The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature
Introduction: We report our experience regarding the clinical features and pathological findings of the calcification of the ligamentum flavum (CLF) and ossification of the ligamentum flavum (OLF) in the spine. In addition, we reviewed the previous studies on CLF and OLF to enhance the understanding...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/1/105 |
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| author | Misao Nishikawa Masaki Yoshimura Kentaro Naito Toru Yamagata Hiroyuki Goto Mitsuhiro Hara Hiromichi Ikuno Takeo Goto |
| author_facet | Misao Nishikawa Masaki Yoshimura Kentaro Naito Toru Yamagata Hiroyuki Goto Mitsuhiro Hara Hiromichi Ikuno Takeo Goto |
| author_sort | Misao Nishikawa |
| collection | DOAJ |
| description | Introduction: We report our experience regarding the clinical features and pathological findings of the calcification of the ligamentum flavum (CLF) and ossification of the ligamentum flavum (OLF) in the spine. In addition, we reviewed the previous studies on CLF and OLF to enhance the understanding of these conditions. Materials and Methods: We compared the clinical, radiological, and histopathological features of CLF and OLF. Results: In CLF, a computed tomography (CT) scan showed egg-shaped or speck-like calcification in the ligamentum flavum. Magnetic resonance (MR) imaging demonstrated spinal cord compression due to a thickened ligamentum flavum, which appeared as a low-intensity mass. Pathological findings demonstrated fused islands of calcification resembling sand-like calcification. In OLF, CT showed beak-like ossification extending into the intervertebral foramen. MR imaging demonstrated spinal cord compression by a low-intensity mass. Pathological findings revealed laminar ossification of LF with chondrocytes near the calcification and laminar hyaline cartilage. Conclusions: CLF and OLF appear to be distinct entities based on their clinical, neuroradiological, histopathological, and pathogenetic features. We suggest that the causes of CLF include both metabolic and dystrophic factors, while the pathogenesis of OLF is characterized by enchondral ossification induced by a genetic cascade triggered by shearing/tension stress. |
| first_indexed | 2024-03-08T15:04:04Z |
| format | Article |
| id | doaj.art-3869845e3d6646e8ab8eb8ec4ad1a93a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T15:04:04Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3869845e3d6646e8ab8eb8ec4ad1a93a2024-01-10T15:01:05ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-0113110510.3390/jcm13010105The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the LiteratureMisao Nishikawa0Masaki Yoshimura1Kentaro Naito2Toru Yamagata3Hiroyuki Goto4Mitsuhiro Hara5Hiromichi Ikuno6Takeo Goto7Department of Neurosurgery, Moriguchi-Ikuno Memorial Hospital, 6-17-33 Satanakamachi, Moriguchi City 570-0002, Osaka, JapanDepartment of Neuropathology, Yao Tokusyukai General Hospital, 1-17, Wakakusacho, Yao City 581-0011, Osaka, JapanDepartment of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City 545-8595, Osaka, JapanDepartment of Neurosurgery, Moriguchi-Ikuno Memorial Hospital, 6-17-33 Satanakamachi, Moriguchi City 570-0002, Osaka, JapanDepartment of Neurosurgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Kita-ku, Osaka City 530-0012, Osaka, JapanDepartment of Neurosurgery, Moriguchi-Ikuno Memorial Hospital, 6-17-33 Satanakamachi, Moriguchi City 570-0002, Osaka, JapanDepartment of Radiology, Moriguchi-Ikuno Memorial Hospital, 6-17-33 Satanakamachi, Moriguchi City 570-0002, Osaka, JapanDepartment of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City 545-8595, Osaka, JapanIntroduction: We report our experience regarding the clinical features and pathological findings of the calcification of the ligamentum flavum (CLF) and ossification of the ligamentum flavum (OLF) in the spine. In addition, we reviewed the previous studies on CLF and OLF to enhance the understanding of these conditions. Materials and Methods: We compared the clinical, radiological, and histopathological features of CLF and OLF. Results: In CLF, a computed tomography (CT) scan showed egg-shaped or speck-like calcification in the ligamentum flavum. Magnetic resonance (MR) imaging demonstrated spinal cord compression due to a thickened ligamentum flavum, which appeared as a low-intensity mass. Pathological findings demonstrated fused islands of calcification resembling sand-like calcification. In OLF, CT showed beak-like ossification extending into the intervertebral foramen. MR imaging demonstrated spinal cord compression by a low-intensity mass. Pathological findings revealed laminar ossification of LF with chondrocytes near the calcification and laminar hyaline cartilage. Conclusions: CLF and OLF appear to be distinct entities based on their clinical, neuroradiological, histopathological, and pathogenetic features. We suggest that the causes of CLF include both metabolic and dystrophic factors, while the pathogenesis of OLF is characterized by enchondral ossification induced by a genetic cascade triggered by shearing/tension stress.https://www.mdpi.com/2077-0383/13/1/105calcification of the ligamentum flavumossification of the ligamentum flavumpathogenesisclinical featureradiological findingsurgical management |
| spellingShingle | Misao Nishikawa Masaki Yoshimura Kentaro Naito Toru Yamagata Hiroyuki Goto Mitsuhiro Hara Hiromichi Ikuno Takeo Goto The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature Journal of Clinical Medicine calcification of the ligamentum flavum ossification of the ligamentum flavum pathogenesis clinical feature radiological finding surgical management |
| title | The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature |
| title_full | The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature |
| title_fullStr | The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature |
| title_full_unstemmed | The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature |
| title_short | The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature |
| title_sort | symptomatic calcification and ossification of the ligamentum flavum in the spine our experience and review of the literature |
| topic | calcification of the ligamentum flavum ossification of the ligamentum flavum pathogenesis clinical feature radiological finding surgical management |
| url | https://www.mdpi.com/2077-0383/13/1/105 |
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