scholarly journals Thoracic Spinal Schwannoma Simulating Lumbar Sciatica-like pain: A Case Report and Review of Literature

2021 ◽  
Vol 8 (1) ◽  
pp. 43-50
Author(s):  
Khodakaram Rastegar ◽  
◽  
Hasan Ghandhari ◽  
Ebrahim Ameri ◽  
Farzam Mokarami ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Underlying Disease ◽  
Cord Compression ◽  
Leg Pain ◽  
Magnetic Resonance Imaging Scan ◽  
Spinothalamic Tract ◽  
Burning Pain ◽  
Thoracic Spinal ◽  
Thoracic Cord ◽  
Physical Findings

A 45-year-old man presented to our facility with predominantly Sciatica-like leg pain and lower extremity motor weakness, who did not get relief despite undergoing two consecutive lumbar surgeries for suspected lumbar disc herniation. Medical history, physical findings, and a magnetic resonance imaging scan revealed thoracic cord tumor as the underlying disease. Our patient had complete resolution of his back and leg pain following surgical resection of the thoracic Schwannoma. Thoracic cord compression often results in diffuse pain and myelopathic symptoms caused by the irritation of ascending spinothalamic tract, which causes a vague and burning pain that should be differentiated from nerve root lesions and can be the first presentation of a thoracic cord lesion.

scholarly journals A Shock-Like Pain and Inability to Ambulate: Thoracic Spinal Cord Compression from Hepatocellular Carcinoma

2021 ◽  
pp. 56-61
Author(s):  
Kay Chen ◽  
Mashya Abbassi ◽  
Naomi Y. Ko
Keyword(s):  
Hepatocellular Carcinoma ◽  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Advanced Hepatocellular Carcinoma ◽  
Vertebral Metastases ◽  
Thoracic Spinal Cord ◽  
Oncological Emergency ◽  
Thoracic Spinal ◽  
Thoracic Cord

Hepatocellular carcinoma commonly metastasizes to organs, but there are few reports of vertebral metastases causing cord compression. Here, we present a case of thoracic cord compression in a patient with advanced hepatocellular carcinoma. Providers’ and patient’s awareness of this risk is important, as this is an oncological emergency.

scholarly journals Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fang-Ting Yu ◽  
Guang-Xia Ni ◽  
Guo-Wei Cai ◽  
Wen-Jun Wan ◽  
Xiao-Qing Zhou ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Lumbar Disc ◽  
Pilot Trial ◽  
Sham Acupuncture ◽  
Leg Pain ◽  
Power Calculation ◽  
Clinical Trial Registry ◽  
Randomized Controlled ◽  
Link Type

Abstract Background Acupuncture is widely used for pain diseases while evidence of its efficacy for sciatica is insufficient. We aim to explore the feasibility and efficacy of acupuncture with different acupoint selecting strategies for sciatica induced by lumbar disc herniation. Methods This is a multicenter, three-arm, patient-assessor-blinded randomized controlled pilot trial. Ninety patients will be assigned randomly into 3 groups including disease-affected meridians (DAM) group, non-affected meridians (NAM) group, and sham acupuncture (SA) group in a 1:1:1 ratio. The trial involves a 4-week treatment along with follow-up for 22 weeks. The primary outcome is the change of leg pain intensity measured by the visual analogue scale (VAS) from baseline to week 4 after randomization. Secondary outcomes include functional status, back pain intensity, and quality of life. Adverse events will also be recorded. Discussion The results will inspire the optimal acupuncture strategy for sciatica and help establish a better design as well as power calculation for a full-scale study. Trial registration ChiCTR2000030680 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 9 March 2020).

Transdural herniation of the thoracic spinal cord: untethering via a posterolateral transpedicular approach

2004 ◽  
Vol 1 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Ryder Gwinn ◽  
Fraser Henderson
Keyword(s):  
Spinal Cord ◽  
Posterior Approach ◽  
Thoracic Spinal Cord ◽  
Dural Repair ◽  
Content Type ◽  
Transpedicular Approach ◽  
Thoracic Spinal ◽  
Novel Approach ◽  
Spinal Cord Herniation ◽  
Thoracic Cord

✓ Anterior spinal cord herniation is a well-documented condition in which the thoracic cord becomes tethered within a defect in the anterior dura mater. Typical procedures have involved a posterior approach with direct manipulation of the thoracic cord to expose and blindly release its point of tethering. The authors report three cases in which a novel approach for the treatment of anterior thoracic cord herniation was performed, cord manipulation and traction are minimized, and direct dural repair of the defect is performed.

Thoracic spinal cord compression masquerading as cauda equina syndrome

2016 ◽  
Vol 34 (4) ◽  
pp. 756.e3-756.e5 ◽  
Author(s):  
Katherine Stolper ◽  
Erin R. Hanlin ◽  
Michael D. April ◽  
John L. Ritter ◽  
Curtis J. Hunter ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Cord Compression ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Recurrent Abdominal Pain During Childhood

1993 ◽  
Vol 14 (8) ◽  
pp. 313-319
Author(s):  
Tim F. Oberlander ◽  
Leonard A. Rappaport
Keyword(s):  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Underlying Disease ◽  
Careful Examination ◽  
Environmental Aspects ◽  
Successful Management ◽  
Developmental Issues ◽  
Physical Findings ◽  
Over Time

RAP offers a complex and often confusing array of symptoms and diagnostic possibilities. This may be due to its unique age of presentation, its inherent somatic and cognitive developmental issues, or the physiology of abdominal pain itself. A careful examination of the historic and physical findings should produce a therapeutic plan that addresses somatic, psychological, and environmental aspects of the child. This process will avoid overly simplistic and premature misdiagnosis or potentially unnecessary investigations that convey a sense of disinterest, haste, and disbelief in the problem. The successful management of RAP lies in the recognition that serious underlying disease frequently is not present and that time usually is on our side. It is the process of continued and thoughtful evaluation and reassurance over time that counts.

Extradural Thoracic Arteriovenous Malformation in a Patient with Klippel-Trenaunay-Weber Syndrome: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1275-1279 ◽  
Author(s):  
Michael J. Alexander ◽  
Peter M. Grossi ◽  
Robert F. Spetzler ◽  
Cameron G. McDougall
Keyword(s):  
Spinal Cord ◽  
Cord Compression ◽  
Magnetic Resonance Imaging Scan ◽  
Lower Extremity Weakness ◽  
Thyrocervical Trunk ◽  
Weber Syndrome ◽  
History Of ◽  
Cutaneous Hemangioma ◽  
The Right ◽  
Upper Thoracic

Abstract OBJECTIVE AND IMPORTANCE Spinal cord involvement in Klippel-Trenaunay-Weber (KTW) syndrome is rare. Cases of intradural spinal cord arteriovenous malformations (AVMs) have been associated with this syndrome. Likewise, cases of epidural hemangioma and angiomyolipoma have been reported to occur at the same segmental level as cutaneous hemangioma in KTW syndrome. This report details a rare case of an extradural thoracic AVM in a patient with KTW syndrome. CLINICAL PRESENTATION A 30-year-old man presented with a 10-month history of progressive myelopathy, bilateral lower-extremity weakness, and numbness, with the right side affected more than the left. His symptoms had progressed to the point that he was unable to walk. The patient had the characteristic manifestations of KTW syndrome, including numerous cutaneous angiomas and cavernomas, limb hypertrophy and syndactyly, and limb venous malformations. A magnetic resonance imaging scan and subsequent angiogram demonstrated a large extradural AVM causing cord compression at the T3–T4 levels. INTERVENTION The patient underwent two separate endovascular procedures, including embolization of upper thoracic and thyrocervical trunk feeders. Subsequently, he underwent T1–T4 laminectomy and microsurgical excision of the AVM. Clinically, the patient improved such that he could walk without assistance. CONCLUSION KTW syndrome represents a spectrum of clinical presentations. Although involvement of the spinal cord is uncommon, the manifestations of this syndrome may include both intradural and extradural AVMs in addition to various tumors.

scholarly journals Open discectomy vs microdiscectomy for lumbar disc herniation - a protocol for a pragmatic comparative effectiveness study

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2170 ◽  
Author(s):  
Andreas Sørlie ◽  
Sasha Gulati ◽  
Charalampis Giannadakis ◽  
Sven M. Carlsen ◽  
Øyvind Salvesen ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Relative Effectiveness ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Leg Pain ◽  
Secondary Outcome ◽  
Clinical Registry

Introduction:  Since the introduction of lumbar microdiscectomy in the 1970’s, many studies have attempted to compare the effectiveness of this method with that of standard open discectomy with conflicting results. This observational study is designed to compare the relative effectiveness of microdiscectomy (MD) with open discectomy (OD) for treating lumbar disc herniation, -within a large cohort, recruited from daily clinical practice. Methods and analysis:   This study will include patients registered in the Norwegian Registry for Spine Surgery (NORspine). This clinical registry collects prospective data, including preoperative and postoperative outcome measures as well as individual and demographic parameters. The primary outcome is change in Oswestry disability index between baseline and 12 months after surgery. Secondary outcome measures are improvement of leg pain and changes in health related quality of life measured by the Euro-Qol-5D between baseline and 12 months after surgery, complications to surgery, duration of surgical procedures and length of hospital stay.

scholarly journals Chronic Venous Insufficiency (CVI) - A Study of 100 Cases

1970 ◽  
Vol 9 (1) ◽  
pp. 20-26
Author(s):  
MM Shahin-Ul-Islam ◽  
Md Zahirul Haque ◽  
Saki Md Jakiul Alam ◽  
Mesbahuddin Noman ◽  
FM Siddiqui
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Leg Pain ◽  
Advanced Stage ◽  
College Hospital ◽  
Prolonged Standing ◽  
Burning Pain ◽  
Significant Difference ◽  
Ceap Classification ◽  
Relationship Of

This study was carried out in the out patient department of Dhaka Medical College Hospital. 100 patients presented with chronic venous insufficiency during the period of January 2005 to June 2005 were studied to find out the various modes of presentation, risk factors and relationship of symptoms with age, sex and Body Mass Index of the patients. It was found that, maximum patients presented with heaviness in the leg (87%), followed by aching leg pain (75%), leg swelling (70%), cramping leg pain (68%), tiredness (48%), burning pain (43%), engorged leg vein (39%), restless leg at night (21%), throbbing leg pain (18%), itching (13%), various skin changes without active ulceration (7%) and active leg ulceration only 3% of cases. Increasing age of the patients, obesity, increasing number of pregnancy, prolonged standing and sitting position at work were found to be positively correlated with CVI. Advanced age is associated with more advanced stage of CVI according to clinical CEAP classification. There is almost equal sex distribution among the stages of CVI except in advanced stage, in stage C4, C5 and C6 there is 10 patients out of them 9 are male and only 1 is female. Relationship of symptoms with BMI of the patients were also sort out and found that, in C3 group of CEAP classification out of 61 patients 46 are obese according to BMI, of which 32 are female and 14 are male and only 17 patients have BMI within normal range, but in other group there is no significant difference in incidence between two groups.   DOI = 10.3329/jom.v9i1.1421 J MEDICINE 2008; 9 : 20-26

Posterior Epidural Migration of Sequestrated Lumbar Disc Fragments Into the Bilateral Facet Joints

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. E1148-E1151 ◽  
Author(s):  
Tzuu-Yuan Huang ◽  
Kung-Shing Lee ◽  
Tai-Hsin Tsai ◽  
Yu-Feng Su ◽  
Shiuh-Lin Hwang
Keyword(s):  
Differential Diagnosis ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Synovial Cyst ◽  
Leg Pain ◽  
Hybrid Technique ◽  
Facet Joints ◽  
Disc Disease ◽  
First Case ◽  
Rod System

Abstract BACKGROUND AND IMPORTANCE Symptomatic lumbar disc herniation is common. Migration of a free disc fragment is usually found in rostral, caudal, or lateral directions. Posterior epidural migration is very rare. We report the first case with posterior epidural migration and sequestration into bilateral facet joints of a free disc fragment. CLINICAL PRESENTATION A 78-year-old female presented with low back pain and right leg pain. Plain radiographs showed lumbar spondylolisthesis. Magnetic resonance imaging revealed a posterior epidural mass and intrafacet mass, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. The lesion in the left L3-4 facet joint had rim enhancement, whereas the right one was not contrasted after gadolinium injection. Preoperative differential diagnosis included abscess, tumor, hematoma, or synovial cyst. An interbody cage fusion at L3-4 and L4-5 for spondylolisthesis was performed, and a hybrid technique was applied with the Dynesys flexible rod system at L3-S1 for multisegment degenerative disc disease. The lesion proved to be an epidural disc fragment with sequestration into bilateral facet joints. CONCLUSION A free disc fragment should be considered in the differential diagnosis of posterior epidural lesions, and even in the facet joint.

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