Conclusions
Microscopic findings in OLF specimens showed an overgrowth of type II collagen preceding the development of ossification. There was also a reduction in the amount of elastin. OLF was confirmed to be mainly endochondral ossification. Additional intramembranous ossification was, however, seen at the tip of the nodule-shaped ossification. Ossification extended along the superficial layer of the hypertrophied ligament, as in OPLL. It was suggested that the mechanism of OLF development depends intimately not only on dynamic and static mechanical stresses but also on the role of some growth factors as well.
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Yoshida, M. (2006). Pathology of Ossification of the Ligamentum Flavum. In: Yonenobu, K., Nakamura, K., Toyama, Y. (eds) OPLL. Springer, Tokyo. https://doi.org/10.1007/978-4-431-32563-5_9
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