1/40. MRI in decompression illness.We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/40. paraparesis after posterior spinal fusion in neurofibromatosis secondary to rib displacement: case report and literature review.In patients with neurofibromatosis, rib displacement into the spinal canal is a rare cause of paraplegia. We report a patient with paraplegia caused by rib displacement whose signs and symptoms began after posterior in situ fusion for dysplastic scoliosis. There was complete recovery after anterior decompression and resection of the rib.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
3/40. Inappropriate medical management of spinal epidural abscess.A 67 year old man with longstanding rheumatoid disease was referred to the regional spinal surgery unit with acute onset of paraparesis due to an extensive spinal epidural abscess of the lumbar spine. Ten months previously, he had started antibiotic treatment at another hospital for an epidural abscess arising at the level of the L2-3 disc space. Despite completing seven months of medical treatment with appropriate antibiotics, he had a recrudescence of acute back pain shortly after restarting methotrexate treatment. Urgent anterior spinal decompression with excision of the necrotic vertebral bodies of L1-3 was performed. The indications for the surgical management of spinal epidural abscess are reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
4/40. spinal cord compression due to extramedullary haematopoiesis in two patients with thalassaemia: complete regression with blood transfusion therapy.Extramedullary haematopoiesis, a common finding in thalassaemia, is rarely localized in the spinal cord and even more rarely has neurological manifestations. We present two patients suffering from thalassaemia (intermedia and beta homozygous) and paraparesis due to spinal cord compression from intrathoracic extramedullary haematopoietic masses. diagnosis was based on magnetic resonance imaging findings, and treatment consisted of blood hypertransfusions. The majority of published cases have been successfully treated by radiation and in some cases by blood transfusions. Our two patients completely recovered, and there has been no recurrence during the 4 years since their treatment. diagnosis and treatment of this rare condition are discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = compression (Clic here for more details about this article) |
5/40. Early recovery after retropleural approach in a paraparesis thoracic disc patient.A 56 years old Thai male developed acute paraparesis 2 days before admission. The investigation showed T6-7 thoracic disc herniation on the left side with thoracic cord compression. A lateral retropleural (extracavity) approach from the left side without penetrating the pleural cavity was performed. He was able to sit up and start the rehabilitation program within the first day after the operation on the bed and neurological status was gradually recovered within 2 months after continue home program for rehabilitation. Finally he can walk with gait aids. The motor power of his legs were grade IV according to Frankel classification and he can well control the uro-genital function.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
6/40. Orbital, adnexal, and unusual systemic involvement in Rosai-Dorfman disease.PURPOSE: To describe the unusual clinical course of a patient with Rosai-Dorfman disease (RDD) affecting the eyelid and orbital tissues and involving the spinal cord. methods: Case report. RESULTS: A 68-year-old Indian man first presented in 1994 with a right lower eyelid lump for 1 year. An en bloc excisional biopsy was reported to show "reactive lymphoid hyperplasia with sclerosis." The patient subsequently defaulted follow-up and presented again in 1999 with bilateral lower eyelid masses and proptosis. Computerized tomography showed bilateral orbital, ethmoidal sinus, and frontal sinus soft tissue masses. Bilateral excisional biopsies of the orbital and eyelid masses showed histologic features of RDD. The patient had a history of paraplegia with decompression laminectomy and excision of an epidural mass in 1994. In addition, he underwent excision of soft tissue masses from the abdominal wall in 1993. Retrospective review of the histologic specimens from these two areas showed a histologic picture similar to that of eyelid specimens (in 1994 and 1999). CONCLUSIONS: It is important to consider RDD in addition to lymphoproliferative disorders in a patient with orbital and ocular adnexal masses. The initial histologic presentation may not be pathognomonic.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
7/40. Intramedullary spindle cell hemangioendothelioma of the thoracic spinal cord--case report.A 28-year-old Malay man presented with progressive paraparesis over a period of 6 months. magnetic resonance imaging of the spine revealed a thoracic intramedullary spinal cord tumor at the T-7 level with homogeneous enhancement following intravenous gadolinium administration. laminectomy and partial decompression of the tumor was performed. Histological examination of the tumor revealed features of spindle cell hemangioendothelioma. The patient was managed with limited field radiotherapy followed by systemic interferon therapy. Good neurological improvement was seen subsequently. The patient has survived 48 months with growth restraint at the primary site, although residual neurological deficit persists. immunotherapy should be considered as a treatment modality for intramedullary hemangioendothelioma of the spinal cord after surgery and radiotherapy.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
8/40. Ossification of the ligamentum flavum in a Caucasian. Case report.There have been few reports of ossification of the yellow ligaments causing spinal cord compression in Caucasian population. This disease is described mainly in Japanese patients and is termed as "Japanese disease". We describe the case of a 58-year-old Caucasian male with progressive paraparesis. Radiographic features were suggestive of ossification of the yellow ligaments in the lower thoracic level causing spinal cord compression. Early decompressive laminectomy and removal of the ossified ligament resulted in a marked clinical improvement. The etiological hypothesis, epidemiological, histological, clinical and radiological features of this disease are reviewed.- - - - - - - - - - ranking = 0.33333333333333keywords = compression (Clic here for more details about this article) |
9/40. Upper thoracic spinal cord injury without vertebral bony lesion: a report of two cases.STUDY DESIGN: Case report. OBJECTIVES: To describe a rarely reported type of upper thoracic spinal cord injury without vertebral bony lesion in two cases with multiple trauma. SUMMARY OF BACKGROUND DATA: Because it is supported by the stiffness of the rib cage, the upper thoracic spine has greater stability than the cervical and lumbar regions, and thus its fracture or fracture dislocation is less frequent. Nevertheless, when fracture or fracture dislocation of upper thoracic spine occurs, spinal cord involvement and severe concomitant injuries are frequently associated. methods: Two cases who were suspected to have thoracic spinal cord injuries were referred to our emergency center: a 19-year-old girl presented with paraparesis after her motorcycle collided with a truck, and a 63-year-old male involved in an industrial accident presented with paraplegia. RESULTS: Radiograph and computed tomography scan showed no abnormality or dislocation in the vertebral bodies in these two cases, although the upper thoracic spinal cord injuries were suspected by clinical features. Magnetic resonance images detected abnormal signals, suggesting spinal cord injuries, and these signals each emanated from levels that coincided with the observed clinical features. CONCLUSIONS: Transient subluxation or displacement might have caused the upper thoracic spinal cord injuries after the support of the rib cages was temporarily lost on application of excessive force, although such findings could not be confirmed by imaging procedures.- - - - - - - - - - ranking = 0.034121366223163keywords = fracture (Clic here for more details about this article) |
10/40. paraparesis in a black man brought on by ossification of the ligamentum flavum: case report and review of the literature.We present the second case of paraparesis secondary to ossification of the ligamentum flavum at the midthoracic region in a black man. Ossification of the ligamentum flavum is frequently described in the Japanese population where the presentation is often in the lower thoracic region. The patient is a 37-year-old black man who, over the 6 months before admission, noticed progressive paraparesis. CT myelogram revealed severe thoracic stenosis by an ossified ligamentum flavum from T4 to T7 with most severe involvement at the T5, T6, and T7 levels. The patient underwent multilevel laminectomies and medial facetectomies from T4 to T7. Over the past decade, ossification of the ligamentum flavum has been reported with increasing frequency in non-Asian patients. This is the third case report in a black man. In addition, ossification of the ligamentum flavum in this particular location is rarely reported. The increased use of advanced neuroimaging techniques in the evaluation of "back pain" may reveal that the prevalence of this condition is higher than expected in non-Asian populations. Improvement in neurologic symptoms secondary to decompressive laminectomies will depend on the degree and duration of spinal cord compression.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
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