J Korean Soc Spine Surg.  2016 Mar;23(1):36-40. 10.4184/jkss.2016.23.1.36.

Cauda Equina Syndrome due to Lumbar Ossification of the Posterior Longitudinal Ligament: A Case Report

Affiliations
  • 1Department of Orthopedic Surgery, College of Medicine, Dong A University, Korea. gylee@dau.ac.kr

Abstract

STUDY DESIGN: A case report.
OBJECTIVES
To report a rare case of cauda equina syndrome due to lumbar ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF LITERATURE REVIEW: Lumbar OPLL with neurologic symptoms is very rare.
MATERIALS AND METHODS
A 49-year-old female had experienced weakness in both lower extremities and radiating pain for 1 day prior to presentation. Simple radiography and CT showed OPLL at the L1-L2 level. We performed a total laminectomy and posterolateral fusion at the L1-L2 level using a posterior approach.
RESULTS
After treatment, the patient showed improvement of symptoms and is currently living without discomfort.
CONCLUSIONS
Cauda equina syndrome due to lumbar OPLL is rare; however, rapid neurologic recovery can be achieved through early diagnosis and surgery.

Keyword

Cauda equina syndrome; Ossification of posterior longitudinal ligament

MeSH Terms

Cauda Equina*
Early Diagnosis
Female
Humans
Laminectomy
Longitudinal Ligaments*
Lower Extremity
Middle Aged
Neurologic Manifestations
Ossification of Posterior Longitudinal Ligament
Polyradiculopathy*
Radiography

Figure

  • Fig. 1. A plain lateral radiograph of the lumbar spine shows ossification of the posterior longitudinal ligament (OPLL) (arrows) at the T12-L1 and L1-L2 levels.

  • Fig. 2. (A) A sagittal view of a CT scan shows ossification of the posterior longitudinal ligament (OPLL) at the T12-L1 and L1-L2 levels, (B) An axial CT image at L1-L2 shows OPLL, (C) An axial CT image at the endplate superior to L2 shows narrowing of the spinal canal space by OPLL.

  • Fig. 3. Sagittal T2- (A) and T1- (B) weighted MRI images show ossification of the posterior longitudinal ligament (OPLL) at the T12-L1 and L1-2 levels, Axial T2- (C) and T1- (D) weighted MRI images show OPLL distinct from the disc at the L1-L2 level.


Reference

1. Okada S, Maeda T, Saiwai H, et al. Ossification of the posterior longitudinal ligament of the lumbar spine: A Case series. Neurosurgery. 2010; 67:1311–8.
Article
2. Albisinni U, Chianura G, Merlini L, et al. Ossification of the posterior longitudinal ligament of the lumbar spine. Radiol Med. 1988; 75:482–5.
3. Tamura M, Machida M, Aikawa �, et al. Surgical treatment of lumbar ossification of the posterior longitudinal ligament. Report of two cases and description of surgical technique. J Neurosurg Spine. 2005; 3:230–3.
4. Sakamoto R, Ikata T, Murase M, et al. Comparative study between magnetic resonance imaging and histopathologic findings in ossification or calcification of ligament. Spine (Phila Pa 1976). 1991; 16:1253–61.
5. Kurihara A, Tanaka Y, Tsumura N, et al. Hyperostotic lumbar spinal stenosis. A review of 12 surgically treated cases with roentgenographic survey of ossification of the yellow ligament at the lumbar spine. Spine (Phila Pa 1976). 1988; 13:1308–16.
6. Izumi S, Hayashi Y, Uemura M, et al. A clinical study on ossification of the posterior longitudinal ligament of the lumbar spine. Orthop Surg. 1991; 42:893–8.
7. Noda M, Kawai S, Oda H, et al. A clinical study on ossification of the posterior longitudinal ligament of the lumbar spine. Orthopedics & Traumatology. 1988; 36:813–6.
Article
8. Hori T, Kawaguchi Y, Kimura T. How does the ossification area of the posterior longitudinal ligament thicken following cervical laminoplasty? Spine (Phila Pa 1976). 2006; 31:2807–12.
Article
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