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November 15, 1985

Progressive Myelopathy

Author Affiliations

Cook County Hospital Chicago

JAMA. 1985;254(19):2740. doi:10.1001/jama.1985.03360190046018

To the Editor.—  In the article entitled "Progressive Myelopathy in a 32-Year-Old Man," Dr Chintapalli1 draws attention to myelopathy caused by ossification of the lower thoracic ligamentum flavum. Although an uncommon occurrence, this entity is an important cause of thoracic cord myelopathy. Whereas this entity can be easily overlooked unless carefully sought for on conventional roentgenograms, it is recognized readily on computed tomographic (CT) scanning.

Report of a Case.—  We recently encountered the case of a 63-year-old man who was initially seen with symptoms and signs pointing to a lower thoracic cord lesion. The patient was investigated from the beginning by magnetic resonance imaging (MRI). Magnetic resonance imaging revealed a low-intensity signal lesion localized to a small part of the dorsal thoracic cord at the T-10 level (Fig 1). This lesion was interpreted as a small vascular lesion, perhaps an arteriovenous malformation (AVM). The physicians requested us to perform spinal