scholarly journals Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization: A single-center retrospective study

2020 ◽  
Author(s):  
Yukako Ishida ◽  
Hideki Shigematsu ◽  
Shinji Tsukamoto ◽  
Yasuhiko Morimoto ◽  
Eiichiro Iwata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Tumor Board ◽  
Spine Stabilization ◽  
Minimally Invasive Spine ◽  
Minimally Invasive Spine Stabilization

Abstract Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with minimally invasive spine stabilization (MISt). We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, ambulation status, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses. Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. We noted good functional prognosis in patients capable of ambulation within seven days and in patients who could survive longer than three months after the surgery. Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.

scholarly journals Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization

2020 ◽  
Author(s):  
Yukako Ishida ◽  
Hideki Shigematsu ◽  
Shinji Tsukamoto ◽  
Yasuhiko Morimoto ◽  
Eiichiro Iwata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Tumor Board ◽  
Spine Stabilization ◽  
Before And After ◽  
Minimally Invasive Spine ◽  
Minimally Invasive Spine Stabilization

Abstract Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL.Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses.Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within seven days (p < 0.05) and in patients who could survive longer than three months after the surgery (p < 0.05).Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.

Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor

Neurosurgery ◽  
2010 ◽  
Vol 66 (3) ◽  
pp. E620-E622 ◽  
Author(s):  
Alexander Taghva ◽  
Khan W. Li ◽  
John C. Liu ◽  
Ziya L. Gokaslan ◽  
Patrick C. Hsieh
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Spinal Cord Compression ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Pedicle Screw Fixation ◽  
Lower Extremity Weakness ◽  
Hardware Failure ◽  
Minimally Invasive Surgical ◽  
Potential Benefits

Abstract OBJECTIVE Metastatic epidural spinal cord compression is a potentially devastating complication of cancer and is estimated to occur in 5% to 14% of all cancer patients. It is best treated surgically. Minimally invasive spine surgery has the potential benefits of decreased surgical approach–related morbidity, blood loss, hospital stay, and time to mobilization. CLINICAL PRESENTATION A 36-year-old man presented with worsening back pain and lower extremity weakness. Workup revealed metastatic adenocarcinoma of the lung with spinal cord compression at T4 and T5. INTERVENTION AND TECHNIQUE T4 and T5 vertebrectomy with expandable cage placement and T1–T8 pedicle screw fixation and fusion were performed using minimally invasive surgical techniques. RESULT The patient improved neurologically and was ambulatory on postoperative day 1. At the 9-month follow-up point, he remained neurologically intact and pain free, and there was no evidence of hardware failure. CONCLUSION Minimally invasive surgical circumferential decompression may be a viable option for the treatment of metastatic epidural spinal cord compression.

scholarly journals Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

Spine ◽  
2016 ◽  
Vol 41 (18) ◽  
pp. 1469-1476 ◽  
Author(s):  
Mingxing Lei ◽  
Jianjie Li ◽  
Yaosheng Liu ◽  
Weigang Jiang ◽  
Shubin Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Metastatic Spinal Cord Compression ◽  
Decompressive Surgery ◽  
Spine Stabilization

scholarly journals Cervical myelopathy due to neurovascular compression syndrome caused by persistent first intersegmental artery: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Takuro Endo ◽  
Taku Sugawara ◽  
Naoki Higashiyama
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cervical Myelopathy ◽  
Anatomical Variation ◽  
Cord Compression ◽  
Burning Sensation ◽  
Motor Dysfunction ◽  
Neurological Deficits ◽  
Left Shoulder ◽  
Neurovascular Compression

Abstract Background Persistent first intersegmental artery (PFIA) is a rare anatomical variation of vertebral arteries and is an asymptomatic finding in most cases. Here we report a rare case of cervical myelopathy caused by spinal cord compression by the PFIA. Case presentation The patient was a 52-year-old man who complained of numbness and burning sensation around the neck and left shoulder area, partial weakness in the left deltoid muscle, right side thermal hypoalgesia, and disturbance of deep sensation since the past 1 year, and the symptoms had gradually worsened. Magnetic resonance imaging (MRI) and computed tomography (CT) showed spinal cord compression by the left PFIA at the C1/C2 level. Because conservative treatment was ineffective, microvascular decompression (MVD) of the PFIA was performed. The left PFIA was laterally transposed using polytetrafluoroethylene (PTFE) bands and anchored to the dura mater using three PTFE bands. To achieve adequate transposition, the small blood vessels bridging the spinal cord and PFIA and the dorsal root nerve had to be sacrificed. Postoperative T2-weighted MRI showed a small hyperintense region in the lateral funiculus of the spinal cord, but no new neurological deficits were identified. In the early postoperative stage, the patient’s deep sensory impairment and motor dysfunction were improved. His numbness and burning sensation almost disappeared, but slight thermal hypoalgesia remained in the lower limb. Conclusion MVD is an effective treatment for spinal cord compression caused by the PFIA, but further studies are necessary to help address technical difficulties and avoid complications.

scholarly journals Non-fusion palliative spine surgery without reconstruction is safe and effective in spinal metastasis patients: retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Siravich Suvithayasiri ◽  
Borriwat Santipas ◽  
Sirichai Wilartratsami ◽  
Monchai Ruangchainikom ◽  
Panya Luksanapruksa
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Survival Data ◽  
Spinal Metastasis ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Survival Duration ◽  
Related Complication ◽  
The Mean ◽  
Anterior Reconstruction

AbstractConsidering the shorter life expectancy and poorer prognosis of metastatic epidural spinal cord compression patients, anterior reconstruction and fusion may be unnecessary. This study aimed to investigate the outcomes of palliative surgery for metastatic epidural spinal cord compression with neurological deficit among patients who underwent posterior decompression and instrumentation without fusion or anterior reconstruction. This single-center retrospective review included all patients aged > 18 years with thoracic or lumbar spinal metastasis who were surgically treated for metastatic spinal cord compression without fusion or anterior reconstruction at the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during July 2015 to December 2017. Data from preoperation to the 1-year follow-up, including demographic and clinical data, Frankel classification, pain scores, complication, revision surgery, health-related quality-of-life scores, and survival data, were collected and analyzed. A total of 30 patients were included. The mean age was 59.83 ± 11.73 years, and 20 (66.7%) patients were female. The mean operative time was 208.17 ± 58.41 min. At least one Frankel grade improvement was reported in 53.33% of patients. The pain visual analog scale, the EuroQOL five-dimension five-level utility score, and the Oswestry Disability Index were all significantly improved at a minimum of 3 months after surgery. No intraoperative mortality or instrument-related complication was reported. The mean survival duration was 11.4 ± 8.97 months. Palliative non-fusion surgery without anterior reconstruction may be considered as a preferable choice for treating spinal metastasis patients with spinal cord compression with neurological deficits.

scholarly journals IgG4-Related Sclerosing Disease Causing Spinal Cord Compression: The First Reported Case in Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Nooraldin Merza ◽  
Ahmed Taha ◽  
John Lung ◽  
Anthony W. Benderman ◽  
Stephen E. Wright
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Pathological Examination ◽  
Tissue Mass ◽  
Systemic Steroids ◽  
First Case

Immunoglobulin G4-related disease (IgG4-RD) is known for forming soft tissue mass lesions that may have compressive effects. It is an extremely rare disease that most frequently affects the pancreas causing autoimmune pancreatitis. It can also affect the gallbladder, salivary glands, and lacrimal glands causing respective organ-specific complications. In our report, we describe an IgG4-RD case that affected the spinal cord. A 60-year-old female presented with cervical spinal cord compression caused by IgG4-RD leading to several neurological deficits. Pathological examination of the excisional biopsy of the mass revealed dense lymphoplasmacytic cells infiltration and stromal fibrosis with IgG4 and plasma cells. The patient showed a dramatic response to the administration of systemic steroids with almost resolution of her neurological symptoms. This case highlights the first case in literature for IgG4-RD of the extradural tissue causing spinal compression. Hereby, we also demonstrate the dramatic response of IgG4-RD to the administration of systemic steroids as the patient had no recurrence after 5 years of close follow-up, the longest reported period of follow-up reported in the literature to date.

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