{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:18:11Z","timestamp":1780319891736,"version":"3.54.1"},"reference-count":5,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground:<\/jats:title>\nSpinal stenosis may result in myelopathy, radiculopathy, and neurogenic claudication. It is often difficult to differentiate between these conditions. A comprehensive history and physical examination and a magnetic resonance imaging (MRI) of the entire spine accurately confirm the diagnosis.<\/jats:p>\n<\/jats:sec>\n\nCase Description:<\/jats:title>\nHere, we report a patient with low back and progressive bilateral lower extremity pain, numbness, and weakness with bowel incontinence, urinary retention, and gait abnormalities. A lumbar MRI demonstrated multilevel severe spondylosis\/stenosis from L3-S1. The patient underwent a decompressive lumbar laminectomy from L3-5. However, the patient continued to experience the same symptoms postoperatively along with flexor spasms of the left leg, dystonic posturing of the left foot, hyperactive bilateral patellar and Achilles deep tendon reflexes, and a Babinski sign. An NCV of the legs revealed no lumbar radiculopathy. The thoracic MRI, however, demonstrated severe spondylosis at the T11-12 level attributed to a large synovial cyst. Following decompression\/cyst resection, the patient\u2019s symptoms partially resolved within 1 postoperative month.<\/jats:p>\n<\/jats:sec>\n\nConclusion:<\/jats:title>\nSpinal surgeons should be alert to the potential for overlapping symptoms\/signs of thoracic myelopathy and lumbar myeloradiculopathy. If there are features of upper and lower motor neuron disease, MR scans of the entire spine are necessary before lumbar surgical decompression to identify significant cephalad surgical pathology.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_352_2019","type":"journal-article","created":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T11:32:23Z","timestamp":1566732743000},"page":"158","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Missed thoracic myelopathy: Do not throw the hammer away yet"],"prefix":"10.25259","volume":"10","author":[{"given":"Lisa B. E.","family":"Shields","sequence":"first","affiliation":[{"name":"Norton Neuroscience Institute, Norton Healthcare, University of Louisville School of Medicine, Louisville, Kentucky, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasudeva G.","family":"Iyer","sequence":"additional","affiliation":[{"name":"Neurodiagnostic Center of Louisville, University of Louisville School of Medicine, Louisville, Kentucky, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Ping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Norton Neuroscience Institute, Norton Healthcare, University of Louisville School of Medicine, Louisville, Kentucky, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Shields","sequence":"additional","affiliation":[{"name":"Norton Neuroscience Institute, Norton Healthcare, University of Louisville School of Medicine, Louisville, Kentucky, USA."},{"name":"Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2019,8,9]]},"reference":[{"key":"10.25259\/SNI_352_2019\/ref-1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3171\/SPI-07\/07\/013","article-title":"Results of surgical treatment for thoracic myelopathy: Minimum 2-year follow-up study in 132 patients","volume":"7","author":"Aizawa","year":"2007","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_352_2019\/ref-2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jcm.2011.10.007","article-title":"Clinical presentation of a patient with thoracic myelopathy at a chiropractic clinic","volume":"11","author":"Gay","year":"2012","journal-title":"J Chiropr Med"},{"key":"10.25259\/SNI_352_2019\/ref-3","doi-asserted-by":"crossref","first-page":"e0207709","DOI":"10.1371\/journal.pone.0207709","article-title":"Assessment of degenerative cervical myelopathy differs between specialists and may influence time to diagnosis and clinical outcomes","volume":"13","author":"Hilton","year":"2018","journal-title":"PLoS One"},{"key":"10.25259\/SNI_352_2019\/ref-4","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/B978-0-444-53486-6.00052-1","article-title":"Myelopathy","volume":"136","author":"Oyinkan Marquis","year":"2016","journal-title":"Handb Clin Neurol"},{"key":"10.25259\/SNI_352_2019\/ref-5","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1227\/00006123-198704000-00014","article-title":"Thoracic spondylosis: An unusual cause of myelopathy","volume":"20","author":"Smith","year":"1987","journal-title":"Neurosurgery"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/missed-thoracic-myelopathy-do-not-throw-the-hammer-away-yet\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/missed-thoracic-myelopathy-do-not-throw-the-hammer-away-yet\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T11:32:25Z","timestamp":1566732745000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/missed-thoracic-myelopathy-do-not-throw-the-hammer-away-yet\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,9]]},"references-count":5,"alternative-id":["10.25259\/SNI_352_2019"],"URL":"https:\/\/doi.org\/10.25259\/sni_352_2019","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,9]]},"article-number":"158"}}