Calcium Crystal Deposition in the Ligamentum Flavum of the Cervical Spine

Baba, H.; Maezawa, Yasuhisa; Kawahara, Norio; Tomita, Katsuro; Furusawa, Nobuaki; Imura, Satoru

doi:10.1097/00007632-199311000-00005

Cited by 65 publications

(44 citation statements)

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“…Others have suggested that fibroblasts within cervical spine ligaments can transform into chondrocytes, thus making these ligaments susceptible to calcification (28,29). Hydroxyapatite crystal deposition has also been reported in other areas of the cervical spine, including deposition in the longus coli muscle causing calcific tendinitis of the neck, as well as deposition in cervical intervertebral discs and the ligamentum flavum (18,30,31).…”

Section: Discussionmentioning

confidence: 94%

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

Wu¹,

Reginato²,

Torriani³

et al. 2005

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 94%

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

Wu¹,

Reginato²,

Torriani³

et al. 2005

Arthritis & Rheumatism

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“…However, CPPD crystal deposition on the cervical spine is less well known and only a limited number of cases of this condition have been reported to date (6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

CPPD crystal deposition disease of the cervical spine: A common cause of acute neck pain encountered in the neurology department

Sekijima

Yoshida

Ikeda

2010

Journal of the Neurological Sciences

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“…The calcification usually appears as an oval-shaped lesion located in the paramedian area of the posterior part of the spinal canal [11]. As in our cases, the mid-cervical spine is most frequently involved, especially at C4-C5 and C5-C6 levels [1]. Although ossification of ligamenta flava (OLF) rarely occurs in the cervical spine [8], diagnostic confusion may arise between OLF and CLF.…”

Section: Discussionmentioning

confidence: 50%

“…Most of them (over 90%) were diagnosed in Japanese patients [1]. Our report of two West Indian patients, as well as a previous one involving a black American [3] suggests the disease may be overlooked in people of African ancestry.…”

Section: Discussionmentioning

confidence: 58%

“…Our report of two West Indian patients, as well as a previous one involving a black American [3] suggests the disease may be overlooked in people of African ancestry. The prominent neurological picture is a chronic cervical myelopathy affecting old women with symptoms and signs of impairment of the posterior spinal tracts [1,6]. CT examination is the key procedure in making a diagnosis of CLF.…”

Section: Discussionmentioning

confidence: 99%

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Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients

Pascal‐Moussellard

Cabre

Smadja

et al. 1999

European Spine Journal

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IntroductionCalcification of the ligamenta flava (CLF) of the cervical spine causing myeloradiculopathy is a rare disorder occasionally reported in Japanese people [6]. CLF seems to be exceptional in non-Asian populations. We encountered for the first time two such cases in black patients living in the French West Indies. We present here the clinical and radiological findings and outcome in these patients. Case reportsCase 1A 72-year-old black woman first noticed numbness in her hands 3 months before admission. During the next weeks, she had difficulty walking and working with her hands. She had no history of spinal injury or rheumatic disease. On admission, the gait was clearly ataxic and neurological exam showed a proximal weakness in the lower limbs. There was no impairment of touch sensation, but position sense, in particular, was absent in all limbs. Deep tendon reflexes were brisk, a bilateral Hoffman sign was found and plantar responses were extensor. She complained of neither radiating pain nor urinary symptoms. General examination was otherwise normal. Routine blood tests were unremarkable. Myelography revealed a partial block at the level C4-C5 and a subsequent CT scan showed voluminous oval masses involving both ligamenta flava at the same level (Fig. 1). The patient was then treated with posterior decompressive C4 and C5 laminectomies. At surgery, the above masses appeared as white granular deposits within degenerated ligamenta flava and were easily dissected from the dura matter. Microscopic examination of the removed material revealed hydroxyapatite crystals (HAP) at the centre of the nodules, surrounded by calcium pyrophosphate dihydrate crystals (CPPD). After surgery, there was dramatic improvement. The gait returned to nearly normal and disturbances of the deep sensation Abstract Two cases of cervical myelopathy due to calcification of the ligamenta flava (CLF) are described for the first time in black patients from the French West Indies. A pre-operative CT scan differentiated the diagnosis from one of ossification of the ligamenta flava. Microanalysis on the operatively excised specimen in one patient revealed a mixture of calcium pyrophosphate dihydrate crystals and hydroxypatite crystals. Poor outcome in one patient contrasting with excellent recovery in the other one, who had undergone posterior decompressive laminectomy, emphasizes the importance of surgery in the management of CLF.

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Calcium Crystal Deposition in the Ligamentum Flavum of the Cervical Spine

Cited by 65 publications

References 0 publications

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

CPPD crystal deposition disease of the cervical spine: A common cause of acute neck pain encountered in the neurology department

Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients

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