Radiologic Evaluation of Ossification of the Posterior Longitudinal Ligament with Dural Ossification

There are 3 basic radiological patterns of dural ossification (DO). Although double-layer DO is most common, when examining neuroimaging of ossification of the posterior longitudinal ligament (OPLL), isolated DO or masse DO should be kept in mind. Bone window computed tomography (CT) is most sufficient in identifying any type of DO associated with OPLL. Sagittal reformation of CT has replaced polytomography. MRI is not optimal for identification of DO and OPLL. Surgical approaches should be determined based on this important radiological information to avoid an unexpected complication. Expansive laminoplasty is the procedure of choice when DO is predominant.