Cervical cord compression due to delayed scarring around epidural electrodes used in spinal cord stimulation

2010 ◽  
Vol 12 (4) ◽  
pp. 409-412 ◽  
Author(s):  
Phong Dam-Hieu ◽  
Elsa Magro ◽  
Romuald Seizeur ◽  
Alexandre Simon ◽  
Bertrand Quinio
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Scar Tissue ◽  
Cord Compression ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Posterior Aspect ◽  
Paramedical Staff ◽  
Delayed Complication

The authors report on 2 cases of delayed compression of the cervical spinal cord by dense scar tissue forming around epidural electrodes implanted for spinal cord stimulation (SCS). This complication has not been previously reported. Myelopathy developed in 2 patients 5 and 16 years after the surgical placement of a cervical epidural electrode. Prior to myelopathy, both patients experienced a tolerance phenomenon. Magnetic resonance imaging in both cases showed severe compression of the spinal cord by the electrode. At surgery, thick scar tissue surrounding the electrode and compressing the posterior aspect of the cord was discovered. Both patients experienced a full recovery following the removal of both scar tissue and the electrode. Medical and paramedical staff dealing with SCS should be aware of this severe and delayed complication. In addition, the development of epidural fibrosis can explain the occurrence of tolerance.

Cervical cord compression secondary to epidural fibrous scar tissue around the spinal cord stimulation electrode

2016 ◽  
Vol 64 (6) ◽  
pp. 1363
Author(s):  
SayoaÁ de Eulate-Beramendi ◽  
Elena Santamarta-Liébana ◽  
RamonFernandez-De Leon ◽  
Antonio Saiz-Ayala ◽  
FernandoJ Seijo-Fernandez
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Scar Tissue ◽  
Cord Compression ◽  
Cervical Cord ◽  
Cervical Cord Compression ◽  
Fibrous Scar Tissue ◽  
Stimulation Electrode

Remarkable epidural scar formation compressing the cervical cord after osteoplastic laminoplasty with hydroxyapatite spacer

2011 ◽  
Vol 15 (5) ◽  
pp. 497-501 ◽  
Author(s):  
Keita Kuraishi ◽  
Junya Hanakita ◽  
Toshiyuki Takahashi ◽  
Manabu Minami ◽  
Masanao Mori ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Giant Cells ◽  
Scar Tissue ◽  
Scar Formation ◽  
Cervical Cord ◽  
Multinucleated Giant Cells ◽  
Resonance Imaging ◽  
Laminectomy Membrane

The authors report on an 81-year-old woman whose condition deteriorated 2 months after undergoing osteoplastic laminoplasty with placement of hydroxyapatite spacers. Magnetic resonance imaging showed postlaminectomy scar formation compressing the cervical spinal cord. The patient underwent laminectomy and removal of remarkably thick epidural scar tissue, which resulted in resolution of her symptoms. Histological diagnosis of the scar was fibrous granulation tissue with foreign body granuloma, characterized by multinucleated giant cells and marked increases of capillary vessels, fibroblasts, and collagen fibers. This case of symptomatic postlaminectomy scar formation after osteoplastic laminoplasty suggests that osteoplastic laminoplasty cannot always prevent laminectomy membrane formation.

scholarly journals Transcutaneous spinal cord stimulation of the cervical cord modulates lumbar networks

2020 ◽  
Vol 123 (1) ◽  
pp. 158-166 ◽  
Author(s):  
Trevor S. Barss ◽  
Behdad Parhizi ◽  
Vivian K. Mushahwar
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
H Reflex ◽  
Cervical Cord ◽  
Arm Cycling ◽  
Cord Injury ◽  
Walking Capacity ◽  
Transcutaneous Spinal Cord Stimulation ◽  
Lumbar Cord

It has been established that coordinated arm and leg (A&L) cycling facilitates corticospinal drive and modulation of cervico-lumbar connectivity and ultimately improves overground walking in people with incomplete spinal cord injury or stroke. This study examined the effect of noninvasive transcutaneous spinal cord stimulation (tSCS) on the modulation of cervico-lumbar connectivity. Thirteen neurologically intact adults participated in the study. The excitability of the Hoffmann (H) reflex elicited in the soleus muscle was examined under multiple conditions involving either the arms held in a static position or rhythmic arm cycling while tSCS was applied to either the cervical or lumbar cord. As expected, soleus H-reflex amplitude was significantly suppressed by 19.2% during arm cycling (without tSCS) relative to arms static (without tSCS). Interestingly, tSCS of the cervical cord with arms static significantly suppressed the soleus H-reflex (−22.9%), whereas tSCS over the lumbar cord did not suppress the soleus H-reflex (−3.8%). The combination of arm cycling with cervical or lumbar tSCS did not yield additional suppression of the soleus H-reflex beyond that obtained with arm cycling alone or cervical tSCS alone. The results demonstrate that activation of the cervical spinal cord through both rhythmic arm cycling and tonic tSCS significantly modulates the activity of lumbar networks. This highlights the potential for engaging cervical spinal cord networks through tSCS during rehabilitation interventions to enhance cervico-lumbar connectivity. This connectivity is influential in facilitating improvements in walking function after neurological impairment. NEW & NOTEWORTHY This is the first study to investigate the modulatory effects of transcutaneous spinal cord stimulation (tSCS) on cervico-lumbar connectivity. We report that both rhythmic activation of the cervical spinal cord through arm cycling and tonic activation of the cervical cord through tSCS significantly modulate the activity of lumbar networks. This suggests that engaging cervical spinal cord networks through tSCS during locomotor retraining interventions may not only enhance cervico-lumbar connectivity but also further improve walking capacity.

Value of gas myelography in early management of acute cervical spinal cord injuries

1975 ◽  
Vol 42 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Alain B. Rossier ◽  
Jean Berney ◽  
Arthur E. Rosenbaum ◽  
Jurg Hachen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Cervical Cord ◽  
Valuable Contribution ◽  
Early Management ◽  
Specific Patient ◽  
Content Type ◽  
Cord Injury

✓ Gas myelography was carried out in 22 patients with acute cervical spinal cord injuries in whom oily contrast media seemed contraindicated. The authors believe this technique makes a valuable contribution to the basic decision regarding the surgical versus medical treatment of a specific patient with a cervical cord injury. They emphasize the importance of visualizing cord compression due to disc herniation in these cases and conclude that gases are the optimal contrast agents for visualization of the entire circumference of the spinal cord.

Cervical spinal cord compression from delayed epidural scar tissue formation around plate lead for SCS

2019 ◽  
Vol 63 (3) ◽  
Author(s):  
Giusy Guzzi ◽  
Giorgio Volpentesta ◽  
Domenico Chirchiglia ◽  
Attilio Della Torre ◽  
Francesco Lavano ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cervical Spinal Cord ◽  
Scar Tissue ◽  
Cord Compression ◽  
Tissue Formation ◽  
Scar Tissue Formation

Delayed postoperative tethering of the cervical spinal cord

1994 ◽  
Vol 81 (2) ◽  
pp. 196-201 ◽  
Author(s):  
Kris A. Smith ◽  
Harold L. Rekate
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Severe Headache ◽  
Neurological Deficits ◽  
Cervical Region ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Content Type ◽  
Surgical Exploration ◽  
Spinal Cord Tethering

✓ Tethering of the spinal cord in the lumbar and sacral regions of children with congenital anomalies is a well-recognized problem; however, tethering in the cervical region has rarely been reported. A search of the literature revealed no reports of symptomatic postoperative cervical spinal cord tethering. The authors present five cases of delayed postoperative cervical spinal cord tethering and discuss the benefit of detethering in these patients. All five patients were young (16 to 42 years of age) at presentation. All had done well after an initial surgical procedure but returned between 1 and 31 years postoperatively with symptoms including severe headache, upper-extremity pain, and progressive neurological deficits. In each case, magnetic resonance imaging indicated dorsal tethering of the cord in the cervical region. Surgical exploration with microscopic sharp detethering of the cervical cord was performed on each patient with favorable results. To avoid retethering, wide Tutoplast duraplasty is recommended.

Effects of cervical spinal cord stimulation on cerebral blood flow in the rat

2000 ◽  
Vol 93 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Oren Sagher ◽  
Dah-Luen Huang
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Peripheral Vasculature ◽  
Doppler Flowmetry ◽  
Content Type ◽  
Fine Print

Object. Spinal cord stimulation (SCS) is frequently used for the treatment of chronic pain. Although the mechanisms by which SCS alleviates pain are unclear, they are believed to involve changes within the dorsal horn of the spinal cord. Spinal cord stimulation has also been found to cause significant vasodilation in the peripheral vasculature. The mechanisms underlying this effect are thought to involve sympathetic blockade. A rostral vasodilatory effect has also been described, but changes in cerebral blood flow (CBF) have been poorly delineated. Using laser Doppler flowmetry (LDF), the authors examined the effects of cervical SCS on CBF in rats. Methods. Cervical SCS was found to result in a significant increase in cortical LDF values (83 ± 11% [mean ± standard error of the mean]). The increase in cortical LDF values was not accompanied by a significant increase in systemic blood pressure. Stimulation of the upper cervical spinal cord was more effective in inducing LDF changes than was that of the lower cervical cord. Changes in SDS-induced LDF values were significantly attenuated after spinal cord transection at the cervicomedullary junction and by the administration of the sympathetic blocker hexamethonium. Conclusions. These results indicate that cervical SCS may induce cerebral vasodilation and that this effect may involve indirect effects on vasomotor centers in the brainstem as well as an alteration in sympathetic tone.

scholarly journals Spinal cord compression from hypertrophic nerve roots in chronic inflammatory demyelinating polyradiculoneuropathy – A case report

2021 ◽  
Vol 12 ◽  
pp. 114
Author(s):  
Md Tanvir Hasan ◽  
Subodh Patil ◽  
Vanisha Chauhan ◽  
David Gosal ◽  
John Ealing ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Nerve Root ◽  
Cervical Spinal Cord ◽  
Clinical Manifestations ◽  
Neurofibromatosis Type ◽  
Cord Compression ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Cervical Cord ◽  
Therapeutic Decision Making

Background: Spinal cord compression secondary to nerve root hypertrophy is often attributed to hereditary neuropathies. However, to avoid misdiagnosis, rare immune-mediated neuropathy such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) should not be overlooked. This report presents a case of multilevel nerve root hypertrophy leading to significant cord compression from CIDP. Case Description: We report a 56-year-old gentleman with type two diabetes mellitus who presented with subacute cervical cord syndrome following a fall. Mixed upper and lower motor neuron features were noted on examination. Magnetic resonance imaging showed significant pan-spinal proximal nerve root hypertrophy, compressing the cervical spinal cord. Initial radiological opinion raised the possibility of neurofibromatosis type 1 (NF-1), but neurophysiology revealed both axonal and demyelinating changes that were etiologically non-specific. C6 root and sural nerve biopsies taken at cervical decompression displayed striking features suggestive for CIDP. Although NF-1 is the most observed condition associated with root hypertrophy, other important and potentially treatable differentials need to be entertained. Conclusion: While rare, CIDP can cause significant spinal cord compression. Furthermore, clinical manifestations of CIDP can mimic those of inherited peripheral neuropathies. Neurologists and neurosurgeons should be aware of this condition to optimize subsequent therapeutic decision-making.

Anomalous vertebral artery—induced cervical cord compression causing severe nape pain

2001 ◽  
Vol 95 (1) ◽  
pp. 146-149 ◽  
Author(s):  
Kei Watanabe ◽  
Kazuhiro Hasegawa ◽  
Kou Takano
Keyword(s):  
Spinal Cord ◽  
Rare Case ◽  
Cord Compression ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Content Type ◽  
Cervical Cord Compression ◽  
Vertebral Arteries ◽  
Signal Void ◽  
Fine Print

✓ The authors describe a very rare case of cervical cord compression caused by anomalous bilateral vertebral arteries (VAs). A 65-year-old woman had been suffering from intractable nape pain and torticollis. Magnetic resonance imaging revealed a signal void region in which spinal cord compression was present. Angiography demonstrated anomalous bilateral VAs compressing the spinal cord. Microvascular decompressive surgery was successfully performed. Neuroradiological and intraoperative findings are presented.

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