scholarly journals Late presentation of spinal cord compression in hereditary multiple exostosis: case reports and review of the literature

2019 ◽  
Vol 13 (5) ◽  
pp. 463-470
Author(s):  
R. Gigi ◽  
B. T. Kurian ◽  
A. Cole ◽  
J. A. Fernandes
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Cord Compression ◽  
Late Presentation ◽  
Level Of Evidence ◽  
Hereditary Multiple Exostoses ◽  
Clear Cut ◽  
Cord Injury

Introduction Osteochondromas are usually found in the long bones of patients with hereditary multiple exostoses (HME). The spine is reported to be involved in over 50% of cases, but few of these patients are symptomatic as the result of an existing spinal exostosis. Methods We reviewed the current literature in order to find the right approach to patients with HME-complicated spinal exostosis and describe three paediatric patients that were diagnosed late with spinal cord compression due to cervical exostosis. Results Our three cases were all late presentations with neurology and unfortunately had minimal improvement of neurology after the lesion was surgically removed. There is general agreement that late presentation of spinal cord injury due to osteochondromas involving the cervical spine may cause severe and irreversible neurological sequelae. Our literature review revealed that there are no clear-cut guidelines to develop more comprehensive screening measures for these patients. Conclusions A high index of suspicion is the most important factor for correct diagnosis and appropriate management. Physicians who treat HME should bear in mind that thorough history taking and a neurological examination at follow up are essential for these patients. Clearer guidelines for the development of more comprehensive screening programmes are essential. Level of evidence IV

scholarly journals Improved rat spinal cord injury model using spinal cord compression by percutaneous method

2013 ◽  
Vol 14 (3) ◽  
pp. 329 ◽  
Author(s):  
Wook-Hun Chung ◽  
Jae-Hoon Lee ◽  
Dai-Jung Chung ◽  
Wo-Jong Yang ◽  
A-Jin Lee ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Rat Spinal Cord ◽  
Spinal Cord Injury Model ◽  
Injury Model ◽  
Cord Injury

The therapeutic window for spinal cord decompression in a rat spinal cord injury model

2005 ◽  
Vol 3 (4) ◽  
pp. 302-307 ◽  
Author(s):  
Christopher B. Shields ◽  
Y. Ping Zhang ◽  
Lisa B. E. Shields ◽  
Yingchun Han ◽  
Darlene A. Burke ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Stenosis ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Therapeutic Window ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury ◽  
Fine Print

Object. There are no clinically based guidelines to direct the spine surgeon as to the proper timing to undertake decompression after spinal cord injury (SCI) in patients with concomitant stenosis-induced cord compression. The following three factors affect the prognosis: 1) severity of SCI; 2) degree of extrinsic spinal cord compression; and 3) duration of spinal cord compression. Methods. To elucidate further the relationship between varying degrees of spinal stenosis and a mild contusion-induced SCI (6.25 g-cm), a rat SCI/stenosis model was developed in which 1.13- and 1.24-mm-thick spacers were placed at T-10 to create 38 and 43% spinal stenosis, respectively. Spinal cord damage was observed after the stenosis—SCI that was directly proportional to the duration of spinal cord compression. The therapeutic window prior to decompression was 6 and 12 hours in the 43 and 38% stenosis—SCI lesions, respectively, to maintain locomotor activity. A significant difference in total lesion volume was observed between the 2-hour and the delayed time(s) to decompression (38% stenosis—SCI, 12 and 24 hours, p < 0.05; 43% stenosis—SCI, 24 hours, p < 0.05) indicating a more favorable neurological outcome when earlier decompression is undertaken. This finding was further supported by the animal's ability to support weight when decompression was performed by 6 or 12 hours compared with 24 hours after SCI. Conclusions. Analysis of the findings in this study suggests that early decompression in the rat improves locomotor function. Prolongation of the time to decompression may result in irreversible damage that prevents locomotor recovery.

Neurological Recovery Is Impaired by Concurrent but Not by Asymptomatic Pre-existing Spinal Cord Compression After Traumatic Spinal Cord Injury

Spine ◽  
2012 ◽  
Vol 37 (17) ◽  
pp. 1448-1455 ◽  
Author(s):  
Kensuke Kubota ◽  
Hirokazu Saiwai ◽  
Hiromi Kumamaru ◽  
Kazu Kobayakawa ◽  
Takeshi Maeda ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Recovery ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

scholarly journals Acute Spinal Cord Compression due to Chloroma as the Initial Presenting Feature of Acute Myeloid Leukemia

2019 ◽  
Vol 08 (02) ◽  
pp. 130-132
Author(s):  
Sushant Kumar Patro ◽  
Biswaranjan Nayak ◽  
Arun Kumar ◽  
Balappa Holeppagol Krishnamurthy ◽  
Debabrata Biswal ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Case Reports ◽  
Cord Compression ◽  
Interesting Case ◽  
Leukemic Cells ◽  
Diagnostic Challenge ◽  
Antitubercular Drugs ◽  
Previous Diagnosis ◽  
Acute Back Pain

AbstractChloroma is the deposits in leukemic cells outside the bone marrow and is not common. It is extremely rare to find a chloroma compressing the spinal cord causing paraplegia without any prior symptoms. Only few case reports have been found in the literature till date. We report an interesting case of a 7-year-old boy who presented with acute back pain and paraplegia with a dorsal extradural mass, and with a previous diagnosis of tuberculosis of the dorsal spine, treated with antitubercular drugs without any other signs of systemic illness. After surgical decompression and histopathologic examination of the tissue, it was found to be chloroma. There are only few reported cases of this disease initially presented as paraplegia without any systemic signs of malignancy in the literature, and chloroma presents as a diagnostic challenge to the surgeon. Chloromas are a rare cause of acute spinal cord compression but should be diagnosed and treated promptly to prevent neurologic dysfunction.

Cerebrospinal fluid lactate and electrolyte levels following experimental spinal cord injury

1976 ◽  
Vol 44 (6) ◽  
pp. 715-722 ◽  
Author(s):  
Douglas K. Anderson ◽  
Leon D. Prockop ◽  
Eugene D. Means ◽  
Lawrence E. Hartley
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Spinal Cord Tissue ◽  
Post Injury ◽  
Content Type ◽  
Protein Levels ◽  
Cord Injury ◽  
Csf Lactate

✓ Cerebrospinal fluid (CSF) lactate, sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg++), and chloride (Cl−) levels were determined for 17 to 21 days following experimental spinal cord compression in cats. Laminectomies were performed at L-2 under general anesthesia with aseptic techniques. Paraplegia was produced by applying a 170-gm weight transdurally for 5 minutes. Significant increases in CSF lactate levels were observed on the first through ninth days post injury with peak levels (50% above normal) occurring at Day 5. The only significant postinjury CSF electrolyte changes were elevation in Ca++ concentration on Days 3, 9, 11, 13, and 15, elevation in K+ concentration on Days 9 and 11 and decline in Cl− levels on the first day. The CSF K+ increase probably reflected cellular loss of K+ from damaged tissue whereas the Ca++ rise may have resulted from increased CSF protein levels. The prolonged elevation of CSF lactate indicates that tissue hypoxia plays a role in spinal cord compression paralysis, and that there is a continuing hypoxia of metabolically active spinal cord tissue for several days post injury.

Neurological manifestations, imaging characteristics, and surgical outcome of intraspinal osteochondroma

2010 ◽  
Vol 12 (5) ◽  
pp. 474-489 ◽  
Author(s):  
Iraj Lotfinia ◽  
Payman Vahedi ◽  
R. Shane Tubbs ◽  
Mostafa Ghavame ◽  
Ali Meshkini
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Surgical Outcome ◽  
Posterior Approach ◽  
English Literature ◽  
Cord Compression ◽  
Surgical Removal ◽  
Hereditary Multiple Exostoses ◽  
Imaging Characteristics ◽  
Google Search

ObjectSpinal osteochondromas (OCs) are rare and can originate as solitary lesions or in the context of hereditary multiple exostoses. Concurrent spinal cord compression is a very rare entity. The purpose of this study was to evaluate the authors' 10-year experience with the imaging characteristics and surgical outcome in patients with symptomatic spinal OC.MethodsBetween 1997 and 2007, 8 consecutive cases of symptomatic intraspinal OC with documented spinal cord compression were treated surgically. These patients were analyzed with regard to presentation, imaging, and outcome. The relevant English literature was reviewed using MEDLINE and Google search engines.ResultsThree patients had cervical, 2 had thoracic, and 3 had lumbar lesions. Classic MR imaging characteristics were rarely found. Multiple hereditary exostoses were equally responsible for cervical, thoracic, and lumbar lesions (33%). The origin of the lesion was from the pedicle (25%), lamina (25%), vertebral body (25%), and superior or inferior facets (25%). A posterior approach to the spine was used in 6 patients, and a combined anterior and posterior approach with fusion was performed for 2 thoracic lesions. Surgical outcome was satisfactory in 75% of patients. The prognosis was poor in the patients with thoracic lesions.ConclusionsIn the authors' experience, early detection and surgical removal in cases of symptomatic spinal OC is a key element for the best outcome. Posterior approaches are generally sufficient. The chronicity of symptoms may limit functional recovery postoperatively, especially with cervical and thoracic lesions.

Spinal Cord Compression: A Complication of Silicone-Coated Dacron Dural Grafts. Report of Two Cases

Neurosurgery ◽  
1989 ◽  
Vol 24 (1) ◽  
pp. 115-118 ◽  
Author(s):  
Heldo Gomez ◽  
John R. Little
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cervical Spinal Cord ◽  
Case Reports ◽  
Cord Compression ◽  
Tissue Reaction ◽  
Synthetic Graft ◽  
Surface Contaminants ◽  
Two Factors

Abstract Two case reports of compression of the cervical spinal cord associated with silicone-coated Dacron dural grafts are presented. In both cases, the cervical spinal cord was distorted and compressed by an intense tissue reaction that encapsulated the synthetic graft. At least two factors are thought to play a role in precipitating this reaction: (1) the introduction of surface contaminants into the wound, and (2) repeated motion at the graft site.

Evaluation of clinical experience using cell-based therapies in patients with spinal cord injury: a systematic review

2012 ◽  
Vol 17 (Suppl1) ◽  
pp. 230-246 ◽  
Author(s):  
James S. Harrop ◽  
Robin Hashimoto ◽  
Dan Norvell ◽  
Annie Raich ◽  
Bizhan Aarabi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
English Language ◽  
Spinal Cord Injuries ◽  
Case Reports ◽  
A Priori ◽  
Level Of Evidence ◽  
Hematopoietic Stem ◽  
Cellular Therapies ◽  
Cord Injury ◽  
Current Utilization

Object Using a systematic approach, the authors evaluated the current utilization, safety, and effectiveness of cellular therapies for traumatic spinal cord injuries (SCIs) in humans. Methods A systematic search and critical review of the literature published through mid-January 2012 was performed. Articles included in the search were restricted to the English language, studies with at least 10 patients, and those analyzing cellular therapies for traumatic SCI. Citations were evaluated for relevance using a priori criteria, and those that met the inclusion criteria were critically reviewed. Each article was then designated a level of evidence that was developed by the Oxford Centre for Evidence-Based Medicine. Results The initial literature search identified 651 relevant articles, which decreased to 350 after excluding case reports and reviews. Evaluation of articles at the title/abstract level, and later at the full-text level, limited the final article set to 12 papers. The following cellular therapies employed in humans with SCI are reviewed: bone marrow mesenchymal and hematopoietic stem cells (8 studies), olfactory ensheathing cells (2 studies), Schwann cells (1 study), and fetal neurogenic tissue (1 study). Overall the quality of the literature was very low, with 3 Grade III levels of evidence and 9 Grade IV studies. Conclusions Several different cellular-mediated strategies for adult SCI have been reported to be relatively safe with varying degrees of neurological recovery. However, the literature is of low quality and there is a need for improved preclinical studies and prospective, controlled clinical trials.

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