Posterior Paravertebral Ossification Causing Cervical Myelopathy

Eighteen cases of a new type of cervical myelopathy, caused by a characteristic posterior paravertebral ossification in the region of the posterior longitudinal ligament, are presented. The main symptoms are a spastic gait and numbness of the fingers. Characteristic roentgenographic findings, seen on lateral roentgenograms of the cervical spine, are ossification along the posterior wall of the upper part of the cervical spinal canal, the ossification being most prominent in the mid-line. Neurological findings are exaggerated tendon reflexes and decreased skin sensation on the upper and lower extremities. Routine laboratory examinations are negative. Surgical decompression was performed by an anterior approach in three patients and by a posterior approach in eight patients. Improvement was obtained in eight patients; one by the anterior approach and seven by the posterior approach. Two patients became quadriplegic and died after anterior decompression. Our surgical experience indicates that decompression by laminectomy is valuable when the patient's chief complaints are difficulty in walking and sensory disturbance.