Ligamentum flavum calcification (LFC) in the thoracic spine produces the posterior encroachment visible on CT as a dumbbell-shaped or flat calcified mass projecting from the posterior canal wall. It is more common in Asian populations and produces thoracic myelopathy from cord compression. Surgical posterior decompression with laminectomy and en-bloc removal of the calcified ligament is required.
| Origin | Inferior lamina of each thoracic vertebra (anterior surface) |
|---|---|
| Insertion | Superior lamina of the lower thoracic vertebra — the calcified ligament projects into the posterior canal |
| Actions | In calcification the elastic ligament becomes a rigid canal-encroaching mass — most commonly in the lower thoracic spine (T10-T11) |
|---|
Thoracic LFC is identified on lateral thoracic radiograph and confirmed on CT. MRI shows T2 cord signal change at the compression level indicating myelopathy. Surgical decompression through laminectomy must remove the calcified ligament completely — piecemeal removal risks dural tear and cord injury from calcific debris.
Ectopic thoracic flavum calcification producing posterior cord compression managed with laminectomy and en-bloc calcification removal.
