scholarly journals Thoracic vertebral canal stenosis due to articular process hypertrophy in two cats treated by hemilaminectomy with partial osteotomy of the spinous process

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691986317 ◽  
Author(s):  
Beatrice Enrica Carletti ◽  
Irene Espadas ◽  
Daniel Sanchez-Masian
Keyword(s):  
Spinous Process ◽  
Cord Compression ◽  
Urinary Continence ◽  
Spinal Diseases ◽  
Imaging Features ◽  
Vertebral Canal ◽  
Canal Stenosis ◽  
Articular Process ◽  
Satisfactory Outcome ◽  
Postural Reaction

Case summary A 9-year-old neutered female British Shorthair cat (case 1) and a 13-year-old neutered male domestic shorthair cat (case 2) showed signs of chronic T3–L3 myelopathy, which progressed over 6 and 12 months, respectively. On presentation, case 1 had moderate pelvic limb proprioceptive ataxia and ambulatory paraparesis, and case 2 was non-ambulatory paraparetic and had urinary incontinence. Bilateral enlargement of the articular process joints at T11–T12 in case 1 and T3–T4 in case 2 causing dorsolateral extradural spinal cord compression was shown on MRI. Surgical decompression by a unilateral approach through hemilaminectomy with partial osteotomy of the spinous process was performed in both cases. The side of the approach was chosen based on the severity of the cord compression. Surgery resulted in a satisfactory outcome with short hospitalisation times. On discharge, case 1 showed mild postural reaction deficits on both pelvic limbs. Case 2 had regained urinary continence and could ambulate unassisted, although it remained severely ataxic. The 6 month follow-up showed very mild paraparesis and proprioceptive ataxia in both cats. No chronic medical treatment was required. Relevance and novel information This is the first report to describe clinical presentation, imaging features, surgical treatment and outcomes of thoracic vertebral canal stenosis owing to bilateral articular process hypertrophy in cats with no adjacent spinal diseases. Thoracic articular process hypertrophy should be included in the differential diagnosis of adult cats with chronic progressive myelopathy. Hemilaminectomy with partial osteotomy of the spinous process might be an appropriate surgical technique in these cases.

Cranial thoracic vertebral canal stenosis in three juvenile large-breed brachycephalic dogs treated by unilateral hemilaminectomy

2017 ◽  
Vol 30 (03) ◽  
pp. 223-229 ◽  
Author(s):  
Andrew Marchevsky ◽  
Amanda Miller
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Case Series ◽  
Neurological Status ◽  
Cord Compression ◽  
Vertebral Canal ◽  
Neurological Signs ◽  
Canal Stenosis ◽  
Spinal Cord Segment ◽  
Independent Ambulation

SummaryObjective: To describe the surgical treatment and outcome for juvenile dogs with cranial thoracic vertebral canal stenosis treated by unilateral hemilaminectomy.Study design: Case series.Animals: Three large-breed brachycephalic dogs of various breeds (Dogue de Bordeaux, Australian Bulldog, Boerboel) with neurological signs consistent with a myelopathy of the third thoracic (T) to third lumbar (L) spinal cord segment.Methods: Information on clinical presentation, diagnostic imaging, surgical procedures, postoperative complications, recovery and outcome is described.Results: Neurological signs were present and progressive for two to four weeks prior to surgery and ranged from mild ataxia to paralysis. Cranial thoracic vertebral canal stenosis was diagnosed with computed tomography imaging. Lateral and dorsolateral spinal cord compression was present at multiple sites between T2 and T6. Alternating left and right-sided compressions were common. Surgical treatment was by unilateral, continuous hemilaminectomy over three to six vertebral spaces. Postoperative morbidity was minimal and return of independent ambulation was rapid (median: 13.5 days, range: 2–29 days). Neurological status in one dog worsened four months after surgery due to reoccurrence of osseous compression; unilateral hemilaminectomy was repeated in this dog. Long-term follow-up ranged from six to 10 months; neurological signs had completely resolved in one dog and substantially improved in the other two dogs.Clinical significance: Unilateral hemilaminectomy was associated with rapid return of independent ambulation and substantial improvement in neurological scores.

Thoracic Vertebral Canal Stenosis Associated with Vertebral Arch Anomalies in Small Brachycephalic Screw-Tail Dog Breeds

2020 ◽  
Author(s):  
Alessandro Conte ◽  
Marco Bernardini ◽  
Steven De Decker ◽  
Cristoforo Ricco ◽  
Sebastien Behr ◽  
...  
Keyword(s):  
Neurological Deficits ◽  
Imaging Features ◽  
Multicentric Study ◽  
Long Term Outcome ◽  
Vertebral Canal ◽  
Neurological Signs ◽  
Canal Stenosis ◽  
Group 2 ◽  
Clinical Records ◽  
Group 1

Abstract Objective The aim of this study was to describe clinical and imaging features of thoracic vertebral canal stenosis secondary to the hypertrophy of the vertebral lamina and articular processes in screw-tail brachycephalic dog breeds, to evaluate the prevalence of the malformation in a large group of screw-tail dog breeds and to determine if degree of stenosis is associated with presence of neurological signs. Study Design This is a retrospective multicentric study. Materials and Methods Clinical records of 185 screw-tail brachycephalic dogs (French Bulldogs, English Bulldogs, Boston Terriers) and Pugs were reviewed. Ten dogs with neurological deficits secondary to thoracic vertebral canal stenosis diagnosed on magnetic resonance imaging were identified (Group 1). Neurologically normal dogs (n = 175) of the same breeds underwent computed tomographic imaging of the thoracic vertebral column for other medical reasons (Group 2). Cross-sectional measurements were used to calculate a stenotic ratio. Results Group 1 consisted of three French Bulldogs, six English Bulldogs and one Pug. Eight were males. Most dogs presented with progressive non-painful pelvic limbs ataxia and paresis. Twenty stenotic sites were identified with the most common being T4–T5. Three of ten dogs were treated surgically and all had a good long-term outcome. In Group 2, 33 of 175 dogs had one or more stenotic sites with the most common being T2–T3. The degree of the stenosis was significantly higher in Group 1 (p = 0.019). A stenotic ratio of 0.56 had sensitivity and specificity of 67% to differentiate between dogs with and without neurological signs. Conclusion Cranial thoracic vertebral canal stenosis is observed predominantly in young male Bulldogs, but not all stenoses are clinically relevant.

Imaging and clinical features of neurocutaneous melanosis in the pediatric population.

2021 ◽  
Vol 17 ◽  
Author(s):  
Mormina Enricomaria ◽  
Granata Francesca ◽  
Vinci Sergio Lucio ◽  
Coglitore Alessandra ◽  
Caragliano Antonio Armando ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Pediatric Population ◽  
Cord Compression ◽  
Imaging Method ◽  
Imaging Features ◽  
Multisystem Disease ◽  
Neurocutaneous Melanosis ◽  
Pubmed Database

Background: Neurocutaneous melanosis (NCM) is a rare nonfamilial phakomatosis characterized by the presence of congenital melanocytic nevi and abnormal melanocytes infiltration of the leptomeninges. Objective & Methods: This paper shows the importance of early diagnosis and the most important imaging features of the disease on CT and MR scans. PubMed database was searched from January 1972 to September 2020. Papers including imaging findings of NCM, clinical, follow-up, and treatment features were collected, selecting only 89 studies. Discussion: NCM is a term used for the first time by van Bogaert in 1948. It refers to a condition caused by an error during morphogenesis and migration leading to leptomeningeal melanocytic accumulation. Although histological findings are the gold standard for diagnosis confirmation, neuroimaging and clinical features strongly support the suspect of NCM. Localization and extension of the lesions are predictive of neurological manifestations related to increased intracranial pressure, mass lesions, or spinal cord compression. CT demonstrates sites of increased density in the anterior temporal lobe - mainly the amygdala - thalami, cerebellum, and frontal lobes base. However, MRI is the best imaging method to diagnose central nervous system lesions, often appearing as T1-short signal areas of the cerebral parenchyma, indicative of central nervous system melanosis. MRI can also reveal associated intracranial and intraspinal abnormalities. Conclusion: Early imaging, when available, is helpful if NCM suspect is raised and may be of guidance in comparing later studies. NCM requires a multidisciplinary approach since it is a multisystem disease with a genetic component.

Incidence, Presentation, and Outcome of Spinal Cord Disease in Children With Systemic Cancer

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 438-443
Author(s):  
Donald W. Lewis ◽  
Roger J. Packer ◽  
Beverly Raney ◽  
Ihor W. Rak ◽  
Jean Belasco ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Delayed Diagnosis ◽  
Cord Compression ◽  
High Dose ◽  
Spinal Cord Disease ◽  
Satisfactory Outcome ◽  
First Relapse ◽  
Age Range ◽  
Neurologic Emergency

During a 40-month period, in 24 of 643 (4%) newly diagnosed patients with systemic cancer younger than 18 years of age (range: 3 months to 17 years) spinal cord disease developed. Patients with spinal cord disease included 21 children with metastatic spinal cord compression, two with treatment-related transverse myelopathies, and one with an anterior spinal artery stroke. Spinal cord disease occurred in 13 of 102 children (12%) with sarcomas, six of 82 (7%) with neuroblastomas, and four of 94 (4%) with lymphomas. Spinal cord compression occurred as the presenting sign of malignancy in six children (four with sarcomas and two with lymphomas). In the remaining 15 patients, cord compression occurred a median of 13 months after initial diagnosis, and in four patients it occurred at the time of first relapse. Symptoms of metastatic cord compression included back pain in 17 patients (80%), weakness in 14 (67%), sphincter dysfunction in 12 (57%), and sensory abnormalities in three (14%). Findings on plain radiographs of the spine were abnormal in only seven of 20 patients with cord compression, and myelography was needed to differentiate compression from other causes of spinal cord disease. Treatment included high-dose corticosteroids followed by operation (seven patients) or radiotherapy (14 patients). After treatment, nine of 15 nonambulatory patients became ambulatory, and five of 10 incontinent patients regained sphincter control. None of the patients with nonmetastatic spinal cord disease had a satisfactory outcome. Incorrect and delayed diagnosis was frequent in children with spinal cord disease (median time from onset of symptoms to diagnosis, 2 weeks) and 12 children were paraplegic and ten had loss of sphincter control at diagnosis. Spinal cord disease is a relatively common neurologic emergency in children with cancer, especially in those with sarcoma, and requires immediate investigation and intervention.

scholarly journals Aneurysmal bone cyst in thoracolumbar spine

2020 ◽  
Vol 6 (3) ◽  
pp. 20190133
Author(s):  
Alex Kiu ◽  
Tiffany Fung ◽  
Pranav Chowdhary ◽  
Sungmi Jung ◽  
Tom Powell ◽  
...  
Keyword(s):  
Treatment Options ◽  
Bone Cyst ◽  
Thoracolumbar Spine ◽  
Cord Compression ◽  
Central Canal ◽  
Neurological Deficits ◽  
Primary Bone Tumors ◽  
Canal Stenosis ◽  
Aneurysmal Bone Cysts ◽  
Primary Bone

Aneurysmal bone cysts (ABC) are rare, benign primary bone tumors. Although benign, they can be locally aggressive resulting in erosion of bone and surrounding tissues over time. In later stages, depending on the clinical urgency, immunotherapy or surgical resection remain treatment options. This report illustrates a case of a 32-year-old female who presented with chronic worsening low back pain without neurological deficits. Radiological imaging revealed a large destructive mass arising from the thoracic spine invading into the central canal, causing critical central stenosis and cord compression. Histopathology revealed ABC. This case highlights the importance of including ABCs and other ‘benign’/locally aggressive lesions in the differential of patients with insidious musculoskeletal complaints. This case also demonstrates that one can be neurologically asymptomatic despite having critical central canal stenosis and cord compression if the causative lesion is slow growing. Understanding this allows us to arrange for most appropriate management.

scholarly journals P26 Case of atypical cutaneous Mycobacterium chelonae infection in a patient with SLE after cyclophosphamide therapy

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Sheraz Rasool ◽  
Amr Afifi ◽  
Denise De Lord
Keyword(s):  
Peripheral Neuropathy ◽  
Antimicrobial Agents ◽  
Cord Compression ◽  
Cervical Cord ◽  
Close Monitoring ◽  
Disc Disease ◽  
Mycobacterium Chelonae ◽  
Canal Stenosis ◽  
The Right ◽  
High Index Of Suspicion

Abstract Background Mycobacterium chelonae is a rapidly growing non-tuberculous mycobacteria that can be isolated from water, soils and aerosols. Localised infection has been reported associated with surgical and cosmetic procedures. Disseminated infection is rare and usually occurs in individuals who are immunocompromised. We present a patient with severe SLE on immunosuppressive therapy who developed localised severe cutaneous infection of the foot. Methods A 69-year-old lady with complex SLE - RNP+, Raynaud's, arthritis, stable for several years had deteriorated within the last year with cardiac myositis and, peripheral neuropathy. Three months pulsed intravenous cyclophosphamide (EUROLUPUS regime) was completed in November 2018. Five weeks later she developed severe pain, inability to weight-bear and extensive erythema and swelling of the right ankle and lower leg. An MRI showed extensive skin thickening especially dorsally in the R foot and anteriorly in distal leg. There was also increased signal in the distal achilles tendon. Orthopedic review confirmed no evidence of septic arthritis or osteomyelitis. A skin biopsy was performed, cultures from which grew Mycobacterium chelonae. She was admitted and started on tobramycin, on which she developed long QTc, linezolid which caused thrombocytopenia and clarithromycin. In March 2019 she was re-admitted with confusion, weakness and AKI, secondary to clarithromycin. She was, then switched to clofazimine and low dose clarithromycin, on which she was stabilized. MRI brain scan was normal, lumbar puncture was negative for M chelonae PCR and MRI spine confirmed cervical cord compression and cervical and lumbar canal stenosis due to osteophytes and disc disease. Results The infection improved considerably after 5 months of successful mycobacterial treatment. It was then possible to treat with rituximab for a deteriorating peripheral neuropathy confirmed on EMG and cardiac myositis. Sadly, whilst awaiting rehabilitation, the patient died unexpectedly in April 2019 from an arrhythmia. Conclusion Mycobacterium chelonae is an uncommon cause of soft tissue infection, which is resistant to all anti-tuberculous drugs. It is susceptible to a wider range of antimicrobial agents including tobramycin, imipenem, clarithromycin, linezolid, co-trimoxazole. A high index of suspicion is necessary for diagnosis, particularly in immunocompromised patients. The incidence may be increasing, possibly due to enhanced detection. Infection can mimic MSK presentations including capsulitis, tendonitis and tenosynovitis. Close monitoring is required as anti-microbial therapy complications are common including prolongation of QTc on tobramycin. Vigilance for disseminated multiorgan involvement is essential due to high mortality, particularly with CNS and lung involvement. Atypical infections should always be considered in the immunocompromised, particularly mycobacteria, nocardia & fungi. Disclosures S. Rasool None. A. Afifi None. D. De Lord None.

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