Abstract
Ossification of the ligamentum flavum (OLF) predominantly affects the thoracic spine;
cervical involvement is rare and often underrecognized, typically progressing slowly
with motor or sensory symptoms. Here, the authors present a 70-year-old male who has
experienced a subacute progression of hemiparesis, which is atypical for OLF and could
easily be misdiagnosed as a stroke attack, attributed to OLF that resolved following
a laminectomy. A 70-year-old man with diabetes mellitus developed initial bilateral
upper limb numbness, followed by progressive left upper and lower extremity weakness
over 1 month. Initial stroke suspicion was negated by normal brain imaging. A cervical
magnetic resonance imaging revealed ossified lesions at C5–C6 with posterior spinal
cord compression. Cervical laminectomy was performed, and pathological examination
confirmed OLF. Neurological symptoms improved steadily following surgery and rehabilitation.
Cervical OLF may cause severe hemiparesis in such a short period of time, presenting
in an atypical manner for its nature and may resemble cerebrovascular disease. Accurate
and timely diagnosis is essential to prevent permanent neurological deficit through
appropriate surgical decompression, such as laminectomy.
Keywords
cervical lesion - hemiparesis - laminectomy - ligamentum flavum - ossification
