Advancements in the pathogenesis of ossification of the posterior longitudinal ligament

Abstract

Ossification of the posterior longitudinal ligament (OPLL) is a degenerative disease with a series of clinical manifestations caused by compression of the spinal cord and nerve roots. The disease is prevalent in East Asian countries, and the average prevalence rate of Chinese people is 3.08%. Disease progression can lead to paraplegia, but there is no effective preven-tion and cure. The pathogenesis of OPLL is still unclear. Most scholars suggest it may be related to genes, hormones, environment, lifestyle and other factors, but all stay in the stage of hypothesis and theory. In this paper, we searched Pubmed, Embase, CNKI and Wanfang database. According to the included literatures, the pathogenesis of OPLL was divided into the following parts: extra-cellular microenvironment, intracellular cytokines, genetic factors, biomechanical factors, and endocrine and living habits. We summarized and analyzed these literatures. These existing studies independently elucidated the possible mechanisms of OPLL from different angles. Different pathogenic factors promote mesenchymal stem cells to differentiate into osteoblasts through corre-sponding molecular pathways, initiate osteogenesis, and lead to the formation of ectopic ossification. However, none of these stud-ies have clarified the complete pathogenesis of OPLL. Most of the studies focused on the field of genetics. In recent years, a large number of susceptible genes or loci related to the pathogenesis of OPLL have been screened, but they have shortcomings such as insufficient sample size, ethnic regional differences, and poor reproducibility.