{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:07:55Z","timestamp":1789150075168,"version":"build-2803163510"},"reference-count":21,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,23]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    We present an exceptionally rare case of a late 30\u2009s female with a known history of Cowden syndrome who developed extensive thoracic ossification of the yellow ligament (OYL) causing severe spinal cord compression. OYL is the abnormal ossification of the ligamentum flavum that can compress the spinal cord. The patient underwent a T10-11 posterior decompressive laminectomy and fusion that resulted in recovery of ambulatory function and improvement of motor strength. This case raises awareness of OYL as a potential, though unconfirmed, complication in patients with\n                    <jats:italic>PTEN<\/jats:italic>\n                    -related disorders, highlighting the possible value of spinal surveillance in this population.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-271377","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:25:35Z","timestamp":1789147535000},"page":"e271377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multilevel thoracic ossification of the yellow ligament in a Cowden syndrome patient"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5062-3690","authenticated-orcid":false,"given":"Ohsang","family":"Kwon","sequence":"first","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1947-7046","authenticated-orcid":false,"given":"Jaehyuk","family":"Choi","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun hyeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Min","family":"Park","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Joong","family":"Kim","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Seob","family":"Yeom","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091110252516000_19.9.e271377.1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djt277"},{"key":"2026091110252516000_19.9.e271377.2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-052218-125823"},{"key":"2026091110252516000_19.9.e271377.3","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-2283"},{"key":"2026091110252516000_19.9.e271377.4","doi-asserted-by":"publisher","DOI":"10.1172\/JCI121277"},{"key":"2026091110252516000_19.9.e271377.5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197806)41:6<2393::AID-CNCR2820410644>3.0.CO;2-K"},{"key":"2026091110252516000_19.9.e271377.6","doi-asserted-by":"crossref","first-page":"158","DOI":"10.22603\/ssrr.1.2016-0031","article-title":"Ossification of the ligamentum flavum","volume":"1","author":"Hirabayashi","year":"2017","journal-title":"Spine Surg Relat Res"},{"key":"2026091110252516000_19.9.e271377.7","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2014.8.1.89"},{"key":"2026091110252516000_19.9.e271377.8","doi-asserted-by":"crossref","first-page":"348","DOI":"10.14245\/kjs.2012.9.4.348","article-title":"Symptomatic myelopathy caused by ossification of the yellow ligament","volume":"9","author":"Park","year":"2012","journal-title":"Korean J Spine"},{"key":"2026091110252516000_19.9.e271377.9","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1177\/2192568220903766","article-title":"The Natural History of Ossification of Yellow Ligament of the Thoracic Spine on MRI: A Population-Based Cohort Study","volume":"11","author":"Tang","year":"2021","journal-title":"Global Spine J"},{"key":"2026091110252516000_19.9.e271377.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026"},{"key":"2026091110252516000_19.9.e271377.11","doi-asserted-by":"publisher","DOI":"10.1172\/JCI121277"},{"key":"2026091110252516000_19.9.e271377.12","doi-asserted-by":"publisher","DOI":"10.1242\/dev.058016"},{"key":"2026091110252516000_19.9.e271377.13","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41413-018-0030-y","article-title":"NUMB maintains bone mass by promoting degradation of PTEN and GLI1 via ubiquitination in osteoblasts","volume":"6","author":"Ye","year":"2018","journal-title":"Bone Res"},{"key":"2026091110252516000_19.9.e271377.14","doi-asserted-by":"crossref","unstructured":"Zhang G , Song S , Chen Z , et al . Inhibition of PTEN promotes osteointegration of titanium implants in type 2 diabetes by enhancing anti-inflammation and osteogenic capacity of adipose-derived stem cells. 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Genetic\/familial high-risk assessment: breast, ovarian, pancreatic, and prostate. Plymouth Meeting, PA; 2026. 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