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Case Reports
. 2018 Jan 10:9:4.
doi: 10.4103/sni.sni_364_17. eCollection 2018.

Isolated ligamentum flavum ossification in primary hypoparathyroidism

Amir H Sohail  1 , Muhammad A A Maan  1 , Muhammad S Khan  1 , Qamar Masood  2
Affiliations
Case Reports

Isolated ligamentum flavum ossification in primary hypoparathyroidism

Amir H Sohail et al. Surg Neurol Int. .

Abstract

Background: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentum flavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented with ligamentum flavum ossification causing both cervical and thoracic myelopathy.

Case description: A 43-year-old male presented with backache, urinary retention, and lower limb weakness for the last few days. Magnetic resonance imaging scan showed ossification of the ligamentum flavum in the cervical and thoracic regions, with severe spinal stenosis. Following spinal decompressive surgery, the patient made a complete recovery. Primary hypoparathyroidism was found to be the underlying cause for ligamentum flavum ossification.

Conclusion: Ossification of ligamentum flavum secondary to hypoparathyroidism should be considered as a possible cause of myelopathy in all patients presenting with symptoms of spinal cord compression.

Keywords: Hypoparathyroidism; ligamentum flavum; myelopathy; ossification; parathyroid hormone.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
T2-weighted sagittal section showing multilevel ossification of ligamentum flavum (arrows) causing cord compression at multiple levels in cervical and thorax spine
Figure 2
Figure 2
T2-weighted axial section at T10-T11 level showing ossification of ligamentum flavum with severe spinal canal stenosis and cord compression (arrow)
Figure 3
Figure 3
T2-weighted sagittal section at T10-T11 level showing ossification of ligamentum flavum with severe spinal canal stenosis and cord compression (arrow)
Figure 4
Figure 4
T2-weighted axial section at T10-T11 level showing intramedullary hyperintense signal changes (arrow) suggesting cord edema
Figure 5
Figure 5
T2-weighted sagittal section showing intramedullary hyperintense signal changes at T10-T11 and T3 levels (arrows) suggesting cord edema
Figure 6
Figure 6
T2 weighted sagittal section at T10-T11 level showing removal of previously present large ossified ligamentum flavum segment (arrow). Significant postsurgical changes are seen
See this image and copyright information in PMC

References

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