The first use of streptomycin for bone tuberculosis: a 47-year follow-up.

VOL. 76-B, No. 4, JULY i994 Decompression laminectomy at L4 to Ii was performed in January 1993. The ligamentum flavum was severely thickened and the epidural space contained a white toothpaste-like material. The patient was relieved of her symptoms immediately after the operation. Tissue obtained from the spinal canal revealed crystals typical of calcium pyrophosphate when viewed by polarised light (Fig. 3). Discussion. Stenosis of the spinal canal is most common in the lumbar region. It has been well described by Wiltse et al (1984). The most common cause is degenerative arthritis but this usually results in a lateral recess or foraminal type of stenosis. Central lumbar spinal stenosis can be congenital as in achondroplasia or acquired as in post-traumatic deformity and osteoarthritis, Paget’s disease, fluorosis or any cause of epidural infiltration. Intermittent claudication with strong peripheral pulses is typically seen in central lumbar stenosis and neurological claudication of this type begins and intensifies with walking and is not completely relieved by rest. CT is used to demonstrate and measure canal diameter in central stenosis; in this case it showed ectopic calcification. Spinal decompression gave immediate and complete relief of symptoms.