Cervical spinal cord compression attributable to a calcified intervertebral disc in a patient with X-linked hypophosphatemic rickets: case report and review of the literature.
OBJECTIVE
X-linked hypophosphatemic rickets is a common inherited phosphate-wasting disorder, but it is a rare cause of spinal cord compression. We present the first reported case of a calcified intervertebral disc causing spinal canal stenosis in X-linked hypophosphatemic rickets.


METHODS
A 44-year-old woman presented with paresthesia of her left arm and a loss of grip in both hands. Magnetic resonance imaging revealed a calcified intervertebral disc, as well as a posterior osteophytic bar causing marked cervical cord compression at C6/C7.


METHODS
An anterior cervical discectomy at C6/C7 and fusion with autologous bone graft were performed. The patient then exhibited significant improvement.


CONCLUSIONS
A review of the 16 published cases demonstrates that thickening of the vertebral laminae, facet joint hypertrophy, and ossification of the intervertebral discs, posterior longitudinal ligament, and/or ligamentum flavum contribute to spinal canal stenosis in X-linked hypophosphatemic rickets. Those changes are caused by the disease itself and are unlikely to be related to long-term vitamin D treatment. Eleven of 16 patients were reported to have experienced favorable outcomes after surgery.
Department of Surgical Neurology, The National Hospital for Neurology and Neurosurgery, London, England.
Martin
M
Soehle
Adrian T H
AT
Casey
D000328:Adult; D002114:Calcinosis / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007015:Hypophosphatemia, Familial / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D017887:Ossification of Posterior Longitudinal Ligament / Q000175:diagnosis / Q000235:genetics / Q000601:surgery; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000175:diagnosis / Q000235:genetics / Q000601:surgery