{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:19:54Z","timestamp":1783469994674,"version":"3.55.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Thoracic ligamentum flavum hematoma (LFH) is rare. Furthermore, hematoma enlargement due to repeated rebleeding is extremely rare. The authors report on a rare surgical case of thoracic epidural hematoma of the ligamentum flavum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 58-year-old man with hypertension presented to the emergency department with thoracic myelopathy, including recurrent back pain and right lower limb paralysis for 9 months. Imaging revealed an epidural mass lesion at T8\u20139, and surgery was performed based on a diagnosis of hemorrhage with fibrous components. The patient\u2019s neurological findings improved, and he was discharged home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Slow-growing LFH in the lower thoracic spine is extremely rare compared to the lumbar spine. Herein, the authors report on the mechanisms of LFH.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26334\">https:\/\/thejns.org\/doi\/10.3171\/CASE26334<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26334","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:15:24Z","timestamp":1782864924000},"source":"Crossref","is-referenced-by-count":0,"title":["Slow-growing hematoma in the thoracic ligamentum flavum: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0539-6273","authenticated-orcid":true,"given":"Fumiaki","family":"Fujihara","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hakujyuji Hospital, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisaaki","family":"Uchikado","sequence":"additional","affiliation":[{"name":"Uchikado NeuroSpine Clinic, Hakata, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukino","family":"Irie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakujyuji Hospital, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ohtani","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hakujyuji Hospital, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syuji","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakujyuji Hospital, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tooru","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakujyuji Hospital, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fukuoka University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Orthop Surg Res","first-page":"595","article-title":"A systematic review of surgical procedures on thoracic myelopathy","volume":"15","author":"Zhu","year":"2020","unstructured":"Zhu SWang YYin PSu Q.A systematic review of surgical procedures on thoracic myelopathy. J Orthop Surg Res. 2020;15(1):595. doi:10.1186\/s13018-020-02081-y"},{"issue":"4","key":"bib2","series-title":"Spine Surg Relat Res","first-page":"409","article-title":"Patient-reported outcomes and patient satisfaction following surgery for thoracic myelopathy","volume":"8","author":"Ito","year":"2024","unstructured":"Ito YOhtomo NNakamoto HPatient-reported outcomes and patient satisfaction following surgery for thoracic myelopathy. Spine Surg Relat Res. 2024;8(4):409-414. doi:10.22603\/ssrr.2023-0279"},{"issue":"1","key":"bib3","series-title":"J Craniovertebr Junction Spine","first-page":"7","article-title":"Ligamentum flavum hematomas: why does it mostly occur in old Asian males? Interesting point of reported cases: review and case report","volume":"7","author":"Ozdemir","year":"2016","unstructured":"Ozdemir BKanat ABatcik OEGucer HYolas C.Ligamentum flavum hematomas: why does it mostly occur in old Asian males? Interesting point of reported cases: review and case report. J Craniovertebr Junction Spine. 2016;7(1):7-12. doi:10.4103\/0974-8237.176605"},{"issue":"1","key":"bib4","series-title":"Spinal Cord Ser Cases","first-page":"65","article-title":"A patient with cervical ligamentum flavum haematoma: case report","volume":"10","author":"Xu","year":"2024","unstructured":"Xu NJiang C,Chen ZFeng ZJiang CCao Y.A patient with cervical ligamentum flavum haematoma: case report. Spinal Cord Ser Cases. 2024;10(1):65. doi:10.1038\/s41394-024-00679-6"},{"issue":"4","key":"bib5","series-title":"Clin Imaging","first-page":"265","article-title":"Ligamentum flavum hematoma in the thoracic spine","volume":"25","author":"Maezawa","year":"2001","unstructured":"Maezawa YBaba HUchida KKokubo YKubota CNoriki S.Ligamentum flavum hematoma in the thoracic spine. Clin Imaging. 2001;25(4):265-267. doi:10.1016\/s0899-7071(01)00289-3"},{"issue":"4","key":"bib6","series-title":"J Neurosurg Spine","first-page":"495","article-title":"Ligamentum flavum hematoma in the rigid thoracic spinal segment: case report","volume":"2","author":"Miyakoshi","year":"2005","unstructured":"Miyakoshi NShimada YOkada KHongo MKasukawa YItoi E.Ligamentum flavum hematoma in the rigid thoracic spinal segment: case report. J Neurosurg Spine. 2005;2(4):495-497. doi:10.3171\/spi.2005.2.4.0495"},{"issue":"1","key":"bib7","series-title":"J Korean Neurosurg Soc","first-page":"47","article-title":"Spontaneous ligamentum flavum hematoma in the rigid thoracic spine: a case report and review of the literature","volume":"44","author":"Lee","year":"2008","unstructured":"Lee HWSong JHChang IBChoi HC.Spontaneous ligamentum flavum hematoma in the rigid thoracic spine: a case report and review of the literature. 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Spine (Phila Pa 1976). 2009;34(25):E942-E944. doi:10.1097\/BRS.0b013e3181b3f87c"},{"issue":"2","key":"bib9","series-title":"J Orthop Sci","first-page":"347","article-title":"Hematoma of the ligamentum flavum in the thoracic spine: report of two cases and possible role of the transforming growth factor beta-vascular endothelial growth factor signaling axis in its pathogenesis","volume":"18","author":"Matsumoto","year":"2013","unstructured":"Matsumoto YFujiwara TImamura RHematoma of the ligamentum flavum in the thoracic spine: report of two cases and possible role of the transforming growth factor beta-vascular endothelial growth factor signaling axis in its pathogenesis. 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Radiol Case Rep. 2023;18(9):3060-3064. doi:10.1016\/j.radcr.2023.05.073"},{"key":"bib15","series-title":"Front Surg","first-page":"1077343","article-title":"Successful treatment of thoracic myelopathy caused by spontaneous spinal epidural hematoma (SSEH) combined with calcification of the ligamentum flavum (CLF) by posterior percutaneous endoscopic surgery (PPES): a case report","volume":"9","author":"Lisheng","year":"2023","unstructured":"Lisheng HDong ZXuedong BSuccessful treatment of thoracic myelopathy caused by spontaneous spinal epidural hematoma (SSEH) combined with calcification of the ligamentum flavum (CLF) by posterior percutaneous endoscopic surgery (PPES): a case report. 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