J Korean Soc Spine Surg.  2002 Sep;9(3):257-261. 10.4184/jkss.2002.9.3.257.

Thoracic Myelopathy Due to Ossification of Ligamentum Flavum: Three cases Report

• Kim J
• Cho JH
• Oh HK

• KMID: 2003234
• DOI: http://doi.org/10.4184/jkss.2002.9.3.257

Abstract

Ossification of the ligamentum flavum (OLF) is a definite clinical entity and is thought to be a form of ectopic ossification which develops predominantly in the lower thoracic spine. OLF causes progressive compressive myelopathy, radiculopathy, or combination of both. We experienced 3 cases of OLF with neurological symptoms, which were treated by posterior decompressive laminectomy and removal of the ossified ligamentum flavum with or without fusion with symptomatic improvement.

Keyword

Thoracic myelopathy; Ossification of ligamentum flavum

MeSH Terms

Laminectomy
Ligamentum Flavum*
Ossification, Heterotopic
Radiculopathy
Spinal Cord Compression
Spinal Cord Diseases*
Spine

Figure

• 

  Fig 1. Preoperative anteroposterior & lateral radiographs shows a compression fracture of the body of T12 and triangular shaped mass are protruded into the spinal canal at T10-11, T11-12 level (case 1).

• 

  Fig 2. On CT scan, the spinal canal is compressed by ossified mass and intervertebral disc at T11-12 level.

• 

  Fig 3. The postoperative plain lateral radiograph shows that ossified mass was removed.

• 

  Fig 4. Microscopically, section of the mass shows an area of ossification in the ligamentum flavum (H&E × 400).

• 

  Fig 5. The preoperative MRI show that spinal canal is compressed by ossified nodular mass at T11-12 level (case 2).

• 

  Fig 6. The preoperative CT scan reveal ossification of posterior longitudinal ligament and ligamentum flavum at T1-2 level (case 3).

Reference

1). Casino CM, Blando AV. Calcification of ligamentum flavum causing spinal cord compressing in a stroke patient. Arch. Phys Med Rehabil. 75:226–228. 1994.

2). Kim NH, Han DY, Kang SS. Ossification of ligamentum flavum. J Korean Orthop Assoc. 24:977–981. 1989.

3). Ko JH, Lee SC, Lee DH. Paraplegia caused by the ossified ligamentum flavum. J Korean Orthop Assoc. 1:356–360. 1994.

4). Kudo S, Ono M, Russel WT. Ossification of thoracic ligamenta flava. AJR, 141-. 1:117–121. 1983.

5). Miyamoto S, Takaoka K, Yonenobu K, Ono K. Ossification of the ligamentum flavum induced by bone mor -phogenic protein. J Bone Joint Surg. 74B:279–283. 1992.

6). Miyasaka K, Kaneda K, Ito T. Ossification of spinal ligaments causing thoracic radiculomyelopathy. Radiology. 143:463–468. 1982.

7). Okada K, Oka S, Tohge K. Thoracic myelopathy caused by ossification of the ligementum flavum, clinicopathologic study and surgical treatment. Spine. 280-287:1991.

8). Otani K, Aihara T, Tanaka A. Ossification of the ligamentum flavum of the thoracic spine. Int Orthop. 10:135–139. 1986.

9). Park SR, Kim HS, Kang JS, Lee YH, Lee JH, Park JS. Ossification of the ligamentum flavum and the posterior longitudinal ligament of the lumbar spine. J Korean Orthop Assoc. 4:356–360. 1997.

10). Polgar F. Uber interarkuelle wibelverkalkung. fortschr. Geb. Rontgen. 40:292–298. 1929; (Quoted in Kudo S. Ossification of thoracic ligamenta flava. AJR,. 141(1):1181983).