Acute Calcification of Intervertebral Disc and Posterior Longitudinal Ligament in a 7-Year-Old Girl: A Case Report

Abstract

A 7-year-old girl presented with a 2-day history of acute neck pain without any preceding injury. The pain was around the left posterior paraspinal muscle and was aggravated by neck movement. There was no neurological abnormality; white cell count and inflammatory markers were slightly elevated. Radiology of the cervical spine showed calcification of C3/4 and C4/5 discs as well as the posterior longitudinal ligament over C3/4. She was treated conservatively with a neck collar and Panadol syrup. No non-steroidal anti-inflammatory drug was prescribed. Two months later, calcification of the posterior longitudinal ligament had resolved and calcification at C3/4 and C4/5 discs and the C4 lower endplate had decreased. After one year, she was painfree with no tenderness over her neck and had full range of neck motion and complete resolution of the calcification.

Regression of intervertebral disc calcification combined with ossification of the posterior longitudinal ligament: A case report

“…OPLL is usually considered a degenerative cervical or thoracic pathology in adults and was first reported in 1838[ 10 ]. IDC combined with OPLL in pediatric patients is much less frequent, and to date only 8 cases have been published[ 1 - 7 ].…”

“…The patients in the previously reported cases were two men and six women, aged 6-years-old to 11-years-old. In general, the injury occurs in a single segment of the disc, and a few cases have also involved two parts of the disc[ 1 , 4 , 6 , 7 ]. In the imaging examinations of the reported cases, abnormal signs of intervertebral discs were seen, and the masses penetrated into the spinal canal and compressed the spinal cord.…”

“…Generally, imaging findings are the main basis for diagnosis[ 15 ]. However, for this disease, there exists a possibility that the imaging performance and clinical symptoms are inconsistent[ 1 , 2 , 5 - 7 , 12 ].…”

“…Intervertebral disc calcification (IDC) with ossification of the posterior longitudinal ligament (OPLL) is rare. To date, only 8 cases of IDC with OPLL in children have been reported[ 1 - 7 ]. Of the 8 reported cases, 6 were in the cervical spine and 2 were in the thoracic spine.…”

“…Finally, the clinical symptoms of all patients disappeared after conservative treatment. However, according to imaging evaluation, 4 patients recovered completely[ 2 , 4 , 6 , 7 ], 1 patient had persistent mild OPLL[ 3 ], 2 patients had persistent mild IDC[ 4 , 5 ], and 1 patient had progressive IDC 1 . All reported patients had neck pain or back pain to varying degrees due to the IDC and OPLL extending into the spinal canal, compressing the spinal cord or nerve root, and all went to the hospital with or without neurological defects.…”