Acute Thoracic Myelopathy

J Orthop Sports Phys Ther. 2020 Dec;50(12):723. doi: 10.2519/jospt.2020.9262.

Abstract

A 45-year-old man presented to an emergency department reporting back pain, bilateral lower extremity weakness with paresthesia, and 1 episode of bladder incontinence. Radiographs and magnetic resonance imaging of the thoracolumbar spine were negative for cauda equina syndrome and positive for central canal stenosis and cord signal change from T2 to T4. The emergency department referred him to his primary care provider, who referred him to physical therapy. Following examination, due to the progressive neurological compromise correlated with magnetic resonance imaging findings, the physical therapist contacted neurosurgery for immediate referral. Two days later, the patient underwent emergency thoracic laminectomies, without fusion, for decompression of the spinal stenosis had resulted in thoracic myelopathy. J Orthop Sports Phys Ther 2020;50(12):723. doi:10.2519/jospt.2020.9262.

Keywords: lower extremity; magnetic resonance imaging; radiography; spine; thoracic spine.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Emergency Service, Hospital
  • Humans
  • Laminectomy
  • Lower Extremity / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Paresthesia / etiology
  • Radiography
  • Recovery of Function
  • Spinal Cord Diseases / complications
  • Spinal Cord Diseases / diagnostic imaging*
  • Spinal Cord Diseases / surgery
  • Spinal Stenosis / complications
  • Spinal Stenosis / diagnostic imaging*
  • Spinal Stenosis / surgery
  • Thoracic Vertebrae / diagnostic imaging*
  • Thoracic Vertebrae / surgery
  • Time-to-Treatment
  • Urinary Incontinence / etiology