1/20. Unilateral thoracic canal stenosis.Two unusual cases of thoracic spinal canal stenosis are reported. The cord compression was a result of unilateral hypertrophy of the lamina and facet joint. Bony decompression resulted in rapid neurological recovery.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
2/20. 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 = 1keywords = hypertrophy (Clic here for more details about this article) |
3/20. Lumbar canal stenosis caused by hypertrophy of the posterior longitudinal ligament: case report.STUDY DESIGN: This is a case report of a patient with hypertrophy of the posterior longitudinal ligament (HPLL) in the lumbar spine, with assessment of operative treatment and a 10-year follow-up using magnetic resonance imaging. OBJECTIVES: To report on the long-term outcome of a case of lumbar HPLL, to review the literature on case reports of HPLL, and to outline the pathology of HPLL in the lumbar spine. SUMMARY OF BACKGROUND DATA: There have been several reports of HPLL in the cervical spine and thoracic spine. However, the authors found no reports of this condition in the lumbar spine and no reports of long-term follow-up. Two types of pathology are associated with HPLL: primary hypertrophy of the ligament and secondary hypertrophy associated with intervertebral disc herniation. methods: A 10-year follow-up evaluation of a 56-year-old man with HPLL at L2 is reported. The patient was observed using serial physical examinations, radiographs, and MRIs over 10 years. Because he did not respond to conservative management, surgical treatment was applied. After complete decompression by hemilaminectomy and resection of hypertrophied ligament, the nerve roots were freed of constriction through the neural foramens at L2 and L3. RESULTS: One year after the operation the patient was asymptomatic without evidence of recurrence of the disease. CONCLUSIONS: HPLL is a very rare disease. This appears to be the first report of the disease in the lumbar spine.- - - - - - - - - - ranking = 7keywords = hypertrophy (Clic here for more details about this article) |
4/20. High cervical and lumbar canal stenosis of varied etiology: a case report.Developmental stenosis without any significant spondylotic changes frequently occurs at C3 vertebra or below, and typically extends to C6-C7. However, high cervical focal canal stenosis is unusual. A case of cervical canal segmental stenosis at C2-3 level in addition to a developmental stenosis of the lumbar region, in a 45 year old male, has been presented in this article. The dynamics of the spinal canal in relation to the likely pathology of such conditions are reviewed. We speculate that focal segmental stenosis in the high cervical region may be due to a possible premature fusion of the neurocentral synchondrosis of the cartilage, or due to an abnormal rotary biomechanics which can result in facetal hypertrophy.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
5/20. T1-2 disc herniation following an en bloc cervical laminoplasty.We report a rare case of T1-2 disc herniation following cervical laminoplasty. A 56-year-old male patient presented with left foot-drop and gait disturbance of abrupt onset 11 years after a successful laminoplasty from C3-7. magnetic resonance imaging revealed spinal stenosis at T1-2 due to intervertebral disc herniation and ligamentum flavum hypertrophy. Three days later, laminectomy with disc fragment excision was performed at that level. Two weeks after surgery, he was able to walk without assistance. Mechanical stresses may have directly affected the T1-2 intervertebral disc following laminoplasty and may have caused disc herniation.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
6/20. Cervical spinal cord compression attributable to a calcified intervertebral disc in a patient with X-linked hypophosphatemic rickets: case report and review of the literature.OBJECTIVE AND IMPORTANCE: X-linked hypophosphatemic rickets is a common inherited phosphate-wasting disorder, but it is a rare cause of spinal cord compression. We present the first reported case of a calcified intervertebral disc causing spinal canal stenosis in X-linked hypophosphatemic rickets. CLINICAL PRESENTATION: A 44-year-old woman presented with paresthesia of her left arm and a loss of grip in both hands. magnetic resonance imaging revealed a calcified intervertebral disc, as well as a posterior osteophytic bar causing marked cervical cord compression at C6/C7. INTERVENTION: An anterior cervical discectomy at C6/C7 and fusion with autologous bone graft were performed. The patient then exhibited significant improvement. CONCLUSION: A review of the 16 published cases demonstrates that thickening of the vertebral laminae, facet joint hypertrophy, and ossification of the intervertebral discs, posterior longitudinal ligament, and/or ligamentum flavum contribute to spinal canal stenosis in X-linked hypophosphatemic rickets. Those changes are caused by the disease itself and are unlikely to be related to long-term vitamin d treatment. Eleven of 16 patients were reported to have experienced favorable outcomes after surgery.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
7/20. Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.STUDY DESIGN: A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. OBJECTIVES: To provide further evidence that S1 radiculopathy is predisposed to develop neurogenic muscle hypertrophy. SUMMARY OF BACKGROUND DATA: Calf hypertrophy, specifically hypertrophy of the gastrocnemius muscle, is a rare but recognized presentation of S1 and less commonly L5 radiculopathies. The pathophysiology of this is incompletely understood. methods: We present a 59-year-old patient with painless progressive distal right leg weakness and calf enlargement. Electrodiagnostic studies and magnetic resonance imaging scanning were performed to evaluate the extent and cause of radicular damage as the etiology for unilateral calf hypertrophy. RESULTS: Examination and electrodiagnostic studies revealed right L5, right S1, and left L5 radiculopathies. Imaging studies demonstrated lumbar stenosis at L3-L4, L4-L5, and L5-S1 vertebral levels as well as L4-L5 and L5-S1 foraminal stenosis. After decompressive surgery the progressive nature of the patient's symptomatology halted, and he had partial resolution of his deficits. CONCLUSION: Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.- - - - - - - - - - ranking = 12keywords = hypertrophy (Clic here for more details about this article) |
8/20. Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury.We describe the case of a 47-year-old female who sustained a C5/6 fracture with C6 complete spinal cord injury 26 years ago. She presented with increased spasticity of the lower extremities, the abdominal wall and episodes of autonomic dysreflexia. Imaging of the spine revealed post-traumatic kyphosis at the level of the injury and degenerative changes of the lumbar spine with marked facet joint hypertrophy at the level of L4/5 causing severe spinal canal stenosis. Discussants of this case comment on the possible pathophysiological mechanisms causing autonomic dysreflexia, especially the development of degenerative changes, Charcot arthropathy and the role of tethering mechanisms. The diagnostic options and management approaches are also discussed.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
9/20. Multilevel myelopathy in Maroteaux-Lamy syndrome and review of the literature.An 18-year-old male with Maroteaux-Lamy syndrome was presented with spastic quadriparesis. magnetic resonance imaging of whole spinal canal revealed stenosis at multiple levels of cervical, thoracic and lumbar regions. By the guidance of combined evaluations of neurological examination, neuroradiological and electrophysiological findings, the most responsible spinal segment was detected each time he developed myelopathy and he underwent craniocervical, cervical and thoracolumbar decompressions consecutively. ligamentum flavum hypertrophy was found to be the principal pathology responsible for the cord compression and myelopathy for all levels. The etiology of myelopathy and priority of the level for which decompression should be done in diffuse spinal stenosis were discussed with the literature review of Maroteaux-Lamy syndrome.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
10/20. Atlas hypoplasia associated with non-traumatic retro-odontoid mass.A 38-year-old man presented with progressive cervical myelopathy due to atlas hypoplasia associated with non-traumatic retro-odontoid mass. The neuroimaging findings suggested hypertrophy of the transverse ligament of the atlas. No histological confirmation of the retro-odontoid mass was obtained. Clinical manifestations improved after posterior decompression. Decompressive laminectomy of the atlas with or without fusion can achieve a good outcome in such cases.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
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