Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
World Neurosurg. 2019 Dec;132:63-66. doi: 10.1016/j.wneu.2019.08.177. Epub 2019 Aug 31.
Symptomatic calcification of the ligamentum flavum (CLF) is common in the cervical spine but rare in the thoracic spine. Rapidly progressing CLF in the thoracic spine has not been reported in the literature.
A 76-year-old Asian male experienced back pain after a fall and was diagnosed with osteoporotic vertebral fractures at T11 and L1. He was treated conservatively because of the lack of neurologic deficits. Nine months after the initial visit, he complained of progressive incomplete paraplegia. Magnetic resonance imaging and computed tomography of the thoracic spine showed CLF at T11-T12 severely compressing the spinal cord. This finding had not been seen on imaging studies at the initial visit. The patient underwent surgical resection of CLF and posterior instrumented spine fusion. Symptoms of muscle weakness recovered postoperatively.
In this case, sequential imaging studies with a 9-month interval showed evidence of rapidly progressing thoracic CLF. The preceding osteoporotic vertebral fracture may have triggered the development of CLF.
黄韧带（LF）的症状性钙化在颈椎中很常见，但在胸椎中很少见。胸椎 LF 的快速进展尚未在文献中报道。
一名 76 岁亚裔男性在跌倒后出现背痛，并被诊断为 T11 和 L1 的骨质疏松性椎体骨折。由于没有神经功能缺损，他接受了保守治疗。在初次就诊后 9 个月，他抱怨进行性不完全性截瘫。胸椎的磁共振成像和计算机断层扫描显示 T11-T12 的 LF 严重压迫脊髓。这一发现在初次就诊的影像学研究中没有看到。患者接受了 LF 的手术切除和后路器械脊柱融合术。术后肌无力症状恢复。
在本例中，9 个月间隔的连续影像学研究显示出胸椎 LF 快速进展的证据。先前的骨质疏松性椎体骨折可能引发了 LF 的发生。
