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Radiculopathy due to Ossification of the Yellow Ligament at the Lower Lumbar Spine

Yano, Tomonori, MD*; Doita, Minoru, MD; Iguchi, Tetsuhiro, MD*; Kurihara, Akira, MD*; Kasahara, Koichi, MD*; Nishida, Kotaro, MD; Yoshiya, Shinichi, MD

doi: 10.1097/01.BRS.0000092347.32845.43
Case Report
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Study Design. A case report.

Objectives. To report a rare case of a 27-year-old female with ossification of yellow ligament at the lower lumbar spine presenting radiculopathy with a drop foot.

Summary of Background Data. The majority of cases of ossification of yellow ligament occur at the lower third of the thoracic or the thoracolumbar spine. There are only a few reports of ossification of yellow ligament in the lumbar spine and radiculopathy due to ossification of yellow ligament at L4–L5 and L5–S1 levels is very uncommon.

Methods. A 27-year-old female with a prior fracture of posterior ring apophysis of L5 presented with leg pain and a drop foot. Magnetic resonance imaging demonstrated stenosis with compression of the cauda equina at the L4–L5 and L5–S1 levels.

Results. Decompressive laminectomy of L5 and removal of the ossified yellow ligaments were performed. Histologic examination of en bloc specimen of ossification of yellow ligament revealed degenerative changes of the elastic fibers in the yellow ligament with adjacent chondrosis and ossification. The patient’s severe leg pain disappeared completely, although the extent of the drop foot had not fully recovered at the final follow-up examination.

Conclusions. The mechanism of ossification of yellow ligament in the present case was unclear. The patient did not have any previous generalized disorders besides the history of a ring apophysial fracture or any family history of treatment for ossification of the posterior longitudinal ligament or ossification of yellow ligament. Therefore, localized mechanical stress might have influenced the development of ossification of yellow ligament at lower lumbar spine. Spine 2003;28:E401–E404

From the *Department of Orthopaedic Surgery, Kobe Rosai Hospital, and

†Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Acknowledgment date:.

First revision date:.

Acceptance date:.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Minoru Doita, MD, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; E-mail: doita@med.kobe-u.ac.jp

© 2003 Lippincott Williams & Wilkins, Inc.