Cases reported "Spinal Diseases"

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1/451. Conus medullaris hematomyelia associated with an intradural-extramedullary cavernous angioma.

    A unique case of a 50-year-old woman with a conus medullaris hematomyelia associated with a low thoracic intradural-extramedullary cavernous angioma localized 2 cm above is reported. The patient had a 2-month history of progressive paraparesis, hypoesthesia of legs, and bowel and bladder disturbances. The symptoms worsened acutely during the last days before admission. A thoraco-lumbar MRI showed a space-occupying lesion at T10-T11 (vertebral interspace associated with a hematomyelia localized about 2 cm below. A T10-L1 laminectomy was performed and complete removal of both lesions was obtained with microsurgical technique. A non-traumatic hematomyelia should always prompt the suspicion of a spinal AVM or, more rarely, of a cavernous angioma. The possible anatomical and clinical correlations of this unusual association are discussed.
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ranking = 1
keywords = disc
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2/451. Possible manifestation of temporomandibular joint dysfunction on chiropractic cervical X-ray studies.

    OBJECTIVE: Our purpose was to show that biomechanical alterations toward and away from normal on x-ray studies may be the result of changes in temporomandibular joint dysfunction and to discuss possible neurologic explanations for this phenomenon. CLINICAL FEATURES: Two patients are discussed; the first had migraine headache symptoms, and the second had chronic hypomobility of mandibular opening, dizziness, headache, and neck pain and stiffness. In both patients mensuration changes in different types of cervical x-ray studies were noted in conjunction with exacerbation of, and elimination of, temporomandibular joint dysfunction. INTERVENTION: Comanagement of these cases was done with dental professionals. chiropractic treatment included vectored/linear, upper cervical, high-velocity, low-amplitude chiropractic manipulation of the atlas vertebra, diversified manipulation, myofascial therapy, stretch and spray procedures, and soft tissue manual techniques. CONCLUSION: temporomandibular joint dysfunction may cause cervical muscular and spinal biomechanical changes that may become visible and change on x-ray examination. Further investigation into this phenomenon is recommended.
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ranking = 2
keywords = disc
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3/451. Vertebral osteomyelitis in insulin-dependent diabetics.

    Vertebral osteomyelitis continues to be a diagnostically and therapeutically challenging disease with a relatively high incidence in diabetics. The clinical features, investigations and treatment of 7 insulin-dependent diabetics with vertebral osteomyelitis are presented and possible aetiological factors in this group are discussed.
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ranking = 1
keywords = disc
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4/451. Vertebra plana of the lumbar spine caused by an aneurysmal bone cyst: a case report.

    The patient was a 15-year-old girl who had a lesion of the fourth lumbar vertebra. Plain radiographs suggested vertebra plana, with complete collapse of the body of the fourth lumbar vertebra and no involvement of the intervertebral disk spaces. The presumptive diagnosis was eosinophilic granuloma. Progressive neurologic symptoms required surgical excision of the lesion, decompression, and fusion. Histopathologic examination of the operative specimen confirmed the diagnosis of an aneurysmal bone cyst.
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ranking = 913.59134774883
keywords = intervertebral disk, intervertebral, disk
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5/451. Purulent osteomyelitis of the cervical spine with epidural abscess. Operative treatment by means of dorsal and ventral approach.

    The present case concerns an acute purulent osteomyelitis with an epidural abscess, located particularly in the intervertebral foramen between C5 and C6, which led to infection by staphylococci of the adjacent vertebral arches and vertebral bodies. An obstruction of the CSF passage was discovered by myelography at the level between C5 and C6. The bony tissue changed by inflammation was removed as far as possible by laminectomy. After irrigation of the epidural space with antibiotics and after control of the severe inflammation, the vertebral bodies C6 and C7 which were destroyed by the spreading inflammatory granulations, could be removed by a ventral approach 4 weeks later. The defect was filled with spongiosa chips. After immobilisation in a plaster shell and Crutchfield extension for 8 weeks the patient was slowly mobilized. A fusion of the vertebral bodies C5 and C6, C6/C7 and C7/C1 was achieved. A dislocation of the cervical spine did not occur and the patient recovered completely except for a paresis of the right hand. Treatment of this very rare and severe case was only possible by a combined dorsal and ventral procedure on the cervical spine.
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ranking = 331.37774095434
keywords = intervertebral, disc
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6/451. Brucellar spinal epidural abscess.

    Spinal epidural abscesses account for approximately one of every 10, 000 admissions to tertiary hospitals. The midthoracic vertebrae are the most frequently affected, whilst the cervical spine is involved in fewer patients. staphylococcus aureus is identified as the cause in most cases of epidural abscess; other bacteria responsible include gram-negative bacteria, streptococcus species and brucella species. We report the case of a patient with cervical spondylodiscitis at level C4-C5 and an epidural abscess which was compressing the spinal cord and the retropharyngeal space. The previous symptoms of brucellosis were atypical. We discuss the clinical manifestations, diagnosis, treatment and prognosis of the case.
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ranking = 2
keywords = disc
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7/451. Fungal spinal osteomyelitis in the immunocompromised patient: MR findings in three cases.

    The MR imaging findings of fungal spinal osteomyelitis in three recipients of organ transplants showed hypointensity of the vertebral bodies on T1-weighted sequences in all cases. Signal changes and enhancement extended into the posterior elements in two cases. Multiple-level disease was present in two cases (with a total of five intervertebral disks involved in three cases). All cases lacked hyperintensity within the disks on T2-weighted images. In addition, the intranuclear cleft was preserved in four of five affected disks at initial MR imaging. MR features in candida and aspergillus spondylitis that are distinct from pyogenic osteomyelitis include absence of disk hyperintensity and preservation of the intranuclear cleft on T2-weighted images. Prompt recognition of these findings may avoid delay in establishing a diagnosis and instituting treatment of opportunistic osteomyelitis in the immunocompromised patient.
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ranking = 915.69143033156
keywords = intervertebral disk, intervertebral, disk
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8/451. Vertebral involvement in SAPHO syndrome: MRI findings.

    We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (synovitis, Acne, Pustulosis, hyperostosis, osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis.
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ranking = 461.83597581411
keywords = intervertebral, intervertebral disc, disc
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9/451. Helical computed tomography and three-dimensional reconstruction of a bipedicular developmental anomaly of the C2 vertebra.

    STUDY DESIGN: A case of bilateral failure of fusion of the C2 neural arch resembling a bipedicular fracture in a 9-year-old boy involved in a motor vehicle accident. OBJECTIVES: To describe the use of helical computed tomography and three-dimensional reconstruction images to identify the defect as congenital. SUMMARY OF BACKGROUND DATA: Congenital defects in the C2 neural arch are rare. Diagnostic difficulties arise when they are discovered during the assessment of patients after trauma, when they may resemble C2 arch fractures. methods: Lateral cervical spine radiograph, transverse section computed tomography, and three-dimensional reconstruction images were used to delineate the anatomy of the defect. RESULTS: The three-dimensional reconstruction views showed that normal alignment of the vertebrae was maintained, despite the pedicle defects. CONCLUSIONS: Differentiation of a C2 fracture from a congenital defect may be difficult. Reconstruction in three dimensions from helical computed tomography is a useful adjunct to conventional computed tomography in the evaluation of such patients.
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ranking = 1
keywords = disc
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10/451. Anaesthetic implications of rigid spine syndrome.

    The perioperative management of a 14-year-old girl, suffering from the muscular disorder rigid spine syndrome, is presented. The anaesthetic implications with regard to possible difficult intubation, cardiac involvement, malignant hyperthermia, neuromuscular blocking agents, and postoperative recovery are discussed.
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ranking = 1
keywords = disc
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