50 yo/M patient presents with non-specific neck disomfort.
No prior trauma, surgeries, carcinoma orcorticosteroid/opioid regimen reported.
The C2 disc shows annular calcification. Spondylosis/DISH like change is seen at C4-5 motor unit with degenerative disc disease at C5.
The keys finding is the thin vertical density posterior to the C2-4 levels involving posterior longitudinal ligament. This is best seen on the close -up view.
T2-weighted sequences are considered the most effective in the evaluation of spinal cord compression. (1) Radiopaedia.com
The axial CT scan – bone window shows OPLL which causes mass effect on the cord. (4) mrimedicvn.blogspot
DISCUSSION: The mass effect of the OPLL seen on the axial CT image may causes stages of cord damage described by Radiopaedia.com seen above. The cases of OPLL that occupy 30-60% of the cross-sectional diameter are more likely to show myelopathy. Laterally deviated OPLL masses have a higher risk of myelopathy than those at the midline (5)