1/10. Dysphagia in a patient with giant osteophytes: case presentation and review of the literature.A patient with increasing dysphagia due to external bone compression of the oesophagus is presented. Radiographic evaluation revealed the underlying condition to be a diffuse idiopathic skeletal hyperostosis with exuberant and bumpy change within the anterior longitudinal ligament.- - - - - - - - - - ranking = 1keywords = idiopathic skeletal hyperostosis, diffuse idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
2/10. Clinics in diagnostic imaging (55). Ossification of the posterior longitudinal ligament.Ossification of the posterior longitudinal ligament (OPLL) of the cervical spine associated with diffuse idiopathic skeletal hyperostosis is described in a 70-year-old Caucasian man presenting with a rapidly progressive myelopathy. The acute nature of his myelopathic symptoms and cervical canal stenosis necessitated posterior decompressive surgery. Four other patients with OPLL are presented to illustrate the spectrum of imaging findings. The computed tomographic features of OPLL are distinctive.A 2-5 mm thick linear ossified strip along the posterior vertebral margin usually at mid cervical (C3 to C5) level characterises the condition. Magnetic resonance (MR) imaging is valuable in excluding possible cord damage and associated disc lesions prior to surgery. A calcified central sequestrated disc is the only condition that may be mistaken for the segmental and retrodiscal forms of OPLL In a clinical setting of compressive myelopathy, it is pertinent to distinguish between these two conditions since a sequestrated disc has a more favourable surgical prognosis. The merits and relevance of anterior and posterior surgery together with their possible complications are outlined.- - - - - - - - - - ranking = 1keywords = idiopathic skeletal hyperostosis, diffuse idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
3/10. Stenosis of the cervical canal in craniodiaphyseal dysplasia.Craniodiaphyseal dysplasia (CDD) is a rare sclerosing bone disorder, the severity of which depends on its phenotypic expression. hyperostosis can cause progressive foraminal stenosis leading to palsy of cranial nerves, epilepsy and mental retardation. We report the only case of CDD in an adult, with stenosis of the cervical canal leading to quadriparesis as a late complication of hyperostosis, and describe the problems associated with its treatment. Although the syndrome is rare, its pathophysiological and therapeutic considerations may be applicable to the management of stenosis of the spinal canal in other hyperostotic bone disorders.- - - - - - - - - - ranking = 0.032072448620255keywords = hyperostosis (Clic here for more details about this article) |
4/10. Recurrent transverse myelitis after lumbar spine surgery: a case report.STUDY DESIGN: A case of recurrent idiopathic transverse myelitis occurring after surgery is reported. OBJECTIVES: To present a case of idiopathic transverse myelitis recurring after surgery and to heighten awareness for the diagnosis and management of this disorder. SUMMARY AND BACKGROUND DATA: Transverse myelitis presenting with acute spinal pain and neurologic deficit must be considered along with structural causes of myelopathy by the spine specialist. This intramedullary spinal cord disorder may be caused by parainfectious and postvaccinal sequelae, multiple sclerosis, spinal cord ischemia, autoimmune disorders, and paraneoplastic syndromes. These various etiologies are often difficult to differentiate. However, a patient's history, clinical course, MRI studies, and laboratory findings often allow such classification. Determination of etiology provides pertinent information regarding potential recurrence, treatment, and prognosis. methods: The patient history, physical examination, radiologic and laboratory studies, and pertinent literature were reviewed. RESULTS: Thoracolumbar myelitis developed in the reported patient 6 weeks after lumbar spine surgery during an otherwise uncomplicated postoperative recovery. The workup did not identify a specific cause, and the patient recovered to ambulatory status. However, 4 months after surgery, acute transverse myelitis developed again, this time affecting the cervical spinal cord. Despite aggressive intervention with corticosteroids, the patient has remained nonambulatory with severe neurologic residua. In spite of an extensive workup, a definitive cause was not determined, although an autoimmune etiology was suspected. The patient has stabilized without recurrence using immunosuppressant therapies. CONCLUSIONS: Acute transverse myelitis is an intramedullary spinal cord disorder that may present to the spine specialist during the postoperative period. This diagnosis requires swift and aggressive diagnostic and treatment intervention. Although sometimes difficult, establishment of causation may help to determine therapy and prognosis.- - - - - - - - - - ranking = 0.00014049613997404keywords = idiopathic (Clic here for more details about this article) |
5/10. Isolated atlantal stenosis in a patient with idiopathic growth hormone deficiency, and Klippel-Feil and Duane's syndromes.OBJECTIVE AND IMPORTANCE: Isolated atlantal stenosis is very rare with less than ten cases reported, mostly in adult Asians; however, this pathology should be recognized by the neurosurgeon. An unusual case of this rare clinical entity is reported in conjunction with multiple other anomalies. CLINICAL PRESENTATION: We report a Caucasian girl with symptomatic stenosis of the first cervical vertebrae who presented with episodes of loss of tone with subsequent falling, facial cyanosis, urinary incontinence, hand weakness, and difficulties with swallowing. This patient also had the diagnoses of Duane's and Klippel-Feil syndromes, and idiopathic growth hormone deficiency. In addition, this patient was found to have retroflexion of the odontoid process, which further compromised the spinal canal. Flexion-extension radiographs failed to identify cervical spine instability. INTERVENTION: Following suboccipital craniectomy and the removal of the posterior arch of the atlas, the patient's symptoms were resolved and her urinary incontinence improved. CONCLUSIONS: We theorize that our case represents a variant of Wildervanck syndrome. Further case reports are necessary to verify that isolated atlantal stenosis is a component of this constellation of findings. Furthermore, our case demonstrates that degenerative changes of the spine are not necessary for the production of symptoms in cases of isolated stenosis of the atlas.- - - - - - - - - - ranking = 0.00035124034993509keywords = idiopathic (Clic here for more details about this article) |
6/10. Unilateral sensorineural hearing loss after spine surgery: Case report and review of the literature.BACKGROUND: Sudden sensorineural hearing loss is infrequent, with an estimated incidence of 5 to 20 cases yearly per 100,000 people. Although multiple etiologies have been identified, infection and idiopathic SNHL are most common. Sudden sensorineural hearing loss after nonotologic noncardiac surgery is highly unusual, particularly after spinal surgery. CASE DESCRIPTION: We report a case of unilateral sudden SNHL after lumbar spinal fusion with review of the literature. Potential etiologies, treatment, and prognosis are summarized. CONCLUSION: Multiple etiologies have been proposed for SNHL after nonotologic noncardiac surgery. Excessive positive upper airway pressure during induction of anesthesia or Valsalva maneuvers can result in SNHL from LMR. Aberrant NO accumulation in the middle ear cavity during general anesthesia with subsequent LMR is also a potential etiology, as is excessive leakage of CSF causing a form of endolymphatic hydrops. There is no definitive treatment of postoperative SNHL, although middle ear exploration may be beneficial for suspected overpressure injury to the middle ear, causing a perilymphatic fistula. Corticosteroids have been beneficial in certain cases of idiopathic SNHL; however, its effectiveness for postoperative SNHL is undocumented.- - - - - - - - - - ranking = 0.00014049613997404keywords = idiopathic (Clic here for more details about this article) |
7/10. Thoracic spinal cord compression caused by diffuse idiopathic skeletal hyperostosis (DISH).Diffuse idiopathic skeletal hyperostosis (DISH) is now recognized with increasing frequency in the elderly population. Whilst usually a relatively asymptomatic process, serious neurological sequelae have been reported. A previously unreported complication, severe focal thoracic canal stenosis, is presented. attention is drawn to the need for full assessment of the whole spine by CT myelography in patients presenting with evidence of myelopathy.- - - - - - - - - - ranking = 4.4727405612747keywords = idiopathic skeletal hyperostosis, diffuse idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
8/10. Postmyelographic cauda equina syndrome in an asymptomatic acquired spinal stenosis of a young acromegalic.Early postmyelographic cauda equina syndrome in an asymptomatic young acromegalic is presented. The patient was asymptomatic for more than 1 yr despite myelographic evidence of acquired spinal stenosis at the L2-L4 level. Radiographic and/or myelographic findings should be clinically correlated. It is postulated that, in acromegaly, the combined simultaneous bony apposition-remodeling resorption mechanism is involved in the spine as platyspondyly, hyperostosis of spinous processes and vertebral scalloping to counteract soft tissue hyperplasia within the spinal canal; entrapment myelopathy, cauda equina syndrome and/or radiculopathy are ascribed to a soft tissue edematous mechanism superimposed on congenital or degenerative spinal stenosis, traumatic or postoperative spondylolisthesis, postmyelographic and/or postoperative arachnoiditis and a traumatic swollen or protrused intervertebral disc.- - - - - - - - - - ranking = 0.032072448620255keywords = hyperostosis (Clic here for more details about this article) |
9/10. Diffuse idiopathic skeletal hyperostosis (DISH) causing spinal stenosis and sudden paraplegia.Neurologic complications due to spinal cord compression developed in a patient with diffuse, idiopathic skeletal hyperostosis (Forestier's disease) originally mistaken for ankylosing spondylitis. Emergency laminectomy stopped progression of the symptoms and resulted in slow improvement.- - - - - - - - - - ranking = 2.3637028063737keywords = idiopathic skeletal hyperostosis, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
10/10. Lumbar spinal stenosis in a patient with diffuse idiopathic skeletal hypertrophy syndrome.Lumbar spinal stenosis is associated with a variety of conditions, including dysplastic narrowing of the spine, lumbar spondylosis, Paget's disease, and achondroplastic dwarfism. No case of lumbar stenosis associated with diffuse idiopathic skeletal hyperostosis (DISH) previously has been described. It would appear that this case could represent either another manifestation of DISH characterized by involvement of the ligamentum flavum or coincidental association with lumbar spondylosis. In either case, physicians treating spinal and skeletal diseases should be aware of potential neurologic complications requiring surgical decompression due to narrowing of the spinal canal in this unusual disorder.- - - - - - - - - - ranking = 1.8879323620761keywords = idiopathic skeletal hyperostosis, diffuse idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
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