Thoracic spondylosis: an unusual cause of myelopathy

Narrowing or stenosis of the spinal canal may result in myelopathy, radiculopathy, and neurogenic claudication. Degenerative changes, or spondylosis, are the most common causes of these symptoms throughout the spinal axis, but these changes are encountered least frequently in the thoracic region. The pathological changes consisting of laminar, articular process, and ligamentum flavum hypertrophy, with a variable degree of disc degeneration, are the same in the thoracic spine as the changes found in the lumbar and cervical regions. We present seven patients with symptomatic thoracic spondylosis evaluated over the past 4 years. Spinal computed tomography readily defined the abnormality. A predilection for the T10-T-12 levels is evident. The prognosis for at least partial recovery is good, even in those with long-standing disease and severely impaired function. The previous literature concerning this unusual cause of thoracic compression is reviewed, and the differential diagnostic possibilities are discussed.