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Cases reported "Radiculopathy"

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31/177. Root and spinal cord compression from methylmethacrylate vertebroplasty.

    STUDY DESIGN: Case report and literature review. OBJECTIVES: Clinicians use methylmethacrylate vertebroplasty to treat vertebral hemangiomas, metastases, and osteoporotic fractures. Cement may leak out of the vertebral body and compress the adjacent spinal cord and nerve roots. We review a case of nerve-root and cord compression from methylmethacrylate extrusion during vertebroplasty. SUMMARY OF BACKGROUND DATA: A 50-year-old female presented with disabling thoracic back pain. A metastasis to T1 was discovered, with collapse of the vertebral body but without cord compression. methylmethacrylate vertebroplasty was performed. After injection, portable computed tomography (CT) showed a leakage of methylmethacrylate into the C8 and T1 foramina and spinal canal. radiculopathy and myelopathy developed. Surgical decompression using the anterior approach was necessary. methods: Case report. RESULTS: Early surgical intervention decompressed the neural elements and relieved the neurological deficits. CONCLUSIONS: Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.
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ranking = 1
keywords = spinal, nerve
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32/177. synovial cyst at the intervertebral foramina causing lumbar radiculopathy.

    OBJECTIVE: To determine the presence of intraforaminal synovial cysts resulting in nerve root compression. methods: A 26 year old man presenting with left leg pain was admitted. He had no motor, sensory, or reflex changes. magnetic resonance imaging (MRI) and MRI-myelography showed an intra and extra foraminal, extradural, cystic lesion at L4 vertebra on the left side. RESULTS: At surgery there was a cystic mass pressing on the nerve root, and no connection or communication with the dural structures could be found. CONCLUSION: Synovial cysts are uncommon extradural degenerative lesions. Intraspinal synovial cysts occur most often at the L4-5 level, but they have been reported in all areas of the spine except the intraforaminal region and the sacrum.
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ranking = 0.25812382312778
keywords = spinal, nerve
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33/177. Sacral radiculopathy secondary to multicentric osteosarcoma.

    STUDY DESIGN: A case of multicentric osteosarcoma presenting with sacral radiculopathy is reported. OBJECTIVE: To present unusual clinical and radiologic findings of multicentric osteosarcoma. SUMMARY OF BACKGROUND DATA: Multicentric osteosarcoma is a rare variant of osteosarcoma. To the authors' knowledge, no cases of multicentric osteosarcoma presenting as sacral radiculopathy have been reported previously. methods: A 14-year-old boy had a large sacral tumor extending into the spinal canal, which was found to account for the initial symptoms, which mimicked those of herniated nucleus pulposus. At diagnosis, a bone survey showed multiple foci of osteosarcoma in the long bones. RESULTS: The patient was treated with chemotherapy, but died of the disease 8 months after the initial presentation. CONCLUSION: Multicentric osteosarcoma should be considered in the differential diagnosis for a pediatric patient with low back pain and sciatica.
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ranking = 0.14837523537444
keywords = spinal
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34/177. Post-traumatic lumbar nerve root avulsion.

    Lumbar nerve root avulsion is a rarely seen clinical entity that may complicate major trauma. The majority of previously reported cases have associated pelvic or lumbar vertebral fractures. Two cases of traumatic pseudomeningoceles at the lumbar level with associated avulsions of the lumbar nerve roots are presented. Both patients were involved in high velocity motor vehicle accidents. Case 1 had associated pelvic fractures but no spinal fractures and, interestingly, case 2 had no fractures of the spine or pelvis. The value of MRI in making the diagnosis is demonstrated.
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ranking = 0.47762099863445
keywords = spinal, nerve
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35/177. Spinal leptomeningeal metastasis from cerebral glioblastoma multiforme presenting with radicular pain: case report and literature review.

    BACKGROUND: We present a case of spinal leptomeningeal metastasis from an intracranial glioblastoma multiforme that presented with radicular pain.CASE DESCRIPTION: A 55-year-old man with a previously treated supratentorial glioblastoma multiforme presented with a 12-month history of thoracic radicular pain. MRI of the thoracic spine demonstrated an intradural extramedullary metastatic tumor deposit at the levels of T8-T10. External beam radiotherapy to the thoracic spine provided a minimal decrease in the intensity of the radicular pain. The lack of appreciation of the metastatic potential of the primary intracranial tumor resulted in delayed diagnosis and treatment.CONCLUSION: Spinal leptomeningeal metastasis needs to be suspected in patients with a past history of intracranial glioblastoma multiforme, who present with the clinical features of radiculopathy or myelopathy. awareness of this condition will facilitate appropriate intervention.
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ranking = 0.14837523537444
keywords = spinal
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36/177. Tumoral calcinosis in the upper cervical spine causing progressive radiculomyelopathy--case report.

    A 54-year-old woman with chronic renal failure presented with tumoral calcinosis manifesting as progressive radiculomyelopathy. magnetic resonance imaging revealed a spinal epidural mass in the C-2 to C-4 levels. The clinical and radiological findings suggested malignant tumor. Resection of the lesion was performed with total C-2 laminectomy and C-3 and C-4 laminoplasty. The symptoms totally disappeared after surgery. The histological diagnosis was tumoral calcinosis. Tumoral calcinosis is a rare tumoral calcium pyrophosphate dihydrate crystal deposition disease which presents as periarticular soft tissue calcification. Tumoral calcinosis should be considered in patients with a mass lesion involving the upper cervical spine and associated with metabolic abnormalities. Surgical excision is the treatment of choice, because this is completely curative without known recurrence.
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ranking = 0.14837523537444
keywords = spinal
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37/177. Lumbar nerve root compression caused by herniated intradiscal gas: description of a clinical case with recurrence.

    The authors report a rare case of recurrence of lumbar nerve root compression caused by herniated intradiscal gas treated surgically with resolution of pain symptoms. They describe the possible causes of the formation of gaseous material reported in the literature. They believe that to avoid recurrence it is important to associated removal of the hernia with complete emptying of the disc and resection of the posterior longitudinal ligament.
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ranking = 0.27437146938334
keywords = nerve
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38/177. Intramuscular myxoma causing lumbar radiculopathy. Case report and review of the literature.

    The authors present the rare case of a myxoma, a benign soft-tissue tumor of mesenchymal origin noted for occurring in the left atrium of the heart, which was found in the lumbar paraspinal muscles of an 80-year-old woman. This patient experienced low-back pain for over 20 years and had noted its increasing severity with the development of an L-5 radiculopathy over a 3-month period. magnetic resonance imaging of the lumbar spine revealed a large paraspinal mass that invaded the L-5 vertebral body and the left foramen of L5-S1. A computerized tomography-guided biopsy sampling procedure was performed, and examination of the specimen revealed an intramuscular myxoma. The patient underwent resection of the tumor and nerve root decompression. The diagnosis of intramuscular myxoma was confirmed, and the patient experienced complete resolution of her presenting symptoms. This patient represents the third reported case (the first in the English-language literature) of an intramuscular (paraspinal) myxoma presenting with lumbar nerve root compression.
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ranking = 0.55487429387667
keywords = spinal, nerve
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39/177. Dermatomal somatosensory evoked potential demonstration of nerve root decompression after VAX-D therapy.

    Reductions in low back pain and referred leg pain associated with a diagnosis of herniated disc, degenerative disc disease or facet syndrome have previously been reported after treatment with a VAX-D table, which intermittently distracts the spine. The object of this study was to use dermatomal somatosensory evoked potentials (DSSEPs) to demonstrate lumbar root decompression following VAX-D therapy. Seven consecutive patients with a diagnosis of low back pain and unilateral or bilateral L5 or S1 radiculopathy were studied at our center. Disc herniation at the L5-S1 level was documented by MRI or CT in all patients. All patients were studied bilaterally by DSSEPs at L5 and S1 before and after VAX-D therapy. All patients had at least 50% improvement in radicular symptoms and low back pain and three of them experienced complete resolution of all symptoms. The average pain reduction was 77%. The number of treatment sessions varied from 12 to 35. DSSEPs were considered to show improvement if triphasic characteristics returned or a 50% or greater increase in the P1-P2 amplitude was seen. All patients showed improvement in DSSEPs after VAX-D therapy either ipsilateral or contralateral to the symptomatic leg. Two patients showed deterioration in DSSEPs in the symptomatic leg despite clinically significant improvement in pain and radicular symptoms. Overall, 28 nerve roots were studied before and after VAX-D therapy. Seventeen nerve root responses were improved, eight remained unchanged and three deteriorated. The significance of DSSEP improvement contralateral to the symptomatic leg is emphasized. Direct compression of a nerve root by a disc herniation is probably not the sole explanation for referred leg pain.
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ranking = 0.38412005713667
keywords = nerve
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40/177. Halo pin intracranial penetration and epidural abscess in a patient with a previous cranioplasty: case report and review of the literature.

    STUDY DESIGN: Report of a patient with an epidural abscess after halo pin intracranial penetration at the site of a previous cranioplasty. OBJECTIVES: To report a rare case of intracranial penetration at the site of a previous cranioplasty associated with epidural abscess, and to discuss the diagnostic and therapeutic approach to its management. SUMMARY OF BACKGROUND DATA: The most serious complications associated with use of halo device occur when pins penetrate the inner table of the skull, resulting in cerebrospinal fluid leak and rarely in an intracranial abscess. However, no mention of intracranial halo pin penetration at the site of a previous cranioplasty was found in the literature. methods: A 64-year-old man with ankylosing spondylitis had a halo vest placed for management of a fracture dislocation through the C5-C6 intervertebral disc space associated with left C6 radiculopathy. One week later, the patient experienced fever and headache associated with pain, redness, and drainage at the site of the insertion of the left posterior pin. Computed tomography of the brain showed a 1.5-cm intracranial penetration of the halo pin through a previous cranioplasty of the temporal bone, associated with epidural abscess and cerebral edema in the left temporoparietal lobe. The pins and the halo vest were removed, the pin site was cleaned, and a philadelphia cervical collar was applied. staphylococcus epidermidis grew on the culture of drainage from the pin site. The patient started immediate intravenous antibiotic treatment for 2 weeks, followed by oral antibiotics for 2 additional weeks. RESULTS: The patient had gradual improvement of his symptoms within the first 48 hours. At the latest follow-up visit, he had fully recovered and his fracture had healed. CONCLUSIONS: The halo device should not be used for patients with a previous cranioplasty, especially if the pins cannot be inserted at other safe areas of the skull. A thorough medical history and physical examination of the skull are important before the application of a halo device. Computed tomography of the skull may be necessary before elective halo application for patients with concomitant head trauma, confusion, or intoxication and for patients with a previous cranioplasty to ascertain the safest pin sites.
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ranking = 0.14837523537444
keywords = spinal
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Last update: April 2009
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