Ossification of ligamentum flavum – an unusual presentation: a case report

Introduction: In context of thoracic myelopathy, ossification of ligamentum flavum(OLF) has been described as one of the common associations. But the resolution of the presentation by just conservative management is quite unique. Such a scenario is a rare presentation with a few reported cases in the available literature.
Case Presentation: We present a case of post-traumatic thoracic myelopathy associated with ossification of ligamentum flavum in an adult patient who presented to us 5 days after injury. A thorough pre-op assessment was done. But in the due course, there was a rather significant recovery in the deficits in the due course of hospitalisation. Therefore the plan for his decompressive surgery was deferred and he was discharged. 3-month follow-up showed significant improvement in symptoms with near-normal power.
Conclusion: Thoracic myelopathy following Ossification of ligamentum flavum may pose a challenge for a clinician because of the associated difficulty in the treatment plan. Thorough work-up and planning play an anecdotal role in the management. And if there is improvement in the deficits and signs, it is advisable to wait and watch for the results.