Ossification of ligamentumflavum (OLF), though rare, is being increasingly recognized as a cause of thoracic myelopathy. Earlier, OLF has been reported almost exclusively in East Asian countries, particularly in Japan and Korea. Studies of OLF from other regions, such as India, Middle East &Caribbean are increasingly being reported. In view of the low incidence of this disorder and rarity of large clinical reports, the treatment guidelines and surgical prognosis in patients with this disease remain unclear. Hence, the study was conducted. Objectives: We retrospectively& prospectively studied the risk factors, clinical manifestations, radiological aspects, surgical treatment, and prognostic factors in 31 patients ofthoracic ossification of ligamentumflavum (OLF). Methods and results: A total of 31 patients who underwent surgical treatment for thoracicmyelopathy secondary to OLF between 2014 and 2018 were studied retrospectively&prospectively.Preoperative and postoperative neurological data were reviewed and the correlationbetween the variables of patient characteristics, preoperative duration of symptoms,preoperative neurological status, and the functional outcome were analyzed. The maleto female ratio was 1.9:1. In total, 23 patients (74.2%) were in the 5th & 6th decadeof life. The lower thoracicregion (D9–D11) was most commonly affected (48.4%).All patientsunderwent wide decompressive laminectomy with medial one-third facetectomyandOLF was resected. The average follow-up was 2 years. Conclusion: In all, 21 patients (67.7%) had good outcome, 6 patients (19.4%) had fair outcome, 2 patients(6.5%) improved but still required help for their routine work &2 patients (6.5%)were bed-ridden at last follow-up.Mostcommoncomplications observed were dural tear &csf leak (6.4%).

Keywords: Ligamentumflavum; Thoracicspine; Ossification; Laminectomy.