scholarly journals THORACIC INTERVERTEBRAL DISC PROLAPSE WITH SPINAL CORD COMPRESSION

1952 ◽  
Vol 15 (4) ◽  
pp. 227-241 ◽  
Author(s):  
V. Logue
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Disc Prolapse

scholarly journals To cut or not to cut? A case report on pediatric intervertebral disc calcification

2021 ◽  
Vol 12 ◽  
pp. 307
Author(s):  
Hunter J. King ◽  
Rohin Ramchandani ◽  
Christina Maxwell ◽  
Atom Sarkar ◽  
Tina Loven
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Sensory Loss ◽  
Common Symptom ◽  
Thoracic Spinal Cord ◽  
Intervertebral Disc Calcification ◽  
Thoracic Spinal

Background: Intervertebral disc calcification (IVDC) is a rare cause of acute spinal pain in pediatric patients. The most common symptom is back or neck pain, but muscle spasm, muscle weakness, and sensory loss also occur. Many patients have an alarming presentation and radiological findings concerning for spinal cord compression. Case Description: A 10-year-old female presented with 2 weeks of worsening back pain and restricted neck flexion with no history of preceding trauma. Magnetic resonance imaging (MRI) showed T4/5 and T5/6 vertebral disc calcification and posterior herniation causing thoracic spinal cord compression. Despite concerning imaging findings, we decided to manage this patient conservatively with nonsteroidal anti-inflammatory drugs, leading to the improvement of symptoms within 9 days, and resolution of all pain within 1 month after hospital discharge. At 6 months follow-up, MRI showed complete resolution of calcification within the spinal canal. Conclusion: This case report emphasizes IVDC as an important differential diagnosis of pediatric disc disease that does not require surgical intervention. X-ray imaging with PA and lateral views is an adequate screening for these patients. Majority of cases resolve within 6 months with conservative therapy.

Spinal cord compression due to prolapse of cervical intervertebral disc (herniation of nucleus pulposus)

1983 ◽  
Vol 59 (5) ◽  
pp. 847-853 ◽  
Author(s):  
Sean A. O'Laoire ◽  
David G. T. Thomas
Keyword(s):  
Spinal Cord ◽  
Nucleus Pulposus ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Cervical Disc ◽  
Intervertebral Disc Herniation ◽  
Disc Prolapse ◽  
Content Type ◽  
History Of ◽  
High Cervical

✓ Twenty-six patients who presented with spinal cord compression due to cervical disc prolapse (herniation of the nucleus pulposus) were treated by anterior discectomy. There was a high incidence of disc prolapse at the C3–4 level. The most severe degrees of preoperative disability were associated with prolapse at that level. Impairment of posterior column function, particularly in the upper limbs, played a major part in producing disability. High cervical disc prolapse can produce a clinical picture that is predominantly like that of a posterior cord syndrome. Preexisting fusion of vertebral bodies in the cervical spine and a history of cervical spinal trauma appear to be predisposing factors. Discectomy is an effective treatment of this condition. Spinal cord compression due to cervical disc prolapse should be distinguished from spondylotic myelopathy.

Management of cervical spinal cord injury in ankylosing spondylitis: the intervertebral disc as a cause of cord compression

1992 ◽  
Vol 77 (2) ◽  
pp. 241-276 ◽  
Author(s):  
David W. Rowed
Keyword(s):  
Spinal Cord ◽  
Ankylosing Spondylitis ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Recurrent Dislocation ◽  
Cord Compression ◽  
Flexion Deformity ◽  
Extradural Hematoma ◽  
Halo Vest ◽  
Content Type

✓ Twenty-one patients with universal syndesmophytosis due to ankylosing spondylitis were identified in a consecutive series of 1578 patients with acute spine and spinal cord injuries. They were predominantly male, older than spinal cord-injured patients in general, and most were injured by falls. Approximately one-half were managed by halo-vest immobilization alone with good clinical and radiological outcomes. The remainder required surgery either for recurrent dislocation or for spinal cord compression associated with neurological deterioration. Extradural hematoma, a recognized cause of spinal cord compression in ankylosing spondylitis patients with spinal fractures, was encountered in two patients. Herniated intervertebral disc as a cause of spinal cord compression in ankylosing spondylitis does not appear to have been previously reported and was recognized three times in the present series, once in association with extradural hematoma. The pathology of ankylosing spondylitis is such that the nucleus pulposus tends to be spared, allowing disc herniation to occur in the heavily ossified spine. In virtually all patients, satisfactory correction of the flexion deformity could be safely accomplished following spinal fracture. It is concluded that fracture/dislocations of the cervical spine should be managed initially by halo-vest immobilization, without prior traction and with careful incremental correction of flexion deformity. Decompression is performed as required for extradural hematoma or intervertebral disc herniation, and internal fixation is carried out for recurrent dislocation.

Impact of morphological restoration of the spinal cord from the preoperative to early postoperative periods on C5 palsy development

2021 ◽  
pp. 1-9
Author(s):  
Masahiro Mizutani ◽  
Takashi Fujishiro ◽  
Takuya Obo ◽  
Atsushi Nakano ◽  
Yoshiharu Nakaya ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Postoperative Period ◽  
Morphological Changes ◽  
Cord Compression ◽  
Early Postoperative Period ◽  
Decompression Surgery ◽  
Transverse Diameter ◽  
C5 Palsy

OBJECTIVE C5 palsy (C5P) is a known complication of cervical decompression surgery. The tethering effect of the C5 nerve root following the posterior shift of the spinal cord is the most accepted pathologic mechanism for C5P development; however, this mechanism cannot fully explain C5P by itself in clinical practice. Separately, some studies have suggested that preoperative severe spinal cord compression and postoperative morphological changes in the spinal cord affect C5P development; however, no previous study has quantitatively addressed these possibilities. The aim of this study was to examine whether spinal cord morphology and morphological restoration after surgery affect C5P development. METHODS The authors reviewed consecutive patients with degenerative cervical myelopathy who underwent laminoplasty including the C3–4 and C4–5 intervertebral disc levels. All participants underwent MRI both preoperatively and within 4 weeks postoperatively. To assess the severity of spinal cord compression, the compression ratio (CR; spinal cord sagittal diameter/transverse diameter) was calculated. As an index of morphological changes in the spinal cord during the early postoperative period, the change rate of CR (CrCR, %) was calculated as CRwithin 4 weeks postoperatively/CRpreoperatively × 100. These measurements were performed at both the C3–4 and C4–5 intervertebral disc levels. The study cohort was divided into C5P and non-C5P (NC5P) groups; then, CR and CrCR, in addition to other radiographic variables associated with C5P development, were compared between the groups. RESULTS A total of 114 patients (mean age 67.6 years, 58.8% men) were included in the study, with 5 and 109 patients in the C5P and NC5P groups, respectively. Preoperative CR at both the C3–4 and C4–5 levels was significantly lower in the C5P group than in the NC5P group (0.35 vs 0.44, p = 0.042 and 0.27 vs 0.39, p = 0.021, respectively). Patients with C5P exhibited significantly higher CrCR at the C3–4 level than those without (139.3% vs 119.0%, p = 0.046), but the same finding was not noted for CrCR at the C4–5 level. There were no significant differences in other variables between the groups. CONCLUSIONS This study reveals that severe compression of the spinal cord and its greater morphological restoration during the early postoperative period affect C5P development. These findings could support the involvement of segmental cord disorder theory, characterized as the reperfusion phenomenon, in the pathomechanism of C5P, in addition to the tethering effect.

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