Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system but isolated primary spinal NCC is of very rare occurrence. The authors report a case of 44-year-old male, a postoperative case of multiple spinal NCC lesion excision 2 years ago, who presented with cauda equina syndrome and magnetic resonance imaging revealed a lesion mimicking an arachnoid cyst in the D1-9 region of the spinal cord. On intraoperative surgical exposure multiple cysts were found and excised. The suspicion of recurrence of NCC was confirmed by histopathology. Postoperatively there was significant improvement in neurological symptoms of the patient. Recurrence of primary spinal NCC should be considered in differential diagnosis of an arachnoid cyst if there is a definitive past history.
Objective The aim of this article was to analyze the clinical and radiological outcomes of transpedicular decompression (posterior approach) and anterolateral approach in patients with traumatic thoracolumbar spinal injuries.
Methods It was a prospective study of patients with fractures of dorsolumbar spine from December 2011 to December 2013. A total of 60 patients with traumatic spinal injuries were admitted during the study period (December 2011–2013), of which 51 cases were finally selected and taken for operations while 3 were eventually lost in follow-up. Twenty patients were operated by anterolateral approach, titanium mesh cage, and fixation with bicortical screws. Twenty-eight patients were treated with posterior approach and transpedicular screw fixation. Clinical and radiographic evaluations were performed on all 48 patients before and after surgery.
Results There were 48 patients of thoracolumbar burst fractures with 40 male and 8 female patients. Range of follow-up was from 1 month to 20 months, with a mean of 7.4. Preoperatively in anterior group, 65% of the patients were bed ridden, 20% patients were able to walk with support, and 15% of the patients were able to walk without support. In posterior group, 78.57% patients were bed ridden, 10.71% were able to walk with support, and 10.71% patients were able to walk without support. Kyphotic angle changes were seen in 16 patients out of 18 in anterior group and 20 patients in posterior group out of 25. Out of 18 patients in anterior group, 14 showed reduction in kyphotic angle of 10 to 100 (improvement), with mean improvement of 4.070. In posterior group, 7 patients showed improvement of 10 to 80 (reduction in kyphotic angle) whereas 13 patients showed deterioration of 1 to 120. The mean improvement was 2.140 in 7 patients and mean deterioration was 4.920. No statistical difference was found (p > 0.05) regarding improvement in urinary incontinence during the follow-up period.
Conclusion There are significant differences in anterior and posterior approaches in terms of clinical improvement. Compared with posterior approach, the anterolateral approach can reduce fusion segment and well maintain the kyphosis correction. The selection of treatment should be based on clinical and radiological findings, including neurological deficit.
Background?Lesions of the thoracic and lumbar spine are numerous. These lesions affect one or more columns (anterior, middle, and posterior) of the spine and compress the spinal cord either from anterior or posterior, giving rise to the features of radiculomyelopathy. These lesions can be approached either from the anterior or posterior aspect of the spine. We present our past 10 years' experience regarding the comparison between the two approaches.
Methods?Retrospective analysis of records of all patients with thoracic and lumbar lesion treated in our hospital between January 2005 and June 2014 was performed. Over the past 10 years, we came across 186 patients of thoracic and lumbar lesion who were operated either by anterior or posterior approach and were the focus of this study. Follow-up ranged from 6 months to 7 years.
Results?All the patients presented with neurological deficits. They were evaluated with investigation protocol of our hospital. Anterior approach was done in 38 cases (n?=?38), and posterior approach was done in 148 cases (n?=?148). We compared between the two groups in terms of perioperative complications, recovery, persisting symptoms, and mortality.
Conclusion?Complete recovery is better in the posterior approach (74.3 vs. 52.6%) and morality is more in the anterior approach (7.9 vs. 1.3%).
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