Myelopathy caused by Ossification of Thoracic Ligamentum Flavum

Abstract

Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9–11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient. Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty

Thoracic myeloradiculopathy due to multilevel ossification of ligamentum flavum

“…The study reported a case of OLF at the level of T9-11. 12 Our case-report is the first publication on multilevel OLF from Indonesia.…”

“…3 There was only one Indonesian OLF case that had been published. 12 To the best of our knowledge, this is the first published multilevel OLF case from Indonesia. Through this case report we aim to describe the natural history of the patient and our treatment strategy in managing multilevel OLF case.…”