Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 4;6(10):CASE23340.
doi: 10.3171/CASE23340. Print 2023 Sep 4.

Single-level ossified ligamentum flavum causing a holocord syrinx: illustrative case

Prashant Punia, Ashish Chugh, Sarang Gotecha, Apurva Lachake

Single-level ossified ligamentum flavum causing a holocord syrinx: illustrative case

Prashant Punia et al. J Neurosurg Case Lessons. .

Abstract

Background: Syringomyelia is a neurological disorder that is caused by abnormal cerebrospinal fluid flow or circulation. It is an incidental finding in most cases, predominantly presenting with sensory symptoms of insensitivity to pain and temperature. Spinal ossified ligamentum flavum (OLF) leading to syringomyelia is one of the rare causes. The authors report an unusual case of syringomyelia due to a thoracic OLF.

Observations: A 54-year-old female presented with backache, difficulty walking, spasticity in the bilateral lower limbs, tingling sensation in the bilateral lower limbs, and paraparesis for 5 years. Her radiological investigations were suggestive of an OLF causing a syrinx. She underwent laminectomy, and her syrinx resolved on subsequent follow-up.

Lessons: A syrinx due to a single-level OLF is rare, and this uncommon cause should be kept in mind while formulating treatment plans.

Keywords: OLF; ossified ligamentum flavum; syringomyelia; syrinx.

PubMed Disclaimer

Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1
FIG. 1
Sagittal (left) and axial (right) MRI showing a syrinx from the C3 vertebral level up to the conus and cord compression at T11–12 level.
FIG. 2
FIG. 2
Sagittal (left) and axial (right) T2-weighted MRI on follow-up, with complete dilation of the central canal and thinned out parenchyma.
FIG. 3
FIG. 3
Sagittal (left) thoracic spine and axial (right) CT images at the T11–12 level, showing ligamentum flavum ossification compromising the canal with the fusion of bilateral ossified masses at the midline.
FIG. 4
FIG. 4
Intraoperative photograph showing complete excision of OLF with exposed spinal cord.
FIG. 5
FIG. 5
Postoperative sagittal (left) and axial (right) T2-weighted MRI showing a resolving syrinx with a CSF pocket at the operative site.
See this image and copyright information in PMC

References

    1. Greitz D. Unraveling the riddle of syringomyelia. Neurosurg Rev. 2006;29(4):251–264. - PubMed
    1. Milhorat TH, Chou MW, Trinidad EM, et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44(5):1005–1017. - PubMed
    1. Roy AK, Slimack NP, Ganju A. Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management. Neurosurg Focus. 2011;31(6):E15. - PubMed
    1. Klekamp J, Batzdorf U, Samii M, Bothe HW. Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma. J Neurosurg. 1997;86(2):233–240. - PubMed
    1. Roser F, Ebner FH, Sixt C, Hagen JM, Tatagiba MS. Defining the line between hydromyelia and syringomyelia. A differentiation is possible based on electrophysiological and magnetic resonance imaging studies. Acta Neurochir (Wien) 2010;152(2):213–219. discussion 219. - PubMed

LinkOut - more resources