Cervical myelopathy due to amyloid deposition with accompanying cardiac abnormalities

J Spinal Cord Med. 2023 Jul;46(4):697-701. doi: 10.1080/10790268.2022.2027322. Epub 2022 Feb 2.

Abstract

Background: Amyloidosis is a rare group of diseases in which fibrillar amyloid proteins are deposited in systemic organs to result in functional disorder. However, amyloidosis affecting the cervical spine is very rare. We herein describe a case of systemic amyloidosis including a combination of cervical myelopathy with amyloid deposition and cardiac dysfunction due to cardiac amyloidosis.

Case presentation: An 86-year-old man with cervical myelopathy accompanied with cardiac dysfunction due to cardiac amyloidosis underwent posterior cervical laminectomy from C3 to C4. We were able to identify the patient's cardiac amyloidosis and significant cardiac dysfunction before surgery and manage his perioperative treatment successfully. Preoperative cervical computed tomography (CT) showed multiple fine calcifications below the lamina, which were later confirmed by pathological analysis as amyloid deposition.

Conclusions: This is a relatively rare report of systemic amyloidosis including a combination of cervical myelopathy with amyloid deposition and cardiac dysfunction from cardiac amyloidosis. CT findings of multiple fine calcifications suggest the possibility of amyloidosis and may warrant further examination of cardiac function.

Keywords: Amyloid; Calcification; Cardiac dysfunction; Cervical myelopathy; Surgical management.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Amyloidosis* / complications
  • Amyloidosis* / diagnosis
  • Amyloidosis* / pathology
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery
  • Heart Diseases* / complications
  • Heart Diseases* / pathology
  • Humans
  • Male
  • Spinal Cord Diseases* / complications
  • Spinal Cord Diseases* / diagnostic imaging
  • Spinal Cord Injuries* / pathology