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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on a boy with a congenital disorder of glycosylation (CDG) Ia and a severe narrowing of the spinal canal caused by atlantoaxial subluxation with anterior displacement of C1. C1-laminectomy improved the progressive paresis. Progressive paresis caused by spinal cord compression is a hitherto unrecognized complication in patients with CDG-Ia.
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PMID:Skeletal dysplasia and myelopathy in congenital disorder of glycosylation type IA. 1642 9

Medical records of six cats diagnosed with lumbosacral intervertebral disk disease were reviewed. Clinical signs included reluctance to jump, low tail carriage, elimination outside the litter box, reluctance to ambulate, pelvic-limb paresis, urinary incontinence, and constipation. All cats had lumbosacral hyperpathia on palpation. Computed tomography in four cats revealed evidence of extradural spinal cord compression at the seventh lumbar (L(7)) to first sacral (S(1)) vertebral interspace. Compression was confirmed via myelography in three of these four cats, with confirmation in the fourth cat at the time of decompressive laminectomy. Each of the six cats underwent dorsal decompressive laminectomy at the L(7) to S(1) interspace. Postoperative clinical follow-up lasted 3 to 35 months, with most cats having excellent outcomes.
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PMID:Lumbosacral intervertebral disk disease in six cats. 1845 Oct 68

A 15-week-old Manx kitten was presented for evaluation of progressive hind limb paresis and ataxia. Spinal radiographs and computed tomography revealed a malformation of T3 causing thoracic spinal cord compression. Decompressive surgery consisting of dorsal laminectomy, without vertebral stabilisation, resulted in improvement of clinical signs.
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PMID:Surgical management of vertebral malformation in a Manx cat. 1909 23

Bone malignancies account for merely about 1.5% of all cancers, with a small percentage of these tumours developing in the cervical spine. However, the cervical spine is also the site of benign tumours and neoplasms involving not only bony tissue. Benign tumours do not metastasize but pose a threat to the spinal cord when located intrathecally. Even though such tumours do not represent malignancy, they are considered to be locally malignant. The most common cervical spine neoplasms are intradural tumours, usually extramedullary: neurofibromas, meningiomas or gliomas.Indications for surgery depend of the nature and location of the tumour and the consequences of tumour growth. Surgery is obviously necessary for intrathecal tumours compressing the spinal cord. The choice of surgical approach and manner of stabilisation depend primarily on the location of the lesion and the presence of spinal cord compression.Rehabilitation is indicated in all patients, but is particularly important, and at the same time difficult, when the growth of the tumour has resulted in neurological disturbances. The task is all the more difficult when in the presence of a massive and high spinal cord damage. Rehabilitation programmes should be designed individually for each patient and should account for the degree of paresis, stage of the underlying malignant disease, survival prognosis, disturbances in the function of other systems, apart from musculoskeletal apparatus, age of the patient, his or her commitment to treatment and other factors.The treatment of malignant neoplasms is usually associated with an unfavourable outcome. However, combination drug treatments, radiation therapy and surgery with subsequent rehabilitation will often prolong survival, ameliorate suffering and improve patients' quality of life.
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PMID:Surgery and subsequent rehabilitation for cervical spine tumours compressing neural structures. 1927 65

Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated cervicodorsal extramedullary schwannoma in a 33-year-old female patient with subacute cord compression and sphincteric involvement is presented. Spinal MR imaging showed a C2-D3 midline ventrally situated extramedullary tumor with severe spinal cord compression. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. There was a gradual improvement in left-sided spasticity but the patient had mild diaphragmatic paresis. MR imaging showed no evidence of the tumor at followup after 6 months. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed.
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PMID:Pure ventral midline long segment schwannoma of the cervicodorsal spine: a case report. 1962

A four-year-old male Dachshund was presented with pelvic limb paresis due to intervertebral disc extrusion. The spine was surgically explored and decompressed by a bilateral mini-hemilaminectomy and intervertebral disc fenestration at T12-13, and a bilateral pediculectomy of T13. Five days post-operatively, the dog deteriorated because of T13 dorsal laminar subluxation and secondary spinal cord compression. This was surgically investigated and stabilised using bilateral articular facet positional screws and a dorsal spinal plate; the dog subsequently recovered well. Clinically significant spinal instability associated with mini-hemilaminectomy and pediculectomy surgery has not been reported previously.
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PMID:Spinal instability resulting from bilateral mini-hemilaminectomy and pediculectomy. 1975 Feb 89

Intradural spinal arachnoid cysts with cord compression are rare. When becoming symptomatic they cause variable symptoms involving gait disturbance, paraparesis or tetraparesis and neuropathic pain, decreasing significantly the patients' life quality. The extension of such cysts averages 3.7 vertebral bodies. The diagnosis is clinical and radiological with the use of MRI, CT myelography or a combination of both. The best treatment option is complete removal of the cyst. However, even when paresis is regressing there is no good recovery from neuropathic pain. Laminectomy approach can cause postoperative complications especially when the cyst(s) expand(s) in more than one level. Alternatively, a cyst fenestration can be performed, including the levels of the maximal spinal cord compression. The clinical outcome is as good as after the cyst resection enabling the patient to walk again. The neuropathic pain may persist and require medication. A clinical case is presented, and the literature is reviewed. In the present case we report a patient with intradural arachnoid cysts extending from T6 to L2 and causing severe gait ataxia as well as neuropathic pain and hypaesthesia. The spinal-cord was compressed at T8 and T12. Surgical treatment with partial cyst resection in the compressed levels with an interlaminar approach brought similar results as complete resection. The patient was able to walk without help which was not possible before surgery. The cysts' extension is impressive as well as the minimal operative procedure.
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PMID:Spinal cord compression caused by idiopathic intradural arachnoid cysts of the spine: review of the literature and illustrated case. 1976 37

Spontaneous spinal epidural haematoma (SSEH) is a rare cause of spinal cord compression in adults, especially in the elderly. We report an independent 88-year-old female, on aspirin only for chronic atrial fibrillation, who presented with a 12-hour history of acute lumbar back pain, urinary incontinence and progressive bilateral lower limb paresis. Examination revealed saddle anaesthesia and reduced anal tone. Urgent spinal MRI demonstrated an epidural haematoma extending from T7 to L5. The patient made a poor initial post-operative recovery, but four months later had begun to mobilise independently after intensive physiotherapy. The case highlights the significance of clinical suspicion, especially in those patients on anti-platelet therapy, rapid spinal radiography and emergent decompressive surgery in SSEH patients, as well as the importance of ongoing rehabilitation in restoring neurological function.
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PMID:Spontaneous spinal epidural haematoma in a geriatric patient on aspirin. 1991 71

The surgical treatment of ventral spinal canal compression has traditionally required either an anterior or combined anterior-posterior decompression and stabilization. These types of approaches carry a significant morbidity and may not be appropriate for all patients. We report our experience with multi-level corpectomies and reconstruction performed via a single, posterolateral approach. A retrospective review was performed of six consecutive patients at a single institution who were treated for ventral multi-level spinal cord compression via a single posterolateral approach. All six patients underwent reconstruction and stabilization with an expandable cage and posterior fixation. Five patients had metastatic cancer with spinal cord compression and one patient had osteomyelitis with a ventral epidural abscess and vertebral body collapse. All patients underwent 2-level corpectomies. Pre-operative and post-operative neurologic function and stabilization construct integrity were analyzed. All patients had successful decompression and stabilization and there were no hardware complications. Three peri-operative complications were encountered: post-operative pleural effusion needing thoracostomy drainage, transient leg paresis that resolved at 2months and a post-operative wound infection needing operative debridement. At last follow-up all patients had improvement or stabilization of their neurological function. Long-term follow-up was limited by the progression of metastatic disease and death in all the patients with cancer. This study demonstrates that symptomatic improvement can be achieved in select patients requiring multi-level corpectomies when using a single posterolateral approach with expandable cage reconstruction and posterior stabilization.
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PMID:Multi-level corpectomies and reconstruction via a single posterolateral approach. 2069 72

This 60-year-old man with cervical spondylosis experienced bilateral arm pain and weakness. After anterior cervical fusion and posterior decompression at a local hospital his symptoms worsened and he was admitted to our hospital. On admission he manifested bilateral motor weakness, neuropathic pain, and numbness below the C5 level. Radiological findings showed spinal cord compression at the C4 to C7 level. He again underwent posterior decompression and anterior fusion. Although his paresis was improved, his severe neuropathic pain and numbness persisted. Because treatment with NSAIDs, clonazepam, and gabapentin failed to control his symptoms we administered ketamine (NMDA receptor antagonist) because his symptoms were alleviated upon ketamine test challenge. His severe symptoms improved and there were no complications. However, upon cessation of ketamine treatment they reappeared. Therefore, we continued daily ketamine treatment for 6 months, after which we changed to codeine phosphate. His symptoms were controlled without any complications. Ketamine is useful for the control of severe neuropathic pain, however, as long-term ketamine administration is inadvisable, we suggest that treatment be tailored to each patient's particular clinical status.
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PMID:[Ketamine treatment for severe neuropathic pain with cervical spondylotic myelopathy. A case report]. 2116 Jan 5


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