Previous genetic studies of OPLL have revealed the following osteogenic gene loci that may be involved in the pathogenesis of cervical OPLL: NPPS, COL6A1, COL11A2, BMP2, BMP4, BMP9, TGF-β1, TGF-β3, TGFΒR2, ESR1, FGFR1, IL-1β, IL-15RA, RUNX2 and RSPO2 [6–18]. Here, COL6A1 is linked to ossification of the posterior longitudinal ligament of the spine.