Ossification of the posterior longitudinal ligament at the craniocervical junction presenting with Brown-Séquard syndrome: A case report
- Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, Netherlands,
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, Netherlands,
- School for Mental health and Sciences, Maastricht University, Maastricht, Netherlands.
Valérie Nicole Elise Schuermans, Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, Netherlands.
DOI:10.25259/SNI_704_2021Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Valérie Nicole Elise Schuermans1, Jasper van Aalst1, Alida A. Postma2,3, Anouk Y. J. M. Smeets1. Ossification of the posterior longitudinal ligament at the craniocervical junction presenting with Brown-Séquard syndrome: A case report. 06-Oct-2021;12:501
How to cite this URL: Valérie Nicole Elise Schuermans1, Jasper van Aalst1, Alida A. Postma2,3, Anouk Y. J. M. Smeets1. Ossification of the posterior longitudinal ligament at the craniocervical junction presenting with Brown-Séquard syndrome: A case report. 06-Oct-2021;12:501. Available from: https://surgicalneurologyint.com/surgicalint-articles/11159/
Background: Several case reports about spinal cord compression due to hyperostosis at the craniocervical junction are available. However, compression at C1-C2 solely due to ossification of the posterior longitudinal ligament (OPLL) is rare.
Case Description: A 50-year-old Asian male, with a history of lumbar spinal canal stenosis, presented with a progressive quadriparesis within 3 months. Imaging showed central OPLL at the C1-C2 level contributing to severe spinal cord compression. The patient improved neurologically after a C1-C2 laminectomy.
Conclusion: A patient presented with a progressive Brown-Séquard syndrome due to OPLL at the craniocervical junction (C1-C2 level) and improved following a decompressive laminectomy.
Keywords: Brown-Séquard syndrome, Craniocervical junction, Myelopathy, Ossification of the posterior longitudinal ligament
The literature about high cervicomedullary junction ossification of the posterior longitudinal ligament (OPLL) is limited. Here, we report a case in which OPLL contributed to severe C1-C2 spinal cord compression resulting in myelopathy/quadriparesis that largely resolved following posterior decompressive surgery.
A 50-year-old male of Asian origin presented with a progressive quadriparesis of 3 months’ duration [
The patient underwent a C1-C2 laminectomy without fusion. The postoperative MR performed 6 months later confirmed adequate cord decompression [
Stenosis of the spinal canal at the craniocervical junction due to OPLL and/or ossification of the transverse atlantal ligament is rare.[
A patient with central C1-C2 OPLL was successfully decompressed with a partial laminectomy without instrumentation.
The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
The patient has consented to submission of the case report and publication in the journal.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013).
The authors certify that they have obtained all appropriate patient consent.
Dr. A. Postma has received institutional grants from Siemens Healthineers and Bayer.
There are no conflicts of interest.
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