Ossification of Posterior Longitudinal Ligament
Spinal Cord Compression
Spinal Cord Diseases
Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients. (1/67)Two cases of cervical myelopathy due to calcification of the ligamenta flava (CLF) are described for the first time in black patients from the French West Indies. A pre-operative CT scan differentiated the diagnosis from one of ossification of the ligamenta flava. Microanalysis on the operatively excised specimen in one patient revealed a mixture of calcium pyrophosphate dihydrate crystals and hydroxypatite crystals. Poor outcome in one patient contrasting with excellent recovery in the other one, who had undergone posterior decompressive laminectomy, emphasizes the importance of surgery in the management of CLF. (+info)
MR imaging of a hemorrhagic and granulomatous cyst of the ligamentum flavum with pathologic correlation. (2/67)Cysts of the ligamentum flavum are uncommon causes of neurologic signs and symptoms and usually are seen in persons over 50 years of age. We report a case of an epidural cyst located in the ligamentum flavum, which contributed to spinal stenosis in a 30-year-old man. Radiologic features were similar to those of a synovial cyst, but synovium was not identified histologically. The imaging and pathologic features were unusual, including hemorrhage and a fibrohistiocytic reaction with giant cells. (+info)
Histology of the ligamentum flavum in patients with degenerative lumbar spinal stenosis. (3/67)The degree of calcification as well as the structural changes of the elastic fibres in the ligamentum flavum in patients with degenerative lumbar spinal stenosis were evaluated and the results were compared to those of patients without spinal stenosis. In 21 patients (13 male, 8 female) with lumbar spinal stenosis the ligamentum flavum was removed, histologically processed and stained. The calcification, the elastic/collagenous fibre ratio as well as the configuration of the fibres were evaluated with an image analyzing computer. As a control group, 20 ligaments of 10 human corpses were processed in the same way. The results were statistically analysed using the Mann-Whitney-Wilcoxon test (alpha = 0.05) and the t-test (alpha = 0.05). Nearly all the ligaments of patients with lumbar spinal stenosis were calcified (average 0.17%, maximum 3.8%) and showed relevant fibrosis with decreased elastic/collagenous fibre ratio. There was a significant correlation between age and histological changes (P<0.05). In the control group we only found minimal calcification in 3 of 20 segments (average 0.015%). No relevant fibrosis was found and the configuration of elastic fibres showed no pathologic changes. The results of this study illustrate the important role of histological changes of the ligamentum flavum for the aetiology of lumbar spinal stenosis. (+info)
Calcification of the cervical ligamentum flavum--case report. (4/67)A 52-year-old male presented with calcification of the cervical ligamentum flavum manifesting as hypesthesia of the bilateral middle, ring, and little fingers and ulnar halves of both forearms, as well as motor weakness in the bilateral upper extremities and gait disturbance. Cervical x-ray tomography detected a round calcified mass on the posterior wall of the cervical canal at the C-5 level. Computed tomography showed the round, nodular calcified mass more clearly. Magnetic resonance imaging showed an epidural low intensity mass compressing and distorting the cervical cord at the C-5 level on both T1- and T2-weighted images. Administration of gadolinium-diethylenetriaminepenta-acetic acid caused marginal enhancement of the mass. The lesion was eventually removed by posterior laminectomy. The mass was composed of a very hard crystal-like calcified deposition in the ligamentum flavum. X-ray diffraction analysis of the histological specimen showed calcium pyrophosphate dihydrate (CPPD) and hydroxyapatite in the crystal-like substance, confirming that CPPD is responsible for calcification of the cervical ligamentum flavum. (+info)
Spinal cord and cauda equina compression in 'DISH'. (5/67)Diffuse idiopathic skeletal hyperostosis (DISH) has long been regarded as a benign asymptomatic clinical entity with an innocuous clinical course. Precise information is lacking in the world literature. Authors report the results of a retrospective analysis of 74 cases of DISH. Eleven patients presented with progressive spinal cord or cauda equina compression. In nine cases ossified posterior longitudinal ligament (OPLL) and in two cases ossified ligamentum flavum (OLF) were primarily responsible. Surgically treated patients (eight) had far better outcome as compared to the patients managed conservatively, as they had refused surgery. 'DISH' is neither a benign condition, nor it always runs a innocuous clinical course. In fact, in about 15% of the cases, serious neurological manifestations occur, which may require a major neurosurgical intervention. (+info)
Activation and localization of cartilage-derived morphogenetic protein-1 at the site of ossification of the ligamentum flavum. (6/67)Localization and expression of cartilage-derived morphogenetic protein (CDMP)-1 in tissues at the site of ossification of the ligamentum flavum (OLF) were examined by immunohistochemistry and in situ hybridization. The CDMP-1 protein and messenger ribonucleic acid (mRNA) were localized in spindle-shaped cells and chondrocytes in the OLF tissues. CDMP-1 was not detected in cells in non-ossified sites. These data indicate that CDMP-1 is locally activated and localized in spindle-shaped cells and chondrocytes at the site of OLE. Given the previously reported promoting action of CDMP-1 for chondrogenesis, the current results suggest that CDMP-1 may be involved in the progression of OLF, leading to the narrowing of spinal canal and thus causing severe clinical manifestations. (+info)
The lumbar epidural space in pregnancy: visualization by ultrasonography. (7/67)Epidural anaesthesia is an important analgesia technique for obstetric delivery. During pregnancy, however, obesity and oedema frequently obscure anatomical landmarks. Using ultrasonography, we investigated the influence of these changes on spinal and epidural anatomy. We examined 53 pregnant women who were to receive epidural block for vaginal delivery or Caesarean section. The first ultrasound imaging was performed immediately before epidural puncture; the follow-up scan was done 9 months later. The ultrasound scan of the spinal column was performed at the L3/4 interspace in transverse and longitudinal planes, using a Sonoace 6000 ultrasonograph (Kretz, Marl, Germany) equipped with a 5.0-MHz curved array probe. We measured two distances from the skin to the epidural space: the minimum (perpendicular) and the maximum (oblique) needle trajectory. The quality of ultrasonic depiction was analysed by a numerical scoring system. An average weight reduction of 12.5 kg had occurred by the follow-up examination. During pregnancy, the optimum puncture site available on the skin for epidural space cannulation was smaller, the soft-tissue channel between the spinal processes was narrower, and the skin-epidural space distance was greater. The epidural space was narrower and deformed by the tissue changes. The visibility of the ligamentum flavum, of the dura mater and of the epidural space decreased significantly during pregnancy. Nevertheless, ultrasonography offered useful pre-puncture information. Thus far, palpation has been the only available technique to facilitate epidural puncture. Ultrasound imaging enabled us to assess the structures to be perforated. We anticipate that this technique will become valuable clinically. (+info)
Thoracic cord compression due to ossified hypertrophied ligamentum flavum. (8/67)Ossified ligamentum flavum is increasingly appreciated as an important cause of thoracic myeloradiculopathy. Fifteen patients with age ranging from 30-61 years were studied. Fourteen presented with spastic paraparesis, and radiculopathy was the only complaint in one patient. Routine skiagrams and myelograms showed non-specific changes. Baseline CT and CT myelogram, however, documented the ossification of ligamentum flavum comprehensively. MRI was done in three patients. Multiple levels of the disease were seen in two cases. Four patients had ossified posterior longitudinal ligament. Thickened ligamentum flavum should be considered as an important cause of thoracic cord compression. (+info)
Heterotopic ossification can cause a range of symptoms depending on its location and severity, including pain, stiffness, limited mobility, and difficulty moving the affected limb or joint. Treatment options for heterotopic ossification include medications to reduce inflammation and pain, physical therapy to maintain range of motion, and in severe cases, surgical removal of the abnormal bone growth.
In medical imaging, heterotopic ossification is often diagnosed using X-rays or other imaging techniques such as CT or MRI scans. These tests can help identify the presence of bone growth in an abnormal location and determine the extent of the condition.
Overall, heterotopic ossification is a relatively rare condition that can have a significant impact on a person's quality of life if left untreated. Prompt medical attention and appropriate treatment can help manage symptoms and prevent long-term complications.
OPLL is relatively rare in children but becomes more common with age, particularly after the age of 40. It is more common in people of Asian descent and those with a family history of the condition. Other risk factors for OPLL include smoking, obesity, and diabetes.
The exact cause of OPLL is not known, but it may be related to wear and tear on the spine over time or to certain genetic mutations. Treatment options for OPLL typically involve a combination of pain management medication and physical therapy exercises to help maintain flexibility and mobility in the spine. In severe cases, surgery may be necessary to remove the bony growth and relieve pressure on the surrounding nerves.
Also known as: Posterior longitudinal ligament ossification, OPLL, Spondylosis with osteogenesis.
There are several types of spinal cord compression, including:
1. Central canal stenosis: This occurs when the central canal of the spine narrows, compressing the spinal cord.
2. Foraminal stenosis: This occurs when the openings on either side of the spine (foramina) narrow, compressing the nerves exiting the spinal cord.
3. Spondylolisthesis: This occurs when a vertebra slips out of place, compressing the spinal cord.
4. Herniated discs: This occurs when the gel-like center of a disc bulges out and presses on the spinal cord.
5. Bone spurs: This occurs when bone growths develop on the vertebrae, compressing the spinal cord.
6. Tumors: This can be either primary or metastatic tumors that grow in the spine and compress the spinal cord.
7. Trauma: This occurs when there is a direct blow to the spine, causing compression of the spinal cord.
Symptoms of spinal cord compression may include:
* Pain, numbness, weakness, or tingling in the arms and legs
* Difficulty walking or maintaining balance
* Muscle wasting or loss of muscle mass
* Decreased reflexes
* Loss of bladder or bowel control
* Weakness in the muscles of the face, arms, or legs
* Difficulty with fine motor skills such as buttoning a shirt or typing
Diagnosis of spinal cord compression is typically made through a combination of physical examination, medical history, and imaging tests such as X-rays, CT scans, or MRI scans. Treatment options for spinal cord compression depend on the underlying cause and may include medication, surgery, or a combination of both.
In conclusion, spinal cord compression is a serious medical condition that can have significant impacts on quality of life, mobility, and overall health. It is important to be aware of the causes and symptoms of spinal cord compression in order to seek medical attention if they occur. With proper diagnosis and treatment, many cases of spinal cord compression can be effectively managed and improved.
Symptoms of spinal stenosis may include:
* Pain in the neck, back, or legs that worsens with walking or standing
* Numbness, tingling, or weakness in the arms or legs
* Difficulty controlling bladder or bowel functions
* Muscle weakness in the legs
Treatment for spinal stenosis may include:
* Pain medications
* Physical therapy to improve mobility and strength
* Injections of steroids or pain relievers
* Surgery to remove bone spurs or decompress the spinal cord
It is important to seek medical attention if symptoms of spinal stenosis worsen over time, as untreated condition can lead to permanent nerve damage and disability.
There are several types of radiculopathy, including:
1. Cervical radiculopathy: This type affects the neck and arm region and is often caused by a herniated disk or degenerative changes in the spine.
2. Thoracic radiculopathy: This type affects the chest and abdominal regions and is often caused by a tumor or injury.
3. Lumbar radiculopathy: This type affects the lower back and leg region and is often caused by a herniated disk, spinal stenosis, or degenerative changes in the spine.
4. Sacral radiculopathy: This type affects the pelvis and legs and is often caused by a tumor or injury.
The symptoms of radiculopathy can vary depending on the location and severity of the nerve compression. They may include:
1. Pain in the affected area, which can be sharp or dull and may be accompanied by numbness, tingling, or weakness.
2. Numbness or tingling sensations in the skin of the affected limb.
3. Weakness in the affected muscles, which can make it difficult to move the affected limb or perform certain activities.
4. Difficulty with coordination and balance.
5. Tremors or spasms in the affected muscles.
6. Decreased reflexes in the affected area.
7. Difficulty with bladder or bowel control (in severe cases).
Treatment for radiculopathy depends on the underlying cause and severity of the condition. Conservative treatments such as physical therapy, medication, and lifestyle changes may be effective in managing symptoms and improving function. In some cases, surgery may be necessary to relieve pressure on the nerve root.
It's important to seek medical attention if you experience any of the symptoms of radiculopathy, as early diagnosis and treatment can help prevent long-term damage and improve outcomes.
Some common types of spinal diseases include:
1. Degenerative disc disease: This is a condition where the discs between the vertebrae in the spine wear down over time, leading to pain and stiffness in the back.
2. Herniated discs: This occurs when the gel-like center of a disc bulges out through a tear in the outer layer, putting pressure on nearby nerves and causing pain.
3. Spinal stenosis: This is a narrowing of the spinal canal, which can put pressure on the spinal cord and nerve roots, causing pain, numbness, and weakness in the legs.
4. Spondylolisthesis: This is a condition where a vertebra slips out of place, either forward or backward, and can cause pressure on nearby nerves and muscles.
5. Scoliosis: This is a curvature of the spine that can be caused by a variety of factors, including genetics, injury, or disease.
6. Spinal infections: These are infections that can affect any part of the spine, including the discs, vertebrae, and soft tissues.
7. Spinal tumors: These are abnormal growths that can occur in the spine, either primary ( originating in the spine) or metastatic (originating elsewhere in the body).
8. Osteoporotic fractures: These are fractures that occur in the spine as a result of weakened bones due to osteoporosis.
9. Spinal cysts: These are fluid-filled sacs that can form in the spine, either as a result of injury or as a congenital condition.
10. Spinal degeneration: This is a general term for any type of wear and tear on the spine, such as arthritis or disc degeneration.
If you are experiencing any of these conditions, it is important to seek medical attention to receive an accurate diagnosis and appropriate treatment.
Intracranial hematoma occurs within the skull and is often caused by head injuries, such as falls or car accidents. It can lead to severe neurological symptoms, including confusion, seizures, and loss of consciousness. Extracranial hematomas occur outside the skull and are commonly seen in injuries from sports, accidents, or surgery.
The signs and symptoms of hematoma may vary depending on its location and size. Common symptoms include pain, swelling, bruising, and limited mobility. Diagnosis is typically made through imaging tests such as CT scans or MRI scans, along with physical examination and medical history.
Treatment for hematoma depends on its severity and location. In some cases, conservative management with rest, ice, compression, and elevation (RICE) may be sufficient. However, surgical intervention may be necessary to drain the collection of blood or remove any clots that have formed.
In severe cases, hematoma can lead to life-threatening complications such as infection, neurological damage, and organ failure. Therefore, prompt medical attention is crucial for proper diagnosis and treatment.
There are many different types of cysts that can occur in the body, including:
1. Sebaceous cysts: These are small, usually painless cysts that form in the skin, particularly on the face, neck, or torso. They are filled with a thick, cheesy material and can become inflamed or infected.
2. Ovarian cysts: These are fluid-filled sacs that form on the ovaries. They are common in women of childbearing age and can cause pelvic pain, bloating, and other symptoms.
3. Kidney cysts: These are fluid-filled sacs that form in the kidneys. They are usually benign but can cause problems if they become large or infected.
4. Dermoid cysts: These are small, usually painless cysts that form in the skin or organs. They are filled with skin cells, hair follicles, and other tissue and can become inflamed or infected.
5. Pilar cysts: These are small, usually painless cysts that form on the scalp. They are filled with a thick, cheesy material and can become inflamed or infected.
6. Epidermoid cysts: These are small, usually painless cysts that form just under the skin. They are filled with a thick, cheesy material and can become inflamed or infected.
7. Mucous cysts: These are small, usually painless cysts that form on the fingers or toes. They are filled with a clear, sticky fluid and can become inflamed or infected.
8. Baker's cyst: This is a fluid-filled cyst that forms behind the knee. It can cause swelling and pain in the knee and is more common in women than men.
9. Tarlov cysts: These are small, fluid-filled cysts that form in the spine. They can cause back pain and other symptoms, such as sciatica.
10. ganglion cysts: These are noncancerous lumps that form on the joints or tendons. They are filled with a thick, clear fluid and can cause pain, swelling, and limited mobility.
It's important to note that this is not an exhaustive list and there may be other types of cysts that are not included here. If you suspect that you have a cyst, it's always best to consult with a healthcare professional for proper diagnosis and treatment.
Some common examples of spinal cord diseases include:
1. Spinal muscular atrophy: This is a genetic disorder that affects the nerve cells responsible for controlling voluntary muscle movement. It can cause muscle weakness and wasting, as well as other symptoms such as respiratory problems and difficulty swallowing.
2. Multiple sclerosis: This is an autoimmune disease that causes inflammation and damage to the protective covering of nerve fibers in the spinal cord. Symptoms can include vision problems, muscle weakness, balance and coordination difficulties, and cognitive impairment.
3. Spinal cord injuries: These can occur as a result of trauma, such as a car accident or a fall, and can cause a range of symptoms including paralysis, numbness, and loss of sensation below the level of the injury.
4. Spinal stenosis: This is a condition in which the spinal canal narrows, putting pressure on the spinal cord and nerve roots. Symptoms can include back pain, leg pain, and difficulty walking or standing for long periods.
5. Tumors: Benign or malignant tumors can grow in the spinal cord, causing a range of symptoms including pain, weakness, and numbness or tingling in the limbs.
6. Infections: Bacterial, viral, or fungal infections can cause inflammation and damage to the spinal cord, leading to symptoms such as fever, headache, and muscle weakness.
7. Degenerative diseases: Conditions such as amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS) can cause progressive degeneration of the spinal cord nerve cells, leading to muscle weakness, twitching, and wasting.
8. Trauma: Traumatic injuries, such as those caused by sports injuries or physical assault, can damage the spinal cord and result in a range of symptoms including pain, numbness, and weakness.
9. Ischemia: Reduced blood flow to the spinal cord can cause tissue damage and lead to symptoms such as weakness, numbness, and paralysis.
10. Spinal cord infarction: A blockage in the blood vessels that supply the spinal cord can cause tissue damage and lead to symptoms similar to those of ischemia.
It's important to note that some of these conditions can be caused by a combination of factors, such as genetics, age, lifestyle, and environmental factors. It's also worth noting that some of these conditions can have a significant impact on quality of life, and in some cases, may be fatal.
Philadelphia Surgery Center
Posterior atlantoaxial ligament
Microsurgical lumbar laminoplasty
Posterior sacrococcygeal ligament
Lumbar spinal stenosis
Index of anatomy articles
List of MeSH codes (A02)
Central cord syndrome
Internal vertebral venous plexuses
Outline of human anatomy
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Sublaminar wire insertion
- The wavelengths of 650 and 532 nm differentiated epidural space from the ligamentum flavum. (asahq.org)
- Mean magnitudes for 650 nm, 532 nm, and their ratio were 3.565 +/- 0.194, 2.542 +/- 0.145, and 0.958 +/- 0.172 at epidural space and 3.842 +/- 0.191, 2.563 +/- 0.131, and 1.228 +/- 0.244 at ligamentum flavum, respectively. (asahq.org)
- Epidural space could be identified by the changes in the reflective pattern of light emitted at 650 nm, which were specific for the ligamentum flavum and dural tissue. (asahq.org)
- Cervical spine ligamentum flavum gaps: MR characterisation and implications for interlaminar epidural injection therapy. (cornell.edu)
- Default Manufacturer This model is an ultrasound compatible trainer that includes the lumbar vertebrae, iliac crest, spinous process, ligamentum flavum, the epidural space and dura. (usneurologicals.com)
- The ligamentum flava are the ligaments (aka yellow ligaments) that connect from the axis of the spine (in the neck at level C2) to the sacrum of the spine (the lowest part of the spine at level S1). (spengelchiropractic.com)
- A novel method for treatment of lumbar spinal stenosis in high-risk surgical candidates: pilot study experience with percutaneous remodeling of ligamentum flavum and lamina. (omeka.net)
- The ligamentum flavum are removed cranial and caudal to the lamina where the wire is to be passed. (aofoundation.org)
- Lumbar MRI: "very mild disc bulge, congenital changes, mild ligamentum flavum hypertrophy a. (medhelp.org)
- Design We present one confirmed and one clinical case of ATTR deposition in ligamentum flavum causing lumbar canal stenosis. (bmj.com)
- MRI lumbar spine showed a disc bulge in combination with ligamentum flavum thickening at L2/3 causing stenosis of the vertebral canal. (bmj.com)
- Hansson T, Suzuki N, Hebelka H, Gaulitz A. The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum. (vertosmed.com)
- When a thoracic herniated disc compresses or irritates a nearby nerve root as it branches off the spinal cord en route to exiting the central canal, it can cause thoracic radiculopathy. (spine-health.com)
- Prevalence and distribution of incidental thoracic disc herniation, and thoracic hypertrophied ligamentum flavum in patients with back or leg pain: A Magnetic Resonance Imaging-Based Cross-Sectional Study. (spine-health.com)
- It can be mistaken for a pars interarticularis fracture or, rarely, for a calcified ligamentum flavum in older patients. (radiopaedia.org)
- In case resistance is encountered, it may be that the tip of the wire is catching the stump of the ligamentum flavum. (aofoundation.org)
- This study is aimed at investigating the correlation between lumbar spinal stenosis (LSS) severity, ligamentum flavum hypertrophy, and the upregulation of inflammatory markers. (nih.gov)
- Characterization of ligamentum flavum hypertrophy based on m6A RNA methylation modification and the immune microenvironment. (cdc.gov)