Cases reported "Spinal Diseases"

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1/90. 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.
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2/90. 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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3/90. Spinal subdural hematoma: a rare complication of lumbar puncture. Case report and review of the literature.

    Spinal subdural hematoma, though rare, is an established complication of lumbar puncture. A young man with persistent back and neck pain after a traumatic lumbar puncture for the diagnosis of lymphocytic meningitis is presented. A diagnosis of spinal subdural hematoma at T2 to T8 levels without significant spinal cord compression was confirmed by magnetic resonance imaging. Symptoms resolved after one month of analgesics and muscle relaxants.
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keywords = neck
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4/90. Progressive destructive vertebral sarcoid leading to surgical fusion.

    Skeletal sarcoidosis is rare. This report describes a 31-year-old African American man who presented with a destructive osteolytic lesion of C2 and another lesion in a rib. The lesion at C2 was treated with corpectomy and bone graft. Four months later the lesion recurred and a new lesion was discovered in the cervical vertebral column. The patient declined surgery for instability for another 3 months, choosing to remain in a halo. Seven months following the initial operation, a technetium bone scan showed spread of the disease to the calvarium and thoracic and lumbar vertebrae. The patient had no symptoms referable to these sites. The patient agreed to have his neck fused at this point. For the next 10 months, the patient was on steroids and a further new lesion appeared at L5 without localizing signs or symptoms. The patient declined further evaluation over the next 12 months and is now considered lost to follow-up.
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keywords = neck
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5/90. Human and behavioral factors contributing to spine-based neurological cockpit injuries in pilots of high-performance aircraft: recommendations for management and prevention.

    In high-performance aircraft, the need for total environmental awareness coupled with high-g loading (often with abrupt onset) creates a predilection for cervical spine injury while the pilot is performing routine movements within the cockpit. In this study, the prevalence and severity of cervical spine injury are assessed via a modified cross-sectional survey of pilots of multiple aircraft types (T-38 and F-14, F-16, and F/A-18 fighters). Ninety-five surveys were administered, with 58 full responses. Fifty percent of all pilots reported in-flight or immediate post-flight spine-based pain, and 90% of fighter pilots reported at least one event, most commonly (> 90%) occurring during high-g (> 5 g) turns of the aircraft with the head deviated from the anatomical neutral position. Pre-flight stretching was not associated with a statistically significant reduction in neck pain episodes in this evaluation, whereas a regular weight training program in the F/A-18 group approached a significant reduction (mean = 2.492; p < 0.064). Different cockpit ergonomics may vary the predisposition to cervical injury from airframe to airframe. Several strategies for prevention are possible from both an aircraft design and a preventive medicine standpoint. Countermeasure strategies against spine injury in pilots of high-performance aircraft require additional research, so that future aircraft will not be limited by the human in control.
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keywords = neck
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6/90. Intraosseous calcifying pseudotumor of the axis: a case report.

    STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To present the first case of intraosseous calcifying pseudotumor arising from the axis. SUMMARY OF BACKGROUND DATA: Calcifying pseudotumor is a very rare disease. Only 24 cases have been previously reported. methods: A case of calcifying pseudotumor involving the body, dens, and laminae of the axis in a 60-year-old male patient was managed with total laminectomy of the axis and instrumented occipitocervical fusion, followed by the curettage of the body and dens of the axis and autogenous iliac bone graft. medical records, imaging studies, microscopic findings, and related literature are reviewed. RESULTS: Microscopic examination showed amorphous, basophilic, and chondroid calcifying masses surrounded with palisading histiocytes and foreign body-type giant cells. The findings were consistent with those of calcifying pseudotumors previously reported in other sites of the body. At 24 months after operation, a significant reduction of neck pain was achieved. But there was evidence of local recurrence of the lesion in the body and dens of the axis with a local progression of the preexisting lesion in the facet joints. CONCLUSION: This is the first report of intraosseous calcifying pseudotumor arising from the axis.
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keywords = neck
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7/90. Neonatal cervical osteomyelitis with paraspinal abscess and Erb's palsy. A case report and brief review of the literature.

    An unusual case of pyogenic cervical osteomyelitis is reported in a newborn who immediately after birth had no movements in the left shoulder. There was a fullness in the left cervical region. Left Erb's palsy due to an unrecognized birth trauma was diagnosed in a peripheral hospital. Later, the child developed fever and a significant swelling in the left cervical region. On transfer to our institution, the x-rays of the cervical spine, ultrasound and computed tomography (CT) established the diagnosis of C(6) cervical osteomyelitis and paraspinal abscess which extended to the posterior triangle of the neck. The abscess was drained, and the lamina and lateral mass of the C(6) vertebra were debrided. staphylococcus aureus was grown from the pus. The patient was put on long-term antibiotics to which he responded very well, and he became asymptomatic. In the immediate post-operative period, some movements at the left shoulder were noted, and at 6-month follow-up in the out-patient clinic, the child was virtually normal with near-complete regeneration of the C(6) lamina and lateral mass.
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ranking = 1
keywords = neck
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8/90. Penetrating neck trauma: hidden injuries-oesophagospinal traumatic fistula.

    Injuries to the eosophagus are notoriously difficult to diagnose pre-operatively. patients with such injuries usually will not have pre-operative signs and symptoms to suggest the presence of this type of injury. These injuries require a high index of suspicion, appreciation of the presence of injuries to adjacent structures, and an understanding that the clinical and radiological findings may evolve over a period of time. We describe a child with a rare presentation of an acute traumatic esophageal spinal fistula due to a bullet wound. This complicated injury required a variety of diagnostic modalities, including contrast radiography, multiple computerised tomography (CT) scans and operative assessments to make the definitive diagnosis.
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ranking = 4
keywords = neck
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9/90. Cervical epidural actinomycosis. Case report.

    Cervical actinomycosis causing spinal cord compression is a rare clinical entity. In a review of the literature, the authors found only 13 cases with actinomycosis-related spinal neurological deficit. The authors describe the case of a 26-year-old man who presented with neck pain and partial paresis of the upper limbs. magnetic resonance imaging revealed a long cervical epidural enhancing lesion that extended from C-1 to T-2. The radiological findings resembled metastasis and other epidural infections. The patient was treated medically with penicillin and amoxicillin for 7 months and recovered neurologically. The authors conclude that although cervical epidural actinomycosis is a rare clinical entity resembling metastasis and other infections in this region, it should be considered so that this unique infection can be diagnosed in the least invasive fashion and, whenever possible, unnecessary surgery can be avoided.
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keywords = neck
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10/90. Hematogenous pyogenic facet joint infection of the subaxial cervical spine. A report of two cases and review of the literature.

    Two cases of hematogenous, pyogenic, subaxial cervical facet joint infection are reported, and the literature is reviewed. infection of the cervical facet joint is a rarely diagnosed condition; only one case has been reported in the literature. Lumbar facet joint infections are also rare but more commonly reported. Approximately one fourth of facet joint infections in the lumbar spine are complicated by epidural abscess formation, which can lead to a neurological deficit. Because of the paucity of reports on cervical facet joint infections, the clinical characteristics of this entity are not well known. Both patients presented with an acute onset of unilateral neck pain that radiated into the ipsilateral shoulder. Frank radicular pain was initially absent. Unilateral upper-extremity motor weakness that was attributed to associated epidural abscess or granulation tissue formation was also demonstrated in both patients. leukocyte count and erythrocyte sedimentation rate were elevated in both cases. magnetic resonance imaging was necessary to obtain an accurate diagnosis. staphylococcus aureus was identified as the offending pathogen in both cases. Decompressive surgery and antibiotic therapy were required to cure the condition. One patient recovered completely and the other sustained a permanent motor deficit. Hematogenous cervical facet joint infection is a rare clinical entity that has many characteristics in common with the more-common lumbar homolog. All three reported cases, however, have been complicated by epidural abscess or granulation tissue formation that has led to a neurological deficit. This finding suggests that a facet joint infection in the cervical spine may have a less benign clinical course than that in the lumbar spine.
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keywords = neck
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