J Neurol Surg A Cent Eur Neurosurg 2019; 80(02): 131-133
DOI: 10.1055/s-0038-1675784
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Black-Colored Ligamentum Flavum Due to Alkaptonuria

Seyho Cem Yucetas
1   Department of Neurosurgery, Adiyaman University, Education and Research Hospital, Adiyaman, Turkey
Necati Ucler
1   Department of Neurosurgery, Adiyaman University, Education and Research Hospital, Adiyaman, Turkey
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17. Dezember 2017

14. Mai 2018

26. November 2018 (online)


Alkaptonuria is a rare metabolic disease caused by deficiency of homogentisic acid oxidase and characterized by bluish-black discoloration of cartilages and skin (ochronosis). Defective production of this enzyme results in the accumulation of homogentisic acid (HGA), a tyrosine degradation product, in the bloodstream. Accumulation of HGA and its metabolites in tissues causes ochronosis. The word ochronosis refers to the dark bluish-black discoloration of connective tissues including the sclera, cornea, auricular cartilage, heart valves, articular cartilage, tendons, and ligaments. Neurogenic claudication resulting from focal hypertrophy of the ligamentum flavum in the lumbar spine due to ochronotic deposits has only been previously reported once in the literature. In this article, we present a 71-year-old male patient with alkaptonuria-associated degenerative L3–L4–L5 stenosis, diagnosed after lumbar decompressive laminectomy.

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