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Case Reports
. 2012 Jun 30;2(2):25-29.
doi: 10.4322/acr.2012.013. eCollection 2012 Apr-Jun.

Calcification of the ligamentum flavum in the thoracolumbar spine: an unusual cause of compressive myelopathy

João Augusto Dos Santos Martines  1 , Brenda Margatho Ramos Martines  1 , José de Arimatéia Batista Araújo  2 , Lorena Elaine Amorim Pinto  2 , Cláudio Campi de Castro  1   3
Affiliations
Case Reports

Calcification of the ligamentum flavum in the thoracolumbar spine: an unusual cause of compressive myelopathy

João Augusto Dos Santos Martines et al. Autops Case Rep. .

Abstract

The focal calcification or ossification of the ligamentum flavum is a rare cause of thoracic myelopathy and most often occurs among individuals of Japanese descent. It is rare in other ethnic groups and in individuals below the age of 50. It is most often described at the lower thoracic level, being uncommon in the lumbar region and rare in the cervical region. Here, we present the case of a 44-year-old White female patient who sought medical attention with an eight-month history of paraesthesia of the lower limbs and progressive difficulty in walking. The clinical profile, together with computed tomography and nuclear magnetic resonance imaging of the spine, led to a diagnosis of compressive thoracic myelopathy due to ossification of the ligamentum flavum in the thoracic and lumbar spine. The patient underwent laminectomy and dissection of some of the affected ligamentum flavum, without any intraoperative complications. After three months of clinical follow-up, the patient had progressed favorably, having no sensory complaints and again becoming ambulatory.

Keywords: Ligamentum flavum; Ossification of the posterior longitudinal ligament; Spinal cord compression; Spine.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. - Axial soft tissue window and bone window computed tomography scans (A and B, respectively) of the thoracic spine showing hypertrophied and calcified ligamenta flava (arrows) causing spinal canal narrowing.
Figure 2
Figure 2. - Axial soft tissue window and bone window computed tomography scans (A and B, respectively) of the lumbar spine showing calcified ligamenta flava (arrows) causing no spinal canal narrowing.
Figure 3
Figure 3. - Coronal reconstruction of soft tissue window and bone window computed tomography scans (A and B, respectively) of the thoracic spine showing hypertrophied and calcified ligamenta flava causing spinal canal narrowing, which is most evident at T6, T10, and T11.
Figure 4
Figure 4. - Sagittal reconstruction of soft tissue window and bone window computed tomography scans (A and B, respectively) of the thoracic spine showing hypertrophied and calcified ligamenta flava causing spinal canal narrowing, which is most evident at T6, T10, and T11.
Figure 5
Figure 5. - Magnetic resonance imaging of the thoracic spine: T2-weighted sequence showing hyperintense areas in the spinal cord at T6–T7 and T10–T11, suggesting compressive myelopathy.
Figure 6
Figure 6. - Topographic anatomy of the ligamentum flavum.
See this image and copyright information in PMC

References

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