1/69. Rigid spine syndrome. Case report.We describe a patient who had difficulty in walking since toddling stage and presented proximal upper and lower member weakness which have evolved to a progressive limitation of neck and trunk flexure, compatible with rigid spine syndrome. The serum muscle enzymes were somewhat elevated and the electromyography showed a myopatic change. The muscle biopsy demonstrated an active and chronic myopathy. The dna analysis through PCR did not display any abnormality for dystrophin gene. The dystrophin by immunofluorescence was present in all fibers, but some interruptions were found in the plasma membrane giving it the appearance of a rosary. The test for merosin was normal.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/69. actinomycosis--an unusual case of an uncommon disease.actinomycosis is an uncommon disease caused by organisms of the actinomyces genus. These organisms are commonly found in the mucous membranes but do not cause infection unless there is disruption of the membranes, as occurs, for example, during dental trauma or abdominal surgery. Use of an IUD is also a risk factor for pelvic actinomycosis. The disease is usually insidious and is often mistaken for other conditions. Treatment of the infection, once diagnosed, is a regimen of long-term antibiotics such as penicillin, clindamycin, and others. Our patient had pelvic and sacral actinomycosis without any of the traditional risk factors for infection.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
3/69. synovial cyst of the transverse ligament of the atlas in a patient with os odontoideum and atlantoaxial instability.STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To describe the diagnosis and successful treatment of a synovial cyst arising from the transverse ligament in a patient with os odontoideum and atlantoaxial instability. SUMMARY OF BACKGROUND DATA: Synovial cysts arising from the transverse ligament of the atlas are extremely rare. Development of a synovial cyst is thought to be attributable to degenerative changes of the C1-C2 facet joints or to microtrauma. Direct excision of the cyst is the only treatment cited in previous reports. methods: A synovial cyst arising from the transverse ligament of the atlas in a 45-year-old man with os odontoideum and atlantoaxial instability was treated surgically with posterior atlantoaxial fusion alone. The magnetic resonance images, surgical treatment, and related literature are reviewed. RESULTS: Preoperative magnetic resonance images of the cervical spine showed a large cystic mass located ventral to the cord arising at the level of the transverse ligament of the atlas: the mass was of low signal intensity on T1-weighted images, was of high signal intensity on T2-weighted images, and was enhanced marginally with gadolinium-DTPA on T1-weighted images. Spontaneous regression of the cyst was identified on the follow-up magnetic resonance images taken 3 months after C1-C2 posterior wiring and fusion. CONCLUSIONS: A patient with a synovial cyst arising at the C1-C2 junction ventrally at the level of the transverse ligament showed spontaneous regression of the lesion after C1-C2 posterior wiring and fusion.- - - - - - - - - - ranking = 13410.907142395keywords = ligament (Clic here for more details about this article) |
4/69. Cervical and thoracic juxtafacet cysts causing neurologic deficits.STUDY DESIGN: case reports and review of the literature. OBJECTIVES: To review the clinical features, treatment, and outcome of juxtafacet cysts. SUMMARY OF BACKGROUND DATA: There have previously been 4 reported cases of thoracic juxtafacet cysts and 19 cases of cervical juxtafacet cysts. Cervical cysts have usually originated from the cruciate ligament and caused myelopathy. Thoracic cysts are usually signaled by myelopathy. methods: The records of the neurosurgery Department of Royal Adelaide Hospital from 1980 through 1995 were reviewed for cases of intraspinal juxtafacet cysts. RESULTS: Eight cases of intraspinal juxtafacet cysts were identified; six were in the lumbar spine. One patient had a cervical cyst related to a facet joint and had unilateral radiculopathy. A second patient with a thoracic cyst had the gradual onset of myelopathy. Both patients had surgical excision of the cyst without resection of the adherent dura. The symptoms and neurologic signs improved in each case. CONCLUSIONS: Cervical and thoracic juxtafacet cysts are rare lesions that are usually signaled by myelopathy. Results of surgery are excellent in most cases, even if the cyst is not completely excised.- - - - - - - - - - ranking = 1490.1007935995keywords = ligament (Clic here for more details about this article) |
5/69. femoral neuropathy secondary to ossification of the ligamentum flavum.radiculopathy resulting from ossification of the ligamentum flavum (OLF) is extremely rare and concerns only intercostal neuralgias. We describe a 37-year-old Caucasian woman with a lumbar radiculopathy revealing an OLF. Her symptoms were completely and definitively relieved by surgery.- - - - - - - - - - ranking = 7450.5039679973keywords = ligament (Clic here for more details about this article) |
6/69. Ossification of the posterior longitudinal spinal ligament in association with anterior longitudinal ligament ankylosing hyperostosis: case report.A case of ossification of the posterior spinal longitudinal ligament in association with anterior ankylosing hyperostosis is presented, with a review of the relevant literature. Improvement followed laminectomy. Evaluation of this entity by computerized tomography is demonstrated.- - - - - - - - - - ranking = 13410.907142395keywords = ligament (Clic here for more details about this article) |
7/69. Ossification of the posterior longitudianl ligament of the cervical spine: subtotal vertebrectomy as a treatment.If the ossification is localized in the central part of the intervertebral space, anterior decompression surgery of Cloward may be indicated. However, if most posterior ligamentous ossification covers the posterior surface of the vertebral body and the lateral sides, Cloward's method is not indicated. We have developed a method of anterior decompression and fusion surgery to clear the ossified area, resecting the vertebral body (subtotal vertebrectomy). The results were excellent in 3 of 4 patients with preoperative radiculopathy; there were 2 excellent and 16 good results in 22 patients with myelopathy. Of course laminectomy can produce some good effects, but the anterior obstruction removes through the anterior approach. Anterior decompression may be indicated when ossification is localized below the C3--4 intervertebral space, and when the spinal canal is not narrowed in the upper cervical region, even if ossification extends over the whole cervical spine. laminectomy is advised when ossification involves all levels of the cervical spine, the upper cervical spine is narrowed or the sagittal dimension of the spinal canal is reduced more than 60%.- - - - - - - - - - ranking = 7450.5039679973keywords = ligament (Clic here for more details about this article) |
8/69. Acute paraplegia in a patient with spinal tophi: a case report.A 28-year-old man with a 5-year history of gouty arthritis suffered from an acute episode of lower back pain. He visited a rehabilitative clinic and received physical therapy following his examination. Weakness and numbness of both lower legs developed rapidly after physical therapy. He was sent to our hospital with complete paralysis of both lower limbs and complete sensory loss below the umbilicus 3 hours after the physical therapy. No peripheral tophi were found. myelography showed an extrinsic compression of the dura sac at T10. Emergency decompressive laminectomy of T9 to T11 was performed. During the surgery, caseous material was found deposited in the ligamentum flavum and the left T9 to T10 facet joint, with indentation of the dura sac. The pathologic diagnosis was spinal tophi. After surgery, the patient's neurologic function recovered rapidly. It was suspected that inappropriate physical therapy might have aggravated acute inflammation of spinal gout and resulted in a rapid deterioration of neurologic function. Though gout is a chronic medical disease, an acute attack of spinal gout may be disastrous and requires emergency neurosurgical intervention.- - - - - - - - - - ranking = 1490.1007935995keywords = ligament (Clic here for more details about this article) |
9/69. Intraspinal cervical degenerative cyst. Report of three cases.The authors report three cases of cervical degenerative cysts causing medullary or radiculomedullary compression. Anatomicopathological examination confirmed the fibrous nature of the cyst wall and the absence of a synovial layer. One of the cysts was embedded in the ligamentum flavum, whereas the other two were most lateral and adherent to the facet joint. The physiopathogenesis of these cysts is discussed.- - - - - - - - - - ranking = 1490.1007935995keywords = ligament (Clic here for more details about this article) |
10/69. candida vertebral osteomyelitis: a case report and review of the literature.candida species are low virulence organisms which inhabit the skin and mucous membranes of most individuals. There has been increasing incidence of disseminated and deep-seated candida infections owing to the increasing number of immune compromised hosts. However, the candida species are still rarely suggested as causative pathogens of vertebral osteomyelitis. We present a 51-year-old man with neck pain and cervical radiculopathy. Three months prior to visiting our hospital, he had undergone a urological operation which was complicated by a urinary tract infection. magnetic resonance imaging and x-rays showed erosion of the body of the 5th cervical spine and collapse of the C5-C6 disc. After open debridement, tissue pathology results revealed candida infection. Clinical stability was achieved during the 6-month follow-up period with a combination of amphotericin b and posterior fixation method. We reviewed the literature and found a high rate of surgical intervention for patients suggested of having candida vertebral osteomyelitis. However, the surgical intervention may not be necessary. early diagnosis using noninvasive percutaneous needle biopsy may help reduce the incidence of delayed treatment.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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