• Title/Summary/Keyword: tetraplegia

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Aneurysmal Bone Cyst of the Thoracic Spine with Scoliosis - Case Report - (척추 측만증을 동반한 흉추에 발생한 동맥류성 골낭종 - 증례 보고 -)

  • Han, Chung-Soo;Kim, Ki-Tack;Cho, Chang-Hyun;Yang, Hyoung-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.76-81
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    • 1999
  • Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

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Improvement of unilateral hyperhidrosis in spinal cord injury following treatment with revised Boyanghwano-tang: a case report (보양환오탕가감방으로 호전된 경추 손상 유래 편측성 다한증 1례)

  • Oh, Ji-Seok;Yang, Su-Young;Lee, Jin-Woo;Oh, Young-Seon;Lee, Yong-Koo;Park, Yang-Chun
    • Journal of Haehwa Medicine
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    • v.20 no.1
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    • pp.85-89
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    • 2011
  • Hyperhidrosis is common complication of spinal cord injury, but localized unilateral hyperhidrosis is relatively rare disorder without autonomic disreflexia. A 52-year-old man with a 10-month history of cervical injury induced tetraplegia complained of excessive intermittent left-sided sweating. The sweating occurred by urinary retention or without any autonomic dysreflexia. The patient sweated excessively on the left face and upper body. In the point of Differentiation of Syndrom (辨證), the patient was diagnosed as Gi-Heo-Hyeol-Eo (Pi-Wei-Qi-Xu 氣虛血瘀) and was administered revised Boyanghwano-tang (reserved Bu-Yang-Huan-Wu-tang), and he was almost complaint free during 4 month about none dysreflexial hyperhidrosis.

A Case Report of Complex Korean Medical Treatment for Cervical Spinal Cord Injury and Neurogenic Bladder (한의복합치료 후 호전된 경부척수손상 환자의 사지마비 및 신경인성 방광: 증례보고)

  • Song, Min-Yeong;Jo, Hee-Guen;Kim, Tae-Gwang;Choi, Jin-Bong
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.143-151
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    • 2016
  • A 57-year-old male patient was diagnosed as Incomplete cervical spinal cord injury and Neurogenic bladder after falling accident and suffered from tetraplegia and urinary retention. The patient was hospitalized and treated with Complex Korean Medical treatment such as acupuncture, electro-acupuncture, bee venom pharmacopuncture and herbal medication for 13 weeks. International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) was adopted to evaluate the functional recovery and Korean version of Modified Barthel Index (K-MBI) was adopted to evaluate the recovery of activities of daily living (ADL). After treatment, Total scores of ISNCSCI and K-MBI were improved. Also patient's micturition reflex was recovered and symptoms of neurogenic bladder were improved. This result shows that Korean Medical treatment may be an effective treatment option for spinal cord injury and neurogenic bladder patients. Further clinical studies are needed to clarify the effect of Korean Medical treatment on spinal cord injury.

Management of Postoperative Intra-Abdominal Hypertension in a Dog Undergoing Cervical Disc Surgery

  • Kim, Dongseok;Choi, Geonho;Lee, Sang-Kwon;Lee, Kija;Lee, Won-Jae;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Min
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.277-281
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    • 2022
  • The dog with tetraplegia was presented for magnetic resonance imaging and cervical ventral slot decompression. Intra-abdominal pressure (IAP) was measured every hour after surgery, along with respiratory rate, heart rate, and arterial pressure. Three hours after surgery, abdominal distension with agitation and respiratory distress were observed, and IAP rose to 12 mmHg, indicating mild intra-abdominal hypertension (IAH). Additional fentanyl and ketamine CRI did not alleviate IAH and acepromazine (0.01 mg/kg, IV) was administered to alleviate the agitation and respiratory distress. After acepromazine administration, the agitation subsided and IAP dropped to 4 mmHg. During the next 24 hours, the patient's vital signs and IAP remained stable, with normal urine output. This case report suggests the possibility of postoperative IAH monitoring in dogs. However, considering the nature of a single surgical case of cervical ventral slot, further study is required for indication of IAH monitoring.

Bacterial Meningitis Complicated by Myelitis Following Anterior Cervical Spinal Surgery (전방 경추 수술 후 발생한 세균성 뇌수막염과 동반된 척수염)

  • Ham, Dong-Hun;Choi, Byeong-Yeol;Jung, Myung-Cheol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.519-524
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    • 2021
  • Meningitis after spinal surgery occurs rarely but can be fatal. A 49-year-old male was diagnosed with compressive myelopathy due to cervical disc herniation at the C 5, 6 level and underwent anterior cervical discectomy and fusion (ACDF). He complained of severe neck pain and stiffness with fever postoperatively and one week after surgery, the patient presented with abrupt tetraplegia. The follow-up magnetic resonance imaging and cerebrospinal fluid analysis revealed bacterial meningitis complicated by myelitis. The patient was treated with antibiotics and steroid, but the outcome was poor. The authors report a case of meningitis combined with myelitis following anterior cervical spinal surgery.

Feline Infectious Peritonitis associated Neuropathy in a Cat (고양이에서 발생한 고양이전염성복막염에 의한 신경병증 증례)

  • Kim, Nam-Kyun;Kim, Min-Ju;Jang, Hyo-Mi;Song, Joong-Hyun;Yu, Do-Hyeon;Hwang, Tae-Sung;Lee, Hee-Chun;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.388-391
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    • 2017
  • A 8-month-old, spayed female, Domestic shorthair cat lived in a shelter was presented with pelvic limbs ataxia and dysuria. Serum biochemical profile abnormalities were hyperproteinemia and decreased albumin/globulin (A:G) ratio (0.70). Results of cerebrospinal fluid (CSF) analysis were mixed cells pleocytosis with predominance neutrophils and an increase in protein concentration. In addition, feline coronavirus was detected by realtime RT-PCR in CSF. Magnetic resonance imaging (MRI) findings revealed lesions of the lumbar spinal cord. Based on clinical signs, MR finding, CSF analysis and realtime RT-PCR result in CSF, this case was diagnosed as feline infectious peritonitis (FIP) associated meningomyelitis. Although prednisolone and mycophenolate mofetil were administrated, clinical signs were not resolved and progressed to tetraplegia and coma status. This case presentation describes that feline infectious peritonitis virus could affect the lumbar spinal cord only and cause meningomyelitis with pelvic limbs ataxia without other neurological signs.

The Study of the Driving Characteristics in Persons With Spinal Cord Injury (척수손상 장애인의 자가운전 특성에 관한 연구)

  • Kim, Su-Il;Rah, Ueon-Woo;Kim, Deog-Young;Bae, Ha-Suk
    • Physical Therapy Korea
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    • v.10 no.2
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    • pp.71-84
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    • 2003
  • The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

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A Case of Schinzel-Giedion Syndrome (Schinzel-Giedion 증후군 1례)

  • Jeoung Min-Jee;Yim Hyung-Eun;Hong Young-Sook;Lee Joo-Won;Kim Soon-Kyum;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.57-62
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    • 2004
  • Schinzel-Giedion syndrome is a rare, distinct dysmorphic syndrome characterized by congenital hydronephrosis, skeletal dysplasia, and severe developmental retardation, likely to be inherited as an autosomal recessive trait, but not yet confirmed. This syndrome is characterized by coarse facial features such as midfacial retraction, bulging forehead, short nose with anteverted nostrils, low-set malformed ears, protruding large tongue, and hypertelorism. Skeletal and limb defects, choanal stenosis, simian creases, hypospadias, microphallus, hypertrichosis, and intractable seizures are the frequently associated clinical findings. Urogenital involvement is a major component of the syndrome, and this problem sometimes is associated with nephrocalcinosis and urinary tract infection in the clinical course of the disease. We report a 22 month-old girl with Schinzel-Giedion syndrome complicated by medullary nephrocalcinosis and urinary tract infection due to Klebsiella pneumoniae. This patient had also been suffering from postnatal growth deficiency, intractable seizure, spastic tetraplegia, delayed development and severe mental retardation.

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Case Report of Autonomic Dysreflexia in a Pressure Sore Patient (욕창 환자에서 자율신경성 반사부전증의 경험례)

  • Nam, Seung Min;Park, Eun Soo;Park, Sun A;Kim, Young Bae
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.531-534
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    • 2007
  • Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

A Case of Intradiscal Oxygen-ozone Injection Therapy for Cervical Herniated Intervertebral Disc in a Dog (개에서 탈출된 경추디스크에 대한 디스크내 오존가스 주입 치료)

  • Jang, Ha-Young;Lee, Jun-Sub;Lee, Bo-Ra;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.273-275
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    • 2009
  • A 6-year-old castrated male Shih-tzu was presented because of a 1-month history of progressive tetraplegia. On the basis of the findings of neurological examination, radiographs and magnetic resonance imaging, herniated intervertebral disc of C4-C5, C5-C6 and C6-C7 compressed spinal cord. The oxygen-ozone was intra-operatively injected into the C4-C5 and C6-C7 intervertebral disc and a ventral decompression performed at C5-C6 intervertebral space. Immediately after the surgery, neck pain was disappeared and three weeks after surgery, there was complete resolution of the neurological deficits with normal gaits. On magnetic resonance images at 2-month after surgery, herniated disc materials of C5-C6 and C6-C7 were completely removed and that of C4-C5 remarkably reduced. Consequently decompression which was performed at all of the three lesions resulted in good clinical outcome without additional internal fixation for minimizing postoperative instability.