Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Spinal Cord Compression”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,549 records · Page 86Linked to original sources
PubMed1987

Operative treatment of thoraco-lumbar metastases, using methylmetacrylate and Kempf's rods for vertebral replacement and stabilization. Report of 15 cases.

The authors report their experience in the treatment of 15 cases in thoracolumbar metastases with spinal cord compression. A decompressive laminectomy was routinely performed and followed by a transversoarthropediculectomy. Most part of the neoplastic tissue was removed from the epidural space, vertebral body and retroperitoneal or retro-pleural areas. Complete decompression of the nervous elements was always achieved. Stabilization was obtained by replacement of the neoplastic vertebral body with a methylmetacrylate prothesis and eventually by Kempf's compression instrumentation. The surgical treatment was completed in a single stage operation, by a classical posterolateral approach. Orthopaedic, neurologic and oncologic advantages of this treatment are discussed.

Female↗
PubMed1986

Computed tomography in spinal hemangioma with cord compression. Report of two cases.

Two teenagers with spinal cord compression due to a thoracic vertebral hemangioma are presented. Myelography showed a complete block in both patients. Selective intercostal arteriography was normal or non-conclusive. Only computed tomography (CT) gave precise information about the extent and nature of the compressive lesion. In the first case it showed angiomatous involvement of the body and all parts of the neural arch of T4, and a posterior epidural ossified angiomatous mass. In the second case it showed angiomatous involvement of the vertebral body and an anterior extradural soft tissue mass; this latter was considered to represent a resolving extradural hematoma. CT, preferably performed after intrathecal contrast injection, is the diagnostic procedure of choice for spinal hemangioma with cord involvement.

Adolescent↗
PubMed1991

The odontoid process in Morquio-Brailsford's disease. The effects of occipitocervical fusion.

High definition computed cervical myelograms have been made in flexion and extension in 13 patients with Morquio-Brailsford's disease. We observed that: 1) odontoid dysplasia was present in every case, with a hypoplastic dens and a detached distal portion which was not always ossified; 2) atlanto-axial instability was mild, and anterior atlanto-axial subluxation was absent in most cases; 3) severe spinal cord compression, when present, was due to anterior extradural soft-tissue thickening; 4) this compression was not relieved by flexing or extending the neck and was manifested early in life; 5) posterior occipitocervical fusion resulted in disappearance of the soft-tissue thickening and normalisation of subsequent development of the dens. We conclude that the severity of neurological involvement at the craniovertebral junction was determined by soft-tissue changes, not by the type of odontoid dysplasia nor by subluxation. Posterior occipitocervical fusion proved to be an effective treatment.

Adult↗
PubMed1997

Electrophysiological investigations of the mild spinal cord injury in rats.

Somatosensory evoked potentials (SEPs) waveform recorded from the normal and injured spinal cord in rats were analyzed. A mild compression spinal cord injury was performed in two experimental models. The first model was used to assess the disappearance and the second one the return of the electrophysiological spinal cord function after injury. In the first experimental model typical changes in waveforms morphology from normal to isoelectric line during spinal cord compression were investigated. In the second model an isoelectric line was achieved by more severe but a shorter time of compression and the typical changes in SEPs morphology after decompression were described. Our evidence suggests that the spinal cord function disappears gradually during mild compression and can return early after decompression. The amplitude after decompression first improved and then gradually deteriorated which is probably caused by secondary insult. Experimental models are both effective and simple and may be used to evaluate the effect of treatment of spinal cord injuries.

Animals↗
PubMedDate not supplied

Ossification of the ligamentum flavum causing thoracic myelopathy: a case report.

Ossification of the ligamentum flavum is a well reported clinicopathologic entity causing narrowing of the spinal canal and subsequent spinal cord compression. The patient described in this case report complained of 9 mo of middle and lower back pain, difficulty with balance, progressive gait disturbance, and recent onset of bladder retention. Magnetic resonance imaging and computed tomographic scan revealed a bone density mass at the T2-3 level causing 25% cord compression and edema. A decompressive laminectomy was performed at T-2. The etiology of the compression was found to be attributable to an ossified ligamentum flavum at the T-2 level, which was confirmed by histologic examination. His neurologic signs and symptoms and functional status markedly improved after surgery and subsequent comprehensive rehabilitation. The patient was able to ambulate independently with a walker as opposed to previously being wheelchair-bound. Prompt surgical intervention and appropriate rehabilitation management play a key role in improving the functional outcome of myelopathy caused by ossified ligamentum flavum. This article acquaints rehabilitation personnel with the clinical features, proposed etiologies, association with other diseases, work-up, treatment, and rehabilitation concerns of patients with myelopathy caused by ossified ligamentum flavum.

Adult↗
PubMed2006

Symptomatic cervical disc herniation in a pediatric Klippel-Feil patient: the risk of neural injury associated with extensive congenitally fused vertebrae and a hypermobile segment.

STUDY DESIGN: A case report. OBJECTIVE: To report the occurrence of a herniated cervical disc following a high-impact activity in a pediatric Klippel-Feil patient who presented with spinal cord compression, myelopathy, and myelomalacia requiring posterior instrumented fusion followed by an anterior discectomy and fusion at the hypermobile nonfused segment. SUMMARY OF BACKGROUND DATA: The primary hallmark of Klippel-Feil syndrome (KFS) is the presence of at least one congenitally fused cervical segment. Studies have reported the potential risk of cervical injury from hypermobility associated with the nonfused cervical segment in KFS. The manifestation of a cervical disc herniation in the pediatric KFS patient is rare. To the authors' knowledge, the development of a symptomatic cervical herniated disc attributed to mechanical fatigue following a high-impact activity has not been addressed in the literature with respect to the pediatric KFS patient having extensive cervical fusion and a hypermobile segment. METHODS: A 16.8-year-old KFS boy with occipitalization of C1 and fusion of C2-C3 and C4-T1 presented with myelopathy, severe cord compression, and myelomalacia stemming from a left-sided herniated cervical disc at C3-C4 with onset following an 8-foot high rooftop jump. On radiographic evaluation, the patient's C3-C4 segment was hypermobile. RESULTS: The patient was operatively managed via a same-day combined posterior-anterior procedure. The posterior aspect of the procedure entailed a posterior lateral mass plate-screw fixation at C3-C4 with autologous iliac crest bone fusion. Anteriorly, a discectomy was performed at C3-C4 with application of an interbody tricortical autograft. After surgery, the patient wore a halo vest for 3 months, followed by a soft collar for an additional 3 months. On final follow-up at 39 months, the patient was asymptomatic with no instrumentation-related complications, fusion of the posterior graft-bed and anterior interbody graft was noted, and cervical alignment was maintained. CONCLUSIONS: A hypermobile segment in the pediatric KFS patient is a risk factor that may lead to cord compression. A symptomatic herniated cervical disc may develop from an excessive mechanical load stress in a pediatric KFS patient with multiple fused segments. In such a patient, a same-day combined posterior-anterior procedure provides cord decompression and stabilizes the spine with a favorable outcome.

Adolescent↗
PubMed2001

[Metastatic epidural spinal compression: prognostic factors and results of radiotherapy].

BACKGROUND: The metastatic epidural spinal cord compression is an oncologic emergency. Presently, there is no agreement on a standard diagnostic or therapeutic algorithm. In spite of improvement in diagnostic imaging, a great proportion of patients are plegic at the time of the first presentation. PATIENTS AND METHODS: Therapy charts of 53 consecutive patients--31 male and 22 female--with metastatic epidural spinal cord compression treated with radiation therapy only have been analyzed. Median age was 60 years. The most frequent primary tumors were bronchogenic carcinoma (13 patients), breast cancer (ten patients) and prostate cancer (ten patients). RESULTS: MRI was the most sensitive diagnostic tool in detecting spinal cord compression. Plain X-ray films were not useful. Pain symptoms were improved in 66% of the patients. The most important prognostic factor was the pretreatment mobility status. 94% of the ambulatory patients kept their walking ability, but only one plegic patient could walk again after radiation therapy (p < 0.001). Patients whose back pain was presented to an oncologist were more likely to keep their walking ability by the end of the therapy. Patients with bronchogenic cancer and plegic patients had a significantly worse survival. CONCLUSION: Patients with a known malignant tumor and progressive or axial back pain should undergo MRI scan to rule out spinal cord compression. For patients without severe neurologic deficit and MRI proven epidural compression, radiation therapy is able to preserve walking ability and reduce pain. For patients with neurologic symptoms radiation therapy should start within 24 hours.

Adenocarcinoma↗
PubMed1982

Spinal metastases. A retrospective survey from a general hospital.

One hundred and thirty-one patients presenting to a general hospital with neurological symptoms deriving from spinal metastases were reviewed. The primary site of tumour was the lung in 33 per cent, breast in 28 per cent, other sites in 25 per cent and unknown in 14 per cent. Haematological malignancies were excluded. In 47 per cent of cases the spinal metastasis produced the first evidence of malignant disease. Spinal or radicular pain was the initial complaint in 69 per cent of cases, followed by the appearance of neurological symptoms. Leg weakness usually preceded sphincter disturbance, and was the commonest reason for referral. Spinal cord compression occurred in 106 patients, 10 had compression of conus medullaris or cauda equina and 15 had evidence of radicular compression only. Plain x-rays of the spine were abnormal in 84 per cent of patients, and in 94 per cent of those with carcinoma of the breast. The results of treatment by radiotherapy alone were retrospectively compared with those of surgical decompression (with or without radiotherapy). There was no significant difference between these results for immediate response to treatment or for long-term outcome. The best predictor of outcome was the site of primary tumour. Only 17 per cent of patients with lung cancer responded well to treatment and only 2 per cent were alive one year after treatment; 51 per cent of patients with breast cancer responded well and 36 per cent were alive at one year. Surgical treatment is considered preferable in cases in which the diagnosis of cancer is not proven, when there is a possibility of neural compression by diseased bone rather than soft tumour tissue and when the area has previously been irradiated. These groups accounted for about 60 per cent of our patients. Radiotherapy alone may be preferred if multiple lesions are demonstrated. In other cases a therapeutic decision is required. The availability of neurosurgical and radiotherapeutic facilities will be a factor. There is no clear evidence from our figures or from the literature of a difference between results obtained by radiotherapy alone and those with surgical decompression followed by irradiation. The choice of treatment will depend upon the particular requirements of each individual parent.

Female↗
PubMed2003

Lateral approach for resection of the C3 corpus: technical case report.

OBJECTIVE AND IMPORTANCE: The C3 level is the transition zone between the upper and lower cervical spine. Because of its high position and anatomic relationships to significant structures, exposing C3 is challenging, and the surgical approach is controversial. CLINICAL PRESENTATION: A 16-year-old girl was admitted to our institution with a 3-year history of neck pain and progressive quadriparesis. Neuroradiological examination revealed severe spinal cord compression from kyphosis at the C3 level. TECHNIQUE: We used the lateral approach to resect the C3 corpus and realign the cervical spine. Resecting the transverse processes of C2-C4 and mobilizing the V2 segment of the vertebral artery adequately exposed C3 for resection. Bilateral occipitocervical fusion was performed in a second procedure, and no postoperative complications occurred. The patient's neurological status improved drastically after surgery, and she has had no craniocervical instability during the follow-up period. CONCLUSION: The lateral approach to the C3 corpus offers the greatest degree of cord decompression and easy access to the lesion in a wide and sterile operative field. We describe the surgical technique of this approach as an alternative to the anterior transmucosal or anterolateral retropharyngeal approach.

Adolescent↗
PubMed2004

Anterior correction of cervical kyphotic deformity: effects on myelopathy, neck pain, and sagittal alignment.

OBJECT: Cervical myelopathy may develop as a result of spinal cord compression with or without deformity. The effect of persistent kyphotic deformity on the ability of the cervical cord to recover following decompressive surgery is not known. METHODS: Between 1997 and 2000, a total of 28 patients with progressive myelopathy and kyphotic deformity underwent anterior decompression, deformity correction (0-4 degrees of lordosis), and fusion with anterior plating. Patients received clinical and radiological follow-up care, with independent analysis. Variables assessed included patient characteristics, severity of preoperative myelopathy, neck pain, and cervical sagittal alignment. Twenty-six patients (93%) underwent follow-up review for a minimum of 18 months. Two patients died: one died in the perioperative period and was excluded from further analysis, and in the other only 3 months of follow-up data could be obtained. Local deformity was corrected to neutral or lordosis in 24 cases (89%), and the overall cervical curve was corrected to neutral or lordosis in 20 cases (74%). There was a significant improvement in myelopathy scores in those patients in whom the target (0 to 4 degrees of lordosis) local angle was achieved (p = 0.04). There was a variable change in overall cervical sagittal alignment following local correction. Improvement in myelopathy was unrelated to patient age, previous surgery, or number of segments fused. Improvement in pain score was not related to correction of kyphotic angle. CONCLUSIONS: The correction of sagittal alignment may promote recovery in spinal cord function in patients with kyphotic deformity.

Activities of Daily Living↗
PubMed1982

Metastatic epidural tumors in children.

Spinal cord compression is a rare but serious complication of malignant diseases in children. Epidural cord compression was noted in 81 patients within the past 17 years at this center. The complication developed at different times during the course of the primary disease. For 29 of our patients, cord dysfunction was one of the initial signs of cancer--Ewing sarcoma, neuroblastoma, Hodgkin disease, and malignant lymphoma. By contrast, for most of the patients with osteosarcoma and rhabdomyosarcoma, it appeared later in their clinical course. The treatment outcome of patients who were paraplegia with complete loss of sensory function for greater than or equal to 48 hours was poor. Only four of 22 in this group became ambulatory. Ten patients with osteosarcoma did not undergo laminectomies because they all had multiple metastases and terminal disease. Paraplegia developed in all ten. There was no difference in ambulatory rates among other patients, with or without laminectomies.

Child↗
PubMed1987

Atypical forms of spinal tuberculosis.

Twenty-three patients with atypical forms of spinal tuberculosis treated between 1975 and 1985, are described. All presented with signs and symptoms of compression of the spinal cord or cauda equina, ranging from paraesthesiae and increasing weakness of extremities to paraplegia and loss of sphincter control. None of them showed visible or palpable spinal deformity nor the typical radiographic appearance of destruction of the intervertebral disc and the two adjoining vertebral bodies. These atypical forms constituted about 12 percent of all the cases of spinal tuberculosis seen (a total of 190 cases); and fell into three well-defined groups: those with the involvement of neural arch only; those with the involvement of a single vertebral body; and, those without bony involvement. The correct surgical approach in these groups was found to be different: spinal cord compression caused by the tuberculous disease of the neural arch was best treated by laminectomy; whereas single vertebral body disease required an anterior or anterolateral approach. Spinal computerized tomography was helpful in defining the extent of disease and planning the surgical approach. Histological confirmation of tuberculosis was obtained in all the cases and acid fast bacilli (A.F.B.) were found in, and cultured from, the biopsy specimens of 18 cases.

Adolescent↗
PubMed2006

Giant cervicothoracic extradural arachnoid cyst: case report.

The pathogenesis, etiology, and treatment of the spinal arachnoid cyst have not been well established because of its rarity. A 57-year-old male was presented with spastic quadriparesis predominantly on the left side. His radiological examination showed widening of the cervical spinal canal and left neural foramina due to a cerebrospinal fluid-filled extradural cyst that extended from C2 to T2 level. The cyst was located left anterolaterally, compressing the spinal cord. Through a C4-T2 laminotomy, the cyst was excised totally and the dural defect was repaired. Several features of the reported case, such as cyst size, location, and clinical features make it extremely unusual. The case is discussed in light of the relevant literature.

Arachnoid Cysts↗