Background: Ligamentum flavum hematoma (LFH) rarely causes neural compression in the thoracic region. Here, a 74-year-old female presented with a progressive paraparesis attributed to T10-T11 LFH that was successfully removed utilizing a microendoscopic hemilaminectomy decompressive technique. Case Description: A 74-year-old female jazz dance instructor presented with a progressive thoracic mild paraparesis. The magnetic resonance (MR) revealed a posterior T10-T11 likely LFH epidural mass compressing the spinal cord. She successfully underwent a microendoscopic hemilaminectomy through a 16-mm tubular retractor. Intraoperatively, a dark reddish hematoma was found within the ligamentum flavum and was successfully separated from the dura despite marked adhesions. The histopathology was diagnostic of an LFH. Postoperatively, the patient’s paraparesis immediately improved postoperatively, and the MR confirmed adequate spinal cord decompression. Conclusion: Microendoscopic hemilaminectomy provided excellent visualization for total resection of a T10-T11 LFH.
Ishibashi et al. (2026) studied this question.