Ossification of the Ligamentum Flavum of the Lumbar Spine

Ossification of the ligamenta flava (OLF) is a rare and likely multifactorial condition that most commonly affects the lower thoracic spine. It can result in chronic pain and neurological deficits and has a higher prevalence in men of Japanese descent. We present the case of OLF of the lumbar spine in a Caucasian man with a history of multiple sports-related injuries. To treat his severe lumbar spinal stenosis, the patient underwent endoscopic intralaminar laminotomy with partial facetectomy and complete resection of OLF with lateral recess decompression, which immediately resolved his symptoms. We noted signs of OLF based on T1 and T2 signal changes upon re-evaluation of MRI.