Ossified Ligamentum Flavum causing Cervical Myelopathy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Cord Imaging

Background:

• Ossification of the ligamentum flavum (OLF) is an uncommon condition.
• OLF can lead to severe neurological deficits such as cervical myelopathy and radiculopathy.
• Compressive symptoms at the C5-6 level can significantly impact patient mobility and sensation.

Purpose of the Study:

• To report a rare case of cervical myelopathy caused by OLF.
• To describe the diagnostic findings and surgical management of OLF.
• To highlight the positive outcomes following surgical decompression.

Main Methods:

• A 50-year-old male presented with progressive hand numbness, tingling, and gait disturbance.
• Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans revealed OLF with C5-6 spinal cord compression.
• Surgical intervention involved subtotal laminectomy and left-sided foraminotomy at C5-6.

Main Results:

• The patient experienced significant improvement in gait post-surgery.
• Resolution of sensory symptoms (hypesthesia and paresthesia) in the hands was observed.
• Histopathological confirmation of ossified ligamentum flavum was obtained.

Conclusions:

• Surgical decompression by removing the ossified ligamentum flavum is an effective treatment for OLF-induced cervical myelopathy.
• Early diagnosis and surgical intervention can lead to favorable neurological recovery.
• This case underscores the importance of considering OLF in the differential diagnosis of cervical spinal cord compression.