Recurrent spinal cord tethering by sacral nerve root following lipomyelomeningocele surgery

1991 ◽  
Vol 75 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Giancarlo Barolat ◽  
Dale Schaefer ◽  
Sergio Zeme
Keyword(s):  
Nerve Root ◽  
Lower Extremities ◽  
Nerve Roots ◽  
Content Type ◽  
Surgical Exploration ◽  
Sacral Nerve Root ◽  
The Right ◽  
Progressive Weakness ◽  
Spinal Cord Tethering ◽  
Fine Print

✓ A 21-year-old woman had recurrent progressive weakness/hypesthesia and pain in both lower extremities. At the age of 5 and 19 years, she had undergone surgical resection of a lipomyelomeningocele at L5—S1. Surgical exploration revealed that the cord was tethered and pulled over to the side by an excessively short right S-1 nerve root. The contralateral L-5 and S-1 nerve roots were markedly stretched. Division of the right S-1 nerve root resulted in prompt disappearance of pain in the lower extremities and improvement in neurological function.

Traumatic lumbar nerve root meningocele

1973 ◽  
Vol 39 (4) ◽  
pp. 528-532 ◽  
Author(s):  
James E. McLennan ◽  
William T. McLaughlin ◽  
Stanley A. Skillicorn
Keyword(s):  
Functional Recovery ◽  
Nerve Root ◽  
Surgical Intervention ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Fine Print

✓ A patient is described who developed an acute, occult, lumbosacral nerve root meningocele following a partial traumatic avulsion of the L-4 and L-5 nerve roots accompanied by fracture of the pelvis and fibula. Almost total functional recovery ensued. The differences between acute and chronic nerve root meningoceles are discussed, as well as the possibility of surgical intervention.

Changes in nerve root motion and intraradicular blood flow during intraoperative femoral nerve stretch test

2003 ◽  
Vol 99 (3) ◽  
pp. 298-305 ◽  
Author(s):  
Shigeru Kobayashi ◽  
Yoshihiko Suzuki ◽  
Takahiro Asai ◽  
Hidezo Yoshizawa
Keyword(s):  
Blood Flow ◽  
Disc Herniation ◽  
Standard Error ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Femoral Nerve ◽  
Nerve Roots ◽  
Content Type ◽  
The Mean ◽  
Fine Print

Object. It is not known whether changes in intraradicular blood flow (IRBF) occur during the femoral nerve stretch test (FNST) in patients with lumbar disc herniation. An FNST was conducted in patients with lumbar disc herniation to observe the changes in IRBF, and results were then compared with clinical features. Methods. The study was composed of four patients with L3–4 disc herniation who underwent microdiscectomy. Patients were placed prone immediately before surgery, so that their knee flexed on the operating table with the hip joint kept in hyperextension, and the FNST was performed to confirm at which region pain developed in the anterolateral thigh. During the operation, the hernia-affected nerve roots were visualized under a microscope. The needle sensor of a laser Doppler flowmeter was then inserted into each nerve root immediately above the hernia, and the change in IRBF was measured during the intraoperative FNST. After removal of the herniated disc, a similar procedure was repeated and IRBF was measured again. The intraoperative FNST showed that the hernia compressed the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (mean 96.9 ± 3.7% [± standard error of the mean]) relative to the blood flow before the test. This study demonstrated that the blood flow in the nerve root is reduced when the nerve root is compressed in vivo. Conclusions. The intraoperative FNST showed that the hernia compressd the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (96.9 ± 3.7% [mean ± standard error of the mean]).

Lumbar nerve root compression by synovial cysts of the ligamentum flavum

1984 ◽  
Vol 60 (3) ◽  
pp. 617-620 ◽  
Author(s):  
Adel F. Abdullah ◽  
Robert W. Chambers ◽  
Dennis P. Daut
Keyword(s):  
Nerve Root ◽  
Ligamentum Flavum ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Synovial Cysts ◽  
Fine Print

✓ Synovial cysts of the ligamentum flavum, measuring 1 cm in diameter, caused compression of the lumbar nerve roots in four patients. The authors discuss the association of these cysts with advanced focal spondylosis, and speculate on their etiology.

Intradural sacral nerve root metastasis mimicking herniated disc

1978 ◽  
Vol 49 (5) ◽  
pp. 764-768 ◽  
Author(s):  
Leonard F. Hirsh ◽  
Bernard E. Finneson
Keyword(s):  
Nerve Root ◽  
Correct Diagnosis ◽  
Clinical Suspicion ◽  
Herniated Disc ◽  
Spinal Tumors ◽  
Content Type ◽  
Sacral Nerve Root ◽  
Sacral Nerve ◽  
Herniated Discs ◽  
Fine Print

✓ Spinal tumors may mimic herniated discs but the neurological findings and radiographs usually indicate the correct diagnosis. A case of metastasis to the S-1 intradural nerve rootlets is reported, with symptoms closely simulating a herniated disc. The correct diagnosis could not be made preoperatively in spite of clinical suspicion of a tumor.

Extraspinal meningioma

1986 ◽  
Vol 64 (2) ◽  
pp. 328-330 ◽  
Author(s):  
A. Wahab Ibrahim ◽  
Mohamed B. Satti ◽  
E. Mustafa Ibrahim
Keyword(s):  
Nerve Root ◽  
Spinal Canal ◽  
Total Resection ◽  
Content Type ◽  
The Right ◽  
Two Stages ◽  
Fine Print ◽  
Considerable Size

✓ A case of ectopic extraspinal meningioma is reported which presented as a tumor at the back of the neck of a 51-year-old woman. This neoplasm was of considerable size and arose extradurally in the region of the C-2 nerve root, with its main bulk lying almost totally outside the spinal canal in the right suboccipital region. Total resection was accomplished in two stages, with no evidence of recurrence after 1 year. The rarity of such cases prompted this report.

scholarly journals Tethering of the spinal cord in mouse fetuses and neonates with spina bifida

2003 ◽  
Vol 99 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Dorothea Stiefel ◽  
Takashi Shibata ◽  
Martin Meuli ◽  
Patrick G. Duffy ◽  
Andrew J. Copp
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Mouse Model ◽  
Spinal Nerve ◽  
Nerve Roots ◽  
Content Type ◽  
Spina Bifida Aperta ◽  
Mouse Fetuses ◽  
Spinal Cord Tethering ◽  
Fine Print

Object. Tethering of the spinal cord is a well-known complication in humans with spina bifida aperta or occulta. Its pathogenesis consists of a pathological fixation of the spinal cord resulting in traction on the neural tissue which, in turn, leads to ischemia and progressive neurological deterioration. Although well established in humans, this phenomenon has not been described in animal models of spina bifida. Methods. A fetal mouse model with naturally occurring, genetically determined spina bifida was produced by generating double mutants between the curly tail and loop-tail mutant strains. Microdissection, labeling with 1,1′-dioctadecyl-3,3,3,′,3′-tetramethylindocarbocyanine perchlorate, immunohistochemistry for neurofilaments, H & E staining of histological sections, and whole-mount skeletal preparations were performed and comparisons made among mutant and normal fetuses. Normal fetuses exhibited the onset of progressive physiological ascent of the spinal cord from embryonic Day 15.5. Spinal cord ascent resulted, by embryonic Day 18.5, in spinal nerve roots that pass caudolaterally from the spinal cord toward the periphery. In contrast, fetuses with spina bifida exhibited spinal cord tethering that resulted, at embryonic Day 18.5, in nerve roots that run in a craniolateral direction from the spinal cord. The region of closed spinal cord immediately cranial to the spina bifida lesion exhibited marked narrowing, late in gestation, suggesting that a potentially damaging stretch force is applied to the spinal cord by the tethered spina bifida lesion. Conclusions. This mouse model provides an opportunity to study the onset and early sequelae of spinal cord tethering in spina bifida.

Spinal extradural schwannoma

2005 ◽  
Vol 2 (4) ◽  
pp. 447-456 ◽  
Author(s):  
Paolo Celli ◽  
Giuseppe Trillò ◽  
Luigi Ferrante
Keyword(s):  
Nerve Root ◽  
Pyramidal Tract ◽  
Tumor Resection ◽  
Spinal Nerve ◽  
Cervical Region ◽  
Nerve Roots ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Fine Print

Object. The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve. Methods. A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed. Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk. Conclusions. Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.

Myelographic block caused by redundant lumbar nerve root

1973 ◽  
Vol 38 (4) ◽  
pp. 504-505 ◽  
Author(s):  
Des Raj Gulati ◽  
Damodar Rout
Keyword(s):  
Nerve Root ◽  
Muscular Atrophy ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
The Right ◽  
Myelographic Block ◽  
Fine Print ◽  
Degree Of Recovery

✓ A patient with weakness and muscular atrophy of the right leg was shown to have a myelographic block caused by a redundant lumbar nerve loop. Decompressive laminectomy was followed by a marked degree of recovery.

Hemangioma of spinal nerve root

1999 ◽  
Vol 91 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
William E. Krauss
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Capillary Hemangioma ◽  
Spinal Nerve Root ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Fine Print

Object. Hemangiomas of the spinal nerve roots are rare. Only 12 cases have been reported in the literature, all since 1965. These lesions occurred in adults, primarily in males, and were located in the cauda equina. Of the 12 lesions, eight were cavernous hemangiomas. The authors report here the clinicopathological features of 10 cases of hemangioma of the spinal nerve root, nine of which were of the capillary type. Methods. The group included six men and four women who ranged in age from 40 to 62 years. The majority of patients presented with pain and weakness. One patient also experienced worsening of pain during menses. In all cases, gadolinium-enhanced magnetic resonance imaging or computerized tomography myelography demonstrated a discrete intraspinal extramedullary mass. Administration of contrast agent resulted in uniform, intense enhancement. A gross-total resection was achieved in all but one case; in most cases, it was necessary to sacrifice the parent nerve root. Preoperative symptoms and signs improved in nine cases. On histological examination, all but one tumor, a spindle-cell hemangioendothelioma, were shown to be ordinary capillary hemangiomas. Two lesions exhibited a cavernous component, and five showed a partly solid growth pattern resembling juvenile capillary hemangioma. In all cases, the relationship with the nerve root was histologically confirmed. The tumor—nerve relation varied. The intact nerve was displaced by the epineurial mass in three cases. The fascicles appeared separated in six cases, and individual nerve fibers were seen throughout one lesion with endoneurial involvement. Conclusions. Hemangiomas of spinal nerve roots pose a challenging diagnostic problem. Knowledge of their existence is relevant in that they may mimic tumors and are amenable to surgical treatment.

Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

1987 ◽  
Vol 67 (2) ◽  
pp. 269-277 ◽  
Author(s):  
Wesley W. Parke ◽  
Ryo Watanabe
Keyword(s):  
Nerve Root ◽  
Sensory Nerve ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Ventral Horn ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Almost All

✓ An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

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