Double trouble: Concurrent ossification of ligamentum flavum with infective spondylodiscitis in the thoracic spine resulting in paraplegia: A case report.

BACKGROUND

Thoracic ossification of the ligamentum flavum (OLF) and tuberculous infective spondylodiscitis rarely combine to cause paraplegia. Here, a 48-year-old female with both thoracic OLF and tuberculous spondylodiscitis experienced the acute onset of paraplegia successfully managed with a T8-L1 laminectomy with fusion.

CASE DESCRIPTION: A 48-year-old female presented with the acute onset of paraplegia attributed to magnetic resonance-documented thoracic OLF and infective spondylodiscitis. Imaging revealed spinal cord compression (i.e., occupying >50% of the spinal canal) from D8 to D10 level and infective spondylodiscitis at the D10-D11 level. Surgery included a D8-L1 laminectomy with instrumented fusion. Histology and cultures revealed the presence of tuberculosis, and anti-tubercular therapy was administered. Both surgery and continued antibiotic therapy contributed to neurological improvement.

CONCLUSION

Thoracic OLF combined with tuberculous spondylodiscitis may be effectively treated with decompression, fusion, and appropriate anti-tubercular therapy.

KEYWORDS: Dorsal spine, Infective spondylodiscitis, Koch's, Neurological deficit, Ossified ligamentum flavum (OLF), Paraplegia, Tuberculosis spine instability score (TSIS).