The Pathology of Ligamentum Flavum in Degenerative Lumbar Disease

Okuda, Teruaki; Baba, Itsushi; Fujimoto, Yoshinori; Tanaka, Nobuhiro; Sumida, Tadayoshi; Manabe, Haruhiko; Hayashi, Yuzo; Ochi, Mitsuo

doi:10.1097/01.brs.0000132510.25378.8c

Cited by 106 publications

(105 citation statements)

References 53 publications

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“…CPPD crystal deposition is occasionally observed in the cervical [11,12] or lumbar spine [13,14], but rarely in the thoracic spine [15,16]. Generally, CPPD crystal deposition in the LF has been observed in normal asymptomatic elderly individuals as one of the physiological aging processes [17,18]. However, the mechanism of CPPD crystal deposition in the present series cannot be explained simply as a physiological aging process, because the calcification was not detected on the CT scan at the time of occurrence of PJF.…”

Section: Discussioncontrasting

confidence: 44%

Progressive thoracic myelopathy caused by spinal calcium pyrophosphate crystal deposition because of proximal junctional vertebral compression fracture after lumbopelvic fusion

Odate¹,

Shikata²,

Fujibayashi

et al. 2012

Eur Spine J

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Purpose We describe cases presenting with progressive thoracic myelopathy after lumbopelvic fusion attributed to proximal junctional vertebral compression fracture (PJF) followed by spinal calcium pyrophosphate dehydrate (CPPD) crystal deposition. Methods The study included six patients, ranging from 62 to 75 years. All patients had been treated previously with lumbopelvic fusion. The mean period from the detection of PJF to the onset of myelopathy was 4.8 months. Notably, five patients demonstrated upper-instrumented vertebra (UIV) collapse. Results After revision surgery involving decompressive laminectomy and extension of the spinal fusion, all patients experienced significant improvement. Photomicrographs of the resected ligamentum flavum showed CPPD crystals and multinucleated giant cells. Conclusions The combination of mechanical stress plus PJF and CPPD crystal deposition followed by a foreign body reaction to the deposited crystals caused myelopathy. Patients with radiographic evidence of PJF, especially UIV collapse, after lumbopelvic fusion should be followed carefully for the emergence of myelopathy.

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Section: Discussioncontrasting

confidence: 44%

Progressive thoracic myelopathy caused by spinal calcium pyrophosphate crystal deposition because of proximal junctional vertebral compression fracture after lumbopelvic fusion

Odate¹,

Shikata²,

Fujibayashi

et al. 2012

Eur Spine J

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“…5,6 Increasing patient age has been shown to correlate with LF thickening at the L4 -5 level, 6,7 presenting as young as 30 years of age in 1 recent study 8 ; however, Safak et al 9 have recently found no such association.…”

Section: Discussionmentioning

confidence: 84%

The “Thickened” Ligamentum Flavum: Is It Buckling or Enlargement?

Chokshi¹,

Quencer²,

Smoker³

2010

AJNR Am J Neuroradiol

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“…With the development of imaging methods and the increased aging of society, the incidence of LSS has shown an annual increase. LSS is one of the main causes of leg pain in older individuals (1)(2)(3)(4), including intermittent claudication, numbness of buttocks and legs, activity disorder of waist and legs, muscle wasting and tendon dysreflexia (5). Intermittent claudication caused by neuropathic pain (NP) is a special chief complaint of LSS, which may be reconstructed by clinical workers; however, its mechanisms remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Brain-derived neurotrophic factor expression in dorsal root ganglia of a lumbar spinal stenosis model in rats

Liu

Chu

et al. 2013

Molecular Medicine Reports

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Abstract. This study aimed to investigate the expression of brain-derived neurotrophic factor (BDNF) in dorsal root ganglia (DRG) of a rat model of lumbar spinal stenosis (LSS). Adult male rats were divided into the operation and sham operation groups. The operation group was comprised of the rat models of LSS. Walking distance and BDNF expression levels in DRG were measured in the two groups at different time points. The total BDNF protein levels and positive cell mean optical density (MOD) values in the operation group were significantly higher at each time point compared with that of the sham operation and preoperative control groups (P<0.05). The total BDNF protein levels and MOD values following sport in the operation group were significantly higher compared with those prior to sport (P<0.05). In the sham operation group, BDNF protein levels and MOD values before and after sport at each time point showed no significant differences than those of the operation group (P>0.05). Moreover, BDNF protein levels and MOD values in the operation group indicated a negative correlation with walking distance. The present study demonstrated that the expression of BDNF in rat models of LSS increased with time and was associated with a decrease in walking distance. BDNF was therefore important for the process of intermittent claudication caused by LSS.

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The Pathology of Ligamentum Flavum in Degenerative Lumbar Disease

Cited by 106 publications

References 53 publications

Progressive thoracic myelopathy caused by spinal calcium pyrophosphate crystal deposition because of proximal junctional vertebral compression fracture after lumbopelvic fusion

Progressive thoracic myelopathy caused by spinal calcium pyrophosphate crystal deposition because of proximal junctional vertebral compression fracture after lumbopelvic fusion

The “Thickened” Ligamentum Flavum: Is It Buckling or Enlargement?

Brain-derived neurotrophic factor expression in dorsal root ganglia of a lumbar spinal stenosis model in rats

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