title: Eight years of follow-up after laminectomy of calcium pyrophosphate crystal deposition in the cervical yellow ligament of patient with Coffin-Lowry syndrome: A case report.
abstract: BACKGROUND
  We report 8 years of follow-up after decompression to treat cervical myelopathy in a patient with Coffin-Lowry syndrome (CLS). CLS is a rare X-linked semidominant syndrome associated with growth and psychomotor retardation, general hypotonia, and skeletal abnormalities. In this patient, the spinal cord was compressed by calcium pyrophosphate crystal deposition in the cervical yellow ligament (YL). To date, only 1 report has described clinical features after surgery for calcified cervical YL in CLS.
  
  
  METHODS
  A 15-year-old male with tetraplegia secondary to compression of the cervical spinal cord induced by a hypoplastic posterior arch of C1 and calcification of the YL from C2 to C7 was treated surgically with laminectomy from C1 to C7. The patient's history, clinical examination, imaging findings, and treatment are reported. The patient was incapable of speech because of mental retardation, so he could not describe his symptoms. Gait disturbance worsened over the 2 months before admission to our hospital. At admission, the patient could not move his extremities, and tendon reflexes of the upper and lower extremities were significantly increased. Computed tomography of the cervical spine showed YL calcification from C2 to C7. Magnetic resonance imaging showed consecutive compression of the cervical spinal cord. We diagnosed quadriplegia secondary to cervical cord damage and performed emergency surgery.
  
  
  RESULTS
  During C1-C7 laminectomy, YL calcification in C2-C7 was observed. The calcification was confirmed as calcium pyrophosphate by crystal analysis. Quadriplegia gradually resolved, and almost disappeared by 2 weeks after the operation. Cervical hyperlordosis was observed in radiographs starting from 1 month after the operation, but it has not progressed and is not associated with any symptoms.
  
  
  CONCLUSIONS
  The efficacy of decompression continued, and no postoperative complications have occurred during at least 8 years of follow-up.
authors: Spine Center, Ehime University School of Medicine Department of Pediatrics, Ehime University School of Medicine Department of Orthopedic Surgery, Ehime University School of Medicine, Shitsukawa, Tohon City, Ehime, Japan.
authors: Tadao
authors: T
authors: Morino
authors: Tadanori
authors: T
authors: Ogata
authors: Hideki
authors: H
authors: Horiuchi
authors: Shintaro
authors: S
authors: Yamaoka
authors: Mitsumasa
authors: M
authors: Fukuda
authors: Hiromasa
authors: H
authors: Miura
mesh_terms: D000293:Adolescent; D002131:Calcium Pyrophosphate / Q000737:chemistry; D002574:Cervical Vertebrae / Q000601:surgery*; D038921:Coffin-Lowry Syndrome / Q000150:complications*; D019299:Decompression, Surgical; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D017843:Ligamentum Flavum / Q000473:pathology / Q000601:surgery*; D008297:Male; D009999:Ossification, Heterotopic / Q000150:complications / Q000601:surgery*; D011782:Quadriplegia / Q000209:etiology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D055815:Young Adult
chemical_list: D002131:Calcium Pyrophosphate