en Spine Case report <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:107%">Background and Importance:</span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"> Acute spinal cord injury without an apparent spinal fracture/dislocation in an asymptomatic subject with silent thoracic ossification of the ligamentum flavum (TOLF) is an extremely rare with only seven fully documented example with this specific scenario in the literature. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:107%">Case Presentation:</span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"> A previously healthy middle-aged woman with a history of MRI documented silent TOLF who developed sever weakness of the lower limbs immediately after a minor fall is presented.&nbsp; Repeat MRI revealed appearance of a myelopathy at the site of the preexisting silent T10-T11 OLF. Laminectomy and excision of the O LF result in complete recovery within 6 months.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:107%">Conclusion:</span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"> We believe that our asymptomatic patient should had undergone prophylactic surgical intervention before this catastrophic event. In a survey of medical literature, we found that the presented case is the first example with MRI documented TOLF in its silence period.</span></span></span></span></span></div> Fall, Laminectomy, Ligamentum flavum, Ossification, Spinal cord injury 228 233 http://irjns.org/browse.php?a_code=A-10-126-5&slc_lang=en&sid=1 Abolfazl Rahimizadeh a_rahimizadeh@hotmail.com 100319475328460011365 100319475328460011365 Yes Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, University of Medical Sciences, Tehran, Iran Housain Soufiani soufianihousein@gmail.com 100319475328460011366 100319475328460011366 No Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, University of Medical Sciences, Tehran, Iran Mahan Amirzade Mahan.amirzade@gmail.com 100319475328460011367 100319475328460011367 No Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, University of Medical Sciences, Tehran, Iran Walter Williamson wlw83@hotmail.com 100319475328460011368 100319475328460011368 No The Office of Clinical Research (OCR), Baylor College of Medicine, Houston, Texas, USA. Shaghayegh Rahimizadeh sherryrahimi@hotmail.com 100319475328460011369 100319475328460011369 No Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, University of Medical Sciences, Tehran, Iran Naser Asgari nvasgari@gmail.com 100319475328460011370 100319475328460011370 No Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, University of Medical Sciences, Tehran, Iran