DeCure for Ossification of the posterior longitudinal ligament of the spine
DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for ossification of the posterior longitudinal ligament of the spine — screening already-approved drugs against its 15-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleOssification of the posterior longitudinal ligament of the spine maps to a 15-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
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ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
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Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for ossification of the posterior longitudinal ligament of the spine is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
hydroxyacid oxidase 1 (HAO1) — HAO1 is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet fmndrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 2NZL · 1.35 Å · ligand FLAVIN MONONUCLEOTIDE (FMN). Experimental structure, not a prediction.
What the evidence adds up to
A 2011 systematic review of cohort studies comparing anterior and posterior surgical approaches for multilevel ossification of the posterior longitudinal ligament found no randomised controlled trials. Three retrospective cohort studies were included, but heterogeneity of interventions and outcome measures prevented meta-analysis. The review concluded that multilevel corpectomy and fusion (anterior approach) carried a significantly higher rate of cerebrospinal fluid leakage and graft- or instrumentation-related complications. No definitive conclusion could be drawn about which surgical treatment was most effective, and the authors called for a well-designed, prospective, randomised multicentre trial.
A 1980 report from a single Japanese department described anterior decompression in twelve cases of cervical OPLL. The procedure involved removing the central part of the vertebral body and the ossified ligament, then filling the defect with an iliac crest bone graft. The authors reported marked improvement of radicular and spinal cord signs in all twelve cases, with no neurological worsening after surgery. Fracture of the grafted bone occurred in two cases, and the lateral parts of the ossified ligament were not completely removed in three cases. When the spinal canal was narrowed by more than fifty percent and cord signs were severe, improvement was delayed. The authors stated that theoretically any ossification could be removed by the anterior approach as long as no more than five vertebral bodies (C3 to C7) were involved.
A 1991 follow-up study of 86 OPLL patients (57 male, 29 female; mean age 55 years) found that ossification of the posterior longitudinal ligament and ligamentum flavum in the thoracic and lumbar spine complicated cervical OPLL in 51% of cases. Decompression of the cervical spine and other spinal levels was necessary in only 17% of all cases. The authors emphasised that neurological signs and morphological examinations were most important for identifying the main lesion, and suggested that spinal action potential measurement might become useful in the future.
What is still missing is a prospective, randomised controlled trial comparing surgical approaches, which has not been performed. Patient stratification by number of levels involved, degree of canal narrowing, and presence of thoracic or lumbar ossification remains poorly standardised. Funding for such a multicentre trial, and agreement on uniform outcome measures, have not been secured.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Orthopedics · 2011 · 15 citations
Systematic Review of Cohort Studies Comparing Surgical Treatment for Multilevel Ossification of Posterior Longitudinal Ligament: Anterior vs Posterior Approach
AbstractThere have been no standards or guidelines for the treatment of ossification of posterior longitudinal ligament, especially multilevel ossification of posterior longitudinal ligament. The purpose of this study was to compare results of major surgical treatment for multilevel ossification of posterior longitudinal ligament. Databases including MEDLINE, EMBASE, the Cochrane library, and bibliographies of identified and review articles were searched to find randomized, controlled trials or retrospective cohort studies comparing anterior and posterior approach from 1980 to December 2010. Approximately 1375 articles were found initially, 92 abstracts were screened, 23 articles were retrieved in full; 3 studies were included in the review. No randomized, controlled studies were identified. Because all the studies included in this study are cohort studies with disparity of surgical interventions, heterogeneity of outcome measures and different qualities, we were unable to perform a meta-analysis. All comparison studies are retrospective cohort studies, comparing surgical outcomes of anterior approach (corpectomy and fusion) with that of posterior approach (laminoplasty or laminectomy) for the treatment of multilevel ossification of posterior longitudinal ligament in the cervical spine. A systematic review of retrospective cohort studies was performed to determine which surgical treatment is the most effective in patients with multilevel ossification of posterior longitudinal ligament. Definitive conclusions regarding the surgical treatment of multilevel ossification of posterior longitudinal ligament could not be made in this article. Multilevel corpectomy and fusion are more technical and have a significantly higher rate of cerebrospinal fluid leakage and graft, instrumentation related complications. A well-designed, prospective, randomized controlled, multicenter trial is needed.
Neurologia medico-chirurgica · 1980 · 4 citations · open access
Anterior Decompression for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine
AbstractThe operative procedures for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine are mainly divided into two types, i.e., the posterior approach and the anterior approach. We conducted surgical treatment on about fifty cases of OPLL by the posterior approach until 1977. The results were mostly satisfactory for the spinal cord signs, but sometimes we could not improve the radicular signs. In addition, since ossification of the ligament continued to progress, we could do nothing about aggravation arising several years later. Therefore, we have tried a new and radical method which is called anterior decompression since 1978. The central part of the vertebral body and the ossified area of the posterior longitudinal ligament are removed and the defect is filled with a bonegraft. Twelve cases of OPLL were operated on in our department in the last two years. Surgical techniques, operative results and indications are discussed. A longitudinal groove of sufficient length and approximately 1.2-1.5 cm in width is made in the center of the vertebral bodies using a rongeur and an air-drill. When the posterior surface of the vertebral bodies is approached, the procedure should be performed with extra caution under a surgical microscope. The normal part of the dura must be exposed first, and the ossified ligament is carefully removed with a micro-rongeur. When the ossified ligament adheres tightly to the dura, the dura involved must be extirpated. The posterior part of the body should be cut widely so that the lateral part of the ossified ligament can be removed easily. A bone-graft taken from the iliac crest is made to fit the graft bed. The operative results were excellent even though the lateral parts of the ossified ligament were not removed completely in three cases and fracture of the grafted bone occurred in two cases. Marked improvements of radicular and spinal cord signs were seen in all twelve cases. There were no cases in which signs of aggravation of the neurological symptoms appeared after the operation. Three bodies fused in one case, four bodies in nine cases, and five bodies in two cases. The highest level of the fusion was C2 and the lowest level was T1. When the percent narrowing of the cervical spinal canal was over fifty percent and remarkable cord signs were present, there was a tendency for the improvement of the cord signs to be delayed. When there is a gait disturbance, the operation should be performed without hesitation. Theoretically, it is considered that any ossification of the ligament can be removed by the anterior approach as long as the number of vertebral bodies involved does not exceed five (C3 C7). Spinal CT scans were valuable and essential to obtain more detailed information about the stenotic spinal canal and shape of the ossified ligament.
AbstractEighty-six cases of ossification of the posterior longitudinal ligament (OPLL) were studied, which consisted of 57 males and 29 females. Their ages ranged from twenty-nine to wighty-four years old (average: 55 years). Ossification of the posterior longitudinal ligament and ligamentum flavum of the thoracic and lumbar spine were complicated in 51% of OPLL in the cervical spine. But decompression of the cervical spine and other spine were necessary in 17% of all cases.Neurological signs and morphological examinations were most important for diagnosis of main lesion. In future measurement of spinal action potential will be usefull.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
