Ossifying lipoma of the cervical spine

2010 ◽  
Vol 5 (3) ◽  
pp. 283-284 ◽  
Author(s):  
Ashley Brones ◽  
Sarah Mengshol ◽  
C. Corbett Wilkinson
Keyword(s):  
Cervical Spine ◽  
Neurological Deficits ◽  
Heterotopic Bone ◽  
Spinal Lipoma ◽  
Ossifying Lipoma

The authors present the case of a 21-month-old girl with a posterior cervical subcutaneous/spinal lipoma that contained heterotopic bone. The patient demonstrated no neurological deficits and the lesion was resected without complication. The lesion was determined to be an ossifying lipoma. The literature on ossifying lipomas and osteolipomas is reviewed and the differences between the two are enumerated.

Synovial Sarcoma of the Cervical Spine: Case Report

2021 ◽  
Author(s):  
Nuno Oliveira ◽  
Sofia Carvalho ◽  
Paulo Cunha ◽  
Joni Nunes ◽  
Pedro Varanda ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Soft Tissue ◽  
Synovial Sarcoma ◽  
Therapeutic Strategy ◽  
Osteolytic Lesion ◽  
Neurological Deficits ◽  
Soft Tissue Tumour ◽  
Tissue Tumour ◽  
Primary Bone

Abstract PurposeTo describe a very rare case of Synovial Sarcoma affecting cervical spine vertebra.SS is a rare malignant and aggressive soft tissue tumour arising from mesenchymal cells. Primary bone origin SS is a much rarer entity that affects more commonly long bones. Ideal therapeutic strategy is yet to be defined due to very small number of cases reported so far.Case reportA 55-year-old male, construction worker, with no other relevant medical history presented with a progressive tetraparesis after recurring several times during a 4-week period to assistant physician and emergency department complaining about bilateral shoulder pain. Image studies revealed an osteolytic lesion centred on C4 vertebra with intracanalar and intraforaminal extension, causing neurologic compression. Patient was submitted to urgent surgical decompression intervention. C3 and C4 corpectomy and excisional biopsy followed by stabilization with C2-C5 arthrodesis.OutcomesNeurological deficits did not improve after surgery. Histopathological and immunohistochemical analysis revealed phenotypical characteristics of a biphasic Synovial Sarcoma. Patient died 4 weeks after surgery due to a respiratory tract infection.DiscussionSS is a malignant rare and aggressive soft tissue tumour that usually affects young adults. Very few cases of primary bone SS affecting the spine are described in literature. Imaging studies may suggest the diagnosis of synovial sarcoma but definitive diagnosis can only be confirmed by histological and immunohistochemical analysis.The rarity of these lesions demands high clinical suspicion for the diagnosis and due to the low number of cases reported ideal therapeutic strategy is yet to be defined.

EOSINOPHILIC GRANULOMA OF THE CERVICAL SPINE IN CHILDREN

PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 746-752
Author(s):  
Robin I. Davidson ◽  
John Shillito
Keyword(s):  
Cervical Spine ◽  
Pyramidal Tract ◽  
Eosinophilic Granuloma ◽  
Cervical Vertebra ◽  
Signs And Symptoms ◽  
Neurological Deficits ◽  
Restricted Range ◽  
Cervical Pain ◽  
Range Of Movement

Eosinophilic granuloma of the cervical spine is recorded in six children, two of whom had neurological deficits. A flaccid monoparesis occurred in one child with a C5 arch lesion. Pyramidal tract signs were present in a patient with a defect at the atlanto-occipital joint. Cervical pain, restricted range of movement, torticollis, and tenderness were other presenting signs and symptoms and occurred in all except one patient. A lytic defect in the arch or centrum of a cervical vertebra was associated with this presentation. Treatment following biopsy consisted of immobilization and radiotherapy in a range of 450 to 750 rads. Cure was effected in all instances.

scholarly journals Osteoid Osteoma and Osteoblastoma of the Cervical Spine: The Cause of Unusual Persistent Neck Pain

2010 ◽  
Vol 6;13 (6;12) ◽  
pp. 549-554
Author(s):  
Tuncay Kaner
Keyword(s):  
Cervical Spine ◽  
Retrospective Study ◽  
Neck Pain ◽  
Osteoid Osteoma ◽  
Tumor Resection ◽  
Spinal Instrumentation ◽  
The Other ◽  
Neurological Deficits ◽  
Common Symptom

Background: The most important symptom in patients with osteoid osteoma and osteoblastoma is a resistant localized neck pain and stiffness in the spine. Objective: To evaluate and analyze 6 cases of osteoid osteoma and osteoblastoma of the cervical spine that were surgically treated over a 7-year period and to emphasize the unusual persistent neck pain associated with osteoid osteoma and osteoblastoma of the cervical spine. Study Design: Retrospective study. Methods: Six patients, 3 male and 3 female, with a mean age of 21 years (range 16-31) diagnosed with osteoid osteoma or osteoblastoma during 2003 to 2009 were analyzed retrospectively. The preoperative neurological and clinical symptoms, neck pain duration, preoperative deformity, location of lesion, radiological findings, surgical technique and clinical follow-up outcomes of each patient were evaluated. Results: The average follow-up duration was 40.5 months (range, 19 to 83 months). Three patients had osteoid osteoma (2 female and one male), and 3 patients had osteoblastoma (one female and 2 male). Two male patients had recurrent osteoblastoma. The locations of the lesions were as follows: C7 (2 patients), C3 (one patient), C2 (one patient), C3-C4 (one patient) and C5-C6 (one patient). The most common symptom was local neck pain in the region of the tumor. Among all patients, only one patient, who had osteoblastoma, had neurological deficits (right C5-C6 root symptoms). The other patients had no neurological deficits. All patients were treated with surgical resection using microsurgery. Two patients underwent only tumor resection, one patient underwent tumor resection and fusion, and the other 3 patients underwent tumor resection, fusion and spinal instrumentation. No perioperative complications developed in any of our patients. There was no tumor recurrence during the follow-up period. Limitations: A retrospective study with 6 analyses of cases. Conclusion: Surgical treatment of osteoid osteoma and osteoblastoma of the spine has been standardized. The most common symptom of osteoid osteoma and osteoblastoma of the cervical spine is local persistent neck pain in the region of the tumor. This symptom can be significant in the diagnosis of these tumors. Key words: neck pain, osteoid osteoma, osteoblastoma, bone tumors, cervical spine

Intradural Spinal Lipoma of the Conus: A Case Report

2019 ◽  
Vol 8 (2) ◽  
pp. 112-114 ◽  
Author(s):  
Shafiul Alam ◽  
Kaiser Haroon ◽  
Tayseer Farzana ◽  
Md Arif Reza ◽  
Abdullah Alamgir ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Mass Effect ◽  
Neurological Deficits ◽  
Subtotal Resection ◽  
Total Excision ◽  
Spinal Lipoma

Intradural spinal lipomas are rare, and their origin is unknown. Although the clinical presentation may not be distinctive, patients usually present with neurological deficits secondary to mass effect. Total excision may not be possible all time, although subtotal resection is easily done by microsurgery. We report a case of intradural spinal lipoma of the conus medullaries. Total excision was done under microscope and histopathology proved lipoma. Bang. J Neurosurgery 2019; 8(2): 112-114

Perioperative acute neurological deficits in instrumented pediatric cervical spine fusions

2019 ◽  
Vol 24 (5) ◽  
pp. 528-538
Author(s):  
Bram P. Verhofste ◽  
Michael P. Glotzbecker ◽  
Michael T. Hresko ◽  
Patricia E. Miller ◽  
Craig M. Birch ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neurological Complications ◽  
Neurological Function ◽  
Spine Fusion ◽  
Neurological Symptoms ◽  
Neurological Deficits ◽  
Complex Disorder ◽  
Spine Instrumentation ◽  
Estimated Blood Loss ◽  
Cervical Spine Fusion

OBJECTIVEPediatric cervical deformity is a complex disorder often associated with neurological deterioration requiring cervical spine fusion. However, limited literature exists on new perioperative neurological deficits in children. This study describes new perioperative neurological deficits in pediatric cervical spine instrumentation and fusion.METHODSA single-center review of pediatric cervical spine instrumentation and fusion during 2002–2018 was performed. Demographics, surgical characteristics, and neurological complications were recorded. Perioperative neurological deficits were defined as the deterioration of preexisting neurological function or the appearance of new neurological symptoms.RESULTSA total of 184 cases (160 patients, 57% male) with an average age of 12.6 ± 5.30 years (range 0.2–24.9 years) were included. Deformity (n = 39) and instability (n = 36) were the most frequent indications. Syndromes were present in 39% (n = 71), with Down syndrome (n = 20) and neurofibromatosis (n = 12) the most prevalent. Eighty-seven (48%) children presented with preoperative neurological deficits (16 sensory, 16 motor, and 55 combined deficits).A total of 178 (96.7%) cases improved or remained neurologically stable. New neurological deficits occurred in 6 (3.3%) cases: 3 hemiparesis, 1 hemiplegia, 1 quadriplegia, and 1 quadriparesis. Preoperative neurological compromise was seen in 4 (67%) of these new deficits (3 myelopathy, 1 sensory deficit) and 5 had complex syndromes. Three new deficits were anticipated with intraoperative neuromonitoring changes (p = 0.025).Three (50.0%) patients with new neurological deficits recovered within 6 months and the child with quadriparesis was regaining neurological function at the latest follow-up. Hemiplegia persisted in 1 patient, and 1 child died due a complication related to the tracheostomy. No association was found between neurological deficits and indication (p = 0.96), etiology (p = 0.46), preoperative neurological symptoms (p = 0.65), age (p = 0.56), use of halo vest (p = 0.41), estimated blood loss (p = 0.09), levels fused (p = 0.09), approach (p = 0.07), or fusion location (p = 0.07).CONCLUSIONSAn improvement of the preexisting neurological deficit or stabilization of neurological function was seen in 96.7% of children after cervical spine fusion. New or progressive neurological deficits occurred in 3.3% of the patients and occurred more frequently in children with preoperative neurological symptoms. Patients with syndromic diagnoses are at higher risk to develop a deficit, probably due to the severity of deformity and the degree of cervical instability. Long-term outcomes of new neurological deficits are favorable, and 50% of patients experienced complete neurological recovery within 6 months.

Risk of early closed reduction in cervical spine subluxation injuries

1999 ◽  
Vol 90 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Gerald A. Grant ◽  
Sohail K. Mirza ◽  
Jens R. Chapman ◽  
H. Richard Winn ◽  
David W. Newell ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Mr Imaging ◽  
Disc Herniation ◽  
Closed Reduction ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Neurological Deterioration ◽  
Neurological Deficits ◽  
Content Type ◽  
Fine Print

Object. The authors retrospectively reviewed 121 patients with traumatic cervical spine injuries to determine the risk of neurological deterioration following early closed reduction. Methods. After excluding minor fractures and injuries without subluxation, the medical records and imaging studies (computerized tomography and magnetic resonance [MR] images) of 82 patients with bilateral and unilateral locked facet dislocations, burst fractures, extension injuries, or miscellaneous cervical fractures with subluxation were reviewed. Disc injury was defined on MR imaging as the presence of herniation or disruption: a herniation was described as deforming the thecal sac or nerve roots, and a disruption was defined as a disc with high T2-weighted signal characteristics in a widened disc space. Fifty-eight percent of patients presented with complete or incomplete spinal cord injuries. Thirteen percent of patients presented with a cervical radiculopathy, 22% were intact, and 9% had only transient neurological deficits in the field. Early, rapid closed reduction, using serial plain radiographs or fluoroscopy and Gardner—Wells craniocervical traction, was achieved in 97.6% of patients. In two patients (2.4%) closed reduction failed and they underwent emergency open surgical reduction. The average time to achieve closed reduction was 2.1 ± 0.24 hours (standard error of the mean). The incidence of disc herniation and disruption in the 80 patients who underwent postreduction MR imaging was 22% and 24%, respectively. However, the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association motor score and the Frankel scale following early closed reduction. Only one (1.3%) of 80 patients deteriorated, but that occurred more than 6 hours following closed reduction. Conclusions. Although disc herniation and disruption can occur following all types of traumatic cervical fracture subluxations, the incidence of neurological deterioration following closed reduction in these patients is rare. The authors recommend early closed reduction in patients presenting with significant motor deficits without prior MR imaging.

scholarly journals Association of Atlanto-Occipital Dislocation, Retroclival Hematoma, and Hydrocephalus: Management and Survival in a Pediatric Patient

2017 ◽  
Vol 78 (01) ◽  
pp. e46-e51
Author(s):  
Isaac Lee ◽  
Luis Vasquez ◽  
Alan Tyroch ◽  
Todd Trier
Keyword(s):  
Cervical Spine ◽  
Pediatric Patient ◽  
Morbidity And Mortality ◽  
Neurological Deficits ◽  
Definitive Treatment ◽  
High Morbidity ◽  
Cervical Fusion ◽  
Improved Outcomes ◽  
Surgical Fixation

AbstractAtlanto-occipital dislocation (AOD) is an injury with high morbidity and mortality. We present a case of survival of a pediatric patient with the diagnoses of AOD, retroclival hematoma, and resulting hydrocephalus. The patient's cervical spine was stabilized until occipital-cervical fusion provided definitive treatment, and the hydrocephalus was treated with a ventriculostomy. The patient survived with no neurological deficits. A better understanding and awareness of the radiologic criteria of AOD will lead to earlier recognition of AOD and improved outcomes, even in the presence of complications from AOD. Surgical fixation should be used for definitive treatment of injuries with AOD.

Clinical Correlations of Cervical Myelopathy and the Hoffmann Sign

2008 ◽  
Vol 9 (3) ◽  
pp. 237-242 ◽  
Author(s):  
John K. Houten ◽  
Louis A. Noce
Keyword(s):  
Cervical Spine ◽  
Cervical Myelopathy ◽  
Imaging Study ◽  
Posterior Longitudinal Ligament ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Positive Sign ◽  
Cervical Cord ◽  
Babinski Sign ◽  
Tertiary Center

Object The Hoffmann sign is commonly used in clinical practice to assess cervical spine disease. It is whether the sign correlates with the severity of myelopathy, and no consensus exists regarding the significance a positive sign in asymptomatic individuals. Methods In a retrospective review of cervical spine surgeries for myelopathy due to cervical spondylosis, fication of the posterior longitudinal ligament, or disc herniation performed at a tertiary center, the authors data on the presence of hyperreflexia, the Hoffmann and Babinski signs, and modified Japanese Orthopaedic ciation (mJOA) scale scores. Then, in a prospective evaluation, new patients with lumbar spine complaints examined for the presence of a Hoffmann sign, and, if present, a cervical MR imaging study was assessed for compression. Results Of the 225 surgically treated patients, a Hoffmann sign occurred in 68%, hyperreflexia in 60%, and Babinski sign in 33%. In patients with milder disability (mJOA Scores 14–16), the Hoffmann sign was present 46%, whereas a Babinski sign occurred in 10%; in those with severe myelopathy and mJOA scores of ≤ 10, Hoffmann sign was present in 81% and the Babinski sign in 83%. Of 290 patients presenting exclusively with bar spine–related complaints, 36 (12%) had a positive Hoffmann sign. Magnetic resonance imaging demonstrated spinal cord compression in 91% when the sign was present bilaterally and 50% when positive unilaterally. Conclusions In patients surgically treated for cervical myelopathy, the Hoffmann sign is more prevalent more likely to be seen in individuals with less severe neurological deficits than the Babinski sign. In patients lumbar symptoms, a bilateral Hoffmann sign was a highly sensitive marker for occult cervical cord compression, whereas a unilateral Hoffmann sign correlated with similar disease in about one-half of patients.

Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management

2011 ◽  
Vol 115 (6) ◽  
pp. 1197-1205 ◽  
Author(s):  
Felipe C. Albuquerque ◽  
Yin C. Hu ◽  
Shervin R. Dashti ◽  
Adib A. Abla ◽  
Justin C. Clark ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Basilar Artery ◽  
Arterial Injury ◽  
Neurological Deficits ◽  
Endovascular Stenting ◽  
Chiropractic Manipulation ◽  
Patient Series ◽  
Patterns Of Injury

Object Chiropractic manipulation of the cervical spine is a known cause of craniocervical arterial dissections. In this paper, the authors describe the patterns of arterial injury after chiropractic manipulation and their management in the modern endovascular era. Methods A prospectively maintained endovascular database was reviewed to identify patients presenting with craniocervical arterial dissections after chiropractic manipulation. Factors assessed included time to symptomatic presentation, location of the injured arterial segment, neurological symptoms, endovascular treatment, surgical treatment, clinical outcome, and radiographic follow-up. Results Thirteen patients (8 women and 5 men, mean age 44 years, range 30–73 years) presented with neurological deficits, head and neck pain, or both, typically within hours or days of chiropractic manipulation. Arterial dissections were identified along the entire course of the vertebral artery, including the origin through the V4 segment. Three patients had vertebral artery dissections that continued rostrally to involve the basilar artery. Two patients had dissections of the internal carotid artery (ICA): 1 involved the cervical ICA and 1 involved the petrocavernous ICA. Stenting was performed in 5 cases, and thrombolysis of the basilar artery was performed in 1 case. Three patients underwent emergency cerebellar decompression because of impending herniation. Six patients were treated with medication alone, including either anticoagulation or antiplatelet therapy. Clinical follow-up was obtained in all patients (mean 19 months). Three patients had permanent neurological deficits, and 1 died of a massive cerebellar stroke. The remaining 9 patients recovered completely. Of the 12 patients who survived, radiographic follow-up was obtained in all but 1 of the most recently treated patients (mean 12 months). All stents were widely patent at follow-up. Conclusions Chiropractic manipulation of the cervical spine can produce dissections involving the cervical and cranial segments of the vertebral and carotid arteries. These injuries can be severe, requiring endovascular stenting and cranial surgery. In this patient series, a significant percentage (31%, 4/13) of patients were left permanently disabled or died as a result of their arterial injuries.

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