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Maigne Syndrome and Thoracolumbar Compression Fracture – An Overlooked Combination in Low Back Pain: A Case Report

The Nerve.2025;11(1):21-25. doi:10.21129erve.2025.00710

Maigne syndrome, also known as thoracolumbar junction syndrome, is an underdiagnosed cause of low back pain that often involves superior cluneal nerve entrapment. This condition can overlap with osteoporotic vertebral compression fractures (OVCFs), complicating the diagnosis. We report two cases of elderly female patients with OVCFs and persistent buttock pain due to cluneal nerve entrapment. Both patients showed significant pain relief after undergoing L1 corpectomy and posterior pedicle screw fixation, with numeric rating scale scores dropping from 8 to 1-3. Early recognition of Maigne syndrome can improve outcomes in patients with atypical pain presentations.

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Ligamentum Flavum Cyst of the Lumbar Spine Causing Radiculopathy: A Rare Case Report and Review of Literature

Jun-Yong CHA ; Jun-Hyoung LEE ; Jae Hyeon LIM ; Il-Tae JANG

The Nerve.2025;11(1):10-14. doi:10.21129erve.2024.00591

Ligamentum flavum cysts (LFCs) are rare but clinically significant lesions in the lumbar spine. These cysts, often found incidentally, can mimic the symptoms of intervertebral disc herniation and cause radiculopathy. This article details a case involving an 80-year-old woman with severe lower back and radicular pain due to an LFC at the right L5/S1 facet joint that was unresponsive to conservative treatment. Magnetic resonance imaging and neurography confirmed that the cyst compressed the right S1 nerve root. Surgical excision via partial hemilaminectomy resulted in complete symptom relief and nerve decompression. Histopathological analysis identified the cyst as degenerative without a synovial lining. This case underscores the importance of considering LFCs in the differential diagnosis of neurogenic leg pain and highlights the efficacy of surgical excision for symptom resolution and preventing recurrence.

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Conditions Mimicking Cervical Radiculopathy – Key Shoulder Disorders and Diagnostic Insights: A Review Article

Jae-Yong SHIM ; Myung-Hoon SHIN

The Nerve.2025;11(1):1-9. doi:10.21129erve.2025.00724

Differentiating cervical radiculopathy from shoulder pathologies is challenging due to the overlap of symptoms such as pain, weakness, and paresthesia. This review highlights key aspects of cervical radiculopathy, including clinical history, neurological findings, and provocation tests, while also focusing on common shoulder conditions such as rotator cuff disorders, adhesive capsulitis, and calcific tendinitis. Cervical radiculopathy often presents with radiating pain, sensory disturbances, and motor weakness, which can easily be confused with symptoms stemming from shoulder pathologies. A detailed clinical history, including onset, duration, and aggravating or alleviating factors, plays a crucial role in distinguishing among these conditions. Neurological assessments, such as reflex testing and sensory evaluation, provide further insights into the nature of the symptoms and assist in identifying nerve root involvement.

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Carpal Tunnel Syndrome Caused by Idiopathic Tumoral Calcinosis: A Case Report

Joong Hyuk KIM ; Hyeon Gyu LIM ; Jae Hyoung KIM ; Shin Woo NAM ; Il-Tae JANG ; Eui-Jin CHO

The Nerve.2025;11(1):15-20. doi:10.21129erve.2025.00696

Carpal tunnel syndrome (CTS) is a common form of hand mononeuropathy that is typi-cally caused by median nerve compression. Although it is often idiopathic, CTS can also result from various conditions, including space-occupying lesions. Tumoral calcinosis, a rare condition characterized by periarticular deposition of calcified masses, is an un-common cause of secondary CTS. We present a case of a 78-year-old woman with idio-pathic tumoral calcinosis that caused secondary CTS. Despite conservative treatments, her symptoms persisted, and diagnostic imaging, including radiographs, computed to-mography, and magnetic resonance imaging, revealed a calcified mass in the carpal tun-nel. A surgical intervention involving carpal tunnel release and excisional biopsy con-firmed the diagnosis of tumoral calcinosis. Postoperatively, the patient showed complete resolution of symptoms, with no recurrence on follow-up radiographs. This case high-lights the importance of considering space-occupying lesions, such as tumoral calcinosis, as a rare but treatable cause of secondary CTS.

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Median Nerve Anatomy and Entrapment Syndromes

Se-Hyuck PARK

The Nerve.2024;10(1):7-18. doi:10.21129erve.2024.00549

Peripheral neuropathies, including entrapment or injury, are quite common and are encountered frequently. To ensure accurate diagnosis and effective treatment for these conditions, it is essential to have a comprehensive understanding of peripheral nerve anatomy and assessment techniques. This may involve the use of methods like ultrasonography, as well as requiring clinical proficiency. The median nerve, which is one of the main nerves in the upper extremity, primarily controls motor function in the flexor muscles of the forearm and hand. It is responsible for actions such as wrist flexion and the movement of the first three fingers. The purpose of this article is to enhance understanding and improve the diagnosis of peripheral nerve disorders, with a particular focus on neuropathies associated with the median nerve.

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Tarsal Tunnel Syndrome: A Narrative Review

Jahyung KIM ; Jaeho CHO

The Nerve.2024;10(1):1-6. doi:10.21129erve.2024.00528

Tarsal tunnel syndrome is a compressive neuropathy of the posterior tibial nerve beneath the flexor retinaculum on the medial ankle. Several intrinsic or extrinsic factors may contribute to pain over the medial plantar aspect of the foot that is aggravated by activities. In the presence of suggestive clinical features, appropriate use of radiographic and electrodiagnostic tests can be helpful. Surgical management is considered in patients who do not respond to non-operative treatment or those who have a space-occupying lesion within the tarsal tunnel. Along with surgical decompression of the posterior tibial nerve, complete removal of the causative space-occupying lesion is needed to prevent recurrence.

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Clinical Characteristics of Sciatica in Patients with Piriformis Syndrome Improved by Decompression Surgery

Dong-kwan LEE ; Byung-chul SON

The Nerve.2024;10(1):25-30. doi:10.21129erve.2024.00521

Objective: To clearly identify the symptoms of sciatica in patients with piriformis syndrome, we retrospectively reviewed patients whose symptoms significantly improved over long-term postoperative follow-up. Methods: Among patients who underwent sciatic nerve decompression for piriformis syndrome over the past 3 years, the preoperative sciatic pain symptoms of 32 patients whose symptoms were confirmed to have improved by more than 50% during more than 1 year of follow-up were analyzed. To identify the characteristics of sciatic pain in piriformis syndrome, we investigated pain when sitting, pain when resting, pain when standing or walking, and pain when resting at night. In addition, the distribution of sciatic pain in the lower back, buttocks, lower extremities, and feet was investigated. Results: The most common symptom was pain when sitting, which was present in 25 patients (81%). Pain characteristically occurred even at rest, occurring in 62.5% of patients while lying down at night and in 53.1% of patients during daytime rest. Sciatic pain from piriformis syndrome was most commonly distributed in the buttock (90.6%) and also present in the lower back (37.5%). Pain was present in the posterior thigh in 23 patients (71.9%), in the calf in 68.8% of patients, and in the foot in 50% of patients. Conclusion Buttock pain exacerbated by sitting was the most common pattern of pain in patients with piriformis syndrome. However, the sciatic pain of this disease was also found to be characterized by pain that persisted even at rest.

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Postoperative Thoracic Cord Compression Induced by a Dural Sealant System (DuraSeal®): A Case Report and Literature Review

Dong Soon JANG ; Seung Hun SHEEN ; Inbo HAN ; Soo Hyun LEE ; Woo Seok CHOI ; Minsung BOCK ; Seil SOHN

The Nerve.2024;10(1):57-62. doi:10.21129erve.2024.00535

Cerebrospinal fluid (CSF) leakage is a rare complication that can occur due to dural defects during spinal surgery, hindering the improvement of the surgical site and increasing the possibility of infection. DuraSeal® is a dural sealing adhesive that prevents CSF leakage and is used as an adjunct to enable the watertight repair of dural defects when the dura is damaged during spinal surgery. In the present case, DuraSeal® was applied to repair a dural defect in the surgical area after thoracic spine surgery, and no neurological problems occurred immediately after surgery. However, a day later, the patient’s paraparesis worsened; therefore, reoperation was performed and the symptoms improved.

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Parvimonas micra-Induced Paraspinal Abscess and Pyogenic Spondylitis Following Dental Extraction: A Case Report with a Brief Literature Review

Jae Wook YU ; Bu Kwang OH ; Dong Wuk SON ; Jun Seok LEE ; Su Hun LEE ; Soon Ki SUNG ; Sang Weon LEE ; Geun Sung SONG

The Nerve.2024;10(1):39-44. doi:10.21129erve.2023.00500

The increasing prevalence of pyogenic spondylitis in older adults is primarily driven by Staphylococcus aureus. Cases caused by anaerobic bacteria are rare. This report focuses on a 71-year-old man diagnosed with spondylitis due to an anaerobic bacterial infection. The causative pathogen—Parvimonas micra—is typically found in the oral cavity. Interestingly, the patient had undergone a tooth extraction before the diagnosis. He was successfully treated with antibiotics; therefore, surgery was not necessary. This case is notable for the uncommon infective organism and, along with a concise literature review, this report provides valuable insights for the medical community.

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Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review

Sang-Jeong SONG ; Jeong-Ho LEE ; Myung-Han RYU ; Min-Seok LEE ; Sang-Jun SUH ; Yoon-Soo LEE ; Soo-Ho CHO

The Nerve.2024;10(1):45-50. doi:10.21129erve.2024.00507

Glioblastomas, which are the most common primary malignant brain tumors in adults, occasionally exhibit radiological features similar to those of other diseases. However, instances of them mimicking meningiomas are rare. This article describes a rare case of a glioblastoma presenting with radiological features similar to those of a meningioma. A 55-year-old man was admitted following 2 months of gait disturbance, mild dysarthria, and dizziness. Magnetic resonance imaging suggested an extra-axial tumor in the interhemispheric fissure exhibiting a cerebrospinal fluid cleft sign, which was indicative of a meningioma. Bifrontal craniotomy for tumor resection revealed a highly vascularized, yellowish-gray friable mass within the interhemispheric fissure. The pathological diagnosis was glioblastoma. The patient’s symptoms improved following treatment with whole-brain radiotherapy and temozolomide chemotherapy, and his condition was stable during a 5-month follow-up period. Glioblastomas may present with radiological features similar to those of meningiomas, making it challenging for physicians to establish an accurate diagnosis and effective treatment plan.

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