Presentation
Results: The patient had an NMO flare constituting Myeloradiculopathy, a rare presentation of NMOSD. She received Plasmapharesis with near complete resolution of her symptoms. Conclusions: Myeloradiculopathy is an uncommon presentation of NMO. [neurology.org]
Tumoral calcinosis is a rare tumoral calcium pyrophosphate dihydrate crystal deposition disease which presents as periarticular soft tissue calcification. [ncbi.nlm.nih.gov]
Case Presentation A 66-year-old male patient, usually in good health, presented progressive paraparesis of three weeks’ duration. Three months prior to admission, he had worked hard for four to five hours a day for three months. [hindawi.com]
A clinical description of the disease is then presented and variations in India from the standard description are highlighted. [books.google.ro]
Entire Body System
- Pain
Neurological improvement was evaluated using the Japanese Orthopaedic Association (JOA) scoring system; radicular pain and deltoid muscle strength were also evaluated clinically. [ncbi.nlm.nih.gov]
T1 paresthesia, pain C7/T1, bilat. [hindawi.com]
Background: Cervical spondylosis causes pain and disability by compressing the spinal cord or roots. Surgery to relieve the compression may reduce the pain and disability, but is associated with a small but definite risk.. [cochrane.org]
- Asymptomatic
After the surgery, the patient had an immediate full recovery and was asymptomatic by the 6-month examination. No operative complications were reported. The histologic report confirmed the presence of a synovial cyst. [journals.sagepub.com]
Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis. Neuroradiology 2003; 45 : 727–729. 24. Kozlowski K. Late spinal blocks after tuberculous meningitis. AJR Am J Radiol 1963; 90 : 1220–1226. 25. [nature.com]
Asymptomatic degenerative disk disease and spondylosis of the cervical spine: MR imaging. Radiology. 1987 Jul. 164(1):83-8. [Medline]. Brown BM, Schwartz RH, Frank E, Blank NK. [emedicine.medscape.com]
In most instances it will remain asymptomatic. However, in some persons the stenosis of the spinal canal leads to a compression of the spinal cord. [bmcmusculoskeletdisord.biomedcentral.com]
- Surgical Procedure
CONCLUSIONS: The aforementioned surgical procedure was safely completed and the surgical outcomes were satisfactory for CSRM including CSA. The instability (the angulation and the vertebral slippage) did not significantly change after surgery. [ncbi.nlm.nih.gov]
Conclusions The aforementioned surgical procedure was safely completed and the surgical outcomes were satisfactory for CSRM including CSA. The instability (the angulation and the vertebral slippage) did not significantly change after surgery. [thejns.org]
It can be considered as the optimal surgical procedure due to providing complete union at the last follow-up and no complications in the radiologic and clinical studies. [synapse.koreamed.org]
Surgical Procedures Approach The external occipital protuberance (inion) and the spinous processes of C2 and C7 serve as landmarks of the midline. [musculoskeletalkey.com]
Decompressive laminectomy along with debridement is the most frequent surgical procedures employed in these patients. [nature.com]
- Arm Pain
T1 paresthesia, pain C7/T1, bilat. [hindawi.com]
As regard clinical state there was a statistically significant improvement in VAS in neck and arm pain (p<0.001), and also in NDI (p<0.001). All cases with myelopathy had significant satisfactory improvement in spasticity with improved ability. [mjcu.journals.ekb.eg]
By placing the open-side gutter on the side of the arm pain and making the gutter slightly wider and outside, the multilevel intervertebral foramen can be decompressed simultaneously. [musculoskeletalkey.com]
[…] and bilateral buttock and leg pain. [orthobullets.com]
- Turkish
Joint Diseases and Related Surgery is an official publication of the Turkish Joint Diseases Foundation. [tevak.org]
Spinal Görüntüleme Bulgusu Olan ve Subakut Kombine Dejenerasyon Tanısı Alan Sekiz Hastanın Klinik, Demografik ve Radyolojik Özellikleri, Ondokuz Mayıs Üniversitesi, Nöroloji, Samsun, Türkiye, Journal of Neurological Sciences [Turkish] 2011, 28: 29; 552 [medicaljournal.gazi.edu.tr]
Gastrointestinal
- Vomiting
[…] enteroviruses and influenza Neisseria meningitidis (meningococcal) disease Other causes of bacteremia including Streptococcus pneumoniae and Haemophilus influenzae Other diseases including Henoch Schonlein purpura, ITP and leukaemia Illness characterised by vomiting [rch.org.au]
Many children with Henoch-Schonlein purpura develop belly pain, nausea, vomiting and bloody stools. These symptoms sometimes occur before the rash appears. Kidney involvement. Henoch-Schonlein purpura can also affect the kidneys. [mayoclinic.org]
Gut problems such as nausea, vomiting, diarrhea, or stomach pain. Kidney problems, particularly protein or blood in the urine. Excessive tiredness. [medicalnewstoday.com]
- Nausea
Gut problems such as nausea, vomiting, diarrhea, or stomach pain. Kidney problems, particularly protein or blood in the urine. Excessive tiredness. [medicalnewstoday.com]
- Abdominal Pain
Symptoms of Henoch-Schonlein Purpura The classic symptoms of HSP are rash, joint pain and swelling, abdominal pain, and/or related kidney disease, including blood in urine. [webmd.com]
Most adults experience symptoms including: nausea, poor appetite, abdominal pain, fatigue, jaundice (yellow eyes and skin), and dark urine. Although the symptoms resolve over several weeks, fatigue can be prolonged. [instagramwebs.com]
The symptoms of HSP usually begin suddenly and may include headache, fever, loss of appetite, cramping, abdominal pain, painful menstruation, hives, bloody diarrhea, and joint pain. Red or purple spots typically appear on the skin (petechiae). [rarediseases.org]
Henoch-Schonlein purpura can also cause abdominal pain and aching joints. Rarely, serious kidney damage can occur. Henoch-Schonlein purpura can affect anyone, but it's most common in children between the ages of 2 and 6. [mayoclinic.org]
If the clinical picture is suggestive of Henoch Schonlein purpura (purpura on the lower limbs and buttocks in a well child, with or without arthritis or abdominal pain), treat as per HSP guideline Petechiae in well children due to mechanical causes Children [rch.org.au]
- Dysphagia
Cervical spondylotic dysphagia. South Med J. 1977 May. 70(5):613-4. [Medline]. Umerah BC, Mukherjee BK, Ibekwe O. Cervical spondylosis and dysphagia. J Laryngol Otol. 1981 Nov. 95(11):1179-83. [Medline]. Sobol SM, Rigual NR. [emedicine.medscape.com]
• Serum matrix Gla protein may be a marker of osteometabolic syndromes, such as DISH, that cause hyperostosis.11 22. complications attributable to DISH -• dysphagia, unstable spinal fractures, spinal stenosis, postsurgical heterotropic ossifications, [slideshare.net]
Dysphagia (usually a late feature with significant speech difficulties). Accompanying emotional lability (inappropriate laughing or crying) - as with pseudobulbar palsies. [patient.info]
[…] and migration 7-20% with two level anterior corpectomies two-level corpectomies should be stabilized from behind Postlaminectomy kyphosis treat with anterior/posterior procedure Postoperative axial neck pain Vertebral artery injury Esophageal Injury Dysphagia [orthobullets.com]
Musculoskeletal
- Osteophyte
Osteophytes in the neural foramina, most commonly between C5 and C6 or C6 and C7, can cause radiculopathy (a nerve root disorder). Sometimes the cord and nerve roots are affected, causing radiculomyelopathy. [msdmanuals.com]
The extra mobility between adjacent vertebral areas probably results in osteophyte formation. [thamburaj.com]
Cervical osteophytes: a cause of potentially life-threatening laryngeal spasms. Case report. J Neurosurg Spine. 2006 May. 4(5):419-20. [Medline]. Kanbay M, Selcuk H, Yilmaz U. Dysphagia caused by cervical osteophytes: a rare case. [emedicine.medscape.com]
- Neck Pain
C6 paresthesia C3/4, lt MRI, OR, histology connection (−) C3–6 laminectomy Rapid recovery unknown F-U Yamamoto et al., 2001 2 81/m Progr. paraparesis, 1 mo neck pain, bilat. arm leg paresthesia C3/4, lt MRI, OR, histology connection (−) Laminectomy [hindawi.com]
Further investigation will include the association of chronic neck pain and postoperative kyphosis, and high fusion rates among a veteran population of heavy smokers. [ncbi.nlm.nih.gov]
The clinical manifestations of cervical myelopathy include neck/shoulder pain, numbness/weakness of four limbs, sensorimotor impairment, and sociopsychological dysfunction. [clinicaltrials.gov]
Detailed Study Description Neck pain, which is common in population recently, is causing the huge burden in the global medical service system. [centerwatch.com]
- Lordosis
Cervical lordosis, flexion-extension angles, range of motion (ROM), and the angulation and the extent of vertebral slippage at the affected nerve root levels were measured preoperatively and at last follow-up examination. [ncbi.nlm.nih.gov]
Cervical lordosis, flexion–extension angles, range of motion (ROM), and the angulation and the extent of vertebral slippage at the affected nerve root levels were measured preoperatively and at last follow-up examination. [thejns.org]
6 The posterior complex, including the lamina and supra- and interspinous ligaments, are preserved, serving as the reattachment sites for the paracervical muscles that may help restore cervical stability and maintain preoperative cervical lordosis.7 [musculoskeletalkey.com]
Loss of cervical lordosis is an early finding. Spinal cord narrowing correlates with myelopathy. Neurophysiologhical studies (EMG and nerve conduction studies) can be used when the diagnosis is in doubt. [thamburaj.com]
- Back Pain
pain and bilateral buttock and leg pain. [orthobullets.com]
Patients will frequently report moderate-to-severe back pain as a part of their initial symptomatology. [consultant360.com]
Most patients with vertebral involvement present with back pain, leg weakness and a gibbus deformity. [nature.com]
Neurologic
- Myelopathy
This study will provide a complete clinical management guideline in cervical myelopathy, which is expected to be globally leading reference in the management of cervical myelopathy. Clinical Study Identifier: NCT03396055 [centerwatch.com]
We report two cases of disabling myelopathy in association with pulmonary infection byMycobacterium kansasii andMycobacterium malmoense; the myelopathy is presumed to be a para-infectious phenomenon. [thorax.bmj.com]
T., Experimental cervical myelopathy. J. Neurosurg. 43 (1975), 9–17. PubMed Google Scholar 14. Guidetti, B., Fortuna, A., Long term results of surgical treatment of myelopathy due to cervical spondylosis. J. Neurosurg. 30 (1969), 714–721. [link.springer.com]
We report two cases of disabling myelopathy in association with pulmonary infection by Mycobacterium kansasii and Mycobacterium malmoense; the myelopathy is presumed to be a para-infectious phenomenon. ID: 4108158 [research.ed.ac.uk]
- Radiculopathy
Authors' conclusions: Both small trials had significant risks of bias and do not provide reliable evidence on the effects of surgery for cervical spondylotic radiculopathy or myelopathy. [cochrane.org]
One trial with 81 patients compared surgical decompression with either physiotherapy or cervical collar immobilization in patients with cervical radiculopathy. [ncbi.nlm.nih.gov]
[…] with cervical disc disorder ( M50.1 ) radiculopathy with lumbar and other intervertebral disc disorder ( M51.1- ) radiculopathy with spondylosis ( M47.2- ) Radiculopathy Approximate Synonyms Cervical (neck) radiculitis Cervical (neck) radiculopathy Cervical [icd10data.com]
- Cervical Radiculopathy
Authors' conclusions: Both small trials had significant risks of bias and do not provide reliable evidence on the effects of surgery for cervical spondylotic radiculopathy or myelopathy. [cochrane.org]
One trial with 81 patients compared surgical decompression with either physiotherapy or cervical collar immobilization in patients with cervical radiculopathy. [ncbi.nlm.nih.gov]
- Unable to Walk
Within a week she was readmitted with band-like thoracic pain associated with urinary incontinence, paraesthesiae in the legs, and worsening bilateral leg weakness such that she was unable to walk. [thorax.bmj.com]
Positive serology for Campylobacter jejuni, cytomegalovirus (CMV), Epstein-Barr virus (EBV), or Mycoplasma pneumoniae is more frequently associated with the severe form of the disease (unable to walk at the nadir). 30 While the sequence of pathophysiologic [consultant360.com]
[…] unassisted Grade 4 Unable to walk without assistance Grade 5 Wheelchair or bedbound Based on gait and ambulatory function Ranawat Classification Class I Pain, no neurologic deficit Class II Subjective weakness, hyperreflexia, dyssthesias Class IIIA Objective [orthobullets.com]
- Radiculitis
NOS Lumbar neuritis or radiculitis NOS Lumbosacral neuritis or radiculitis NOS Thoracic neuritis or radiculitis NOS Radiculitis NOS Type 1 Excludes neuralgia and neuritis NOS ( M79.2 ) radiculopathy with cervical disc disorder ( M50.1 ) radiculopathy [icd10data.com]
Treatment
This treatment protocol delivered rapid clinical benefits and long-term tumor control demonstrating the viability of SRS in the treatment of this difficult and rare condition. [ncbi.nlm.nih.gov]
One trial (68 patients with mild functional deficit associated with cervical myelopathy) found no significant differences between surgery and conservative treatment in three years following treatment. [cochrane.org]
Prognosis
However, most of the previous studies tend to justify patients, prognosis in a single dimension. [clinicaltrials.gov]
No evidence of any complications associated with irradiation was apparent, and the patient continued to demonstrate a positive prognosis. [ncbi.nlm.nih.gov]
Prognosis Gastrointestinal or pulmonary bleeding can be life-threatening. The long term prognosis depends on the extent of the renal involvement. [orpha.net]
Author/year Number of cases Age/sex Presenting symptom/signs Location Diagnostic modality Treatment Prognosis follow-up period Associated condition Takano et al., 1992 1 72/m Spastic paraparesis, 1 yr bilat. [hindawi.com]
Etiology
Such characteristic similarities in both clinical and radiologic features are important in considering the etiology of calcification of the cervical ligamenta flawa. [ncbi.nlm.nih.gov]
Etiology SHP is associated with deposition of IgA-dominant immune complexes in arterioles, capillaries, and venules, but the exact etiology remains unknown. [orpha.net]
Source: The Veterinary record 2001 v.148 no.13 pp. 403-407 ISSN: 0042-4900 Subject: etiology, blood serum, dogs, German Shepherd, alpha-tocopherol, chronic diseases Agid: 1537403 http://dx.doi.org/10.1136/vr.148.13.403 Links DOI: 10.1136/vr.148.13.403 [pubag.nal.usda.gov]
It brings together information on all aspects of OPLL - epidemiology, etiology, diagnosis, and treatment - with contributions by Japanese researchers and surgeons, including members of the Ministry of Health and Welfare Investigation Committee, and by [books.google.com]
Etiology• The etiology and pathogenesis of DISH is uncertain.• Research has focused on many possible risk factors, which include: – trauma or occupational stress, – Endocrine abnormalities including acromegaly, hypoparathyroidism, diabetes, growth hormone [slideshare.net]
Epidemiology
The characteristics of the virus, its epidemiology and the diag nosis and management of the various forms of infection are all considered. [books.google.ro]
It brings together information on all aspects of OPLL - epidemiology, etiology, diagnosis, and treatment - with contributions by Japanese researchers and surgeons, including members of the Ministry of Health and Welfare Investigation Committee, and by [books.google.com]
Each chapter begins with a shot historical account of the disease, followed by a critical evaluation of the epidemiological and/or hospital based data. This is then compared with the data of other global populations. [books.google.de]
Summary Epidemiology SHP usually affects children and is rare in adults. Annual incidence in children is estimated at between 1/6,660 and 1/4,880, whereas it is estimated at around 1/1,000,000 in adults. The male-to-female ratio is 1.5:1. [orpha.net]
Pathophysiology
View Article PubMed Google Scholar Baptiste DC, Fehlings MG: Pathophysiology of cervical myelopathy. Spine J. 2006, 6: 190S-197S. 10.1016/j.spinee.2006.04.024. [bmcmusculoskeletdisord.biomedcentral.com]
Pathophysiology Cervical spondylosis is the result of disk degeneration. As disks age, they fragment, lose water, and collapse. Initially, this starts in the nucleus pulposus. [emedicine.medscape.com]
Etiology and pathophysiology: The primary event is a progressive decrease in the degree of hydration resulting in loss of disc height, disc fibrosis and annular weakening. [thamburaj.com]
The characteristic bilateral occurrence and associated cervical subluxation at the involved segment supported the degenerative pathophysiology in the cyst. Conflicts of Interest The authors declare no conflicts of interest regarding this manuscript. [hindawi.com]
Schönlein-henoch purpura in children and adults: diagnosis, pathophysiology and management. Biodrugs. 2001;15:99-138. Saulsbury FT. Henoch-Schönlein purpura. Curr Opin Rheumatol. 2001;13:35-40. INTERNET Clowse MEB. Henoch-Schönlein purpura. [rarediseases.org]
Prevention
Getting prompt treatment will help prevent any potential complications. [healthline.com]
Chapter 69 Surrogate Markers of Antiretroviral Efficacy 826 Overcoming Barriers to Providing ARV Therapy in ResourceLimited Settings 831 Chapter 71 Antiretroviral Drugs for HIV Prevention 836 Chapter 72 Acute HIV Infection 843 Chapter 73 Opportunistic [books.google.com]
[…] in 19% of 84 cases of post-traumatic cerebrospinal fluid (CSF) rhinorrhea in one series.1 In the less common "spontaneous" CSF leaks, the incidence of meningitis is uncertain, since only a few isolated cases have been reported.2,3 Consequently, the prevention [jamanetwork.com]
In order to prevent damage to the spinal cord, the instrumentation should be completed before the laminectomy. [bmcmusculoskeletdisord.biomedcentral.com]