A case of paraparesis with thoracic ossification of the posterior longitudinal ligament and the ligamentum flavum induced by falling down on the abdomen

Abstract

Aim:To describe an educational case. Methods: Case report. Results: A 71-year-old female was transported to our emergency department with complaints of lower abdominal pain and gate disturbance after falling down on her abdomen. She had lower abdominal painful paresthesia in the dermatome from the twelfth thoracic to the first lumbar level without signs of peritoneal stimulation. Paraparesis and dysesthesia of the lower extremities was predominant on the left side. Abdominal computed tomography revealed severe thoracic ossification of the posterior longitudinal ligament and the ligamentum flavum at the thoracic level 10/11. Laminectomy and spinal fusion with rods resulted in recovery of the patient's symptoms. Conclusion:Physician should pay attention to thoracic spinal cord injury induced by hyperextensive stress on the spine, even in cases of minor trauma, among patients with preexisting bony pathologies at the thoracolumbar level.

Risk factors for spinal cord injury without radiographic abnormality in trauma cases at a single trauma center

“…Spinal canal stenosis has been established as a risk factor for cervical SCIWORA. [6,17–25] In the study by Kasimatis et al, [24] among the seven patients diagnosed with cervical SCIWORA, cervical spondylosis was detected in five patients using CT, spinal canal stenosis due to osteophyte formation was detected in one patient, and stenosis in the cervical spinal cord was detected in six patients using MRI. Furthermore, in this study, cervical SCIWORA was observed significantly more frequently in cases with spinal canal stenosis based on CT and MRI findings than those with cervical cord injury with radiographic abnormality.…”