Spine: ossification of the posterior longitudinal ligament: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: ossification of the posterior longitudinal ligament

Sample item

A 58-year-old East Asian man has gradually progressive clumsiness of the hands and spastic gait. A CT of the cervical spine shows a continuous band of calcification lying behind the vertebral bodies from C3 to C5, narrowing the canal. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Ossification of the posterior longitudinal ligament

Ossification of the posterior longitudinal ligament lies in the canal immediately behind the vertebral bodies and causes myelopathy. It is more common in East Asian populations and is linked with diabetes and DISH. Ossified ligamentum flavum lies posterior to the cord, arising from the laminae.

Option by option

  • A. Ossification of the posterior longitudinal ligament (correct)

    Correct. Calcification directly behind the vertebral bodies in the canal is the posterior longitudinal ligament.

  • B. Diffuse idiopathic skeletal hyperostosis

    DISH produces flowing anterior ossification of the vertebral bodies and does not by itself define the intracanal band.

  • C. Calcific discitis

    Calcific discitis shows calcification confined to the disc, mostly in children.

  • D. Ossification of the ligamentum flavum

    Ligamentum flavum ossification sits behind the cord, at the laminar level.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Ossification of the posterior longitudinal ligament. Ossification of the posterior longitudinal ligament lies in the canal immediately behind the vertebral bodies and causes myelopathy.

Why is "Diffuse idiopathic skeletal hyperostosis" not the answer?

DISH produces flowing anterior ossification of the vertebral bodies and does not by itself define the intracanal band.

Why is "Calcific discitis" not the answer?

Calcific discitis shows calcification confined to the disc, mostly in children.

Why is "Ossification of the ligamentum flavum" not the answer?

Ligamentum flavum ossification sits behind the cord, at the laminar level.

What concept does this question test?

It tests Spine: ossification of the posterior longitudinal ligament in Orthopaedics. It is more common in East Asian populations and is linked with diabetes and DISH. Ossified ligamentum flavum lies posterior to the cord, arising from the laminae.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: ossification of the posterior longitudinal ligament?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.