1/8. Epidural hematoma after immobilization of a "hangman's" fracture: case report and review of the literature.BACKGROUND CONTEXT: Neurologic deterioration after immobilization of traumatic spondylolisthesis of the axis rarely occurs because of the decompressive nature of the injury itself and the large amount of space available for the cord in the upper cervical spine. PURPOSE: To document neurologic deterioration after reduction (without the use of traction) and halo immobilization of a Type IIA traumatic spondylolisthesis of the axis (hangman's fracture) secondary to an epidural hematoma. STUDY DESIGN/SETTING: Case report. PATIENT SAMPLE AND OUTCOME MEASURES: The patient population consisted of one patient; no outcome measures were used. methods: The medical record and radiographic studies of a 27-year-old patient involved in a motor vehicle crash that resulted in a traumatic spondylolisthesis of the axis were retrospectively reviewed, and a review of the English literature was performed. RESULTS: Upon evaluation, the patient was found to have, in addition to other injuries, a Type IIA hangman's fracture of the C2 vertebra, which was stabilized in a halo. Shortly thereafter, the patient developed a gradual progressive neurologic deficit. magnetic resonance imaging revealed the presence of a large epidural hematoma with cord compression treated with posterior laminectomy and transdural decompression of an anterior hematoma. Postoperatively, the patient's neurologic examination improved and returned to normal within 6 months. CONCLUSION: An epidural hematoma can occur after traumatic spondylolisthesis of the axis, but its symptoms may not present until after the spondylolisthesis is treated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/8. Complete L1-L2 lateral dislocation without fracture and neurologic deficit in a child.spinal injuries in the infantile age group are relatively rare, mainly due to anatomical and biomechanical features of the pediatric spine. With its hypermobile character, pediatric spine can withstand trauma without fracture, and the elastic nature of the young spine allows easy slippage between segments, especially under the age of 8. Clinically, a few of the cases present with subluxation only, which seldom involve the lumbar level. We report an extremely rare case of traumatic complete upper lumbar lateral lystesis in a 3-year-old boy. The patient was treated conservatively and followed up for 2 years with some degree of correction.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/8. Acute bowel ischemia following spinal surgery.Acute mesenteric ischemia is a morbid condition that may be difficult to diagnose due to nonspecific nature of its symptoms. To our knowledge, such a complication has not previously been reported after spinal surgery via the posterior approach. We describe the case of a 43-year-old woman who developed acute mesenteric ischemia several days after a surgical procedure for a lumbar spondylolisthesis via the posterior route. This chronic course is suggestive for venous intestinal ischemia. prone position and hypotension during the procedure may have favored blood stasis and mesenteric vein occlusion in this patient with an inherited hypercoagulable state.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/8. Primary spondylolysis of the axis vertebra (C2) in three children, including one with pyknodysostosis.This report describes 3 children with a cleft in the pedicles of the second cervical vertebra of uncertain cause. One of these patients had pyknodysostosis. Previous instances of such defects in the literature are reviewed with some considerations on the possible nature of the lesion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/8. spondylolysis of the axis. A case report and review of the literature.Bilateral congenital defects in the pedicles of the second cervical vertebra were noted on conventional x-rays and tomography of a 42-year-old male. He had been assaulted after which he suffered upper neck and occipital pain. Subsequent CT scanning demonstrated the incomplete nature of the axis defects. This is felt to be important in prognosticating the likelihood of spondylolisthesis formation and counselling the patient with regard to acceptable future physical activity. The role of CT examination for this purpose has not been stressed before. The importance of differentiation from old trauma is emphasized.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/8. Traumatic spondylolisthesis of the axis in a patient presenting with torticollis. A case report.In a 34-year-old man with an acute traumatic spondylolisthesis (ATS) of the axis, the presenting physical sign was severe torticollis associated with reactive spasm of the right sternomastoid muscle. Computed axial tomography (CAT) was useful both in assessing the nature of ATS (which involved more displacement of the axis fracture and adjacent soft-tissues on the right side of the neck) and in ascertaining reduction, realignment, and healing. The reduction was sustained by halo-vest immobilization.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/8. Autoamputation of the first sacral nerve roots in spondyloptosis.To our knowledge, this is the first reported case of bilateral autoamputation of the first sacral nerve roots in a patient who has spondyloptosis. The authors think that autoamputation occurred in adolescence during a period of rapid forward displacement of the fifth lumbar vertebra on the sacrum. It is postulated that the lack of motor weakness is due to the long-standing nature of the denervation and that other adjacent nerve roots supplying the triceps surae have, over time, increased the power of those muscle fibers not supplied by the first sacral roots. This finding would encourage development of methods for early reduction and fusion in children showing marked restriction of straight leg raising (ie, tight hamstrings) to prevent rapid listhesis and fixation of the fifth lumbar vertebra to the sacrum.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/8. Subependymoma of the thoracic cord: potential pitfalls in diagnosis.Subependymomas are rare tumours, usually intracranial, which have a distinctive histological appearance and a relatively benign nature. A symptomatic case of a thoracic spinal intramedullary tumour is presented. Complete removal with neurological recovery was achieved. Increased awareness of this lesion is desirable. Histological examination of small tumour specimens may result in an erroneous tissue diagnosis of astrocytoma and inadequate treatment.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |