• Title/Summary/Keyword: 척수부신경

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Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Effect of Low Frequency Electroacupuncture on the Chronic Monoarthritis and the Abundance of mRNA Encoding Substance P and Trk A mRNA levels at the Spinal Level in Rats (저빈도 전침이 만성 단발성 관절염 흰쥐의 관절염 치료효과 및 척수에서의 P 물질과 trk A mRNA 발현조절에 미치는 영향)

  • Park, Hi-joon;Lim, sabina;Lee, Hyang-sook;Xia, Ying-qiu;Wang, Yun;Han, Ji-sheng;Lee, Hye-jung
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.97-110
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    • 2002
  • 목적 : 본 연구는 (a) 저빈도 전침의 만성 단발성 관절염에 대한 치료 효과와 (b) 척수에서 동통과 관련되는 지표인 P 물질과 trk A mRNA의 발현조절에 미치는 영향을 연구하기 위해 실행되었다. 방법 : Complete Freund's adjuvant를 실험동물의 우측 경족근관절에 주입하여 관절염을 유발시키고 9주 동안 관찰하였다. 만성 관절염의 최적의 치료조건을 찾기 위하여 각각 세 종류의 경혈(환도, 용천, 족삼리)과 전침자극강도(0.5, 1, 2 mA)를 사용하여, 행동학적 지표로서 동통을 측정하였다. 측정 결과 가장 큰 효과를 나타낸 군을 선택하여 RT-PCR 방법을 사용하여 P 물질 및 trk A mRNA의 변화를 척수 후각과 후근신경절에서 측정하였다. 결과 : 관절의 굴신을 통한 통증 검사와 족과관절 둘레 길이 측정을 통하여 관찰한 결과 원위부에 위치한 환도에 저강도의 자극을 시행한 경우(환도, 0.5 mA)가 가장 우수한 치료 효과를 나타내었다. RT-PCR을 시행한 결과, 환측 후근신경절의 P물질이 관절염 유발 대조군의 경우 정상군에 비해 증가하였고 환도-0.5mA 군에서 다시 감소하는 것을 관찰하였으며, trk A는 관절염 유발군의 경우 척수 후각에서 양측성 증가를 나타내었고 이는 전침치료에 의해 다시 감소되는 것을 관찰하였다. 결론 : 환도 0.5mA의 저빈도 전침은 관절염을 효과적으로 감소시킬 뿐 아니라 관절염으로 증가된 후근신경절의 P 물질과 척수후각의 trk A mRNA 발현을 효과적으로 감소시켰으며, 이는 원위취혈로 선혈된 환도혈의 만성관절염에 대한 치료효과를 분명히 보여준다고 할 수 있다.

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A Case of Compressive Myelopathy due to Ossification of the Cervical Ligamentum Flavum (경추부 황색인대골화에 의한 압박척수병증 1예)

  • Lee, Dong-Ha;Cho, Yong-Jin;Kim, Han-Joon;Hong, Keun-Sik;Cho, Joong-Yang
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.109-111
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    • 2008
  • Ossification of the ligamentum flavum (OLF) usually occurs in the lower thoracic spine, and is rare in the cervical region. We report the case of a 67-year-old woman who presented a seven month's history of progressive weakness and paresthesia in her right upper extremity. MRI and CT scans of the spine revealed the presence of ossified ligamentum flavum from C3-C4. A cervical laminectomy resulted in a good post-operative improvement of muscle strength.

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An Intradural Extramedullary Hemangioblastoma of Distal Spinal Cord - A Case Report - (척수 원위부에 발생한 경막내수막외 혈관아세포종 - 증례보고 -)

  • Park, Sung-Ho;Cho, Joon;Youn, Seung-Whan;Chang, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1523-1526
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    • 2000
  • It has been known that hemangioblastoma of spinal cord occurs about 4% of all the spinal tumors. The authors present a rare case of intradural extramedullary(IDEM) hemangioblastoma of distal spinal cord in 41-year-old male patient. This IDEM mass at the level of conus medullaris showed iso-signal intensities on T1-weighted image(T1-WI) and high-signal intensities on T2-WI, and was enhanced homogeneously on MRI. At surgery, T12- L1 total laminectomy and enbloc mass removal were performed. This IDEM hemangioblastoma was confirmed by histopathologic findings. For less postoperative complication in IDEM tumors, we suggest that precise preoperative evaluation and complete excision via proper surgical approach to distal conus should be reemphasized.

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A Case Report on Cervical Myelopathy Applied Chuna Treatment (추나 요법을 적용한 경수부 척수 손상 환자의 경과관찰 1례)

  • Lee, Jin-Bok;Cho, Yi-Hyun;Im, Jeong-Gyun;Jeong, Si-Yeong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.81-89
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    • 2010
  • Objects : This study was to report a clinical effect of Chuna Treatment for a patient diagnosed by Magnetic Resonance Imaging(MRI) as Cervical Myelopathy. Methods: In order to alleviate shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, phamacopucture, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results: VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions: Korean Treatment can be effectively used for a patient with Cervical Myelopathy. Further clinical studies are needed to verify the findings.

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Diagnosis of Spinal Arachnoid Cyst using Magnetic Resonance Imaging in a Dog (개에서 자기공명영상을 이용한 척추부 지주막 낭종의 진단)

  • Shin, Chang-ho;Kim, Young-ki;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.464-468
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    • 2015
  • A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.

A Patient with Spinal Accessory Neuropathy after Self Neck Massage Treated with TMJ Balancing Therapy: A Case Report (경부 자가 마사지 후 척수부신경병증을 호소하는 환자의 턱관절균형요법 치험례)

  • Hakwon Kim;Jung Eun Choi;Sang Soo Park;Wang Jung Hur;Horyong Yoo;Miso S. Park
    • Journal of TMJ Balancing Medicine
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    • v.13 no.sup
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    • pp.27-33
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    • 2023
  • The purpose of this study is to describe the effects of temporomandibular joint balancing therapy on a patient with a spinal accessory neuropathy. A patient reported sternocleidomastoid muscle and trapezius muscle weakness after self-massage. The patient was instructed to wear the Accurate Balancing Appliance (ABA) for at least 8 hours per day and maintain an upright posture. The patient received cervical spine manipulation on day 2, 4, and 6. The patient's progress was tracked based on the angle at which the head turned to the right from the midline when she lifted her head while lying down, as well as the muscle strength and pain in the right trapezius muscle. The patient recovered spontaneously after 7 days. The ABA and cervical spine manipulation assisted the patient in reducing fatigue and discomfort during daily activities.

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Spontaneous Thoracic Epidural Hematoma - Case Report - (흉추부에 발생한 자발성 척수 경막외 혈종 - 증 례 보 고 -)

  • Koo, Tae Heon;Mok, Jin Ho;Lee, Young Bae;Park, Yong Seok;Lee, Kye Chun;Kim, Han Sik
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.131-135
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    • 2000
  • Spontaneous spinal epidural hematoma, an idiopathic accumulation of blood in the vertebral epidural space without identifiable predisposing factors, is a rare condition. The diagnosis can be made from a careful history and neurological examination, but clinical diagnosis is often difficult because of its non-specific symptomatology and it can be confused with myocardial infarct, musculoskeletal pain, vasculitis and acute dissection of an aortic aneurysm. For a favourable outcome, early decompressive laminectomy and evacuation of hematoma are necessary. We report a 50-year-old female who presented with acute paraparesis and back pain on thoracic area. Diagnosis of spinal epidural hematoma which extended over $T_4-T_9$ was made by magnetic resonance imaging. We performed immediately decompressive laminectomy and evacuated the epidural hematoma. No cause for bleeding was evident. Postoperatively, neurological symptoms disappeared within six weeks.

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Surgical Treatment for Metastatic Spinal Tumor (전이성 척추 종양의 수술적 치료)

  • Han, Chung-Soo;Kim, Ki-Tack;Soh, Jae-Ho;Lee, Jung-Hee;Shin, Dong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.1-9
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    • 2000
  • Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

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Vertebral Osteosarcoma Causing Compression of the Lumbar Spinal Cord in a Dog (개에서 요추부 척수를 압박하는 척추 골육종 발생례)

  • Kang, Byung-Jae;Ryu, Hak-Hyun;Park, Sung-Su;Rahman, Md. Mizanur;Sung, Gyu-Jin;Kim, Yong-Sun;Park, Jun-Won;Kim, Wan-Hee;Yoon, Jung-Hee;Kim, Dae-Yong;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.588-592
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    • 2010
  • A 15-year-old neutered male Yorkshire terrier was presented with a gait disorder of the pelvic limbs. For differential diagnosis of neural disease, magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. CT showed bone defect in the 4th lumbar vertebra and adjacent soft tissue mass. MRI revealed a mass in left side of the 4th lumbar vertebra. The mass was uniformly enhanced on contrast-enhanced T1-weighted imaging (T1W1). Excision of the mass alleviated back pain. Vertebral osteosarcoma was identified by the histopathological examination. Therefore, CT and MRI were helpful to diagnose vertebral osteosarcoma in the dog and to plan surgical excision of the mass.