Calcium pyrophosphate deposition disease causing cervical myelopathy

Area of Science:

• Neurology
• Orthopedics
• Rheumatology

Background:

• Pseudogout (calcium pyrophosphate deposition - CPPD) commonly affects joints.
• Spinal CPPD typically involves ligamentum flavum, intervertebral discs, and posterior longitudinal ligaments.
• Dural calcification (DC) from CPPD is a rare spinal finding.

Purpose of the Study:

• To report a rare case of dural calcification (DC) in the spine.
• To emphasize the importance of differentiating DC from ossification of the ligamentum flavum (OLF).
• To describe the clinical presentation and management of spinal DC.

Main Methods:

• Case report of an elderly woman with progressive cervical myelopathy.
• Radiological assessment including CT scan and MRI.
• Surgical intervention: posterior cervical decompression, stabilization, and fusion.

Main Results:

• Radiological findings suggested dural calcification (DC) over ossification of the ligamentum flavum (OLF).
• Intraoperative observation confirmed calcification and crystalline deposits on the dura.
• Patient experienced favorable neurological recovery post-surgery.

Conclusions:

• Dural calcification (DC) is a rare manifestation of calcium pyrophosphate deposition (CPPD) in the spine.
• Accurate differentiation between DC and OLF is crucial for appropriate diagnosis and treatment.
• Surgical management can lead to positive neurological outcomes in symptomatic spinal DC.