• Title/Summary/Keyword: Severe cord compression

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Cervical Stenotic Myelopathy in a Thoroughbred Colt

  • Oh, Ye-Eun;Lee, Eun-Bee;Song, Mingeun;Jo, Hyoung-Nam;Suh, Myeong-Won;Kim, Jae-Hoon;Park, Hyunjung;Kang, Tae-Young;Seo, Jong-pil
    • Journal of Veterinary Clinics
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    • v.36 no.6
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    • pp.340-344
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    • 2019
  • A 14-month-old Thoroughbred colt with hind limbs lameness was referred to Equine Hospital of Jeju National University. During physical examination, the patient could not walk in a straight line but wobbled especially with hind limbs. He hesitated when backing and crossed hind limbs while circling tightly by protracting the outer hind limb keeping the inner hind limb stationed. Stenosis was observed between the 2nd (C2) and 3rd (C3), and the C3 and 4th (C4) cervical vertebrae on radiographs. The colt diagnosed as cervical stenotic myelopathy (CSM) based on the clinical signs and radiological findings. To confirm the diagnosis, postmortem computed tomography (CT) and histopathologic examination were performed after the euthanasia. The CT images revealed severe compression of the spinal cavity and cord between C3 and C4 cervical vertebrae. Grossly, there was compression of the spinal cord between the C3 and C4 cervical vertebrae. Histopathologically, severe axonal swelling and demyelination characterized by vacuolation and cavity formation were observed in the white matter of the spinal cord, especially in C3 and C4. CSM is problematic in the horse racing industry because of abnormal walking. This case report of CSM may offer information for diagnosis of the disease in the equine veterinary fields in the Republic of Korea.

Spinal Epidural Lipomatosis -A case report- (척추 경막외 지방종증 -증례보고-)

  • Kim, Sae Young
    • The Korean Journal of Pain
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    • v.22 no.3
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    • pp.249-252
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    • 2009
  • Spinal epidural lipomatosis (SEL) is a rare condition of pathological overgrowth of fat tissue in the vertebral canal. SEL leads to back pain, radiculopathy or paraparesis. Glucocorticoids seem to play a major role in the development of SEL. SEL is best diagnosed by magnetic resonance imaging. The treatment of SEL is directed at reducing the body weight and decreasing the excess glucocorticoid. In severe cases, decompressive laminectomy with removal of the excess epidural fat might become necessary to alleviate the neurological symptoms caused by spinal cord compression.

Brown Sequard Syndrome Resulting from Cervical Disc Herniation Treated by Anterior Foraminotomy

  • Kim, Yeon-Seong;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.136-140
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    • 2005
  • The authors describe two cases of Brown-Sequard syndrome associated with cervical disc herniation. In both cases, magnetic resonance images of the cervical spine showed a large paramedian disc herniation at C5-C6 with ipsilateral severe spinal cord compression. Microsurgical removal of the herniated disc via anterior foraminotomy was performed and complete decompression of the spinal cord was achieved. Postoperatively, the neurological symptoms recovered rapidly and both patients experienced a complete remission of their symptoms. Although Brown-Sequard syndrome is rarely associated with degenerative cervical spine disease, cervical disc herniation should be kept in mind and prompt evaluations are mandatory. To the best of our knowledge, these are the first reported case of Brown-Sequard syndrome produced by cervical disc herniation which was treated by anterior foraminotomy.

Giant Ventral Midline Schwannoma of Cervical Spine : Agonies and Nuances

  • Mahore, Amit;Chagla, Aadil;Goel, Atul
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.454-457
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    • 2010
  • Pure ventral midline giant schwannoma is an extremely rare entity. Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated giant pan cervical extramedullary schwannoma in an 18-year-old male patient with compressive myelopathy and sphincter involvement is presented. Spinal MR imaging showed a midline ventrally situated extramedullary tumor with severe spinal cord compression extending from clivus to C7 vertebra. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. Post operative MR imaging showed no evidence of the tumor. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed.

Intrathecal administration of naringenin improves motor dysfunction and neuropathic pain following compression spinal cord injury in rats: relevance to its antioxidant and anti-inflammatory activities

  • Fakhri, Sajad;Sabouri, Shahryar;Kiani, Amir;Farzaei, Mohammad Hosein;Rashidi, Khodabakhsh;Mohammadi-Farani, Ahmad;Mohammadi-Noori, Ehsan;Abbaszadeh, Fatemeh
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.291-302
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    • 2022
  • Background: Spinal cord injury (SCI) is one of the most debilitating disorders throughout the world, causing persistent sensory-motor dysfunction, with no effective treatment. Oxidative stress and inflammatory responses play key roles in the secondary phase of SCI. Naringenin (NAR) is a natural flavonoid with known anti-inflammatory and antioxidative properties. This study aims at evaluating the effects of intrathecal NAR administration on sensory-motor disability after SCI. Methods: Animals underwent a severe compression injury using an aneurysm clip. About 30 minutes after surgery, NAR was injected intrathecally at the doses of 5, 10, and 15 mM in 20 µL volumes. For the assessment of neuropathic pain and locomotor function, acetone drop, hot plate, inclined plane, and Basso, Beattie, Bresnahan tests were carried out weekly till day 28 post-SCI. Effects of NAR on matrix metalloproteinase (MMP)-2 and MMP-9 activity was appraised by gelatin zymography. Also, histopathological analyses and serum levels of glutathione (GSH), catalase and nitrite were measured in different groups. Results: NAR reduced neuropathic pain, improved locomotor function, and also attenuated SCI-induced weight loss weekly till day 28 post-SCI. Zymography analysis showed that NAR suppressed MMP-9 activity, whereas it increased that of MMP-2, indicating its anti-neuroinflammatory effects. Also, intrathecal NAR modified oxidative stress related markers GSH, catalase, and nitrite levels. Besides, the neuroprotective effect of NAR was corroborated through increased survival of sensory and motor neurons after SCI. Conclusions: These results suggest intrathecal NAR as a promising candidate for medical therapeutics for SCI-induced sensory and motor dysfunction.

The convergence effect of medical industry through stem cell implant treatment (줄기 세포 이식 치료를 통한 의료 산업적 융합효과)

  • Lee, Tae-Hoon
    • Journal of Convergence for Information Technology
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    • v.8 no.2
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    • pp.61-65
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    • 2018
  • Our experiment studied that grafted stem cells reduced behavioral deficiency in rodent animal models of clip compressive surgery inducing spinal cord infarction. Our research proved the effect of embryonic stem cells to the spinal cord infarction caused by compressing T9-10 with an aneurysm clip, focusing the application of grafted stem cells for reduction of infarction and regeneration of spinal cord nervous injury. Therefore, our research suggests manifest results that implantation of mouse embryonic stem cell could show behavioral improvement after severe spinal cord damage. Therefore, mouse embryonic stem cell (mESC) could be useful application for the method in neurological injury. Conclusively, stem cell implant therapy may enhance the effectiveness of stem cell implant for central nervous system injury.

A Case of Tuberculous Spondylitis Combined with Schwannoma of Spinal Cord - A Case Report - (척수 신경초종을 동반한 결핵성 척추염 1례 - 증례보고 -)

  • Park, Jong Hoon;Kim, Kyu Hong;Lee, Woon Gi;Choi, Jeong Hoon;Lee, In Chang;Bae, Sang Do
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1241-1244
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    • 2001
  • The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39- year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.

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Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation : A Case Report and Review of the Literature

  • Lee, Dae-Kyu;Cho, Keun-Tae;Im, So-Hyang;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.406-409
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    • 2007
  • Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.

Medical Treatment of Breast Cancer Bone Metastasis: From Bisphosphonates to Targeted Drugs

  • Erdogan, Bulent;Cicin, Irfan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1503-1510
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    • 2014
  • Breast cancer bone metastasis causing severe morbidity is commonly encountered in daily clinical practice. It causes pain, pathologic fractures, spinal cord and other nerve compression syndromes and life threatening hypercalcemia. Breast cancer metastasizes to bone through complicated steps in which numerous molecules play roles. Metastatic cells disrupt normal bone turnover and create a vicious cycle to which treatment efforts should be directed. Bisphosphonates have been used safely for more than two decades. As a group they delay time to first skeletal related event and reduce pain, but do not prevent development of bone metastasis in patients with no bone metastasis, and also do not prolong survival. The receptor activator for nuclear factor ${\kappa}B$ ligand inhibitor denosumab delays time to first skeletal related event and reduces the skeletal morbidity rate. Radionuclides are another treatment option for bone pain. New targeted therapies and radionuclides are still under investigation. In this review we will focus on mechanisms of bone metastasis and its medical treatment in breast cancer patients.

An Image-guided Radiosurgery for the Treatment of Metastatic Bone Tumors using the CyberKnife Robotic System

  • Cho, Chul-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.14-21
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    • 2007
  • Bone is a common site for metastatic spread from many kinds of malignancies. The morbidity associated with this metastatic spread can be significant, including severe pain. When it comes to spinal metastasis, occupying nearly 40% of skeletal metastases, the risks of complications, such as vertebral body collapse, nerve root impingement, or spinal cord compression, are also significant. Because of the necessity of preserving the integrity of the spinal column and the proximity of critical structures, surgical treatment has limitations when durable local control is desired. Radiotherapy, therefore, is often used as an adjunct treatment or as a sole treatment. A considerable limitation of standard radiotherapy is the reported recurrence rate or ineffective palliation of pain, either clinically or symptomatically. This may be due to limited radiation doses to tumor itself because of the proximity of critical structures. CyberKnife is an image-guided robotic radiosurgical system. The image guidance system includes a kilovoltage X-ray imaging source and amorphous silica detectors. The radiation delivery device is a mobile X-band linear accelerator (6 MV) mounted on a robotic arm. Highly conformal fields and hypofractionated radiotherapy schedules are increasingly being used as a means to achieve biologic dose escalation for body tumors. Therefore, we can give much higher doses to the targeted tumor volume with minimizing doses to the surrounding critical structures, resulting in more effective local control and less severe side effects, compared to conventional fractionated radiotherapy. A description of this technology and a review of clinical applications to bone metastases are detailed herein.

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