# Malignant character of an ossified posterior longitudinal ligament in a hyperflexion injury: A case report

## TL;DR

A 50-year-old man with cervical spine ossification suffered severe neurological issues after minor trauma, highlighting the potential severity of this condition.

## Contribution

This is the first reported case of a lethal outcome following trauma in a patient with extensive cervical osteophyte due to OPLL.

## Key findings

- The patient developed quadriparesis and respiratory insufficiency after minor head trauma.
- This case highlights the potential for syncope and lethal outcomes in OPLL patients with significant canal stenosis.
- Management of OPLL with canal stenosis should not be delayed unnecessarily.

## Abstract

The present study reports the case of a 50-year-old obese male with ankylosing spondylitis, Scheuermann's kyphosis. The patient was asymptomatic concerning the ectopic ossification of the posterior longitudinal ligament (OPLL) at the cervical spine; he developed quadriparesis and respiratory insufficiency following minor head trauma. Even though trauma to the cervical spine in patients with OPLL is common, to the best of our knowledge, this is the first reported case of an extensive osteophyte with a lethal outcome after syncope. In rare occasions, it may be present with syncope and potentially lethal outcomes, particularly when precipitated by trauma. Therefore, the management of OPLL with significant canal stenosis should not be unnecessarily delayed.