Paraplegia after a Routine Lumbar Laminectomy: Report of a Rare Complication and Successful Management

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 638-640 ◽  
Author(s):  
Patrick L. Valls ◽  
Gill L. Naul ◽  
Steven L. Kanter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Arachnoid Cyst ◽  
Spinal Canal ◽  
Rare Complication ◽  
Resonance Imaging ◽  
Thoracic Spinal

Abstract Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.

Congenital Cervical Spine Stenosis in a Multicenter Global Cohort of Patients With Degenerative Cervical Myelopathy: An Ambispective Report Based on a Magnetic Resonance Imaging Diagnostic Criterion

Neurosurgery ◽  
2018 ◽  
Vol 83 (3) ◽  
pp. 521-528 ◽  
Author(s):  
Aria Nouri ◽  
Lindsay Tetreault ◽  
Satoshi Nori ◽  
Allan R Martin ◽  
Anick Nater ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Surgical Outcomes ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Resonance Imaging ◽  
Baseline Severity ◽  
Degenerative Cervical Myelopathy

Abstract BACKGROUND Congenital spinal stenosis (CSS) of the cervical spine is a risk factor for acute spinal cord injury and development of degenerative cervical myelopathy (DCM). OBJECTIVE To develop magnetic resonance imaging (MRI)-based criteria to diagnose preexisting CSS and evaluate differences between patients with and without CSS. METHODS A secondary analysis of international prospectively collected data between 2005 and 2011 was conducted. We examined the data of 349 surgical DCM patients and 27 controls. Spinal canal and cord anteroposterior diameters were measured at noncompressed sites to calculate spinal cord occupation ratio (SCOR). Torg–Pavlov ratios and spinal canal diameters from radiographs were correlated with SCOR. Clinical and MRI factors were compared between patients with and without CSS. Surgical outcomes were also assessed. RESULTS Calculation of SCOR was feasible in 311/349 patients. Twenty-six patients with CSS were identified (8.4%). Patients with CSS were younger than patients without CSS (P = .03) and had worse baseline severity as measured by the modified Japanese Orthopedic Association score (P = .04), Nurick scale (P = .05), and Neck Disability Index (P < .01). CSS patients more commonly had T2 cord hyperintensity changes (P = .09, ns) and worse SF-36 Physical Component scores (P = .06, ns). SCOR correlated better with Torg–Pavlov ratio and spinal canal diameter at C3 than C5. Patients with SCOR ≥ 65% were also younger but did not differ in baseline severity. CONCLUSION SCOR ≥ 70% is an effective criterion to diagnose CSS. CSS patients develop myelopathy at a younger age and have greater impairment and disability than other patients with DCM. Despite this, CSS patients have comparable duration of symptoms, MRI presentations, and surgical outcomes to DCM patients without CSS.

scholarly journals Toxicity of Shiga Toxin 1 in the Central Nervous System of Rabbits

2001 ◽  
Vol 69 (10) ◽  
pp. 6545-6548 ◽  
Author(s):  
Jun Fujii ◽  
Yoshimasa Kinoshita ◽  
Takashi Yutsudo ◽  
Hatsumi Taniguchi ◽  
Tom Obrig ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Shiga Toxin ◽  
Brain Lesions ◽  
Resonance Imaging ◽  
The Central Nervous System

ABSTRACT The action of Shiga toxin (Stx) on the central nervous system was examined in rabbits. Intravenous Stx1 was 44 times more lethal than Stx2 and acted more rapidly than Stx2. However, Stx1 accumulated more slowly in the cerebrospinal fluid than did Stx2. Magnetic resonance imaging demonstrated a predominance of Stx1-dependent lesions in the spinal cord. Pretreatment of the animals with anti-Stx1 antiserum intravenously completely protected against both development of brain lesions and mortality.

scholarly journals Magnetic Resonance Imaging and Multidetector Computed Tomography Evaluation of Craniovertebral Junction Abnormalities

2021 ◽  
Vol 8 (10) ◽  
pp. 532-536
Author(s):  
Abhishek Biswas ◽  
Nihar Ranjan Sarkar ◽  
Alak Pandit
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Congenital Anomalies ◽  
Craniovertebral Junction ◽  
Resonance Imaging ◽  
Systematic Classification ◽  
Study Results

BACKGROUND The craniovertebral junction is a complex articulation between occiput, atlas, axis and supporting ligaments enclosing the soft tissue structures of cervicomedullary junction which includes medulla, spinal cord and lower cranial nerves. The incidence of different types of CVJ anomalies varies with demographic environment & ill-defined genetic factors. CVJ anomalies are more frequently found in Indian subcontinent than anywhere else in the world. Even in India, these anomalies are more frequently documented from Bihar, Uttar Pradesh, Rajasthan and Gujarat. The reason for this geographical clustering is more speculative. The CVJ anomalies can be either due to bony or soft tissue anomalies. They are common in all age groups and almost equal in both sex groups. The anomalies can be due to congenital or acquired causes. There has been a renewed interest in the normal anatomy & pathological lesions of CVJ anomalies with dynamic xrays, computed tomography (CT) and magnetic resonance imaging (MRI). The clinical features are often delayed up to 2 nd or 3rd decade, since they are subtle and often missed. Various congenital anomalies and acquired disease processes can affect the craniovertebral junction. They often cause diagnostic dilemmas. Only few studies have been conducted in this regard. This study is an attempt to define importance of precise diagnosis for pre-treatment evaluation and systematic classification of CVJ abnormalities with MRI and multi-detector computed tomography (MDCT). METHODS We conducted this cross-sectional descriptive study with 55 patients, who had been referred to us for CT / MRI from Department of Neurology. 3 Tesla MRI (GE Healthcare) and 16 slice MDCT (Philips) were used in this study. RESULTS In our study, congenital anomalies were the most common type of CVJ abnormality followed by degenerative changes and trauma. MRI proved to be better at detecting soft tissue abnormalities and assessing spinal cord compression, although CT was very much accurate at demonstrating bony lesions with short scan times and ability to reconstruct in three orthogonal planes. CONCLUSIONS CT and MRI cannot be compared in imaging the craniovertebral junction and should be complementary to each other. KEYWORDS Craniovertebral Junction, MRI, MDCT

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