The cervical portion of the posterior longitudinal ligament, running posterior to the vertebral bodies and discs within the spinal canal, firmly attached at disc levels and expanded laterally at disc interspaces.
Resists flexion and posterior disc herniation into the canal — the lateral lacunae represent zones of weakness where posterolateral disc herniation most commonly occurs.
OPLL (ossification of the posterior longitudinal ligament) is a common cause of cervical myelopathy in East Asian populations, narrowing the canal progressively. Anterior corpectomy and fusion or posterior laminoplasty decompresses the canal. The hourglass shape of the normal PLL produces lateral lacunae through which disc herniations migrate.
Posterior longitudinal ligament ossification progressively narrowing the cervical spinal canal producing upper motor neuron signs, managed by anterior decompression or posterior laminoplasty.
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