Zhiyi Fu1, Jiangang Shi, Lianshun Jia, Wen Yuan, Zhengmao Guan. 1. From the Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, Shanghai, People's Republic of China. fuzhiyi@sina.cn
Abstract
STUDY DESIGN: Intervertebral disc calcification of T6-T7, T7-T8 discs associated with ossification of posterior longitudinal ligament (OPLL) in a child is reported. OBJECTIVE: To discuss the natural history and management of calcification of T6-T7, T7-T8 discs with OPLL. SUMMARY OF BACKGROUND DATA: Calcified intervertebral discs are rare in children. Cervical disc calcification has already been described. However, thoracic disc calcification associated with OPLL has not been reported. METHODS: An 11-year-old boy presented with progressive back pain for 6 months. Neurologic examination showed numbness in both lower extremities. The knee jerk reflex of the patient was hypertonic. The muscle strength of both lower extremities were Grade 4, with reduction. He was treated with a lumbar belt for 2 weeks. RESULTS: Initial thoracic spine radiograph and CT scan showed two adjacent calcified discs of T6-T7, T7-T8 associated with T6-T7 OPLL, resulting in marked spinal canal stenosis. His neurologic symptoms subsided and his back pain disappeared after a 2-week conservative treatment. Three months later CT scan showed that the calcification of T6-T7, T7-T8 discs was aggravated, but the T6-T7 OPLL was relieved. CONCLUSION: The natural history of intervertebral disc calcification is usually benign. In this case, the improvement of OPLL is associated with the stabilization of the maturely fused calcified disc. Spontaneous resolution of the OPLL and recovery of normal neurologic function can be expected with conservative treatment.
STUDY DESIGN:Intervertebral disc calcification of T6-T7, T7-T8 discs associated with ossification of posterior longitudinal ligament (OPLL) in a child is reported. OBJECTIVE: To discuss the natural history and management of calcification of T6-T7, T7-T8 discs with OPLL. SUMMARY OF BACKGROUND DATA: Calcified intervertebral discs are rare in children. Cervical disc calcification has already been described. However, thoracic disc calcification associated with OPLL has not been reported. METHODS: An 11-year-old boy presented with progressive back pain for 6 months. Neurologic examination showed numbness in both lower extremities. The knee jerk reflex of the patient was hypertonic. The muscle strength of both lower extremities were Grade 4, with reduction. He was treated with a lumbar belt for 2 weeks. RESULTS: Initial thoracic spine radiograph and CT scan showed two adjacent calcified discs of T6-T7, T7-T8 associated with T6-T7 OPLL, resulting in marked spinal canal stenosis. His neurologic symptoms subsided and his back pain disappeared after a 2-week conservative treatment. Three months later CT scan showed that the calcification of T6-T7, T7-T8 discs was aggravated, but the T6-T7 OPLL was relieved. CONCLUSION: The natural history of intervertebral disc calcification is usually benign. In this case, the improvement of OPLL is associated with the stabilization of the maturely fused calcified disc. Spontaneous resolution of the OPLL and recovery of normal neurologic function can be expected with conservative treatment.