scholarly journals Microsurgical Repair of Severed Thoracic Spinal Cord and Clinical Outcome: Technical Case Report

2021 ◽  
Author(s):  
Chandrasekaran Kaliaperumal
Keyword(s):  
Spinal Cord ◽  
Thoracic Spine ◽  
Lower Limb ◽  
Operative Management ◽  
Thoracic Spinal Cord ◽  
Stab Injury ◽  
Thoracic Spinal ◽  
Impairment Score ◽  
History Of ◽  
Knife Injury

Abstract This report describes a case of successful repair of severed thoracic spine in a young man who presented with a penetrating stab injury to spine resulting in Brown-Séquard syndrome. Surgical technique and post-operative management is discussed.A 34-year-old fit and well healthy man was admitted with a history of stab injury to the thoracic spine at thoracic T2/3 level with ASIA impairment score (AIS) score D with an incomplete spinal cord affecting his left lower limb with complete paralysis and right lower limb paresis with impaired sensation below T6 level to L5. Neuroimaging confirmed a penetrating knife injury traversing the T2/3 level causing hemi-section of the spinal cord confirmed intraoperatively. He underwent an urgent exploratory surgery of his spine and a T2/3 laminectomy was performed to aid removal of the knife. The dura was noted to be contused and severed spinal cord was noted to be severed with associated cord oedema. A microsurgical repair of the severed cord was performed with duroplasty followed by intense neuro-rehabilitation. On a three month follow up his AIS score is E with lower limb power is 5/5 bilaterally and he is able to mobilise independently up to 8-10 steps without any supportive aid and with crutches he is independently functional and mobile.This is the first documented case of microsurgical repair of severed thoracic spinal cord secondary to traumatic knife injury. In the management of such scenario, apart from the removal of foreign body, repair of the cord with duroplasty should be carefully considered. The role of spinal neuroplasticity in healing following timely repair of the spinal cord along with intense rehabilitation remains the key. This had resulted in a good clinical and functional outcome with in a 12 month period.

Multiple hemangiomas (hemangiomatosis) of the cauda equina and spinal cord

2000 ◽  
Vol 92 (2) ◽  
pp. 229-232 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
H. Gordon Deen
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Unique Case ◽  
Nerve Roots ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal ◽  
History Of ◽  
Leg Weakness

✓ A case of multiple hemangiomas of the cauda equina nerve roots, conus medullaris, and lower spinal cord is described. The 74-year-old male patient presented with a 9-month history of progressive bilateral leg weakness. He had a history of lymphoma at the age of 39 years and renal cell carcinoma in his early 40s. Neither disease was evident at the time of this presentation. A magnetic resonance image revealed multiple enhancing nodules in the cauda equina region as well as on the pial surface of the lower thoracic spinal cord and conus medullaris. The patient underwent an L2–3 laminectomy. Cauda equina nerve roots were found to be studded with numerous purple nodules, the largest measuring 6 to 8 mm. The nodules were adherent to nerve roots from which they could not be resected. Two lesions were histologically examined and found to be capillary hemangiomas. Twelve months into an uneventful postoperative course, the patient is neurologically unchanged. This unique case might represent a distinct form of hemangiomatosis confined to the cauda equina nerve roots and spinal cord.

Anaplastic Astrocytoma in the Spinal Cord of an African Pygmy Hedgehog (Atelerix albiventris)

2008 ◽  
Vol 45 (6) ◽  
pp. 934-938 ◽  
Author(s):  
C. J. Gibson ◽  
N. M. A. Parry ◽  
R. M. Jakowski ◽  
D. Eshar
Keyword(s):  
Spinal Cord ◽  
Anaplastic Astrocytoma ◽  
Grey Matter ◽  
Postmortem Examination ◽  
Lumbar Spinal Cord ◽  
Cellular Infiltration ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
History Of ◽  
Lumbar Spinal

A 2–year-old, female hedgehog presented with an 8–month history of progressive, ascending paresis/paralysis and was tentatively diagnosed with wobbly hedgehog syndrome. She died awaiting further diagnostic tests, and the owners consented to postmortem examination. Grossly, the bladder was large and flaccid and the cervical and lumbar spinal cord were regionally enlarged, light grey, and friable with multifocal hemorrhages. The thoracic spinal cord was grossly normal. Microscopically all regions of the spinal cord had similar changes, although the cervical and lumbar sections were most severely affected. These regions were completely effaced by a moderately cellular infiltration of highly pleomorphic polygonal to spindle shaped cells, mineralization, and necrosis, which were most consistent with anaplastic astrocytoma. The thoracic spinal cord white matter was similarly infiltrated by the neoplastic cells, with perivascular extension into the otherwise normal grey matter. A diagnosis of anaplastic astrocytoma was confirmed using immunohistochemical stains that were positive for glial fibrillary acidic protein and S100.

Penetrating Stab Injury to the Thoracic Spinal Cord: A Case Report

2015 ◽  
Vol 12 (02) ◽  
pp. 149-151
Author(s):  
Ravi Tiwary ◽  
Ashish Desai ◽  
Amit Garg ◽  
Sushil Kumar
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Thoracic Spinal Cord ◽  
Stab Injury ◽  
Thoracic Spinal

scholarly journals Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy

2019 ◽  
Vol 6 ◽  
pp. 2329048X1984245 ◽  
Author(s):  
Ashutosh Kumar ◽  
Salman Rashid ◽  
Sumit Singh ◽  
Rong Li ◽  
Leon S. Dure
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
World Health ◽  
Thoracic Spinal Cord ◽  
Lower Extremity Weakness ◽  
Thoracic Spinal ◽  
History Of ◽  
Health Organization ◽  
Cerebrospinal Fluid Pleocytosis ◽  
Diffuse Midline Glioma

Objective: We report a child presenting with spinal myelopathy secondary to H3K27M mutant diffuse midline glioma. Case Report: A 4-year-old boy presented with a 3-week history of progressive gait difficulty. Examination revealed bilateral hand and lower extremity weakness, left leg hypertonia with ankle clonus, and a right hemisensory deficit. Magnetic resonance imaging of neuroaxis showed cervical and thoracic spinal cord with expansion and irregular areas of enhancement. Serum and cerebrospinal fluid studies were unremarkable for infectious, autoimmune, inflammatory, and neoplastic causes but showed mild cerebrospinal fluid pleocytosis, hypoglycorrhachia, and high protein level. A thoracic cord biopsy revealed a diffuse midline glioma (World Health Organization grade IV). Consequently, the tumor involved intracranial structures and patient died within 4 months after diagnosis. Conclusion: High-grade spinal cord gliomas are very rare but should be considered in the differential diagnosis of pediatric myelopathy. Tissue biopsy is recommended in indeterminate cases to facilitate diagnosis and to guide management.

scholarly journals Intramedullary Capillary Hemangioma of the Thoracic Spine: Case Report and Review of the Literature

Rare Tumors ◽  
2009 ◽  
Vol 1 (1) ◽  
pp. 4-6 ◽  
Author(s):  
Rahul Kasukurthi ◽  
Wilson Z. Ray ◽  
Spiros L. Blackburn ◽  
Eriks A. Lusis ◽  
Paul Santiago
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Thoracic Spine ◽  
Rare Case ◽  
Capillary Hemangioma ◽  
Review Of The Literature ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Vascular Neoplasms ◽  
Spine Case

Capillary hemangiomas are benign vascular neoplasms. When associated with the spine, these growths frequently involve the vertebral body, but rarely have they been reported to occur as intradural lesions, while even more rarely occurring in a true intramedullary location. We report a rare case of an intramedullary capillary hemangioma of the thoracic spinal cord and a review of the literature.

scholarly journals Thoracic Spinal Cord Stab Injury: A Case Report and Literature Review

2015 ◽  
Vol 05 (04) ◽  
pp. 113-117
Author(s):  
Aurélien Ndoumbe ◽  
Marc Leroy Guifo ◽  
Mathieu Motah ◽  
Samuel Takongmo
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Literature Review ◽  
Thoracic Spinal Cord ◽  
Stab Injury ◽  
Thoracic Spinal

Intraspinal Penetrating Stab Injury to the Middle Thoracic Spinal Cord With No Neurologic Deficit

Orthopedics ◽  
2012 ◽  
Vol 35 (5) ◽  
pp. e770-e773 ◽  
Author(s):  
Xinning Li ◽  
Emily J. Curry ◽  
Micah Blais ◽  
Richard Ma ◽  
Arno S. Sungarian
Keyword(s):  
Spinal Cord ◽  
Neurologic Deficit ◽  
Thoracic Spinal Cord ◽  
Stab Injury ◽  
Thoracic Spinal

scholarly journals Thoracic spinal cord compression secondary to metastatic synovial sarcoma: case report

2009 ◽  
Vol 8 (2) ◽  
pp. 206-211 ◽  
Author(s):  
Paul M. Arnold ◽  
Michael C. Park ◽  
Kathy Newell ◽  
John J. Kepes ◽  
J. Brantley Thrasher
Keyword(s):  
Spinal Cord ◽  
Synovial Sarcoma ◽  
Spinal Cord Compression ◽  
Soft Tissues ◽  
Cord Compression ◽  
Posterior Fixation ◽  
Soft Tissue Neoplasm ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
History Of

Synovial sarcoma is an uncommon malignant soft tissue neoplasm, occurring primarily in adolescents and young adults. It is prevalent in the periarticular soft tissues near large joints of the extremities and rarely involves the trunk. Metastases are not uncommon and usually involve the lungs; metastasis to the thoracic spine is rare. We report the case of a 47-year-old man with a history of synovial sarcoma of the lower back, with subsequent metastases to the lung, penis, and perineum (all previously resected), presenting with a 3-month history of low back pain and lower extremity paresthesias. Magnetic resonance imaging (MRI) demonstrated multiple lesions involving multiple contiguous vertebral bodies, with the mass at T12 compressing the spinal cord. The patient underwent T11-T12 laminectomy, transpedicular decompression, tumor debulking, and posterior fixation and fusion. The patient died six months later due to disease progression. Although not curative, decompression and stabilization of the spine are often necessary in patients who present spinal cord compression.

scholarly journals An update on hemilaminectomy of the cranial thoracic spine: Review of six cases

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kathryn Y. Bray ◽  
Peter J. Early ◽  
Natasha J. Olby ◽  
Melissa J. Lewis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Thoracic Spine ◽  
Surgical Approach ◽  
Cord Compression ◽  
Thoracic Vertebrae ◽  
Disc Disease ◽  
Thoracic Spinal Cord ◽  
Neurologic Status ◽  
Thoracic Spinal

Background: The optimal surgical approach to relieve spinal cord compression in the cranial thoracic spine is not well described, and the anatomy of the cranial thoracic vertebrae creates added surgical difficulty.Aim: This study describes the surgical approach, treatment, and outcome of three dogs and three cats that underwent a cranial thoracic hemilaminectomy for the treatment of extradural spinal cord compression. Surgical positioning was tailored to avoid extensive dissection and provide for a restricted, careful approach.Methods: Three dogs and three cats presenting for cranial thoracic spinal cord compression requiring surgical intervention were included.Results: All patients were discharged within 5 days. No patients experienced postoperative deterioration in neurologic status, and four animals had improved neurologic status at discharge.Conclusion: In cases with cranial thoracic spinal cord compression, the spinous processes can be spared, extensive muscle dissection minimized, and successful outcomes achieved with the appropriate positioning and limited approach. Keywords: Hemilaminectomy, Intervertebral Disc Disease, Myelopathy, Thoracic.

Endoscopic Access to the Ventral Thoracic spine: PETD vs. Thoracoscopy

2018 ◽  
Vol 1 (2) ◽  
pp. 3
Author(s):  
Jun Ho Le
Keyword(s):  
Spinal Cord ◽  
Thoracic Spine ◽  
Posterior Approach ◽  
Shoulder Girdle ◽  
Spinal Mobility ◽  
Thoracic Spinal Cord ◽  
Invasive Approach ◽  
Perioperative Morbidity ◽  
Thoracic Spinal ◽  
Cord Injury

Symptomatic thoracic disc herniation (TDH) is estimated to afflict between 1 in 1,000 and 1 in 1,000,000 people; affecting men more frequently than women, with the highest incidence seen at 40-50 years of age. TDH occurs at all levels of the thoracic spine but 75% of cases occur below T8, with T11-T12 being the most common site due to spinal mobility and weakness of the posterior longitudinal ligament.Manipulation of the thoracic spinal cord through the conventional posterior approach has been associated with poor outcomes. A conventional posterior approach consisting of laminectomy, cord retraction, and disc removal was historically done to treat TDH but this causes spinal cord injury and irreversible paraplegia due to cord manipulation on the relatively rigid spinal cord.The anterior approach to the spine is also intimidating to the spine surgeon due to the unique anatomy of the thoracic spine. Conventional open approaches to the thoracic spine involve a thoracotomy, rib resection, and corpectomy to view the spinal cord anteriorly. This has been associated with perioperative morbidity due to surgical site pain, difficult/painful breathing, shoulder girdle dysfunction, and wound healing problems.In order to spare the patients suffering from these postoperative iatrogenic sequelae, the author presents two different minimally invasive approach techniques; percutaneous endoscopic thoracic discectomy (PETD) vs. thoracoscopy, each applied to a different indication or thoracic pathology, to gain an enough but safe access to the ventral thoracic spinal canal through minimized surgical damages without yielding a postsurgical morbidity.

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