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Updated: Jul 8, 2026
Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum (TOLF) Using Ultrasonic and Conventional Osteotomes
Published on: April 21, 2023
Slow-growing hematoma in the thoracic ligamentum flavum: illustrative case
Fumiaki Fujihara1, Hisaaki Uchikado2, Yukino Irie1
1Department of Neurosurgery, Hakujyuji Hospital, Fukuoka.
Background:
Thoracic ligamentum flavum hematoma (LFH) is rare. Furthermore, hematoma enlargement due to repeated rebleeding is extremely rare. The authors report on a rare surgical case of thoracic epidural hematoma of the ligamentum flavum.
Observations:
A 58-year-old man with hypertension presented to the emergency department with thoracic myelopathy, including recurrent back pain and right lower limb paralysis for 9 months. Imaging revealed an epidural mass lesion at T8-9, and surgery was performed based on a diagnosis of hemorrhage with fibrous components. The patient's neurological findings improved, and he was discharged home.
Lessons:
Slow-growing LFH in the lower thoracic spine is extremely rare compared to the lumbar spine. Herein, the authors report on the mechanisms of LFH. https://thejns.org/doi/10.3171/CASE26334.
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01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...