Postoperative Paraplegia in Patient with Thoracic Ossification of Ligamentum Flavum and Thoracolumbar Kyphosis Derived from Wedged Vertebrae

World Neurosurgery
Hui Wang, Wenyuan Ding

Abstract

Thoracic ossification of the ligamentum flavum (OLF) is a common cause of thoracic myeloradiculopathy. Thoracolumbar kyphosis derived from abnormal embryonic development of the spine vertebrae often progresses continuously and causes neurologic deterioration. These conditions are presented separately in most cases. A diagnosis of both OLF and thoracolumbar kyphosis in the same patient is rare, and no definite principle of surgical strategy for this case could be found in the literature. Here we report a 36-year-old woman who suffered from weakness and numbness of bilateral lower extremities for 2 years and urinary dysfunction for 1 month. On physical examination, the strength of muscles of lower limbs was grade 2 and the sensory system was bilaterally lost below the inguinal groove with numbness in the saddle area. Hyperreflexia was found in both lower limbs, and the Babinski sign was positive bilaterally. Thoracic OLF and thoracolumbar kyphosis were diagnosed on the basis of clinical presentation, radiograph, computed tomography, and magnetic resonance imaging. We performed 1-stage laminectomy and kyphosis correction by posterior vertebral column resection. The patient experienced postoperative paraplegia, and the strength of ...Continue Reading

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