OPLL (JAPANESE DISEASE ) AND DISH(FORESTIER DISEASE)

1. OSSIFIED POSTERIOR
LONGITUDINAL LIGAMENT AND
DISH

2. OSSIFICATION OF POSTERIOR
LONGITUDINAL LIGAMENT
JAPANESE DISEASE

4. • THOUGH IT IS CALLED JAPANESE DISEASE, IT IS
NOT CONFINED TO THAT RACE,
• BUT IT IS MORE COMMON AMONG ASIAN
POPULATION

5. • MORE COMMON IN MEN THAN WOMEN
4 TH TO 6TH DECADE

6. OSSIFIED POSTERIOR LONGITUDINAL
LIGAMENT
• SITE
• CERVICAL(C5) > THORACIC > LUMBAR

7. THERE IS LESS ROOM FOR SPINAL
CORD, MAKES IT INCREASES CHANCE
FOR SPINAL CORD INJURY AFTER
MINOR TRAUMA

9. • HISTOLOGICAL STUDIES – SHOWN THAT THIS
OSSIFICATION IS BY “” ENDOCHONDRAL
OSSIFICATION””

10. GENES
• BMP – 2
• TGF- BETA
• COL 11A2
• COL 6 A1
• NPPS

11. ASSOCIATIONS
• OSSIFIED LIGAMENTAM FLAVUM
• DISH
• ANKYLOSING SPONDYLITIS

12. MANAGEMENT
• CONSERVATIVE
• SURGICAL
– ANTERIOR
– POSTERIOR APPROACH(IN OLD PATIENTS)

13. DISH (FORESTIER DISEASE)

14. • CHARACTERISED BY BONE FORMATION IN
TENDINOUS AND LIGAMENT INSERTION SITES
• MOSTLY ANTERIOR LONGITUDINAL
CALCIFICATION (THORACIC AREA )
• SOMETIMES – POSTERIOR LONGITUDINAL
LIGAMENT

15. • D/D
• ANKYLOSING SPONDYLITIS
• IN DISH, SACROILIAC JOINT SPARED, NO
MORNING STIFFNESS, NO HLA B 27 +VITY,
FLOWING WAX CALCIFICATION