1/71. Lumbar disc herniation in a 27-month-old child. Case report.The occurrence of disc herniation is rare in children. A 27-month-old child fell from his cradle and developed, in the following 2 weeks, irritability, low-back pain, and difficulty in walking. On physical examination a compensatory gait, paravertebral muscle spasm, and a restricted right straight-leg raising test were demonstrated. Plain x-ray films revealed a narrowed L4-5 intervertebral space. magnetic resonance imaging of the lumbosacral spine demonstrated decreased signal in the L4-5 disc, with posterior disc protrusion. At surgery, blood infiltrating the subperiosteal plane was observed. Via a left hemilaminectomy and under microscopic magnification, the left L-5 nerve root was found to be intact, and on the right side significant nerve root compression was identified. During dissection an accidental dural tear occurred. A right L-4 hemilaminectomy was performed, and the disc fragments were removed until a complete nerve root decompression was obtained and the dura was repaired. The child recovered uneventfully and was asymptomatic 7 years postsurgery. This child is one of the youngest patients with a herniated disc reported in the world literature. The authors discuss the diagnostic difficulties and management of this entity in children.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/71. Spontaneous vertebral arteriovenous fistula--case report.A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura. The fistula was successfully obliterated by coil embolization, resulting in rapid improvement of the signs and symptoms. Mechanical compression to the nerve roots by the engorged epidural veins with arterial pressure was considered to be the major cause of radiculopathy. vertebral artery dissection induced by chiropractic manipulation is most likely responsible for the development of the fistula.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
3/71. A ganglion cyst causing lumbar radiculopathy in a baseball pitcher: a case report.This report describes a case of a professional baseball pitcher who developed acute left lumbar radicular symptoms after a baseball game and was subsequently sidelined for the rest of the season. physical examination revealed depressed reflexes in the left posterior tibialis and left medial hamstring muscles, mild weakness in the left extensor hallucis longus, and positive dural tension signs. magnetic resonance imaging demonstrated an ovoid mass at the L4-L5 level, causing compression of the dura. Surgical resection of the mass resulted in resolution of his symptoms. pathology revealed that the mass was a ganglion cyst. A ganglion cyst is a rare cause of lumbar radiculopathy and should be considered in the differential diagnosis if a patient with lumbar radiculopathy fails to respond to conservative treatment.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
4/71. Neck-tongue syndrome.Two patients with neck-tongue syndrome, a rare disorder of the upper cervical nerves that results in paroxysmal neck pain and paresthesia of the tongue, are described. Signs are the result of compression of the C2 root by disorders affecting the first two cervical vertebrae. Conservative management is effective in most cases if no masses are in the involved area. The disorder has been observed rarely in children. Clinical onset occurred at 6 and 11 years of age, respectively, in the reported patients.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
5/71. neck pain secondary to radiculopathy of the fourth cervical root: an analysis of 12 surgically treated patients.neck pain can originate from any number of factors. Perhaps the most difficult symptom complex to resolve is axial neck pain arising from upper cervical nerve root compression. The purpose of this study is to report the results of surgical intervention in a series of patients with neck pain from C4 radiculopathy. Twelve consecutive patients who were diagnosed with C4 radiculopathy were retrospectively reviewed (follow-up, 22 /-16.3 months). patients underwent either anterior cervical discectomy and fusion or posterior laminoforaminotomy at the C3-C4 segment. The results show that a good to excellent clinical result can be achieved in most patients (92% in our series). The importance of identifying patients with C4 radiculopathy lies in the fact that surgery can alter the natural history of neck pain secondary to upper cervical root radiculopathy, unlike axial neck pain from degenerative disk disease.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
6/71. spinal canal stenosis at the level of axis.We describe a rare case of marked segmental stenosis of the axis secondary to developmental hypertrophy of the posterior neural arch causing severe neck pain and headache in the occipital region. The patient made a remarkable recovery following decompressive laminectomy and foraminal decompression.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
7/71. L5 radicular pain related to a cystic lesion of the posterior longitudinal ligament.A 35-year-old man with a long history of left L5 radicular pain was found to have an intraspinal cystic lesion causing radicular compression. magnetic resonance imaging demonstrated a round lesion situated in the anterior epidural space, with uniform high signal intensity on T2-weighted sequences characteristic of a cystic lesion. During surgery a liquid-containing cyst originating from the posterior longitudinal ligament was punctured and resected. The histologic aspect was that of a ganglion cyst without synovial layers. The radiologic differential diagnoses are discussed.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
8/71. role of weight-bearing flexion and extension myelography in evaluating the intervertebral disc.magnetic resonance imaging has many advantages compared with myelography and/or computed tomography in evaluating the lumbar spine for herniated nucleus pulposus. The authors have included a series of three patients whose histories and physical examinations were clinically suggestive of herniated nucleus pulposus but whose magnetic resonance imaging scans were interpreted by a radiologist as a disc bulge without nerve root compression. Because all patients had not responded to a conservative care treatment program and surgical intervention was to be considered, subsequent testing with lumbar myelography with weight-bearing flexion and extension views demonstrated more clearly the presence of herniated nucleus pulposus along with compression of the nerve root; it also revealed that a positional change in the disc occurred with flexion and extension.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
9/71. Tarlov cyst as a rare cause of S1 radiculopathy: A case report.A 37-year-old female physician presented with a chief complaint of left posterior thigh pain, which began insidiously approximately 4 months before her initial examination. Initially, she had been evaluated by her physician, and magnetic resonance imaging (MRI) was ordered. The MRI scan was reported to be within normal limits, with the exception of minimal disc bulging at L4-5. She had received physical therapy with little benefit and was referred for physiatric assessment. review of the patient's original MRI scan showed the presence of perineurial (Tarlov) cysts within the sacral canal at the level of S2, with compression of the adjacent nerve root. Subsequent electrodiagnostic testing showed axonal degeneration consistent with an S1 radiculopathy. tarlov cysts can be a rare cause of lumbosacral radiculopathy and should be considered in the differential diagnosis of radicular leg pain.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
10/71. Root and spinal cord compression from methylmethacrylate vertebroplasty.STUDY DESIGN: Case report and literature review. OBJECTIVES: Clinicians use methylmethacrylate vertebroplasty to treat vertebral hemangiomas, metastases, and osteoporotic fractures. Cement may leak out of the vertebral body and compress the adjacent spinal cord and nerve roots. We review a case of nerve-root and cord compression from methylmethacrylate extrusion during vertebroplasty. SUMMARY OF BACKGROUND DATA: A 50-year-old female presented with disabling thoracic back pain. A metastasis to T1 was discovered, with collapse of the vertebral body but without cord compression. methylmethacrylate vertebroplasty was performed. After injection, portable computed tomography (CT) showed a leakage of methylmethacrylate into the C8 and T1 foramina and spinal canal. radiculopathy and myelopathy developed. Surgical decompression using the anterior approach was necessary. methods: Case report. RESULTS: Early surgical intervention decompressed the neural elements and relieved the neurological deficits. CONCLUSIONS: Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.- - - - - - - - - - ranking = 3.5675259053279keywords = compression, fracture (Clic here for more details about this article) |
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