In this report, we presented a case of solitary spine amyloidoma, its clinical and radiological findings and management, and a review of the literature on vertebral amyloidosis.
Amyloidosis/*complications/diagnosis/pathology ; Case Report ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Spinal Cord Compression/*etiology ; Spinal Diseases/*complications/diagnosis/pathology

Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis.
Decompression ; Diagnosis* ; Pathology ; Postoperative Complications ; Pseudarthrosis* ; Radiculopathy ; Risk Factors* ; Spinal Cord Diseases ; Spine*

Cervical disc disease and spondylosis have troubled human beings since the earliest recording of human ailment, encountered in term of one's life and still is one of the most intricated neurosurgical disorders, although there are a good many kind of diagnostic and surgical advances. Cervical disc disease has been studied more extensively and also diagnostic studies have developed considerably in recent times including myelography, computerized tomographic scan and magnetic resonance imaging. The treatment for cervical disc disease may be medical, surgical, or both but surgery, is increasingly popular owing to development of microanatomy, pathology, diagnostic tools and microsurgery. The surgical approaches to cervical disc disease have developed as the clinical syndrome, mechanisms of disease, and pathological changes that ensue have been better defined. Dramatic result of posterior decompressive laminectomy was reported by Horsley in 1901 and modified by Scoville, Kahn, Fager, and others. The anterior approach to compressive lesions, a more recent development by Robinson in 1955, by Cloward in 1958, and Boldrey, has become increasingly popular. The anterolateral approach, offered by Verbiest in 1968, provided an third avenue to the pathological cervical disc disease. Surgical results for cervical root compression can be relieved well, but myelopathy responds less well to decompression, provided the preoperative diagnosis is accurate and the operation is done carefully from either anterior or posterior approach. The authors has reviewed 79 cases cervical disc disease which treated surgically in Kyung Hee Medical Center from March, 1984 to May, 1990, the result as follows: 1) Cervical disc disease were more frequently encountered between 5th and 6th decades(67%) and the ratio of male to female was 2:1. 2) The symptom onset was acute in 58% of patients but the causes could not define clearly in 76% of patients. 3) The most frequent clinical symptom was pain in the neck(88.6%). 4) The most frequent site of disc herniation was C5-6 level as a single lesion, but the multiple level was effected in 12.7% of patients. 5) Postoperative complications were occurred in 11.4% of patients. 6) The prognosis was influenced by age, sex, time interval between the symptom onset and operation, and direction and character of disc herniation.
Decompression ; Diagnosis ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Microsurgery ; Myelography ; Pathology ; Postoperative Complications ; Prognosis ; Spinal Cord Diseases ; Spondylosis

Brain ; pathology ; Globus Pallidus ; pathology ; Hepatitis B, Chronic ; complications ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Diseases ; diagnosis ; etiology

BACKGROUNDOssification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy. This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF.

METHODSThe data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively. The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI). The clinical presentation and radiological characteristics in patients with SK were analyzed. Posterior en bloc laminectomy with OLF was performed, and the surgical results were evaluated.

RESULTSSK was found in seven patients (7.4%) based on preoperative MRI. The patients included one male and six females with an average age of 55.6 years (range, 48-64 years). Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis. In all cases, the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF. The degree of SK varied from mild to severe. The tip of the CM was located between the upper third of T11 to the lower third of L1, above the lower edge of L1. With an average follow-up of 30.4 months, the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t = 12.05; P < 0.0001) with an improvement rate of 63.1 ± 12.3%.

CONCLUSIONSSK is a rare radiological phenomenon. It is typically located at the thoracolumbar junction, where the CM is compressed by the OLF. Our findings indicate that these patients may benefit from a posterior decompressive procedure.

Female ; Humans ; Ligamentum Flavum ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Ossification, Heterotopic ; complications ; Radiography ; Spinal Cord Compression ; diagnosis ; diagnostic imaging ; surgery ; Spinal Cord Diseases ; diagnosis ; diagnostic imaging ; etiology ; surgery

Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Arteriovenous Malformations ; complications ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Sclerosis ; Spinal Cord Diseases ; complications ; metabolism ; pathology

Hepatic myelopathy is a rare complication of chronic liver disease that is associated with extensive portosystemic shunts. The main clinical feature of hepatic myelopathy is progressive spastic paraparesis in the absence of sensory or sphincter impairment. Early and accurate diagnosis of hepatic myelopathy is important because patients with early stages of the disease can fully recover following liver transplantation. Motor-evoked potential studies may be suitable for the early diagnosis of hepatic myelopathy, even in patients with preclinical stages of the disease. Here we describe two patients who presented with spastic paraparesis associated with a spontaneous splenorenal shunt and without any previous episode of hepatic encephalopathy. One patient experienced improved neurologic symptoms after liver transplantation, whereas the other patient only received medical treatment, which did not prevent the progression of spastic paraparesis.
Adult ; Disease Progression ; Evoked Potentials, Motor/physiology ; Hepatitis B, Chronic/complications/diagnosis ; Hepatitis C, Chronic/complications/diagnosis ; Humans ; Liver Cirrhosis/*complications/diagnosis ; Liver Transplantation ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paraparesis, Spastic/etiology/pathology ; Renal Veins/*radiography ; Spinal Cord Diseases/*diagnosis/etiology/radiography ; Splenic Vein/*radiography ; Tomography, X-Ray Computed ; Vascular Fistula/*radiography