Calcification of the Ligamentum Flavum Causing Cervical Radiculomyelopathy

Rhyu, Kwan Uk; Lee, Kyung Jin; Park, Sung Chan; Park, Hae Kwan; Cho, Kyung Keun; Rha, Hyung Kyun; Choi, Chang Rak; Kang, Joon Ki

Abstract

A case of cervical radiculomyelopathy was caused by calcification of the ligamentum flavum of the cervical spine. A 63-year-old woman with dysesthesia on both upper extremities and gait disturbance was transferred to our hospital. Neurologic examimation revealed only mild right hemiparesis, while a plain cervical X-ray and a computed tomogram revealed nodular calcification in the posterior paramedial portion of the spinal canal at the level of C3-4. A well-defined low signal intensity mass on T1- and T2-weighted MR images demonstrated severe posterior compression of the spinal cord. The nodular mass together with the ligamentum flavum was removed by partial inferior laminectomy of C3 and partial superior laminectomy of C4. The calcified mass, confined within the ligamentum flavum, was composed of numerous fine amorphous particles and chalky white substances with a paste-like consistency, and caused marked underlying spinal cord compression. It had no connection, however, with the lamina or dura mater. The patient's neurological deficits were resolved two weeks after surgery. A clinical summary of the case and review of the corresponding literature are presented