{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:01Z","timestamp":1756325401753,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,2]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Pseudogout, also called calcium pyrophosphate deposition (CPPD), is commonly observed in various joints. In the spine, this deposition is typically found in structures such as the ligamentum flavum, intervertebral disc and posterior longitudinal ligaments. However, the occurrence of calcification or calcific deposits over the dura due to calcium pyrophosphate crystals is a rare phenomenon. It is essential to distinguish dural calcification (DC) from ossification of the ligamentum flavum (OLF) to arrive at the right diagnosis. In this case, an elderly woman presented with rapid-onset cervical myelopathy that was progressive. Radiological assessments, including CT scan and MRI, suggested the presence of DC rather than OLF alone. Routine haematological investigations were within the normal limits. Subsequently, she underwent posterior cervical decompression, stabilisation and fusion. Signs of calcification were observed over the dura, accompanied by greyish-white crystalline deposits. Postoperatively, the patient showed favourable neurological recovery.<\/jats:p>","DOI":"10.1136\/bcr-2025-265904","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T08:35:35Z","timestamp":1752654935000},"page":"e265904","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Calcium pyrophosphate deposition disease causing cervical myelopathy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3381-3806","authenticated-orcid":false,"given":"Vaishak Balekkala","family":"Bhat","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daivik T","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Father Muller Medical College, Mangaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishwara","family":"Keerthi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5023-1147","authenticated-orcid":false,"given":"Sumith Marian","family":"Colaco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0922-150X","authenticated-orcid":false,"given":"Sinchana","family":"Kolavalli Mohan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharada","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"2025082712434612000_18.7.e265904.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1511117"},{"key":"2025082712434612000_18.7.e265904.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2018.10.009"},{"key":"2025082712434612000_18.7.e265904.3","first-page":"470","article-title":"Calcium pyrophosphate dihydrate of the ligamentum flavum in the cervical spine \u2013 A review of the literature","volume":"13","author":"Ehioghae","year":"2022","journal-title":"SurgNeurol Int"},{"key":"2025082712434612000_18.7.e265904.4","first-page":"5","article-title":"Pseudogout mimicking cervical spine osteomyelitis and ventral epidural abscess: A case report and literature review","volume":"15","author":"Wilkinson","year":"2024","journal-title":"SurgNeurol Int"},{"key":"2025082712434612000_18.7.e265904.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2023.108815","article-title":"Compressive cervical myelopathy due to calcium pyrophosphate dihydrate deposition in ligamentum flavum: A case report and review of literature","volume":"111","author":"Afzal","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"2025082712434612000_18.7.e265904.6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/brain\/95.1.87","article-title":"The pathogenesis of the spinal cord disorder associated with cervical spondylosis","volume":"95","author":"Nurick","year":"1972","journal-title":"Brain (Bacau)"},{"key":"2025082712434612000_18.7.e265904.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013887","article-title":"Dural ossification associated with ossification of ligamentum flavum in the thoracic spine: a retrospective analysis","volume":"6","author":"Li","year":"2016","journal-title":"BMJ Open"},{"key":"2025082712434612000_18.7.e265904.8","doi-asserted-by":"crossref","first-page":"e842","DOI":"10.5435\/JAAOS-D-21-01253","article-title":"Ossified Ligamentum Flavum: Epidemiology, Treatment, and Outcomes","volume":"30","author":"Daniels","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"2025082712434612000_18.7.e265904.9","unstructured":"Hasue M , Kikuchi S , Fujiwara M , et al . Roentgenographic analysis of ossification of the spinal ligament with special reference to the finding of the whole spine."},{"key":"2025082712434612000_18.7.e265904.10","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1002\/art.42962","article-title":"Features Associated With Different Inflammatory Phenotypes of Calcium Pyrophosphate Deposition Disease: A Study Using Data From the International American College of Rheumatology\/EULAR Calcium Pyrophosphate Deposition Classification Criteria Cohort","volume":"76","author":"Pascart","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"2025082712434612000_18.7.e265904.11","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13010105","article-title":"The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature","volume":"13","author":"Nishikawa","year":"2024","journal-title":"JCM"},{"key":"2025082712434612000_18.7.e265904.12","article-title":"Calcium pyrophosphate dihydrate crystal deposition disease of the spinal dura mater: a case report","volume":"4","author":"Wada","year":"2018","journal-title":"BJR Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:43:56Z","timestamp":1756323836000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,16]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bcr-2025-265904"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265904","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}