Cervical ossification of the posterior longitudinal ligament: A case report and literature review

Ossification of the posterior longitudinal ligament (OPLL) is a rare but important cause of cervical myelopathy, characterized by progressive ossification that narrows the spinal canal and compresses the spinal cord. Although more prevalent in East Asian populations, cases are increasingly reported worldwide. We present the case of a 48-year-old Moroccan man with no notable medical history who developed progressive tetraparesis and urinary incontinence. Imaging revealed multilevel cervical OPLL from C2 to C5 with spinal cord compression and myelomalacia. The patient underwent posterior decompressive laminectomy from C2 to C7. Postoperative evolution showed mild right-sided motor improvement, with persistent left-sided deficits and urinary dysfunction. This case underscores the need to consider OPLL in the differential diagnosis of cervical myelopathy, even in non-endemic regions. Early recognition and appropriate surgical intervention are essential to prevent irreversible neurological damage and improve clinical outcomes.