PubMed · 16606778
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Yuval Karmon, Natan Gadoth. 2006. A head bulge.. https://doi.org/10.1001/archneur.63.4.606
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The past decade has witnessed significant advances in the surgical treatment of cervical myelopathy and myeloradiculopathy. In this article, we discuss in detail the indications for combined ventral and dorsal surgery for the treatment of cervical myelopathy and myeloradiculopathy. In addition, the advances in surgical technique and instrumentation in cervical spine surgery are explored. Finally, complication avoidance and management strategies are discussed. Combined ventral and dorsal decompression, reconstruction, and instrumentation procedures are viable options in the treatment of a select group of patients with complex cervical myelopathy or myeloradiculopathy.
CASE REPORT: An 11-month-old boy presented with a 3-month history of lower extremity weakness. CT and MRI of the spine revealed an enhancing epidural mass, extending from T1 through T5 and exiting through multiple foramina. The largest extraspinal extent was located at the T3 vertebral level and was accompanied by complete T3 vertebral collapse. A second lytic lesion at the L2 vertebral body without an obvious enhancing mass was also noted. Open biopsy and decompression of the spinal cord were performed, and histopathological analysis revealed a mixed inflammatory lesion with abundant S-100 and CD1a immunoreactive Langerhans cells consistent with the diagnosis of Langerhans cell histiocytosis (LCH). DISCUSSION: The authors present a very rare pediatric case of spinal LCH causing spinal cord compression. Possible clues to early detection, consideration of differential diagnoses, and a brief literature review are presented.
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