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J Neurol Surg A Cent Eur Neurosurg 2018; 79(04): 353-356
DOI: 10.1055/s-0038-1641146
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Symptomatic Ruptured Seed-Type Partial Ossification of the Ligamentum Flavum: A Case Report

Hyeun Sung Kim
1   Department of Neurosurgery, Nanoori Hospital (Suwon), Suwon, Korea (the Republic of)
,
Nitin Maruti Adsul
1   Department of Neurosurgery, Nanoori Hospital (Suwon), Suwon, Korea (the Republic of)
,
Farid Yudoyono
1   Department of Neurosurgery, Nanoori Hospital (Suwon), Suwon, Korea (the Republic of)
2   Department of Neurosurgery, Hasan Sadikin Hospital, College of Medicine, Padjadjaran University Bandung, Jawa Barat, Indonesia
,
Jee Soo Jang
1   Department of Neurosurgery, Nanoori Hospital (Suwon), Suwon, Korea (the Republic of)
,
Il Tae Jang
3   Department of Neurosurgery, Nanoori Hospital Seoul, Gangnam-gu, Seoul, Korea (the Republic of)
,
Seong Hoon Oh
4   Department of Neurosurgery, Nanoori Hospital Incheon, Incheon, Korea (the Republic of)
› Author Affiliations
Further Information

Publication History

14 October 2017

29 December 2017

Publication Date:
11 April 2018 (online)

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Abstract

Background Seed-type partial ossification of the ligamentum flavum (OLF) causing severe radiculopathy after rupture has not yet been described in the literature.

Case Description A 51-year-old man presented with sudden onset severe back pain and right anterior thigh pain without any neurologic deficit after lifting a heavy weight. On preoperative computed tomography, we identified a ruptured seed-type partial OLF at the L1–L2 level. T2-weighted magnetic resonance sagittal and axial images showed thecal sac compression by the ruptured OLF. There was no improvement in his symptoms after 2 weeks of conservative management. The patient had percutaneous full endoscopic interlaminar removal of OLF. Postoperatively he experienced prompt improvement of his symptoms.

Conclusion Rupture of seed-type partial OLF causing severe radiculopathy is extremely rare, and percutaneous endoscopy is a safe and effective alternative to open surgery in selected cases.

Keywords

ossification - ligamentum flavum - seed type - percutaneous endoscopy
 

  • References

  • 1 Ruiz Santiago F, Alcázar Romero PP, López Machado E, García Espona MA. Calcification of lumbar ligamentum flavum and facet joints capsule. Spine 1997; 22 (15) 1730-1734 ; discussion 1734–1735
    CrossrefPubMedGoogle Scholar
  • 2 Trivedi P, Behari S, Paul L, Banerji D, Jain VK, Chhabra DK. Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien) 2001; 143 (08) 775-782
    CrossrefPubMedGoogle Scholar
  • 3 Kubota T, Kawano H, Yamashima T, Ikeda K, Hayashi M, Yamamoto S. Ultrastructural study of calcification process in the ligamentum flavum of the cervical spine. Spine 1987; 12 (04) 317-323
    CrossrefPubMedGoogle Scholar
  • 4 Mohindra S, Chhabra R, Mukherjee KK, Gupta SK, Vaiphei K, Khosla VK. Spinal compression due to ossified yellow ligament: a short series of 5 patients and literature review. Surg Neurol 2006; 65 (04) 377-384 ; discussion 384
    CrossrefPubMedGoogle Scholar
  • 5 Ahn DK, Lee S, Moon SH, Boo KH, Chang BK, Lee JI. Ossification of the ligamentum flavum. Asian Spine J 2014; 8 (01) 89-96
    CrossrefPubMedGoogle Scholar
  • 6 Liao C-C, Chen T-Y, Jung S-M, Chen L-R. Surgical experience with symptomatic thoracic ossification of the ligamentum flavum. J Neurosurg Spine 2005; 2 (01) 34-39
    CrossrefPubMedGoogle Scholar
  • 7 Sato T, Tanaka Y, Aizawa T, Koizumi Y, Kokubun S. Surgical treatment for ossification of ligamentum flavum in the thoracic spine and its complications. Spine Spinal Cord. 1998; 11: 505-510
    PubMedGoogle Scholar
  • 8 Muthukumar N. Dural ossification in ossification of the ligamentum flavum: a preliminary report. Spine 2009; 34 (24) 2654-2661
    CrossrefPubMedGoogle Scholar