Cervical myelopathy in pseudogout. Case report.

Ogata, Manabu; Ishikawa, Kôichirô; Ohira, Takashi

doi:10.2106/00004623-198466080-00023

Cited by 33 publications

(12 citation statements)

References 4 publications

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“…It has been postulated that CPPD deposition of the atlantoaxial joint can be explained by the presence of chondroid cells within the transverse ligament of the atlas, thus rendering it structurally analogous to the meniscus of the knee, a fibrocartilaginous structure (24). Others have suggested that fibroblasts within cervical spine ligaments can transform into chondrocytes, thus making these ligaments susceptible to calcification (28,29). Hydroxyapatite crystal deposition has also been reported in other areas of the cervical spine, including deposition in the longus coli muscle causing calcific tendinitis of the neck, as well as deposition in cervical intervertebral discs and the ligamentum flavum (18,30,31).…”

Section: Discussionmentioning

confidence: 99%

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

Wu¹,

Reginato²,

Torriani³

et al. 2005

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 99%

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

Wu¹,

Reginato²,

Torriani³

et al. 2005

Arthritis & Rheumatism

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“…In fact, it is unclear why there is such dramatic CPPD deposition in noncartilaginous structures in patients with CPPD deposition disease of the cervical spine. Ogata et al 7 and Doherty and Dieppe 8 suggest that fibroblasts within ligamentous tissues in the cervical spine undergo a metamorphosis into functioning chondrocytes. These transformed chondrocytes produce large amounts of inorganic pyrophosphate 9 that bind with ionized calcium and are deposited on collagen or degenerated elastic fibrils.…”

Section: Commentmentioning

confidence: 99%

Compressive Cervical Myelopathy Due to Calcium Pyrophosphate Dihydrate Deposition Disease

Fye¹,

Weinstein²,

Donald³

1999

Arch Intern Med

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Calcium pyrophosphate dihydrate (CPPD) deposition disease is an inflammatory arthropathy that is defined by the deposition of CPPD crystals in articular and periarticular structures. The deposition of CPPD in hyaline cartilage and fibrocartilage leads to the chondrocalcinosis that is characteristic of the disease. It can occur independently or in association with any of a number of inflammatory or endocrine disorders. This form of crystal-induced arthritis tends to affect the peripheral joints, particularly the knees, ankles, shoulders, wrists, and second and third metacarpophalangeal joints, but involvement of the lumbar spine is not uncommon. Cervical spine disease due to CPPD deposition is, however, rare. We report a case of compressive cervical myelopathy due to CPPD deposition disease of the cervical spine in a woman with long-standing rheumatoid arthritis. We also, from a review of the English-language literature, describe the collective reported clinical experience with CPPD deposition disease of the cervical spine.

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“…However, recent reports favour a wider spectrum of histopathological features, such as HAP in the dural side of the ligamenta flava [4] or acute inflammation accompanying the crystalline deposits [5]. It is commonly accepted that mineralized deposits precipitate around the degenerated elastic fibers of the ligamentum flavum [9] due to a conjunction of various factors including aging process, decrease in oestrogen in older women, mechanical stress of the mid-cervical spine [13] and chondrocytic metaplasia [12].…”

Section: Discussionmentioning

confidence: 99%

Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients

Pascal‐Moussellard

Cabre

Smadja

et al. 1999

European Spine Journal

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IntroductionCalcification of the ligamenta flava (CLF) of the cervical spine causing myeloradiculopathy is a rare disorder occasionally reported in Japanese people [6]. CLF seems to be exceptional in non-Asian populations. We encountered for the first time two such cases in black patients living in the French West Indies. We present here the clinical and radiological findings and outcome in these patients. Case reportsCase 1A 72-year-old black woman first noticed numbness in her hands 3 months before admission. During the next weeks, she had difficulty walking and working with her hands. She had no history of spinal injury or rheumatic disease. On admission, the gait was clearly ataxic and neurological exam showed a proximal weakness in the lower limbs. There was no impairment of touch sensation, but position sense, in particular, was absent in all limbs. Deep tendon reflexes were brisk, a bilateral Hoffman sign was found and plantar responses were extensor. She complained of neither radiating pain nor urinary symptoms. General examination was otherwise normal. Routine blood tests were unremarkable. Myelography revealed a partial block at the level C4-C5 and a subsequent CT scan showed voluminous oval masses involving both ligamenta flava at the same level (Fig. 1). The patient was then treated with posterior decompressive C4 and C5 laminectomies. At surgery, the above masses appeared as white granular deposits within degenerated ligamenta flava and were easily dissected from the dura matter. Microscopic examination of the removed material revealed hydroxyapatite crystals (HAP) at the centre of the nodules, surrounded by calcium pyrophosphate dihydrate crystals (CPPD). After surgery, there was dramatic improvement. The gait returned to nearly normal and disturbances of the deep sensation Abstract Two cases of cervical myelopathy due to calcification of the ligamenta flava (CLF) are described for the first time in black patients from the French West Indies. A pre-operative CT scan differentiated the diagnosis from one of ossification of the ligamenta flava. Microanalysis on the operatively excised specimen in one patient revealed a mixture of calcium pyrophosphate dihydrate crystals and hydroxypatite crystals. Poor outcome in one patient contrasting with excellent recovery in the other one, who had undergone posterior decompressive laminectomy, emphasizes the importance of surgery in the management of CLF.

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Cervical myelopathy in pseudogout. Case report.

Cited by 33 publications

References 4 publications

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

The crowned dens syndrome as a cause of neck pain: Report of two new cases and review of the literature

Compressive Cervical Myelopathy Due to Calcium Pyrophosphate Dihydrate Deposition Disease

Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients

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