• Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Nobuhiro Kaku, Masanori Kawano, and Hiroshi Tsumura.
• From the Department of Orthopaedic Surgery, Oita University, Oita, Japan.
• Spine. 2014 Apr 15;39(8):E538-41.

Study DesignA case report.ObjectiveTo describe a rare case of symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with ossification of the ligamentum flavum (OLF).Summary Of Background DataSpinal cord kinking without spinal surgery is rare, and symptomatic spinal cord kinking due to focal adhesive arachnoiditis, with OLF is even rarer.MethodsA 66-year-old female presented with numbness of the lower extremities and subsequently experienced gait disturbance due to motor weakness. Magnetic resonance imaging of the thoracic spine showed anterior displacement and kinking of the spinal cord from T11 to T12. Laminectomy and OLF resection were performed. The arachnoid membrane at the affected part was markedly thick and seemed cloudy. Adhesiolysis for arachnoid adhesion and release of spinal kinking were performed.ResultsShe could walk with a cane 6 months postoperatively. One year postoperatively, thoracic computed tomography-myelography showed that the cord was repositioned in the dural sac, and that release of the spinal cord kink was maintained.ConclusionSymptomatic spinal cord kinking due to focal adhesive arachnoiditis, with OLF is a rare clinical condition. It was difficult to diagnose the precise pathology of the spinal cord before surgery. Microsurgical arachnoidolysis resolved the spinal cord kinking, and no recurrence was noted within the follow-up period.Level Of EvidenceN/A.

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