جستجوی مقالات مرتبط با کلیدواژه « ligamentum flavum » در نشریات گروه « پزشکی »

Background and Importance:

 Acute spinal cord injury without an apparent spinal fracture/dislocation in an asymptomatic subject with silent thoracic ossification of the ligamentum flavum (TOLF) is an extremely rare with only seven fully documented example with this specific scenario in the literature.

A previously healthy middle-aged woman with a history of MRI documented silent TOLF who developed sever weakness of the lower limbs immediately after a minor fall is presented.  Repeat MRI revealed appearance of a myelopathy at the site of the preexisting silent T10-T11 OLF. Laminectomy and excision of the O LF result in complete recovery within 6 months.

We believe that our asymptomatic patient should had undergone prophylactic surgical intervention before this catastrophic event. In a survey of medical literature, we found that the presented case is the first example with MRI documented TOLF in its silence period.

Background and Importance: A 60-year-old diabetic man with simultaneous diffuse idiopathic hyperostosis, massive ossification of the posterior longitudinal ligament and cervical and higher part of thoracic ligamentum flavum is reported in this article. Such comorbidity rarely occurs. The patient’s chief complaint was sensation abnormalities without gait disturbance or severe cord compression symptoms despite the advanced stage of the disease. Computed tomography scan and magnetic resonance imaging confirmed multi-level involvement of cervicothoracic spine. After surgical treatment, his symptoms resolved completely with no complication.

Lumbar spinal canal stenosis (LSCS) has prominent position in spinal disorders of the elderly. Ligamentum flavum hypertrophy plays a dominant role in narrowing of the LSCS. There are some clues that Ligamentum flavum hypertrophy is associated with diabetes mellitus. Our objective was comparison of histological properties of ligamentum flavum in Lumbar spinal canal stenosis patients with and without diabetes mellitus.
In this case control study, during 9 months, twenty-nine patients, who were candidate for decompressive laminectomy because of ligamentum flavum hypertrophy, were studied. They were labeled as diabetic if had history of diabetes mellitus or fasting blood sugar ≥126mg/dl for two times or blood sugar >200mg/dl anytime with symptom of hyperglycemia. Ligamentum flavum was removed through surgery. Samples were evaluated by pathologist using Hematoxylin &Eosin, Masson’s trichrome and Verhoeff van Gieson staining. Evaluation includes grading of fibrosis, loss of elastin fibers, calcification and number of cellularity of samples. Data analyzed with Fisher’s test and Mann-Whitney test.
In this study 41% of patients (12 persons) were suffering from diabetes mellitus. There was no significant difference between diabetic and nondiabetic patients in histological properties. (P>0.05); but the weight of diabetic patients was higher than nondiabetics (P-value =0.038)
These results show that diabetes mellitus has no effect on histological change in ligamentum flavum of spinal canal stenosis and mechanical stress (due to overweight) has a more important role in pathogenesis of spinal canal stenosis.