Rare Cause of Thoracic Myelopathy

Sagar, Harpreet; Fernandez-Madrid, Felix; Kupsky, William J.

doi:10.1097/rhu.0b013e3181eeb94f

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…3,31,32 Ossification of the ligamentum flavum is very rare among black patients, with only a few reports in the literature. 8,[50][51][52][53][54] In 1998, Pascal-Mousselard et al reported an unusual OLF in the thoracic spine in a black patient presenting with progressive spastic paraparesis. 8 Because of its rarity in black patients, OLF is a diagnosis of exclusion in this population.…”

Section: Discussionmentioning

confidence: 99%

Compressive Myelopathy Due to Ossification of the Ligamentum Flavum: Case Report and Review of the Literature

et al. 2017

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Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, due to mechanical, biological and genetic factors, becomes ossified. Due to its nature and anatomic location, OLF produces symptoms characteristic of spinal cord compression. The diagnostic confirmation is based primarily on imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI). Ossification of the ligamentum flavum most often affects Asian populations, rarely occurring in black people. The authors report a case of a 61-year-old black man with progressive paraparesis due to OLF, and review the literature regarding the pathology's prevalence, pathogenesis, clinical features, diagnosis, treatment and prognosis.

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Section: Discussionmentioning

confidence: 99%

Compressive Myelopathy Due to Ossification of the Ligamentum Flavum: Case Report and Review of the Literature

et al. 2017

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“…OLF was first diagnosed by Polgar in 1920 and was traditionally viewed as a disease affecting East Asians with a predominance among Japanese. [5] However, recent case series and reports have also been published from North and South America, Africa, Middle East, India and Europe. [6] The higher prevalence among Japanese is thought to be attributed to the traditional custom of kneeling and standing, which causes increased mechanical stress on the thoracic spine.…”

Section: Discussionmentioning

confidence: 99%

Thoracic myelopathy secondary to multi-level ossification of the ligamentum flavum in an Asian patient

Chong

Lim

2017

CRIM

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Thoracic myelopathy occurs less frequently than lumbar myelopathy. There are several causes of thoracic myelopathy of which ossification of the ligamentum flavum (OLF) is one. OLF has several unique features, arising posteriorly and causing proprioceptive issues first before extending to cause motor and sensory loss. We present a case of a 58-year-old gentleman with a six-month history of progressive lower limb weakness, numbness, back pain and recurrent falls due to OLF. Magnetic resonance and computed tomography imaging revealed extensive thoracic OLF and concomitant facet hypertrophy involving T6-7, T7-8, T9-10, T10-11 and L1-2. Severe central canal stenosis and L1-2 cauda equina root compression were also seen on radiological imaging. The patient developed sphincter disturbance during his admission and had difficulty passing urine. He underwent physiotherapy but was only able to sit and stand with the help of a walking frame at best. He did not regain motor or sensory function in his lower limbs although his back pain improved. Surgical decompression is associated with good neurological outcomes in OLF. Despite this, our patient declined surgery and opted for conservative therapy instead. We wish to highlight a rare case of thoracic myelopathy and the potentially irreversible neurological deterioration that occurs if there is no early surgical intervention.

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“…Re zo nans ma gne tycz ny (MRI) i to mo gra fia kom pu te ro wa (TK) uwi dacz nia ją ty po we, prze ro śnięte, wpu kla ją ce się do wnę trza ka na łu krę go we go, skost nia łe wię za dła żół te. MRI i TK po zwa la ją nie tyl ko po sta wić pra wi dło we roz po zna nie cho ro by, ale rów nież są nie zbęd ne to od po wied nie go pla no wa nia le cze nia ope ra cyj ne go, po zwa la jąc na wy ko na nie proce du ry ma ło in wa zyj nej, ogra ni czo nej wy łącz nie do pa to lo gicz nie zmie nio ne go seg men tu krę go słu pa [33].…”

Section: Clinical Symptomsunclassified

“…MRI and CT tests reveal typical ossified ligamenta flava, which are hypertrophic and penetrate into the spinal canal. MRI and CT examinations not only make it possible to establish a diagnosis, but are also essential in order to plan appropriate surgical treatment, so that a less invasive procedure can be used, limited exclusively to the pathologically changed segment of the spine [33].…”

Section: Le Cze Niementioning

confidence: 99%

Contemporary views on the ossification of the ligamenta flava

Kłosiński

Skrzat²,

Walocha³

et al. 2012

Ortopedia, traumatologia, rehabilitacja

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Wię za dła żół te są struk tu ra mi, któ re wraz z blasz ka mi łu ków krę go wych, bu du ją tyl ną ścia nę ka na łu krę gowe go. Bez po śred nie są siedz two z struk tu ra mi ner wo wy mi rdze nia krę go we go po wo du je, że ka żda pa to lo gia pro wa dzą ca do ich prze ro stu pro wa dzi w kon se kwen cji do za bu rzeń neu ro lo gicz nych. Jed ną z naj częst szych przy czyn ta kie go prze ro stu jest he te ro to po we kost nie nie. Głów ny mi re jo na mi świa ta do tknię ty mi tym scho rzeniem są kra je Azji, zwłasz cza Ja po nia. Zda rza ją się jed nak co raz częst sze przy pad ki wy stę po wa nia skost nień wię za deł żół tych wśród in nych po pu la cji. Za naj wa żniej szą przy czy nę two rze nia się ek to pi czej tkan ki kost nej w ob rę bie tych wię za deł uwa ża się stres me cha nicz ny o cha rak te rze ro ta cyj nym i roz cią go wym, a ta kże uwarun ko wa nia ge ne tycz ne. Le cze nie tej pa to lo gii ogra ni cza się głów nie do pro ce dur ope ra cyj nych. Ni niej szy arty kuł jest prze glą dem współ cze snej wie dzy na te mat przy czyn he te ro to po we go kost nie nia wię za deł żół tych, skut ków wy wo ły wa nych przez to scho rze nie oraz spo so bów ich le cze nia. Sło wa klu czo we: wię za dła żół te, kost nie nie he te ro to po we, ka nał krę go wy, krę go słup SUMMARY The ligamenta flava, together with the vertebral lamina, form the posterior wall of the spinal canal. Since they are located immediately adjacent to the nerve structures of the spinal cord, every pathology that involves hypertrophy produces neurological disturbances as a result. One of the most common reasons for hypertrophy of the ligamenta flava is heterotopic ossification. The main regions of the world where this disorder occurs are the Asian countries, especially Japan, but there are increasing numbers of such cases in other populations. The most important causes of the formation of ectopic osseous tissue in the vicinity of the ligamenta flava are thought to be mechanical stress and genetic predisposition. Treatment is mostly limited to surgical procedures. The present study is a review of the current state of our knowledge concerning the ossification of the ligamenta flava, the sequelae of this pathology, and the treatment methods.

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Rare Cause of Thoracic Myelopathy

Cited by 4 publications

References 11 publications

Compressive Myelopathy Due to Ossification of the Ligamentum Flavum: Case Report and Review of the Literature

Compressive Myelopathy Due to Ossification of the Ligamentum Flavum: Case Report and Review of the Literature

Thoracic myelopathy secondary to multi-level ossification of the ligamentum flavum in an Asian patient

Contemporary views on the ossification of the ligamenta flava

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