Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of thoracic disc herniation in a 53-year-old woman who presented to the Emergency Department (ED) with a 2-week history of acute lower back numbness and intermittent fecal incontinence. On examination, she had lower extremity hyperreflexia, an abnormal gait, and lower lumbar pain but lacked any radicular findings. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. The patient underwent successful T2-3 anterior discectomy with T2-3 rib autograft fusion. Nine months after surgery her weakness and gait had improved, but she continued to have recurrent intermittent fecal incontinence. Thoracic disc herniation is an uncommon, but treatable cause of spinal cord compression. Prompt recognition and early treatment are the keys to preventing permanent neurologic sequelae.
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PMID:T2-3 Thoracic disc herniation with myelopathy. 1797 78

Background: Indications and clinical outcomes of percutaneous endoscopic thoracic discectomy(PETD) in treating thoracic disc herniation is rarely reported and still controversial. We reported an unsatisfied recovery of thoracic disc herniation with PETD, treated by a second posterior thoracic laminectomy and Ponte osteotomy.Case description: A male presented with lower extremity weakness and stagger caused by T3/4 intervertebral disc herniation. The upper thoracic curve was in excessive kyphosis with T2-5 Cobb angle of 34.3 degrees. The preoperative ODI score was 34 and Roelzs's JOA score was 14. Percutaneous transforaminal endoscopic thoracic discectomy (PETD) from a posterior lateral approach was performed. At five-month follow-up, his thoracic back pain and staggering gait did not improve. The postoperative T2-5 Cobb angle was 32.1 degrees, the ODI score was 24 and Roelzs's JOA score was 14. A second posterior thoracic decompression this time with fixation was performed, but no disc herniation was detected. A Ponte osteotomy was performed to correct the kyphosis. One month after the second surgery, muscle strength of the lower limbs was improving with the T2-5 Cobb angle decreased to 19.4 degrees, the ODI score decreased to 10 and Roelzs's JOA score increase to 16. Six month later, the ODI score decreased to 0 and Roelzs's JOA score improved to 18. In review of the literature, PETD doesn't guarantee the patient a satisfactory neurological recovery for kyphotic thoracic disc herniation. Posterior decompression with Ponte osteotomy may be beneficial to release the tension and decompression of the spinal cord tension.Conclusions: Thoracic disc herniation with kyphosis angle >20 degrees (T2-5), percutaneous endoscopic thoracic discectomy is not likely to get good neurologic results. Posterior laminectomy with ponte osteotomy might be beneficial for these patients to induce dorsal drifting of the spinal cord from anterior herniation.
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PMID:Thoracic de-kyphosis for revision surgery of a failure case of endoscopic discectomy: a case report and literature review. 3227 70