Shah Darshil, Dhawale Arjun, Chaudhary Kshitij, Achalare Ajinkya
Department of Orthopaedics, Sir H. N. Reliance Foundation Hospital, Mumbai, India.
Int J Spine Surg. 2021 Feb;14(s4):S89-S95. doi: 10.14444/7170. Epub 2021 Jan 18.
To report 2 different presentations of thoracic myelopathy with ossification of ligamantum flavum (OLF) due to fluorosis.
Two females presented with thoracic myelopathy secondary to spinal stenosis with OLF due to fluorosis. On examination, the first patient had a grade 4 power in both lower limbs with altered sensation below L1 dermatome. She had segmental OLF on magnetic resonance imaging and computed tomography and was treated with posterior thoracic laminectomy and recovered well. The second patient had a history of a prior thoracic laminectomy at another institution and presented with paraplegia with bladder involvement. Radiological investigations revealed a 3-column injury at the level of D8/D9. This patient was treated with decompression and stabilization.
The first patient recovered neurologically and regained independent ambulation while the second patient had a reduction in spasticity but no recovery of power or bladder function.
Different presentations and causes of myelopathy due to OLF should be recognized and treated. An unstable injury is very rare and should not be missed.
报告2例因氟中毒导致的伴有黄韧带骨化（OLF）的胸段脊髓病的不同表现。
两名女性因氟中毒继发脊髓狭窄伴OLF而出现胸段脊髓病。检查时，首例患者双下肢肌力为4级，L1皮节以下感觉改变。磁共振成像和计算机断层扫描显示节段性OLF，接受了后路胸椎椎板切除术，恢复良好。第二例患者曾在另一机构接受过胸椎椎板切除术，现出现截瘫并伴有膀胱受累。影像学检查显示D8/D9水平存在三柱损伤。该患者接受了减压和稳定治疗。
首例患者神经功能恢复，重新获得独立行走能力，而第二例患者痉挛减轻，但肌力和膀胱功能未恢复。
应认识并治疗因OLF导致的脊髓病的不同表现和病因。不稳定损伤非常罕见，不应漏诊。
