scholarly journals Ossification of the yellow ligament in the cervical spine – an unusual location

BioMedicine ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 14 ◽  
Author(s):  
Jacob Yoong-Leong Oh ◽  
Victor Tzong-Jing Wang ◽  
Timothy Wei Wen Teo ◽  
Arun-Kumar Kaliya-Perumal ◽  
Hwan Tak Hee
Keyword(s):  
Cervical Spine ◽  
Spinous Process ◽  
Neurological Status ◽  
Cord Compression ◽  
Lower Limbs ◽  
Limb Weakness ◽  
Unusual Location ◽  
Unsteady Gait ◽  
Bony Mass ◽  
Immediate Surgery

Ossification of the yellow ligament (OYL) or ligamentum flavum, usually occurs in the thoracic spine. Focal OYL occurring in the cervical spine is considered rare and is sparsely reported in the literature. We came across a 30-year-old male patient with progressive left upper limb and bilateral lower limb weakness over a period of 3 months, associated with an unsteady gait. Clinical examination revealed bilateral generalized hyper-reflexia in both upper and lower limbs, inverted supinator jerk, Hoffman’s sign and clonus. Myelopathy due to cord compression was suspected and further investigations were done. MRI and CT scans revealed a bony mass in relation to the C6 spinous process projecting anterosuperiorly and narrowing the cervical spinal canal causing cord signal changes from C4 to C6 levels. In view of the deteriorating neurological status, immediate surgery in the form of decompression and posterior stabilization from C4-C6 was performed. Patient gradually recovered after surgery and attained full functional status. We report this case considering the unusual location of OYL and its successful management.

scholarly journals Spinal cord compression secondary to vertebral echinococcosis

2016 ◽  
Vol 7 (01) ◽  
pp. 143-146 ◽  
Author(s):  
Abat Sahlu ◽  
Brook Mesfin ◽  
Abenezer Tirsit ◽  
Knut Wester
Keyword(s):  
Muscular Strength ◽  
Cord Compression ◽  
Lower Limbs ◽  
Resonance Imaging ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Anterior Plating

ABSTRACTWe describe a patient with progressive lower limb weakness and paresthesia 3 days after falling from a considerable height. Magnetic resonance imaging and computed tomography revealed collapsed Th2 and Th3 vertebrae. A tuberculous (TB) spondylitis was suspected, and anti-TB medication was started however with no clinical improvement. She was referred to our center and operated. A 3 level discectomy and 2 level corpectomy were performed with iliac bone grafting and anterior plating via an anterior cervical approach. The patient developed an esophagocutaneous fistula that was repaired and cured. The biopsy specimen showed a hydatid cyst of the vertebra as the cause of the lesion. After the result, she was started on oral albendazole. At follow-up nearly 4 months after surgery, the patient had regained significant power in her lower limbs with a muscular strength of 5/5 in both legs, thus making it possible to walk without support.

scholarly journals Transpedicular Approach for Subaxial Cervical Spine

2016 ◽  
Vol 13 (1) ◽  
pp. 11-18
Author(s):  
Krishna Sharma
Keyword(s):  
Cervical Spine ◽  
Spinous Process ◽  
Pedicle Screws ◽  
Fusion Rate ◽  
Cord Compression ◽  
Natural State ◽  
Connecting Rod ◽  
Transpedicular Approach ◽  
Subaxial Cervical Spine ◽  
Unstable Cervical Spine

Cervical spine decompression, fusion and fixation are required when pathologies like trauma, degeneration, infection or tumor destabilizes the spine or cause compression on neurovascular structures. Many approaches and instrumentation technique have evolved to achieve a stable spine closest to its natural state, preserving the anatomy and the function. Transpedicular approach to cervical spine has been a new addition to the attempt. Here, our experience of the procedure is presented.Total of 38 cases underwent this procedure from 2014 February to 2015 December. Twenty-four cases had unstable spine due to trauma, twelve had severe multilevel spondylotic cord compression and two had dump bell schwannomas. Their age ranged from 24 to 76 years with 22 males and 16 females. The procedures were done under general anesthesia in prone position on Gardner-Wells pins and a horseshoe headrest. After exposing the pedicles, 3.5 mm by 22 mm titanium poly-axial screws where inserted through the pedicles using the technique described by Professor Abumi. The pedicle screws were connected by a connecting rod, which had been bent in accordance with the normal cervical lordosis. Fusion was done using the bones obtained from the spinous process and laminae.There were fifty-six screws which were mis-directed, and had to be immediately corrected. There was no incidence of significant pedicle penetration or injury to neuro-vascular structures. There was temporary weakness of upper limbs postoperatively in seven patients, which recovered fully in two months’ time. There were six deaths due to uncontrolled septicaemia triggered by chest infection. The rest of the patients were discharged between one to six weeks after surgery.Transpedicular fixation of unstable cervical spine provides biomechanically a very rigid and good correction of sagittal alignment with a high-fusion rate and a few surgical complications. After realizing these advantages, transpedicular screw fixation in cervical spine is becoming an increasingly popular spine surgeon's armamentarium.Nepal Journal of Neuroscience 13:11-18, 2016  

scholarly journals Case Report: Huge Dumbbell-Shaped Primary Hydatid Cyst Across the Intervertebral Foramen

2020 ◽  
Vol 11 ◽  
Author(s):  
Yu Tian ◽  
Mei Jiang ◽  
Xin Shi ◽  
Yujun Hao ◽  
Lei Jiang
Keyword(s):  
Back Pain ◽  
Hydatid Cyst ◽  
Cord Compression ◽  
Lower Limbs ◽  
Pathological Examination ◽  
Intervertebral Foramen ◽  
Limb Weakness ◽  
Fine Grained ◽  
Pastoral Area ◽  
Primary Hydatid Cyst

Primary hydatid cyst of the spinal canal is extremely rare. We reported a 42-year-old Kazakh man with right lower back pain and weakness in both lower limbs for 2 months, who lived in the pastoral area. Clinical examination revealed that the patient had no cysts on other organs and no previous medical history except for a huge cyst inside and next to the vertebrae. MRI examination revealed a huge dumbbell-shaped primary cyst across the intervertebral foramen. Pathological examination after operation confirmed a fine-grained hydatid cyst disease. Therefore, in the pastoral area, doctors should be alert to the occurrence of hydatid cyst disease if patients complained about progressive back pain and lower limb weakness or other spinal cord compression symptoms. Once hydatid cysts in other organs or systems were detected, the occurrence of the disease could be highly suspected. Complete resection is an effective treatment for hydatid cyst disease.

Lateral Approach for Resection of the C3 Corpus: Technical Case Report

Neurosurgery ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 977-981 ◽  
Author(s):  
Uğur Türe ◽  
Memet Özek ◽  
M. Necmettin Pamir
Keyword(s):  
Cervical Spine ◽  
Neurological Status ◽  
Cord Compression ◽  
Lateral Approach ◽  
Easy Access ◽  
High Position ◽  
History Of ◽  
Neuroradiological Examination ◽  
Craniocervical Instability ◽  
Second Procedure

Abstract 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.

scholarly journals Spontaneous ventral spinal epidural hematoma in a child: A case report and review of literature

2016 ◽  
Vol 07 (02) ◽  
pp. 297-299 ◽  
Author(s):  
Shailendra Ratre ◽  
Yadram Yadav ◽  
Sushma Choudhary ◽  
Vijay Parihar
Keyword(s):  
Epidural Hematoma ◽  
Neurological Status ◽  
Cord Compression ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Sensory Loss ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
History Of ◽  
Spinal Epidural

ABSTRACTSpontaneous spinal epidural hematoma is very uncommon cause of spinal cord compression. It is extremely rare in children and is mostly located in dorsal epidural space. Ventral spontaneous spinal epidural hematoma (SSEH) is even rarer, with only four previous reports in childrens. We are reporting fifth such case in a 14 year old male child. He presented with history of sudden onset weakness and sensory loss in both lower limbs with bladder bowel involvment since 15 days. There was no history of trauma or bleeding diasthesis. On clinical examination he had spastic paraplegia.Magnetic resonance imaging (MRI) of dorsal spine was suggestive of ventral spinal epidural hematoma extending from first to sixth dorsal vertebrae. Laminectomy of fourth and fifth dorsal vertebrae and complete evacuation of hematoma was done on the same day of admission. Postoperatively the neurological status was same.

scholarly journals Is there a right time for surgery in paraplegic patients secondary to non traumatic spinal cord compression?

2012 ◽  
Vol 10 (4) ◽  
pp. 508-511 ◽  
Author(s):  
Leonardo Giacomini ◽  
Roger Neves Mathias ◽  
Andrei Fernandes Joaquim ◽  
Mateus Dal Fabbro ◽  
Enrico Ghizoni ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Prognostic Factor ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Indication For Surgery ◽  
Sensory Deficits ◽  
Sensory Involvement ◽  
Spinal Cord Decompression

Paraplegia is a well-defined state of complete motor deficit in lower limbs, regardless of sensory involvement. The cause of paraplegia usually guides treatment, however, some controversies remain about the time and benefits for spinal cord decompression in nontraumatic paraplegic patients, especially after 48 hours of the onset of paraplegia. The objective of this study was to evaluate the benefits of spinal cord decompression in such patients. We describe three patients with paraplegia secondary to non-traumatic spinal cord compression without sensory deficits, and who were surgically treated after more than 48 hours of the onset of symptoms. All patients, even those with paraplegia during more than 48 hours, had benefits from spinal cord decompression like recovery of gait ability. The duration of paraplegia, which influences prognosis, is not a contra-indication for surgery. The preservation of sensitivity in this group of patients should be considered as a positive prognostic factor when surgery is taken into account.

scholarly journals A rare case of Paget’s disease affecting the cervical spine

2019 ◽  
Vol 101 (2) ◽  
pp. e38-e42
Author(s):  
J Holton ◽  
M Jones ◽  
Z Klezl ◽  
M Czyz ◽  
M Grainger ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Independent Living ◽  
Paget’S Disease ◽  
Posterior Part ◽  
Cord Compression ◽  
Bone Cell ◽  
Paget's Disease ◽  
History Of ◽  
Posterior Instrumented Fusion ◽  
Degenerative Cervical Spine

We present the case of a 75-year-old man with a rapidly progressive cervical myelopathy on a background of a 3-year history of neck pain and a severely degenerative cervical spine. The patient developed progressive myelopathy over a six-month period and suffered from worsening kyphosis. Suspicion of an underlying oncological process prompted transfer to our tertiary referral unit. Biopsy was consistent for Paget’s disease, an extremely rare diagnosis of the cervical spine. Magnetic resonance imaging revealed cord compression between C4 and C6 with associated cord signal change indicative of myelopathy. A three-level corpectomy and posterior instrumented fusion was performed. There was significant blood loss (3.5l) intraoperatively, consistent with a diagnosis of Paget’s disease of the bone. Cell salvage was used, as was neuromonitoring for both the anterior and posterior part of the procedure. Postoperatively, neurological function improved slightly and the patient required community neurorehabilitation to allow independent living.

Resection of 2 Intradural Extramedullary Cervical Spine Tumors in a Patient With Neurofibromatosis Type 2: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. 274-274
Author(s):  
Simone E Dekker ◽  
Chad A Glenn ◽  
Thomas A Ostergard ◽  
Osmond C Wu ◽  
Fernando Alonso ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Treatment Options ◽  
Tumor Resection ◽  
Neurofibromatosis Type ◽  
Cord Compression ◽  
Neurofibromatosis Type 2 ◽  
3 Dimensional ◽  
Intradural Extramedullary

Abstract This 3-dimensional operative video illustrates resection of 2 cervical spine schwannomas in a 19-yr-old female with neurofibromatosis type 2. The patient presented with lower extremity hyperreflexity and hypertonicity. Magnetic resonance imaging (MRI) demonstrated 2 contrast-enhancing intradural extramedullary cervical spine lesions causing spinal cord compression at C4 and C5. The patient underwent a posterior cervical laminoplasty with a midline dural opening for tumor resection. Curvilinear spine cord compression is demonstrated in the operative video. After meticulous dissection, the tumors were resected without complication. The dural closure was performed in watertight fashion followed by laminoplasty using osteoplastic titanium miniplates and screws. Postoperative MRI demonstrated gross total resection with excellent decompression of the spinal cord. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

Poster 38: Chondroma of the Cervical Spine Causing Cord Compression: A Case Report

PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S119-S119
Author(s):  
Alain Pierre-Louis ◽  
Seth D. Scholl ◽  
Mark A. Testaiuti
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Cord Compression
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