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Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
Online ISSN 1827-1855
Albanese A., Braconi A., Anile C., Mannino S., Sabatino G., Mangiola A.
Institute of Neurosurgery Catholic University Medical School, Rome, Italy
Spontaneous infarction of the ligamentum flavum is a very rare cause of mielo-radicular com-pression. In the literature only four cases are reported, all characterized by a clinical history of slowly progressive mielo-radiculopathy and good outcome after surgical treatment. A 70 year-old female patient presented with a four months clinical history of spontaneous, sub-continuous, progressive lumbar pain with bilateral irradiation to the L4-L5 dermatomers, right leg monoparesis and hypoaesthesia affecting tactile, thermal and pain sensivity, urinary inconti-nence and constipation. CT scan and MRI evidenced an extradural ovalar lesion in correspon-dence of the L1-L2 levels, that exerted compression over the dural sac, dislocating it anteriorly. The patient underwent a L1-L2 laminectomy and the lesion was totally resected. Rapid improvement of the patient’s symptomatology has been noticed in the postoperative pe-riod, with complete recovery during the following month. Histologic examinations demon-strated that the mass was a haematoma of the ligamentum flavum. It’s our opinion, that a picture of ligamentum flavum haematoma should be taken into account in differential diagnosis of pos-terior mielo-radicular compression. The progressive growth of the haematoma may explain the long clinical history of these patients and surgical treatment, even if delayed, permits an excel-lent clinical outcome.