Calcification of the intervertebral disc and ossification of posterior longitudinal ligament in children

Abstract

BackgroundIDC in children, first reported by Baron in 1924, is very rare. OPLL of the cervical spine mainly affect people ages 50–70 years. The coexistence of IDC and OPLL in children is very rare, only six cases with 3 to 24 months’ follow-up were reported to date.Case presentationA 6-year-old boy presented with complains of neck pain at July 2007. The boy was treated by conservative treatment and observed up for 9 years. Neck pain greatly improved after a one-month conservative treatment and never recur. Laboratory tests revealed elevated ESR and CRP at admission and found nothing abnormal at 19-month and 9-year follow-up. Computed tomography and magnetic resonance imaging revealed IDC at C2/3, C3/4 and OPLL at C3/4 at admission and found minor calcification at C2/3 remained but calcification at C3/4 and OPLL at C3/4 completely disappeared at 19-month and 9-year follow-up. Nineteen months after initial diagnosis, restoration of T2-weighted signal intensity of C2/3 and C3/4 discs was observed through MRI. Loss of T2-weighted signal intensity of C2/3 disc and decrease of T2-weighted signal intensity of C3/4 disc was observed at 9-year follow-up.ConclusionsIDC with OPLL in children is very rare. Conservative treatments are recommended with affirmative short-term and long-term clinical effects. More intensive observation with long-term follow-ups may be needed to warrant the clinical effects.

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

“…The exact cause of IDC accompanied by OPLL is still unclear. However, trauma is often considered an inducer because some children’s disc calcifications occur before trauma[ 12 , 13 ]. Beluffi et al [ 9 ] suggested that there are two types of IDC: Symptomatic and asymptomatic.…”

“…Simple IDC disappears in 3 to 60 mo, with an average of 15 mo[ 8 ]. However, after 9 years of follow-up, Du et al [ 4 , 12 ] found that residual IDC persisted and the height of the affected intervertebral space had become narrow, indicating that residual IDC may not subside spontaneously with time.…”

“…Physical examination can often reveal neck muscle spasms, tenderness at the lesion site, and limited neck movement. If there is nerve root or spinal cord compression, there may be corresponding signs of nervous system defects[ 12 , 15 ]. In the reported cases, the most frequently reported symptoms were neck pain.…”

“…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 ].…”

Comparative Effectiveness and Functional Outcome of C2 Dome-like Expansive Versus C2 Expansive Open-door Laminoplasty for Upper Cervical Ossification of the Posterior Longitudinal Ligament

“…8 Surgical treatment is effective that can create possibilities for the recovery of nerve function. 9,10 For the patients with three or more segments OPLL in Kline positive, posterior approach surgery is recommend. 11 Since the range of most OPLL is below C2 level in clinical, the general scope of surgery is C3-7 laminectomy or expansive laminoplasty.…”