A clinico-radiological analysis of 74 cases of ossification of the posterior longitudinal ligament is reported. Eighteen cases (24%) were asymptomatic or only had neck or shoulder pain; 16 cases (22%) showed signs of radiculopathy, and the remaining 40 cases (54%) had myelopathy. Ossification of the posterior longitudinal ligament developed most frequently at C5, and was rare in thoracic and lumbar regions. Ossification of the posterior longitudinal ligament led to stenosis of the spinal canal; more marked stenosis caused clinical myelopathy. The data showed that 30% of stenosis caused by ossification of the posterior longitudinal ligament was critical for the production of myelopathy.
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