胸椎管内血管周细胞瘤致脊髓压迫症1例报道

<正>血管周细胞瘤(HPC)又称血管外皮细胞瘤,是一种罕见的源于软组织血管外皮细胞或未分化的间质细胞且具有侵袭性的中间型肿瘤。HPC可发生于身体任何部位,以深部软组织多见,神经系统的HPC较为少见,而源于椎管内的HPC更为罕见。我院于2014年11月收治了1例T4~T7范围椎管内HPC导致脊髓压迫症的患者,经手术治疗取得良好效果,报告如下。     

胸椎管内痛风石致脊髓压迫症1例报告

<正>痛风是现代社会较为常见的代谢性疾病。当高尿酸血症持续存在,尿酸盐结晶形成并沉积,即形可成痛风石。痛风石常见于足跖趾关节背侧,肘后、耳廓、足跟、膝前也很常见,但出现在椎管内者罕见。我院2014年10月收治1例胸椎管内痛风石导致脊髓压迫症的患者,经手术治疗取得了良好效果,报告如下。患者男,51岁,办公室工作人员。因"背痛4年,加重伴双下肢无力行走不利7d"于2014年10月入院。患者4     

Spinal cord compression in Scheuermann's kyphosis: case report.

Compression of the spinal cord secondary to disc disorders in Scheuermann's kyphosis is rare. This review reports an unusual case emphasizing mechanisms of compression of the spinal cord from this disc disorder. Contrasts and comparisons with previously published cases are included.     

硬膜外脂肪瘤内痛风石形成致脊髓压迫症1例

正患者,男,38岁。因"双下肢麻木、无力1个月,加重5 d"入院。平车推入病房。T7、T8棘突压痛及叩击痛,伴双下肢放射痛,耻骨联合水平以下感觉减退;左下肢肌力(3+),右下肢肌力(3-),双下肢肌张力减弱,双上肢肌力5级,肌张力正常。右腕关节及右踝关节处肿胀明显,压痛阳性。双下肢直腿抬高试验及加强试验阴性。双侧Hoffmann征、克氏征阴性,     

脊柱痛风石压迫脊髓致瘫痪1例报告

<正>痛风是一种嘌呤代谢紊乱所致的疾病,多见于男性及绝经期后女性,临床特点为高尿酸血症和尿酸盐结晶沉积在关节、滑囊、肌腱、韧带、肾脏、皮下和其他组织,所导致的特征性关节炎、痛风石形成、肾脏等组织器官受损[1]。痛风石形成的典型部位位于耳轮,也常见于第一跖趾、指(趾)间、踝、腕、膝、肘关节等处,发生在脊柱部位的痛风石较为罕见。目前原因仍不明确,考虑与负重损伤及温度有关,因腰椎负重大,易损伤,故脊柱痛风多发生于腰椎,颈     

Spinal cord compression from intrathecal catheter-tip inflammatory mass: case report and a review of etiology

OBJECTIVES: The majority of intrathecal pumps are implanted by anesthesiologists. Despite a recent increase in case reports involving intrathecal catheter-tip inflammatory masses, this complication is rarely reported in the anesthesiology literature. The present case report describes a patient with spinal cord compression as a result of an inflammatory mass and reviews the current literature as to the etiology of inflammatory mass formation. CASE REPORT: A 47-year-old man with intractable neck and arm pain received an intrathecal pump implantation in 2001, at a stable dose of morphine 8 mg and clonidine 40 microg/d. After an injury in late 2001, his dose requirement for intrathecal morphine steadily increased. In May 2002, hydromorphone was substituted for morphine. The concentrations of hydromorphone and clonidine were 12.5 mg/mL and 150 microg/mL, respectively, infusing at 0.3 mL/d. In October 2003, he developed progressive T9 paraparesis. A computed tomography scan with myelogram showed complete blockage of contrast flow at T8-9. Surgical exploration found an intradural-extramedullary mass compressing the spinal cord anteriorly and to the left. Four weeks after surgical removal of the mass, the patient's neurologic function had improved minimally. All the microbiological analyses were negative. Review of the current literature suggests that the development of an inflammatory mass is related to the delivery of the high dose opioids in the intrathecal space. CONCLUSION: Delivery of high-dose intrathecal opioids can result in the formation of an inflammatory mass, leading to poor pain control and neurologic complications. Anesthesiologists should be vigilant as to these complications when managing patients receiving intrathecal pump therapy.     

Spinal cord compression due to intradural extramedullary aspergilloma and cyst: a case report

A case of thoracic spinal cord compression caused by intradural extramedullary cyst associated with aspergilloma is presented. The specific diagnosis was extremely difficult and required specialized tissue studies. Clinical suspicion of fungal infection, surgical intervention for spinal cord decompression, and tissue biopsy and relentless diagnostic laboratory studies are particular features of this case.     

Spinal cord compression by hematoma in the cervical ligamentum flavum: a case report

Background contextThere have been some reports describing hematoma in the thoracic and lumbar ligamentum flavum, but there have been only three reports of hematoma in the cervical ligamentum flavum.PurposeWe describe another case of the ligamentum flavum hematoma in the cervical spine with a different feature of occurrence that required surgical treatment.Study designCase report.Patient samplePatient with ligamentum flavum hematoma in the cervical spine.Outcome measuresPreoperative magnetic resonance imaging and pathologic finding from operative specimen confirmed the diagnosis.MethodsA 69-year-old man insidiously presented with pain in his left upper arm and difficulty in left shoulder abduction. Neurologic examination demonstrated a cervical myelopathy with diffuse muscle weakness of left upper extremity and sensory disturbance. Imaging studies revealed a mass of high intense on T1-weighted images and isointense on T2-weighted images posterior to the dura at C4 lower end level. The patient underwent C4–C5 hemilaminectomy and the removal of the mass. The mass existed within the ligamentum flavum and was connected toward the pedicle like the beads of a rosary.ResultsHistopathologic examination of the surgical specimen showed that the hematoma was present within the ligamentum flavum and contained macrophages that had phagocytosed red blood cells and hemosiderin. After surgery, the patients' symptoms immediately improved, and no recurrence was observed at 2 years postoperatively.ConclusionsWe reported a very rare case of hematoma in the ligamentum flavum of the cervical spine that required surgery. Because the patient was without the history of trauma, it was suggested that the use of antiplatelet drugs was responsible for the occurrence of the disease.     

Spinal cord compression in beta-thalassemia: case report and review of the literature

STUDY DESIGN: A case report of thoracic spinal cord compression in a 34-year-old male with beta-thalassemia is reported. OBJECTIVES: In patients with thalassemia, neurologic complaints should lead to a high index of suspicion for spinal cord compression from marrow expansion, ectopic bone formation and resultant stenosis. Initial presentation, diagnosis, radiographic findings, surgical treatment and follow-up are reviewed. SETTING: This case is reported from Chicago, Illinois. METHOD: A chart review is performed for the purposes of this case report. RESULTS: Patient underwent decompressive laminectomy with good surgical outcome. CONCLUSION: Rapid diagnosis and treatment of such a condition is essential to optimize the chances of recovery.     

Spinal cord compression complicating subarachnoid infusion of morphine: case report and laboratory experience

The intraspinal administration of morphine has been employed increasingly in the management of intractable pain of malignant as well as benign origin. We have encountered a previously unreported clinical complication: spinal cord compression by an inflammatory tissue mass surrounding a subarachnoid infusion catheter administering morphine, leading to paraplegia. The patient was referred to our institution after catheter and pump implantation for chronic, intractable pain associated with pre-existing lumbar arachnoid fibrosis, after multiple myelograms and surgeries. The patient may, therefore, have had an underlying propensity to foreign body reactions. We have encountered a similar phenomenon, however, in a canine laboratory model. The pathological features in both our patient and our laboratory preparation, with inflammatory tissue masses around the tip of the catheter but not around proximal subarachnoid segments, suggest an effect related to infusion, as opposed to infection or the presence of the catheter. We review the pathological features in both settings and the pertinent literature.     

Spinal cord proliferative sparganosis in Taiwan: a case report

A 43-year-old woman suffered from low back pain and bilateral footdrop. A cisternal myelogram unexpected revealed multiple filing defects in the spinal canal extending from the lower cervical region to the caudal equina. Diagnostic exploration revealed numerous cystic organisms adhering to the spinal cord and nerve roots. Histopathological examination showed these organisms to be proliferative sparganum cestode larvae. Although these cestode larval infections have been reported a dozen times in humans from various parts of the world, this is probably the first reported case of spinal cord infection.     

局麻下胸椎经皮椎体后凸成形术致脊髓麻醉1例报道

脊髓麻醉(spinal anesthesia,SA)是局麻药注入蛛网膜下腔产生的效果,但如果过量局麻药误入蛛网膜下腔,可导致高位脊髓麻醉甚至全脊髓麻醉,危及患者生命[1]。我们在行经皮椎体后凸成形术(percutaneous kyphoplasty,     

Spinal cord compression by a unifocal eosinophilic granuloma: a case report of an adult with unusual roentgenological features

We describe an unusual case of unifocal eosinophilic granuloma of the spine in a 38-year-old woman who presented with spinal cord compression. After 2 years of back pain, x-ray films of the spine were normal, but computed tomography and magnetic resonance imaging demonstrated a lytic lesion of the 1st lumbar vertebral body with cephalic extension in the epidural space. The lesion was later confirmed at operation to be an eosinophilic granuloma spreading into the surrounding tissues.     

Benign metastasizing leiomyoma causing spinal cord compression

BACKGROUND: Leiomyoma as a cause of cord compression is extremely rare. To our knowledge this is the first report of a dural-based leiomyoma and second report of a leiomyoma causing cord compression. CASE DESCRIPTION: A 38-year-old female renal transplant recipient presented with features of cervical cord compression. On imaging and at surgery, the tumor was mistaken for a neurofibroma. A cervical laminectomy and near total excision of the tumor was done. She did well in the postoperative period but presented 5 months later with thoracic empyema leading to septicemia and her demise. Ultrasound examination and autopsy showed leiomyomas in many other sites including the uterus. CONCLUSIONS: The presence of extrauterine and uterine leiomyomas is a curious condition termed as "benign metastasizing leiomyoma." As our patient was on immunosuppressant therapy following a renal transplant, it might have predisposed her to this rare condition with multifocal tumors.