A CASE OF RECURRENT INTRADURAL LUMBAR SCHWANNOMA COMPLICATED BY THORACIC OSSIFIED LIGAMENTUM FLAVUM (OLF)

G.SHARIFI, M.D; B.DANESHPAJOUH, M.D; K.HADDADIAN, M.D; O.REZAEE, M.D and M.SAMADIAN, M.D.
From Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
ABSTRACT
We report a recurrent intradural extramedullary lumbar spine tumor (e.g. schwannoma) that is complicated by the progression of thoracic spine ossification of ligament flavum due to degeneration. The patient is a 52 year old lady that underwent surgery for resection of a lumbar schwannoma 13 years before recent admition. At that time, she was complaining of low back pain and right-sided sciatalgya and urinary urge incontinency that dramatically recovered after near total tumor resection. Total resection was not possible because of severe tissue adhesions. At the second admition, 13 years after first surgery, she complained of recurrent progressive low back pain and urge incontinency since 5 months before. During neurologic examination we found both lower (e.g. paraparesis) and upper (e.g. Babinski’s sign) motor neuron signs. In MRI, there was evidences of tumor regrowth in lumbar region and ossification of ligament flavum (OLF) in thoracic region (T10) as emerge of lower and upper motor neuron signs, respectively. We decided to treat OLF first and observe the course of the disease, afterward. The signs and symptoms significantly recovered after re-operation. So, we determined to go on close observation for future possible neurologic signs. She is, now, symptom-free for 1 year except low back pain without sciatalgya that is presumed to be due to iatrogenic lumbar post-laminectomy scoliosis
(Keywords: Ossified Ligamentum Flavum (OLF;