Ossification of the proximal thoracic ligamenta flava causing acute myelopathy in a Caucasian: case report and literature review.

STUDY DESIGN

Case report and literature review.

OBJECTIVE

To illustrate that ossification of the proximal thoracic ligamenta flava can be a rare cause of acute myelopathy in a Caucasian patient and that timely surgery can lead to a good outcome.

SETTING

Nottingham, UK.

METHODS

Proximal multiple contiguous ossified thoracic ligamenta flava from T3/T4 to T5/T6 causing acute myelopathy was diagnosed in a Caucasian man based on history and examination followed by magnetic resonance imaging and computed tomography scanning. The literature is reviewed for all reported cases of ossified ligamenta flava causing myelopathy in Caucasians.

RESULTS

Following prompt diagnosis and T3 to T5 laminectomies, our patient made near-complete neurological recovery over a 10-month period. This condition usually affects the lower thoracic spine. Although chronic and subacute myelopathy secondary to this circumstance has been reported in Caucasians, acute myelopathy has not been reported and proximal thoracic involvement has been reported twice.

CONCLUSION

Ossification of the proximal thoracic ligamenta flava can be a rare cause of acute myelopathy in Caucasians. Prognosis following decompressive surgery is usually good.