Two Cases of Thoracic Myelopathy Secondary to Ossification of the? Ligamentum Flavum

J Korean Neurol Assoc > Volume 13(4); 1995 > Article

Journal of the Korean Neurological Association 1995;13(4): 1001-1006.

황색 인대의 골화에 이차적으로 나타난 흉부 척수병증 2예

김성률, 김재우, 김상호, 김갑진, 최기종, 김규홍

동아대학교 신경과. 신경외과

Two Cases of Thoracic Myelopathy Secondary to Ossification of the? Ligamentum Flavum

Seong Ryul Kim, M.D., Jae Woo Kim, M.D., Sang Ho Kim, M.D., Gab Jin Kim, M.D., Ki Jong Choi, M.D., and Kju Hong Kim, M.D.

Department of Neurology and Neurosurgery, College of Medicine, Dong-A University

Abstract

Hypertrophied ligamentum flavum is not a common cause of myelopathy. Only a minority of cases in the previous reports of myelopathy or radiculopathy secondary to thickening of the ligamentum f lavum had calcification of the ligamentum. We report two cases of thoracic myelopathy caused by ossified ligamentum flavum. One case was a twenty-five year old female who complained of weakness of lower limbs. The other was a fifty-three year old male who complained of tingling sensation on both lower extremities and weakness of right leg. These two patients showed weakness of lower extremities associated with hypesthesia below the level of calcified ligamentum flavum, positive ankle clonus, extensor plantar response, and hyperreflexia. Magnetic resonance imaging (MRI) showed clearly the spinal cord compression at the second to fourth thoracic level by a low-intensity-signal lesion. Metrizamide myelography with computerized tomography showed precise preoperative diagnosis and anatomic localization of the lesion. About one month after laminectomy and removal of the ossified ligaments flava, there was improvement of weakness, hypesthesia and ankle clonus.