Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literature review

Guo, Qunfeng; Ni, Bin; Yang, Jun; Zhu, Zhuangchen; Yang, Jian

doi:10.1007/s00586-010-1538-z

Cited by 37 publications

(21 citation statements)

References 36 publications

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“…DISH is an asymptomatic condition in general; however, it can present with neurological symptoms due to compression of the spinal cord. Qunfeng et al (4) reported neurological deficits due to OPLL and OLF causing spinal cord compression associated with DISH. Reisner and Wilson also reported that OLF associated with DISH had an important role in the development of neurologic deficits, mainly in the thoracic spine (7,8).…”

Section: Discussionmentioning

confidence: 99%

“…DISH mostly occurs in males and in the fifth decade of the life and may be associated with systemic diseases, such as diabetes mellitus and obesity (2). The anterior longitudinal ligament is the primary site of involvement in DISH; however, ossified posterior longitudinal ligament (OPLL) and ossified ligamentum flavum (OLF) have been also described in DISH patients (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Thoracic Myelopathy Due to a Combination of Disc Herniation, Ossified Ligamentum Flavum, and Bridging New Bone Formation in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: Triple Crush!

Ulaşlı¹,

Erdal²,

Duymuş³

et al. 2014

Turk J Phys Med Rehab

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ÖzetTorasik miyelopati nadir görülen bir durumdur ve difüz idiyopatik skeletal hiperostoz (DİSH), ossifiye posterior longitudinal ligament, ossifiye ligamentum flavum (OLF) ve disk herniasyonlarına bağlı olabilir. Biz bu olguda her iki bacağında güçsüzlük, hissizlik ve yürüme güçlüğü ile baş-vuran DİSH'li bir hastayı tartıştık. Disk herniasyonu, köprüleşen yeni kemik oluşumları ve OLF ileri spinal kanal darlığına katkıda bulunmuşlardı. DİSH yaşlı insanların hastalığı olsa da, hasta nispeten gençti ve diyabet ile obezite hikayesi yoktu. Dahası hasta minör bir travma öncesine kadar asemptomatik idi. Bu olgu, klinisyenlerin hızlı tanı konulup erken cerrahi uygulandığında daha iyi bir prognozla sonuçlanan bu nadir durumun farkında olması amacıyla sunulmuştur. Anahtar Kelimeler: Difüz idiyopatik skeletal hiperostoz, torasik miyelopati, ligamentum flavum AbstractThoracic myelopathy is an uncommon condition and may be due to diffuse idiopathic skeletal hyperostosis (DISH), ossified posterior longitudinal ligament (OPLL), ossified ligamentum flavum (OLF), and disc herniation. In the present case, we discussed a patient with DISH who presented with weakness and numbness in both legs and gait difficulty after a sudden trauma. Disc herniation, bridging new bone formation, and OLF were found to contribute to severe spinal canal narrowing. Although DISH is a disease of elderly patients, the patient was relatively young with no history of diabetes and obesity. Furthermore, the patient was asymptomatic until a minor trauma. This case was reported for clinicians to be aware of this rare condition, in which prompt diagnosis and early surgical management may result in better prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thoracic Myelopathy Due to a Combination of Disc Herniation, Ossified Ligamentum Flavum, and Bridging New Bone Formation in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: Triple Crush!

Ulaşlı¹,

Erdal²,

Duymuş³

et al. 2014

Turk J Phys Med Rehab

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“…This abnormality appears to be higher in the middle-aged men than women [1]. DISH is rarely accompanied with Ossification of the Posterior Longitudinal Ligament (OPLL) and Ossification of the Ligamentum Flavum (OLF) [2]. OPLL characterized by calcification of the posterior longitudinal ligament [3] leads to cord compression [3].…”

Section: Background and Importancementioning

confidence: 99%

Simultaneous Diffuse Idiopathic Hyperostosis, Ossification of the Posterior Longitudinal Ligament and Ligamentum Flavum

Alijani

Yousefzadeh-Chabok

Ramzannejad

et al. 2018

IrJNS

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Background and Importance: A 60-year-old diabetic man with simultaneous diffuse idiopathic hyperostosis, massive ossification of the posterior longitudinal ligament and cervical and higher part of thoracic ligamentum flavum is reported in this article. Such comorbidity rarely occurs. Case Presentation: The patient's chief complaint was sensation abnormalities without gait disturbance or severe cord compression symptoms despite the advanced stage of the disease. Computed tomography scan and magnetic resonance imaging confirmed multi-level involvement of cervicothoracic spine. Conclusion: After surgical treatment, his symptoms resolved completely with no complication.

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“…[1][2][3][4][5][6][7] We describe a case of cervical myelopathy secondary to OPLL and OLF that required surgery. Patients are usually treated with cervical laminectomy or laminoplasty with JOSS CASE REPORT [1][2][3] …”

Section: Introductionmentioning

confidence: 99%

Cervical Myelopathy Secondary to Combined Ossification of Ligamentum Flavum and Posterior Longitudinal Ligament

Chachan¹,

Kasat²,

Thng³

2016

The Journal of Spinal Surgery

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In the cervical spine, the combined ossification of the ligamentum flavum (OLF) and ossification of the posterior longitudinal ligament (OPLL) is rarely seen. Patients are usually treated with cervical laminectomy or laminoplasty with OLF resection. In most of the cases, OLF is adhered to the dura and there is a risk of dural tear or cerebrospinal fluid (CSF) leakage during its resection. In this case report, authors present results of laminectomy with debulking instead of complete excision of OLF for spinal cord decompression in a cervical myelopathy case where OLF was adhered to the dura. A 69-year-old man presented with insidious-onset weakness in bilateral lower limbs and unsteady gait since 1 month. He had a history of neck pain with left upper limb radiation for 2 years. Magnetic resonance imaging (MRI) showed C5 to C6 severe central canal stenosis with underlying myelomalacia. Computed tomography (CT) showed OPLL and OLF contributing to severe central canal stenosis at C5 to C6 level. Patient underwent C4 to C6 laminectomy, debulking of OLF, posterior instrumentation, and fusion with autogenous bone graft from C3 to C6. Histological specimen showed osseous tissue within the ligamentum flavum. After surgery, patient's symptoms improved, and no recurrence was observed at 4 years after surgery. The symptoms of myelopathy were successfully treated with debulking instead of complete excision of OLF, thus reducing the risk of dural tear or CSF leakage.

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Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literature review

Cited by 37 publications

References 36 publications

Thoracic Myelopathy Due to a Combination of Disc Herniation, Ossified Ligamentum Flavum, and Bridging New Bone Formation in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: Triple Crush!

Thoracic Myelopathy Due to a Combination of Disc Herniation, Ossified Ligamentum Flavum, and Bridging New Bone Formation in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: Triple Crush!

Simultaneous Diffuse Idiopathic Hyperostosis, Ossification of the Posterior Longitudinal Ligament and Ligamentum Flavum

Cervical Myelopathy Secondary to Combined Ossification of Ligamentum Flavum and Posterior Longitudinal Ligament

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