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OLF can significantly contribute to a spatial reduction of the thoracic spinal canal, resulting in slowly progressive paraparesis or acute paraplegia after trauma to the back. Prognosis remains poor for acute myelopathy Thoracic myelopathy secondary to ossification of ligamentum flavum needs surgical intervention, should be considered in patients with fused type Ossification of ligamentum flavum compressing the spinal cord even if they do not have a definite symptom of myelopathy because poor outcome would be expected in delayed surgery when an overt symptom of myelopathy has occurred.