Biomol Ther  
Molecular Pathophysiology of Ossification of the Posterior Longitudinal Ligament (OPLL)
Dae Cheol Nam1,†, Hyun Jae Lee2,†, Choong Jae Lee3,* and Sun-Chul Hwang1,*
1Department of Orthopaedic Surgery and Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727,
2Smith Liberal Arts College and Department of Addiction Science, Graduate School, Sahmyook University, Seoul 01795,
3Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
E-mail: hscspine@hanmail.net (Hwang SC), LCJ123@cnu.ac.kr (Lee CJ)
Tel: +82-55-750-8102 (Hwang SC), +82-42-580-8255 (Lee CJ)
Fax: +82-55-750-8104 (Hwang SC), +82-42-585-6627 (Lee CJ)
The first two authors contributed equally to this work.
Received: March 8, 2019; Revised: March 31, 2019; Accepted: April 9, 2019; Published online: May 2, 2019.
© The Korean Society of Applied Pharmacology. All rights reserved.

Abstract
Ossification of the posterior longitudinal ligament (OPLL) can be defined as an ectopic ossification in the tissues of spinal ligament showing a hyperostotic condition. OPLL is developed mostly in the cervical spine and clinical presentations of OPLL are majorly myelopathy and/or radiculopathy, with serious neurological pathology resulting in paralysis of extremities and disturbances of motility lowering the quality of life. OPLL is known to be an idiopathic and multifactorial disease, which genetic factors and non-genetic factors including diet, obesity, physical strain on the posterior longitudinal ligament, age, and diabetes mellitus, are involved into the pathogenesis. Up to now, surgical management by decompressing the spinal cord is regarded as standard treatment for OPLL, although there might be the risk of development of reprogression of ossification. The molecular pathogenesis and efficient therapeutic strategy, especially pharmacotherapy and/or preventive intervention, of OPLL has not been clearly elucidated and suggested. Therefore, in this review, we tried to give an overview to the present research results on OPLL, in order to shed light on the potential pharmacotherapy based on molecular pathophysiologic aspect of OPLL, especially on the genetic/genomic factors involved into the etiology of OPLL.
Keywords: OPLL, Pathophysiology, Novel therapeutic approach


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