Abstract
INTRODUCTION: Spine deformities, including degenerative spondylolisthesis and scoliosis, are caused by several factors such as intervertebral disk degeneration and facet joint arthrosis, leading to spinal instability. Degenerative spondylolisthesis of the thoracic spine is less common because of the stabilizing properties of the rib cage and facet joints in the anterior-posterior position. METHODS: A 70-year-old female patient reported of back pain and left lower extremity weakness. The patient's premorbid ambulation status was wheelchair-bound because of right-sided monoparesis caused by a history of cerebral palsy. Neurological examination revealed grade 1 left-sided hip flexion and knee extension. RESULTS: Radiological findings showed lumbar scoliosis, severe disk degeneration, degenerative spondylolisthesis with facet arthrosis, and yellow ligament hypertrophy at T10-T12. Increased high signal intensity in T2-weighted magnetic resonance imaging and cord compression was observed at T10-T11, indicating thoracic myelopathy. We performed total laminectomy and posterior instrumented fusion at T10-T12. At a 3-month follow-up, the patient's motor grade improved to grade 4. CONCLUSION: Thoracic myelopathy in our case was caused by segmental instability, including multilevel lower thoracic degenerative spondylolisthesis, the presence of ossification of the ligament flavum, and lumbar scoliosis. This rare case, involving multiple complex spinal conditions, provides valuable insights into the development of thoracic myelopathy.