Multilevel myelopathy associated with pseudohypoparathyroidism simulating diffuse skeletal hyperostosis: a case report and literature review.

STUDY

DESIGN

A case report and review of previous literature are presented.

OBJECTIVE

The objective of this manuscript was to report a case of pseudohypoparathyroidism (PHP) 1a simulating diffuse idiopathic skeletal hyperostosis and resulting in spinal cord compression, and discuss the pathogenesis of this disease.

SUMMARY OF BACKGROUND DATA: Spinal cord compression due to PHP is not common, to the authors' knowledge, none of the previous reported cases simulated diffuse idiopathic skeletal hyperostosis.

METHODS

The patient's history, clinical examination, imaging findings, and treatment were reported; and the pathogenesis was discussed.

RESULTS

Characteristic findings were revealed from imaging studies, a multiplane reconstruction of the computed tomography images, and magnetic resonance imaging. The patient was treated by 2-stage posterior decompression on the basis of the images. A mild improvement was observed after the surgeries and the patient's neurology was not completely restored after 6 months.

CONCLUSION

We reported a rare case of skeletal and ligamentous abnormality resulting in spinal cord compression associated with PHP. A multiplane reconstruction of the computed tomography images was very necessary for diagnosis and treatment of this case. The unfavorable neurologic restoration might be due to the severe injury of the spinal cord caused by diffuse ossification of the posterior longitudinal ligament and ligamentum flavum.