A Rare Case of Thoracic Spinal Stenosis in a White Male

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Excerpt

Thoracic myelopathy due to thoracic spinal stenosis is a rare condition, which is most commonly because of the ossification of the ligamentum flavum (OLF) as first described in 1960 (1). Thoracic spinal stenosis due to OLF has been noted to occur predominantly in older East Asian populations and is rare among whites (2,3). The mean age at presentation is 50 to 60 years, and the duration of symptoms before diagnosis has been shown to range from 1 to 3 years (4,5). Symptoms at presentation are often vague, but generally include chest, abdominal, or lower-extremity motor or sensory changes. Symptoms can include leg numbness, gait disorder, foot weakness, bowel or bladder involvement, zonesthesia of the abdomen or chest, heaviness in the lower extremity, or back pain (6–8).
Although far less common than either cervical or lumbar spinal stenosis, thoracic spinal stenosis deserves consideration in the differential diagnosis of patients presenting with vague lower-extremity motor or sensory symptoms. The inconsistent presentation and spectrum of symptoms can contribute to a delay in diagnosis where initiation of treatment is time sensitive. The case presented illustrates the rare presentation of thoracic spinal stenosis due to OLF in a younger white male.

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