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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Colostomies are sometimes used to manage those SCI patients who have large pressure sores that are frequently soiled by stool. Seventeen such patients in an Acute Spinal Cord Injury Unit were reviewed to define the problem of ostomy prolapse in paraplegic patients. It was concluded that prolapse is more likely in those patients with an injury at or above the T-10 level. The two patients who had loop colostomies developed prolapse. Those ostomies that were end-sigmoid and exteriorized into an area where there was sensation and abdominal wall muscular integrity were the most successful.
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PMID:Ostomy prolapse in paraplegic patients: etiology, prevention, and treatment. 233 79

Twenty-six patients who presented with spinal cord compression due to cervical disc prolapse (herniation of the nucleus pulposus) were treated by anterior discectomy. There was a high incidence of disc prolapse at the C3-4 level. The most severe degrees of preoperative disability were associated with prolapse at that level. Impairment of posterior column function, particularly in the upper limbs, played a major part in producing disability. High cervical disc prolapse can produce a clinical picture that is predominantly like that of a posterior cord syndrome. Preexisting fusion of vertebral bodies in the cervical spine and a history of cervical spinal trauma appear to be predisposing factors. Discectomy is an effective treatment of this condition. Spinal cord compression due to cervical disc prolapse should be distinguished from spondylotic myelopathy.
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PMID:Spinal cord compression due to prolapse of cervical intervertebral disc (herniation of nucleus pulposus). Treatment in 26 cases by discectomy without interbody bone graft. 661 37

The diagnostic value of computed tomography (CT), myelography, myelo-CT and magnetic resonance imaging (MRI) was retrospectively investigated in 94 patients in whom Cloward's operation had been performed due to symptoms of cervical myelopathy (CM). In 55 patients with "classical" cervical spondylotic myelopathy all investigated diagnostic procedures demonstrated a comparably high degree of sensitivity and specificity, thus proving comparable for diagnosing pathological alterations of the cervical spine. In 39 patients with CM as a consequence of an acute cervical disk prolapse, however, MRI was superior and offered the highest diagnostic accuracy. The following general diagnostic strategy in patients with CM can be suggested: Conventional plain film radiography of the cervical spine, axial CT of the involved segments and MRI of the cervical spine in sagittal and transversal orientation, using T1 and T2 weighted pulse sequences. The combined use of these techniques allows the exact evaluation of any relevant structure alterations of the cervical spine that determine differential therapeutic approaches.
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PMID:[Value of neuroradiologic procedures in preoperative assessment of cervical myelopathy]. 848 11

Arachnoid cysts are rare lesions of the spine and can present with myelopathy, radiculopathy, local pain or a combination of these symptoms. Nerve root prolapse into an arachnoid cyst causing radiculopathy has not been reported before. We report a nerve root prolapse into a spinal arachnoid cyst presenting clinically as radiculopathy. An 18-year-old female patient presented with mid-back pain, right anterior thigh pain and hip flexor weakness. Magnetic resonance imaging (MRI) and computerized tomography (CT) myelography revealed an arachnoid cyst at T12-L1 level on the right side. At surgery, a nerve root was seen prolapsing into an extradural arachnoid cyst. The nerve root was replaced back into dural sac and the dural defect closed. At 20 months of follow-up, the patient continues to be asymptomatic with no evidence of recurrence on imaging. Replacing the prolapsed nerve root into the dural sac with meticulous closure of the dural defect could lead to good clinical outcome. We propose a modification to the popular classification of these lesions to better rationalize their surgical management. Classification of extradural arachnoid spinal cysts (Nabors's type 1) should be based on the presence or absence of dural communication. Sacral meningoceles (Nabors' type 1B) should be excluded from the classification as they have free communication with the thecal sac and are not true spinal cysts.
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PMID:Nerve root prolapse into a spinal arachnoid cyst--an unusual cause of radiculopathy. 1918 84

Idiopathic spinal cord herniation is a rare spinal cord disorder caused by spinal cord prolapse through a adural defect. It is a curable disease, so early detection is of particular importance. We report a 38-year-old woman with Brown-Sequard syndrome which was caused by the thoracic spinal cord herniation. Her weakness was almost completely resolved after surgical management, which emphasizes the importance of early diagnosis and surgical management in this rare disease entity.
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PMID:Idiopathic spinal cord herniation as a treatable cause of progressive brown-sequard syndrome. 1951 34

The authors present results of surgical treatment of cervical spine degenerative disease via Implaspin biotitanium replacement. Surgery was indicated for a group of 24 patients with symptoms of cervical spondylogenic myelopathy or the irritation decay root syndrome non-reacting to conservative treatment. Pre-surgery X-ray and MRI examinations showed spinal canal stenosis caused by the intervertebral disk osteochondrosis combined with prolapse or dorsal osteophytes. Clinical problems of the group of patients were evaluated through the JOA classification before surgery and during the 2nd, the 6th and month 12th after surgery. The surgery rate of success was evaluated in percentages during post-surgery examinations that took place in the 12th month. Based on the JOA classification, that rate of success falls into the good surgery results zone. The post-surgery X-ray examinations showed two sank replacements by 1/3 of its height into the surrounding vertebral bodies. In these cases we performed the control MRI. No signs of the new spinal compression were found and the spinal canal was free in the operated site. Based on our short-term experiences, the Implaspin bioactive replacement seems to be a suitable alternative to the other types of replacements designed for intervertebral fusion in the lower cervical spine area.
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PMID:Bioactive titan cage Implaspin in treatment of degenerative disease of the cervcal spine--the results from 2007 till 2008. 2049 81

Myotonic dystrophy is the most common autosomal dominant myopathy in adults. Our patient, a 41 year-old female suffering from myotonic muscular dystrophy, developed upper thoracic myelopathy due to hypertrophy of the ligamentum flavum and the posterior longitudinal ligament. She had a typical hatchet face and ptosis with "head hanging forward" appearance caused by neck weakness. Motor weakness, sensory changes and severe pain below T4 level, along with urinary incontinence began 3 months ago. Genetic and electrodiagnostic studies revealed myotonic dystrophy type 1. Magnetic resonance imaging of the spine showed loss of cervical lordosis and spinal cord compression due to hypertrophied ligamentum flavum and posterior longitudinal ligament at T1 to T3 level. We concluded that her upper thoracic myelopathy was likely related to the thickness of the ligamentum flavum and posterior longitudinal ligament due to repetitive mechanical stress on her neck caused by neck muscle weakness with myotonic dystrophy.
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PMID:Upper thoracic myelopathy caused by delayed neck extensor weakness in myotonic dystrophy. 2297 86

We report the first case of ocular myasthenia gravis (OMG) in a patient with complete tetraplegia, highlighting diagnostic and management challenges. Spinal multidisciplinary rural clinic and specialised inpatient Spinal Cord Injury Unit, NSW, Australia. A 61-year-old man with established C5 AIS A tetraplegia, presented with sudden onset of diplopia and bilateral ptosis, later diagnosed as OMG, in context of other complex co-morbidities, including a cervical cord syrinx, obstructive sleep apnoea and labile blood pressure. Clinical findings were consistent with fluctuating bilateral partial third and sixth nerve palsies. Acetylcholine receptor antibodies were negative, but electromyography demonstrated muscle fatigue. The ocular signs responded well to pyridostigmine. Medications taken before diagnosis, including solifenacin for neurogenic bladder overactivity, were ceased to avoid attenuating the anti-cholinesterase effect. However, the unopposed anti-cholinesterase activity led to frequent and painful abdominal spasms, associated with uncontrolled detrusor hyperreflexia and worsening autonomic dysreflexia (AD). A trans-vesical phenol block to treat this provided only short-lasting benefit. Pyridostigmine was ceased to avoid provoking his abdominal spasms and his regular medications were recommenced. It was decided that the most appropriate treatment for his distressing diplopia was an eye patch. After discharge home, he continued to experience problems with recurrent urinary tract infections, abdominal spasms, episodic postural hypotension and AD. After 5 months, the patient died from an acute myocardial infarction. This case report contributes new knowledge about the rare presentation of OMG in a person with chronic tetraplegia.
Spinal Cord Ser Cases 2016
PMID:Ocular myasthenia gravis in a person with tetraplegia presenting challenges in diagnosis and management. 3126 10