Ossification of the ligamentum flavum in a Caucasian man

2008 ◽  
Vol 9 (5) ◽  
pp. 427-437 ◽  
Author(s):  
Risheng Xu ◽  
Daniel M. Sciubba ◽  
Ziya L. Gokaslan ◽  
Ali Bydon
Keyword(s):  
Thoracic Spine ◽  
Clinical Presentation ◽  
Ligamentum Flavum ◽  
East Asian ◽  
Posterior Longitudinal Ligament ◽  
Documented Case ◽  
Asian Populations ◽  
Imaging Characteristics ◽  
Spinal Ligaments

Abnormal ossification of spinal ligaments is a well-known cause of myelopathy in East Asian populations, with ossification of the ligamentum flavum (OLF) and the posterior longitudinal ligament being the most prevalent. In Caucasian populations, OLF is rare, and there has been only 1 documented case of the disease affecting more than 5 spinal levels. In this report, the authors describe the clinical presentation, imaging characteristics, and management of the second published case of a Caucasian man with OLF affecting almost the entire thoracic spine. The literature is then reviewed with regard to OLF epidemiology, pathogenesis, presentation, and treatment.

scholarly journals Association between Severity of Diffuse Idiopathic Skeletal Hyperostosis and Ossification of Other Spinal Ligaments in Patients with Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (20) ◽  
pp. 4690
Author(s):  
Soraya Nishimura ◽  
Takashi Hirai ◽  
Narihito Nagoshi ◽  
Toshitaka Yoshii ◽  
Jun Hashimoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ligamentum Flavum ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Posterior Longitudinal Ligament ◽  
Computed Tomography Images ◽  
Prevalence Level ◽  
High Prevalence ◽  
Spinal Ligaments ◽  
Grade 3 ◽  
Whole Spine

Background: Although diffuse idiopathic skeletal hyperostosis (DISH) is known to coexist with the ossification of spinal ligaments (OSLs), details of the radiographic relationship remain unclear. Methods: We prospectively collected data of 239 patients with symptomatic cervical ossification of the posterior longitudinal ligament (OPLL) and analyzed the DISH severity on whole-spine computed tomography images, using the following grades: grade 0, no DISH; grade 1, DISH at T3–T10; grade 2, DISH at both T3–T10 and C6–T2 and/or T11–L2; and grade 3, DISH beyond C5 and/or L3. Ossification indices were calculated as the sum of vertebral and intervertebral levels with OSL for each patient. Results: DISH was found in 107 patients (44.8%), 65 (60.7%) of whom had grade 2 DISH. We found significant associations of DISH grade with the indices for cervical OPLL (r = 0.45, p < 0.0001), thoracic ossification of the ligamentum flavum (OLF; r = 0.41, p < 0.0001) and thoracic ossification of the supra/interspinous ligaments (OSIL; r = 0.53, p < 0.0001). DISH grade was also correlated with the index for each OSL in the whole spine (OPLL: r = 0.29, p < 0.0001; OLF: r = 0.40, p < 0.0001; OSIL: r = 0.50, p < 0.0001). Conclusion: The DISH grade correlated with the indices of OSL at each high-prevalence level as well as the whole spine.

scholarly journals Thoracic ossification of the ligamentum flavum causing acute myelopathy in a patient with cervical ossification of the posterior longitudinal ligament: illustrative case

2021 ◽  
Vol 2 (10) ◽  
Author(s):  
Kishan S. Shah ◽  
Christopher M. Uchiyama
Keyword(s):  
Ligamentum Flavum ◽  
Surgical Complication ◽  
East Asian ◽  
Posterior Longitudinal Ligament ◽  
Surgical Approaches ◽  
North American Population ◽  
Illustrative Case ◽  
Complication Rates ◽  
The North ◽  
Csf Leaks

BACKGROUND Ossification of the ligamentum flavum (OLF) has been well characterized as a distinct entity but also in tandem with ossification of the posterior longitudinal ligament (OPLL) in noncontiguous spinal regions. The majority of OLF cases are reported from East Asian countries where prevalent, but such cases are rarely reported in the North American population. OBSERVATIONS The authors present a case of a Thai-Cambodian American who presented with symptomatic thoracic OLF in tandem with asymptomatic cervical OPLL. A “floating” thoracic laminectomy, resection of OLF, and partial dural ossification (DO) resection with circumferential release of ossified dura were performed. Radiographic dural reexpansion and spinal cord decompression occurred despite the immediate intraoperative appearance of persistent thecal sac compression from retained DO. LESSONS Entire spinal axis imaging should be considered for patients with spinal ligamentous ossification disease, particularly in those of East Asian backgrounds. A floating laminectomy is one of several surgical approaches for OLF, but no consensus approach has been clearly established. High surgical complication rates are associated with thoracic OLF, most commonly dural tears/cerebrospinal fluid (CSF) leaks. DO commonly coexists with OLF, is recognizable on computed tomographic scans, and increases the risk of CSF leaks.

scholarly journals Myelopathy caused by Ossification of Thoracic Ligamentum Flavum

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Farid Yudoyono ◽  
Rully Hanafi Dahlan ◽  
Sevline Esthetia Ompusunggu ◽  
Laniyati Hamijoyo ◽  
Muhammad Zafrullah Arifin
Keyword(s):  
Cervical Spine ◽  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Pathological Condition ◽  
Thoracic Myelopathy ◽  
History Of ◽  
Spinal Ligaments ◽  
Ossification Of Ligamentum Flavum ◽  
Nerve Dysfunction ◽  
The Right

Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9–11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient. Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty

scholarly journals Aggravation of Ossified Ligamentum Flavum Lesion Is Associated With the Degree of Obesity

2021 ◽  
pp. 219256822110315
Author(s):  
Tsutomu Endo ◽  
Yoshinao Koike ◽  
Yuichiro Hisada ◽  
Ryo Fujita ◽  
Ryota Suzuki ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Risk Of Progression ◽  
Severely Obese ◽  
Prevalence Of Obesity ◽  
Obese Subjects

Study Design: Retrospective cross-sectional study. Objectives: There is insufficient data on the clinical features of ossification of the ligamentum flavum (OLF) of the thoracic spine and the risk of progression of ossified lesions. The link between obesity and ossification of the posterior longitudinal ligament (OPLL), which frequently coexists with OLF, has been demonstrated. However, the link between obesity and OLF has not been recognized. We aimed to determine the prevalence of obesity in thoracic OLF and whether the severity of OLF is associated with the degree of obesity. Methods: A total of 204 symptomatic Japanese subjects with thoracic OLF and 136 subjects without spinal ligament ossification as controls were included. OLF subjects were divided into 3 groups: 1) localized OLF (OLF <2-intervertebral regions); 2) multilevel OLF (OLF ≥3-intervertebral regions); and 3) OLF + OPLL. The severity of OLF was quantified using the OLF index using computed tomography imaging of the entire spine. Results: The proportion of severely obese subjects (BMI ≥ 30 kg/m2) was significantly higher both in the multilevel OLF group (25.5%) and the OLF + OPLL group (44.3%) than in the localized OLF group (3.6%) and the control group (1.4%) ( P < 0.01). BMI, age, and coexistence of cervical OPLL and lumbar OLF were associated with thoracic OLF index in the multiple regression analysis. Conclusions: Our findings demonstrated that obesity is a distinct feature of multilevel OLF in the thoracic spine and that the severity of OLF is associated with the degree of obesity.

1188-P: Glycemic Efficacy of Sitagliptin in East Asian Populations: A Pooled Analysis

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1188-P
Author(s):  
JOAO M. CONCEICAO ◽  
CLAUDIO D. GONZALEZ ◽  
SAMUEL S. ENGEL ◽  
JONGHO AHN ◽  
SHIGERU TOKITA ◽  
...  
Keyword(s):  
East Asian ◽  
Pooled Analysis ◽  
Asian Populations

Complications of Asian Double Eyelid Surgery: Prevention and Management

2020 ◽  
Vol 36 (05) ◽  
pp. 592-601
Author(s):  
Stephanie Ming Young ◽  
Yoon-Duck Kim
Keyword(s):  
East Asian ◽  
Eyelid Surgery ◽  
Patient Dissatisfaction ◽  
Optimal Outcomes ◽  
Asian Populations ◽  
Underlying Causes ◽  
Double Eyelid

AbstractDouble eyelid surgery remains one of the most popular aesthetic surgeries, especially among East Asian populations. Complications related to double eyelid surgery can be divided into various categories: (1) patient dissatisfaction, (2) problems with the eyelid crease, (3) problems with the eyelid height, (4) suture-related complications, and (5) complications related to eyelid surgery in general. As with all eyelid surgeries, it is important to understand and appreciate the normal and abnormal function and anatomy of the Asian eyelid to reduce the risk of complications. It is also important to recognize the various complications and their underlying causes so that the surgeon can confidently revise the surgery to achieve optimal outcomes.

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