Fully Endoscopic Decompression in Dorsal Spinal Myelopathy due to Ligamentum Flavum Calcification

The ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy (TM) and most often occurs among East Asian countries such as Japan, Korea, and China. It is rare in other ethnic groups and in individuals below the age of 50 years. It is most often described at the lower thoracic level, being uncommon in the lumbar region and rare in the cervical region. Here, we present the case of a 48-year-old male patient who came to medical attention with a 2-month history of paresthesia of the lower limbs and progressive difficulty in walking. The clinical profile, together with computed tomography and nuclear magnetic resonance imaging of the spine, led to a diagnosis of compressive TM due to OLF in the thoracic spine. The patient underwent endoscopic over-the-top dorsal decompression and resection of the affected ligamentum flavum, without any intraoperative complications. After surgery, the patient had progressed favorably, having no sensory complaints and again becoming ambulatory.