Cervical Intradural Disc Herniation After Spinal Manipulation Therapy in a Patient With Ossification of Posterior Longitudinal Ligament

Hsieh, Jung-Hao; Wu, Chieh‐Tsai; Lee, Shih-Tseng

doi:10.1097/brs.0b013e3181bee8a7

Cited by 27 publications

(17 citation statements)

References 14 publications

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“…Finding of intradural air on CT should also raise the suspicion for transdural herniation. 4,8 In our case the patient had a purely intramedullary mass with rim enhancement. The presence of significant cord edema might indicate direct trauma to the cord from the herniation; whereas the lack of diametrical cord expansion may negate an evolving intramedullary process.…”

Section: Discussionmentioning

confidence: 54%

Thoracic Myelopathy Due to an Intramedullary Herniated Nucleus Pulposus

Teufack

Campbell²,

Sharma

et al. 2012

Neurosurgery

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Section: Discussionmentioning

confidence: 54%

Thoracic Myelopathy Due to an Intramedullary Herniated Nucleus Pulposus

Teufack

Campbell²,

Sharma

et al. 2012

Neurosurgery

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“…It is conceivable that high-velocity adjustments could cause a fracture of the HO or contribute to disc derangement. 28,29 …”

Section: Discussionmentioning

confidence: 99%

Chiropractic Care of a Patient With Neurogenic Heterotopic Ossification of the Anterior Longitudinal Ligament After Traumatic Brain Injury: A Case Report

Morgan

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this case report is to describe the use of chiropractic care for a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament in the cervical spine and soft tissues of the right hip after a traumatic brain injury and right femur fracture. Clinical Features A 25-year-old military officer was referred to a hospital-based chiropractic clinic with complaints of pain and stiffness of the neck and back along with reduced respiratory excursions that began several months after a motor vehicle accident in which he had a traumatic brain injury. The patient had a fractured right femur from the accident, which had since been treated surgically, but had complications of heterotopic ossification in the soft tissues of the hip. His overall pain level was 3 of 10 on a verbal pain scale during use of oxycodone HCL/ acetaminophen. Chest excursion was initially measured at .5 cm. Intervention and Outcome: With the intent to restore respiratory chest motion and to reduce the patient's back and neck pain, the patient was placed on a program of chiropractic and myofascial manipulation, exercise therapy, and respiratory therapy. After a year of care, the patient rated overall pain at 3 of 10 verbal pain scale level but was no longer taking medications for pain and an increase in respiratory chest excursions measured at 3.5 cm. Conclusion: This case demonstrated that chiropractic treatment provided benefit to a patient with heterotopic ossification concurrent with musculoskeletal pain.

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“…Included in this review, a search of PubMed, Web of Science, and gray literature, for cases of acute onset (which we defined as a period of up to 2 weeks) rapidly progressive myelopathy. [24579101213141618192021] Three reported cases documented imaging findings of OPLL,[4910] and all three were treated with an anterior surgical decompression, with one case electing for additional posterior instrumentation. The clinical presentation of acute herniation leading to rapid, profound myelopathy often began with minor, focal neck pain, and slow progression of neurologic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Acute spontaneous cervical disc herniation causing rapidly progressive myelopathy in a patient with comorbid ossified posterior longitudinal ligament: Case report and literature review

2014

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Background:Ossification of the posterior longitudinal ligament (OPLL) and cervical disc herniation are commonly encountered neurosurgical conditions. Here we present an unusual case of nontraumatic rapidly progressive myelopathy due to cervical disc herniation with comorbid OPLL and conduct a literature review focusing on the frequency and management of disc herniations with OPLL.Case Description:A 52-year-old healthy female presented with a 72-h history of rapid progression of dense quadriparesis with sensory deficits, with a precedent 4-week history of nontraumatic midline neck pain. Clinical examination revealed profound motor deficits below the C5 myotome. Spinal neuroimaging revealed OPLL (computed tomography [CT]) and a cervical disc herniation spanning from C4/5 to C5/6 with significant retrovertebral disease (magnetic resonance imaging [MRI]). Operative management involved an anterior cervical corpectomy and instrumented fusion, with removal of both the sequestered disc material and the locally compressive OPLL. The patient recovered full motor function and independent ambulation with no residual signs or symptoms of myelopathy at the time of discharge.Conclusion:This unique case of a spontaneous cervical disc herniation in the context of OPLL causing rapidly progressive myelopathy illustrates the complementarity of CT and MRI in diagnosing the underlying cause of a rapidly progressive neurologic deficit in the absence of antecedent trauma. Though the optimal surgical management of such pathology remains uncertain; in this case, the anterior approach was motivated by the significant retrovertebral ventrally compressive sequestrum, and provided for excellent neurologic outcome. This article also reviews the occurrence/management of such acute cervical discs with OPLL.

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Cervical Intradural Disc Herniation After Spinal Manipulation Therapy in a Patient With Ossification of Posterior Longitudinal Ligament

Cited by 27 publications

References 14 publications

Thoracic Myelopathy Due to an Intramedullary Herniated Nucleus Pulposus

Thoracic Myelopathy Due to an Intramedullary Herniated Nucleus Pulposus

Chiropractic Care of a Patient With Neurogenic Heterotopic Ossification of the Anterior Longitudinal Ligament After Traumatic Brain Injury: A Case Report

Acute spontaneous cervical disc herniation causing rapidly progressive myelopathy in a patient with comorbid ossified posterior longitudinal ligament: Case report and literature review

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