Ossified longitudinal ligament causing same level cord contusion in a case of Klippel-Feil syndrome

Klippel-Feil syndrome (KFS) is a congenital fusion of two or more cervical vertebrae due to faulty segmentation of the vertebral axis during gestation. (1-5) These patients present with a constellation of manifes­tations and are typically prone to cervical cord injury after a minor fall or a major traumatic episode. (2, 5-8) 34 years old gentlemen, a plumber by profession presented with a history of slipped and fall about two stairs height while he was working.

An unusual cause of polymorphic ventricular tachycardia: Acute cervical cord injury.

Cardiovascular disturbances are the leading causes of morbidity and mortality in patients of spinal cord particularly cervical cord injury accounting for approximately 30% of deaths. Most common cardiovascular dysfunctions are sinus bradycardia, hypotension, cardiac arrest, supraventricular tachycardia and all these occurs due to sympathetic withdrawal and unopposed vagal action. Here we are reporting a case of acute cervical cord injury with neurogenic shock in a 25 year young patient who developed polymorphic ventricular tachycardia, which degenerated to ventricular fibrillation and cardiac arrest. We described all possible mechanisms of development this arrythmia and its management.

Integrative treatment of paralytic small intestine following acute cervical cord injury: A case report

Background: A patient developed paralysis of the small intestine following an acute traumatic hyperextension cervical spinal cord injury attributed to the ossification of the posterior longitudinal ligament (OPLL) C3–C6. The persistent ileus finally resolved utilizing Kampo medications (traditional Chinese therapy) consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16). Case Description: A 63-year-old male became acutely quadriplegic secondary to a hyperextension injury incurred during a fall. Radiographic studies confirmed mixed OPLL extending from C3–C6 resulting in marked cord compression, there was a clear spinal cord contusion. His neurological status using the American Spinal Injury Association (ASIA) Scale was Grade “A;” there were was complete motor and sensory loss below the C5 level. After a C3–C6 expansive laminoplasty, the ASIA scale improved to Grade B. However, he then developed a persistent small intestine ileus resulting in marked abdominal distention. When conventional therapies failed to resolve the problem, Kampo medicines, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), were administered. The ileus improved within 2 days and fully resolved within the 1st postoperative week. Conclusion: The utilization of Kampo medications, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), or the combined bukuryoingohangekobokuto (TJ-116) effectively resolved a postoperative paralytic small bowel ileus following a cervical laminoplasty performed in a quadriplegic patient. Keywords: Acute cervical cord injury, Cervical ossification of the posterior longitudinal ligamentOPLL, Complication management, Integrative medicine, Paralytic small intestine