abnormal calcifications of the spine

see also:

• CT spine - cervical (Cx), thoracic (Tx) or lumbar (Lx)
• ankylosing spondylitis (AS)

• a hyperostotic condition that results in ectopic calcification of the posterior longitudinal ligament
• most common in those from East Asia backgrounds
• four subtypes:
  • continuous
  • segmental
  • mixed
  • localized or other

• genetic factors
  • familial inheritance (genes including BMP4, BMP9, and COL6A1) has been associated with the development of OPLL

• conservative unless develops neurologic symptoms in which case will need neurosurgical Mx

• often seen with Diffuse Idiopathic Skeletal Hyperostosis (DISH) (aka Forestier’s disease)
• mostly observed in the elderly
• large cervical ossifications can make endotracheal intubation extremely difficult during anesthesia; specialized awake fiberoptic intubation techniques are often planned

• gentle stretching and ROM exercises to maintain mobility of spine
• surgery is reserved for rare cases with severe complications such as progressive dysphagia, severe dyspnea, or airway obstruction