PMC4754591_01
Typical ochronotic pigmentation secondary to deposition on the nose, sclera and jowl.
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F1
Physical examination showed cyan pigmentation on the nose, sclera, and the ear auricle and also in other parts of the body (Fig. 1).
The AP (A) and lateral (B) view of the cervial spine showing reduced disc spaces, pronounced disc calcifications and spondylosis.
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F2
CT scans indicated multilevel degenerative disc disease from cervical to lumbar spine, including narrowing, calcification, osteophytosis and vacuum phenomenon (Fig. 2, 3).
Sagittal (A) and axial CT (B) view of the lumbar spine showing the typical vacuum phenomenon and profound water-like calcification with sparing of the central nucleus pulposus.
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F3
CT scans indicated multilevel degenerative disc disease from cervical to lumbar spine, including narrowing, calcification, osteophytosis and vacuum phenomenon (Fig. 2, 3).
A and B : The cervical MRI show the spinal cord is compressed at multi-level mainly from the redundant ligamentum flavum posteriorly (C2 : arrow head).
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F4
MRI showed the cervical spinal compression in multi-segment by disc extrusion and ligamentum flavum redundancy simultaneously (Fig. 4).
Black oxidized HGA pigmentation (long arrow) is found in the ligamentum flavum between the C2 (arrowhead)-3 lamina.
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F5
During the operation, the ossificated nuchal ligament and the ligamentum flavum between C2-3 were stained black in color due to the deposition of the oxidized HGA pigmentation (Fig. 5).
A and B : The X-ray picture of the laminoplasty procedure postoperatively, which shows the artificial wedged coral bone interposition from the C4 to the C6.
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F6
After surgery, the patient recovered uneventfully (Fig. 6).