PubMed · 12956471
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Kenneth M Browne. 2003. Posterolateral disc herniation.. https://pubmed.ncbi.nlm.nih.gov/12956471/
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STUDY DESIGN: A case report of a child with quadriplegia as a result of neurofibromatosis type I who had cervical laminectomy for spinal cord decompression followed by occipitocervical instrumentation is described. OBJECTIVES: To describe the consequences of severe neurofibromatosis type I and an effective surgical technique of occipitocervical instrumentation. SUMMARY OF BACKGROUND DATA: Neurofibromatosis type I is one of the most commonly inherited genetic disorders in the human population. Extensive intraspinal involvement by neurofibromas can cause significant distortion of normal spinal structure as well spinal cord compression. Extensive laminectomy (with subsequent risk of postsurgical kyphosis) is often required for adequate decompression of the spinal cord. METHODS: The clinical and radiographic presentation of a child with severe neurofibromatosis type I resulting in quadriplegia is described. The severe neurologic deficit was caused by compression of the spinal cord by intraspinal neurofibromas. Extensive laminectomy was required to adequately decompress the spinal cord. Occipitocervical fusion from the occiput to C6 was done to stabilize the spine and prevent future kyphosis. RESULTS: Decompression of the spinal cord led to complete neurologic recovery, and instrumentation of the cervical spine was successful in preventing the development of postlaminectomy kyphosis in this pediatric patient. CONCLUSIONS: The reported case emphasizes the need for treating acute neurologic symptoms caused by spinal cord compression in neurofibromatosis type I as well as addressing the future risk of spinal deformity following laminectomy.
STUDY DESIGN: A case of cervical cord compression in an elderly lady with Hurler's syndrome is reported. OBJECTIVE: To report the occurrence of cervical cord compression in a 56-year-old patient of Hurler's syndrome, making her the oldest patient with Hurler's. The case report also highlights the appropriate management that could be given to this group of difficult patients. SUMMARY OF BACKGROUND DATA: The literature on Hurler's syndrome is reviewed in terms of long-term survival and surgical management of spinal compression. No report in the literature describes cervical spine decompression in Hurler's syndrome in a patient this old. METHOD: Clinical and radiologic features of Hurler's induced cervical cord compression are described. Pathologic changes of Hurler's myleopathy are also reported. RESULTS: The patient underwent cervical spine decompression and tolerated the procedure well. The patient was able to mobilize free of the wheel chair and showed significant neurologic recovery. CONCLUSION: The case report highlights the success of surgery in Hurler's induced cervical cord compression. It also adds to the literature the oldest patient of Hurler's syndrome to undergo any form of spinal surgery.We present here a 59-year-old lady with Hurler's syndrome, who underwent a successful cervical spine decompression and stabilization for cervical myelopathy. At 59 years of age, she was the oldest case of Hurler's to undergo spinal surgery. The case highlights the importance of undertaking major spinal surgeries in these difficult inherited disorders with reasonable success, as against common belief.
Phantom and in vitro studies were performed to evaluate the potential application of digital circular tomosynthesis in imaging of the breast and upper cervical spine. A prototype volumetric x-ray system was used to image a mammographic phantom, a fresh mastectomy specimen, and a head phantom containing the upper cervical spine. Results show that breast tissue visualization is improved by the ability to produce sectional images that blur overlying structures and yield three-dimensional information about calcification clusters. In upper cervical spine imaging, digital circular tomosynthesis effectively blurs overlying jaw and skull structures so that C1 and C2 can be visualized in a standard anteroposterior view.