Myelopathy Caused by Ossification of Ligamentum Flavum

Abstract

Ossification of ligamentum flavum is an uncommon cause of myelopathy in the Chinese population. It can present acutely after minor trauma. Posterior decompression, especially with en bloc dissection of laminae, gives satisfactory results.

Thoracic myelopathy due to ossification of ligamentum flavum: a retrospective analysis of predictors of surgical outcome and factors affecting preoperative neurological status

“…Park et al [32] in a non-statistical survey found that recovery is less in this group of * Statistically significant at P \ 0.05 Table 9 Independent factors associated with preoperative neurological status (preoperative JOA score) with MRA patients. However, we agree with Hur et al [15] and Li et al [33] who reported that trauma has no influence on recovery in a statistical and nonstatistical survey, respectively. Compressive effects of hematoma and edema of spinal cord after traumatic event are likely to regress, resulting in good surgical outcome.…”

“…No attempts at complete removal of OLF should be made when dura is found adherent to avoid dural tear and leaving a floating adherent fragment gives satisfactory results [33]. We found no patient with less than 12 months of duration of symptoms with adhesions, indicating that prolonged compression of dura is necessary to cause adhesion.…”

“…Being predominantly a static compressive myelopathy [10,35], preoperative neurological status and recovery correlate with the canal measurements. Although an argument of vascular involvement leading to more severe myelopathy and lesser recovery despite less severe stenosis could be given, a reasonable explanation is that vascular causes are more likely in anteriorly located thoracic OPLL, while OLF being posterior spares anterior circulation [32,33,38]. Since we excluded OPLL cases, vascular causes are unlikely to be operating in our series, thereby 'allowing' canal measurements to correlate.…”

Removal of ossified ligamentum flavum via a minimally invasive surgical approach

“…Several studies have revealed that multilevel laminectomies with removal of the ligaments and facets for the treatment of OLF have resulted in the delayed development of a kyphotic deformity. 5,6,8 Preservation of the facets and/or ligaments is necessary to avoid a fusion. Therefore, some authors advocate the use of laminoplasty as a treatment option.…”

Ossification of the ligamentum flavum: Diet and genetics

“…17 Our patient represents an unusual combination of race, lifestyle and pathology. There is only a single literature report of OLF in a Chinese subject, 18 despite the immense Chinese population base. Although of Chinese extraction by birth, our patient was raised in Japan and has a pathology that is very common in Japan.…”