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At least 343 records · Page 19Linked to original sources
PubMed1996

Embolization as treatment for spinal cord compression from renal cell carcinoma: case report.

OBJECTIVE AND IMPORTANCE: Metastatic renal cell carcinoma may involve the vertebrae, resulting in acute spinal cord compression. Embolization has been used to reduce operative blood loss during surgical decompression, but it has not been considered as an alternative that may eliminate the need for open debulking. CLINICAL PRESENTATION: A case is presented of a 30-year-old woman with renal cell carcinoma who developed increasing severe back pain, lower extremity weakness, and sensory loss. Magnetic resonance evaluation revealed a T5 metastasis, resulting in significant spinal cord compression. INTERVENTION: Transarterial embolization was performed with polyvinyl alcohol particles and platinum microcoils. One month after embolization, the patient's lower extremity strength and sensation had improved, and magnetic resonance imaging demonstrated a dramatic response with a significant reduction of cord compression. She deteriorated again 4 months later, and a new sacral mass was embolized. She again improved after treatment. CONCLUSION: This report illustrates that embolization may be used as palliative treatment for spinal cord compression and obviate the need for open surgical decompression.

Adult↗
PubMed2006

Spinal cord compression in a patient with a pain pump for failed back syndrome: a chalk-like precipitate mimicking a spinal cord neoplasm: case report.

OBJECTIVE AND IMPORTANCE: The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump. CLINICAL PRESENTATION: We report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain. INTERVENTION: Magnetic resonance imaging revealed impingement on the thoracic cord by a mass. The mass was originally thought to be a spinal cord tumor; however, operation and chemical analysis of the mass showed that it was a bupivacaine precipitate at the tip of the catheter of the pain pump. CONCLUSION: This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.

Aged↗
PubMed1993

[Reversible spinal cord compression caused by extramedullary hematopoietic foci in thalassemia].

A now 42-year-old Thai woman was known to have been anaemic since childhood. When aged 33 years she was diagnosed as having beta zero/HBE thalassaemia. Computed tomography demonstrated a tumour in the posterior mediastinum, histologically found to be an extramedullary haematopoietic focus. Subcutaneous infusion of deferoxamine (2 g five times weekly), initiated because of massive iron overload, reduced the serum ferritin level from 3,460 ng/ml to less than 500 ng/ml. The haemoglobin level in the subsequent years was between 6 and 8 g/dl. Five years later sensory deficits were noted from the 5th thoracic vertebra downwards. Magnetic resonance imaging demonstrated a tumour which compressed the spinal cord: it, too, was an ectopic haematopoietic focus. The neurological symptoms disappeared after radiotherapy with 3,000 cGy, but they recurred 4 years later. Because of the low radiation reserve of the spinal cord, hypertransfusion treatment was initiated, namely 16 RBC concentrates within 4 months and afterwards two transfusions every 3 months. By this means the haemoglobin level was kept at about 9 g/dl. The tumour had regressed 4 months after onset of treatment. For 2 years since the beginning of the hypertransfusion treatment the patient has remained free of neurological symptoms.

Adult↗
PubMed2002

Metastatic spinal cord compression of testicular yolk sac tumor.

INTRODUCTION: Pediatric testicular tumors are rare. Spinal metastasis of testicular yolk sac tumor (YST) is extremely rare, with only one reported case. CASE REPORT: We report a rare case of metastatic spinal cord compression of testicular YST in a 14-month-old boy who presented with progressive paraparesis and neurological bladder dysfunction. Two months prior to admission, he underwent a left radical orchiectomy for YST of the testis. Magnetic resonance imaging revealed severe spinal cord compression by the ventral epidural mass from T-9 to T-11 and at S-3. Emergency surgical resection was performed for tissue diagnosis and spinal decompression. Histopathological features of the epidural mass indicated metastasis of the testicular YST. CONCLUSION: Although spinal involvement with metastatic YST is rare, it must be considered in children with testicular YST exhibiting evidence of pain or weakness, and surgical decompression followed by adjuvant chemotherapy should not be delayed.

Decompression, Surgical↗
PubMed2000

Mucopolysaccharidoses and spinal cord compression: case report and review of the literature with implications of bone marrow transplantation.

OBJECTIVE AND IMPORTANCE: We present a patient with mucopolysaccharidosis with spinal cord compression, and we review previously published cases. This is the first published case of a patient with mucopolysaccharidosis with spinal cord compression who has undergone bone marrow transplantation. CLINICAL PRESENTATION: A 2-year-old patient with Hurler syndrome underwent bone marrow transplantation. Although the bone marrow transplantation improved many of the systemic effects of Hurler syndrome, the patient presented at 8 years of age with a cervical myelopathy. Magnetic resonance imaging revealed soft tissue compression of the upper cervical cord. The literature review demonstrates that spastic tetraparesis, secondary to cervical cord compression, is the most common presentation of this subgroup of patients. INTERVENTION: A suboccipital craniectomy and C1-C5 laminectomy and decompression with duraplasty were performed. Pathological examination of compressive soft tissue and lamina was consistent with mucopolysaccharidosis. Postoperatively, the patient showed substantial improvement in neurological function. CONCLUSION: Mucopolysaccharidoses can induce a compressive "metabolic myelopathy." Decompressive procedures have shown significant improvement in neurological function in the majority of patients without spinal instability. Bone marrow transplantation may allow more patients with mucopolysaccharidoses to survive long enough to require neurosurgical treatment in the future. The effect of bone marrow transplantation on the prevention of spinal cord compression is unclear.

Bone Marrow Transplantation↗
PubMed2002

Cervical osteochondroma as a cause of spinal cord compression in a patient with hereditary multiple exostoses: Computed tomography and magnetic resonance imaging findings.

Spinal cord compression is a rare but extremely serious complication of hereditary multiple exostoses (HME). Imaging of the spine is important for surgical planning and follow up. We present CT and MR findings in a male patient with HME who developed spinal cord compression from a cervical osteochondroma. Complete recovery was achieved following surgery.

Cervical Vertebrae↗
PubMed1998

Spinal cord compression caused by thoracic vertebral hemangioma involving only the posterior elements of two contiguous vertebrae.

An unusual case of symptomatic thoracic vertebral hemangioma involving two contiguous vertebrae but confined to the posterior elements is presented. The lesion displaced and compressed the cord. The diagnosis was not considered prior to biopsy. There was uncontrolled bleeding at biopsy. Only partial surgical resection was performed, with incomplete relief of motor weakness after initial surgery. The patient refused further surgical resection. Motor power was gradually recovered after a course of postoperative radiotherapy.

Hemangioma, Capillary↗
PubMed1988

Spinal cord compression by epidural lipomatosis in juvenile rheumatoid arthritis.

Two cases of spinal cord compression secondary to steroid-induced epidural lipomatosis in systemic juvenile rheumatoid arthritis (JRA) patients are reported. This complication of prolonged corticosteroid therapy has not been described previously in children with JRA. Epidural lipomatosis should be considered in the differential diagnosis of JRA patients receiving high-dose and/or prolonged corticosteroid therapy who present with neurologic signs and symptoms referable to the spinal cord.

Adrenal Cortex Hormones↗
PubMed1985

Spinal cord compression due to postoperative cervical pseudomeningocele.

A case of spinal cord compression due to postoperative cervical pseudomeningocele is reported. A 63-year-old man had undergone osteoplastic laminectomy of the C-3 through C-6 laminae for quadriplegia after a traffic accident 1 year and 4 months earlier. Computer-assisted tomography with metrizamide injection showed a pseudomeningocele in the paraspinous area at the C-3 through C-6 level.

Humans↗
PubMed1993

Spinal cord compression in breast cancer: a review of 70 cases.

Spinal cord compression (SCC) is a relatively uncommon but frequently disabling complication of metastatic breast cancer. We have conducted this retrospective study of 70 patients with SCC secondary to breast cancer with the aims of determining risk factors for its development and predictors of outcome. Median age at diagnosis of breast cancer was 51 years with median time to SCC 42 months. All patients had radiological evidence of bone metastases at the time of SCC, and only five were not known to have bone metastases prior to SCC. The most frequent symptom of SCC was motor weakness (96%) followed by pain (94%), sensory disturbance (79%) and sphincter disturbance (61%). Ninety-one percent of patients had at least one symptom for more than a week. Radiotherapy (RT) was given as primary treatment in 43 cases, whilst 21 had decompressive surgery and seven of these went onto have postoperative radiotherapy. Six patients were deemed too unwell for either modality. Following treatment, 96% of those who were ambulant before therapy maintained the ability to walk. In those unable to walk, 45% regained ambulation, with RT and surgery being equally effective. Median survival following SCC was 4 months, with no significant difference between those treated by RT or surgery. The most important predictor of survival was ability to walk after treatment, followed by time from diagnosis of breast cancer to SCC. We conclude that the majority of patients have warning symptoms of SCC and that nearly all will have evidence of spinal bone metastases before compression occurs. The results suggest that earlier diagnosis and intervention could improve outcome. There was no evidence of benefit from surgery over radiotherapy as primary treatment, survival in both treatment groups being poor.

Adult↗
PubMed1991

[Treatment of spinal cord compression caused by malignant disease].

Patients suffering from metastatic spinal cord compression can be treated with decompressive surgery and/or radiotherapy. The best treatment regimen remains to be established. In the present paper we report our experience of a therapeutic regimen with main emphasis on radiotherapy, but where selected patients were treated with laminectomy followed by radiotherapy. 67 patients were treated during a two year period, 60 with radiotherapy as the sole treatment modality. The ambulation rate after treatment was 56.7%. Degree of loss of neurological function before treatment and tumour histology were prognostic factors for a successful outcome, defined as the patient's ability to walk after treatment. We emphasize the importance of starting treatment before development of advanced neurological deficits.

Adolescent↗
PubMedDate not supplied

Spinal epidural malignant lymphoma presenting with spinal cord compression.

Malignant lymphoma initially presenting with symptoms and signs of spinal cord compression are a rare occurrence. We present 20 cases of spinal epidural lymphoma first diagnosed on laminectomy biopsy specimens with a review of clinical data and histology, as well as an immunohistochemical study to determine the immunophenotype of these lymphomas. Eighteen cases were typed as B cell lymphomas, 2 as T cell lymphomas.

Adolescent↗
PubMed1996

Spinal cord compression from metastatic Leydig's cell tumor of the testis: case report.

A case of spinal cord compression from metastatic Leydig's cell tumor of the testis is presented. This 67-year-old man exhibited paraparesis and neurogenic bladder dysfunction secondary to a spinal epidural mass at the T5 level as the initial manifestation of his cancer. Surgical resection was undertaken for tissue diagnosis and spinal cord decompression. The histopathological features of the epidural mass and the excised left testicle were identical, indicative of Leydig's cell carcinoma. The literature is reviewed for previous experience with this exceedingly rare tumor. Unlike most metastatic spinal malignancies, radiation therapy is an ineffectual treatment modality for this tumor. Surgical resection is the only therapeutic option available for amelioration of spinal cord compression.

Aged↗
PubMedDate not supplied

Spinal cord compression related to vertebral osteonecrosis.

The authors report 3 cases of spinal cord compression by vertebral collapse related to osteonecrosis. Two patients needed surgical decompression permitting pathological diagnosis. In the third case, osteonecrosis was ascertained by radiological evidence of an intravertebral vacuum phenomenon. Three etiologic factors were noticed: osteoporosis, corticotherapy, and radiotherapy. The relative frequency of neurologic complications in vertebral collapse related to osteonecrosis compared to those observed in osteoporosis is discussed.

Aged↗