Lumbosacral intradural periradicular ossification

1978 ◽  
Vol 49 (1) ◽  
pp. 132-137 ◽  
Author(s):  
George Varughese

✓ Intrathecal ossification causing progressive myelopathy or radiculopathy does not occur frequently. The majority of the reported lesions have been in the thoracic spine and seldom in the sacral canal. This report presents the occurrence of disabling low backache and sciatica from intradural periradicular ossification in the lumbosacral region in a previously healthy man.

2000 ◽  
Vol 93 (2) ◽  
pp. 291-293 ◽  
Author(s):  
Matthew T. Mayr ◽  
Stephen Hunter ◽  
Scott C. Erwood ◽  
Regis W. Haid

✓ The authors describe two cases of calcifying pseudoneoplasms, rare degenerative lesions that mimic tumor or infection. One case involved the cervical spine and the second the thoracic spine. Both patients experienced progressive myelopathy from extradural compression of the spinal cord. The radiological evaluation, pathological findings in the lesions, treatment, and follow up are described. Total or subtotal excision can relieve symptoms and prevent recurrence of this lesion.


2004 ◽  
Vol 100 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Mehmet Arazi ◽  
Onder Guney ◽  
Mustafa Ozdemir ◽  
Omer Uluoglu ◽  
Nuket Uzum

✓ The authors report the case of a 53-year-old woman with monostotic fibrous dysplasia of the thoracic spine. The patient presented with a 1-month history of pain in the thoracic spinal region. En bloc resection of the lesion was successfully performed via a transthoracic approach, and a histopathological examination confirmed the diagnosis of fibrous dysplasia. At 24-month follow-up examination, pain and vertebral instability were absent. The findings in this case illustrate that, although very rare, monostotic fibrous dysplasia of the thoracic spine should be considered in the differential diagnosis of spinal tumors. Although a consensus for management of this disease has not been achieved, the authors recommend radical removal of all involved bone as well as internal fixation or bone graft—assisted fusion to achieve long-term stabilization.


1976 ◽  
Vol 44 (6) ◽  
pp. 748-752 ◽  
Author(s):  
Mohammed N. Gonem

✓ A case of osteoclastoma arising in the body of the T-9 vertebra is presented. Osteoclastoma rarely involves the vertebrae, and treatment, whether by surgery or radiotherapy, seldom results in eradication of the lesion or prevention of recurrence.


1981 ◽  
Vol 55 (6) ◽  
pp. 979-982 ◽  
Author(s):  
F. Douglas Jones ◽  
Ronald E. Woosley

✓ The authors present a case of delayed myelopathy arising 8 years after a stab wound to the thoracic spine, with intradural retention of the knife tip. Following removal of the knife tip, the patient had a good recovery. A review of the literature documents eight additional cases of delayed myelopathy secondary to retained fragments from spinal stab wounds.


2004 ◽  
Vol 100 (4) ◽  
pp. 353-357 ◽  
Author(s):  
Masashi Komagata ◽  
Makoto Nishiyama ◽  
Atshuhiro Imakiire ◽  
Hirobumi Kato

✓ Lung cancers invading the chest wall and spinal column are often considered unresectable, and consequently there are few reports describing resection of invasive vertebral lesions. The authors developed a new anterior approach procedure for the en bloc resection of primary lung adenocarcinoma invading the thoracic spine and chest wall, in which the primary tumor does not need to be separated from the vertebrae. The authors describe a total spondylectomy for the en bloc resection of lung cancer invading the spine. A combination of surgical techniques was required, including resection of the osseous elements T-2 and T-3 (the pedicles were excised using a thread saw), anterolateral thoracotomy, apical lobectomy, chest wall resection, vertebrectomy, anterior spinal column reconstruction with a titanium mesh cage containing bioactive glass ceramic, and placement of anterior and posterior spinal instrumentation. At 46 months after surgery, there is no evidence of local recurrence or distant metastasis, and the patient continues to improve. This new procedure allows for the en bloc resection of primary lung tumors and adherent vertebral invasion without separation of the lesion from the vertebra. Thus, surgical management by complete excision of Pancoast tumors can achieve longer-term survival rates without sequelae.


2005 ◽  
Vol 2 (2) ◽  
pp. 226-229 ◽  
Author(s):  
Mutsuhiro Tamura ◽  
Masashi Saito ◽  
Masafumi Machida ◽  
Keiichi Shibasaki

✓ The anterior approach is commonly used to reach the upper thoracic region to achieve decompression and stabilization; however, upper thoracic lesions are difficult to treat because of the regional anatomical structures, and this approach is associated with risks of complication. The authors evaluated the advantages of using a transsternoclavicular approach to aid in treating upper thoracic lesions. The procedure and surgery-related outcomes are discussed.


1995 ◽  
Vol 82 (6) ◽  
pp. 1059-1061 ◽  
Author(s):  
Kimihiko Mii ◽  
Satoru Shimizu ◽  
Chihiko Tanaka ◽  
Kuniaki Matsumori ◽  
Kazuko Hasegawa ◽  
...  

✓ A case of thoracic flexion myelopathy is reported in a 36-year-old man. The patient had a history of gradually progressing transverse thoracic myelopathy. Conventional myelography in the neutral position failed to reveal cord compression; however, a severe block of the dye column was evident on studies in the flexed position. Excellent recovery from this condition was obtained with posterolateral fusion of the thoracic spine in the neutral position.


2005 ◽  
Vol 3 (3) ◽  
pp. 182-190 ◽  
Author(s):  
Todd J. Albert ◽  
David H. Kim

✓ Appropriate timing for surgical intervention following destabilizing cervical or thoracic spine trauma remains controversial. Clinical investigators have failed to provide convincing evidence that the timing of surgery significantly affects neurological outcome in most situations. Nevertheless, early surgical stabilization of the injured spine has been shown to provide significant nonneurological benefits such as more rapid patient mobilization, facilitation of treating associated injuries, reduction in rates of pulmonary and pressure sore complications, reduction in duration of intensive care unit and hospital stays, and a decrease in overall medical costs. The findings of basic science studies have improved our understanding of the molecular and cellular events surrounding initial and secondary spinal cord injury (SCI), and analysis of these findings suggests that the early postinjury period may present a unique opportunity for meaningful intervention. This possibility has been supported by results obtained in animal studies that demonstrate the potential for improving functional outcome when surgical intervention is performed within a few hours following experimental SCI. Despite the absence of significant neurological recovery in most clinical studies, the results of most recent clinical studies strongly support the overall clinical benefits of early surgical intervention, particularly in the setting of unstable thoracic spinal column injury with associated SCI. Based on the best available scientific and clinical evidence, the authors report that it is therefore recommended that surgical stabilization be performed in as timely a fashion as possible, particularly for unstable thoracic spine trauma, within the constraints of the patient's overall medical condition and availability of appropriate resources.


1993 ◽  
Vol 78 (4) ◽  
pp. 579-586 ◽  
Author(s):  
H. Alan Crockard ◽  
Alan E. Heilman ◽  
John M. Stevens

✓ Late-onset progressive myelopathy, years after odontoid fracture, is considered a rarity. Sixteen patients with diagnosis of their odontoid fractures delayed from four months to 45 years have been studied and treated. Three had forgotten about the injury and, in the rest, the significance had been minimized by their clinicians. Fifteen patients had characteristic C-2 nerve root pain and 10 had noted weak hands and walking difficulties. Fifteen patients had Type II fractures, which were mobile in 11; hypertrophic pseudarthrosis was marked in two. In seven patients it was confirmed at surgery that all or part of the transverse ligament was interposed in the fracture. Transoral surgery, combined with a variety of posterior fusion techniques, has allowed cord decompression, an understanding of the pathomechanics, and sound posterior bone fusion with arrest of the myelopathic condition. Measurements of craniovertebral angles and cord cross-sectional area in this series revealed a rough correlation, but the most striking relationship was between length of delay in diagnosis and diminished cord area in both non-union and malunion, suggesting a progressive injury mechanism. It is proposed that late myelopathy following odontoid fracture may be more common than hitherto believed and should be considered in the evaluation of patients with cervical spondylosis. The condition may be progressive. Finally, non-union may be due to interposition of the transverse ligament.


2005 ◽  
Vol 3 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Mahmoud Hamdy Kamel ◽  
Martin Murphy ◽  
Michael Kelleher ◽  
Kristian Aquilina ◽  
Chris Lim ◽  
...  

✓ The authors report on a case of schistosomiasis of the spinal cord in an individual returning to Ireland after a 25-year residence in Africa, where the infection affects approximately 200 million people.


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