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Ossification of the Ligamentum Flavum in the Cervicothoracic Junction: Case Report on Ossification Found on Both Sides of the Lamina

Mak, Kan-hing, FRCS, FRACS,*; Mak, Kong-ling, FRCPath, FHKCPath,†; Gwi-Mak, Elaine, FRCPA, FRCPath, FHKCPath

Case Report
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Study Design.  A case of ossification on both sides of the ligamentum flavum in the cervicothoracic junction is described.

Objectives.  To review the pathology associated with ossification of the ligamentum flavum in the spine and its incidence at the cervicothoracic junction.

Summary of Background Data.  The literature on the common sites for ossification of the ligamentum flavum is reviewed. No report described ossification on the outer surface of the ligament presenting as ossification nodules on the medial side of the apophyseal joint.

Methods.  The clinical, radiographic, and pathologic features associated with ossification of the ligamentum flavum are presented. The ossified ligament grew into nodular masses on both surfaces: posterolaterally on the medial surface of the apophyseal joint and anteromedially on the undersurface of the lamina. The masses were connected by a film of elastic fibers from the remnant ligamentum flavum.

Results.  The symptoms and physical signs of cervical myelopathy improved after laminectomy and removal of the ossified ligament. There was no recurrence.

Conclusion.  The reported case adds to the literature on the pathology associated with ossification of the spinal ligaments.

From the *Departments of Orthopaedics and Traumatology and

†Pathology, Kwong Wah Hospital, Kowloon, Hong Kong Special Administrative Region, China.

Acknowledgment date: January 4, 2001.

First revision date: April 4, 2001.

Second revision date: June 11, 2001.

Acceptance date: July 5, 2001.

Device status category: 1.

Conflict of interest category: 12,14.

Address reprint requests to

Kan-hing Mak, FRCS, FRACS

Department of Orthopaedics and Traumatology

Kwong Wah Hospital

25 Waterloo Road, Kowloon

Hong Kong Special Administrative Region, China

E-mail: khmak@ha.org.hk

© 2002 Lippincott Williams & Wilkins, Inc.