title: Ossification of the ligamentum flavum causing thoracic myelopathy: a case report.
abstract: Ossification of the ligamentum flavum is a well reported clinicopathologic entity causing narrowing of the spinal canal and subsequent spinal cord compression. The patient described in this case report complained of 9 mo of middle and lower back pain, difficulty with balance, progressive gait disturbance, and recent onset of bladder retention. Magnetic resonance imaging and computed tomographic scan revealed a bone density mass at the T2-3 level causing 25% cord compression and edema. A decompressive laminectomy was performed at T-2. The etiology of the compression was found to be attributable to an ossified ligamentum flavum at the T-2 level, which was confirmed by histologic examination. His neurologic signs and symptoms and functional status markedly improved after surgery and subsequent comprehensive rehabilitation. The patient was able to ambulate independently with a walker as opposed to previously being wheelchair-bound. Prompt surgical intervention and appropriate rehabilitation management play a key role in improving the functional outcome of myelopathy caused by ossified ligamentum flavum. This article acquaints rehabilitation personnel with the clinical features, proposed etiologies, association with other diseases, work-up, treatment, and rehabilitation concerns of patients with myelopathy caused by ossified ligamentum flavum.
authors.affiliation: Denver Health Medical Center, Colorado, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Shenoi
authors.forename: T T
authors.initials: TT
authors.lastname: Duong
authors.forename: K E
authors.initials: KE
authors.lastname: Brega
authors.forename: L B
authors.initials: LB
authors.lastname: Gaido
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000150:complications* / Q000601:surgery; D006801:Humans; D017843:Ligamentum Flavum / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome