From the Guidelines
OPLL is primarily caused by a combination of genetic, metabolic, and mechanical factors, with abnormal calcification and bone formation in the posterior longitudinal ligament of the spine being the underlying mechanism. The exact cause of OPLL remains unclear, but several factors contribute to its development, including genetic predisposition, particularly in East Asian populations, as reported in a study published in the Journal of the American College of Radiology 1.
Key Factors Contributing to OPLL Development
- Genetic factors: OPLL is more common in East Asian populations, suggesting a hereditary component, with certain gene variations related to bone metabolism being associated with its development.
- Metabolic disorders: Conditions like diabetes, obesity, and abnormal calcium metabolism can increase the risk of OPLL.
- Mechanical stress: Occupational activities or trauma that cause mechanical stress on the spine may trigger the ossification process.
- Age and gender: OPLL typically develops in middle-aged and older adults, with men affected more frequently than women, as indicated by a male-to-female ratio of 2:1 1.
Importance of Understanding OPLL Causes
Understanding the causes of OPLL is crucial for identifying at-risk individuals and potentially developing preventive strategies. However, current treatment focuses on managing symptoms and surgical intervention when necessary. The prevalence of OPLL varies, with cervical OPLL being more common than thoracic OPLL, and its prevalence rates ranging from 1.7% in the white United States population to 4.6% in the Korean population, as reported in studies cited in the Journal of the American College of Radiology 1.
From the Research
Causes of OPLL
The causes of Ossification of the Posterior Longitudinal Ligament (OPLL) are multifactorial, involving both genetic and non-genetic factors. Some of the key causes include:
- Genetic factors: OPLL has been shown to have a strong familial link, with multiple candidate genes implicated in its development, including genes for collagen, nucleotide pyrophosphatase, and transforming growth factors 2, 3.
- Non-genetic factors: These include diet, obesity, physical strain on the posterior longitudinal ligament, age, and diabetes mellitus 4, 3.
- Metabolic factors: Hyperinsulinemia and obesity have been linked to OPLL, suggesting a potential role for metabolic factors in its development 3.
- Anatomic factors: The cervical spine is most commonly affected by OPLL, followed by the thoracic spine, suggesting a potential role for anatomic factors in its development 5, 6.
Risk Factors
Several risk factors have been identified for OPLL, including:
- East Asian ethnicity: OPLL is more common in East Asian populations, with prevalence rates of 1.9% to 4.3% reported in Japan 6.
- Family history: A strong familial link has been observed in patients with OPLL, suggesting a potential genetic component to the disease 2, 3.
- Age: OPLL typically develops in older adults, with symptoms often appearing in the 50s or 60s 4, 5.