Abstract
Nontraumatic thoracic spondylolisthesis is extremely rare due to the thoracic spine's inherent stability. We report the case of a 66-year-old male presenting with chronic low back pain and bilateral lower limb numbness. Imaging revealed anterior displacement of the T10 vertebral body with significant spinal cord compression at T10-T11. The patient underwent posterior spinal decompression, thoracic interbody fusion, and screw fixation, achieving complete neurological recovery at 1-year follow-up. Nontraumatic thoracic spondylolisthesis can result from facet joint laxity and disc degeneration causing vertebral micromovements. Early diagnosis and timely surgical intervention are crucial for preventing neurological damage and restoring function, highlighting the importance of comprehensive thoracic spine evaluation in patients with atypical lumbar symptoms.