The incidence of quadriplegia following drainage of cerebrospinal fluid by lumbar puncture (LP) below a spinal occupying lesion is rare. We report a case of acute quadriplegia following LP for presumed normal pressure hydrocephalus (NPH) in a 66-year-old man. Acute cervical myelopathy with a herniated cervical disc was subsequently found on magnetic resonance imaging (MRI) at the C5-6 level. After posterior decompression and anterior cervical discectomy and fusion at the C5-6 level with a cervical plate, the patient's motor and sensory functions recovered. Clinicians should be aware that symptoms of NPH and cervical myelopathy may overlap, and that serious complications may occur when performing LP below a spinal lesion. As a safety measure, cervical spine MRI should be performed before LP.
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http://dx.doi.org/10.13004/kjnt.2020.16.e39 | DOI Listing |
BMJ Open
January 2025
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
Introduction: Individuals with higher neurological levels of spinal cord injury (SCI) at or above the sixth thoracic segment (≥T6), exhibit impaired resting cardiovascular control and responses during upper-body exercise. Over time, impaired cardiovascular control predisposes individuals to lower cardiorespiratory fitness and thus a greater risk for cardiovascular disease and mortality. Non-invasive transcutaneous spinal cord stimulation (TSCS) has been shown to modulate cardiovascular responses at rest in individuals with SCI, yet its effectiveness to enhance exercise performance acutely, or promote superior physiological adaptations to exercise following an intervention, in an adequately powered cohort is unknown.
View Article and Find Full Text PDFN Am Spine Soc J
March 2025
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, United States.
Background: Laminectomy and fusion (LF) and laminoplasty (LP) are common treatments for cervical spondylotic myelopathy and myeloradiculopathy. While both procedures show similar clinical improvement, LF requires bony fusion while LP offers motion preservation. Cervical sagittal alignment and horizontal gaze maintenance are key outcome measures, but their comparative effects between LF and LP remain unclear.
View Article and Find Full Text PDFChilds Nerv Syst
January 2025
Department of Neurosurgery, Hospital da Restauração, Avenida Agamenon Magalhães, S/N, Derby, Recife, PE, 52171-011, Brazil.
Introduction: Glioblastomas (GBM) are aggressive tumors that make up about 7% of central nervous system tumors in children. Spinal GBMs (sGBMs) are extremely rare, accounting for less than 1% of pediatric spinal tumors. sGBMs are difficult to treat due to their infiltrative nature and cause significant morbidity.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Tuina and Spinal Orthopaedic in Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, 518033, China.
Purpose: To explore the relationship between paraspinal muscle degeneration and cervical spondylosis through cervical spine MRI and lateral X-ray.
Methods: A retrospective study included 83 cervical spondylosis patients as the experimental group, consisting of 28 axial joint pain (Group A), 29 cervical radiculopathy (Group B), and 26 myelopathy (Group C), as well as 29 healthy individuals as the control group (Group D). The cross-sectional area (CSA) of paraspinal muscles at the C3-4, C4-5, and C5-6 segments was measured, including the deep extensor area (DEA), deep flexor area (DFA), and superficial extensor area (SEA).
J Bone Joint Surg Am
January 2025
Department of Orthopedics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Background: In the setting of cervical open-door laminoplasty, the question of whether or not every opened laminar level should be instrumented has not been sufficiently investigated. We postulated that the surgical outcomes of open-door laminoplasty with instrumentation of every second opened level (skip-fixation) might not be inferior to those of laminoplasty with instrumentation of every opened level (all-fixation). The purpose of the present study was to test the noninferiority of laminoplasty with skip-fixation in improving myelopathy at 2 years postoperatively compared with all-fixation.
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