Nonsurgical approach to paraparesis due to extramedullary hematopoiesis

1995 ◽  
Vol 82 (4) ◽  
pp. 657-660 ◽  
Author(s):  
Khosrov Parsa ◽  
Ahmad Oreizy
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Spinal Cord Compression ◽  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
The Other ◽  
Blood Transfusions ◽  
Therapeutic Tool ◽  
Content Type ◽  
Fine Print

✓ Two cases of spinal cord compression due to extradural extramedullary hematopoiesis are reported and the non-surgical means used for their diagnosis and treatment are presented. One patient was treated with blood transfusions and radiation therapy, the other with blood transfusions alone. Both patients have made almost complete clinical recoveries from spinal cord compression. A mechanism is proposed to explain how blood transfusions can serve as an important diagnostic, as well as a therapeutic, tool in the management of this entity.

Pediatric spinal epidural metastases

1991 ◽  
Vol 74 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Steven L. Klein ◽  
Robert A. Sanford ◽  
Michael S. Muhlbauer
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Spinal Cord Compression ◽  
Osteogenic Sarcoma ◽  
Cord Compression ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Spinal Epidural ◽  
Fine Print

✓ A total of 2259 children with solid malignant tumors were treated at St. Jude Children's Research Hospital between the years 1962 and 1987. Of these, 112 (5%) developed spinal epidural metastasis with spinal cord compression during the course of their disease process. Metastatic epidural spinal cord compression was caused most commonly by Ewing's sarcoma and neuroblastoma, followed by osteogenic sarcoma, rhabdomyosarcoma, Hodgkin's disease, soft-tissue sarcoma, germ-cell tumor, Wilm's tumor, and (rarely) hepatoma. There was no significant difference in outcome between patients with small-cell tumors (neuroblastoma, Hodgkin's disease, and germ-cell tumors) who received only chemotherapy and/or radiation therapy and the patients with similar lesions who received a decompressive laminectomy alone or prior to chemotherapy and/or radiation therapy. Patients with spinal cord compression from metastatic sarcoma (Ewing's sarcoma, soft-tissue sarcoma, osteogenic sarcoma, and rhabdomyosarcoma) showed a significant improvement with decompressive laminectomy alone or before medical therapy, compared to those who received radiation therapy and/or chemotherapy without posterior decompression. Pediatric tumors invade the spinal canal via the neural foramen, compressing the spinal cord in a circumferential manner, allowing decompressive laminectomy (posterior approach) to be an effective surgical approach. Sixty-six percent of children who had no evidence of motor or sensory function below the level of the compression became ambulatory after surgical decompression and medical treatment, regardless of tumor type.

Progressive paraparesis due to thoracic extramedullary hematopoiesis in myelofibrosis

1993 ◽  
Vol 79 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Nina De Klippel ◽  
Marie F. Dehou ◽  
Claire Bourgain ◽  
Rik Schots ◽  
Jaques De Keyser ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
Hematopoietic Tissue ◽  
Content Type ◽  
Radiotherapy Alone ◽  
Progressive Paraparesis ◽  
Fine Print

✓ A patient with myelofibrosis who developed a progressive paraparesis caused by spinal cord compression due to thoracic extramedullary hematopoietic tissue is reported. He recovered well after local radiotherapy alone.

Spinal cord compression by extramedullary hemopoietic tissue in sickle cell anemia

1975 ◽  
Vol 43 (4) ◽  
pp. 483-485 ◽  
Author(s):  
Abdel A. Ammoumi ◽  
Joanna H. Sher ◽  
Daniel Schmelka
Keyword(s):  
Spinal Cord ◽  
Sickle Cell ◽  
Spinal Cord Compression ◽  
Sickle Cell Anemia ◽  
Cord Compression ◽  
Content Type ◽  
Hemopoietic Tissue ◽  
Fine Print ◽  
Mass Recovery

✓ The authors report a patient with sickle cell anemia who suffered from paraplegia of 18 months duration due to spinal cord compression by a hemopoietic mass. Recovery following removal of the mass was complete.

Spinal cord compression due to Masson's vegetant intravascular hemangioendothelioma

1995 ◽  
Vol 82 (1) ◽  
pp. 125-127 ◽  
Author(s):  
David G. Porter ◽  
Andrew J. Martin ◽  
Conor L. Mallucci ◽  
Catherine N. Makunura ◽  
H. Ian Sabin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Vascular Lesion ◽  
Content Type ◽  
Fine Print

✓ The authors present the case of spinal cord compression in a 16-year-old boy due to the rare vascular lesion, Masson's vegetant hemangioendothelioma.

The therapeutic window for spinal cord decompression in a rat spinal cord injury model

2005 ◽  
Vol 3 (4) ◽  
pp. 302-307 ◽  
Author(s):  
Christopher B. Shields ◽  
Y. Ping Zhang ◽  
Lisa B. E. Shields ◽  
Yingchun Han ◽  
Darlene A. Burke ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Stenosis ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Therapeutic Window ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury ◽  
Fine Print

Object. There are no clinically based guidelines to direct the spine surgeon as to the proper timing to undertake decompression after spinal cord injury (SCI) in patients with concomitant stenosis-induced cord compression. The following three factors affect the prognosis: 1) severity of SCI; 2) degree of extrinsic spinal cord compression; and 3) duration of spinal cord compression. Methods. To elucidate further the relationship between varying degrees of spinal stenosis and a mild contusion-induced SCI (6.25 g-cm), a rat SCI/stenosis model was developed in which 1.13- and 1.24-mm-thick spacers were placed at T-10 to create 38 and 43% spinal stenosis, respectively. Spinal cord damage was observed after the stenosis—SCI that was directly proportional to the duration of spinal cord compression. The therapeutic window prior to decompression was 6 and 12 hours in the 43 and 38% stenosis—SCI lesions, respectively, to maintain locomotor activity. A significant difference in total lesion volume was observed between the 2-hour and the delayed time(s) to decompression (38% stenosis—SCI, 12 and 24 hours, p < 0.05; 43% stenosis—SCI, 24 hours, p < 0.05) indicating a more favorable neurological outcome when earlier decompression is undertaken. This finding was further supported by the animal's ability to support weight when decompression was performed by 6 or 12 hours compared with 24 hours after SCI. Conclusions. Analysis of the findings in this study suggests that early decompression in the rat improves locomotor function. Prolongation of the time to decompression may result in irreversible damage that prevents locomotor recovery.

Atlantoaxial stabilization in rheumatoid arthritis

1991 ◽  
Vol 74 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Stephen M. Papadopoulos ◽  
Curtis A. Dickman ◽  
Volker K. H. Sonntag
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Atlantoaxial Subluxation ◽  
High Rate ◽  
Content Type ◽  
Operative Stabilization ◽  
Asymptomatic Patients ◽  
Fine Print

✓ Atlantoaxial subluxation in patients with rheumatoid arthritis is common. Operative stabilization is clearly indicated when signs and symptoms of spinal cord compression occur. However, many recommend early operative fusion before evidence of appreciable neural compression occurs because 1) the myelopathy in these patients may be irreversible; 2) the overall prognosis is poor once symptoms of cord compression are present; and 3) the risk of sudden death associated with atlantoaxial subluxation is increased even in asymptomatic patients. The authors believe that rheumatoid arthritis patients in relatively good health without advanced multisystem disease and less than 65 years of age should be considered for operative stabilization if mobile atlantoaxial subluxation is greater than 6 mm. Seventeen patients with severe rheumatoid arthritis and atlantoaxial subluxation treated with a posterior arthrodesis are presented. A new method of fusion, devised by the senior author (V.K.H.S.), was utilized in all cases. Indications for operative therapy in these patients included evidence of spinal cord compression in 11 patients (65%) and mobile atlantoaxial subluxation greater than 6 mm but no signs or symptoms of cord compression in six patients (35%). Thirteen patients developed a stable osseous fusion, two patients a well-aligned fibrous union, one patient a malaligned fibrous union, and one patient died prior to evaluation of fusion stability. The details of the operative technique and management strategies are presented. Several technical advantages of this method of fusion make this approach particularly useful in patients with rheumatoid arthritis. Because of multisystem involvement of this disease, a high rate of osseous fusion is often difficult to achieve.

Tophaceous gout producing spinal cord compression

1983 ◽  
Vol 58 (4) ◽  
pp. 580-582 ◽  
Author(s):  
Barry J. Leaney ◽  
James M. Calvert
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Vertebral Column ◽  
Cord Compression ◽  
Tophaceous Gout ◽  
Content Type ◽  
Fine Print

✓ A case of thoracic paraplegia secondary to extradural tophaceous gout is presented. The ability of gout to compromise bone elements, periarticular tissues, and neural elements in the vertebral column is discussed.

A new method for testing the force of clips for aneurysms or experimental spinal cord compression

1979 ◽  
Vol 51 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Eugen J. Dolan ◽  
Charles H. Tator
Keyword(s):  
Spinal Cord ◽  
Early Detection ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
New Method ◽  
Content Type ◽  
Cosine Law ◽  
Fine Print

✓ A new method is described for the determination of force-distance curves for aneurysm clips. A dissecting microscope with a goniometer eyepiece was used to determine the angle between the clip blades as various forces were applied to open the clip. The cosine law was then used to calculate the force-distance curves. The method allows accurate characterization of different clips and is especially useful for the early detection of clip weakening.

Chemotherapy as the initial treatment of spinal cord compression due to disseminated neuroblastoma

1989 ◽  
Vol 70 (5) ◽  
pp. 688-690 ◽  
Author(s):  
I. R. Sanderson ◽  
Jon Pritchard ◽  
Henry T. Marsh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Initial Treatment ◽  
Cord Compression ◽  
Response To Treatment ◽  
Trial Period ◽  
Content Type ◽  
Sick Children ◽  
Spinal Cord Function ◽  
Fine Print

✓ During a 12-month trial period, all children attending the Hospitals for Sick Children, London, England, for management of spinal cord compression due to disseminated neuroblastoma were given chemotherapy as initial treatment rather than radiotherapy or laminectomy. Response to treatment was evaluated by a neurosurgeon as well as by oncologists. Four children were treated in this way and all made a full recovery of spinal cord function.

scholarly journals Spinal cord compression by multistrand cables after solid posterior atlantoaxial fusion

2002 ◽  
Vol 97 (3) ◽  
pp. 359-361 ◽  
Author(s):  
Hideki Sudo ◽  
Kuniyoshi Abumi ◽  
Manabu Ito ◽  
Yoshihisa Kotani ◽  
Akio Minami
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Late Complication ◽  
Cord Compression ◽  
Upper Cervical Spine ◽  
Content Type ◽  
Atlantoaxial Fusion ◽  
Initial Surgery ◽  
High Flexibility ◽  
Fine Print

✓ The sublaminar wiring procedure has been commonly used for stabilizing the atlantoaxial complex. Multistrand braided cables were introduced in the early 1990s. In previous biomechanical studies these cables were demonstrated to be superior to monofilament wires in terms of their flexibility, mechanical strength, and fatigue-related characteristics. To the authors' knowledge, they are the first to describe clinically the occurrence of delayed spinal cord compression resulting from multistrand cables after the completion of rigid spinal arthrodesis in the upper cervical spine. Three patients underwent posterior atlantoaxial fusion in which two sublaminar multistrand cables were placed. Between 15 and 48 months postoperatively, they suffered from upper- and lower-extremity numbness as well as gait disturbance. Plain radiography and computerized tomography myelography revealed spinal cord compression caused by the sublaminar cables, although fusion was complete and physiological alignment was maintained at the fused segment. The radiographs obtained immediately after surgery demonstrated that the initial cable placement had been properly performed. The shape of the cable at the initial surgery was oval and then gradually became circular. The anterior arc of the circular shape of the cable in fact led to the spinal cord compression. Considering the mechanism of this late complication, a cable tends to spring open because of its high flexibility and becomes circular shaped even after the complete arthrodesis. When applying multistrand cables for intersegmental fixation at the atlantoaxial complex, delayed complications related to bowing of the cables is possible.

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