Chronic progressive radiation myelopathy(CPRM) is a rare but serious complication of radiation therapy. It's exact cause is unknown and the diagnosis is usually made based on the exclusion of other causes of myelopathy. Magnetic resonance imaging(MRI) with gadolinium- diethylenetriamine pentaacetic acid(DTPA) enhancement seems to be useful for the diagnosis of CPRM. There is no known effective treatment and the complication is irreversible. We report a case of CPRM after radiation therapy for subglottic cancer which was not respond to high-dose steroid therapy with review of literature.
Diagnosis ; Spinal Cord Diseases*

Idiopathic spinal cord herniation is a rare spinal cord disorder caused by spinal cord prolapse through a adural defect. It is a curable disease, so early detection is of particular importance. We report a 38-year-old woman with Brown-Sequard syndrome which was caused by the thoracic spinal cord herniation. Her weakness was almost completely resolved after surgical management, which emphasizes the importance of early diagnosis and surgical management in this rare disease entity.
Adult ; Brown-Sequard Syndrome* ; Early Diagnosis ; Female ; Humans ; Prolapse ; Rare Diseases ; Spinal Cord Diseases ; Spinal Cord*

It is very difficult to differentiate radiation myelopathy from metastatic intramedullary spinal cord tumor. We described a case of chronic progressive radiation myelopathy, in which serial magnetic resonance imaging was of great value for the differential diagnosis.
Diagnosis, Differential ; Magnetic Resonance Imaging* ; Radiation Injuries ; Spinal Cord Diseases* ; Spinal Cord Neoplasms

The intraspinal extradural meningeal cyst is a rare cause of compression of spinal cord. The most common clinical presentation is a slowly progressive myelopathy, but our case was presented with polyradiculopathy at admission. The authors believe that our case is particularly attributable to a ball-valve mechanism involving an idiopathic dural rent and a herniated segment of an underlying dorsal rootlet in the operative finding. As in our case, magnetic resonance imaging provides accurate diagnosis to identify an intraspinal extradural meningeal cyst. Closure of dural rent with marsupialization of the meningeal cyst through minimal laminectomy can be successfully managed with favorable clinical outcome as in our case.
Diagnosis ; Laminectomy ; Magnetic Resonance Imaging ; Polyradiculopathy ; Spinal Cord ; Spinal Cord Diseases

There have been paucity of reports on atlas hypoplasia, and as a result this condition is not clearly defined, nor well understood. The authors reported three cases of atlas hypoplasia that were found in adults who presented with myelopathic symptoms. On radiographic examination, it was found that the anterior-posterior diameter of the atlas was remarkably narrower in all three cases in comparison with normal persons. The MRI in all three cases also revealed intramedullary high signal lesions at the levels where severe spinal cord compression was present. This led to our diagnosis of atlas hypoplasia causing myelopathy.
Adult* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Compression ; Spinal Cord Diseases*

The thoracic portion of the spinal cord is susceptible to compression by hypertrophic ossification of the spinal ligament in the thoracic spinal canal. Unlike ossification of the posterior longitudinal ligament(OPLL) in the cervical spine, however, thoracic myelopathy due to ossification of the ligamentum flavum(OLF) may be overlooked, misdiagnosed, or treated inappropriately. This is mainly because of lack of knowledge of this condition. We therefore describe our experience with 22 cases of thoracic myelopathy secondary to ossification of the ligamentum flavum among 45 cases of thoracic stenosis. The clinical manifestations of this condition and the results of its surgical treatment are described. The most common cause of thoracic stenosis was OLF(48.9%) and the most common symptoms were numbness or tingling in the legs(81.8%) and motor weakness of the lower extremities(72.7%). Radiologically, OLF occurred mainly at intervertebral segments T9-T10 through T12-L1(86.2%), the most prevalent site was T11-T12(31.0%). Most OLF involved multiple intervertebral segments(81.8%) particularly two or three segments (59.1%). Eleven of the 22 patients were also suffering from other ossified conditions such as OPLL(45.5%) at other spinal sites, suggesting that ossification has a common underlying etiology. According to the authors' experience, surgical treatment, particularly laminectomy, was usually successful and outcomes were very promising(excellent, 27.3% ; good, 45.5%). OLF of the thoracic spine is no longer an uncommon condition and the authors believe that early diagnosis and appropriate surgical treatment, before irreversible damage to the spinal cord has occurred, may be the key to better results.
Constriction, Pathologic* ; Early Diagnosis ; Humans ; Hypesthesia ; Laminectomy ; Ligaments ; Ligamentum Flavum* ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases ; Spinal Stenosis ; Spine

STUDY DESIGN: A case report. OBJECTIVES: To report a rare cause of non-traumatic spinal cord injury (SCI) during surfing SUMMARY OF LITERATURE REVIEW: Surfer's myelopathy is a non-traumatic SCI associated with the hyperextension posture during paddling in surfing. Although the definite pathomechanism has not been identified, cord ischemia followed by arterial infarction may be related to this injury. MATERIALS AND METHODS: A young healthy male patient presented with a SCI that occurred during his first time surfing. Magnetic resonance imaging revealed a T2-hyperintense lesion in the spinal cord from D10 to the conus medullaris. RESULTS: The patient completely recovered without any neurologic deficits after steroid therapy and other forms of supportive management. CONCLUSIONS: Since surfing is becoming more common in Korea, awareness of surfer's myelopathy is important for early diagnosis and proper management.
Early Diagnosis ; Humans ; Infarction ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Posture ; Spinal Cord ; Spinal Cord Diseases* ; Spinal Cord Injuries ; Spinal Cord Ischemia

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease, and it is characterized by chronic progressive inflammatory fibrosis and thickening of the dura mater with resultant compression of the spinal cord or neural structure without any identifiable cause. It can occur in the intracranial or spinal dura mater alone or as a craniospinal form. The spinal form is rarer than the cranial form and the craniospinal form is extremely rare. We report a rare case of IHP in the craniocervical junction involving both the cranial and spinal dura mater and discuss the diagnosis and management of the disease.
Diagnosis ; Dura Mater ; Fibrosis ; Meningitis* ; Rare Diseases ; Spinal Cord

Dynamic spinal cord compression has been investigated for several years, but until the advent of open MRI, the use of dynamic MRI (dMRI) did not gain popularity. Several publications have shown that cervical cord compression is both static and dynamic. On many occasions the evaluation of cervical spondylotic myelopathy (CSM) is straightforward, but patients are frequently encountered with a significantly worse clinical examination than would be suggested by radiological images. In this paper, we present an extensive review of the literature in order to describe the importance of dMRI in various settings and applications. A detailed literature review was performed in the Medline and Pubmed databases using the terms “cervical spondylotic myelopathy”, “dynamic MRI”, “kinetic MRI”, and “myelomalalcia” for the period of 1980-2016. The study was limited to English language, human subjects, case series, retrospective studies, prospective reports, and clinical trials. Reviews, case reports, cadaveric studies, editorials, and commentaries were excluded. The literature search yielded 180 papers, 19 of which met inclusion criteria. However, each paper had evaluated results and outcomes in different ways. It was not possible to compile them for meta-analysis or pooled data evaluation. Instead, we evaluated individual studies and present them for discussion. We describe a number of parameters evaluated in 2661 total patients, including dynamic changes to spinal cord and canal dimensions, transient compression of the cord with changes in position, and the effects of position on the intervertebral disc. dMRI is a useful tool for understanding the development of CSM. It has found several applications in the diagnosis and preoperative evaluation of many patients, as well as certain congenital dysplasias and Hirayama disease. It is useful in correlating symptoms with the dynamic changes only noted on dMRI, and has reduced the incidence of misdiagnosis of myelopathy.
Cadaver ; Cervical Cord ; Diagnosis ; Diagnostic Errors ; Humans ; Incidence ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Prospective Studies ; Retrospective Studies ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Diseases*

We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare.
Aged ; Decompression ; Diagnosis ; Gait Disorders, Neurologic ; Hand ; Humans ; Magnetic Resonance Imaging ; Spinal Canal ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Diseases* ; Spondylolysis