Thoracic Intervertebral Disc Protrusion with Spinal Cord Compression

1968 ◽  
Vol 28 (1) ◽  
pp. 24-28 ◽  
Author(s):  
David L. Reeves ◽  
Howard A. Brown
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Disc Protrusion

scholarly journals To cut or not to cut? A case report on pediatric intervertebral disc calcification

2021 ◽  
Vol 12 ◽  
pp. 307
Author(s):  
Hunter J. King ◽  
Rohin Ramchandani ◽  
Christina Maxwell ◽  
Atom Sarkar ◽  
Tina Loven
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Sensory Loss ◽  
Common Symptom ◽  
Thoracic Spinal Cord ◽  
Intervertebral Disc Calcification ◽  
Thoracic Spinal

Background: Intervertebral disc calcification (IVDC) is a rare cause of acute spinal pain in pediatric patients. The most common symptom is back or neck pain, but muscle spasm, muscle weakness, and sensory loss also occur. Many patients have an alarming presentation and radiological findings concerning for spinal cord compression. Case Description: A 10-year-old female presented with 2 weeks of worsening back pain and restricted neck flexion with no history of preceding trauma. Magnetic resonance imaging (MRI) showed T4/5 and T5/6 vertebral disc calcification and posterior herniation causing thoracic spinal cord compression. Despite concerning imaging findings, we decided to manage this patient conservatively with nonsteroidal anti-inflammatory drugs, leading to the improvement of symptoms within 9 days, and resolution of all pain within 1 month after hospital discharge. At 6 months follow-up, MRI showed complete resolution of calcification within the spinal canal. Conclusion: This case report emphasizes IVDC as an important differential diagnosis of pediatric disc disease that does not require surgical intervention. X-ray imaging with PA and lateral views is an adequate screening for these patients. Majority of cases resolve within 6 months with conservative therapy.

Caudal cervical arthrodesis using a distractable fusion cage in a dog

2010 ◽  
Vol 23 (03) ◽  
pp. 209-213 ◽  
Author(s):  
F. Bernard ◽  
J.-F. Bardet ◽  
Adrega da Silva
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Cervical Fusion ◽  
Disc Protrusion ◽  
Dynamic Component ◽  
Long Term Outcome ◽  
Fusion Cage

SummaryThis case report describes a cervical fusion cage, surgical technique and the long-term outcome of caudal cervical arthrodesis used to stabilise dynamic spinal cord compression at the sixth and seventh cervical intervertebral disc space (C6, C7) in a dog. A seven-year-old, 41 kg, entire male Dobermann Pinscher was admitted for progressive ataxia of two weeks duration. Neurological examination revealed ambulatory tetraparesis. Computed tomographic myelogram scans in neutral and traction positions of the neck were performed and were used to determine presence of a dynamic component. A C6-C7 surgical distraction and stabilisation using a distractable intervertebral fusion cage was performed. There was not any deterioration of neurological status was observed on postoperative neurological evaluation. Within eight weeks after surgery, gait and postural abilities had returned to normal. Computed tomography evaluation indicated a complete bridging callus within and outside the cage at 15 weeks after surgery. There were not any complications or recurrences of initial neurological deficits observed during the 40 month follow-up period. Based on the follow-up period data, a C6-C7 dynamic spinal cord compression with disc protrusion was successfully treated by a distractable cervical fusion cage.

Management of cervical spinal cord injury in ankylosing spondylitis: the intervertebral disc as a cause of cord compression

1992 ◽  
Vol 77 (2) ◽  
pp. 241-276 ◽  
Author(s):  
David W. Rowed
Keyword(s):  
Spinal Cord ◽  
Ankylosing Spondylitis ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Recurrent Dislocation ◽  
Cord Compression ◽  
Flexion Deformity ◽  
Extradural Hematoma ◽  
Halo Vest ◽  
Content Type

✓ Twenty-one patients with universal syndesmophytosis due to ankylosing spondylitis were identified in a consecutive series of 1578 patients with acute spine and spinal cord injuries. They were predominantly male, older than spinal cord-injured patients in general, and most were injured by falls. Approximately one-half were managed by halo-vest immobilization alone with good clinical and radiological outcomes. The remainder required surgery either for recurrent dislocation or for spinal cord compression associated with neurological deterioration. Extradural hematoma, a recognized cause of spinal cord compression in ankylosing spondylitis patients with spinal fractures, was encountered in two patients. Herniated intervertebral disc as a cause of spinal cord compression in ankylosing spondylitis does not appear to have been previously reported and was recognized three times in the present series, once in association with extradural hematoma. The pathology of ankylosing spondylitis is such that the nucleus pulposus tends to be spared, allowing disc herniation to occur in the heavily ossified spine. In virtually all patients, satisfactory correction of the flexion deformity could be safely accomplished following spinal fracture. It is concluded that fracture/dislocations of the cervical spine should be managed initially by halo-vest immobilization, without prior traction and with careful incremental correction of flexion deformity. Decompression is performed as required for extradural hematoma or intervertebral disc herniation, and internal fixation is carried out for recurrent dislocation.

Impact of morphological restoration of the spinal cord from the preoperative to early postoperative periods on C5 palsy development

2021 ◽  
pp. 1-9
Author(s):  
Masahiro Mizutani ◽  
Takashi Fujishiro ◽  
Takuya Obo ◽  
Atsushi Nakano ◽  
Yoshiharu Nakaya ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Postoperative Period ◽  
Morphological Changes ◽  
Cord Compression ◽  
Early Postoperative Period ◽  
Decompression Surgery ◽  
Transverse Diameter ◽  
C5 Palsy

OBJECTIVE C5 palsy (C5P) is a known complication of cervical decompression surgery. The tethering effect of the C5 nerve root following the posterior shift of the spinal cord is the most accepted pathologic mechanism for C5P development; however, this mechanism cannot fully explain C5P by itself in clinical practice. Separately, some studies have suggested that preoperative severe spinal cord compression and postoperative morphological changes in the spinal cord affect C5P development; however, no previous study has quantitatively addressed these possibilities. The aim of this study was to examine whether spinal cord morphology and morphological restoration after surgery affect C5P development. METHODS The authors reviewed consecutive patients with degenerative cervical myelopathy who underwent laminoplasty including the C3–4 and C4–5 intervertebral disc levels. All participants underwent MRI both preoperatively and within 4 weeks postoperatively. To assess the severity of spinal cord compression, the compression ratio (CR; spinal cord sagittal diameter/transverse diameter) was calculated. As an index of morphological changes in the spinal cord during the early postoperative period, the change rate of CR (CrCR, %) was calculated as CRwithin 4 weeks postoperatively/CRpreoperatively × 100. These measurements were performed at both the C3–4 and C4–5 intervertebral disc levels. The study cohort was divided into C5P and non-C5P (NC5P) groups; then, CR and CrCR, in addition to other radiographic variables associated with C5P development, were compared between the groups. RESULTS A total of 114 patients (mean age 67.6 years, 58.8% men) were included in the study, with 5 and 109 patients in the C5P and NC5P groups, respectively. Preoperative CR at both the C3–4 and C4–5 levels was significantly lower in the C5P group than in the NC5P group (0.35 vs 0.44, p = 0.042 and 0.27 vs 0.39, p = 0.021, respectively). Patients with C5P exhibited significantly higher CrCR at the C3–4 level than those without (139.3% vs 119.0%, p = 0.046), but the same finding was not noted for CrCR at the C4–5 level. There were no significant differences in other variables between the groups. CONCLUSIONS This study reveals that severe compression of the spinal cord and its greater morphological restoration during the early postoperative period affect C5P development. These findings could support the involvement of segmental cord disorder theory, characterized as the reperfusion phenomenon, in the pathomechanism of C5P, in addition to the tethering effect.

Scheuermann's Dorsal Kyphosis and Spinal Cord Compression: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 18 (5) ◽  
pp. 628-631 ◽  
Author(s):  
David M. Klein ◽  
Richard L. Weiss ◽  
James E. Allen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Neurological Complications ◽  
Cord Compression ◽  
Posterior Fixation ◽  
Childhood And Adolescence ◽  
Disc Protrusion ◽  
Scheuermann’S Disease ◽  
Scheuermann's Disease ◽  
Thoracic Disc

Abstract Although Scheuermann's disease (juvenile dorsal kyphosis) is a common problem of late childhood and adolescence, its potential for neurological complications is not widely appreciated. In rare instances, spinal cord compression appears to be produced by the kyphotic protrusion alone, and we present an example of this unusual problem. Although the results of surgical treatment in this situation cannot be substantiated, anterior spondylotomy and decompression followed by posterior fixation appear to offer the best mechanical relief. Spinal cord compression can also be produced by extradural cysts, with which Scheuermann's disease is frequently associated. Scheuermann's disease also is reported to occur in combination with thoracic disc protrusion, but the coincidence here may be random. Pertinent literature is reviewed.

Cervical Spinal Cord Compression Attributable to a Calcified Intervertebral Disc in a Patient with X-linked Hypophosphatemic Rickets: Case Report and Review of the Literature

Neurosurgery ◽  
2002 ◽  
Vol 51 (1) ◽  
pp. 239-243 ◽  
Author(s):  
Martin Soehle ◽  
Adrian T.H. Casey
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Cord Compression ◽  
Spinal Canal ◽  
Facet Joint ◽  
Cord Compression ◽  
Spinal Canal Stenosis ◽  
Hypophosphatemic Rickets ◽  
Cervical Cord ◽  
Canal Stenosis

Abstract OBJECTIVE AND IMPORTANCE X-linked hypophosphatemic rickets is a common inherited phosphate-wasting disorder, but it is a rare cause of spinal cord compression. We present the first reported case of a calcified intervertebral disc causing spinal canal stenosis in X-linked hypophosphatemic rickets. CLINICAL PRESENTATION A 44-year-old woman presented with paresthesia of her left arm and a loss of grip in both hands. Magnetic resonance imaging revealed a calcified intervertebral disc, as well as a posterior osteophytic bar causing marked cervical cord compression at C6/C7. INTERVENTION An anterior cervical discectomy at C6/C7 and fusion with autologous bone graft were performed. The patient then exhibited significant improvement. CONCLUSION A review of the 16 published cases demonstrates that thickening of the vertebral laminae, facet joint hypertrophy, and ossification of the intervertebral discs, posterior longitudinal ligament, and/or ligamentum flavum contribute to spinal canal stenosis in X-linked hypophosphatemic rickets. Those changes are caused by the disease itself and are unlikely to be related to long-term vitamin D treatment. Eleven of 16 patients were reported to have experienced favorable outcomes after surgery.

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