Posterior Longitudinal Ligament (Cervical)

ligamentum longitudinale posterius (cervicale)

The posterior longitudinal ligament lines the anterior wall of the spinal canal, wider at disc levels where it provides central resistance to disc herniation. Ossification of the PLL (OPLL), particularly common in East Asian populations, produces progressive cervical canal stenosis and myelopathy from calcified ligament encroachment on the cord.

Anatomical Data

Attachments

Origin	Posterior aspect of vertebral bodies from C2 to the sacrum (wider at disc levels, narrow at vertebral bodies)
Insertion	Continuous along the posterior vertebral column inside the spinal canal

Biomechanics

Function & Actions

Actions	Resists flexion limits posterior disc herniation centrally the ossification of the PLL produces the most common cause of cervical myelopathy in Asian populations

Limits cervical hyperflexion and reinforces the back of the discs within the spinal canal.

Clinical Relevance

Clinical Notes

OPLL affects up to 3% of East Asian adults and is classified by morphology (segmental, continuous, mixed, circumscribed). Surgical treatment, laminoplasty or corpectomy depending on pattern, decompresses the cord. The PLL must be excised in anterior cervical corpectomy for adequate decompression.

Pathology

Common Injuries & Conditions

OPLL (Ossification of the PLL)

Progressive PLL calcification producing cervical myelopathy managed with laminoplasty or anterior corpectomy decompression.

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