scholarly journals Intradural view of the spinal cord and dura after three-column osteotomy: illustrative case

2021 ◽  
Vol 2 (19) ◽  
Author(s):  
Zirun Zhao ◽  
Saman Shabani ◽  
Nitin Agarwal ◽  
Praveen V. Mummaneni ◽  
Dean Chou
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Urinary Incontinence ◽  
Spinal Column ◽  
Tethered Cord ◽  
Leg Pain ◽  
Illustrative Case ◽  
Resonance Imaging ◽  
Intraoperative Visualization ◽  
Spinal Cord Tethering

BACKGROUND A three-column osteotomy results in dural buckling, which may appear concerning upon intraoperative visualization because it may appear that the neural elements may also be buckled. The authors presented an intraoperative view after intentional durotomy of the neural elements and the relaxed state of the dura after three-column osteotomy. OBSERVATIONS A 52-year-old woman with adult tethered cord syndrome and previous untethering presented with worsening leg pain and stiffness, urinary incontinence, and unbalanced gait. Magnetic resonance imaging demonstrated an arachnoid web at T6 and spinal cord tethering. Spinal column shortening via three-column osteotomy was performed with concomitant intradural excision of the arachnoid web. Dural buckling was observed intraoperatively after spinal column shortening. After the durotomy, the spinal cord was visualized without kinking or buckling. LESSONS Dural buckling after spinal column shortening of 15 mm via three-column osteotomy at T6 did not result in concomitant buckling of the underlying neural elements.

scholarly journals An unusual case of unilateral limb hypertrophy: Lipoma of sacral roots

2012 ◽  
Vol 03 (01) ◽  
pp. 89-92 ◽  
Author(s):  
Archana B Netto ◽  
Sanjib Sinha ◽  
Arun B Taly ◽  
Chandrajit Prasad ◽  
A Mahadevan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Unusual Case ◽  
Tethered Cord ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Resonance Imaging ◽  
Chronic Denervation ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Progressive Enlargement

ABSTRACTWe report an unusual case of unilateral limb pseudo hypertrophy in a 21-year-old lady who developed progressive enlargement of the right calf followed by thigh in association with chronic leg pain. Magnetic resonance imaging (MRI) of the affected limb confirmed enlargement of various muscles. Electromyography revealed neurogenic features consistent with S1 radiculopathy. MRI of the lumbosacral spine showed tethered cord with a lipoma infiltrating multiple sacral roots. Our case illustrates that muscular pseudo hypertrophy may follow chronic denervation as a consequence of spinal neural compressive disease. The various mechanisms postulated for this distinct condition are outlined.

Tethered Cord Syndrome in Children – Report of Two Cases

2017 ◽  
Vol 71 (2) ◽  
pp. 136-139
Author(s):  
Filip Duma ◽  
Sonja Bojadzieva ◽  
Aspazija Sofijanova ◽  
Ana Stamatova ◽  
Angelcho Andonovski ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Column ◽  
Tethered Cord ◽  
Final Diagnosis ◽  
Diagnostic Methods ◽  
Tethered Spinal Cord ◽  
Resonance Imaging ◽  
Early Diagnostics ◽  
Clinical Indicators ◽  
Age Dependent

Abstract Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. Attachments may occur congenitally at the base of the spinal cord (medullary cone) or they may develop near the site of an injury to the spinal cord. These attachments cause an abnormal stretching of the spinal cord. The course of the disorder is progressive. We present two patients that were diagnosed at age of three months and three years, respectively. Final diagnosis was made by magnetic resonance imaging, and both patients were referred to University Clinic of Neurosurgery for further treatment. Our aim is to illustrate the advantages of the early diagnostics of this progressive condition, to present diagnostic methods that are age-dependent and to illustrate the early clinical indicators for its existence.

Posttraumatic spinal cord tethering

1993 ◽  
Vol 78 (1) ◽  
pp. 120-121 ◽  
Author(s):  
Neil R. Berrington
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Tonsillar Herniation ◽  
Content Type ◽  
Bulbar Symptoms ◽  
Initial Injury ◽  
Spinal Cord Tethering ◽  
Fine Print

✓ A 53-year-old woman with a complete C-7 traumatic quadriplegia developed progressive neurological deterioration, including bulbar symptoms, 3 years after her initial injury. Magnetic resonance imaging showed tethering of the spinal cord at the level of her injury, with marked stretching of the cervical cord associated with medullary and tonsillar herniation. Following transection of the spinal cord, there was some improvement in her condition. Possible etiological factors accounting for this unique presentation are discussed.

scholarly journals Spinal cord detethering without laminectomy or laminotomy

2021 ◽  
Vol 12 ◽  
pp. 610
Author(s):  
Steven B. Housley ◽  
Devan Patel ◽  
Elizabeth Nyabuto ◽  
Renée M. Reynolds
Keyword(s):  
Spinal Cord ◽  
Surgical Intervention ◽  
Video Recording ◽  
Surgical Techniques ◽  
Spinal Column ◽  
Tethered Cord ◽  
Conus Medullaris ◽  
Leg Pain ◽  
Invasive Technique ◽  
Lower Extremity Weakness

Background: Tethered cord syndrome occurs when there is abnormal tension on the distal spinal cord, which limits its elevation as patients grow. This results in stretching of the neural elements and microvasculature, resulting in both direct and ischemic injury.[7] Animal studies suggest that impairment of oxidative metabolic pathways may contribute to neuronal injury.[7] Associated conditions include myelomeningocele, lipomyelomeningocele, intraspinal lipomas, diastematomyelia, thickened/fatty filum terminale, and trauma.[2] Tethering may be asymptomatic or result in a variety of symptoms including lower extremity weakness/sensory deficits, bowel/bladder dysfunction, scoliosis, pes cavus, and back/leg pain.[6] Early surgical intervention has been shown to improve outcomes and may be performed prophylactically or to prevent symptom progression.[1,3] More specifically, retrospective studies demonstrate that surgical intervention in patients under the age of 2 years is associated with improved outcomes.[5] In some cases, detethering may result in clinical improvement.[3] Case Description: We present a case of a 6-month-old male with a low-lying conus medullaris, lumbar syrinx, mildly abnormal urodynamic studies, and asymmetric utilization of his lower extremities observed during the evaluation of a Y-shaped gluteal cleft. He underwent elective spinal cord detethering via the safe and effective, minimally invasive technique described in the video. The patient’s parents gave informed consent for treatment and video recording. Institutional review board approval was deemed unnecessary. Conclusion: Given the variety of surgical techniques used for cord detethering, this video may assist other surgeons in developing techniques that require little to no compromise of the developing bony spinal column while achieving sufficient release of the spinal cord.[4]

scholarly journals Primary spinal melanoma: illustrative case

2021 ◽  
Vol 2 (20) ◽  
Author(s):  
Hanna House ◽  
Jacob Archer ◽  
Jamie Bradbury
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Illustrative Case ◽  
Resonance Imaging ◽  
Primary Cutaneous Melanoma ◽  
Thoracic Spinal Cord ◽  
Acute Presentation ◽  
Thoracic Spinal

BACKGROUND Primary spinal melanoma is extremely rare, accounting for ∼1% of all primary melanomas. Typically presenting insidiously in the thoracic spinal cord, primary spinal melanomas can have an acute presentation due to their propensity to hemorrhage. OBSERVATIONS Despite its rarity, primary spinal melanoma should be included in the differential diagnosis when a hemorrhagic pattern of T1 and T2 intensities is seen on magnetic resonance imaging. Furthermore, the complete diagnosis is crucial because the prognosis of a primary spinal melanoma is considerably more favorable than that of a primary cutaneous melanoma with metastatic spread. LESSONS Resection is the treatment of choice, with some authors advocating for postoperative chemotherapy, immunotherapy, and/or radiation. We describe a case of acute quadriplegia from hemorrhagic primary spinal melanoma requiring resection.

scholarly journals Changes of Dorsal Root Ganglion Volume in Dogs with Clinical Signs of Degenerative Myelopathy Detected by Water-Excitation Magnetic Resonance Imaging

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1702
Author(s):  
Eiji Naito ◽  
Kohei Nakata ◽  
Yukiko Nakano ◽  
Yuta Nozue ◽  
Shintaro Kimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Clinical Signs ◽  
Intervertebral Disc Herniation ◽  
Resonance Imaging ◽  
Diagnostic Potential ◽  
Water Excitation ◽  
Spinal Cord Segment ◽  
Degenerative Myelopathy

Canine degenerative myelopathy (DM) is a progressive and fatal neurodegenerative disease. However, a definitive diagnosis of DM can only be achieved by postmortem histopathological examination of the spinal cord. The purpose of this study was to investigate whether the volumetry of DRG using the ability of water-excitation magnetic resonance imaging (MRI) to visualize the DRG in dogs has premortem diagnostic value for DM. Eight dogs with DM, twenty-four dogs with intervertebral disc herniation (IVDH), and eight control dogs were scanned using a 3.0-tesla MRI system, and water-excitation images were obtained to visualize and measure the volume of DRG, normalized by body surface area. The normalized mean DRG volume between each spinal cord segment and mean volume of all DRG between T8 and L2 in the DM group was significantly lower than that in the control and the IVDH groups (P = 0.011, P = 0.002, respectively). There were no correlations within the normalized mean DRG volume between DM stage 1 and stage 4 (rs = 0.312, P = 0.128, respectively). In conclusion, DRG volumetry by the water-excitation MRI provides a non-invasive and quantitative assessment of neurodegeneration in DRG and may have diagnostic potential for DM.

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