All patients through the analysis are involved in sports related activities and cause cervical injury, and X-ray and CT images are … If a patient presents with symptoms associated with OPLL, the doctor may order the following diagnostic procedures: When symptoms are mild and not progressive, OPLL can be addressed with nonoperative measures. An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. Ligaments limiting nutation include the sacrospinous, sacrotuberous, anterior capsule, anterior sacroiliac ligament, anterior longitudinal ligament, interosseous ligament, and the short posterior ligaments [1] p62-65 [2] p55-60 and the lower bands of the iliolumbar ligament [3] p545 [4] p52 [5] p45-46. Posterior Longintudinal Ligament - Lateral view. It most commonly occurs in the cervical spine. Background context: No reports to date have accurately evaluated the management for acute spinal cord injury (SCI) caused by ossification of the posterior longitudinal ligament (OPLL) after minor trauma. What anatomical structure which connects the bodies of vertebrae was hurt? Choose from 61 different sets of term:ligament injury = anterior longitudinal flashcards on Quizlet. Diffuse Idiopathic Skeletal Hyperostosis (DISH), Copyright © 2020 Columbia University Department of Neurological Surgery | Disclaimer | Privacy Policy, Ossification of the posterior longitudinal ligament (OPLL) is a condition in which a flexible structure known as the, connects and stabilizes the bones of the spinal column. Lin RM, Wey KL, Tzeng CC. OPLL can also cause. If the cervical strain ligaments in the neck tear or become damaged, symptoms such as severe pain, tenderness, bruising, a feeling of tearing, swelling, or a muscle spasm with stiffness and soreness in the neck can occur. Our understanding of auto injuries has grown impressively over the last 10 years, when the first detailed analysis of spinal mechanics was done. These are the tectorial membrane, the transverse ligament, and the alar ligaments. No cord or epidural hematoma. Eva Ageberg, Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation — using the anterior cruciate ligament-injured knee as model, Journal of Electromyography and Kinesiology, 10.1016/S1050-6411(02)00022-6, 12, 3, (205-212), (2002). indicated only in patient with mild symptoms who are not candidates for surgery; Operative. OPLL. Patients with ossification of the posterior longitudinal ligament (OPLL) sometimes present with acute spinal cord injury caused by only minor trauma. Based on the level of injury and degree of injury, treatments include a cervical collar, known as a PMT collar, surgery, or a halo vest that keeps the head and shoulders steady and immobile. 7. Although whiplash injuries account for a significant annual cost to society, the exact mechanism of injury and affected tissues remain unknown. : Despite its potentially devastating consequences, there is a lack of information about acute cervical SCI complicated by OPLL. If the ligament takes up valuable space within the spinal canal as it thickens, it may compress (squeeze) the spinal cord, producing, (spinal cord compression) include difficulty walking and difficulty with bowel and bladder control. Ligamentum intertransversus 5. OPLL typically begins with no or mild symptoms. Am J Sports Med. Previous investigations documented injuries to the cervical anterior longitudinal ligament in whiplash. The muscles surrounding the ligaments compensate for the injury which results in painful muscle spasms. Cross MJ, Powell JF. Keywords: Posterior longitudinal ligament, Anterior cervical discectomy, Cervical spine Background Spondylotic disease of the cervical spine is considered a well-known cause of neurological dysfunction. Eur Radiol 2000;10:1812-4. Symptoms of cervical radiculopathy include pain, tingling, or numbness in the neck, shoulder, arm, or hand. 1. MR imaging should be done within 72 hours of the injury for the best chance of accurate diagnosis. 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. Ligaments provide stability of the spine during movement and rest. All these scenarios might be implicated in causing or contributing to a back or neck pain syndrome. Continued Surgery for Posterior Cruciate Ligament Injury. Background: This was a retrospective study of 10 cervical spinal cord injury (CSCI), concomitant with ossification of posterior longitudinal ligament (OPLL), that were treated by the author at Sanglah General Hospital-Bali during 2013-2014. However, surgery may be considered if a patient develops signs or symptoms of myelopathy, such as abnormal reflexes or difficulty walking, or if there is radiographic evidence of injury or ongoing compression of the spinal cord. In particular, the C5–C6 anterior longitudinal ligament sustained distraction magnitudes as high as 2.6 mm during the retraction phase, corresponding to 56% of distraction necessary to result in ligament failure. A ligament can overstretch, become twisted, tear, or break as a result of trauma. At Spine Connection we have regenerative and surgical treatments for all spine conditions. Many ligaments are seen at the craniocervical junction. Ligaments are tough bands of tissue that connect bones. Ossification is a process that can affect many tissues in the body, including several in the spine, such as ligaments, membranes and intervertebral discs. Introduction Ossification of the posterior longitudinal ligament (OPLL) is a slowly progressive disorder that can result in spinal stenosis and myelopathy. Excessive movements such as hyperextension or flexion are limited by ligaments and can prevent certain movements. Ligamentum iliolumbalis 4. Therefore, the surgeon advised surgery to repair torn ACL and meniscus. 4). In the present study, we reviewed our experience of acute cervical cord injury associated with OPLL to understand the pathomechanisms and to provide clinical information for management of this disorder. 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. Matsunaga S(1), Sakou T, Hayashi K, Ishidou Y, Hirotsu M, Komiya S. Author information: (1)Department of Orthopaedic Surgery, Faculty of Medicine, Kagoshima University, Kagoshima, Japan. Background: Ossification of the posterior longitudinal ligaments (OPLL) causes myelopathy with progression or trauma. The most common injury is a complete tear. Ossification of the posterior longitudinal ligament, also known as OPLL, is a potentially serious diagnosis that is usually linked to the existence of cervical central canal stenosis. Treatment decisions will depend on a variety of factors, such as the degree of myelopathy, spinal deformity, and the number of segments involved. Warm-ups and stretching are excellent ways to prepare tendons and ligaments for sporting activity. Long-term followup of posterior cruciate ligament rupture: a study of 116 cases. It has been estimated that nearly 25% of patients with cervical myelopathy will have features of OPLL. 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. OPLL typically presents with none or mild symptoms at the beginig. This was justified by the need to remove compressive structures hidden underneath and to prevent nerve root impingement during extreme flexion/extension or rotation. The ligamentum nuchae are v… Ossification: process of changing into a bone or bone-like substance Posterior: anatomical term meaning “further back in position” Longitudinal: anatomical term that means “traveling long-ways” Ligament: soft tissue that connects and supports the bones of jointsOssification 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. J Am Acad Orthop Surg. METHODS: A 73-year-old man presented with cervicothoracic OPLL with bilateral numbness and clumsiness of his hand, weakness of his lower extremities and severe gait disturbance. Ligaments and tendons are fibrous tissues made up of collagen fibers. Longitudinal Ligaments Causing Back or Neck Pain. At the level of the intervertebral discs, it attaches tightly to the posterior surface of the anuli of the discs. They consist of the posterior ligament and the anterior ligament. Surgical treatment is a matter of controversy. 2002 May. Car or sports accidents along with falls are the leading cause of injuries or trauma to the ligaments of the spine. AU - Stuart, Michael J. Y1 - 1999/4. MRI confirms anterior paravertebral hematoma at C2 to C4 level, with disruption of the anterior longitudinal ligament at C3-C4 level. For example, your anterior longitudinal ligament (see below for details) is located in front of your vertebral bodies. A reconstructed sagittal CT image (3) performed one week prior to the MR is available for correlation. Posterior longitudinal ligament (PLL): Is a much narrower ligament that runs along the posterior aspect of the vertebral bodies, or alternatively, along the anterior aspect of the vertebral canal (the canal is made up of all of the vertebral foramen stacked on top of one another). Injured ligaments that lead to spinal instability may require surgery. The ligament is thicker in the thoracic than in the cervical and lumbar regions. CT scans are more detailed than general X-rays. The ligament is adjacent to the spinal cord. In the thoracic and lumbar regions, it presents a series of dentations with intervening concave margins. It is a thick ligamentous broad band that extends from the body of C2 to the occipital bone at the anterior margin of the foramen magnum. 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. 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). Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament. Mild symptoms may include; mild pain, tingling, and/or numbness in the hands. The causes of OPLL are not fully understood. Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine and Patrick C. Reid are experts in treating OPLL. Anterior cervical discectomy with fusion (ACDF), Ossification of the Posterior Longitudinal Ligament (OPLL). The present investigation implemented a comprehensiv … The mechanism of whiplash injury may cause damage to both the back (PLL -posterior longitudinal ligament) and front (ALL -anterior longitudinal ligament) ligaments. Patients commonly present in their Ossification of the posterior longitudinal ligament (OPLL)OPLL is a condition in which the flexible structure of the posterior longitudinal ligament becomes thicker and less flexible. It serves as the posterior border of the supraodontoid space or apical cave . Gas-containing "ganglion" cyst of lumbar posterior longitudinal ligament at L3. To review the clinical characteristics of traumatic cervical spinal cord injury (SCI) associated with ossification of the posterior longitudinal ligament (OPLL). Rinsho Seikei Geka 23:467–472 Google Scholar. T1 - A longitudinal examination of athletes' emotional and cognitive responses to anterior cruciate ligament injury. It extends from the back of the sacrum inferiorly and gradually broadens as it ascends. They do this by limiting the degree of movement in the direction opposite their location. Ossification of the posterior longitudinal ligament (OPLL) is an important cause of cervical myelopathy that results from bony ossification of the cervical or thoracic posterior longitudinal ligament (PLL). Spinal Cord Spinal Cord Injury Thoracic Spine Posterior Approach ... Murata S (1988) The results of surgical treatment for thoracic myelopathy due to ossification of the posterior longitudinal ligament: anterior decompression of the thoracic cord through the posterior (in Japanese). We report on a series of patients who were managed with anterior cervical decompression and arthrodesis for the treatment of cervical myelopathy associated with ossification of the posterior longitudinal ligament. These ligaments connect the individual bones together, and they help form the intervertebral joints. Ossification of the posterior longitudinal ligament (OPLL) is a condition of heterotopic ossification within the posterior longitudinal ligament. However, some patients may have knee instability or posterior sag sign. Genetic, hormonal, environmental, and lifestyle factors seem to play a role. They may not be possible in patients with certain implants or devices, such as pacemakers or old aneurysm clips. Its flexibility is strong, the frequency in the physical activity is higher, and the load is heavy . The anterior surface of the vertebral body is reinforced by the anterior longitudinal ligament and the posterior body by the posterior longitudinal ligament (Fig. Anterior longitudinal ligament is stretched or tears, as the head snaps forward and then back again causing a whiplash injury. OPLL may also cause radiculopathy, or compression of a nerve root. Study design/setting: A retrospective study. 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). Cervical vertebral injuries associated with the ossification of the posterior longitudinal ligament: Imaging features Tetsuo Nakayama1,2 and Shigeru Ehara1 Abstract Background: Spinal injuries associated with ossification of the posterior longitudinal ligament (OPLL) have been characterized. 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. Sometimes there is complete healing and in other cases, chronic pain of variable severity results. indications. The degree of injury determines the outcome. The posterior longitudinal ligament runs in the spinal canal attaching to the vertebral bodies and vertebral discs and tightens with cervical flexion. As OPLL progresses, symptoms typically become more severe. The posterior longitudinal ligament is a flexible structure, connecting and stabilizing the bones of the spinal column. Nonoperative treatments may include pain medications, anti-inflammatory medications, anticonvulsants, non-steroidal anti-inflammatory drugs (NSAIDs) and topical opioids. Anterior decompression is the most ideal surgical pro- cedure, because it can achieve direct dissection of the ossified posterior longitudinal ligament and achieve complete spinal cord decompression8. Clinical data In order to study the reliability of MRI detection and diagnosis of the anterior and posterior longitudinal ligament of the lower cervical spine, a retrospective analysis is used to study the injury of the anterior and posterior longitudinal ligament of the lower cervical spine caused by physical exercise in a hospital. The tectorial membrane is the rostral continuation of the posterior longitudinal ligament. Swelling generally appears within a couple of hours. Instability of the spine occurs after trauma when the spinal ligaments lose their ability stay normally aligned between vertebral segments while they are under a normal weight-bearing load. Sometimes an unpleasant sensation may be present without any touch. Spinal ligaments also provide stability to the column. Ligaments connect bone to bone, bone to cartilage, bone to tendons, and attach muscle to bone. 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. As OPLL progresses, symptoms typically become more severe. The posterior longitudinal ligament covers the posterior vertebral bodies with some space for the vascular structures. of the posterior longitudinal ligament (OPLL) Soon Young Kwon1, Jun Jae Shin1*, Ji Hae Lee2 and Woo Ho Cho2 Abstract Background: Ossification of the posterior longitudinal ligament (OPLL) may increase the risk of spinal cord injury (SCI) with various neurological deficits after minor trauma. Summary of Background Data. Previous investigations documented injuries to the cervical anterior longitudinal ligament in whiplash. According to the anatomical structure, it is composed of seven parts. 5-17 and 5-22). The majority of cases will include a slow progression of symptoms, but in some cases, symptoms may suddenly become worse after a mild injury. The three most important ligaments in the spine are the Ligamentum Flavum, Anterior Longitudinal Ligament, and the Posterior Longitudinal Ligament: Car or sports accidents along with falls are the leading cause of injuries or trauma to the ligaments of the spine. Background: Ossification of the posterior longitudinal ligament is commonly associated with cervical myelopathy. The ligament is composed of longitudinal fibers that are denser than the anterior longitudinal ligament. 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. observation. Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic condition that results in ectopic calcification of the posterior longitudinal ligament.1Although most of the studies on OPLL are from East Asia, OPLL can be encountered Symptoms include pain, a popping sound during injury, instability of the knee, and joint swelling. Routine opening of the PLL during ACDF is a necessary step for complete removal of all disk fragments. Le Breton C, Garreau de Luobresse C, Awky J, Khalil A, Sibony M, Judet T, et al. Drs. Symptoms of cervical radiculopathy include pain, tingling, or numbness in the neck, shoulder, arm, or hand. Case report. What ligament is injured in such case? Med Eng Phys. We are here to help. MR imaging scans use no radiation. The surgeon may perform any of the following procedures: The surgeon will determine the best treatment for each patient and situation. Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic condition that results in ectopic calcification of the posterior longitudinal ligament. Injuries to the posterior cruciate ligament and posterolateral instabilities of the knee. Methods. The ligament is adjacent to the spinal cord. A number of possible etiological factors have been incriminated that possibly initiate the formation and growth of OPLL and maturation of clinical symptoms. X-ray (also known as plain films) –test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Surgical treatment of ossified posterior longitudinal ligament (OPLL) is riddled with confusion and debate. CLINICAL ARTICLE Treatment for Thoracic Ossification of Posterior Longitudinal Ligament with Posterior Circumferential Decompression Zhao-wan Xu, MD1, Yong-cheng Hu, MD2, Chui-guo Sun, MD3, Xiao-peng Shang, MSC1, Deng-xing Lun, MD1, Feng Li, MSC1, Xu-bin Ji, MSC1, Da-yong Liu, MSC1, Nai-wang Chen, MSC1, Qing-shan Zhuang, MSC1 1Department of Spine Surgery, Weifang People’s … The present investigation implemented a comprehensiv … the posterior longitudinal ligament.1 Although most of the studies on OPLL are from East Asia, OPLL can be encountered in any patient population. OPLL can also cause dysesthesia, an unpleasant sensation that accompanies touch. OPLL may also cause. 1. L5 radicular pain related to a cystic lesion of the posterior longitudinal ligament. , or compression of a nerve root. This injury occurred 2001 during a Spirit Rock Residential Meditation Retreat. Lower cervical anterior and posterior longitudinal ligament injury. The posterior longitudinal ligament is a long and dense ligament in the spine.It runs from the top of the spine down to just above the hip and traverses the vertebrae of the back. AU - Morrey, Michael A. Although whiplash injuries account for a significant annual cost to society, the exact mechanism of injury and affected tissues remain unknown. 1 Although most of the studies on OPLL are from East Asia, OPLL can be encountered in any patient population. They can also offer you a second opinion. Most OPLL patients visit the hospital after severe symptoms occur, and surgery did not supply complete relief in severe symptoms related to OPLL. If the ligament takes up valuable space within the spinal canal as it thickens, it may compress (squeeze) the spinal cord, producing myelopathy. It runs along the posterior aspect of the vertebral body inside the vertebral canal from the body of the axis to the sacrum. It courses from the posterior aspect of the body of C2, inferiorly to the sacrum, and possibly to the coccyx (Behrsin & Briggs, 1988). The Spine Hospital at the Neurological Institute of New York, we specialize in treating OPLL. Many patients will be asymptomatic and their clinical examination is unremarkable. What is your diagnosis now? 4. Ossification is a process that can affect many tissues in the body, including several in the spine, such as ligaments, membranes and intervertebral discs. 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. The posterior longitudinal ligament is one of the three more important ligaments that contribute to stability in the spine. Together, these strong, fibrous tissues help to regulate the movement of the vertebral column, preventing it from overextending or over-flexing. 2006; 28(6):515-24 (ISSN: 1350-4533) Stemper BD; Yoganandan N; Pintar FA; Rao RD. Herniation of the cervical disk material results in interruption of the posterior longitudinal ligament (PLL) in the majority of patients. Daniel DM, Stone ML, Barnett P, Sachs R. Use of the quadriceps active test to diagnose posterior cruciate-ligament … Watch videos showcasing the latest technologies and surgery techniques, and keep up to date with patient stories from around the globe. The intervertebral posterior longitudinal ligament may be one of the tissues from which low back pain originates. When the posterior longitudinal ligament becomes thicker and less flexible, ossification of the posterior longitudinal ligament occurs. The Posterior Longitudinal Ligament extends up and down behind the spine and inside the spinal canal. Sometimes an unpleasant sensation ma… This is a protective mechanism to prevent further damage or stretching of the ligaments. The posterior longitudinal ligament (PLL) is the inferior continuation of the tectorial membrane (see Figs. The posterior column include all structures dorsal to the posterior longitudinal ligament including the facet articulation, interspinous ligament , ligamentum flavum and superior and inferior articular process (Fig. As previously mentioned, these ligamentous tissues can suffer injury, degenerative laxity, hypertrophy and ossification. Symptoms of myelopathy (spinal cord compression) include difficulty walking and difficulty with bowel and bladder control. Mild symptoms may include mild pain, tingling, and/or numbness in the hands. direct or indirect surgical decompression followed by stabilization. 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 thicker in the thoracic than in the cervical and lumbar regions. On the X –ray photo there are damages of bodies of two lumbar vertebrae. Ligamentum longitudinale anterior 2. Ossification of the posterior longitudinal ligament, also known as OPLL, is a potentially serious diagnosis that is usually linked to the existence of cervical central canal stenosis. There are two primary ligament systems in the spine, the intrasegmental and intersegmental systems: Helpful diagram of ligaments in the Lumbar Spine which can be injured. It is most common in individuals with Asian, especially Japanese, ancestry. The spine has a number of ligaments that help bind the column as a whole. Cervical vertebra refers to the site between the body thoracic and the head. Patients who may be more likely to need surgery include those who have: PCL injuries in which pieces of bone have torn off and become loose Cold packs, massage, physical therapy, and chiropractors can help. INTRODUCTION. Spinal dislocation or slippage (also known as spondylolisthesis). OPLL can also cause dysesthesia, an unpleasant sensation that accompanies touch. Here at The Spine Hospital at the Neurological Institute of New York, we specialize in treating OPLL. Its main functions are to prevent injury by limiting the amount of flexion — or forward flexibility — the back is able to achieve, and to help protect the spinal cord. Ossification: process of changing into a bone or bone-like substance Posterior: anatomical term meaning “further back in position” Longitudinal: anatomical term that means “traveling long-ways” Ligament: soft tissue that connects and supports the bones of joints. 2001 Sep-Oct. 9(5):297-307. . , from the 2nd vertebra in the cervical spine (neck) all the way down to the sacrum (end of the spine). Mild symptoms may include mild pain, tingling, and/or numbness in the hands. The most common anatomic location is the cervical spine, although the process may also involve the thoracic and lumbar regions. study of choice to delineate bony anatomy of ossified posterior longitudinal ligament; Treatment: Nonoperative. Although whiplash injuries account for a significant annual cost to society, the exact mechanism of injury and affected tissues remain unknown. Posterior Longitudinal Ligament. Below is a list of the main ligaments that affect the movement of the vertebral column, along with their locations and their “jobs”, i.e., the direction into which limit excessive movement. Sometimes an unpleasant sensation may be present without any touch. [1,2,3,4,5,6,7] A number of treatment strategies have been suggested. OPLL most often occurs at the cervical spine (spine in the neck). X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. The posterior longitudinal ligament connects and stabilizes the bones of the spinal column. Ligamentum longitudinale posterior 4. Margheritini F, Rihn J, Musahl V, Mariani PP, Harner C. Posterior cruciate ligament injuries in the athlete: an anatomical, biomechanical and clinical review. When you arch back, it prevents you from going too far. OBJECTIVE: To report intraoperative spinal cord injury by resection of spinous processes in a 73-year-old man with ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Hernia- ... Fortunately, accidental dural injury complicated with. Anterior longitudinal ligament (ALL) injuries following whiplash have been documented both in vivo and in vitro; however, ALL strains during the whiplash trauma remain unknown. It runs almost the entire length of the spine. There is a perfectly matched pair of longitudinal ligaments in each spinal anatomy. They can also offer you a second opinion. shunji@m.kufm.kagoshima-u.ac.jp OBJECT: In these prospective and retrospective studies the … Findings include disk extrusion and inferior stripping of posterior longitudinal ligament at C5-6 (1); disk extrusion and tear of posterior longitudinal ligament and annulus fibrosus at C6-7 (2); flaval ligament tear at C6-7 (3); splaying of dorsal spines and interspinous ligament tear at C6-7 (4); fracture of C6 spinous process (5); and mild superior endplate impaction fractures of T1, T2, and T3 vertebral bodies (6). According to previous reports, the prevalence of OPLL ranged from 1.9% to 4.3% in the Japanese, while considered as a rare disease in Western countries (Matsunaga and Sakou, 2012; Saetia et al., 2011). Posterior Cruciate Ligament Injury The posterior cruciate ligament (PCL) is a ligament within the knee. As every case is unique we encourage you to receive and compare opinions from our Neurosurgeon and Orthopedic Spine Specialists. Only three are the major stabilizers. 1984 Jul-Aug. 12(4):292-7. . OPLL is usually detected in men in their 50’s and 60’s. This instability can lead to more injury, pain, or deformity that may require surgical stabilization. Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report Gregory D.Myer, MS* ; … OPLL typically begins with no or mild symptoms. August 24, 2016. Sagittal gradient-echo MR image (TR/TE, 510/35; flip angle, 20°) obtained on 0.3-T MR scanner shows prevertebral edema or hemorrhage (1), posterior longitudinal ligament tear (2), anterior longitudinal ligament tear (3), large traumatic posterior disk extrusion (4), cord contusion and compression (5), posterior paravertebral edema or hemorrhage, and probable interspinous ligament injury (6). 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