Ossification of the ligamentum flavum causing thoracic myelopathy: a case report.
Ossification of the ligamentum flavum is a well reported clinicopathologic entity causing narrowing of the spinal canal and subsequent spinal cord compression. The patient described in this case report complained of 9 mo of middle and lower back pain, difficulty with balance, progressive gait disturbance, and recent onset of bladder retention. Magnetic resonance imaging and computed tomographic scan revealed a bone density mass at the T2-3 level causing 25% cord compression and edema. A decompressive laminectomy was performed at T-2. The etiology of the compression was found to be attributable to an ossified ligamentum flavum at the T-2 level, which was confirmed by histologic examination. His neurologic signs and symptoms and functional status markedly improved after surgery and subsequent comprehensive rehabilitation. The patient was able to ambulate independently with a walker as opposed to previously being wheelchair-bound. Prompt surgical intervention and appropriate rehabilitation management play a key role in improving the functional outcome of myelopathy caused by ossified ligamentum flavum. This article acquaints rehabilitation personnel with the clinical features, proposed etiologies, association with other diseases, work-up, treatment, and rehabilitation concerns of patients with myelopathy caused by ossified ligamentum flavum.
Shenoi
R M
RM
Denver Health Medical Center, Colorado, USA.
Duong
T T
TT
Brega
K E
KE
Gaido
L B
LB
D000328:Adult; D002114:Calcinosis / Q000150:complications* / Q000601:surgery; D006801:Humans; D017843:Ligamentum Flavum / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome