Brown-Sequard syndrome caused by ossification of the ligamentum flavum

Ossification of the ligamentum flavum (OLF) commonly occurs in the thoracic and lumbar regions. We present a patient with OLF at the C4–5 level with presentation as Brown-Sequard syndrome. Symptoms were relieved following a laminectomy and total lesion excision. The relevant literature is reviewed to discuss the racial distribution, unique presentation and pathogenesis of OLF.