Diaphyseal aclasis with spinal cord compression

1996 ◽  
Vol 84 (3) ◽  
pp. 518-521 ◽  
Author(s):  
Emmanuel K. Labram ◽  
J. Mohan

✓ In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45-year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.

1984 ◽  
Vol 60 (1) ◽  
pp. 196-199 ◽  
Author(s):  
Brien Vlcek ◽  
Kim J. Burchiel ◽  
Thomas Gordon

✓ Subacute paraplegia progressing over 3 months due to spinal cord compression was the presenting symptom of tuberculous meningitis in this patient with a normal chest x-ray film and no radiological or autopsy evidence of Pott's vertebral tuberculosis. The obstructive myelopathy was the result of proliferative granulomatous meningitis. A review of the literature indicates that this is a very unusual presentation of tuberculous meningitis.


1975 ◽  
Vol 43 (4) ◽  
pp. 483-485 ◽  
Author(s):  
Abdel A. Ammoumi ◽  
Joanna H. Sher ◽  
Daniel Schmelka

✓ 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.


1995 ◽  
Vol 82 (1) ◽  
pp. 125-127 ◽  
Author(s):  
David G. Porter ◽  
Andrew J. Martin ◽  
Conor L. Mallucci ◽  
Catherine N. Makunura ◽  
H. Ian Sabin

✓ 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.


2005 ◽  
Vol 3 (4) ◽  
pp. 302-307 ◽  
Author(s):  
Christopher B. Shields ◽  
Y. Ping Zhang ◽  
Lisa B. E. Shields ◽  
Yingchun Han ◽  
Darlene A. Burke ◽  
...  

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.


1991 ◽  
Vol 74 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Stephen M. Papadopoulos ◽  
Curtis A. Dickman ◽  
Volker K. H. Sonntag

✓ 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.


1983 ◽  
Vol 58 (4) ◽  
pp. 580-582 ◽  
Author(s):  
Barry J. Leaney ◽  
James M. Calvert

✓ 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.


1979 ◽  
Vol 51 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Eugen J. Dolan ◽  
Charles H. Tator

✓ 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.


1989 ◽  
Vol 70 (5) ◽  
pp. 688-690 ◽  
Author(s):  
I. R. Sanderson ◽  
Jon Pritchard ◽  
Henry T. Marsh

✓ 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.


2002 ◽  
Vol 97 (3) ◽  
pp. 359-361 ◽  
Author(s):  
Hideki Sudo ◽  
Kuniyoshi Abumi ◽  
Manabu Ito ◽  
Yoshihisa Kotani ◽  
Akio Minami

✓ 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.


1973 ◽  
Vol 38 (3) ◽  
pp. 374-378 ◽  
Author(s):  
Chikao Nagashima

✓ The author reports the successful treatment of a case of irreducile atlantoaxial dislocation due to separation of the dens and secondary arthritic changes causing sagittal narrowing of the atlanto-axial spinal canal to 3 mm. Complete myelography obstruction was present. A one-stage posterior decompression of the foramen magnum and atlas was performed and occipito-cervical fixation accomplished by wire encased in acrylic plastic.


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