Background: Ossification of the posterior longitudinal ligament (OPLL) of the spine is a rare disease with unknown pathology among white population. The disease occurs predominantly in the cervical spine and can cause spinal-cord compression. There is a wide variety of possible neurological signs depending on the amount of pressure on the spinal cord. The progress of the disease is slow and often without neurological symptoms. Different surgical approaches are used depends on the type of involvement. This study reports a patient with this rare syndrome in the east Azerbaijan province.

Case Report: A 45-year-old farmer with the diagnosis of disc herniation in the C3-C5 segments had radiculopathy symptoms for many years. Various physical therapy sessions along with drug treatment had no optimal improvement. Ultimately, surgery was performed by aggravation of the disease symptoms and during the surgery it was found that patient had OPLL syndrome.

Conclusion: Although this syndrome is rare, it should be considered in differential diagnosis of spinal cord compression involvements and its subsequent neurological symptoms.