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At least 757 records · Page 42Linked to original sources
PubMed1998

Correlation between spinal cord compression and abnormal patterns of median nerve somatosensory evoked potentials in compressive cervical myelopathy: comparison of surface and epidurally recorded responses.

To investigate the correlation between the level of spinal cord lesion and the abnormal pattern of median nerve somatosensory evoked potentials (SSEPs), evoked spinal cord potentials (ESCPs) were also recorded from the posterior epidural space intraoperatively in 18 patients with compressive cervical myelopathy. Levels of symptomatic spinal cord compression were determined by ESCP findings. Spinal N13 potential of the SSEPs was recorded from the surface of the posterior neck with anterior neck reference. Brainstem P14 and cortical N20 potential were recorded from the parietal scalp contralateral to the stimulated side. Spinal N13, P14, and N20 potentials were all normal when the ESCPs were abnormal at localized segmental region (C4-5 or C5-6 level alone). Spinal N13 potential was significantly attenuated in all of patients with abnormal ESCP findings at widespread segmental area of the median nerve territory. In four of these seven patients, brainstem P14 potential was also prolonged or diminished, but three patients showed normal P14 and N20 potentials. Isolated P14 abnormality with normal spinal N13 potential was characteristic in patients with abnormal ESCP at the C3-4 lesion. Although sensitivity of abnormal ESCP was higher than that of the SSEPs, abnormal patterns of spinal N13, P14 and N20 potentials following median nerve stimulation were useful in detecting not only the pathology (posterior horn and/or posterior column) but also symptomatic spinal compression level in compressive cervical myelopathy.

Adult↗
PubMed1995

Metastatic paraganglioma causing spinal cord compression.

SUMMARY OF BACKGROUND DATA: Paragangliomas are neoplasms that arise from the autonomic nervous system-associated paraganglia. Most often they are benign tumors. However, infrequently they have been reported to metastasize. Involvement of the spine is rare and usually is intradural at the level of the cauda equina. OBJECTIVES: The authors report two cases of metastatic paraganglioma to the spine, both of which resulted in myelopathy from extradural spinal cord compression. Also provided is a review of the literature. CONCLUSIONS: Paragangliomas rarely metastasize to the spine. Management of the two reported patients involved spinal cord decompression followed by spinal stabilization procedures. Long-term ambulatory status was maintained in both patients. Radiation therapy may be an important adjunctive treatment after surgical removal of these tumors.

Adult↗
PubMed1986

Spinal cord compression as the first presentation of lymphoma--a review of 15 cases.

Fifteen cases are described in which the first presentation of lymphoma was acute spinal cord compression. Lymphoma was diagnosed in laminectomy biopsy specimens using a combination of conventional histological techniques and immunohistochemistry. The patients were predominantly middle-aged or elderly men, some of whom were subsequently shown to have disseminated lymphoma. In other cases, however, the disease was apparently localized to the spine. The tumours consisted of 11 B-cell diffuse follicle centre cell lymphomas, three T-cell lymphomas and one lymphoblastic lymphoma. Following treatment, generally by laminectomy and radiotherapy, some patients have made good recoveries, especially where the disease was localized in the spine.

Adult↗
PubMedDate not supplied

Thoracic vertebral hemangioma with extradural extension and spinal cord compression. Case report.

A 45-year-old man presented with progressive numbness of lower extremities and unsteady gait. Magnetic resonance imaging of the dorsal spine demonstrated multiple hyperintense inactive vertebral hemangiomas on T-1 weighted images. There was an active hemangioma involving D7 vertebral body and neural arch with epidural extension and spinal cord compression. He underwent embolization of the main feeders of the lesion and subsequent surgery. The patient's symptoms resolved after treatment. The clinical, magnetic resonance imaging findings, and treatment of this condition are discussed.

Angiography↗
PubMedDate not supplied

Metastatic thyroid carcinoma presenting as distal spinal cord compression.

The prognosis of metastatic thyroid carcinoma is dependent on the age of the patient, the histologic characteristics of the neoplasm, and the site of metastasis. A more favorable prognosis is found in patients less than 40 years old with follicular carcinoma and without any bony metastases. Metastatic thyroid carcinoma presenting as distal spinal cord compression is extremely rare. We report one such case and review the literature. As reported in the literature, the combination of decompressive laminectomy followed by total thyroidectomy and radioactive iodine therapy has proved to be effective in the treatment of patients with thyroid carcinoma metastatic to the distal vertebral bodies.

Carcinoma, Papillary↗
PubMed1991

Spinal cord compression from a thoracic paraganglioma: case report.

A 34-year-old man with a 4-month history of midthoracic back pain sought treatment for a recent onset of lower extremity paresthesia and stiffness. A myelogram and computed tomographic myelogram disclosed an extradural block at the level of the 8th thoracic vertebral body with involvement of the pedicles, lamina, and spinous process. A posterior decompression of the spinal cord with subtotal resection of a highly vascular tumor was performed. The tumor was identified as a paraganglioma. In a second stage, the remainder of the tumor was embolized preoperatively, and gross total excision and sequential stabilization of the spine with a Luque rectangle and sublaminar wires were performed. The patient has been symptom free and without signs of a recurrence in the spine for over 13 months. A large abdominal paraganglioma was recently resected from its probable origin from the adventitia of the abdominal aorta.

Abdominal Neoplasms↗
PubMedDate not supplied

A case of spinal cord compression by extramedullary haemopoiesis in a thalassaemic patient: a putative role for hydroxyurea?

We report a case of homozygous beta thalassaemia who developed chronic paraparesis due to spinal cord compression by paravertebral extramedullary masses. Our patient was successfully treated with hypertransfusion and hydroxyurea. This drug in addition to its well-known cytostatic effects, may be a good alternative in conditions analogous to our case. This action of hydroxyurea can also be attributed to its favourable effect on foetal haemoglobin production.

Adult↗
PubMed1991

Beta 2 microglobulin-related amyloidosis causing atlantoaxial spondylarthropathy with spinal-cord compression in haemodialysis patients: detection by MRI.

Bone destruction due to beta-2 microglobulin (beta 2-M)-related amyloid deposition is becoming more frequently observed in long-term haemodialysis patients. We report five cases in an unusual site, the upper cervical spine. All patients had been on haemodialysis for more than 13 years and presented with progressive spinal-cord involvement in the region of the first and second cervical nerves. While conventional X-rays and CT scans showed only minor vertebral destruction, MRI disclosed a tumour-like mass within the upper spinal canal, best seen with long TR gradient recalled images. One patient required urgent surgical intervention because of severe spinal-cord compression, and the material was shown to be typically beta 2-M-related amyloid.

Adult↗
PubMed2004

Intraosseous malignant peripheral nerve sheath tumor (MPNST) of the thoracic spine: a rare cause of spinal cord compression.

OBJECTIVE: To describe the management of a patient presenting with intraosseous MPNST of the thoracic spine causing cord compression. SUMMARY OF BACKGROUND DATA: Malignant peripheral nerve sheath tumors (MPNST) are uncommon tumors of cells of peripheral nerve sheath origin. MPNST typically present as an enlarging mass originating from a peripheral nerve root in the trunk, extremities, and head and neck region. METHODS.: A 59-year-old woman presented with midthoracic back pain, paraparesis, and a T4 sensory level. Magnetic resonance image scan revealed a large enhancing and destructive lesion at the T3 level with cord compression. RESULTS: Decompressive laminectomies, tumor debulking, and instrumentation was performed from a posterior approach. At surgery, the lesion was noted to originate from the T3 vertebral body, and separate from the dura and spinal nerve roots. Surgical excision was incomplete and the spine was stabilized with a Ti frame. MPNST was confirmed histologically. Despite adjuvant radiotherapy, she developed metastatic deposits in the spine and femur. CONCLUSIONS: Intraosseous MPNST causing spinal cord compression has not been described as yet and should be added to the differential diagnosis of primary bone tumors causing cord compression. Prognosis with MPNST can be poor, especially in patients with large tumors, undergoing subtotal surgical resection and in association with neurofibromatosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Intradural, extramedullary spinal cord compression from tuberculous granuloma.

A 19-year-old girl presented with acute cord compression following treatment for tuberculous meningitis. Magnetic resonance imaging showed a posterior compressive lesion between T1 and T4. At laminectomy, an intradural extramedullary tuberculous granuloma was excised. To our knowledge, this is the first report of spinal cord compression occurring from a subdural tuberculous mass.

Adult↗
PubMed1999

A case of spinal cord compression syndrome by a fibrotic mass presenting in a patient with an intrathecal pain management pump system.

A 45-year-old woman presented with increasing low back pain, progressive anesthesia in her lower extremities and difficulty ambulating. She had a history of chronic low back pain problems for which, 26 months earlier, she had an intrathecal infusion pump permanently placed for pain and spasm control. Urgent magnetic resonance imaging (MRI) of the lumbar spine revealed a mass at the site of the tip of the intrathecal catheter with high grade spinal cord compression at the level of L-1. At surgical laminectomy the compressing lesion was found to be a reactive tissue fibroma. As more patients receive these devices the physician should consider cord compression syndrome in patients presenting with symptoms of increasing low back pain, anesthesia and progressive proprioceptive loss.

Anesthesia, Spinal↗
PubMed1992

Vertebral hemangioma causing spinal cord compression during pregnancy.

Hemangiomas of bone are extremely common vascular tumors that are most commonly discovered as incidental findings in the vertebral column. Infrequently, these benign lesions may cause local or radicular pain and neurologic deficits, from myeloradiculopathy to paralysis. This report describes the occurrence of a symptomatic vertebral hemangioma during pregnancy, in order to illustrate current methods for diagnosis and treatment of these lesions when associated with spinal cord compression. The possible mechanisms by which they may become symptomatic during pregnancy are reviewed.

Adult↗
PubMed2001

A prospective study of factors predicting clinically occult spinal cord compression in patients with metastatic prostate carcinoma.

BACKGROUND: The objective of this study was to identify clinical parameters that predict occult subarachnoid space or spinal cord (SAS/SC) compression, as determined by magnetic resonance imaging (MRI), in patients with metastatic prostate carcinoma. METHODS: A prospective study was performed in which 68 patients with bone metastases from prostate carcinoma and a normal neurologic examination underwent MRI of the entire spine after documentation of clinical, X-ray, and bone scan parameters potentially predictive of occult SAS/SC compression. RESULTS: Occult SAS/SC compression was diagnosed in 22 patients (32%) using MRI. Nine patients (13%) had compressions at two discontinuous spinal levels. Extensive disease on bone scan, the duration of continuous hormonal therapy prior to study entry, and hemoglobin concentration were found to predict SAS/SC compression by univariate analysis. The extent of disease on bone scan and the duration of continuous hormonal therapy were independent predictors of SAS/SC compression by multivariate analysis (P = 0.02 and P = 0.04, respectively). The risk of occult SAS/SC compression increased from 32% to 44% in patients with a bone scan that showed > 20 metastases as the duration on hormones increased from 0 to 24 months. The risk in patients with fewer metastases increased from 11% to 17% over the same interval. The presence or absence of back pain was not predictive of SAS/SC compression. CONCLUSIONS: Patients who are at high risk for occult SAS/SC compression can be identified using clinical parameters and readily available diagnostic tests. These high-risk patients should undergo MRI screening with the aim of diagnosing and treating spinal cord compression before the development of neurologic deficits that may be irreversible.

Aged↗
PubMed1999

Upregulation of tumor necrosis factor alpha transport across the blood-brain barrier after acute compressive spinal cord injury.

Tumor necrosis factor alpha (TNF) is a cytokine that is involved in the inflammatory process after CNS injury and is implicated in neuroregeneration. A saturable transport system for TNF located at the blood-brain barrier (BBB) is responsible for the limited entry of TNF from blood to the CNS in normal mice. After partial disruption of the BBB by compression of the lumbar spinal cord, permeability to TNF was increased not only in the lumbar spinal cord but also in brain and distal spinal cord segments, where the BBB remained intact. The increase in the entry of TNF to the CNS followed a biphasic temporal pattern, with a first peak immediately after injury and a second peak starting on day 3; these changes lasted longer than the mere disruption of the BBB. The increased entry of TNF was abolished by addition of excess unlabeled TNF, showing that the transport system for TNF remained saturable after spinal cord injury (SCI) and providing evidence that the enhanced entry of TNF could not be explained by diffusion or leakage. This study adds strong support for our concept that the saturable transport system for TNF across the BBB can be upregulated in the diseased state, and it suggests that the BBB is actively involved in the modulation of the processes of degeneration and regeneration after SCI.

Animals↗