Calcium pyrophosphate dihydrate deposition disease causing thoracic cord compression: Case report

OBJECTIVE AND IMPORTANCE: Calcium pyrophosphate dihydrate (CPPD) deposition disease is being increasingly recognized. Spinal involvement in CPPD depos ition disease is rare. When involved, the cervical and lumbar regions are c ommonly affected. We report a rare case of CPPD deposition disease that cau sed thoracic cord compression. CLINICAL PRESENTATION: A 45-year-old woman presented with clinical features suggestive of thoracic cord compression. Radiographic findings were consis tent with calcification of the ligamenta flava in the lower thoracic levels causing cord compression. Calcification of the ligamentum flavum is common ly attributed to CPPD deposition disease. Evaluation for conditions that mi ght be associated with CPPD deposition disease proved to be negative. INTERVENTION: Laminectomy with removal of the calcified ligamenta flava was performed. Histopathological examination of the excised ligaments revealed evidence of CPPD crystals. Postoperatively, the patient's spasticity decre ased and sensations improved, with no significant improvement in motor powe r. CONCLUSION: Calcification of the ligamenta flava due to CPPD deposition dis ease is a rare cause of thoracic cord compression. CPPD deposition disease should be entertained in the differential diagnosis of thoracic cord compre ssion.