A 51-year-old man presented with sudden onset severe back pain and right anterior thigh pain without any neurologic deficit after lifting a heavy weight. On preoperative computed tomography, we identified a ruptured seed-type partial OLF at the L1-L2 level. T2-weighted magnetic resonance sagittal and axial images showed thecal sac compression by the ruptured OLF. There was no improvement in his symptoms after 2 weeks of conservative management. The patient had percutaneous full endoscopic interlaminar removal of OLF. Postoperatively he experienced prompt improvement of his symptoms.

Rupture of seed-type partial OLF causing severe radiculopathy is extremely rare, and percutaneous endoscopy is a safe and effective alternative to open surgery in selected cases 1).


1)
Kim HS, Adsul NM, Yudoyono F, Jang JS, Jang IT, Oh SH. Symptomatic Ruptured Seed-Type Partial Ossification of the Ligamentum Flavum: A Case Report. J Neurol Surg A Cent Eur Neurosurg. 2018 Apr 11. doi: 10.1055/s-0038-1641146. [Epub ahead of print] PubMed PMID: 29642243.
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