Jung HY, Kim GU, Joh YW, Lee JS. Ankle and toe weakness caused by calcified ligamentum flavum cyst: A case report. World J Clin Cases 2023; 11(35): 8392-8398 [PMID: 38130625 DOI: 10.12998/wjcc.v11.i35.8392]
Corresponding Author of This Article
Jun-Seok Lee, MD, PhD, Professor, Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-Ro, Eunpyeong-gu, Seoul 03312, South Korea. junband@naver.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2023; 11(35): 8392-8398 Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8392
Ankle and toe weakness caused by calcified ligamentum flavum cyst: A case report
Ho-Young Jung, Geon-U Kim, Yong-Won Joh, Jun-Seok Lee
Ho-Young Jung, Geon-U Kim, Yong-Won Joh, Jun-Seok Lee, Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
Author contributions: Lee JS conceived and designed the study, and performed the surgery; Jung HY, Kim GU, and Joh YW prepared the figures and collected the data; Jung HY and Lee JS wrote the manuscript; and all authors read and approved the final manuscript.
Informed consent statement: The patient included in the present case gave their consent prior to study inclusion.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Seok Lee, MD, PhD, Professor, Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-Ro, Eunpyeong-gu, Seoul 03312, South Korea. junband@naver.com
Received: September 5, 2023 Peer-review started: September 5, 2023 First decision: November 1, 2023 Revised: November 6, 2023 Accepted: December 4, 2023 Article in press: December 4, 2023 Published online: December 16, 2023 Processing time: 100 Days and 1 Hours
Abstract
BACKGROUND
Ligamentum flavum cysts, which are most common in mobile junctional levels of the spine, can be a rare cause of spinal stenosis. There have been several case reports of ligamentum flavum cysts. However, there is yet to be a documented case report of a calcified ligamentum flavum cyst. Herein, we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.
CASE SUMMARY
A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg, all beginning two weeks prior. Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion. Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level. Magnetic resonance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level. We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level. Intra-operatively, we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum. Pathological examination suggested a calcified pseudocyst without a capsular lining. After the operation, the patient’s motor weakness in the ankle and great toe improved gradually.
CONCLUSION
The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.
Core Tip: Ligamentum flavum cyst in lumbar spine can be a rare cause of spinal stenosis. There have been several case reports of ligamentum flavum cysts. However, to the best of our knowledge, no calcified ligamentum flavum cyst has been reported. We report the first case of a calcified ligamentum flavum cyst causing neurological claudication and motor weakness of lower extremities. We believe that our report would be useful for a diagnostic approach and treatment in patients who have spinal stenosis with neurological claudication and motor weakness.
