Isolated Proximal thoracic ossified ligamentum Flavum Causing Paraparesis in a Caucasian: A Case report and review of the literature

Ossification of the ligamentum flavum is a pathologic condition that affects the yellow ligaments mostly in male adults between fifty to sixty years of age. Ossification is more common in the thoracic spine causing slowly progressive myeloradiculopathy. In fact, OLF is so common in East Asian countries that is regarded as a frequent aging pathology in the people of this region (3,10-15,21,22,31,32,36,40,41). However, affection of other ethnic groups is regarded a rare event as it is in Caucasians (1,4,6,8,9,14,23,25,28,30,34,3739). In the thoracic region, this disorder has a strong predilection for lower segments and is mostly seen in a multilevel form. However, the isolated single type is rare specially at the upper thoracic region even in East Asian reports, meaning that occurrence of isolated OLF at the proximal thoracic area should be regarded as a medical curiosity among the Caucasians. Previously, there have been only three documented case reports in Caucasian with multilevel OLF at this location. Herein, the first Caucasian with an isolated lesion at the proximal thoracic region, who was admitted with severe paraparesis and had a subsequent good outcome after decompressive laminectomy, will be presented.