Ligamentum flavum ossification

Ossification of the ligamentum flavum (OLF) is a phenomenon where there is a formation of ossific-calcific components in the ligamentum flavum. It is recognized causes of myelopathy (especially in the thoracic and to a lesser degree the cervical region).

Epidemiology

The condition as a whole is uncommon. There is a higher prevalence in East Asian ethnic groups (especially Japan).

Pathology

Both intrinsic (genetic and dietary factors) and extrinsic causes (biomechanical alterations) have been postulated. The spinal cord tends to usually get compressed from the posterior side and patients, therefore, tend to show symptoms such as loss of balanced walking (similar to posterior cord syndrome).

Associations

In the cervical region, it can uncommonly be associated with ossification of the posterior longitudinal ligament .

Treatment and prognosis

Management options vary from being conservative to surgical decompression. Some authors propose a  laminectomy combined with lateral fusion at the treatment of choice .  The postoperative outcome is generally considered good .

History and etymology

It is thought to have been first reported by Polgar on a lateral radiograph .

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