'The Japanese disease' or ossification of the posterior longitudinal ligament of the cervical spine was initially thought to affect only the Japanese people. Non-Japanese Asian and Caucasian cases have been reported but appear to be exceedingly rare. The reason is unknown. Although the disease appears to be generally benign, it can cause a myelopathy. We present here 16 non-Japanese patients in Singapore who were found to have ossification of the posterior longitudinal ligament in the cervical, thoracic and lumbar spine.