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[Incipient spinal cord compression syndrome due to a herniation of calcified intervertebral disk in a young girl].

Intervertebral disc calcification in childhood is rare. Calcifications are discovered by occasion during routine examinations of healthy children or evoke symptoms like neck and shoulder pain or discrete neurological symptoms. The prognosis of nearly all patients is excellent. We report on a 11-year-old girl, who suffered from acute pain in the neck and the left shoulder with increasing paresthesias of her left extremities which led to hospitalisation. Intervertebral disc calcifications were found between several cervical and thoracic vertebra. The only paraclinical finding was an elevated erythrocyte sedimentation rate. After 12 days of conservative and analgetic treatment the clinical condition deteriorated with acute worsening of the neck pain. The MRI revealed a posterior herniation of a calcified disc between the lower cervical spine with spinal cord compression. Immediate neurosurgical intervention led to decompression and disappearance of the symptoms. After 14 months the clinically healthy child only showed the persistence of one intervertebral disc calcification and a complete resolution of the former findings.

Calcinosis↗

Spinal cord compression caused by the rod of a Harrington instrumentation device: a late complication in scoliosis surgery.

We report a unique complication caused by the rod of a Harrington instrumentation device, which resulted in spinal stenosis and myelopathy. A literature review revealed no previous causes of direct spinal cord impingement caused by the rod of a Harrington device. In this case, years after the initial operation, the rod penetrated the lamina at the junction between a thoracic and a lumbar curve, causing spinal stenosis and myelopathy. We conclude that regular control of the position of the device and awareness of possible late neurological complications are necessary to identify such complications as early as possible.

Female↗

Indomethacin and dexamethasone treatment in experimental neoplastic spinal cord compression: Part 2. Effect on edema and prostaglandin synthesis.

Edema formation and prostanoid production (prostaglandin E2 (PGE2), thromboxane B2 (TXB2), and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) were studied in a model of neoplastic epidural cord compression (NSCC) in rats harboring a thoracolumbar tumor. Tumor-free and tumor-bearing animals were randomized for three treatments at 12-hour intervals with saline, dexamethasone (10 mg/kg i.p.), or indomethacin (10 mg/kg i.p.). Increase in water content was observed only in the compressed lumbar cord segments of paralyzed rats; the cervical and thoracic segments did not differ from controls. The rate of release of prostaglandins was evenly distributed along the spinal segments in tumor-free rats. In tumor-bearing rats, a consistent significant increase in PGE2 production was found in the compressed lumbar segment in the presence of neurological dysfunction: early (limp tail), P less than 0.05; paraplegia, P less than 0.001. A significantly elevated PGE2 synthesis preceded the increase in water content by 2 to 3 days. A 2-fold increase in TXB2 was detected in only one of three experiments, and synthesis of 6-keto-PGF1 alpha was elevated to 4 times the normal value (P less than 0.005) in two of three experiments. Dexamethasone failed to inhibit prostaglandin synthesis in the spinal cord of normal controls or paralyzed rats, whereas in nonneural tissues (liver, uterus) it reduced synthesis of the three metabolites by at least 50%, thus demonstrating a differential effect on central nervous system (CNS) vs. non-CNS tissues. Dexamethasone also failed to reduce the increased water content of the compressed segments.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗

Anterolateral decompression for traumatic spinal cord compression.

Nine patients with traumatic fractures of dorsolumbar spine leading to pain and neurological deficit are presented. All had radiological evidence of spinal cord or quada equina compression, with either monoparesis, paraparesis or sphincter dysfunction alone. All patients underwent anterolateral decompression through a transpleural or retroperitoneal approach. Seven patients had bone grafting and spinal stabilization with Webb-Morley system. Two patients had decompression only. The results were favourable. This approach is safe and effective and allows early mobilization and functional recovery.

Adult↗