Acute Thoracic Myelopathy

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.