Cases reported "Spinal Stenosis"

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21/256. 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.
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22/256. Lumbar epidural blocks: a case report of a life-threatening complication.

    A case of life-threatening complication resulting from a lumbar epidural block is presented. A 70-year-old woman with spinal stenosis developed cardiac and respiratory arrest 5 minutes after receiving a lumbar epidural block containing 80 mg of triamcinolone acetonide and 6mL of 1.5% lidocaine. The patient received cardiopulmonary resuscitation and recovered without any sequelae. It is suggested that this complication was caused by subdural or intravascular injection of local anesthetics. It might be preventable by injecting a test dose of local anesthetics before injecting a full dose of local anesthetics and by using fluoroscopy.
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23/256. Acute cauda equina syndrome caused by a gas-containing prolapsed intervertebral disk.

    Gas production as a part of disk degeneration can occur, but it rarely causes clinical nerve compression syndromes. A rare case of gaseous degeneration in a prolapsed lumbar intervertebral disk causing acute cauda equina syndrome is described. Radiologic features and intraoperative findings are reported. A 78-year-old woman with severe lumbar canal stenosis had acute cauda equina syndrome. magnetic resonance imaging revealed a large disk protrusion, and she underwent an urgent operation for this. Surgery confirmed the severe lumbar canal stenosis, but the disk prolapse contained gas that had caused the nerve compression.
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24/256. Cervical stenosis secondary to rhizomelic chondrodysplasia punctata.

    Rhizomelic chondrodysplasia punctata (RCDP) is a rare peroxisomal disorder leading to multiple developmental malformations, including skeletal deformity. Specifically, involvement of the vertebral bodies has been described. Presented here is a case of a two-year-old female child with RCDP leading to advanced cervical stenosis as detected on magnetic resonance imaging (MRI) studies of the cervical spine. The practicing clinician should be aware of the possibility of cervical stenosis secondary to RCDP and its impact on the management of the patient with this rare disease process. copyright Wiley-Liss. Inc.
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25/256. Unilateral psoas abscess following posterior transpedicular stabilization of the lumbar spine.

    A case of unilateral psoas abscess in a 58-year-old patient, shortly after posterior lower spine stabilization and fusion for spinal stenosis using transpedicular spine fixation is reported. The diagnosis was delayed because the patient's symptoms were referred to the thigh and the plain roentgenograms were negative for pathology. The technetium scintigram and computed tomography (CT) helped localization, diagnosis and treatment of the psoas abscess. Percutaneous CT-guided drainage was followed by recurrence of the abscess, and open surgical evacuation was performed successfully in combination with antibiotic treatment for 8 weeks. psoas abscess should always be suspected when recurrent pain is associated with fever and elevated erythrocyte sedimentation rate after instrumentation of the lumbar spine. Hardware of a low profile and volume should be used to decrease dead space in the fusion area, and the volume of bone substitutes should be limited for the same reason.
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26/256. Sterile, benign radiculitis associated with lumbosacral lateral recess spinal canal stenosis: evaluation with enhanced magnetic resonance imaging.

    Two cases of symptomatic lumbar lateral recess stenosis are described in which the compressed nerve root became focally enhanced on magnetic resonance imaging (MRI) studies performed with gadolinium dtpa. Two men with low back pain and lumbar radiculopathy were examined with contrast-enhanced MRI studies, which showed intradural enhancement of the symptomatic nerve roots. In selected cases of lateral recess stenosis, focal radicular injury may be visualized on enhanced MRI as a result of a breakdown of the blood-brain barrier.
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27/256. Cervical myelopathy and congenital stenosis from hypoplasia of the atlas: report of three cases and literature review.

    STUDY DESIGN: case reports of patients with cervical myelopathy to hypoplasia of the atlas. OBJECTIVES: To report cases of cervical myelopathy due to congenital hypoplasia of the atlas and to review the literature. SUMMARY OF BACKGROUND DATA: Six previously documented cases of congenital hypoplasia of the atlas as a cause of cervical myelopathy are reported in the literature. methods: Three patient's clinical record and radiologic imaging studies as well as a thorough literature search are reported. Plain radiographs, computed tomography scans, magnetic resonance images, as well as somatosensory-evoked potential changes are displayed. RESULTS: Cervical myelopathy developed in three patients who were found to have congenital hypoplasia of the atlas. laminectomy of C1 provided neurologic improvement in all three patients presented. CONCLUSION: Congenital hypoplasia of the atlas is a rare cause of cervical myelopathy. This report should broaden the radiographic differential diagnosis when seeking an explanation for the signs and symptoms of cervical myelopathy.
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28/256. 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.
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29/256. Sudden sensorineural hearing loss after spinal surgery under general anesthesia.

    Two patients, ages 72 and 71, who underwent lumbar decompressive surgery for spinal stenosis, were evaluated for postoperative sudden sensorineural hearing loss (SSHL). After two uncomplicated spinal procedures, both patients developed SSHL immediately after surgery. hearing loss was moderate to profound in these two patients. None of the patients had a significant otologic history. nitrous oxide administration, Valsalva maneuvers during general anesthesia, and transient drops in cerebrospinal fluid pressure stemming from spinal decompression may, in some combination, lead to an implosive force on the inner ear, causing SSHL. Further causes of postlumbar surgery SSHL may include microemboli or viral infections. SSHL is a rare but possible complication after nonotologic, noncardiac bypass surgery; only 26 cases of SSHL after this surgery have been reported. We encourage the continued reporting of sudden sensorineural hearing loss after spinal surgery.
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30/256. Extended posture of lumbar spine precipitating cauda equina compression arising from a postoperative epidural clot.

    We report a patient with nonoperatively treated acute cauda equina compression arising from an epidural clot that developed after decompressive surgery for lumbar canal stenosis. A 43-year-old woman underwent lumbar laminotomy, and was symptom-free for 3 hours; but this was followed by paresis. Postoperative myelography showed obstruction of the contrast column at the level of the laminotomy; this was relieved by hyperflexion of the lumbar spine. With sustained hyperflexion of the lumbar spine, all neurologic deficits were completely resolved within 5 days. Lumbar lordosis may be present when a patient lies in the supine position on a flat bed with the hips and knees extended; this may exacerbate dural constriction caused by an epidural clot following posterior lumbar spinal surgery.
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