Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An epidural haematoma was observed after epidural lumbar puncture in a 75-year old patient receiving 5,000 units calcium heparinate every 12 h as antithrombotic therapy. The diagnosis was suspected by the occurrence of sudden pain and bleeding through the epidural catheter, followed by a complete paraplegia. The diagnosis was confirmed by contrast myelography. Early surgery did not improve the neurological deficit. This case report emphasized that anticoagulant therapy must be discontinued before epidural anaesthesia.
 ...
PMID:[A case of spinal extradural hematoma during the insertion of an epidural catheter]. 381 54

A technique using a vascularized rib pedicle graft and femoral neck allograft is presented as a new method of anterior spine fusion in the treatment of symptomatic post-traumatic kyphosis. The cases of six patients are reviewed who were treated surgically from seven months to 24 years following their initial injury. Substantial neurologic improvement was achieved in four patients with incomplete neurologic deficits when the procedure was combined with an anterior spine decompression. Two patients, one who was neurologically normal and one with complete paraplegia and L-1 pseudarthrosis were relieved of chronic back and radicular pain following this procedure. At the time of followup, complete anterior spine decompression was verified by lateral planography or computerized axial tomography. All patients were found to have solid anterior spine fusions with a 63% mean improvement in preoperative kyphosis. Early and rapid incorporation of bone grafts had been demonstrated, thus requiring shorter external immobilization periods for the patients.
 ...
PMID:Vertebral body replacement with femoral neck allograft and vascularized rib strut graft. A technique for treating post-traumatic kyphosis with neurologic deficit. 663 90

The role of decompression in spinal metastases with neurologic deficit is controversial. This series demonstrates that the benefit from decompression depends on the nature of the tumor and the neurologic status of the patient. Prognosis is good for patients with incomplete paraplegia, intact sphincter control, a long duration of neurologic deficit and pain, and a gradual onset of compression. The prognosis is poor in cases with complete paraplegia, loss of sphincter control, a short duration of neurologic deficit and pain, and a sudden onset of compression. Surgery is not advocated for all cases, because many patients are already very ill. Surgery is recommended only for selective cases in which the prognosis is good. However, decompression is only palliative. Posterior decompression is preferred, inasmuch as the surgery is less extensive compared to anterior decompression and fusion.
 ...
PMID:The results of decompression of cord or cauda equina compression from metastatic extradural tumors. 710 64

Twenty-five cases of unstable fractures and fracture-dislocations of the spine are reviewed. They were treated at the Catholic Medical College and Centre in a 3-year period, 1975 to 1978. 1. Eleven of the 25 patients were treated by anterior interbody fusion performed at 6 to 8 weeks from injury or initial surgery. 2. Eleven patients had neurological deficits, 3 with incomplete lesions and 8 with complete lesions. Open reduction and decompression laminectomies were performed on patients having neurological deficits prior to anterior interbody fusion. Two patients with incomplete paraplegia showed marked neurological recovery whilst one with complete paraplegia regained some sensation. 3. Solid clinical fusion was obtained in all but one patient within four months of interbody fusion. 4. Amongst the 18 patients with kyphosis at the time of admission 10 had a final improvement of their kyphosis ranging from 3 to 10 degrees (average 6 degrees). Three had no change and 5 demonstrated a mild increase of kyphosis (average 4 degrees). 5. Pain was relieved in 21 patients out of 25. The advantages of this technique include effective stabilization, prevention of late deformity and relatively early mobilization without internal fixation.
 ...
PMID:Anterior interbody fusion in fractures and fracture-dislocations of the spine. 727 16

Charcot spine, also known as neuropathic spinal arthropathy, is a late complication of traumatic spinal cord injury that can produce pain and further disability. We report five cases of Charcot spine occurring in patients with previous traumatic spinal cord injury that we have identified at our institution from 1985 to 1994. All patients had complete paraplegia with levels of neurologic injury ranging from T7 to T12. Common presenting symptoms included back pain, loss of spasticity, change in bladder function, and audible noises with motion. The diagnosis of Charcot spine was made from 6 to 31 years after original spinal cord injury. In four cases where a surgical fusion had been performed, the Charcot joint developed within two spinal segments below the caudal end of the fusion. Radiological studies, especially plain films and computed tomography, were helpful in making the diagnoses. Immobilization of the affected joint is an essential element of treatment. Surgical repair and stabilization were performed in four patients and has been recommended to the other patient. Early diagnosis and proper treatment is important in preventing the progression of this disorder.
 ...
PMID:Charcot spine as a late complication of traumatic spinal cord injury. 904 6

Eight patients with spontaneous spinal epidural hemorrhages are presented. All eight initially had suffered from severe neck or back pain. In seven cases, progressive neurological deficits had developed, some of which led to complete paraplegia. On all eight patients operations were performed. After an average of 11 weeks' follow-up, full recovery from the preoperative pain and neurological deficits could be seen in 6 of the patients. If spinal hemorrhage is treated by decompression at an early stage, there is a good prognosis with respect to pain and neurological deficits. It was found that neurological deficits sometimes showed complete improvement, even if they were older than 36 hours before surgery was performed. In cases of severe local complaints in combination with progressive neurological deficits a spinal hemorrhage always must be considered. The best diagnostic method is magnetic resonance imaging.
 ...
PMID:[Spontaneous spinal hemorrhage. Outcome after surgical therapy of epidural hematomas]. 1070 13

The objective of this study was to describe the clinical course of acute transverse myelitis in children, to identify prognostic factors, and to compare our findings with published data Twenty-four children, aged 2 to 14 years and admitted with a diagnosis of acute transverse myelitis, were studied. Clinical features and results of investigations were collected at admission and during the course of the disease. Motor, sphincter, and global outcomes were compared with those in the main adult and pediatric series. During the initial phase, the most common presenting symptoms were pain (88%) and fever (58%). Motor loss preceded sphincter dysfunction in two thirds of patients and became bilateral in half of the patients. When maximal deficit was achieved (plateau), the patients presented a combination of sensory, motor, and sphincter dysfunctions without radicular involvement The motor loss consistently involved the lower limbs but was inconsistent and moderate in the upper limbs. The mean duration of the plateau was 1 week. The recovery phase was characterized by a progressive improvement of all deficits. Sphincter dysfunction improved more slowly than did the other deficits. A full recovery was achieved by 31% of the patients; minimal sequelae were present in 25% and mild to severe sequelae in 44%. An unfavorable outcome was associated with complete paraplegia (P = .03) and/or a time to maximal deficit shorter than 24 hours (P = .005). A favorable outcome was associated with a plateau shorter than 8 days (P = .03), the presence of supraspinal symptoms (P = .01), and a time to independent walking shorter than 1 month (P = .01). The course of acute transverse myelitis in children proceeds through three stages, an initial phase, a plateau, and a recovery phase, each characterized by specific clinical features. The global outcome was favorable in 56% of patients. Several prognostic factors were identified.
 ...
PMID:Acute transverse myelitis in children: clinical course and prognostic factors. 1288 75

Spinal dural arteriovenous fistulae (SDAVF) are acquired spinal vascular malformations, in which a small connection between a radicular artery and radicular vein causes venous hypertension, congestive myelopathy and infarction of the spinal cord. Here the case of a 47-year-old man is presented who had pain in his back irradiating to his right leg, numbness of his right leg as well as weakness of both legs. Urination was disturbed with detection of residual urine. Six weeks later he developed a progressive paraparesis of the legs. A T2 weighted MRI of the lower back showed intramedullary hyperintensity. A myelitis was assumed and treatment with acyclovir and dexamethasone was started. Nevertheless, he developed total paralysis of his legs. Six years later, re-evaluation of the initial MRI and a new MRI showed abnormal blood vessels on the dorsal side of the spinal cord, which had been overlooked at the first MRI examination. Spinal angiography demonstrated an arteriovenous fistula. Fistula obliteration was performed. Six months later he was able to stand with canes for 2 min and showed improvement in sensibility. The remarkable aspect of this case of SDAVF is the relevant improvement of complete paraplegia by surgical obliteration 78 months after onset of symptoms. The delay of more than 6 years between onset of first symptoms and final diagnosis underlines the difficulties in making a correct diagnosis of SDAVF. However, even after delayed diagnosis, surgical obliteration should be done, as improvement of neurological function can still be achieved.
 ...
PMID:Improvement of paraplegia caused by spinal dural arteriovenous fistula by surgical obliteration more than 6 years after symptom onset. 1901 Sep 54

The study design included a case report of Charcot spinal arthropathy treated with posterior and anterior spinal instrumentation. The objective of the study was to report an unusual case of Charcot spinal arthropathy as a late complication of traumatic spinal cord injury in a patient previously treated with a long posterior thoraco-lumbar instrumentation and postero-lateral fusion. A 33-year-old man with T10-T11 complete paraplegia presented with focal low back pain, kyphotic deformity of the lumbar region with L2-L3 fracture-dislocation and hardware failure. Our treatment consisted of a circumferential arthrodesis performed with a combined anterior and posterior approach. Spinal stabilization was achieved and the patient was pain free and able to resume a sitting posture. This report suggests that the development of a Charcot spine arthropathy must always be considered as a late complication of a spinal cord injury. Moreover, we would emphasize the fundamental role of a strict clinical and radiological follow-up in order to detect an early Charcot spine complication.
 ...
PMID:Onset of a Charcot spinal arthropathy at a level lacking surgical arthrodesis in a paraplegic patient with traumatic cord injury. 1950 71

Spinal manipulation is a form of back and other musculoskeletal pain treatment that often involves a high-velocity thrust, a technique in which the joints are adjusted rapidly. The main objective of chiropractors is to correct spinal malalignment and relieve the nerves, allowing them to function optimally (Ernst In: Expert Rev Neurother 7:1451-1452, 2007; Oppenheim et al. In: Spine J 5:660-666, 2005). The evidence for the effectiveness of this treatment based on randomized clinical trials still remains uncertain (Cassidy et al. In: Spine 33(4 suppl): S176-S183, 2008; Dupeyron et al. In: Ann Readapt Med Phys 46:33-40, 2003; Ernst et al. In: Expert Rev Neurother 7:1451-1452, 2007; Hurwitz et al. In: J Manipulative Physiol Ther 27:16-25, 2007; Thiel et al. In: Spine 32: 2375-2378, 2007). Several case reports and series have been focusing on the risks of chiropraxis, especially on the cervical spine, although the risk/benefit ratio for certain selected patients could be acceptable (Powell et al.In: Neurosurgery 33:73-78, 1993). We describe the case of a 45-year-old woman who suffered complete paraplegia shortly after a chiropractic maneuver in the thoracic spine. Dorsal CT showed a calcified disc herniation at the T8-T9 level and MRI revealed a diffuse spinal cord ischemia from T6 to the conus medullaris without spinal cord compression at the level of herniation. Despite a normal arteriography, authors suggest a vascular injury as the cause of the deficit.
 ...
PMID:Acute paraplegia after chiropraxis. 2055 41


<< Previous 1 2 3 Next >>