J Korean Med Sci.  2004 Aug;19(4):624-626. 10.3346/jkms.2004.19.4.624.

Transient Paraparesis After Laminectomy in a Patient with Multi-Level Ossification of the Spinal Ligament

• Lee KS
• Shim JJ
• Doh JW
• Yoon SM
• Bae HG
• Yun IG

• KMID: 2157699
• DOI: http://doi.org/10.3346/jkms.2004.19.4.624

Abstract

Acute neurologic deterioration is not a rare event in the surgical decompression for thoracic spinal stenosis. We report a case of transient paraparesis after decompressive laminectomy in a 50-yr-old male patient with multi-level thoracic ossification of the ligamentum flavum and cervical ossification of the posterior longitudinal ligament. Decompressive laminectomy from T9 to T11 was performed without gross neurological improvement. Two weeks after the first operation, laminoplasty from C4 to C6 and additional decompressive laminectomies of T3, T4, T6, and T8 were performed. Paraparesis developed 3 hr after the second operation, which recovered spontaneously 5 hr thereafter. CT and MRI were immediately performed, but there were no corresponding lesions. Vascular compromise of the borderlines of the arterial supply by microthrombi might be responsible for the paraparesis.

Keyword

Ossification of Posterior Longitudinal Ligament; Ligamentum Flavum; Paraparesis; Laminectomy; Spinal Stenosis; Postoperative Complications

MeSH Terms

*Cervical Vertebrae/pathology/surgery
Decompression, Surgical/adverse effects
Humans
Laminectomy/*adverse effects
*Ligamentum Flavum/pathology/surgery
*Longitudinal Ligaments/pathology/surgery
Male
Middle Aged
*Ossification, Heterotopic
Paraparesis/*etiology

Figure

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  Fig. 1 Magnetic resonance imaging of the thoracic spine reveals bilateral severe ossification of the ligamentum flavum at T9, T10, and T11.

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  Fig. 2 Computed tomographic scans of the cervical spine revealed ossification of the posterior longitudinal ligament from C4 to C6.

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