitudinal ligament becomes thicker and less flexible.
Where does OPLL occur?
OPLL most often occurs at the cervical spine (spine in the neck).
What causes OPLL?
The causes of OPLL are not fully understood. Genetic, hormonal, environmental, and lifestyle factors seem to play a role.
What is a plain film x-ray?
X-ray (also known as plain films): test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc, and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse, or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
What is MR imaging?
Magnetic resonance (MR) imaging: a diagnostic procedure that uses a combination of large magnets, radio waves, and a computer to produce detailed images of organs and structures within the body. MR imaging scans use no radiation. They may not be possible in patients with certain implants or devices, such as pacemakers or old aneurysm clips.
What is a CT scan?
Computed tomography (CT) scan: a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
What is ossification of the posterior longitudinal ligament of the spine?
Ossification of the posterior longitudinal ligament of the spine (OPLL) is a condition that is characterized by the calcification of the soft tissues that connect the bones of the spine, which may lead to compression of the spinal cord. Many affected people do not have any signs or symptoms, while others may experience mild pain or numbness in the arms and/or legs. In some cases, OPLL may be associated with other conditions such as genetic diseases (i.e. hypophosphatemic rickets ), endocrine disorders (i.e. acromegaly, hypoparathyroidism ), spondyloarthropathies (i.e. ankylosing spondylitis ), and diffuse idiopathic skeletal hyperostosis. OPLL is most commonly diagnosed in men, people of Asian descent and people over age 50. The exact underlying cause is currently unknown; however, scientists suspect that it is a multifactorial condition that is influenced by several different genetic and environmental factors. The treatment of OPLL depends the severity of the condition and the signs and symptoms present in each person. If more conservative treatments such as NSAIDs are not effective, surgery may be necessary. [1] [2] [3]
What is PubMed ossification?
PubMed is a searchable database of medical literature and lists journal articles that discuss Ossification of the posterior longitudinal ligament of the spine. Click on the link to view a sample search on this topic.
What is the HPO database?
People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources.
Why do we post questions on GARD?
Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.
What is Mendelian inheritance in man?
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
What is a GTR?
The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.
What to do if you can't find a specialist?
If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.
What ligaments are in the posterior aspect of the spine?
The posterior longitudinal ligament is one of the three more important ligaments that contribute to stability in the spine. It runs along the posterior aspect of the vertebral body inside the vertebral canal from the body of the axis to the sacrum. The ligament is composed of longitudinal fibers that are denser than the anterior longitudinal ligament. However, like the anterior longitudinal ligament, the denser fibers are deeper and span one vertebra while the superficial fibers span three to four. The superficial layer is a continuation of the tectorial membrane at the axis, and the deep layer is a continuation of the cruciform ligament at the atlas.
Which ligament is thinner, the anterior or posterior longitudinal ligament?
This phenomenon is more visible in the posterior ligament than the anterior. Therefore, the posterior longitudinal ligament is much thinner than the anterior longitudinal ligament, which is significant for the pathophysiology of disc herniations occurring posterolateral.
Which ligament runs along the posterior aspect of the vertebral body inside the vertebral canal from the body of the?
The posterior longitudinal ligament is one of the three more important ligaments that contribute to stability in the spine. It runs along the posterior aspect of the vertebral body inside the vertebral canal from the body of the axis to the sacrum. The ligament is composed of longitudinal fibers tha …
What is the PLL of the lumbar region?
The PLL in the lumbar region is denticulated in appearance (Figs. 7-19 and 7-20). 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. The lumbar PLL is composed of two strata of fibers, superficial and deep. The superficial fibers form a distinct midline band that spans several vertebral levels. The deep fibers are much shorter, and they converge on the IVD and extend laterally to the wide attachment sites of the PLL to the anulus fibrosus of the IVD (Parke & Schiff, 1993 ).
How do oplls form?
OPLL lesions form through a combination of membranous and endochondral ossification [15]. These processes are potentially preceded by a period of ligamentous hypertrophy [8]. Pathologically, OPLL consists of lamellar bone with mature Haversian canals, in addition to fibrous cartilage and woven bone wrapped with calcified cartilage [16]. Ossification typically begins at the attachment of the PLL and lateral vertebral body with subsequent progression along the rostro-caudal axis. Neuronal degeneration, which results from prolonged pressure of OPLL foci on the cord or nerve roots, is highly variable and dependent on the specific lesion location [8]. The vast majority of cases—over 80% in some studies [17] —impact the cervical PLL. OPLL results in myelopathy (caused by spinal cord compression) considerably more often than radiculopathy (caused by nerve root compression). Pathologically, cord compression yields necrosis of the gray matter, decrease in anterior horn cell number and demyelination of white matter. Degree of cord compression and observed gray matter injury generally correspond with the severity of myelopathy [15].
What is OPLL in Japan?
OPLL is one of the major causes of cervical compressive myelopathy in Japan and is often associated with cervical spondylosis.
What is the posterior longitudinal ligament?
The posterior longitudinal ligament (PLL) is the inferior continuation of the tectorial membrane (see Figs. 5-17 and 5-22). It courses from the posterior aspect of the body of C2, inferiorly to the sacrum, and possibly to the coccyx (Behrsin & Briggs, 1988 ). The ALL and PLL have similar tensile properties ( Przybylski et al., 1996). That is, they can withstand similar loads applied to the spine, although the ALL limits forces applied in extension and the PLL resists forces applied in flexion. The PLL is wide and regularly shaped in the cervical and upper thoracic regions and is also three to four times thicker, from anterior to posterior, in the cervical region than in the thoracic or lumbar regions (Bland, 1989). Its superficial fibers span several vertebrae, and its deep fibers course between adjacent vertebrae. Panjabi and colleagues (1991b) found the cervical PLL to be firmly attached to both the vertebral bodies and the IVDs, whereas Bland (1989) found the PLL to have a stronger discal attachment. In either case, the PLL probably functions to help prevent posterior IVD protrusion. Although the PLL is attached to the entire length of the vertebral bodies in the cervical region ( Przybylski et al., 1998 ), it is more loosely attached to the central region of the vertebral bodies to allow the exit of the basivertebral veins from the vertebral bodies ( Standring et al., 2008 ). The PLL in the middle and lower thoracic and lumbar regions differs from the PLL in the cervical region in that it becomes narrow over the vertebral bodies and then widens considerably over the IVDs in the thoracic and lumbar areas.
How to tell if PLL is epidural space?
Remember that the PLL has two layers—a very tough anterior layer containing longitudinal fibers and a thin, transparent posterior layer closely resembling the dura. Sometimes the posterior layer may be mistaken for the dura. To make sure that the exposed membrane is in fact the dura, a Penfield No. 4 dissector is inserted between the dura and the overlying membrane. If the dissector moves smoothly between the two layers, the space is epidural space. When the epidural space is confirmed, the PLL is excised piecemeal using a small Kerrison rongeur. When the dura is tightly adherent to the thickened PLL or the OPLL, it may be torn during the PLL removal, and the underlying arachnoid space and the cord may be seen.
What nerve innervates the PLL?
The PLL receives sensory innervation from the recurrent meningeal nerve (sinuvertebral nerve). Substance P, a known sensory neurotransmitter that is usually associated with pain sensation, has been found in the terminal fibers of the sinuvertebral nerve innervating the lumbar PLL. Korkala and colleagues (1985) also found enkephalins, a known neuromodulator, in the PLL. Together these findings substantiate previous suppositions that the PLL is pain sensitive and may indicate that the PLL (at least in the lumbar region) is highly sensitive to pain. The pain sensitivity of the PLL has been demonstrated by mechanical irritation of the ligament in patients with only local anesthetics administered to the overlying skin. The pain was felt in the midline and radiated into the low back and superior aspect of the buttock ( Edgar & Ghadially, 1976 ).
Where is OPLL found?
OPLL is found primarily in the middle or lower cervical spine of middle-aged and elderly men (almost 3.5:1 more than women) of Japanese origin, living in Japan ( Yamada et al., 2003 ). Japanese people also have a higher incidence of ossification of other spinal ligaments than other ethnic populations.
What is the complaint of a 58 year old man?
A 58-year-old man had a chief complaint of mild neck pain and bilateral hand paresthesias. His upper extremity paresthesias had become worse over the previous 6 months and no longer responded to nonsteroidal antiinflammatory drugs. The paresthesias were constant and did not change with alteration of arm or head position. He reported no gait abnormalities or bowel or bladder dysfunction. When questioned, he commented that he frequently drops objects and said that he wears pullover shirts due to difficulty with buttons.
What is the posterior longitudinal ligament?
The posterior longitudinal ligament (PLL) is the inferior continuation of the tectorial membrane (see Figs. 5-17 and 5-22). It courses from the posterior aspect of the body of C2, inferiorly to the sacrum, and possibly to the coccyx (Behrsin & Briggs, 1988 ). The ALL and PLL have similar tensile properties ( Przybylski et al., 1996). That is, they can withstand similar loads applied to the spine, although the ALL limits forces applied in extension and the PLL resists forces applied in flexion. The PLL is wide and regularly shaped in the cervical and upper thoracic regions and is also three to four times thicker, from anterior to posterior, in the cervical region than in the thoracic or lumbar regions (Bland, 1989). Its superficial fibers span several vertebrae, and its deep fibers course between adjacent vertebrae. Panjabi and colleagues (1991b) found the cervical PLL to be firmly attached to both the vertebral bodies and the IVDs, whereas Bland (1989) found the PLL to have a stronger discal attachment. In either case, the PLL probably functions to help prevent posterior IVD protrusion. Although the PLL is attached to the entire length of the vertebral bodies in the cervical region ( Przybylski et al., 1998 ), it is more loosely attached to the central region of the vertebral bodies to allow the exit of the basivertebral veins from the vertebral bodies ( Standring et al., 2008 ). The PLL in the middle and lower thoracic and lumbar regions differs from the PLL in the cervical region in that it becomes narrow over the vertebral bodies and then widens considerably over the IVDs in the thoracic and lumbar areas.
What is the PLL of the lumbar region?
The PLL in the lumbar region is denticulated in appearance (Figs. 7-19 and 7-20). 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. The lumbar PLL is composed of two strata of fibers, superficial and deep. The superficial fibers form a distinct midline band that spans several vertebral levels. The deep fibers are much shorter, and they converge on the IVD and extend laterally to the wide attachment sites of the PLL to the anulus fibrosus of the IVD (Parke & Schiff, 1993 ).
Where is the PLL located?
The PLL extends along the posterior surface of the vertebral bodies from the clivus to the sacrum. Although OPLL may involve any portion of the PLL, by far the most common anatomic location is the cervical spine—accounting for approximately 75% of cases. The process typically involves 2.5 to 4 levels beginning at approximately C3/C4 and progressing distally to involve C4/C5 and C5/C6, although generally sparing C6/C7. Thoracolumbar involvement is less common, accounting for roughly 25% of cases, usually involving the upper thoracic spine rather than the lumbar segments.
Is ossification of the posterior longitudinal ligament a HO?
Ossification of the posterior longitudinal ligament (OPLL) of the spine is considered as a special type of HO . Contrary to decreased serum leptin levels in typical HO patients (Chauveau et al., 2008), increased serum leptin levels were found in OPLL females. Serum leptin levels were significantly higher in patients in whom OPLL extended to the thoracic and/or lumbar spine than in patients in whom OPLL was limited to the cervical spine, and correlated positively with the number of involved vertebrae. These results suggest that hyperleptinemia may contribute to the development of HO of the spinal ligament in female patients with OPLL (Ikeda et al., 2011 ).
What is the narrow ligament that covers the basivertebral veins?
The posterior longitudinal ligament is narrow at the vertebral bodies, where it covers the basivertebral veins, and widens at the intervertebral disc space. It is generally quite wide and thin.
What is the name of the ligaments that run vertically at the center of the vertebrae?
Posterior longitudinal ligament. Posterior longitudinal ligament, in the thoracic region. (Posterior longitudinal ligament runs vertically at center.) Median sagittal section of two lumbar vertebrae and their ligaments.
Where is the posterior longitudinal ligament located?
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.
Which ligament weakly prevents hyperflexion of the vertebral column?
The posterior longitudinal ligament weakly prevents hyperflexion of the vertebral column. It also limits spinal disc herniation, although it is much narrower than the anterior longitudinal ligament.
Which ligament is narrow at the vertebral bodies?
In the thoracic and lumbar regions, it presents a series of dentations with intervening concave margins. The posterior longitudinal ligament is narrow at the vertebral bodies, where it covers the basivertebral veins, and widens at the intervertebral disc space.
Where is the median sagittal section of the lumbar vertebrae?
(Posterior longitudinal ligament runs vertically at center left.) 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 ...
Which ligaments cause back pain?
The posterior longitudinal ligament contains a higher density of nociceptors than many ligaments, so can cause back pain. It may ossify, particularly around cervical vertebrae.
What is ossification of posterior longitudinal ligament?
Ossification of the posterior longitudinal ligament, also referred to as OPLL, is a spinal condition where the posterior longitudinal ligament becomes calcified and less flexible. The posterior longitudinal ligament runs the entire length of the spine from the neck to the end of the spine and stabilizes the spinal column bones.
What is the procedure to fuse the bones of the spine together?
After the disc is removed, your surgeon will fuse the bones of the spine together to stabilize the spine. Anterior cervical corpectomy with fusion. A anterior cervical corpectomy with fusion is a spinal surgery that is performed to remove bone spurs that are putting pressure on the spinal cord and nerves. Laminectomy.
What causes OPLL in the cervical spine?
The exact cause of OPLL is unknown, but it typically occurs when the soft tissues on the spine calcify and narrow the spinal canal. This causes the compression on the nerves in the cervical spinal cord. Research has shown links to hereditary factors, the environment and an individual’s lifestyle.
What is the procedure to remove a herniated disc in the neck?
Surgical treatment options may include: An anterior cervical discectomy and fusion is a spinal surgery where your spine surgeon will remove a herniated or degenerative disc in the cervical spine (neck). After the disc is removed, your surgeon will fuse the bones of the spine together to stabilize the spine.
What is the procedure called when you have a spinal cord fusion?
Laminoplasty. A laminoplasty is a spinal surgical procedure where your spine surgeon creates space for the spinal cord and nerve roots. This helps reduce the pressure on the spinal cord. A spinal fusion is not performed with a laminoplasty.
What is the procedure called when the vertebrae fuse together?
Laminectomy and fusion. A laminectomy with a spinal fusion is a two-part procedure where a laminectomy is performed followed by a spinal fusion where the vertebrae are fused together to stabilize the spine. Laminoplasty.
What age does OPLL occur?
Age — OPLL typically occurs in men who are in their 50s and 60s
