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.