Neurapraxia of the cervical spinal cord with transient quadriplegia.

Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

“…Other findings diagnostic of, or consistent with, cervical myelopathy included a positive Hoffman sign, positive Romberg sign, impaired tandem walk and ankle clonus [1,9]. The abnormal pyramidal tract findings were accentuated by neck extension and flexion, maneuvers known to aggravate spinal cord compression in the face of spinal stenosis or ventral cervical disc protrusion or bone spurs [1,4,7,26,40,41,42,50]. The bilateral involvement of the upper and lower extremities and the presence of a high thoracic sensory level would localize the neurological abnormalities to the cervical spinal cord or cervicomedullary junction and would be consistent with, if not diagnostic of, the clinical diagnosis of cervical myelopathy.…”

“…Neck extension is known to reduce the antero-posterior spinal canal diameter as a result of increased disc protrusion, infolding of the ligamentum flavum and the gliding action facilitated by the horizontal orientation of the facet articular surfaces [4,26,40,42,48,50]. As the cervical spine is a dynamic structure, we felt that dynamic imaging would be more informative than static imaging.…”

“…2). A midsagittal diameter of 10 mm is acknowledged as stenotic and consistent with symptomatic spinal cord compression, i.e., cervical myelopathy [11,20,27,28,35,48,50]. In fact, Stanley et al concluded that 10 mm must be considered the lower limit of normal for the AP mid-sagittal diameter of the cervical spine, as imaged by CT scan.…”

Importance of checking prehospital neurological findings to reveal incidence of spinal cord concussion

“…Because of its rare incidence, there have been few reports concerning spinal cord concussion in English literatures and no reports in Japanese. [1][2][3][4][5][6] Previous reports of spinal cord concussion conclude that sports and falls were the leading cause of the injury, and that the most common site affected was the cervical or thoracolumbar junction among young subjects. There was controversy whether pre-existing abnormalities of the spine, such as spinal canal stenosis, can be a risk factor for the occurrence of spinal cord concussion.…”

“…There was controversy whether pre-existing abnormalities of the spine, such as spinal canal stenosis, can be a risk factor for the occurrence of spinal cord concussion. [2][3][4][5][6][7][8] We therefore investigated the incidence and characteristics of spinal cord concussion at our institute in an urban setting in Japan.…”