Central Cord Syndrome in a Young Patient with Early Diffuse Idiopathic Skeletal Hyperostosis and Ossification of the Posterior Longitudinal Ligament after Minor Trauma: A Case Report and Review

Abstract

This paper is a case report and literature review. The objective of this article is to address a rather unusual case of central cord syndrome in a patient with diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament. We also discuss the mechanism of injury in central cord syndrome, as well as that specific to involvement of diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL). This case took place at SUNY Upstate Medical University. We report a case of a 39-year-old male with early diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament, presenting with central cord syndrome after minor trauma. The patient presented with tetraparesis, predominating with significant distal upper extremity weakness and hyperpathia. We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws. Since surgery, the patient has had a steady progressive improvement in neurological function and is currently ambulating with a good functional use of his upper extremities. An increased risk of spinal cord injury is a known risk in individuals with pre-existing spinal ankylosing. Few reports are present citing the contribution of focal OPLL with DISH in this age group within the cervical spine contributing to the central cord syndrome.