The most common complaints in patients with OPLL are axial discomforts, which are characterized by dull pain and neck stiffness. Patients with more advanced OPLL develop radiculopathy or compressive myelopathy due to compression of nerve roots or spinal cord. The natural history of the disease is generally chronic static through life, hence prophylactic surgery is rarely recommended. In the OPLL patients with myelopathy, if the symptoms are not serious, the conservative treatment can be considerable.
