Rare cause of thoracic myelopathy: ossified ligamentum flavum

Myelopathy due to ossification of ligamentum flavum was first described in 1938 by Anzai (J Jpn Orthop Assosc. 1938;13:305-316). This is a rare condition that has been described mostly in the far east, most commonly in Japan (Miyasaka et al, Am J Neuroradiol. 1983;4:629-632). Cases reported from the western hemisphere are rare, particularly in the African-American population (Wiseman et al, J Spinal Disord Tech. 2002;15:542-545). We report an African-American patient who presented with progressive back and chest pain of recent onset, numbness, tingling, and gait disturbance due to T3 paraplegia secondary to ossified ligamentum flavum resulting in thoracic spinal stenosis. On cross-sectional imaging, there was cord effacement at multiple levels, most pronounced at T10. The patient required emergency laminectomies, which allowed him to recover significant function. This case presentation should heighten physician awareness to this unusual clinical entity, since early diagnosis and timely surgical intervention can prevent permanent neurologic deficits.