多椎間レベルにわたって発生した頚椎黄色靱帯石灰化の 2 例

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  • Two Cases of Calcified Ligamentum Flavum at Multiple Cervical Levels

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Multiple lesions of the calcified cervical ligamentum flavum are quite rare and no detailed studies have been done in the past, although approximately 100 cases of calcified ligamentum flavum have been reported. We report two cases of such lesions which caused cervical myelopathy. The first case was a 68-year-old woman with a 3 months history of gradually progressing gait disturbance. Plain cervical X-ray revealed narrowing of the spinal canal with thin nodular calcifications in the posterior part of the spinal canal at the level of C4/5, 5/6 and 6/7. Three dimensional (3D) CT scan clearly demonstrated the round, calcified masses situated on the ventral part of the vertebral laminae at same levels. MRI and computed tomography (CT) myelogram disclosed severe compression of the spinal cord by the masses. The second case was a 71-year-old woman with a one month history of an increasing severe neck pain and symptoms of cervical myelopathy, who also harbored the same kind of masses at the level of C3/4, 4/5 and 5/6. In both cases, the masses within the ligamentum flavum were removed surgically from the inner surface of C4, 5, 6, 7 laminae. The masses appeared to have no continuity with the dura mater, and the calcification per se was confined within the ligament. Postoperative imaging studies revealed complete decompression of the spinal cord and the symptoms in both patients decreased. The 3D-CT scan was very useful in understanding the anatomical relationship between the calcified masses and the spinal structures, in making the treatment strategies, and also in differentiating the calcified ligamentum flavum from ossified ligamentum flavum, each of which seemed to be a distinct clinical entity.

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  • 脊髄外科

    脊髄外科 15 (2), 133-138, 2001

    日本脊髄外科学会

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