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Intravascular papillary endothelial hyperplasia as a rare cause of cervicothoracic spinal cord compression:A case report

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World Journal of Clinical Cases 2021年第34期9卷 10681-10688页

作者： Hong-Lin Gu Xiao-Qing Zheng Shi-Qiang Zhan Yun-Bing Chang Department of Spine Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080Guangdong ProvinceChina

BACKGROUND Intravascular papillary endothelial hyperplasia(IPEH)is a rare benign reactive vascular lesion that grows into an expansile compressing mass.It most commonly involves the skin and subcutaneous tissue.spinal involvement is rare,with only 11 reported cases in the literature.We report,to our knowledge,the first case of IPEH in the cervicothoracic spinal canal and present a literature review.CASE SUMMARY A 27-year-old man presented with acute-onset neck pain,numbness,and weakness in his extremities.Magnetic resonance imaging showed an epidural mass in the cervicothoracic(C6-T1)spinal canal and vertebral hemangioma(VH)involving the C7 vertebral body.C6-T1 Laminectomy and radical excision of the mass were performed.Histopathological examinations revealed papillary proliferation of vascular endothelial cells with thrombus formation,and an IPEH diagnosis was made.By his 6-mo follow-up appointment,his symptoms were relieved without recurrence.The possible pathogenesis,clinical and imaging features,differential diagnosis,and management of IPEH were reviewed.CONCLUSION We report,to our knowledge,the first case of IPEH in the cervicothoracic spinal canal,treated via complete resection,and showing a favorable outcome.We found a causal relationship between spinal IPEH and VH;this partly explains the mechanism of IPEH.

关键词： Intravascular papillary endothelial hyperplasia Cervicothoracic spinal cord compression Thrombosis Hemangioma Case report

Epidural spinal cord compression as initial clinical presentation of an acute myeloid leukaemia: case report and literature review

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Chinese Neurosurgical Journal 2016年第1期2卷 -页

作者： Dominique N'Dri Oka Alpha Boubacar Bah André Valentin Tokpa Louis Derou Department of Neurosurgery Teaching Hospital of Yopougon in Abidjan Ivory Coast 21 BP 632 Abidjan C(o)te d'lvoire Department of Neurosurgery Teaching Hospital of Conakry Conakry Guinea

Epidural localization of myeloid leukaemia is rarely reported. spinal cord compression as an initial presentation of acute myeloid leukaemia is extremely rare. This is a report of a 17-year-old black boy who presented to emergency department with neurological symptoms of spinal cord compression. Imaging modalities showed multiple soft tissue masses in the epidural space. After surgical treatment, histopathological examination of the epidural mass showed myeloid leukaemia cells infiltration. Literature review on Medline and “scholar Google” database was done. The characteristics and management of extra-medullary leukaemia are discussed. Granulocytic sarcoma, myeloid sarcoma or chloroma with acute myeloid leukaemia should be considered as part of epidural spinal cord compression. Therefore surgery is indicated on an emergent basis.

关键词： spinal cord compression Initial epidural localization Acute myeloid leukaemia

spinal cord compression Caused by Multifocal Histoplasmosis Treated Conservatively: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2016年第1期6卷 20-24页

作者： Dominique N’Dri Oka Alban Slim Mbende Daouda Sissoko Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

We present the case of a 39-year-old patient admitted for a slow thoracic spinal cord compression syndrome associated with lumbar rachialgia. CT scan and MRI of the thoracic spine showed lysis of T4, T5, T6 and T7 vertebrae, an epiduritis and paravertebral abscesses. CT scan of the lumbar spine demonstrated osteolysis of the left iliac wing with skin invasion. This lesion infiltrated the sacrum and the body of L5. The iliac lesion was biopsied and the analysis revealed a granulomatous osteitis caused by Histoplasma duboisii. The treatment consisted of ketoconazole 400 mg daily for six months. spinal decompressive surgery was not performed. Following antifungal treatment the patient had satisfying clinical and radiological outcome. After three years’ follow-up, the clinical course was uneventful. The patient had neither symptoms of spinal cord compression nor signs of further localizations.

关键词： Histoplasma duboisii Bone Multiple Localization spinal cord compression

A novel mouse model of central cord syndrome

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Neural Regeneration Research 2023年第12期18卷 2751-2756页

作者： Elzat Elham-Yilizati Yilihamu Xiangchuang Fan Zimeng Yang Shiqing Feng Department of Orthopedics Qilu Hospital of Shandong UniversityJinanShandong ProvinceChina Department of Orthopedics Tianjin Medical University General HospitalTianjinChina

Patients with potential spinal stenosis are susceptible to central cord syndrome induced by blunt trauma.Suitable animal models are helpful for studying the pathogenesis and treatment of such injuries.In this study,we established a mouse model of acute blunt traumatic spinal cord injury by compressing the C6 spinal cord with 5 and 10 g/mm~2 compression weights to simulate cervical central cord syndrome.Behavioral testing confirmed that this model exhibited the characteristics of central cord syndrome because motor function in the front paws was impaired,whereas basic motor and sensory functions of the lower extremities were retained.Hematoxylin-eosin staining showed that the diseased region of the spinal cord in this mouse model was restricted to the gray matter of the central cord,whereas the white matter was rarely affected.Magnetic resonance imaging showed a hypointense signal in the lesion after mild and severe injury.In addition,immunofluorescence staining showed that the degree of nerve tract injury in the spinal cord white matter was mild,and that there was a chronic inflammation reaction.These findings suggest that this mouse model of central cord syndrome can be used as a model for preclinical research,and that gray matter is most vulnerable to injury in central cord syndrome,leading to impaired motor function.

关键词： animal model behavior central cord syndrome cervical spinal cord injury cervical spinal cord pathology preclinical research spinal cord spinal cord compression spinal cord injury

Establishment and validation of standardized animal models of spinal cord injury by normal external force-caused fracture dislocation

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Neural Regeneration Research 2011年第35期6卷 2732-2738页

作者： Weibing Shuang Qiang Liu Shoubin Jiao Yang Yang Department of Urology the First Hospital of Shanxi Medical University Taiyuan 030001 Shanxi Province China Department of Urology the Sixth Agricultural Division Hospital of Xinjiang Production and Construction Corps Wujiaqu 831300 Xinjiang Uygur Autonomous Region China Department of Orthopedics the First Hospital of Shanxi Medical University Taiyuan 030001 Shanxi Province China

The duplication of animal models plays a key role in spinal cord injury research; however, there has been limited study into normal, external force-derived fracture dislocation. This study adopted experimental devices, designed in-house, to construct standardized ventral and dorsal spinal cord injury animal models of 6 g and 17 g falling from a height of 2, 4, and 10 cm, and 15, 30 or 50 g transversal compression on the spinal cord. The results showed that gradual increases in the degree of histopathological injury led to decreased Tarlov and Basso, Beattie and Bresnahan scores for the behavioral test, and increased Ashworth scores for the hind limb. Furthermore, there was a gradual decline in the slope test in the rats with dorsal spinal cord injury that correlated to increases in the falling substance weight or falling height. Similar alterations were observed in the ventral spinal cord injured rats, proportional to the increase in compression weight. Our experimental findings indicate that the standardized experimental rat models of dorsal and ventral spinal cord injury are stable, reliable and reproducible.

关键词： spinal cord injury spinal cord compression animal models external force fracture dislocation behavior histopathology

Laminectomy by craniotome for huge spinal extradural arachnoid cyst:a case report

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中华神经外科杂志（英文） 2016年第2期2卷 -页

作者： Bo Jin Ji-zong Zhao Han-bin Wang Ke-da Wang Long-qi Liu Yi-bing Su Department of Neurosurgery Beijing Jishuitan Hospital No.31 Xinjiekou East street Xicheng District Beijing 100035 China

spinal extradural arachnoid cyst is extremely rare. The longest SEACs that have been reported in previous studies involved no more than 5 spinal segments. This study presents a case of SEAC diagnosed from T9 to L4 and excised through a novel laminectomy/laminoplasty. A 22-year-old female presented with a 5-year history of progressive paraparesis and numbness in both lower limbs. MRI revealed posterolateral epidural cystic mass extending from T9-L4 with a length of 190 mm and width of 15 mm. The cyst was totally removed through surgery. The patient’s symptom was completely relieved 1 year after the surgery. There was no recurrence, compression on the spinal cord, or kyphotic deformity based on MRI and CT taken 1 year after. spinal extradural arachnoid cysts are relatively uncommon but surgically curable causes of myelopathy. For symptomatic patients, early surgical intervention is suggested for restoring neurological functions. Performing laminectomy by using crainotome is safe and efficient.

关键词： Extradural arachnoid cyst Laminectomy Laminoplasty spinal cord compression

Single-stage en bloc resection using a posterior approach for sacral tumors

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Oncology and Translational Medicine 2016年第2期2卷 65-68页

作者： Zhong Fang Wei Wu Wei Xiong Guanghui Li Hui Liao Jun Xiao Fengjing Guo Anmin Chen Feng Li Department of Orthopaedic Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

Objective This study aims to investigate the surgical results of single-stage en bloc resections using a posterior approach for sacral tumors and evaluate its benefit for these tumors.Methods A total of 32 cases involving patients with sacral tumors who were treated with single-stage en bloc resection by posterior approach from April 2004 to January 2010 were reviewed. The patient cohort included 20 males and 12 females. The average patient age was 49.1 years old(range, 18 to 75 years old). Twenty-seven patients suffered from primary sacral tumors, including 17 patients with chordomas, 5 patients with giant cell tumors of the bone, 3 patients with chondrosarcoma, 1 patient with sarcoma of the nerve fibers, and 1 patient with neurofibromatosis. Five patients were diagnosed with sacral metastatic tumors, including 2 cases of breast cancer, 1 case of renal carcinoma, 1 case of thyroid cancer, and 1 case of lung cancer. According to the Frankel grading system, there were 3 Grade B tumors, 4 Grade C tumors, 10 Grade D tumors, and 15 Grade E tumors. Results The operation took 265 min on average(range, 130–360 min), and blood loss was 1676 m L on average(range, 800–1800 m L) during the operation. The follow-up period ranged from 6 months to 6.2 years. All patients had pain prior to operation. Twenty-eight patients experienced complete pain-relief, and 4 patients experienced partial pain-relief after their operations. In all patients, neurological function was improved more than one grade using the Frankel grading system. Up to now, 5 patients experienced local recurrence after operation, and 2 patients were deceased. The remaining patients are still alive without recurrence. Conclusion Single-stage en bloc resection through a posterior approach for sacral tumors is feasible, safe, and effective. It has many advantages, such as controlling local recurrence, thorough decompression of the spinal cord, relieving pain, improving quality of life, and prolonging survival.

关键词： sacrum tumor en bloc resection spinal cord compression reconstruction

Metastatic spinal Tumors: Diagnostic Methods, Management and Prognosis at the Yaounde Central Hospital and Yaounde General Hospital

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Open Journal of Modern Neurosurgery 2024年第2期14卷 158-169页

作者： Nassourou Oumarou Haman Figuim Bello Orlane Ndome Toto Roland Ndouh Nchufor Nya Durand Bakop Ronaldo Foalou Anu Vincent de Paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Neurosurgery Department Yaounde General Hospital Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Facuty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly involved level II analgesia (64.36%). High dose

关键词： Metastases spinal Tumors Diagnosis Prognosis spinal cord compression

Compressive Myeloradiculopathies in Multiple Myeloma: Clinical and Radiological Characteristics of a Series of 29 Patients

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Open Journal of Blood Diseases 2021年第4期11卷 133-139页

作者： El Hadji Daouda Niang Mbodji Ahmadou Bamba Ka Mamadou Fall Seynabou Seck Moussa Mbaye Khalifa Ababacar Bousso Elimane Sarr Khadim Faye Atoumane Ndiaye Fatou Samba Diago Ndiaye Moustapha Diop Saliou Department of Haematology Cheikh Anta Diop University Dakar Senegal Department of Neurology Cheikh Anta Diop University Dakar Senegal Internal Medicine Service Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal

Introduction: Patients with multiple myeloma (MM) develop neurological complications such as root and/or spinal cord compression in at least 5% of cases. The aim of this work is to describe the clinical and radiological features of root and/or spinal cord compression occurring during multiple myeloma. Patients and Methods: We conducted a retrospective study in the Clinical Haematology Department of Dalal Jamm Hospital and the National Blood Transfusion Centre, the Neurological Clinic of Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec Hospital in Dakar between January 2016 and December 2019. All patients whose multiple myeloma diagnosis was established according to the International Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular compression, were included in our study. Results: A total of 29 patients were included. The average age was 54.31 years [32 - 76 years]. The sex ratio (M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the patients and spinal pains were reported by 93% of the patients. Neurological signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter disorders. The types of lesions showed by imaging were vertebral lysis in 100% of cases, vertebral compression in 37% of cases, and epidural infiltration in 34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%) had root compression, and 3 patients (10.34%) had my

关键词： Multiple Myeloma spinal cord compression Root compression Bone Lesions