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Thoracic spinal cord compression by ligamentum flavum ossifications
Ali Akhaddar1, Abdelaziz Mansouri, Ibtissame Zrara
1Neurosurgery department, Hôpital Militaire d'Instruction Mohamed V, Rabat, Morocco. akhaddar@hotmail.com
Joint Bone Spine
|July 10, 2002
Summary
Ossification of the ligamentum flavum, a rare spinal condition in the West, can cause severe myelopathy. This case highlights multi-level thoracic ossification and successful surgical decompression for spinal cord compression.
Area of Science:
- Orthopedic Surgery
- Neurology
- Radiology
Background:
- Ossification of the ligamentum flavum (OLF) is prevalent in East Asia but uncommon in Western populations.
- OLF can lead to thoracic myelopathy, a serious neurological complication affecting spinal cord function.
- Multi-level OLF in the thoracic spine is exceptionally rare, posing diagnostic and therapeutic challenges.
Observation:
- A 50-year-old male presented with progressive spinal cord compression and a sensory deficit at the navel.
- Imaging revealed extensive, multi-level ossification of the ligamentum flavum at T5/T6, T7/T8, T9/T10, and T10/T11.
- Laboratory tests were within normal limits, suggesting a non-systemic etiology.
Findings:
- Surgical decompression via laminectomy and foraminotomy resulted in a favorable clinical outcome.
- Histopathological examination confirmed bone metaplasia and calcific deposits within the ligamentum flavum.
- The case underscores the importance of considering OLF in the differential diagnosis of thoracic myelopathy.
Implications:
- This report expands the understanding of the geographic distribution and clinical presentation of OLF.
- It emphasizes the efficacy of surgical intervention for multi-level thoracic OLF causing spinal cord compression.
- Further research into the etiologies of OLF, particularly in non-endemic regions, is warranted.