Cases reported "Paraparesis"

Filter by keywords:



Filtering documents. Please wait...

11/20. Chronic lumbar epidural haematoma presenting with acute paraparesis.

    Chronic spinal epidural haematomas are very rare and have been reported to occur only in the lumbar region. They usually become symptomatic through radicular pain or neurogenic claudication. The epidural bleeding is thought to originate from a rupture of an epidural vein due to a sudden increase in intra-abdominal pressure or due to trauma. The patient reported on here developed acute paraparesis about 8 weeks after a mild fall on the buttocks. MRI showed a spinal epidural mass located dorsolaterally at the level of L3-L5. The mass was surgically removed. Histological and immunohistological studies disclosed an organised haematoma. The clinical, radiological and intra-operative features of this case are described, and the relevant literature is analysed.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

12/20. A syndrome characteristic of tangential bullet wounds of the vertex of the skull.

    Six patients with tangential missile wounds of the vertex of the skull presented symptoms of limb paresis which were more marked proximally in the arms and distally in the legs where there was also sensory loss of a cortical type. Carotid cerebral angiography and operative treatment showed patency of the longitudinal sinus and injury to the medial aspects of the frontoparietal cortex. The term "longitudinal sinus syndrome" formerly applied to these cases is therefore a misnomer since the main underlying cause is cortical injury and not thrombotic occlusion of the superior longitudinal sinus, as previously suspected.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

13/20. Spinal surgery in patients with Parkinson's disease: construct failure and progressive deformity.

    STUDY DESIGN: Retrospective case series review of patients with Parkinson's disease undergoing elective spine surgery at a single tertiary referral center. OBJECTIVES: To assess the rate of complications of spine surgery in the population with Parkinson's disease and characterize the causes of failure and special needs of this unique population. SUMMARY OF BACKGROUND DATA: patients with Parkinson's disease experience a combination of poor bone quality and a severe neuromuscular disorder. There is little information in the literature about outcomes of spine surgery in this population. Preliminary review suggests that these patients have a high rate of instrument-related complications that has not been reported previously. methods: A computerized search using diagnostic and procedural codes identified 14 patients with Parkinson's disease who underwent spine surgery from January 1993 through December 2000. Their charts and radiographs were reviewed, and those not examined within twelve months were invited for follow-up review. The remaining patients were being followed on a regular basis by their spine surgeon, the movement disorders Clinic, or both and were seen and examined during their routine follow-up observation. INDICATIONS AND EXTENT OF INDEX SURGERY VARIED: Complications, revisions, and radiographic evidence of loosening were assessed. Causes of failure were sought with respect to surgical and clinical factors. All patients underwent surgical care by a fellowship-trained spine surgeon. RESULTS: The mean follow-up period from index procedure was 66.8 months; the median follow-up period was 38 months. Of 14 patients, 12 (86%) required additional surgery, undergoing a total of 31 reoperations. Eleven patients (79%) underwent 22 additional procedures at the same or adjacent level for instability, including four patients (29%) who had hardware failure or pullout, necessitating 10 reoperations. The one other patient who required additional surgery had a successful index procedure but underwent another operation to address instability at a remote spinal segment. Of five patients whose index procedure involved only one spinal level, three (60%) required additional procedures, all at that level. Two patients (14%) developed wound infections during the course of treatment but not as the cause of initial treatment failure. The primary mechanisms of failure were relentless kyphosis or segmental instability at the operated-on or adjacent levels. CONCLUSION: patients with Parkinson's disease undergoing spine surgery in a single tertiary referral center had a very high reoperation rate associated with technical complications. patients should be appropriately counseled regarding the increased risk of operative complications and closely followed for incipient failure.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

14/20. Posterior circumferential decompression for late onset paraparesis caused by kyphotic deformity due to infantile tuberculosis--case report.

    A 46-year-old male presented with late onset of paraparesis caused by kyphotic deformity due to infantile tuberculosis. A posterior circumferential decompression was performed from the sixth thoracic to the eighth thoracic levels. His neurological status improved with no evidence of kyphosis progression at the last follow up (2 years 5 months postoperatively). The paraparesis was caused by bony compression following increasing kyphosis above and below the block vertebrae due to growth. Posterior circumferential decompression is a less invasive surgical intervention for this condition.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

15/20. Transient paraparesis after laminectomy for thoracic myelopathy due to ossification of the posterior longitudinal ligament: a case report.

    STUDY DESIGN: Case report. OBJECTIVES: We report a case with thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) of the spine, in which neurologic deterioration progressed after laminectomy and was markedly reversed after additional posterior instrumented fusion. SUMMARY OF BACKGROUND DATA: Many different surgical procedures may be used in the treatment of thoracic OPLL. However, the possibility of postoperative paraplegia remains a major risk, and consistent protocols and procedures for surgical correction of thoracic OPLL have not been established. methods: The patient was a 53-year-old man with continuous OPLL at T3-T8 that compressed the spinal cord anteriorly. Anterior decompression surgery employing a posterior approach was initiated, but during OPLL extirpation electrophysiologic monitoring of spinal cord activity showed abnormalities. As a result, the procedure was converted to a wide laminectomy. Over the next 4 weeks, kyphosis of the thoracic spine increased and myelopathy worsened, producing severe paraparesis. RESULTS: Four weeks after surgery, posterior instrumented fusion (T1-L1) was performed without correction of the kyphosis. After the fusion, neurologic deficits gradually recovered and the patient was fully recovered after 10 months. At follow-up 15 years after the fusion, no neurologic deterioration was seen despite the presence of residual anterior impingement of spinal cord by OPLL. CONCLUSIONS: The present case suggests that kyphosis and instability are major factors that affect the severity of thoracic myelopathy due to OPLL, and posterior fusion with spinal instrumentation is a safe and effective adjunct procedure for surgical treatment of thoracic OPLL.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

16/20. Intraspinal metalloma resulting in late paraparesis.

    The metal-related complications caused by orthopedic implants have long been a concern, but these problems have been considered mostly in the field of arthroplasty or internal fixation of fractures. The recent prevalence of spinal instrumentation has evoked a similar concern among spine surgeons. Here, we present a case of intraspinal metallosis adjacent to the pedicular hook occurring after treatment of vertebral fracture by posterior spinal instrumentation and fusion, and causing paraparesis at the 3rd postoperative year. Metallic granulomas can appear around the pedicular hooks as in the reported case. Crevice and fretting corrosion are results at the junctions of rod-screw, rod-hook, transverse connector rod and other connector rods in modular spinal implants. Adequate usage of transpedicular screws may inhibit the occurrence of such a complication. For this reason, further studies are necessary to increase metallic corrosive resistance to inhibit crevice and fretting corrosion.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

17/20. Thoracic paraparesis following an embolic vascular event during lumbar spinal surgery.

    OBJECTIVE: A case report illustrating the rare occurrence of thoracic paraparesis following the presumed occurrence of an embolic vascular event during lumbar spinal surgery is presented. The goal is to investigate the potential causes of acute postoperative paraparesis following lumbar spine surgery. A discussion of the symptoms, diagnosis, differential diagnosis, and management of spinal cord ischemia and postembolic infarction is presented. This manuscript is intended to heighten the awareness of the potential for this rare complication to improve the speed and accuracy of diagnosis, allowing the timely institution of appropriate treatment. methods: Data analyzed include the patient history, preoperative and postoperative physical examination, clinical course, imaging studies, and input of various consulting services. A review of the English literature on spinal cord ischemia and postembolic infarction was performed. RESULTS: The most likely etiology for the patient's acute postoperative paraparesis appears to be related to an embolic spinal cord infarction. CONCLUSIONS: Management of a spinal cord ischemic event should focus on the following key issues: a prompt diagnosis with timely perioperative imaging studies (magnetic resonance imaging), the attainment of a normotensive state, the institution of systemic anticoagulation if clinically warranted, and maximization of physical function through early rehabilitation.
- - - - - - - - - -
ranking = 5
keywords = operative
(Clic here for more details about this article)

18/20. Imaging-guided costotransversectomy for thoracic disc herniation.

    The surgical management of thoracic disc disease remains challenging. Outcomes after laminectomy had been poor, and modern posterolateral, lateral, and anterior approaches have evolved to replace this older procedure. Each has its own set of complications, and all are hampered, to varying degrees, by the limited visualization of the ventral disc space and spinal cord during decompression. The authors present their early experience with computer-assisted image guidance as an adjunctive tool for preoperative planning and navigation in the treatment of thoracic disc disease. Five consecutive patients underwent image-guided costotransversectomies between January 1999 and April 2000. The levels of herniation were T8-9 in three and T7-8 and T5-6, respectively, in the other two. There were four centrolateral herniations and one midline herniation. Three discs were soft and two hard. Two patients had previously undergone failed disc excisions. All patients had axial pain and myeloradiculopathies preoperatively. Three were unable to walk. Four patients enjoyed good or excellent outcomes, with return of ambulation. One patient experienced only mild improvement in her severe paraparesis. Image-guidance was invaluable in planning the corpectomy and aiding visualization in situations in which the dura or disc were obscured; its use allowed successful surgical excisions in the most challenging circumstances.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

19/20. Traumatic noncontiguous double fracture-dislocation of the lumbosacral spine.

    BACKGROUND CONTEXT: To our knowledge, the presence of noncontiguous fracture-dislocation of the lumbosacral spine occurring at two levels has not been reported. The etiology, evaluation, and treatment of the unusual injury is presented. PURPOSE: To notify spinal traumatologists about the possibility of this unusual injury. STUDY DESIGN: A case report of an unusual noncontiguous double fracture-dislocation of the lumbosacral spine. methods: A 26-year-old man was involved in a motor vehicle accident where his car fell over a bridge and plummeted approximately 300 feet before hitting the ground. The patient was transported to a major medical center where he was found to be conscious, and amazingly, his only major injury was fracture-dislocations of L2-L3 and L5-S1. His preoperative neurologic status showed a partial paraparesis to all motor groups of the lower extremities bilaterally. RESULTS: The patient underwent a posterior reduction, instrumentation, and fusion from L1 to S1 with autogenous bone graft and segmental pedicle screw instrumentation. One week postoperatively, he underwent an anterior spinal fusion of L5/S1. Postoperatively, his neurologic status improved allowing him to be ambulatory, with a normal lumbosacral alignment being well-maintained. CONCLUSIONS: Noncontiguous double fracture-dislocation of the lumbosacral spine is an unusual injury, which results from a very high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization is recommended for neural decompression, spinal alignment, and long-term stabilization.
- - - - - - - - - -
ranking = 3
keywords = operative
(Clic here for more details about this article)

20/20. Intraspinal lymphangioma: 2 case reports and literature review.

    BACKGROUND: lymphangioma of the soft tissue is not uncommon. However, as far as the authors know, intraspinal lymphangioma is clinically rare and very few cases have been reported previously. methods: Two patients who had backache and acratia of the lower limbs and difficulty in relieving themselves were examined by plain radiography and magnetic resonance imaging before surgery. Treatment consisted of the usual technique of surgical resection of the tumor microscopically. Histological examination of the resected material confirmed the diagnosis. Postoperative follow-up assessment was performed by magnetic resonance imaging. RESULTS: Intraspinal lymphangioma is very rare clinically and its cause remains controversial. magnetic resonance imaging can obtain precise position fixing, but it is hard to make preoperative qualitative determination. The most effective treatment of intraspinal lymphangioma is to excise it totally. CONCLUSIONS: The clinical appearance of intraspinal lymphangioma has no character. magnetic resonance imaging is important in diagnosing it. The most effective treatment of intraspinal lymphangioma is to excise it totally. Further observation is recommended because of the possibility of local recurrence.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Paraparesis'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.