Preface
Ossification of the posterior longitudinal ligament (OPLL) is a disease that produces a chronic progressive compressive myeloradiculopathy primarily in the cervical spine. The clinical manifestations of cervical OPLL often resemble cervical spondylotic myelopathy (CSM), but OPLL exhibits unique epidemiological features, such as ethnic groups, age, and gender preponderances. Furthermore, OPLL and CSM are very different in viewpoints of pathophysiology, surgical management, and treatment outcomes.
Countless studies on OPLL have been published since its first description in the mid-nineteenth century. However, little about this unique and famous disease has been known. This fact becomes obvious when considering the absence of any clear-cut guidelines for the proper management or any classification system that is related to clinical outcomes of OPLL. These ambiguities regarding OPLL are partly due to our ignorance on the disease itself. The etiology, pathogenesis, and natural history of OPLL are not clearly known.
Japanese researchers have contributed extensively to our understanding of OPLL as it is, and most of the published articles have dealt with the Japanese population. Therefore, people may regard OPLL as a Japanese disease. However, OPLL is not limited to the Japanese population, and it
is equally prevalent in Korea, China, and other Asian countries. Furthermore, non-Asian reports are readily available nowadays.
Major textbooks on spine surgery have chapters discussing OPLL, and Japanese researchers have published several monographs on the topic of OPLL. However, given the recent surge of interest in OPLL in Korea, we Korean researchers are obliged to summarize and update recent advancements in our knowledge of OPLL. This monograph is the first one directed and presented by Korean researchers, with contributions from China and Japan. The most valuable contribution of this monograph is the inclusion of recent Asian epidemiological studies that are not limited to Japanese results but include Chinese and Korean data. In this monograph, we emphasize the clinical and surgical aspects of OPLL, rather than basic science. Readers will thoroughly enjoy the presented information and discussions on the natural history, novel surgical approaches and techniques, thoracic OPLL, and the relationship to other enthesopathies. I hope that this textbook provides a basis for future research in OPLL in Asian and non-Asian countries.
The chapters in this monograph are based on a symposium to celebrate the retirement of Professor Hyun Jib Kim, the fifth chairman of the Department of Neurosurgery, Seoul National University College of Medicine. Professor Kim was a great mentor and a pioneer of spine surgery in Korea. He has been a dedicated spine surgeon since 1973, and he introduced and developed techniques in spine surgery to educate his colleagues and disciples. Surgery for OPLL was one of Professor Kim’s achievements, and the symposium was directed to focus on OPLL. Authors from many Asian countries were included to obtain a wide and balanced viewpoint of OPLL. I wish that this monograph represents a milestone in the advancement of OPLL research and the legacy of Professor Hyun Jib Kim as a Korean spine surgeon.
Editor
Chun Kee Chung, M.D., Ph.D.
