case_images: PMC4754591_01
case_images: Typical ochronotic pigmentation secondary to deposition on the nose, sclera and jowl.
case_images: jkns-59-65-g001.jpg
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case_images: F1
case_images: Physical examination showed cyan pigmentation on the nose, sclera, and the ear auricle and also in other parts of the body (Fig. 1).
case_images: The AP (A) and lateral (B) view of the cervial spine showing reduced disc spaces, pronounced disc calcifications and spondylosis.
case_images: jkns-59-65-g002.jpg
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case_images: F2
case_images: CT scans indicated multilevel degenerative disc disease from cervical to lumbar spine, including narrowing, calcification, osteophytosis and vacuum phenomenon (Fig. 2, 3).
case_images: Sagittal (A) and axial CT (B) view of the lumbar spine showing the typical vacuum phenomenon and profound water-like calcification with sparing of the central nucleus pulposus.
case_images: jkns-59-65-g003.jpg
case_images: PMC4754591_01_jkns-59-65-g003.jpg
case_images: F3
case_images: CT scans indicated multilevel degenerative disc disease from cervical to lumbar spine, including narrowing, calcification, osteophytosis and vacuum phenomenon (Fig. 2, 3).
case_images: A and B : The cervical MRI show the spinal cord is compressed at multi-level mainly from the redundant ligamentum flavum posteriorly (C2 : arrow head).
case_images: jkns-59-65-g004.jpg
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case_images: F4
case_images: MRI showed the cervical spinal compression in multi-segment by disc extrusion and ligamentum flavum redundancy simultaneously (Fig. 4).
case_images: Black oxidized HGA pigmentation (long arrow) is found in the ligamentum flavum between the C2 (arrowhead)-3 lamina.
case_images: jkns-59-65-g005.jpg
case_images: PMC4754591_01_jkns-59-65-g005.jpg
case_images: F5
case_images: During the operation, the ossificated nuchal ligament and the ligamentum flavum between C2-3 were stained black in color due to the deposition of the oxidized HGA pigmentation (Fig. 5).
case_images: A and B : The X-ray picture of the laminoplasty procedure postoperatively, which shows the artificial wedged coral bone interposition from the C4 to the C6.
case_images: jkns-59-65-g006.jpg
case_images: PMC4754591_01_jkns-59-65-g006.jpg
case_images: F6
case_images: After surgery, the patient recovered uneventfully (Fig. 6).