Combined upper cervical canal stenosis and cervical ossification of the posterior longitudinal ligament resulting in myelopathy: A case series and literature review

Li, Hao; Wang, Jingkai; Chen, Gang; Li, Fangcai; Zhu, Junfeng; Chen, Qixin

doi:10.1016/j.jocn.2017.08.003

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…10 , 11 The majority of patients with degenerative cervical myelopathy need surgery to decompress the cervical spine and halt the development or deterioration of neurological deficits. 7 , 12 The surgical options may include anterior, posterior, or combined approaches. 13 , 14 Anterior cervical discectomy and fusion (ACDF) involves the decompression of the neural elements by removal of the disc material and posterior osteophytes, followed by disc space distraction and height restoration by a structural interbody graft.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Progressive degeneration is characterized by ligamentum flavum hypertrophy, facet arthropathy, generation of osteophytes, and/or ossification of the posterior longitudinal ligament, which cause spinal canal diameter narrowing. 1,[4][5][6][7] Cervical spinal stenosis can cause myelopathy, impairing the extremity functions and causing gait disturbances, due to direct compression, or blood flow compromise as a result of vascular compression, with repeated trauma during flexion and extension movements. 2,8,9 The term degenerative cervical myelopathy (DCM) has been used as an overarching term to describe various cervical spine degenerative conditions.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Mesregah

Formanek

Liu

et al. 2021

Global Spine Journal

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Study Design: Retrospective comparative study. Objectives: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. Methods: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. Results: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. Conclusions: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Mesregah

Formanek

Liu

et al. 2021

Global Spine Journal

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show abstract

Section: Ctmentioning

confidence: 99%

“…No calcifications or ossifications in the hypertrophied ligaments spinal cord compression were managed with posterior decompression and laminectomy [12,16]. Due to the complexed anterior anatomy, which can lead to more complications, the posterior approach is preferred over the anterior approach [16]. However, a recently published technical report has described simultaneous complete removal of OPLL and OLF through single-stage minithoracotomy [14].…”

Section: Ctmentioning

confidence: 99%

Hypertrophied posterior longitudinal ligament and ligamentum flavum causing myelopathy: a case report and literature review

Wettasinghe

Gamage

Wickramasinghe

2023

Spinal Cord Ser Cases

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The occurrence of concurrent hypertrophied posterior longitudinal ligament (HPLL) and hypertrophied ligamentum flavum (HLF) in the thoracic spine is a very rare presentation. This case report describes a young female who developed thoracic myelopathy secondary to a combination of both thoracic HPLL and HLF. CASE PRESENTATION: A 30-year-old previously well female was referred for an MRI scan of the thoraco-lumbar spine. She was having lower limb weakness and difficulty in walking, which had progressed over 3 months. On examination, she was found to have spastic lower limbs with associated motor weakness. Her biochemical investigations were unremarkable. The MRI scan showed HPLL, which was uniformly hypointense on T2W images and was isointense on T1W images. The hypertrophied segment was extending from T2 level to T7 level. Similarly, the ligamentum flavum was hypertrophied from T1 level to T8 level. The thoracic spinal cord was seen compressed between the hypertrophied ligaments. The compressed cord showed central hyperintense signal pattern in T2W images. CT scan of the thoracic spine did not show any calcifications or ossifications along the ligaments. Patient underwent posterior decompressive surgery and she had an uneventful recovery. DISCUSSION: Although few cases of HPLL and HLF were reported in older patients in literature, both these conditions were found in this patient at a younger age. HPLL and HLF are thought to be precursors of ossification of these ligaments and these patients need long-term follow-up.

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Exclusion of Ossified Ligaments Behind C2 Vertebra Combined with Anterior Controllable Antedisplacement and Fusion for Cervical Ossification of the Posterior Longitudinal Ligament Extending to C2 Segment

et al. 2021

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Combined upper cervical canal stenosis and cervical ossification of the posterior longitudinal ligament resulting in myelopathy: A case series and literature review

Cited by 5 publications

References 22 publications

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Hypertrophied posterior longitudinal ligament and ligamentum flavum causing myelopathy: a case report and literature review

Exclusion of Ossified Ligaments Behind C2 Vertebra Combined with Anterior Controllable Antedisplacement and Fusion for Cervical Ossification of the Posterior Longitudinal Ligament Extending to C2 Segment

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