Ossification of ligamentum flavum (OLF), ossification of vertebral arch ligaments (OVAL), ligamentum flavum "pseudogout"
Definitions
Calcification &/or OLF
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Ando K et al: Outcomes of surgery for thoracic myelopathy owing to thoracic ossification of the ligamentum flavum in a nationwide multicenter prospectively collected study in 223 patients: is instrumented fusion necessary? Spine (Phila Pa 1976). 45(3):E170-8, 2020
Ohara Y: Ossification of the ligaments in the cervical spine, including ossification of the anterior longitudinal ligament, ossification of the posterior longitudinal ligament, and ossification of the ligamentum flavum. Neurosurg Clin N Am. 29(1):63-8, 2018
Hirabayashi S: Ossification of the ligamentum flavum. Spine Surg Relat Res. 1(4):158-63, 2017
Hou X et al: Clinical features of thoracic spinal stenosis-associated myelopathy: a retrospective analysis of 427 cases. J Spinal Disord Tech. 29(2):86-9, 2016
Gao R et al: Clinical features and surgical outcomes of patients with thoracic myelopathy caused by multilevel ossification of the ligamentum flavum. Spine J. 13(9):1032-8, 2013
Hirabayashi H et al: Surgery for thoracic myelopathy caused by ossification of the ligamentum flavum. Surg Neurol. 69(2):114-6; discussion 116, 2008
Wang VY et al: Removal of ossified ligamentum flavum via a minimally invasive surgical approach. Neurosurg Focus. 25(2):E7, 2008
Kong Q et al: COL6A1 polymorphisms associated with ossification of the ligamentum flavum and ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976). 32(25):2834-8, 2007
Yayama T et al: Thoracic ossification of the human ligamentum flavum: histopathological and immunohistochemical findings around the ossified lesion. J Neurosurg Spine. 7(2):184-93, 2007
Inamasu J et al: Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history. Neurosurgery. 58(6):1027-39; discussion 1027-39, 2006
Wang W et al: Thoracic myelopathy caused by ossification of ligamentum flavum of which fluorosis as an etiology factor. J Orthop Surg Res. 1:10, 2006
Takeuchi A et al: Thoracic paraplegia due to missed thoracic compressive lesions after lumbar spinal decompression surgery. Report of three cases. J Neurosurg. 100(1 Suppl):71-4, 2004
Ben Hamouda K et al: Thoracic myelopathy caused by ossification of the ligamentum flavum: a report of 18 cases. J Neurosurg. 99(2 Suppl):157-61, 2003
Miyakoshi N et al: Factors related to long-term outcome after decompressive surgery for ossification of the ligamentum flavum of the thoracic spine. J Neurosurg. 99(3 Suppl):251-6, 2003
Muthukumar N et al: Tumoral calcium pyrophosphate dihydrate deposition disease of the ligamentum flavum. Neurosurgery. 53(1):103-8; discussion 108-9, 2003
Seichi A et al: Image-guided resection for thoracic ossification of the ligamentum flavum. J Neurosurg. 99(1 Suppl):60-3, 2003
Akhaddar A et al: Thoracic spinal cord compression by ligamentum flavum ossifications. Joint Bone Spine. 69(3):319-23, 2002
Li KK et al: Myelopathy caused by ossification of ligamentum flavum. Spine. 27(12):E308-12, 2002
Mizuno J et al: Unilateral ossification of the ligamentum flavum in the cervical spine with atypical radiological appearance. J Clin Neurosci. 9(4):462-4, 2002
Vasudevan A et al: Ossification of the ligamentum flavum. J Clin Neurosci. 9(3):311-3, 2002
Hirai T et al: Ossification of the posterior longitudinal ligament and ligamentum flavum: imaging features. Semin Musculoskelet Radiol. 5(2):83-8, 2001
Trivedi P et al: Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien). 143(8):775-82, 2001
Xiong L et al: CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine. Eur Radiol. 11(9):1798-802, 2001
Muthukumar N et al: Calcium pyrophosphate dihydrate deposition disease causing thoracic cord compression: case report. Neurosurgery. 46(1):222-5, 2000
Yamagami T et al: Calcification of the cervical ligamentum flavum--case report. Neurol Med Chir (Tokyo). 40(4):234-8, 2000
Ono K et al: Pathology of ossification of the posterior longitudinal ligament and ligamentum flavum. Clin Orthop. (359):18-26, 1999
Wang PN et al: Ossification of the posterior longitudinal ligament of the spine. A case-control risk factor study. Spine. 24(2):142-4; discussion 145, 1999
al-Orainy IA et al: Ossification of the ligament flavum. Eur J Radiol. 29(1):76-82, 1998
Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
Ido K et al: Surgical treatment for ossification of the posterior longitudinal ligament and the yellow ligament in the thoracic and cervico-thoracic spine. Spinal Cord. 36(8):561-6, 1998
Fam AG: Calcium pyrophosphate crystal deposition disease and other crystal deposition diseases. Curr Opin Rheumatol. 7(4):364-8, 1995
Imai S et al: Cervical radiculomyelopathy due to deposition of calcium pyrophosphate dihydrate crystals in the ligamentum flavum: historical and histological evaluation of attendant inflammation. J Spinal Disord. 7(6):513-7, 1994
Delamarter RB et al: Lumbar spinal stenosis secondary to calcium pyrophosphate crystal deposition (pseudogout). Clin Orthop. (289):127-30, 1993
Gomez H et al: Myeloradiculopathy secondary to pseudogout in the cervical ligamentum flavum: case report. Neurosurgery. 25(2):298-302, 1989
Kawano N et al: Calcium pyrophosphate dihydrate crystal deposition disease in the cervical ligamentum flavum. J Neurosurg. 68(4):613-20, 1988
Berghausen EJ et al: Cervical myelopathy attributable to pseudogout. Case report with radiologic, histologic, and crystallographic observations. Clin Orthop. (214):217-21, 1987
Resnick D et al: Vertebral involvement in calcium pyrophosphate dihydrate crystal deposition disease. Radiographic-pathological correlation. Radiology. 153(1):55-60, 1984
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Ossification of ligamentum flavum (OLF), ossification of vertebral arch ligaments (OVAL), ligamentum flavum "pseudogout"
Definitions
Calcification &/or OLF
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Ando K et al: Outcomes of surgery for thoracic myelopathy owing to thoracic ossification of the ligamentum flavum in a nationwide multicenter prospectively collected study in 223 patients: is instrumented fusion necessary? Spine (Phila Pa 1976). 45(3):E170-8, 2020
Ohara Y: Ossification of the ligaments in the cervical spine, including ossification of the anterior longitudinal ligament, ossification of the posterior longitudinal ligament, and ossification of the ligamentum flavum. Neurosurg Clin N Am. 29(1):63-8, 2018
Hirabayashi S: Ossification of the ligamentum flavum. Spine Surg Relat Res. 1(4):158-63, 2017
Hou X et al: Clinical features of thoracic spinal stenosis-associated myelopathy: a retrospective analysis of 427 cases. J Spinal Disord Tech. 29(2):86-9, 2016
Gao R et al: Clinical features and surgical outcomes of patients with thoracic myelopathy caused by multilevel ossification of the ligamentum flavum. Spine J. 13(9):1032-8, 2013
Hirabayashi H et al: Surgery for thoracic myelopathy caused by ossification of the ligamentum flavum. Surg Neurol. 69(2):114-6; discussion 116, 2008
Wang VY et al: Removal of ossified ligamentum flavum via a minimally invasive surgical approach. Neurosurg Focus. 25(2):E7, 2008
Kong Q et al: COL6A1 polymorphisms associated with ossification of the ligamentum flavum and ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976). 32(25):2834-8, 2007
Yayama T et al: Thoracic ossification of the human ligamentum flavum: histopathological and immunohistochemical findings around the ossified lesion. J Neurosurg Spine. 7(2):184-93, 2007
Inamasu J et al: Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history. Neurosurgery. 58(6):1027-39; discussion 1027-39, 2006
Wang W et al: Thoracic myelopathy caused by ossification of ligamentum flavum of which fluorosis as an etiology factor. J Orthop Surg Res. 1:10, 2006
Takeuchi A et al: Thoracic paraplegia due to missed thoracic compressive lesions after lumbar spinal decompression surgery. Report of three cases. J Neurosurg. 100(1 Suppl):71-4, 2004
Ben Hamouda K et al: Thoracic myelopathy caused by ossification of the ligamentum flavum: a report of 18 cases. J Neurosurg. 99(2 Suppl):157-61, 2003
Miyakoshi N et al: Factors related to long-term outcome after decompressive surgery for ossification of the ligamentum flavum of the thoracic spine. J Neurosurg. 99(3 Suppl):251-6, 2003
Muthukumar N et al: Tumoral calcium pyrophosphate dihydrate deposition disease of the ligamentum flavum. Neurosurgery. 53(1):103-8; discussion 108-9, 2003
Seichi A et al: Image-guided resection for thoracic ossification of the ligamentum flavum. J Neurosurg. 99(1 Suppl):60-3, 2003
Akhaddar A et al: Thoracic spinal cord compression by ligamentum flavum ossifications. Joint Bone Spine. 69(3):319-23, 2002
Li KK et al: Myelopathy caused by ossification of ligamentum flavum. Spine. 27(12):E308-12, 2002
Mizuno J et al: Unilateral ossification of the ligamentum flavum in the cervical spine with atypical radiological appearance. J Clin Neurosci. 9(4):462-4, 2002
Vasudevan A et al: Ossification of the ligamentum flavum. J Clin Neurosci. 9(3):311-3, 2002
Hirai T et al: Ossification of the posterior longitudinal ligament and ligamentum flavum: imaging features. Semin Musculoskelet Radiol. 5(2):83-8, 2001
Trivedi P et al: Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien). 143(8):775-82, 2001
Xiong L et al: CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine. Eur Radiol. 11(9):1798-802, 2001
Muthukumar N et al: Calcium pyrophosphate dihydrate deposition disease causing thoracic cord compression: case report. Neurosurgery. 46(1):222-5, 2000
Yamagami T et al: Calcification of the cervical ligamentum flavum--case report. Neurol Med Chir (Tokyo). 40(4):234-8, 2000
Ono K et al: Pathology of ossification of the posterior longitudinal ligament and ligamentum flavum. Clin Orthop. (359):18-26, 1999
Wang PN et al: Ossification of the posterior longitudinal ligament of the spine. A case-control risk factor study. Spine. 24(2):142-4; discussion 145, 1999
al-Orainy IA et al: Ossification of the ligament flavum. Eur J Radiol. 29(1):76-82, 1998
Ehara S et al: Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol. 27(3):196-205, 1998
Ido K et al: Surgical treatment for ossification of the posterior longitudinal ligament and the yellow ligament in the thoracic and cervico-thoracic spine. Spinal Cord. 36(8):561-6, 1998
Fam AG: Calcium pyrophosphate crystal deposition disease and other crystal deposition diseases. Curr Opin Rheumatol. 7(4):364-8, 1995
Imai S et al: Cervical radiculomyelopathy due to deposition of calcium pyrophosphate dihydrate crystals in the ligamentum flavum: historical and histological evaluation of attendant inflammation. J Spinal Disord. 7(6):513-7, 1994
Delamarter RB et al: Lumbar spinal stenosis secondary to calcium pyrophosphate crystal deposition (pseudogout). Clin Orthop. (289):127-30, 1993
Gomez H et al: Myeloradiculopathy secondary to pseudogout in the cervical ligamentum flavum: case report. Neurosurgery. 25(2):298-302, 1989
Kawano N et al: Calcium pyrophosphate dihydrate crystal deposition disease in the cervical ligamentum flavum. J Neurosurg. 68(4):613-20, 1988
Berghausen EJ et al: Cervical myelopathy attributable to pseudogout. Case report with radiologic, histologic, and crystallographic observations. Clin Orthop. (214):217-21, 1987
Resnick D et al: Vertebral involvement in calcium pyrophosphate dihydrate crystal deposition disease. Radiographic-pathological correlation. Radiology. 153(1):55-60, 1984
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