Thoracic myelopathy from coincident fluorosis and epidural lipomatosis.

Skeletal fluorosis is rare in NorthAmerica. It can present with back pain and extremity weakness. Immobilization of the spine and the extremity joints can occur. It is usually caused by abnormally increased oral fluoride intake over many years. Epidural lipomatosis is usually caused by idiopathic obesity or corticosteroid use. It has been linked to highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV). Fluorosis and epidural lipomatosis are each rare causes of compressive myelopathy, and have never been described previously as a combined cause of spinal stenosis leading to myelopathy. We describe an unusual case of thoracic myelopathy due to coexistence of both conditions.