Spinal Cord Series and Cases最新文献

{"title":"Cauda equina syndrome with beta thalassemia: a case report.","authors":"Ahmed Almoallem, Saud Alhamad, Nayef Bin Dajim, Elamir Bachar Harfouch, Shahid Bashir","doi":"10.1038/s41394-024-00681-y","DOIUrl":"10.1038/s41394-024-00681-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cauda equina syndrome (CES) related to beta thalassemia with extramedullary hematopoiesis is a rarely reported and challenging clinical presentation. A thorough literature review revealed only a limited number of documented cases, each demonstrating a variety of treatment modalities with divergent outcomes.</p><p><strong>Case presentation: </strong>In this case, a 29-year-old male with beta thalassemia, undergoing frequent blood transfusions, and with a history of splenectomy, presented with 2 days of worsening in his lower back pain, extending to both lower limbs, numbness, and urinary incontinence. Following the ASIA ISNCSCI scoring system for physical assessment, there was a significant decrease in anal tone and perianal sensation, suggesting possible sacral nerve roots involvement, but no other upper or lower extremities sensory or motor deficits were detected. Provided with the patient history of frequent blood transfusion and Thalassemia for which hematology referral was promoted. Spinal MRI revealed extramedullary hematopoiesis, disc protrusion, and cauda equina compression.</p><p><strong>Discussion: </strong>Spine surgery, including decompression and laminectomy, resulted in improved back pain and lower limb symptoms during the one-year follow-up. However, persistent sensory impairment and neurogenic bladder necessitated ongoing urological management. The absence of clear guidelines for the management of such cases underscores the need for further data collection and comprehensive outcome reviews.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"68"},"PeriodicalIF":0.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous cell carcinoma of the urinary bladder in patients with chronic spinal cord injury: A case series","authors":"Patrick Levien, Jürgen Pannek, Jan Janzen, Jens Wöllner","doi":"10.1038/s41394-024-00680-z","DOIUrl":"https://doi.org/10.1038/s41394-024-00680-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Patients with spinal cord injury/disorder (SCI/D) and neurogenic lower urinary tract dysfunction (NLUTD) are on a 16–28 folder higher risk for bladder cancer [1]. Whereas in the general population 90% of bladder tumors are transitional cell carcinoma (TCC) patients with NLUTD have a shift to squamous cell carcinoma with 36,8% and only 46.3% TCC [2]. In addition, there is a significant increase in the bladder cancer-specific death rate in SCI patients (3rd most common) compared to the general population (10th most common) [2]. Chronic inflammation and mechanical irritation by permanent indwelling catheters are discussed as risk factors for developing bladder cancer. Typical symptoms of bladder cancer are often absent in patients with NLUTD and a reliable screening has not been established.</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>We present a case series of six patients with SCI and with squamous cell carcinoma diagnosed in the last 5 years in our institution. In five patients, bladder management was performed by indwelling suprapubic catheters, one patient used reflex voiding. Three patients were diagnosed during the regular, annual neuro-urological check-up, the remaining due to increasing spasticity and autonomic dysregulation. Subsequently, five patients underwent cystectomy with ileal conduit or uretercutaneostomy, one patient refused further surgical treatment. Four patients died within one year after diagnosis.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Squamous cell carcinoma of the bladder is more common in patients with NLUTD. Chronic inflammation and mechanical irritation may be the reasons for carcinoma genesis. A regular check including cystoscopy is strongly recommended to detect tumor development early.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"55 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic dysreflexia in patients with cancer and spinal cord injury: a case series.","authors":"Evelyn Qin, Genevieve M Marshall, Lisa Ruppert","doi":"10.1038/s41394-024-00678-7","DOIUrl":"10.1038/s41394-024-00678-7","url":null,"abstract":"<p><strong>Introduction: </strong>Autonomic dysreflexia (AD) is a potentially life-threatening syndrome that can occur in patients with traumatic injury to the spinal cord; however, it has not been well described in patients with non-traumatic spinal cord injury (SCI) from cancer and its treatments.</p><p><strong>Case presentation: </strong>We report four cases of autonomic dysreflexia secondary to primary spinal cord tumors and metastatic disease to the spine, and as sequela to cancer treatment. The clinical characteristics, diagnostic considerations, and therapeutic strategies used to mitigate the symptoms are discussed.</p><p><strong>Discussion: </strong>The case series shows that AD is a rare but important condition to consider among patients with cancer-related SCI. There is a need for close monitoring and early identification of this syndrome in this population. Therapeutic strategies are available to mitigate these symptoms and risks of complications.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"66"},"PeriodicalIF":0.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient with cervical ligamentum flavum haematoma: case report.","authors":"Nixi Xu, Chang Jiang, Zixian Chen, Zhenzhou Feng, Chun Jiang, Yuanwu Cao","doi":"10.1038/s41394-024-00679-6","DOIUrl":"10.1038/s41394-024-00679-6","url":null,"abstract":"<p><strong>Introduction: </strong>Ligamentum flavum haematoma (LFH) is an extremely rare entity, found mostly in the lumbar and thoracic ligamentum flavum and seldom in the cervical ligamentum flavum. Cervical LFH can cause paralysis in patients. We describe a case of LFH in the cervical spine that accepted surgical treatment.</p><p><strong>Case presentation: </strong>A 70-year-old man with incomplete spinal cord injury presented with sudden paralysis of his left limbs for 10 days and hemi-hypaesthesia below the level of the right clavicle. Magnetic resonance imaging (MRI) showed a space-occupying lesion in the left ligamentum flavum between the C4 and C5 laminae. The preliminary diagnoses were concluded to be incomplete spinal cord injury, spinal epidural lesions, and cervical spinal stenosis. After a posterior C3-C6 laminectomy with lateral mass screw instrumentation, the muscle strength and sensation recovered partially. The lesion was greyish black and located in the ligamentum flavum. A pathological examination identified it as a haematoma of the ligamentum flavum. The patient was discharged 15 days after the operation and commenced rehabilitation.</p><p><strong>Discussion: </strong>The LFH was mainly caused by slight trauma during gentle activities and contributed by many factors. MRI is an essential tool but pathological diagnosis is the gold standard. Most LFH patients can be treated surgically.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"65"},"PeriodicalIF":0.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary thoracic spine osteochondroma: a rare cause for spinal cord compression.","authors":"Ghassen Gader, Mohamed Amine Gharbi, Mohamed Ali Kharrat, Ahmed Harbaoui, Ihsèn Zammel","doi":"10.1038/s41394-024-00677-8","DOIUrl":"10.1038/s41394-024-00677-8","url":null,"abstract":"<p><strong>Introduction: </strong>Osteochondromas, also known as osteocartilaginous exostosis, are among the most common benign cartilaginous bone tumors, primarily occurring as solitary lesions. While typically found in long bones, spinal involvement is rare, accounting for only a small percentage of benign lesions in this location. Solitary osteochondromas responsible for spinal cord compression are seldom.</p><p><strong>Case presentation: </strong>We describe the case of a 34-year-old male with no significant medical history, presenting with progressive symptoms suggestive of spinal cord compression. Imaging studies revealed a bony lesion originating from the left lateral aspect of the posterior arch of the T8 vertebra, causing spinal cord compression and myelopathy. Surgical intervention was necessary to decompress the spinal cord and obtain histological samples, resulting in immediate postoperative improvement in motor function. Pathologic exam concluded to an osteochondroma.</p><p><strong>Discussion: </strong>Osteochondromas primarily affect growing bones and are more commonly observed as solitary lesions, particularly in male patients. Spinal involvement is rare, and neurological symptoms are typically indicative of intracanalar extension of the exostosis, leading to compression of neural elements. Imaging modalities such as MRI are crucial for assessing cartilage thickness and the impact of compression on the spinal cord.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"63"},"PeriodicalIF":0.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study.","authors":"Sara Mollà-Casanova, Elena Muñoz-Gómez, Marta Aguilar-Rodríguez, Marta Inglés, Núria Sempere-Rubio, Noemí Moreno-Segura, Pilar Serra-Añó","doi":"10.1038/s41394-024-00675-w","DOIUrl":"10.1038/s41394-024-00675-w","url":null,"abstract":"<p><strong>Study design: </strong>A feasibility pilot study.</p><p><strong>Objective: </strong>To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI).</p><p><strong>Setting: </strong>A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM).</p><p><strong>Methods: </strong>Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention.</p><p><strong>Results: </strong>20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective.</p><p><strong>Conclusion: </strong>A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"64"},"PeriodicalIF":0.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Recognition.","authors":"","doi":"10.1038/s41394-024-00672-z","DOIUrl":"10.1038/s41394-024-00672-z","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"62"},"PeriodicalIF":0.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is deformity correction essential in a \"Myelopathic Cord\"? - A case series.","authors":"Rajat Mahajan, Ganesh Kumar","doi":"10.1038/s41394-024-00676-9","DOIUrl":"10.1038/s41394-024-00676-9","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of preoperative neurological deficits in pediatric patients with complex deformities ranges from 15% to 23%. Furthermore, the likelihood of a postoperative neurological deficit can be considerably increased to 83.3% in the presence of a preoperative neurological deficit. Hence, the management of pediatric spinal deformities with neurological deficits is a challenge for every spine surgeon. Here, we describe four consecutive cases of pediatric spinal deformity with myelopathic cord, all of which were managed with decompressive surgery and stabilization without any attempts to correct the deformity. All the patients recovered well neurologically, without any progression of deformity.</p><p><strong>Case presentation: </strong>The authors obtained the informed written consent from the patient and their parents for the print and electronic publication of the case. All four patients had clinical myelopathy with a progressive, worsening neurological deficit. The pathology was in the thoracic region in all the patients. Of the four cases, two were post-tubercular deformities, and two were congenital deformities. The treatment strategy for all patients was circumferential decompression of the spinal cord with posterior pedicle screw instrumentation. Although all patients had significant neurological deficits (Nurick grade 4 or 5) preoperatively, we used intraoperative neuromonitoring to prevent the worsening of the deficit during the procedure. None of the patients experienced intraoperative signal changes. All patients had significant neurological recovery (Nurick grade 0 to 2) and showed no worsening of deformity at their latest follow-up, up to 4 years. All showed good improvement in all domains of the SRS22r questionnaire.</p><p><strong>Discussion: </strong>It is challenging for spine surgeons to manage complex spinal abnormalities in pediatric patients with myelopathic cords. Even a minimal manipulation of the cord during surgery might result in severe long-term morbidity. The primary objective in managing such patients should be neurological recovery rather than deformity correction-\"First do no harm,\" and if necessary, the deformity can be corrected at a later stage under neuromonitoring.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"61"},"PeriodicalIF":0.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the pandemic on physical and functional disabilities in children and adolescents with spina bifida.","authors":"Ester da Silva Estevam, Camila Scarpino Barboza Franco, Emanuela Juvenal Martins, Danila Cristina Petian-Alonso, Karoliny Lisandra Teixeira Cruz, Ana Claudia Mattiello-Sverzut","doi":"10.1038/s41394-024-00674-x","DOIUrl":"10.1038/s41394-024-00674-x","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective and cross-sectional study.</p><p><strong>Objectives: </strong>The study aimed to carry out telemonitoring to identify the impact of the pandemic on physical and functional disabilities in children and adolescents with SB, as reported by their caregivers, and to investigate adherence to a teleservice.</p><p><strong>Setting: </strong>Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP).</p><p><strong>Methods: </strong>Retrospective and cross-sectional study. Fifty-three patients with SB (mean age 12.0 (4.0) years; 23 males) participated in the telemonitoring. A questionnaire - 'Health management, health conditions, rehabilitation, interest in teleservice, and the well-being of the main caregiver' - investigated the clinical impact of the coronavirus pandemic. Only three caregivers participated in the teleservice (video call).</p><p><strong>Results: </strong>According to telemonitoring, 62% of the patients discontinued physiotherapy sessions, and 69% reported needing adjustments in locomotion devices. The main complaints were muscle weakness and pain.</p><p><strong>Conclusion: </strong>We monitored general health and identified demands related to physical rehabilitation using telemonitoring in 42.4% of children and adolescents with SB monitored at the HCFMRP-USP. Telemonitoring and teleservice may be methods used for monitoring health conditions in patients with SB.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"60"},"PeriodicalIF":0.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal cord injury in high-risk complex adult spinal deformity surgery: review of incidence and outcomes from the Scoli-RISK-1 study.","authors":"Fan Jiang, Hetshree Joshi, Jetan H Badhiwala, Jamie R F Wilson, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Y Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Sigurd H Berven, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Stephen J Lewis, Michael G Fehlings","doi":"10.1038/s41394-024-00673-y","DOIUrl":"10.1038/s41394-024-00673-y","url":null,"abstract":"<p><strong>Study design: </strong>Clinical case series.</p><p><strong>Objective: </strong>To describe the cause, treatment and outcome of 6 cases of perioperative spinal cord injury (SCI) in high-risk adult deformity surgery.</p><p><strong>Setting: </strong>Adult spinal deformity patients were enrolled in the multi-center Scoli-RISK-1 cohort study.</p><p><strong>Methods: </strong>A total of 272 patients who underwent complex adult deformity surgery were enrolled in the prospective, multi-center Scoli-RISK-1 cohort study. Clinical follow up data were available up to a maximum of 2 years after index surgery. Cases of perioperative SCI were identified and an extensive case review was performed.</p><p><strong>Results: </strong>Six individuals with SCI were identified from the Scoli-RISK-1 database (2.2%). Two cases occurred intraoperatively and four cases occurred postoperatively. The first case was an incomplete SCI due to a direct intraoperative insult and was treated postoperatively with Riluzole. The second SCI case was caused by a compression injury due to overcorrection of the deformity. Three cases of incomplete SCI occurred; one case of postoperative hematoma, one case of proximal junctional kyphosis (PJK) and one case of adjacent segment disc herniation. All cases of post-operative incomplete SCI were managed with revision decompression and resulted in excellent clinical recovery. One case of incomplete SCI resulted from infection and PJK. The patient's treatment was complicated by a delay in revision and the patient suffered persistent neurological deficits up to six weeks following the onset of SCI.</p><p><strong>Conclusion: </strong>Despite the low incidence in high-risk adult deformity surgeries, perioperative SCI can result in devastating consequences. Thus, appropriate postoperative care, follow up and timely management of SCI are essential.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"59"},"PeriodicalIF":0.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}