Sudden onset of paraparesis caused by hypertrophy of the thoracic posterior longitudinal ligament

doi:doi:10.1038/sj.sc.3101396

Spinal Cord (2003) 41, 53–55. doi:10.1038/sj.sc.3101396

Sudden onset of paraparesis caused by hypertrophy of the thoracic posterior longitudinal ligament

S Nozawa¹, K Shimizu¹, K Miyamoto¹, Y Sakaguchi¹, H Nishimoto¹ and H Hosoe¹

¹Department of Orthopaedic Surgery, Gifu University, Gifu, Japan

Correspondence: K Shimizu, 40 Tsukasamachi, Gifu 500-8705, Japan

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Abstract

Study design: Case report of a rare form of hypertrophy of the thoracic posterior longitudinal ligament (HPLL), causing paraparesis.

Objective: To describe this very rare pathological condition in the thoracic spine and the results of surgical intervention.

Setting: A department of orthopaedic surgery in Japan.

Methods: A 61-year-old man presented with acute paraparesis associated with HPLL in the thoracic region. A radiographic and pathological review of the case was conducted. Anterior decompression was performed, and he was followed for 3 years after the operation.

Results: Pathologic examination of the surgical specimen revealed proliferation of fibrocartilage and calcification. The patient's paraparesis ameliorated after the operation.

Conclusion: For this case of myelopathy due to HPLL in the thoracic spine, urgent decompression gave excellent results. Clinical awareness of HPLL may aid correct diagnosis and prompt therapy.