Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine.
Department of Sport Medicine, Fukushima Medical University School of Medicine.
Fukushima J Med Sci. 2021 Apr 10;67(1):33-37. doi: 10.5387/fms.2020-26. Epub 2021 Mar 16.
Thoracic ossification of the ligamentum flavum (OLF) is a pathological condition that causes myelopathy, with unilateral lower extremity pain rarely a feature in the presenting complaint. Moreover, most symptomatic cases of thoracic OLF occur in middle-aged men, with younger individuals rarely affected. We present a rare case of severe and chronic unilateral buttock and leg pain mimicking sciatica due to thoracic OLF in a professional baseball pitcher. A 28-year-old, right-handed, Japanese professional baseball pitcher experienced intractable left leg pain with numbness and spasticity. After the initial presentation, extensive testing focusing on lumbar, hip, and pelvis lesions failed to identify a cause for the pain. One year after onset, careful neurological examination showed signs of upper motor neuron disturbance, and thoracic computed tomography and magnetic resonance imaging revealed thoracic OLF at the level of the thoracolumbar junction. After resection of the thoracic OLF, the pain, numbness, and spasticity completely resolved. He resumed full training and was pitching in top condition within four months after surgery. Though rare, thoracic OLF should be considered in the differential diagnosis of lower extremity pain in young athletes, especially amongst high-level baseball pitchers.
黄韧带骨化（OLF）是一种引起脊髓病的病理状况，单侧下肢疼痛很少是其主要表现。此外，大多数有症状的胸段 OLF 发生在中年男性，年轻人很少受影响。
我们报告了一例罕见的因胸段 OLF 引起的严重和慢性单侧臀部和腿部疼痛，类似于坐骨神经痛，患者为职业棒球投手。一位 28 岁、右利手的日本职业棒球投手出现顽固性左腿疼痛伴麻木和痉挛。初始表现后，广泛的腰椎、髋关节和骨盆病变检查未能确定疼痛的原因。发病 1 年后，仔细的神经系统检查显示出上运动神经元障碍的迹象，胸椎计算机断层扫描和磁共振成像显示胸腰椎交界处的胸段 OLF。胸段 OLF 切除后，疼痛、麻木和痉挛完全缓解。他恢复了全面训练，术后四个月内恢复了最佳状态。尽管罕见，但在年轻运动员下肢疼痛的鉴别诊断中应考虑胸段 OLF，尤其是在高水平棒球投手中。
