A rare cause of thoracic cord compression.

Background: The posterior longitudinal ligament (PLL) extends from the foramen magnum to the sacrum. In some cases, it becomes calcified/ossified; the term for this is ossification of the PLL (OPLL).

Case Description: A 50-year-old female presented with acute sphincter dysfunction and paraparesis attributed to T2-T4 OPLL. The patient underwent a C7-T5 laminectomy to decompress the spinal cord. After 1 postoperative week, and certainly by 6 months postoperatively, the patient's motor and sensory deficits showed improvement.

Conclusion: Surgery for thoracic OPLL includes laminoplasty, laminectomy with/without fusion, anterior decompression through a posterior approach (transpedicular, costotransversectomy), and circumferential decompression (e.g. combined anterior/posterior approaches). In cases like the one presented, patients who originally present with acute paraparesis/sphincter dysfunction may demonstrate postoperative improvement.