Cervical myeloradiculopathy as an initial presentation of pseudogout

Liao, Jen-Hsien; Hsieh, Cheng-Ta; Sun, Jui-Ming

doi:10.17712/nsj.2021.1.20200122

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…[20] e presentation of CPPD in the CLF is a rare occurrence; however, it has been disproportionately diagnosed in the Asian population. [6,13,18,19,24] Overall, aging is a major risk factor for CPPD deposit disease in the CLF. e prevalence of CPPD deposit disease increases from 3.7% to 17.5% as age groups increase from 55-59 to 80-84, respectively.…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Muthukumar and Karuppaswanny (2003) [23] 1) 70 y/F 2) 55 y/F [30] 1) 83 y/F 2) 78 y/M 3) 92 y/F 4) 85 y/F --1) Acute posterior neck pain and stiffness 2) Acute posterior neck pain and stiffness 3) Acute posterior neck pain and stiffness 4) Acute posterior neck pain and stiffness -- [14] 78 y/M Spinal cord injury -C6 [18] 65 y/F 2]. [28] Although the direct cause of pseudogout is still unclear, some reported that metabolic risk factors for CPPD deposit disease in the CLF are hyperthyroidism, hypothyroidism, hyperparathyroidism, osteoarthritis, diabetes mellitus, arthrosclerosis, hypertension and hemochromatosis, Wilson's disease, hypophosphatasia, hypomagnesemia, and loop diuretics use.…”

Section: C5-c6mentioning

confidence: 99%

“…[28] Although the direct cause of pseudogout is still unclear, some reported that metabolic risk factors for CPPD deposit disease in the CLF are hyperthyroidism, hypothyroidism, hyperparathyroidism, osteoarthritis, diabetes mellitus, arthrosclerosis, hypertension and hemochromatosis, Wilson's disease, hypophosphatasia, hypomagnesemia, and loop diuretics use. [8,18,23,24] Hyperparathyroidism, hemochromatosis, hypothyroidism, and hypomagnesium have the strongest association with CPPD deposition in the CLF. [31] In addition, CPPD deposition can also be associated with trauma and surgery.…”

Section: C5-c6mentioning

confidence: 99%

“…[ 20 ] The presentation of CPPD in the CLF is a rare occurrence; however, it has been disproportionately diagnosed in the Asian population. [ 6 , 13 , 18 , 19 , 24 ]…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

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Calcium pyrophosphate dihydrate of the ligamentum flavum in the cervical spine – A review of the literature

Ehioghae¹,

Lawlor²,

Mesfin³

2022

Surgical Neurology International

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Background: Calcium pyrophosphate dihydrate (CPPD) deposition, also known as pseudogout, in the cervical ligamentum flavum (CLF), is a rare disease which can cause spinal cord signaling changes leading to rapid deterioration in function. The natural history of cervical myelopathy as a result of CPPD deposition within the CLF is not well understood. Our objective is to describe the presentation, imaging findings, and treatment options of CPPD deposition or pseudogout of the cervical spine. Methods: Using PubMed, we analyzed studies published from 1978 to 2022. Key words used were “pseudogout,” “CPPD deposit disease,” “cervical yellow ligament,” “CLF,” and “cervical spine.” We excluded “crowned dense syndrome” and “ossification of ligament flavum.” Using a department database, we queried for patients treated for CPPD of the cervical spine. Results: Twenty clinical studies on CPPD of the cervical spine with 69 patients aged between 15 and 92 years (mean = 72) were identified. Neck pain and numbness of the hands were the most common symptoms. Diabetes mellitus and hypertension were the most common comorbidities. Males and females were affected at equal rates. C4-C5 and C5-C6 were the most affected segments. Earlier surgical treatment produced better outcomes. A laminectomy and fusion or laminoplasty were the most common procedures performed with most patients experiencing some return of neurologic function. Conclusion: Although rare, CPPD deposit disease in the CLF should be readily considered as a differential diagnosis due to the continuously aging population. CPPD’s progressively worsening nature makes an early diagnosis and treatment important in improving the patient’s overall quality of life.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: C5-c6mentioning

confidence: 99%

Section: C5-c6mentioning

confidence: 99%

“…[ 20 ] The presentation of CPPD in the CLF is a rare occurrence; however, it has been disproportionately diagnosed in the Asian population. [ 6 , 13 , 18 , 19 , 24 ]…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Calcium pyrophosphate dihydrate of the ligamentum flavum in the cervical spine – A review of the literature

Ehioghae¹,

Lawlor²,

Mesfin³

2022

Surgical Neurology International

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Calcium pyrophosphate dihydrate crystal deposition disease and retro-odontoid pseudotumor rupture managed via posterior occipital cervical instrumented fusion: illustrative case

Malhotra¹,

Malhotra

Landry³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Craniocervical junction and subaxial cervical spinal manifestations of calcium pyrophosphate deposition disease are rarely encountered. The authors presented a severe case of retro-odontoid pseudotumor rupture causing rapid quadriparesis and an acute comatose state with subsequent radiographic and clinical improvement after posterior occipital cervical fusion. OBSERVATIONS The authors surveyed the literature and outlined multiple described operative management strategies for compressive cervical and craniocervical junction calcium pyrophosphate deposition disease manifestations ranging from neck pain to paresthesia, weakness, myelopathy, quadriparesis, and cranial neuropathies. In this report, radiographic features of cervical and craniocervical junction calcium pyrophosphate deposition disease were explored. Several previously described surgical strategies were compiled, including patient characteristics and outcomes. LESSONS With this case report, the authors presented for the first time an isolated posterior occipital cervical fusion for treatment of a compressive retro-odontoid pseudotumor with rupture into the brainstem. They demonstrated rapid clinical and radiographic resolution after stabilization of cranial cervical junction only 12 weeks postsurgery.

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Cervical Spine Myelopathy Caused by Calcium Pyrophosphate Dihydrate Deposition of the Ligamentum Flavum: A Case Report

Avetisian,

Ton,

Dowling

et al. 2024

Cureus

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Cervical myeloradiculopathy as an initial presentation of pseudogout

Cited by 4 publications

References 12 publications

Calcium pyrophosphate dihydrate of the ligamentum flavum in the cervical spine – A review of the literature

Calcium pyrophosphate dihydrate of the ligamentum flavum in the cervical spine – A review of the literature

Calcium pyrophosphate dihydrate crystal deposition disease and retro-odontoid pseudotumor rupture managed via posterior occipital cervical instrumented fusion: illustrative case

Cervical Spine Myelopathy Caused by Calcium Pyrophosphate Dihydrate Deposition of the Ligamentum Flavum: A Case Report

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