UPPER THORACIC MYELOPATHY DUE TO COMBINED OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT AND LIGAMENTUM FLAVUM AT THE SAME LEVEL: A CASE REPORT

Thoracic ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the ligamentum flavum (OLF) is an uncommon cause of myelopathy, especially in our population. The optimal treatment for this thoracic myelopathy remains controversial, and the high risk of postoperative paralysis remains a major complication. We report the case of a 66-year-old man with progressive spinal cord compression due to simultaneous OPLL and OLF at T2–T3. Posterior decompression by T2–T3 laminectomy was performed without extirpating the OPLL. Postoperatively, symptoms improved greatly, with residual hyperreflexia and grade 3/5 muscle strength in the lower extremities.
Conclusion: Simultaneous OPLL and OLF in the same thoracic segment is very challenging and risky to treat, regardless of the surgical method selected. Early surgery should be considered for OPLL and OLF in the thoracic spine.