Traumatic Paraplegia in Children without Contiguous Spinal Fracture or Dislocation

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 439-445 ◽  
Author(s):  
John W. Walsh ◽  
David B. Stevens ◽  
Byron A. Young
Keyword(s):  
Spinal Cord ◽  
Clinical Presentation ◽  
Motor Vehicle ◽  
Cord Compression ◽  
Spinal Fracture ◽  
Vehicle Accidents ◽  
Thoracic Level ◽  
Vascular Compromise ◽  
Permanent Loss ◽  
Vertebral Subluxation

Abstract Traumatic paraplegia in children is uncommon and, in almost half of these injuries, no contiguous fracture or dislocation of the spine is found. This report presents eight such cases, three in detail. Most of the children were injured in motor vehicle accidents and sustained thoracic level injuries with a permanent loss of neurological function caudal to the injury. The clinical presentation and radiological diagnosis are reviewed. Four mechanisms of injury have been proposed: transient vertebral subluxation, transient disc herniation, traction and stretching of the spinal cord, and vascular compromise with infarction. Unless extramedullary spinal cord compression is present, laminectomy is not useful.

Metastasizing Meningioma

Neurosurgery ◽  
1986 ◽  
Vol 19 (6) ◽  
pp. 1028-1030 ◽  
Author(s):  
Tom Russell ◽  
T. Moss
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Primary Tumor ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Spinal Tumor ◽  
Cord Compression ◽  
Metastatic Spread ◽  
Intracranial Meningioma

Abstract A very unusual case of metastatic spread of a meningioma is described. The clinical presentation was of extradural spinal cord compression, without evidence of a primary tumor. Computed tomography did not reveal any intracranial meningioma; the histopathology of the extradural spinal tumor was identical with that of two intracranial meningiomas previously excised.

Incidence and severity of acute complications after spinal cord injury

2012 ◽  
Vol 17 (Suppl1) ◽  
pp. 119-128 ◽  
Author(s):  
Robert G. Grossman ◽  
Ralph F. Frankowski ◽  
Keith D. Burau ◽  
Elizabeth G. Toups ◽  
John W. Crommett ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Vehicle Accidents ◽  
The North ◽  
Treatment And Prevention ◽  
Cord Injury ◽  
Study Population

Object The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury. Methods The study was conducted at 9 university-affiliated hospitals that comprise the clinical centers of the North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury. The study population comprised 315 patients admitted to NACTN clinical centers between June 25, 2005, and November 2, 2010, who had American Spinal Injury Association (ASIA) Impairment Scale grades of A–D and were 18 years of age or older. Patients were managed according to a standardized protocol. Results The study population was 79% male with a median age of 44 years. The leading causes of injury were falls (37%) and motor vehicle accidents (28%). The distribution of initial ASIA grades were A (40%), B (16%), C (15%), and D (29%). Fifty-eight percent of patients sustained 1 or more severe, moderate, or mild complications. Complications were associated with more severe ASIA grade: 84% of patients with Grade A and 25% of patients with Grade D had at least 1 complication. Seventy-eight percent of complications occurred within 14 days of injury. The most frequent types of severe and moderate complications were respiratory failure, pneumonia, pleural effusion, anemia, cardiac dysrhythmia, and severe bradycardia. The mortality rate was 3.5% and was associated with increased age and preexisting morbidity. Conclusions Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.

Open kyphoplasty for management of metastatic and severe osteoporotic spinal fracture

2007 ◽  
Vol 6 (3) ◽  
pp. 284-288 ◽  
Author(s):  
Stéphane Fuentes ◽  
Phillipe Métellus ◽  
Grégoire Pech-Gourg ◽  
Tarek Adetchessi ◽  
Henri Dufour ◽  
...  
Keyword(s):  
Spinal Cord ◽  
General Health ◽  
Posterior Instrumentation ◽  
Cord Compression ◽  
Spinal Fracture ◽  
Neurological Dysfunction ◽  
Poor General Health ◽  
Vas Score ◽  
Metastatic Lesions ◽  
The Mean

Object Elderly patients in poor general health frequently suffer vertebral body (VB) fractures due to osteoporosis or vertebral metastatic lesions. Kyphoplasty and vertebroplasty have become the standard treatment for these types of fractures. In certain conditions that cause local kyphosis, such as spinal cord compression due to a metastatic epidural tumor or the shortening of the spinal canal secondary to vertebral compression, the surgical treatment should provide decompression and stabilization during a short intervention. In this study the authors evaluated a surgical technique that frequently combines a same-session surgical decompression, such as a laminectomy, and posterior instrumentation-assisted stabilization during the same open intervention in which the VB is stabilized by kyphoplasty. Methods During an 18-month period, the authors treated 18 patients with VB fractures according to this protocol: 14 patients with vertebral metastatic lesions and four with osteoporosis. The patients' mean age was 60 years. All suffered severe pain preoperatively (mean visual analog scale [VAS] score of 7). Fourteen of the 18 patients suffered a neurological deficit. Twenty-three vertebral levels were treated; in 15 patients it was necessary to place posterior instrumentation. The mean duration of the intervention was 90 minutes. Pain in all patients improved 3 days after the intervention, and the mean VAS score decreased to 2. Patients with a neurological dysfunction improved. The mean quantity of injected cement for the kyphoplasty procedure was 7 ml. The mean duration of hospitalization was 7 days. Neuroimaging revealed cement leaks in two cases: one into the disc interspace and one anteriorly into the fractured part of the vertebra. After the intervention, most patients with metastatic lesions underwent radiotherapy. No procedure-related complications occurred. Conclusions This procedure allows decompression of the spinal cord, consolidation of the VB and thus a stabilization of the vertebral column, and may provide an alternative treatment to invasive VB excision in patients in poor general health.

scholarly journals Analysis of patients with spinal cord trauma associated with traumatic brain injury

2014 ◽  
Vol 13 (4) ◽  
pp. 302-305 ◽  
Author(s):  
João Simão de Melo Neto ◽  
Waldir Antônio Tognola ◽  
Antonio Ronaldo Spotti ◽  
Dionei Freitas de Morais
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Brain Injury ◽  
Injury Risk ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents ◽  
Risk Of Death ◽  
Cord Injury

Objective: Characterize victims of spinal cord injury (SCI) associated with traumatic brain injury (TBI) and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%), aged between 21-30 years (25%), civil status stable union (56%), low level of education (69%) and the Roman Catholic religion (77%) presented the greater number of victims. Motor vehicle accidents (58%) were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001). The neurological status ASIA-E (52%), the syndromic neck pain (35%) and the rate of mild TBI (65%) were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%). The length of hospital stay was significantly higher (20±28 days) and 17% of patients died. Men (RR=2.14, p=0.028) and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022) showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01) higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.

Contrast radiographic findings in canine bacterial discospondylitis: a multicenter, retrospective study of 27 cases

2000 ◽  
Vol 36 (1) ◽  
pp. 81-85 ◽  
Author(s):  
MJ Davis ◽  
CW Dewey ◽  
MA Walker ◽  
SC Kerwin ◽  
ML Moon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Dysfunction ◽  
Anatomical Site ◽  
Significant Component ◽  
Radiographic Findings ◽  
Ultimate Outcome ◽  
Vertebral Subluxation

A multicenter, retrospective study was undertaken to evaluate contrast radiographic findings in canine bacterial discospondylitis. Records and myelograms or epidurograms of 27 patients were obtained from five colleges of veterinary medicine. Fifteen cases (56%) were evaluated as having some degree of spinal cord compression. The majority (73.3%) of the cases had only soft tissue as the compressive mass. The median compression for all cases was 5% of the vertebral canal. No difference was noted for compression based on anatomical site (i.e., cervical versus thoracolumbar versus lumbosacral). No significant correlation between degree of lesion compression and clinical outcome was noted, but there was a trend toward increased mortality with greater compression. There was no correlation between the ambulatory status and the ultimate outcome. Three of the 15 (20%) cases showed vertebral subluxation. Results of this study indicate that static spinal cord compression is not a significant component of the neurological dysfunction associated with bacterial discospondylitis. Identification of vertebral subluxation in some patients may indicate a dynamic lesion that should be evaluated with stress radiography.

scholarly journals Society of Physicians at Kazan University. Surgical section. Meeting 20/11-29

1929 ◽  
Vol 25 (7-8) ◽  
pp. 852-854
Author(s):  
I. Tsimkhes
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Compression ◽  
Spinal Injury ◽  
Lumbar Vertebrae ◽  
Cord Compression ◽  
Spinal Fracture ◽  
Lumbar Region ◽  
Urine Retention ◽  
Spinous Processes

Doctor. V. I. Nizner. Demonstration of the patient after laminectomy for a spinal fracture. B-th, a worker, 35 years old, fell from a staircase 372 meters high. Dizziness, vomiting, back pain, stulag and urine retention. Swelling in the area of the spinous processes of the 12th thoracic and 1st lumbar vertebrae. Spinal cord compression and spinal injury in the lumbar region are suspected.

scholarly journals Spinal synovial cysts causing neurological deficit

2018 ◽  
Vol 21 (2) ◽  
pp. 126-129
Author(s):  
Emerson Magno F. De Andrade ◽  
Raphael Vicente Alves ◽  
Mariano Ebran Fiore ◽  
Airton Batista De Araújo Jr ◽  
Antônio Carlos Montanaro ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Neurological Deficit ◽  
Nerve Root ◽  
Clinical Presentation ◽  
Cord Compression ◽  
Surgical Removal ◽  
Cervical Cyst ◽  
Gradual Development ◽  
Synovial Cysts

Synovial cysts of the spine are usually asymptomatic, rarely causing nerve root or spinal cord compression. The authors report on two cases of spinal synovial cysts. One patient harbored a cervical cyst causing myelophaty, and a secondpatient had a lumbar cyst with gradual development of radiculopathy. In both cases the patients had improvement of the symptoms and good outcome after surgical removal of the cysts. Synovial cysts should be considered in the differential diagnosis of any spinal extradural masses. The literature is reviewed and the etiological, clinical presentation, diagnosis and treatment are discussed.

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