Calcium pyrophosphate deposition disease causing cervical myelopathy

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.