title: Ligamentum flavum hematoma in the rigid thoracic spinal segments: case report.
abstract: Ligamentum flavum hematoma, a rare cause of spinal nerve root and canal compression, typically occurs in the mobile lumbar spine segments. A thoracic ligamentum flavum hematoma is extremely rare--only one such case of a thoracolumbar (T11-12) lesion has been reported. The thoracolumbar region with its floating ribs, however, is structurally and biomechanically similar to the lumbar spine and its mobility is greater than the higher thoracic levels. To the best of their knowledge, the authors report the first case of a ligamentum flavum hematoma in the region of the rigid thoracic spinal segments with the contiguous rib cage. A symptomatic T9-10 ligamentum flavum hematoma is described in the case of a 66-year-old woman with compensatory thoracic lordosis secondary to the lumbar degenerative kyphosis. The hematoma was removed and the diagnosis was histologically confirmed. The authors speculate that thoracic lordosis might have contributed to the development of the hematoma because the ligamentum flavum and the facet joint were subjected to greater axial stress than in individuals with normal spinal alignment.
authors.affiliation: Department of Orthopedic Surgery, Akita University School of Medicine, Akita, Japan. miyakosh@doc.med.akita-u.ac.jp
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Kyoji
authors.initials: K
authors.lastname: Okada
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.forename: Eui
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000368:Aged; D005260:Female; D006406:Hematoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000503:physiopathology; D017843:Ligamentum Flavum / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000209:etiology / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013122:Spinal Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013126:Spinal Nerve Roots / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000503:physiopathology