• Title/Summary/Keyword: Cervical Spinal Cord

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Mobility of Intradural Extramedullary Schwannoma at Spine : Report of Three Cases with Literature Review

  • Kim, Soo-Beom;Kim, Hyung-Seok;Jang, Jee-Soo;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.64-67
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    • 2010
  • Although very rare, a few cases of intradural extramedullary (IDEM) spinal tumor migration have been reported since Tomimatsu first reported a mobile schwannoma of the cervical cord in 1974. Schwan noma is a neurogenic tumor which originates from nerve sheath that it is relatively well-marginated tumor with little attachment or adhesion to surrounding tissue. Mobility of tumor in spinal canal sometimes can result in negative exploration at the expected area. We found three interesting cases in which different tumor locations observed in repeated magnetic resonance image (MRI) findings. All tumors were intradural and extramedullary schwannoma. We reviewed the literature about moving tumor in the spine through PUBMED search.

Outcome of Non-surgical and Surgical Treatments in Dogs with Cervical Intervertebral Disc Disease: 60 cases (개에서 경추 추간판 탈출증의 비수술적 치료와 수술적 치료의 결과 : 60 증례)

  • Sung, Gyu-Jin;Ryu, Hak-Hyun;Park, Sung-Su;Kang, Byung-Jae;Lim, Sung-Jun;Kim, Yong-Sun;Lee, Seung-Hoon;Cho, Sung-Ho;Kim, Jun-Young;Yoon, Jung-Hee;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.713-717
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    • 2010
  • Outcomes of non-surgical and surgical treatments for thoracolumbar intervertebral disc disease (IVDD) are well-reported. However, little is known regarding the outcome for treatments of cervical IVDD. This study systematically reviewed the outcomes in dogs with cervical IVDD that were managed non-surgically and surgically. Clinical success rates for surgical treatment were significantly higher (100%) than for non-surgical treatment (51.4%). In the non-surgical treatment group, clinical success rates were negatively correlated with spinal cord compression rates. Based on the results of this study, surgical treatment is deemed more effective than non-surgical treatment for dogs with cervical IVDD. Also, the degree of spinal cord compression on computed tomography or magnetic resonance imaging is a useful prognostic indicator before non-surgical treatment.

Neurofibromatosis (Von Recklinghausen's Diseased) in Mediastinum -3 case- (종격동에 발생한 다발성 신경섬유종증 -3례 보고-)

  • Pyeon, Seung-Hwan;Jeong, Il-Yeong;Choe, Pil-Jo;U, Jong-Su
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.120-124
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    • 1996
  • We report three cases of posterior mediastinal tumor in Von Recklinghausen's disease on 12-yearsy old boy, 8-years-old girl and 6-years-old boy. Especially the last case was combinded with "Dumbbell" neurilemmoma of cervical spine. In the first case, preoperative CT scan showed a homogeneous large mass In the posterior mediastinum. But the mass did not show intraspinal invasion on the chest MRI scan. In the last case, cervical spine CT with thecal enhancement shows dumbbell shaped neurofibroma, compressed spinal cord and thecal sac In three cases we removed all the masses successfully and the patients were discharged safely without significant problem.t problem.

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A Case of Acute Motor Axonal Guillain-Barré Syndrome combined with Acute Cervical-Upper Thoracic Transverse Myelitis (급성 운동축삭성 길랑-바레 증후군과 동반된 급성 경수-상흉수 횡단성 척수염 1예)

  • Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.172-175
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    • 2001
  • Guillain-$Barr{\acute{e}}$ syndrome(GBS) is a common demyelinating disease of the peripheral nervous system. But recently, the axonal types are also reported. Acute transverse myelitis(ATM) is also a common inflammatory disease of the spinal cord. Generally, it is difficult to identify the etiology of GBS and ATM. I guess the occurrence of the 2 diseases at once is hard to take the place. A 63-year-old woman showed an acute motor axonal GBS and a cervical-upper thoracic ATM occurring at the same time. She was treated by intravenous immunoglobulin and solumedrol therapy. Her sensory symptoms were improved rapidly but motor symptoms showed only mild improvement.

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Delayed Brain Infarction due to Bilateral Vertebral Artery Occlusion Which Occurred 5 Days after Cervical Trauma

  • Jang, Donghwan;Kim, Choonghyo;Lee, Seung Jin;Kim, Jiha
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.141-145
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    • 2014
  • Vertebral artery (VA) injuries usually accompany cervical trauma. Although these injuries are commonly asymptomatic, some result in vertebrobasilar infarction. The symptoms of VA occlusion have been reported to usually manifest within 24 hours after trauma. The symptoms of bilateral VA occlusions seem to be more severe and seem to occur with shorter latencies than those of unilateral occlusions. A 48-year-old man had a C3-4 fracture-dislocation with spinal cord compression that resulted from a traffic accident. After surgery, his initial quadriparesis gradually improved. However, he complained of sudden headache and dizziness on the 5th postoperative day. His motor weakness was abruptly aggravated. Radiologic evaluation revealed an infarction in the occipital lobe and cerebellum. Cerebral angiography revealed complete bilateral VA occlusion. We administered anticoagulation therapy. After 6 months, his weakness had only partially improved. This case demonstrates that delayed infarction due to bilateral VA occlusion can occur at latencies as long as 5 days. Thus, we recommend that patients with cervical traumas that may be accompanied by bilateral VA occlusion should be closely observed for longer than 5 days.

Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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A Study on the Social Adaptation of Spinal Cord Injured Patients (척수 손상자의 사회 적응에 관한 연구)

  • Lee, Dong-Soon;Song, In-Young
    • Journal of Korean Physical Therapy Science
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    • v.4 no.2
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    • pp.405-419
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    • 1997
  • This research has been conducted to provide the spinal cord injured patients with comprehensive necessity of and backup data for their rehabilitation in the community and make the aware of importance of overall community support to patients. The data was collected through questionnaire made to 83 patients charged to general hospital in Jeonbuk Province between 1 and 31 March 1997 to analyse the patients ability on activities of daily living through the research on general characteristics and Modified Barthel Index(MBI). As a result the outcome of the research was as follows : 1. Sexual distribution represented that 57 male (68.7%) and 26 female(31.3%) and in the age distribution majority group was 36 thirties (43.4 %) most active in social activities. 2. Analysis on occupation of patients showed majority group was in technicians, 21 people representing 25.4 % and the major cause of injury was traffic accident, 45people representing 54.2%, fall down, 17 people representing 20.5% and industrial accident, 13 people representing 15.7%, respectively. 3. In the multiple choice questionnaire on complications, the rate of appealing pain was highest and spasticity, pressure sore, contracture, depression which restrict the patients from activities of daily living ability were also appeared. 4. The theoretical points in MBI Should lie between 1 and 115 and the average point be 58 but the average point of the MBI among 83 patients was 63. 5. The MBI point by the level of injured represented statistically critical difference(P<0.001) and the MBI points tested by Duncan's Multiple Area Testing in lumbar(80.1) and in thoracic (65.8) represented critically higher than the one in cervical(42.5). 6. In the distribution of the method of Urination after spine injury, the intermittent catheterization represented highest numbar of 34(41.1 %). Testing by Duncan's Multiple Area Testing, as we found the critical difference in the analysis on MBI points(P<0.001), the point in independent self voiding patients ($90.87{\pm}29.34$) was higher than the one in other self voiding patients(P<0.05). 7. In th category of social activities after spine injury, the number of people classified in others, 41 people representing 49.5% was highest and in the MBI points of the spinal cord injured people in religious activity, hobby activity, private club, occupation was critically higher than the people classified in miscellancous(P<0.01) who are the spinal cord injured people and mostly depend on their family's assistance at home in their daily activities.

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The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.577-583
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    • 2017
  • Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

Neural pathway innervating ductus Deferens of rats by pseudorabies virus and WGA-HRP (흰쥐에서 WGA-HRP와 pseudorabies virus를 이용한 정관의 신경로에 대한 연구)

  • Lee, Chang-Hyun;Chung, Ok-Bong;Ko, Byung-Moon;Lee, Bong-Hee;Kim, Soo-Myung;Kim, In-Shik;Yang, Hong-Hyun
    • Korean Journal of Veterinary Research
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    • v.43 no.1
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    • pp.11-24
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    • 2003
  • This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRY), Bartha strain, into the ductus deferens of rats. After survival times 4-5 days following injection of 2% WGA-HRP and PRV, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned ($30{\mu}m$). These sections were stained by HRP histochemical and PRY inummohistochemical staining methods, and observed with light microscope. The results were as follows ; 1. The location of sympathetic ganglia projecting to the ductus deferens were observed in pelvic ganglion, inferior mesenteric ganglion and L1-6 lwnbar sympathetic ganglia. 2. The location of spinal ganglia projecting to the ductus deferens were observed in T13-L6 spinal ganglia. 3. The PRY labeled neurons projecting to the ductus deferens were observed in lateral spinal nucleus, lamina I, II and X of cervical segments. In thoracic segments, PRY labeled neurons were observed in dorsomedial part of lamina I, II and III, and dorsolateral part of lamina IV and V. Densely labeled neurons were observed in intermediolateral nucleus. In first lumbar segment, labeled neurons were observed in intermediolateral nucleus and dorsal commisural nucleus. In sixth lumbar segment and sacral segments, dense labeled neurons were observed in sacral parasympathetic nuc., lamina IX and X. 4. In the medulla oblongata, PRV labeled neurons projecting to the ductus deferens were observed in the trigeminal spinal nuc., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nuc., rostroventrolateral reticular nuc., area postrema, nuc. tractus solitarius, raphe obscurus nuc., raphe pallidus nuc., raphe magnus nuc., parapyramidal nuc., lateral reticular nuc., gigantocellular reticular nuc.. 5. In the pons, PRV labeled neurons projecting to the ductus deferens were ohserved in parabrachial nuc., Kolliker-Fuse nuc., locus cooruleus, subcooruleus nuc. and AS noradrenalin cells. 6. In midbrain, PRV labeled neurons projecting to the ductus deferens were observed in periaqueductal gray substance, substantia nigra and dorsal raphe nuc.. 7. In the diencephalon, PRV labeled neurons projecting to the ductus deferens were observed in paraventricular hypahalamic nuc., lateral hypothalamic nuc., retrochiasmatic nuc. and ventromedial hypothalamic nuc.. 8. In cerebrum, PRV labeled neurons projecting to the ductus deferens were observed in area 1 of parietal cortex. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat ductus deferens might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and PRV labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of smooth muscles in ductus deferens. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitaing the internal environment. These observations provide evidence for previously unknown projections from ductus deferens to spinal cord and brain which may be play an important neuroanatornical basic evidence in the regulation of ductus deferens function.

Severe Paraspinal Muscle Atrophy with Fatty Degeneration in a Young Adult: A Case Report (젊은 성인의 척추주위근에 발생한 지방 변성을 동반한 심한 근위축: 증례보고)

  • Huh, Jae-Won;Yang, Won-Jong;Park, Eunhee;Lee, Jae Eun;Kim, Chul-Hyun
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.130-134
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    • 2018
  • A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.