Thoracic degenerative spondylolisthesis

Degenerative spondylolisthesis of the spine is less common in the lower thoracic region than in the lumbar and cervical regions. However, lower thoracic degenerative spondylolisthesis may develop secondary to intervertebral disc degeneration. Most are found to have concomitant lumbar spondylosis ¹⁾.

A 78-year-old Japanese man presented with a 6-month history of gait disorder. A magnetic resonance imaging scan of his cervical and thoracic spine revealed anterior spondylolisthesis and severe spinal cord compression at T3 to T4 and T10 to T11, as well as high signal intensity in a T2 weighted image at T10/11. Computed tomography revealed diffuse idiopathic skeletal hyperostosis at T4 to T10. He underwent partial laminectomy of T10 and posterior fusion of T9 to T12. The postoperative magnetic resonance imaging revealed resolution of the spinal cord compression and an improvement in the high signal intensity on the T2-weighted image.

This is the first case of thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis. Neurosurgical intervention resulted in a significant improvement of patient's neurological symptoms ²⁾.

¹⁾

Hsieh PC, Lee ST, Chen JF. Lower thoracic degenerative spondylithesis with concomitant lumbar spondylosis. Clin Neurol Neurosurg. 2014 Mar;118:21-5. doi: 10.1016/j.clineuro.2013.11.019. Epub 2013 Dec 6. PubMed PMID: 24529224.

²⁾

Takagi Y, Yamada H, Ebara H, Hayashi H, Iwanaga T, Shimozaki K, Kitano Y, Kagechika K, Tsuchiya H. Thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis: a case report. J Med Case Rep. 2017 Apr 1;11(1):90. doi: 10.1186/s13256-017-1252-0. PubMed PMID: 28363281; PubMed Central PMCID: PMC5376279.