• Title/Summary/Keyword: 척수 압박

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Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Primary Spinal Epidural Lymphoma Mimicking Epidural Abscess in a Diabetic - A Case Report - (당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종 - 증례보고 -)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.395-399
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    • 2001
  • Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.

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Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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Intercostal Neuralgia and Spinal Cord Compression Symptom due to Spinal Tumor -A Case Report- (척추 종양에 의한 늑간 신경통 및 척수 압박 증상 -증례 보고-)

  • Lee, Hyo-Keun;Shin, Dong-Yeop;Lee, Hee-Jeon;Kim, Chan
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.287-291
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    • 1994
  • A 49 years old male patient was admitted to our neuro-pain clinic with symptoms of left 11th intercostal neuralgic pain and low back pain that developed 2 months prior to admission. Upon initial physical examination, motor weakness or sensory deficit were absent. Intercostal neuralgic pain improved significantly after we performed thoracic root thermocoagulation. However on the afternoon of the procedure the patient started to experience voiding difficulty, saddle anesthesia and rapidly progressing motor weakness and hypoesthesia that involved the lower back area and the lower extremities for three days. Based on these symptoms spinal cord compression was suspected and subsequently plain T-L spine X-rays and T-L spine MRI were performed. A spinal tumor that appeared metastatic in origin was seen at the T11 and T12 level. Liver ultrasonography demonstrated the presence of a $4{\times}4cm$ sized ill defined mass in the posterior segment of the right lobe. The patient was diagnosed to have hepatocellular carcinoma after needle aspiration biopsy and cytologic studies. Further orthopedic surgery was recommended but as the patient rejected any further treatment and examination, it was not possible to confirm the primary focus of the tumor. However as metastasis of a primary liver tumor to the spine is a rare occurrence, some other primary focus of metastasis or even a malignant primary tumor of the spine is more likely to explain this patient's condition.

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Compression Neuropathy (압박성 신경병증)

  • Kim, Byung-Sung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.128-133
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    • 2008
  • Nerve compression is caused by external force or internal pathology, which symptom develops along nerve distribution. There are median, ulnar and radial nerve compression neuropathies below elbow. Carpal tunnel syndrome at the flexor retinaculum is most common among all the entrapment neuropathies. Other causes of median nerve neuropathy include Struther's ligament, biceps aponeurosis, pronator teres, FDS aponeurosis and aberrant muscles, which induce pronator syndrome or anterior interosseous nerve syndrome. Ulnar nerve can be compressed at the elbow by arcade of Struther, medial epicondylar groove, FCU two heads, which develops cubital tunnel syndrome, at the wrist by ganglion, fracture of hamate hook and vascular problem, which develops Guyon's canal syndrome. Radial tunnel syndrome is caused by supinator muscle, which compresses its deep branch. Treatment is conservative at initial stage like NSAID, night splint or steroid injection. If symptom persists, operative treatment should be considered after electrodiagnostic or imaging studies.

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Use of Digital Infrared Thermography on Experimental Spinal Cord Compression in Dogs (개에서 실험적으로 유발한 척수압박에 대한 적외선 체열촬영술의 적용)

  • Kim Wan-Tae;Kim Min-Su;Kim Sun Young;Seo Kang-Moon;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.302-308
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    • 2005
  • This study was performed to examine the absolute skin temperature and temperature difference $({\Delta}T)$ between the left and the right, the upper and the lower parts on the back of dog and to investigate the clinical usefulness of infrared thermography as diagnostic or prognostic aid on experimental spinal cord compression by using Digital Infrared Imaging System. In normal dogs, symmetrical and contouring patterns were observed in thermogram. The skin temperature difference was not significant between the left and the right, the upper and the lower parts on the back. In spinal cord compressed dog, there was symmetrical temperature reduction pattern around lesion. Patterns of ${\Delta}T$ between thoracic and lumbar portions were remarkable and showed the tendency to return to normal after 4 weeks of operation. It is considered that infrared thermography is a useful diagnostic and prognostic aid for spinal cord injury in dogs.

Epidural Abscess Following Continuous Epidural Catheterization (지속성 경막의 차단후 발생한 경막외 농양의 치험)

  • Kim, Sung-Sub;Kim, Hae-Kyu;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.94-96
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    • 1989
  • The cases of continuous epidural catheterization for pain control have increased nowadays. Epidural abscess, one of the complications of continuous epidural catheterization. can cause severe and permanent neurologic deficit. Though the incidence of epidural abscess is rare, we should devote every effort to prevention of abscess formation. And in the occurrence of epidural abscess formation, treatment should be started as early as possible with antibiotic therapy and surgical drainage to prevent permanent neurologic deficit. We experienced a case of epidural abscess following continuous epidural catheterization, and so the case is presented.

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Effect of the Combination of Electroacupuncture and Surgical Decompression on Experimental Spinal Cord Injury in Dogs (개에서 실험적으로 유발한 척수손상에 대한 전침과 감압술의 병용 효과)

  • Kim Sun Young;Kim Min-Su;Seo Kang-Moon;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.297-301
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    • 2005
  • This study was performed to evaluate the effects of the combination of electroacupuncture (EA) and surgical decompression on paraplegia due to spinal compression in dogs. Ten clinically healthy dogs were assigned into two groups (group A and group B). The one is for the combination of EA and surgical decompression, and the other is for surgical decompression alone. After decompression, neurological function was evaluated daily with modified Tarlov grading system. SEPs were measured as objective evaluation of normal spinal cord function before spinal compression and after neurological recovery. The period of rehabilitation in group A was significantly shorter than that in group B (p<0.05). Conduction velocity of SEPs showed a tendency to return to normal when the dogs got full recovery. According to these results, it was considered that the EA with surgical decompression was more effective than surgical decompression alone for paraplegia resulting from spinal cord injury in dog.

Discal Cyst in a Malamute Dog (말라뮤트 개에서 발생한 디스크 낭종 증례)

  • Kim, Jae-Hwan;Park, Noh-Won;Kwon, Young-Hang;Lim, Jong-Hwan;Bae, Jang-Hoon;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.445-448
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    • 2014
  • A 7-year-old, male Alaskan malamute was referred for a routine dental management. On the physical examination, the right hindlimb ataxia with a mild delay in proprioception was noted. On magnetic resonance images, an extradural ventral cystic structure compressing the spinal cord was found at the level between the first and second lumbar vertebra. The cyst showed hypointense on a T1-weighted image with rim enhancement and hyperintense on a T2-weighted image. The cystic lesion was removed through right-side hemilaminectomy. In the histopathological examination, evenly distributed fibroblasts and collagenous stroma with several cartilaginous materials were seen. The neurological signs of the right hindlimb were successfully recovered within a week in follow-up neurological examination and showed normal gait at 6 months after surgery.

Lumbar Angiomatous Meningioma in a Dog (개에서 발생한 요추 혈관종성수막종 증례)

  • Sohn, Jung-Min;Kim, Bo-Eun;Jung, Sun-Young;Ji, Seo-Yeoun;Yoon, Dae-Young;Kweon, Oh-Kyeong;Kim, Dae-Yong;Choi, Min-Cheol;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.152-155
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    • 2014
  • An 11-year-old castrated Schnauzer presented with paraplegia for the last two weeks, initially developed pelvic limb ataxia 6 months ago and left pelvic limb paresis 3 months ago. On neurological examination, paraplegia and postural reaction deficits were noted in the pelvic limbs with no deep pain sensation, and the dog showed exaggerated spinal reflexes and involuntary urination. Magnetic resonance (MR) images of thoracolumbar spinal cord were obtained with a 0.3 Tesla magnet. A mass with a broad base to the dorsal and left dural margins was identified at the level of L2, causing marked spinal cord compression. The mass showed isointensity to the spinal cord on T1-weighted (T1W) precontrast images, hyperintensity on T2-weighted images, marked homogeneous contrast enhancement with well-defined margins and the "dural tail" sign on T1W postcontrast images. An intradural-extramedullay tumor was considered, most likely, meningioma was highly suggestive. Left-sided hemilaminectomy and dorsal laminectomy were performed. An intradural mass partially adherent to dura mater was compressing the spinal cord, and the mass was completely removed with the attached dura mater. A histopathologic diagnosis of angiomatous subtype meningioma was made.