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At least 415 records · Page 23Linked to original sources
PubMed2003

Spinal hydatid disease and its neurological complications.

Bone infection is estimated to represent 0.5-2.5% of cases of hydatid disease. Of these cases, the spine is affected in about 50%. 11 cases of histologically confirmed spinal hydatid disease treated surgically in 2 institutions in Spain and Lebanon were followed up clinically and radiologically for an average of 20 y (1-34 y). On presentation, all patients had severe neurological deficits. All patients underwent posterior spinal decompression, curettage, drainage and washout of paravertebral cyst cavities. Over the period of follow-up, patients underwent an average 4.8 spinal surgical procedures. Neurologically, all patients had partial or complete spinal cord lesions. All patients had recurrences and 18% died as a consequence of the disease. Extravertebral dissemination occurred in 82% of the cases, most commonly to the liver.

Adolescent↗
PubMed2002

[Hydrosyringomyelia in demyelinating diseases].

Spinal cord cavitation is a frequent finding in optic neuromyelitis (Devic's syndrome) (DS) but it is also, although rarely, observed in patients with multiple sclerosis (MS). The objective of our study was to compare the MRI characteristics of the syringomyelic cavities in 6 patients with DS and 3 patients with MS. All the patients with DS had a relapsing clinical form with normal brain MRI. Spinal MRI revealed unenhanced central cavities which extended more than 3 vertebral bodies and remained unchanged in follow-up studies. Two patients presented multiple cavities.MS patients suffered a relapsing remitting form of the disease, they all had hyperintense T2 enhancing lesions on their spinal MRI. Moreover spinal MRI also revealed non communicating cavities which extended less than 2 vertebral bodies. Follow-up studies in MS patients revealed a reduction of both the spinal lesions and the cavities. It is still debated whether DS represents a distinct clinical entity different from MS. These findings help distinguishing both disorders in cases when spinal cavities are present and also contribute to the therapeutic choice.

Adult↗
PubMed1990

Simultaneous presentation of upper lobe fibrobullous disease and spinal pseudarthrosis in a patient with ankylosing spondylitis.

A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced thoracic gibbus presented with two simultaneous complications of longstanding ankylosing spondylitis, upper lobe fibrobullous disease, and spinal pseudarthrosis. No neurological sequelae developed and treatment was conservative. Both these lesions mimic tuberculosis, and so it is important to determine them accurately to avoid unnecessary antituberculosis treatment. Both of these complications are reported to occur in longstanding ankylosing spondylitis and their simultaneous presentation may be more common than is realised. This case is believed to be the first such report of their association.

Bone Resorption↗
PubMed2002

[Imaging findings in 122 cases of Pott's disease].

Spinal tuberculosis is a frequent skeletal involvement in tuberculosis. We report 122 cases between 1983 and 1998 of Pott's disease explored by plain radiographies in all cases, CT-scan in 22 cases and MRI in 6 cases. The lesion involved one localization in 98 cases, two localizations in 9 cases and multiple localizations in 15 cases. The usual form associating the discal and vertebral involvement was noted in 70%. Unusual forms were seen in 30% of the cases The localizations were: posterior arch (20 cases), centrosomatic (10 cases), suboccipital (4 cases) and subligamentar (2 cases). In addition, the CT scan noted vertebral lesion with soft tissue abscess in all cases and epidural lesion in 9 cases. MRI performed in 6 cases showed epidural lesions in 4 cases: epiduritis (2 cases) and abscess (2 cases). The disco-vertebral puncture-biopsy, performed in 12 cases, confirmed the diagnosis in 7 cases. The diagnosis of Pott's disease was confirmed biologically in 30 cases. Radiographic exploration of Pott's disease is improved by the contributions of CT and MRI which can identify sequestra, perilesional sclerosis and epidural or soft tissue abscesses. Discovertebral aspiration biopsy provides the key to diagnosis.

Adolescent↗
PubMed1995

Hodgkin's disease with spinal cord compression. A case report and a review of the literature.

BACKGROUND: Spinal cord compression is a rare complication of Hodgkin's disease, occurring in only 5% of cases, usually in the setting of progressive, advanced disease. As the initial symptom of Hodgkin's disease, it is extremely rare, with only a few cases reported in the literature. METHODS: A case report of a 46-year-old man who presented with signs and symptoms of spinal cord compression and was found to have an extradural mass in the cervical and thoracic spine is described. Biopsy revealed Hodgkin's disease. This case report represents a unique case of a patient with Hodgkin's disease presenting with epidural disease, with spinal cord compression as the only apparent site of initial clinical involvement. A review of the literature of patients with Hodgkin's disease presenting with spinal cord compression from 1970 to the present is presented. RESULTS: The patient, whom we report, received chemotherapy followed by external beam radiation therapy and achieved complete resolution of symptoms and a complete response by radiologic criteria. Based on a review of the literature, Hodgkin's disease involving the spinal epidural space is very responsive to radiation therapy and chemotherapy with a good prognosis for both functional recovery (86%), complete response (61%), and long term survival. CONCLUSIONS: Chemotherapy and/or radiation therapy is successful treatment for Hodgkin's disease presenting with spinal cord compression. For the rare patient who presents with spinal cord compression as the initial symptom of Hodgkin's disease, the therapeutic options include chemotherapy alone, radiation therapy alone, or combined modality therapy.

Hodgkin Disease↗
PubMed2004

Acquired spinal cord and peripheral nerve disease.

Acquired spinal cord diseases in ruminants result most commonly from infectious, traumatic, metabolic/nutritional, or toxic causes and rarely from neoplasia. Clinical signs of spinal cord disease depend on the neuroanatomic location of the lesion. Acquired spinal cord diseases including vertebral osteomyelitis/spinal abscess, cauda-equina disease, enzootic ataxia, lymphosarcoma,polyradiculoneuritis, and degenerative myeloencephalopathy are discussed. Acquired peripheral nerve disease in cattle most often is a result of injury, and most commonly only one limb is involved. Peripheral nerve injuries frequently occur secondary to myopathy in recumbent adult cattle. In small ruminants, peripheral nerve injury seems less common, most likely due to their smaller size,but may occur from predator wounds or iatrogenically following intramuscular drug administration. Injury to the brachial plexus and radial, suprascapular, sciatic, femoral, and obturator nerves is discussed.

Animals↗
PubMed1997

Prevalence of spinal disc disease among interventional cardiologists.

A suspected, but undocumented, excess of axial skeletal disease among interventional cardiologists (possibly a consequence of lead apron use) was investigated by comparing questionnaire responses from cardiologists, orthopedic surgeons, and rheumatologists (n = 714). Cardiologists reported more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease (all p <0.01): "interventionalist's disc disease" is a confirmed entity.

Adult↗
PubMed2005

[Surgical treatment of degenerative lumbar diseases].

BACKGROUND: The diagnosis and treatment of painful degenerative spinal diseases remains controversial in the literature, and surgical treatment differs greatly between centres and surgeons. We have evaluated our results over a nine-year period. MATERIAL AND METHODS: 237 patients referred with chronic degenerative spinal diseases could be evaluated, 132 women and 105 men, median age 48 (17 - 85). Median symptom duration was 10 years (1.5 - 50 years). The patient files were retrospectively studied independently by two surgeons. Out of the patients, 83 (35 %) had previously had lumbar spine operations, mainly discectomies. All patients were controlled as outpatients with clinical examination and an X-ray taken of the lower spine columna at least once. The final evaluation of patient satisfaction with the operation, pain and walking and working capacity was based on a questionnaire. RESULTS: Out of these patients, 64 were treated with decompression only, 173 had additional posterolateral fusion with bone or instrument. Fusion rate was 90 %, with no significant difference between type of fusion (p = 0.07). After a median observation time of 5.2 years (0.5 - 10.5 years) 75 % of the patients were very satisfied or satisfied with the outcome; 48 % were back at work. Factors significantly related to poor results were little preoperative pain (p < 0.001), previous back operations (p = 0.003) and long preoperative sick leave (p = 0.015). INTERPRETATION: Our results are comparable with most published studies. One should be restrictive with surgery on patients with little pain, long sick leave, preoperative inactivity, and previous multiple spinal operations.

Adolescent↗
PubMed2006

Diagnosis and management of metastatic spine disease.

Spinal metastases are a significant source of morbidity in patients with systemic cancer. Roughly 30% of patients with cancer develop symptomatic spinal metastases during the course of their illness, and up to 90% of cancer patients possess metastatic lesions within the spine at the time of death with advances in the treatment of systemic disease, survival in such patients has increased. This factor combined with improved imaging modalities will undoubtedly increase the incidence in which spinal metastases are encountered by physicians. In this review, the authors not only attempt to present the myriad ways in which patient with spinal metastases present, but also the means by which they are currently diagnosed and managed. In addition, we propose a simple algorithm to aid in deciding which patients are ideally treated medically and which patients may benefit from surgery.

Antineoplastic Agents↗
PubMed2004

Posterior surgical approaches and outcomes in metastatic spine-disease.

Spinal cord compression represents a major cause of morbidity and suffering in cancer patients. Surgery should be considered a form of primary therapy in many of these patients. The goals of surgery and the approach used are functions of a number of variables, including the surgeon's preference, the location of disease within the spine (cervical, thoracic, or lumbar),the extent of disease within each vertebra, the number of levels affected, and the patient's medical health and overall prognosis. Currently,the goals of any major debulking surgery are to decompress the spinal cord, prevent local recurrence, reconstruct the spine, and provide immediate stabilization with the use of fixation devices. Posterior approaches, starting with the decompressive laminectomy, have traditionally been the most common surgical procedures for metastatic spine disease. The laminectomy should only be used for disease isolated to the dorsal spine without evidence of concomitant instability. A laminectomy combined with instrumentation has been shown to provide superior results but should be reserved for those patients who cannot tolerate or would not benefit from more aggressive surgery. Various posterolateral approaches have been devised to access more ventrally placed lesions. These include the transpedicular approach, the costotransversectomy, and the lateral extracavitary/parascapular approach. Each of these allows adequate spinal cord decompression anteriorly and posteriorly and the ability to reconstruct and stabilize with acceptable peri-operative risk. It must be remembered that surgery for this disease is almost always palliative.Thus, surgery should be a means to maximize the patient's quality of life while minimizing the risk of suffering surgical complications.

Decompression, Surgical↗
PubMed1990

Colorectal disease in spinal cord patients. An occult diagnosis.

Undiagnosed abdominal emergencies account for 10 percent of all fatalities among patients with spinal cord injuries. A large number of these emergencies involve the lower gastrointestinal tract. The purpose of this study is to bring attention to the occult nature of colorectal disease in spinal cord patients and to highlight the subtle, but characteristic, symptoms and signs that develop in these patients. The authors identified 13 spinal cord patients in whom a lesion developed in either the appendix, colon, rectum, or anus. The average age of all patients was 36.2 years. Trauma and multiple sclerosis were the most common etiology of spinal cord injury. The most common presenting symptoms were abdominal distention, vomiting, and constipation. The average delay in diagnosis of the colorectal disease was 35.8 hours. An 84% morbidity and 22% mortality were observed. This study indicates that any deviation from the normal lifestyle of the spinal cord patient should alert one to the possibility of visceral inflammation. Furthermore, close attention to the signs of autonomic dysreflexia or changes in spasticity, along with a thorough evaluation of the ill-appearing spinal cord patient, may uncover occult colonic or rectal disease.

Adolescent↗