Lumbar canal stenosis caused by hypertrophy of the posterior longitudinal ligament: case report.
METHODS
This is a case report of a patient with hypertrophy of the posterior longitudinal ligament (HPLL) in the lumbar spine, with assessment of operative treatment and a 10-year follow-up using magnetic resonance imaging.


OBJECTIVE
To report on the long-term outcome of a case of lumbar HPLL, to review the literature on case reports of HPLL, and to outline the pathology of HPLL in the lumbar spine.


BACKGROUND
There have been several reports of HPLL in the cervical spine and thoracic spine. However, the authors found no reports of this condition in the lumbar spine and no reports of long-term follow-up. Two types of pathology are associated with HPLL: primary hypertrophy of the ligament and secondary hypertrophy associated with intervertebral disc herniation.


METHODS
A 10-year follow-up evaluation of a 56-year-old man with HPLL at L2 is reported. The patient was observed using serial physical examinations, radiographs, and MRIs over 10 years. Because he did not respond to conservative management, surgical treatment was applied. After complete decompression by hemilaminectomy and resection of hypertrophied ligament, the nerve roots were freed of constriction through the neural foramens at L2 and L3.


RESULTS
One year after the operation the patient was asymptomatic without evidence of recurrence of the disease.


CONCLUSIONS
HPLL is a very rare disease. This appears to be the first report of the disease in the lumbar spine.
Matsumoto
T
T
Department of Orthopaedic Surgery, Wakayama Medical College, Japan. tac@wakayama-med.ac.jp
Yoshida
M
M
Yamada
H
H
Kurimoto
K
K
Tamaki
T
T
D006801:Humans; D006984:Hypertrophy / Q000150:complications; D017846:Longitudinal Ligaments / Q000473:pathology*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery