Thoracic compressive myelopathy due to post-traumatic intradural migration of ossified yellow ligament: Case report

Abstract

Focal ossification of the ligament flavum (OLF) is a rare cause of thoracic myelopathy. The lower thoracic spine is most frequently affected. It is increasingly being recognized as a cause of myeloradiculopathy with advent of computed tomographic (CT) and magnetic resonance (MR) imaging of spine. We report an instance of ossified ligamentum flavum infiltrating and penetrating segmental dura as a result of trauma causing compressive myelopathy in a middle-aged female.

Keywords

compressive myelopathy - decompression laminectomy - ligament ossification - spinal cord compression - ossified yellow ligament - calcified ligamentum flavum

• References

• 1 Fong SY, Wong HK. Thoracic myelopathy secondary to ligamentum flavum ossification. Ann Acad Med Singapore 33 2004; 340-346
• 2 Sugimura H, Kakitsubata Y, Suzuki Y, Kakitsubata S, Tamura S, Uwada O. et al MRI of ossification of ligamentum flavum. J Comput Assist Tomogr 16 1992; 73-76
• 3 Sushil P, Anant K. Ossified-calcified ligamentum flavum causing dorsal cord compression with computed tomography-magnetic resonance imaging features. Surg Neurol 41 1994; 441-442
• 4 Miyasaka K, Kaneda K, Sato S, Iwaski Y, Abe S, Takei H. et al Myelopathy due to ossification or calcification of ligamentum flavum: radiologic and histologic evaluations. Am J Neuroradiol 04 1983; 629-632
• 5 Maigne JY, Ayral X, Guerin-Surville H.. Frequency and size of ossifications in the caudal attachments of the ligamentum flavum of the thoracic spine. Role of rotatory strains in their development. An anatomic study of 121 spines. Surg Radiol Anat 14 1992; 119-245
• 6 Wang PN, Chen SS, Liu HC, Fuh JL, Kuo BI, Wang SJ. Ossification of the posterior longitudinal ligament of the spine. A case-control risk factor study. Spine 24 1999; 142-145
• 7 Otani K, Yoshida M, Fujii E, Nakai S, Shibasaki K. Thoracic disc herniation.Surgical treatment in 23 patients. Spine 13 1988; 1262-1276
• 8 Inaba K, Matsunaga S, Ishidou Y, Imamura T, Yoshida H. Effect of transforming growth factor beta-1 on fibroblasts in ossification of the posterior longitudinal ligament. In Vivo 10 1996; 445-449
• 9 Yamaura I, Yone K, Nakahara S, Nagamine T, Baba H, Uchida K. et al Mechanism of destructive pathologic changes in the spinal cord under chronic mechanical compression. Spine 27 2002; 21-26
• 10 Rivierez M, Vally P. Ossification of ligamentum flavum unmasked by acute paraplegia (French). Neurochirugie 47 2001; 572-575
• 11 Park BC, Min WK, Oh CW, Jeon IH, Kim SY, Kyung HS, Oh SH. Surgical outcome of thoracic myelopathy secondary to ossification of ligamentum flavum. Joint Bone Spine 74 2007; 600-605
• 12 Shiokawa K, Hanakita J, Suwa H, Saiki M, Oda M, Kajiwara M. Clinical analysis and prognostic study of ossified ligamentum flavum of the thoracic spine. J Neurosurg 94 2001; 221-226
• 13 Baba H, Komita T, Maesawa Y, Imura S. Intermittent claudication of the spinal cord due to ossification of the ligamentum flavum.A report of two cases. Int Orthop 17 1993; 169-172
• 14 Nishiura I, Isozumi T, Nishihara K, Handa H, Koyama T. Surgical approach to ossification of thoracic yellow ligament. Surg Neurol 51 1999; 368-372
• 15 Okada K, Oka S, Toghe K, Ono K, Yonenobu K, Hosoya T. Thoracic myelopathy caused by ossification of ligamentum flavum. Clinicopathologic study and surgical trearment. Spine 16 1991; 280-287
• 16 Trivedi P, Behari S, Paul L, Banerji D, Jain VK, Chhabra DK. Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien) 143 2001; 775-782