Spinal Cord Series and Cases最新文献

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Spinal cord injury as a result of Staphylococcus aureus pyogenic spinal infection complicating infected atopic eczema: two case reports. 感染性特应性湿疹并发金黄色葡萄球菌化脓性脊髓感染导致脊髓损伤:两例报告。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-08-14 DOI: 10.1038/s41394-023-00599-x
K MacKay, E J McCaughey, N Fullerton, M Purcell
{"title":"Spinal cord injury as a result of Staphylococcus aureus pyogenic spinal infection complicating infected atopic eczema: two case reports.","authors":"K MacKay, E J McCaughey, N Fullerton, M Purcell","doi":"10.1038/s41394-023-00599-x","DOIUrl":"10.1038/s41394-023-00599-x","url":null,"abstract":"<p><strong>Introduction: </strong>Pyogenic spinal infections (PSI) are a rare cause of spinal cord injury (SCI). These most often affect the lumbar spine, followed by the thoracic spine and least commonly the cervical spine, with Staphylococcus aureus being the most common causative organism. Atopic eczema is a dermatological condition which can lead to a breakdown of the skin's natural barrier function, allowing bacterial colonisation and infection. Haematological seeding of bacteria from a distant source of infection, including the skin and soft tissues, is a recognised aetiology of PSI.</p><p><strong>Case presentation: </strong>We present two patients who sustained a SCI as a result of PSI secondary to infected atopic eczema. Methicillin-sensitive Staphylococcus aureus (MSSA) was identified as the causative organism in both patients. The two patients required prolonged courses of intravenous followed by oral antibiotics. Neurological outcomes varied between the two patients. One patient had incomplete tetraplegia (C3 AIS C), and upon discharge required hoisting from their bed to a power chair, had an indwelling urethral catheter and required bowel care. The other patient had incomplete paraplegia (L3 AIS D), and at discharge was independent with activities of daily living and was mobile with two elbow crutches.</p><p><strong>Discussion: </strong>We believe that the two cases presented here represent the only examples of secondarily infected atopic eczema causing PSI and resultant SCI in the published literature. As SCI is a serious and potentially life-altering complication, medical professionals treating patients with atopic eczema should be aware of this risk.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229388","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}
引用次数: 0
Bilateral phrenic nerve palsy after posterior cervical decompression and fusion surgery: a rare event after surgery. 颈椎后路减压融合手术后双侧膈神经麻痹:术后罕见病例。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-08-12 DOI: 10.1038/s41394-023-00595-1
Glenn A Gonzalez, Jingya Miao, Guilherme Porto, James Harrop
{"title":"Bilateral phrenic nerve palsy after posterior cervical decompression and fusion surgery: a rare event after surgery.","authors":"Glenn A Gonzalez, Jingya Miao, Guilherme Porto, James Harrop","doi":"10.1038/s41394-023-00595-1","DOIUrl":"10.1038/s41394-023-00595-1","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed C5 weakness is a known entity in cervical spine surgery, although with varied clinical presentation and poorly understood mechanism of action. We describe the first case in the literature of a bilateral C5 palsy leading to bilateral phrenic nerve dysfunction following a posterior cervical decompression and fusion.</p><p><strong>Case report: </strong>A 76-year-old male presented with low back pain and was diagnosed as myelopathic. On initial neurological examination, he could not ambulate without assistance and was unsteady on tandem gait. The initial cervical MRI and CT scan showed advanced multilevel degenerative changes of the cervical spine with severe cord compression and myelomalacia. The patient underwent C3-C6 posterior cervical decompression & fusion (PCDF). He awoke with his baseline examination without neurophysiological monitoring changes intraoperatively or C5 root EMG activity. Post-operative MRI of the cervical spine was performed and showed an excellent decompression. The patient was neurologically stable and discharged to a rehabilitation facility. Patient developed a delayed bilateral C5P on postoperative day (POD) 74. Delayed bilateral C5P and phrenic nerve damage was determined to cause this patient's dyspnea. PM&R consult recommended placement of diaphragmatic pacers. However, clinically his respiratory function, as well as motor deficits, have gradually improved.</p><p><strong>Conclusion: </strong>Bilateral diaphragmatic paralysis, a severe complication of cervical spine surgery, may cause respiratory distress and upper limb weakness. C5P, the underlying cause, may arise from various factors. Early detection and management of diaphragmatic weakness with physical therapy and pacers are crucial, emphasizing the need for vigilance by healthcare professionals and surgeons.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237520","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}
引用次数: 0
Comparison of two inspiratory muscle training protocols in people with spinal cord injury: a secondary analysis. 脊髓损伤患者两种吸气肌训练方案的比较:二次分析。
IF 1.2
Spinal Cord Series and Cases Pub Date : 2023-08-12 DOI: 10.1038/s41394-023-00594-2
Anne E Palermo, Jane E Butler, Claire L Boswell-Ruys
{"title":"Comparison of two inspiratory muscle training protocols in people with spinal cord injury: a secondary analysis.","authors":"Anne E Palermo,&nbsp;Jane E Butler,&nbsp;Claire L Boswell-Ruys","doi":"10.1038/s41394-023-00594-2","DOIUrl":"https://doi.org/10.1038/s41394-023-00594-2","url":null,"abstract":"<p><strong>Study design/setting: </strong>Secondary analysis.</p><p><strong>Objectives: </strong>To compare the change in maximal inspiratory pressure (PI<sub>max</sub>) over the first 4 weeks of two different inspiratory muscle training (IMT) protocols and explore if either method is more effective for people with spinal cord injury.</p><p><strong>Methods: </strong>Data originated from two published studies. Participants completed flow-resistive IMT (F-IMT) at 80% daily PI<sub>max,</sub> 7 days/week (supervised weekly), or threshold IMT (T-IMT) at 30-80% weekly PI<sub>max,</sub> twice-daily, 5 days/week (supervised every session). Seven participants from each trial were matched by training adherence, level of spinal cord injury, impairment grade (A-C), and height. Differences between F-IMT and T-IMT groups in training intensity, breaths taken, inspiratory work, and the change in the PI<sub>max</sub> from baseline at the end of week four were analysed.</p><p><strong>Results: </strong>Over 4 weeks, there was no difference in the change in PI<sub>max</sub> between groups (Absolute change in PI<sub>max</sub> (cmH<sub>2</sub>O): p = 0.456, Percent change in PI<sub>max</sub> relative to baseline: p = 0.128). F-IMT participants trained at a higher intensity (median: 77 vs 22 cmH<sub>2</sub>O, p = 0.001 and 80% baseline vs 61% baseline, p = 0.038) but took fewer breaths (840 vs 1404 breaths, p = 0.017) than T-IMT participants. Inspiratory work was similar between groups (64,789 vs 65,910 (% PI<sub>max</sub> × number of breaths), p = 0.535).</p><p><strong>Conclusions: </strong>Our findings support both methods of IMT as the change in PI<sub>max</sub> and inspiratory work were similar between groups. However, daily high-intensity F-IMT with intermittent supervision, required fewer breaths and less participant and therapist time. Future studies should examine optimal dosage and supervision required to achieve increased PI<sub>max</sub>.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229374","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}
引用次数: 0
Posterior cervical congenital dermal sinus tract: case report and review of literature. 颈后先天性真皮窦道:1例报告及文献复习。
IF 1.2
Spinal Cord Series and Cases Pub Date : 2023-08-02 DOI: 10.1038/s41394-023-00575-5
Amir Vokshoor, Harseerat Jajj, Tiffany Grunwald, Steven Kolker, Jack Petros
{"title":"Posterior cervical congenital dermal sinus tract: case report and review of literature.","authors":"Amir Vokshoor,&nbsp;Harseerat Jajj,&nbsp;Tiffany Grunwald,&nbsp;Steven Kolker,&nbsp;Jack Petros","doi":"10.1038/s41394-023-00575-5","DOIUrl":"https://doi.org/10.1038/s41394-023-00575-5","url":null,"abstract":"<p><strong>Background and importance: </strong>Congenital dermal sinus tract (DST) is a rare spinal dysraphism characterized by a persistent tract lined by epithelial cells, beginning at the epidermis and terminating in deeper tissue layers. With 1% of all congenital DST cases found in the cervical region, only 4% of all cases are diagnosed after the age of 20.</p><p><strong>Clinical presentation: </strong>In this case, a 65-year-old woman with a congenital DST at the cervical level presented with symptoms of neck and some arm pain, suboccipital headaches, and unique external characteristics. Neck Disability Index and visual analog scale were used to assess the patient's preoperative and postoperative pain, and quality of life. Patient underwent an operative intervention, where the DST was surgically removed followed by interlaminar decompression at C1-C2, excision of the epidural component, and biopsy followed by plastic surgical repair. Pathology analysis indicated a squamous epithelial-lined sinus tract interacting with the dura. Most notably, a meningothelial proliferation with associated psammomatous calcifications was identified, similar to a meningioma.</p><p><strong>Conclusion: </strong>A review of literature was conducted to further discuss clinical and radiological presentation as well as to document the novel appearance of this congenital DST. As one of the oldest cases of DST, it demonstrated unusual pathological characteristics with a meningothelial proliferation, compatible with meningioma, reported at the epidural level.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945272","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}
引用次数: 0
The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study. 成人脊髓损伤患者准备重复使用导管的时间负担:一项横断面研究。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-08-01 DOI: 10.1038/s41394-023-00596-0
T Miller, L J Roik, T Kalimullina, S Samejima, C Shackleton, R N Malik, R Sachdeva, A V Krassioukov
{"title":"The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study.","authors":"T Miller, L J Roik, T Kalimullina, S Samejima, C Shackleton, R N Malik, R Sachdeva, A V Krassioukov","doi":"10.1038/s41394-023-00596-0","DOIUrl":"10.1038/s41394-023-00596-0","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional OBJECTIVES: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine.</p><p><strong>Setting: </strong>Laboratory METHODS: Twenty individuals with chronic SCI ( ≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS).</p><p><strong>Results: </strong>Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = -0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R<sup>2</sup> = 0.745, β = -0.833, p ≤ 0.001).</p><p><strong>Conclusions: </strong>Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307013","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}
引用次数: 0
Para-spinal abscess presenting with abdominal pain-a case report of 'red herring' symptoms. 伴有腹痛的脊柱旁脓肿--"红线 "症状的病例报告。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-07-31 DOI: 10.1038/s41394-023-00598-y
Mayya Vorona, James Livingstone, Farzan Dholoo
{"title":"Para-spinal abscess presenting with abdominal pain-a case report of 'red herring' symptoms.","authors":"Mayya Vorona, James Livingstone, Farzan Dholoo","doi":"10.1038/s41394-023-00598-y","DOIUrl":"10.1038/s41394-023-00598-y","url":null,"abstract":"<p><strong>Introduction: </strong>Paraspinal abscesses are rare infections affecting the paraspinal muscles and soft tissues. An evolving abscess may pose a threat to the spinal cord via the compressive effect which can manifest as impaired motor or sensory function at the corresponding vertebral level. Paraspinal abscess is often a late diagnosis due to non-specific symptoms at presentation. This results in high morbidity and mortality.</p><p><strong>Case presentation: </strong>We describe the case of a 59-year-old female with a paraspinal abscess presenting with epigastric pain who was initially worked up for a suspected intra-abdominal pathology, however computerised tomography of the chest, abdomen, and pelvis (CTCAP) revealed no abnormality. Later, rising inflammatory markers, accompanied by worsening cervicalgia, prompted a CT of the head, neck and thorax which revealed a soft tissue abscess compressing the thecal sac at cervical levels 1 to 3 (C1-3). This was successfully managed with radiologically guided drainage and long-term intravenous antibiotics. Our patient made a full recovery and a repeat MRI demonstrated resolution of the abscess.</p><p><strong>Conclusion: </strong>We demonstrate that spinal abscess can present with a misleading combination of symptoms and highlight the importance of considering rarer differentials in the face of an evolving clinical picture. Our case also demonstrates that once the correct diagnosis is reached, patients can make an excellent recovery from uncomplicated spinal abscesses.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9986544","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}
引用次数: 0
Intermittent colonic exoperistalsis for chronic constipation in spinal cord-injured individuals. A long-term structured patient feedback survey to evaluate home care use. 间歇性结肠外蠕动治疗脊髓损伤患者的慢性便秘。一项评估家庭护理使用的长期结构化患者反馈调查。
IF 1.2
Spinal Cord Series and Cases Pub Date : 2023-07-29 DOI: 10.1038/s41394-023-00597-z
Jana Bremer, Jörn Bremer, Maike König, Peter Koßmehl, Ines Kurze, Jeannette Obereisenbuchner, Elisabeth Weinschenk, Immaculada Herrero-Fresneda
{"title":"Intermittent colonic exoperistalsis for chronic constipation in spinal cord-injured individuals. A long-term structured patient feedback survey to evaluate home care use.","authors":"Jana Bremer,&nbsp;Jörn Bremer,&nbsp;Maike König,&nbsp;Peter Koßmehl,&nbsp;Ines Kurze,&nbsp;Jeannette Obereisenbuchner,&nbsp;Elisabeth Weinschenk,&nbsp;Immaculada Herrero-Fresneda","doi":"10.1038/s41394-023-00597-z","DOIUrl":"https://doi.org/10.1038/s41394-023-00597-z","url":null,"abstract":"<p><strong>Study design: </strong>Structured patient feedback survey evaluating real-world home care use.</p><p><strong>Objectives: </strong>To assess the long-term effectiveness, tolerability, and satisfaction with the intermittent colonic exoperistalsis (ICE) treatment device MOWOOT in spinal cord-injured (SCI) individuals with chronic constipation.</p><p><strong>Setting: </strong>Four specialized German hospitals.</p><p><strong>Methods: </strong>SCI individuals with chronic constipation were invited to use MOWOOT 10-20 min daily and answer a questionnaire about their bowel situation before treatment (feedback 1, F1) and after ≥10 months of use (feedback 2, F2). Collected variables were device use, bowel function effectiveness, chronic constipation symptoms, concomitant use of laxatives and evacuation aids, and satisfaction with bowel function and management, which were compared between time points. At F2, participants reported efficacy, tolerability/side effects, and ease of use.</p><p><strong>Results: </strong>Eleven participants used the device for a mean (SD) of 13.27 (4.03) months. From F1 to F2, mean time per evacuation decreased by 24.5 min (p = 0.0076) and the number of failed attempts to evacuate/week, by 1.05 (p = 0.0354) with a tendency toward increased bowel movements and softer stool consistency, and decreased incomplete bowel movements. Participants experienced decreased difficulty/strain (p = 0.0055), abdominal pain (p = 0.0230), bloating (p = 0.0010), abdominal cramps (p = 0.0019), and spasms (p = 0.0198), without significant changes in the use of laxatives and evacuation aids. Satisfaction with bowel function and management improved (p = 0.0095) and more participants reported being very satisfied/satisfied (p = 0.0300). Most reported tolerability, efficacy, and ease of use as very good/good.</p><p><strong>Conclusion: </strong>Long-term in-home ICE treatment improved bowel function and chronic constipation symptoms in SCI individuals, providing clinical benefits to this population.</p><p><strong>Sponsorship (mowoot devices lending): </strong>4 M Medical GmbH, Norderstedt, Germany.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10276621","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}
引用次数: 0
Spinal Rosai-Dorfman disease-a report of 2 cases and review of literature. 脊髓罗赛-多夫曼病--2 例病例报告和文献综述。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-07-29 DOI: 10.1038/s41394-023-00600-7
Saumyajit Basu, Rohan Gala, Kushal Gohil
{"title":"Spinal Rosai-Dorfman disease-a report of 2 cases and review of literature.","authors":"Saumyajit Basu, Rohan Gala, Kushal Gohil","doi":"10.1038/s41394-023-00600-7","DOIUrl":"10.1038/s41394-023-00600-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rosai-Dorfman Disease (RDD) is a rare benign histiocytic disease that infrequently affects the spine. We report two cases of spinal RDD and review the relevant literature. This report addresses the various diagnostic dilemmas related to the evaluation of Spinal RDD and its treatment.</p><p><strong>Case presentation: </strong>Case 1: A 32-year-old male presented with low back pain and left anterior thigh for last 8 months. On examination, there was sensory diminution on inner aspects of the thigh with an absent left knee jerk. CT/MRI scans revealed an extradural lesion at L2/3 with neural compression. PET scan showed several hypermetabolic lesions in ribs, humerus, femur, and vertebrae. He underwent en bloc excision of the extradural mass with L2-3 pedicle screw-rod fixation and was later managed with chemotherapy. Case 2: A 42-year-old male presented with spastic paraparesis with urinary incontinence for the last 4 weeks. On examination, he had a neurological level of T6. MRI scan revealed a lesion in posterior elements of T6-7 compressing the spinal cord. He underwent T6-7 laminectomy with decompression. In both cases, the diagnosis was confirmed by histopathology and further managed by Hemato-oncologist. They both did well at 1-year follow-up with improvement in neurology.</p><p><strong>Discussion: </strong>Spinal RDD to date remains a large diagnostic dilemma with no pathognomonic clinical or radiological features; mimicking many osteolytic lesions in the spine. The diagnosis is purely histopathological and immunological. The lesion's complete surgical excision is the mainstay of treatment with a better prognosis and decreased chances of recurrences.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973629","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}
引用次数: 0
A curious cervical spine case: multiple, primary CNS leiomyosarcomas presenting with rapid growth in the immunocompromised patient. 一个奇特的颈椎病例:免疫力低下患者中出现的快速生长的多发性原发性中枢神经系统白肌瘤。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-07-28 DOI: 10.1038/s41394-023-00588-0
Aleka Scoco, Kainaat Javed, Reza Yassari
{"title":"A curious cervical spine case: multiple, primary CNS leiomyosarcomas presenting with rapid growth in the immunocompromised patient.","authors":"Aleka Scoco, Kainaat Javed, Reza Yassari","doi":"10.1038/s41394-023-00588-0","DOIUrl":"10.1038/s41394-023-00588-0","url":null,"abstract":"<p><strong>Introduction: </strong>Primary CNS leiomyosarcomas are rare, dural-based intracranial or intravertebral tumors seen in immunocompromised patients and are associated with latent EBV infection. They may mimic a meningioma or schwannoma on imaging but their clinical presentation progresses much more rapidly. Often times, these tumors are hard to distinguish from secondary, metastatic leiomyosarcoma.</p><p><strong>Case presentation: </strong>A 30-year-old female with congenital HIV presented to clinic with shoulder pain, paresthesias of the right upper extremity and gait instability. She was noted to have a contrast enhancing dural-based spinal canal lesion measuring 1.5 cm at the C1 vertebral level on MRI. Surgery was proposed but patient deferred. She represented to our Emergency Department 1 month later with right-sided hemiparesis and difficulty with ambulation. On repeat MRI, the lesion had grown to 2.6 cm. She was taken to the OR emergently for gross total tumor resection. The histopathology demonstrated a primary CNS leiomyosarcoma. MRI scan of the brain revealed an extra-axial right frontal lobe lesion measuring 1.8 cm which was also treated with subtotal surgical resection followed by proton beam radiotherapy.</p><p><strong>Discussion: </strong>Primary CNS leiomyosarcomas should be considered in young immunocompromised patients presenting with dural-based spinal cord tumors. Histopathological studies including EBV testing can definitively make the diagnosis. These tumors have an aggressive nature and need to be treated with complete surgical resection to prevent severe neurological deterioration and adjuvant therapy to prevent recurrence.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294131","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}
引用次数: 0
Clinical profile of COVID-19 infection among persons with spinal cord injury: a case series. 脊髓损伤患者感染 COVID-19 的临床概况:病例系列。
IF 0.7
Spinal Cord Series and Cases Pub Date : 2023-07-18 DOI: 10.1038/s41394-023-00592-4
Chinzah Zonunsanga, Vanlal Hruaii, Joseph Chhakchhuak Vanlalsanga, Lalnuntluanga Sailo, Asem Rangita Chanu
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