Cervical Radiculomyelopathy Due to Deposition of Calcium Pyrophosphate Dihydrate Crystals in the Ligamentum Flavum

Abstract

Deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the yellow ligament occasionally leads to neurological deficits through compression of the spinal cord. Although it is widely accepted that CPPD crystal induces severe inflammation in arthropathy, little attention has been paid to the acute inflammation that may accompany the CPPD crystals in the ligamentum flavum. The present study reviews eight patients with radiculomyelopathy due to calcification of the cervical yellow ligament. Acute inflammation of the yellow ligament accompanying the crystalline deposits, both with and without attendant granulation tissue-proliferation, was evaluated as contributing to cervical radiculomyelopathy. Three cases with attendant granulation tissue suffered from recurrent attacks of neck pain and fever with coincidental radicular pain in the upper arm. The local inflammation of the ligamentum flavum might have participated in the exacerbation of the cervical radiculopathy.