Asian Spine J.  2014 Feb;8(1):89-96. 10.4184/asj.2014.8.1.89.

Ossification of the Ligamentum Flavum

• Ahn DK
• Lee S
• Moon SH
• Boo KH
• Chang BK
• Lee JI

• KMID: 2270395
• DOI: http://doi.org/10.4184/asj.2014.8.1.89

Abstract

Ossification of the ligamentum flavum is a rare cause of thoracic myelopathy. It develops in East Asians more frequently than in people from other areas. The exact pathophysiology has not been elucidated yet; however, it largely depends on biomechanical alterations, especially changes in the tensile force. Because the spinal cord is compressed from the posterior side, the first and most common clinical manifestation is usually loss of functional gait and spastic paralysis, which develop as the spinal cord compression progresses. The choice of diagnostic imaging is T2 sagittal magnetic resonance imaging scanning. Whole spine scanning is mandatory to identify multiple areas of compression and any associated distal lumbar diseases. Fine computed tomography imaging is necessary to make a differential diagnosis and set up a precise surgical plan. Conservative treatment does not work in this disorder. Decompression surgery is the only option and prognosis after surgical treatment is better with this disorder than with other causes of thoracic myelopathy. The severity of preoperative symptoms and the time interval before surgical treatment are the most important prognostic factors.

Keyword

Ossification of ligamentum flavum; Treatment; Prognostic factors

MeSH Terms

Asian Continental Ancestry Group
Decompression
Diagnosis, Differential
Diagnostic Imaging
Gait
Humans
Ligamentum Flavum*
Magnetic Resonance Imaging
Muscle Spasticity
Paralysis
Prognosis
Spinal Cord
Spinal Cord Compression
Spinal Cord Diseases
Spine