Amyloidosis involving the musculoskeletal system is an uncommon occurrence. The primary form is rare and only six cases involving the spine have been reported in the literature. The following case is believed to be the first reported in Taiwan. A 65-year-old male was admitted due to chronic nonspecific pain in the lower back with progressive paralysis of the lower limbs. Amyloidoma involving both thoracic and lumbar spine, never reported in the literature, was proved by histologic and histochemical studies. Serial radiographic examinations were also presented. Anterior decompression of the thoracic spine with iliac crest strut bone graft and Kaneda device fixation achieved good functional results. The symptoms and signs of spinal amyloidoma are nonspecific and difficult to diagnose; hence a correct diagnosis requires the surgeon to be extremely suspicious. A special histochemical stain is essential for this purpose. Because of the rarity, we report this case with review of the literature.