With slow, gradual progression, neural tissue can
accommodate astonishing levels of compression or
displacement. However, even a minor traumatic
event (such as a sudden concussive blow or hyperextension
injury) can result in the sudden compression of the spinal
cord secondary to acute narrowing of the residual anterior/
posterior diameter of the spinal canal. Unfortunately, with
severe OPLL, this is associated with an approximately
10% incidence of profound, permanent, and irreversible
dysfunction.
As our population ages, and individuals survive into
their ninth decade (like this patient), an increasing
number will harbor cervical stenosis or OPLL which
might become profoundly symptomatic following even
relatively minor trauma. Greater awareness that elderly
patients may harbor such lesions may prompt early
preventive screening, and lead, when appropriate, to
surgical decompression prior to the onset of catastrophic
neurologic deficits