THE ROLE OF CALCIUM DEPOSITION IN THE LIGAMENTUM-FLAVUM CAUSING A CAUDA-EQUINA SYNDROME AND LUMBAR RADICULOPATHY

Our report concerns five patients who underwent lumbar decompressive s urgery for cauda equina syndrome and radiculopathy secondary to degene rative stenosis associated with calcium deposition in the ligamentum f lavum. The resected ligamentum flavum showed diffuse to massive calciu m crystal deposition with a histologically marked degeneration in the elastic fibres. Energy dispensive radiographic microanalysis confirmed the crystal to be calcium pyrophosphate dihydrate in all patients, hy droxyapatite mixed in three and calcium orthophosphate mixed in one. T he deposition appeared to be a change that is associated with the dege nerative process in the ligament and, in some cases having marked depo sition in a localised event, it causes or aggravates the neurological symptoms.