Ossification of the ligamentum flavum in the cervicothoracic junction: case report on ossification found on both sides of the lamina.

Abstract

A case of ossification on both sides of the ligamentum flavum in the cervicothoracic junction is described. To review the pathology associated with ossification of the ligamentum flavum in the spine and its incidence at the cervicothoracic junction. 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. 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. The symptoms and physical signs of cervical myelopathy improved after laminectomy and removal of the ossified ligament. There was no recurrence. The reported case adds to the literature on the pathology associated with ossification of the spinal ligaments.