Unusual Cause of Spinal Stenosis Related to Lumbar Ossification of Posterior Longitudinal Ligament: A Case Report and Literature Review

Abstract

Ossification of the posterior longitudinal ligament (OPLL) is a rare condition characterized by abnormal bone formation in the posterior longitudinal ligament. While more prevalent in individuals of Asian descent, there is a lack of substantial evidence regarding the incidence and management of lumbar OPLL remains poorly documented, and its management is unclear. We present the unique case of a 77-year-old female with a history of T11 vertebroplasty who had concurrent T11 recurrent compression fracture and lumbar OPLL at L1/L2 level, which was confirmed through computed tomography and magnetic resonance imaging examinations, resulting in spinal stenosis following a second fall. Surgical intervention through a posterior approach with decompression alone without OPLL resection for lumbar OPLL and cement-augmented long-segment pedicle screw fixation for recurrent fracture after vertebroplasty successfully alleviated symptoms. This case report emphasizes the importance of considering lumbar OPLL in patients with atypical lumbar calcifications and performing appropriate evaluation and treatment.

Keywords

• case report
• lumbar ossification of the posterior longitudinal ligament
• recurrent fracture after vertebroplasty
• spinal stenosis