scholarly journals Extradural Spinal Tumors: Report of 36 Cases and Review of Literature

2016 ◽  
Vol 13 (1) ◽  
pp. 3-10
Author(s):  
Gopal R Sharma ◽  
Nilam Khadka ◽  
Rajiv Jha ◽  
Dhurba R Adhikari ◽  
Prakash Bista
Keyword(s):  
Back Pain ◽  
Soft Tissues ◽  
Relevant Literature ◽  
Bone Cyst ◽  
Neurological Status ◽  
Motor Deficit ◽  
Spinal Tumors ◽  
Metastatic Lesions ◽  
Wide Range

About 55% of spinal tumors are extradural arising from vertebral bodies, epidural and surrounding neural and soft tissues. More than 90% of extradural spinal tumors are metastatic lesions. Extradural spinal tumors are common cause of back pain, sensory motor deficit and sphincters dysfunction. The wide range of lesions and varied clinical profile, make management of spinal extradural tumors a challenging task for any neurosurgeon.Aim of this study is to analyze and discuss the results of extradural spinal tumors after surgical treatment and relevant literature will be reviewed.This is a retrospective study of 36 patients who were operated for spinal extradural tumors between May 1999 and December 2012 in our institute.Follow up period ranged from 3 years to 12 years. Functional neurological outcome was assessed by McCormick's grading. There were 20 male and 16 female and age ranged from 10 to 80 years. 30 patients presented with back pain and 15 had radicular pain. On presentation 18 patients had motor sensory deficit and 15 had sphincters dysfunction. Most common involved level of spines were thoracic followed by cervical and lumbar.Gross total excision of masses were carried out in all cases. Common pathologies were neurofibromas (16), Ewing's sarcoma (7), granulomas (3), metastatic lesions (2), angiolipoma (2), chondroma (2), aneurysmal bone cyst (1), plasmacytoma (1), rabdomyosarcoma (1) and neuroblastoma (1).Out of 14 patients who harbored malignant pathology 12 patients received radio and chemotherapy. Post operative wound infection occurred in 5 patients. Regarding post operative neurological status, 18 patients showed improvement, 6 patients remained same and 12 patients had deteriorated neurology. Tumor recurrence occurred in 15 patients; 12 patients with malignant and 3 patients with benign lesions on follow up period. There was no surgery related mortality, however, 11 patients died during 3 years follow up period due to adverse pathology they were having.Nepal Journal of Neuroscience 13:3-10, 2016

scholarly journals Comparison of prognostic scales for patients with metastatic spine disease

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Anton Denisov ◽  
Nikita S. Zaborovsky ◽  
Dmitry A. Ptashnikov ◽  
Dmitry A. Mikhailov ◽  
Sergey V. Masevnin ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Neurological Status ◽  
Spinal Tumors ◽  
Analysis Software ◽  
Software Environment ◽  
Prognostic Accuracy ◽  
Metastatic Lesions ◽  
Spinal Lesions ◽  
Spinal Cord Decompression ◽  
Statistical Analysis Software

This is one-centre retrospective study with the aim to identify the scale, which provides the most accurate prediction of life expectancy in patients with metastatic lesions in spine. A retrospective analysis of clinical data of 138 patients with metastatic spinal tumors. Patients underwent spinal cord decompression and instrumented stabilization of affected area. We evaluated the general condition according to the Karnofsky and ECOG scales, the presence of metastases in the visceral organs, spine and other bones, the neurological status and conduction of the medical therapy before spinal surgery. Observed clinical parameters were converted to Tokuhashi, Tomita, and Katagiri scales. For statistical analysis, software environment R 3.4.1 was used. Assessment of prognostic accuracy was performed using ROC analysis. The Tokuhashi scale showed AUC 0.605 (95% CI 0.586-0.616), Tomita scale showed AUC 0.708 (95% CI 0.573-0.842), Katagiri scale showed AUC 0.650 (95% CI 0.508-0.792). The best results for survival rate predicting after surgical treatment for metastatic spinal lesions were shown the Tomita scale.

scholarly journals Spinal meningioma in a patient with multiple sclerosis

2020 ◽  
Vol 11 ◽  
pp. 196
Author(s):  
Sricharan Gopakumar ◽  
Marc Daou ◽  
Ron Gadot ◽  
Alexander E. Ropper ◽  
Jacob Mandel
Keyword(s):  
Multiple Sclerosis ◽  
Back Pain ◽  
Demyelinating Disease ◽  
Tumor Resection ◽  
Review Literature ◽  
Spinal Tumors ◽  
Spinal Meningioma ◽  
Lower Extremity Weakness ◽  
Patient Reported

Background: Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system. Multiple brain and spinal tumors have been linked to MS, but a causal relationship between the two has not been determined. Here, we report a case of spinal meningioma in a patient with MS and review literature discussing the possible connection between these two disease entities. Case Description: A 58-year-old female with MS presented with a 1-year history of progressively worsening back pain in conjunction with worsening right upper and lower extremity weakness. The patient was diagnosed with MS 19 months prior and had multiple known demyelinating plaques in her cervical spine. New MRI revealed an intradural extramedullary thoracic tumor with characteristics consistent with meningioma. She underwent T6- T8 laminectomies for tumor resection and pathology confirmed the radiological diagnosis. At 3-month follow- up, the patient reported complete resolution of her back pain and persistence of weakness-related gait issues. Conclusion: CNS neoplasms including meningioma should be considered in MS patients presenting with newly onset neurological symptoms not entirely consistent with demyelinating disease. Both disease processes should be addressed with appropriate long-term follow-up.

Factors Leading to a Poor Functional Outcome in Spinal Meningioma Surgery: Remarks on 173 Cases

Neurosurgery ◽  
2017 ◽  
Vol 80 (4) ◽  
pp. 602-609 ◽  
Author(s):  
Antonino Raco ◽  
Alessandro Pesce ◽  
Giada Toccaceli ◽  
Maurizio Domenicucci ◽  
Massimo Miscusi ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Functional Improvement ◽  
Motor Deficit ◽  
Spinal Tumors ◽  
Functional Grade ◽  
Who Grade ◽  
Axial Location ◽  
Simpson Grade ◽  
Spinal Meningiomas

Abstract BACKGROUND: Spinal meningiomas are common spinal tumors, in most cases benign and with a good surgical prognosis. However, specific location, infiltration of spinal cord, vascular encasement, or spinal root involvement can bring a less favorable prognosis. OBJECTIVE: To correlate these data with clinical/functional outcome. METHODS: Two hundred twenty-four consecutive patients with spinal meningiomas treated from 1976 to 2013 in our institution were analyzed; among these, 51 were excluded for incomplete clinical data or follow-up. The remaining 173 cases were classified in regards to sex, age, symptoms, axial location, Simpson grade resection, and functional pre-/postoperative status. RESULTS: Most recurring onset symptoms were pain (32.9%) and motor deficit (31.8%); thoracic spine was the most severely affected (69.8%). Functional improvement on the follow-up was observed in 86.7% of cases; 6.4% of patients resulted stable and 6.9% worsened. A low functional grade before surgery was connected to a lesser improvement after. Anterolateral meningiomas were the most represented (42.2%); a gross total resection (Simpson grades I and II) was conducted in 98.8%, and a macroscopically complete removal without dural resection or coagulation (Simpson grade III) was performed in 1.2%. Of the meningiomas, 98.3% were classified as WHO grade I. Recurrence rate was 2.3%, and 7 cases presented complications (4 of 7 required surgical procedure). CONCLUSION: We can affirm that negative prognostic factors in our study were anterior or anterolateral axial location, prolonged presentation before diagnosis, WHO grade >I, Simpson grade resections II and III, sphincter involvement, and worse functional grade at onset.

scholarly journals Spontaneous Decompression of Extradural Hematoma Through Skull Fracture

2014 ◽  
Vol 3 (2) ◽  
pp. 79-81
Keyword(s):  
Epidural Hematoma ◽  
Relevant Literature ◽  
Skull Fracture ◽  
Neurological Status ◽  
Computed Tomography Scan ◽  
Extradural Hematoma ◽  
Surgical Evacuation ◽  
Acute Epidural Hematoma ◽  
Tomography Scan

ABSTRACT It has been increasingly recognized that there is a subgroup of patients, the extradural hematoma can disappear rapidly without surgical evacuation. In present, we report a case of 65-year-old gentleman whose follow-up computed tomography scan, showed reduction in the size of acute epidural hematoma and review the relevant literature. However, we need to remember if there is no improvement in the neurological status of the patient, a follow-up scan still is needed to assess the size of the hematoma. How to cite this article Agrawal A. Spontaneous Decompression of Extradural Hematoma Through Skull Fracture. Panam J Trauma Crit Care Emerg Surg 2014;3(2):79-81.

Unicameral bone cyst of the patella in a young dog

2015 ◽  
Vol 28 (05) ◽  
pp. 359-363 ◽  
Author(s):  
F. Briotti ◽  
B. Beale ◽  
M. Petazzoni
Keyword(s):  
Physical Examination ◽  
Soft Tissues ◽  
Proximal Tibia ◽  
Bone Cyst ◽  
Clinical Signs ◽  
Unicameral Bone Cyst ◽  
Radiographic Examination ◽  
Autogenous Bone ◽  
Hindlimb Lameness

SummaryThis report describes a case of a solitary unicameral patellar bone cyst in a young dog. A five-month-old, male Dobermann Pinscher dog was referred for a 10-day left hindlimb lameness. A mild swelling of the peripatellar soft tissues of the left patella was detected upon physical examination. Signs of pain were elicited upon direct palpation of the patella. Radiographic examination revealed an oval radiolucency within the medullary cavity at the base of the left patella. Radiographic examination, arthroscopy, and histopathology findings supported the diagnosis of a benign patellar bone cyst. The condition was treated by surgical curettage and autogenous bone graft harvested from the ipsilateral proximal tibia. Clinical signs, including lameness and signs of pain upon deep palpation, disappeared three weeks after surgery. Follow-up re-evaluation five years after surgery revealed no recurrence of the cyst and the patient was asymptomatic.

scholarly journals Cohort profile: the AUstralian Twin BACK pain and physical activity study (AUTBACK study)

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036301
Author(s):  
Ana Paula Carvalho-e-Silva ◽  
Marina B Pinheiro ◽  
Manuela L Ferreira ◽  
Markus Hübscher ◽  
Lucas Calais-Ferreira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Back Pain ◽  
Activity Relationship ◽  
Activity Levels ◽  
Health Lifestyle ◽  
Wide Range ◽  
Intensity Physical Activity ◽  
Vigorous Intensity ◽  
Future Plans

PurposeDespite the growing evidence that physical activity and familial factors play a role in low back pain (LBP), there is a lack of robust longitudinal studies that (1) investigate the types and dosages of physical activity that are protective or harmful for LBP, (2) employ objective measures of physical activity and (3) conduct appropriate adjustment for confounders. The AUstralian Twin BACK (AUTBACK) study was established to elucidate the longitudinal LBP–physical activity relationship with the benefits of controlling for familial (both genetic/nongenetic) factors that may influence physical activity engagement and LBP.ParticipantsParticipants are twins registered at Twins Research Australia (TRA), older than 18 years, with access to internet. We collected data on LBP status (weekly) and physical activity levels (monthly) for 12 months as well as a wide range of health, lifestyle and physical activity (objective, self-reported, including different types and dosages) data.Findings to dateWe included 401 twins, 157 being complete twin pairs (n=314). Lifetime prevalence of LBP was 85%. Participants spent 61% of their week in sedentary time and only 4% in moderate/vigorous intensity physical activity (accelerometer). So far, 168 participants (40% of the sample) have completed the 12-month follow-up. A total of 7150 weekly (LBP status) and 1763 monthly questionnaires (physical activity status) have been answered (92% response rate).Future plansThe 12-month follow-up will be completed by June 2020. This cohort represents a novel and comprehensive resource for researchers in the field, and includes high-quality, and frequent data on LBP and physical activity. It allows the investigation of genetic and shared environmental factors on the LBP–physical activity relationship. The AUTBACK group has planned a number of projects, with the main one being the investigation of the influence of physical activity on recurrence of LBP. Data linkage opportunities are available, including with other studies conducted by TRA.

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

Long-term stability of fusiform dilatation of the internal carotid artery following surgery adjacent to the circle of Willis: report of 2 cases

2020 ◽  
pp. 1-4
Author(s):  
Madeline B. Karsten ◽  
R. Michael Scott
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Arachnoid Cyst ◽  
Pediatric Patients ◽  
Internal Carotid ◽  
Imaging Finding ◽  
Neurological Status ◽  
Suprasellar Region

Fusiform dilatation of the internal carotid artery (FDCA) is a known postoperative imaging finding after craniopharyngioma resection. FDCA has also been reported following surgery for other lesions in the suprasellar region in pediatric patients and is thought to be due to trauma to the internal carotid artery (ICA) wall during tumor dissection. Here, the authors report 2 cases of pediatric patients with FDCA. Case 1 is a patient in whom FDCA was visualized on follow-up scans after total resection of a craniopharyngioma; this patient’s subsequent scans and neurological status remained stable throughout a 20-year follow-up period. In case 2, FDCA appeared after resection and fenestration of a giant arachnoid cyst in a 3-year-old child, with 6 years of stable subsequent follow-up, an imaging finding that to the authors’ knowledge has not previously been reported following surgery for arachnoid cyst fenestration. These cases demonstrate that surgery involving dissection adjacent to the carotid artery wall in pediatric patients may lead to the development of FDCA. On very long-term follow-up, this imaging finding rarely changes and virtually all patients remain asymptomatic. Neurointerventional treatment of FDCA in the absence of symptoms or significant late enlargement of the arterial ectasia does not appear to be indicated.

PRIMARY MELANOMA OF THE GALLBLADDER MANIFESTED BY ACUTE CHOLECYSTITIS. DESCRIPTION OF A SINGLE CASE

2018 ◽  
Vol 64 (2) ◽  
pp. 253-255
Author(s):  
Oleg Kit ◽  
Yevgeniy Kolesnikov ◽  
Roman Myagkov ◽  
Leonid Kharin ◽  
Yevgeniya Nepomnyashchaya
Keyword(s):  
Acute Cholecystitis ◽  
Mucous Membrane ◽  
Cutaneous Melanoma ◽  
Multidisciplinary Approach ◽  
Single Case ◽  
Primary Melanoma ◽  
Metastatic Lesions ◽  
Long Term Follow Up

Most of melanomas of the gallbladder are metastatic lesions of cutaneous melanoma. Primary melanomas of the gallbladder are described as single, polypoid, intraluminal masses emanating from the mucous membrane. The most important characteristic is the absence of melanoma damage to the skin. If it is not possible to localize primary melanoma a multidisciplinary approach to diagnostic search comes to the fore. Predicting for primary melanoma of the gallbladder is a difficult task due to the small number of cases and the absence of long-term follow-up for this category of patients.

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