Case report 779

Okada, Gen; Hosoi, Satoshi; Kato, Kou; Ohta, Kenji; Tachi, Yasuhiko; Sonoda, Jun; Yada, Hiroshi

doi:10.1007/bf00206158

Cited by 18 publications

(5 citation statements)

References 5 publications

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“…Because C-OPLL in the lower cervical spine is likely to be masked by shoulder girdle shadows [14, 26]. T-OLF and T-OPLL are likely to be masked by superimposed bony structures such as ribs [29, 34]. MRI is also less sensitive for identifying small ossifications and thickened or folded ligamentum flavum [4, 10].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals

Liang

Liu

et al. 2019

BMC Musculoskelet Disord

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Background The epidemiology and cause of ossification of the spinal ligaments (OSL) remains obscure. To date, there is no study that comprehensively evaluates the prevalence, distribution, and concomitance of each type of OSL by CT among general Chinese population. We therefore aimed to comprehensively investigate epidemiological characteristics of OSL using whole spine CT in the Chinese population and examine the factors that correlate with the presence of OSL. Methods Ossification of the posterior longitudinal ligament (OPLL), ligamentum flavum (OLF), anterior longitudinal ligament (OALL), nuchal ligament (ONL), and diffuse idiopathic skeletal hyperostosis (DISH) were evaluated from the subjects who underwent PET/CT for the purpose of cancer screening in our hospital. Prevalence, distribution, and concomitance of OSL were reviewed. Logistic regression analysis was performed to identify the risk factors of OSL. Results A total of 2000 subjects (1335 men and 665 women) were included. The prevalence rate of cervical OPLL (C-OPLL) was 4.1%, thoracic OPLL (T-OPLL) 2.25%, lumbar OPLL (L-OPLL) 0.8%, thoracic OLF (T-OLF) 37.65%, lumbar OLF (L-OLF) 1.45%, ONL 31.5%, DISH 3.85%. The most commonly involved level was C5 for C-OPLL, T1 for T-OPLL, T10 for T-OLF, and T8/9 for OALL. 21% of subjects with C-OPLL had T-OPLL, 44% of C-OPLL had T-OLF, 38% of T-OPLL had C-OPLL, 53% of T-OPLL had T-OLF, 44% of L-OPLL had T-OPLL, and 56% of L-OPLL had T-OLF. The average age of OSL-positive subjects was significantly higher than that of OSL-negative subjects. The results of the multiple regression analysis revealed that males had a strong association with DISH (odds ratio, 3.15; 95% confidence interval, 1.27–7.78; P = 0.013). Conclusion The prevalence of OSL in the Chinese was revealed. Tandem ossification is not uncommon in people with OSL. There is a high incidence of multiple-regional OPLL in the whole spine. Approximately half of the subjects with OPLL coexist with T-OLF. For patients with clinical symptoms induced by OPLL, thorough evaluation of whole spine using CT is recommended.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals

Liang

Liu

et al. 2019

BMC Musculoskelet Disord

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“…It should be conducted carefully given that OLF frequently is associated with adherence between the ossification and dura mater. 26,49 An air drill may be used to begin decompression by resection of adjacent laminae rostral and caudal to the lesion. In this manner, the area of OLF can be isolated.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Ossification of the Ligamentum Flavum: A Clinical Series From the French Antilles

Pascal‐Moussellard¹,

Cabre²,

Smadja³

et al. 2005

Spine

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“…In addition, we recently reported a case of OLF in a black Caribbean patient [14]. However, OLF merely extends medially from the capsulae of the articular process [10] and exhibits a continuity with the bony laminae [13]. Thus, the CT scans in our cases, which showed oval masses partly contacting the lamina and not the characteristic OLF high-density, Vshaped linear structure [14], implied CLF and not OLF.…”

Section: Discussionmentioning

confidence: 54%

“…However, recent reports favour a wider spectrum of histopathological features, such as HAP in the dural side of the ligamenta flava [4] or acute inflammation accompanying the crystalline deposits [5]. It is commonly accepted that mineralized deposits precipitate around the degenerated elastic fibers of the ligamentum flavum [9] due to a conjunction of various factors including aging process, decrease in oestrogen in older women, mechanical stress of the mid-cervical spine [13] and chondrocytic metaplasia [12].…”

Section: Discussionmentioning

confidence: 99%

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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Case report 779

Cited by 18 publications

References 5 publications

Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals

Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals

Symptomatic Ossification of the Ligamentum Flavum: A Clinical Series From the French Antilles

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

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