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Posterior Longitudinal Ligament (Cervical) Detail

ligamentum longitudinale posterius cervicale detail

The posterior longitudinal ligament in the cervical spine lines the posterior vertebral body surfaces within the spinal canal, narrowing over the vertebral bodies and widening over the disc spaces. The cervical PLL is broader than at other spinal levels.

Region: Head & Skull

Biomechanics

Function & Actions

Resists cervical disc herniation posteriorly, limits cervical hyperflexion, reinforces the posterior annulus, and provides the posterior longitudinal continuity from the skull base to the sacrum within the canal.

Clinical Relevance

Clinical Notes

Ossification of the posterior longitudinal ligament (OPLL) is most clinically significant in the cervical spine, producing progressive myelopathy as the ossified bar narrows the cervical canal. OPLL is more prevalent in East Asian populations. Cervical laminoplasty or combined anterior-posterior decompression addresses cervical OPLL myelopathy.

Pathology

Common Injuries & Conditions

Cervical OPLL Myelopathy

Ossified posterior longitudinal ligament narrowing the cervical canal and causing progressive spastic tetraparesis, managed by laminoplasty for multilevel OPLL or anterior corpectomy for focal disease.

PLL Preservation in Anterior Cervical Discectomy

The PLL may be deliberately left intact or removed during ACDF — incomplete posterior decompression leaving PLL often requires supplemental posterior surgery for adequate cord decompression.