Symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with ossification of the ligamentum flavum: a case report.
METHODS
A case report.


OBJECTIVE
To describe a rare case of symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with ossification of the ligamentum flavum (OLF).


BACKGROUND
Spinal cord kinking without spinal surgery is rare, and symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with OLF is even rarer.


METHODS
A 66-year-old female presented with numbness of the lower extremities and subsequently experienced gait disturbance due to motor weakness. Magnetic resonance imaging of the thoracic spine showed anterior displacement and kinking of the spinal cord from T11 to T12. Laminectomy and OLF resection were performed. The arachnoid membrane at the affected part was markedly thick and seemed cloudy. Adhesiolysis for arachnoid adhesion and release of spinal kinking were performed.


RESULTS
She could walk with a cane 6 months postoperatively. One year postoperatively, thoracic computed tomography-myelography showed that the cord was repositioned in the dural sac, and that release of the spinal cord kink was maintained.


CONCLUSIONS
Symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with OLF is a rare clinical condition. It was difficult to diagnose the precise pathology of the spinal cord before surgery. Microsurgical arachnoidolysis resolved the spinal cord kinking, and no recurrence was noted within the follow-up period.


METHODS
N/A.
From the Department of Orthopaedic Surgery, Oita University, Oita, Japan.
Masashi
M
Miyazaki
Toyomi
T
Yoshiiwa
Toshinobu
T
Ishihara
Nobuhiro
N
Kaku
Masanori
M
Kawano
Hiroshi
H
Tsumura
D000368:Aged; D001100:Arachnoiditis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007796:Laminectomy; D017843:Ligamentum Flavum / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009999:Ossification, Heterotopic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D020127:Recovery of Function; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome