Calcification of the thoracic yellow ligament as a cause of myelopathy

Introduction. Ossified yellow ligaments area rare cause of thoracic myelopathy, which has been reported mainly in Japanese patients. The lower thoracic spine is the most common site affected and symptomatic patients usually begin to develop spactic paraparesis in combination with reduced depth sensation. Clinical case. A 45-year-old female that since 8 months presented progressive gait disturbance with paresthesias to both lower extremities. Neurologic examination revealed a spactic gait with exaggeration of lower extremities reflexes, positive bilateral Babinski! sign and reduced depth sensation. The MRI revealed concentric narrowing of the spinal canal between D-8 to D-11 with spinal cord compression due to enlarged calcified yellow ligaments and hypertrophy of articular processes A D-9-D-10 laminectomy was performed, with removed of calcified yellow ligaments, and foraminotomy in affected levels. The postoperative follow-up during 30 months has been uneventful. Conclusion. Calcified yellow ligaments are a poorly understood cause of thoracic myelopathy which should be treated as early as possible in symptomatic patients.