Advances in the study of ossification of the nuchal ligaments of the cervical spine

doi:10.13418/j.issn.1001-165x.2025.2.19

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (2) : 229-233. DOI: 10.13418/j.issn.1001-165x.2025.2.19

Advances in the study of ossification of the nuchal ligaments of the cervical spine

Ye Wenlin, Chen Chong, Liang Guoyan, Ye Yongyu, Yu Tao, Cheng Xing, Zheng Xiaoqing, Chang Yunbing*

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Abstract

Ossification of the Nuchal Ligament (ONL) refers to the dense calcification or ossification of the soft tissue area of the nuchal ligament often caused by the damage and degeneration of the nuchal ligament tissue, which disrupts the biomechanical balance of the cervical spine and causes neck discomfort. ONL is often found accidentally by X-ray examination of cervical spondylosis, because the initial symptoms of most patients with ossification of the nuchal ligament are mild. Although studies have suggested that the occurrence and development of ONL are related to a variety of molecular and environmental factors, the pathophysiological development of ONL at different stages of development is still unclear. ONL is one type of the heterotopic ossification. Many studies have confirmed the correlation between ONL and preoperative cervical instability and cervical spondylosis. However, ONL is often removed in laminoplasty, and studies on the long-term stability of cervical spondylosis patients with ONL after surgery are rare. Different genes and extrinsic causative factors have been proved to play an important role in the progression of ectopic ossification. Meanwhile, osteogenic precursor cells, local tissue microenvironment and nervous system regulation also play an important role in ectopic ossification. This paper analyzes the epidemiology and etiology, anatomy and biomechanics, clinical history, classification and clinical significance. Pathophysiological mechanism and external pathogenic factors of ONL, and further summarizes them for a better understanding of ONL. In addition, suggestions were provided for the study of cervical spine stability and molecular mechanism of ONL in patients with degenerative cervical myelopathy after single door opening surgery.

Key words

Ossification of nuchal ligament / Heterotopic ossification / Biomechanics / Pathophysiological mechanism

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Ye Wenlin, Chen Chong, Liang Guoyan, Ye Yongyu, Yu Tao, Cheng Xing, Zheng Xiaoqing, Chang Yunbing. Advances in the study of ossification of the nuchal ligaments of the cervical spine[J]. Chinese Journal of Clinical Anatomy. 2025, 43(2): 229-233 https://doi.org/10.13418/j.issn.1001-165x.2025.2.19

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