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Central Cord Syndrome in a Young Patient with Early Diffuse Idiopathic Skeletal Hyperostosis and Ossification of the Posterior Longitudinal Ligament after Minor Trauma: A Case Report and Review.

Galgano M, Chin LS - Cureus (2015)

Bottom Line: The patient presented with tetraparesis, predominating with significant distal upper extremity weakness and hyperpathia.We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws.An increased risk of spinal cord injury is a known risk in individuals with pre-existing spinal ankylosing.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurosurgery, SUNY Upstate Medical University.

ABSTRACT
This paper is a case report and literature review. The objective of this article is to address a rather unusual case of central cord syndrome in a patient with diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament. We also discuss the mechanism of injury in central cord syndrome, as well as that specific to involvement of diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL). This case took place at SUNY Upstate Medical University. We report a case of a 39-year-old male with early diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament, presenting with central cord syndrome after minor trauma. The patient presented with tetraparesis, predominating with significant distal upper extremity weakness and hyperpathia. We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws. Since surgery, the patient has had a steady progressive improvement in neurological function and is currently ambulating with a good functional use of his upper extremities. An increased risk of spinal cord injury is a known risk in individuals with pre-existing spinal ankylosing. Few reports are present citing the contribution of focal OPLL with DISH in this age group within the cervical spine contributing to the central cord syndrome.

No MeSH data available.


Related in: MedlinePlus

Postoperative sagittal cervical spine CTIntrumentation from C2-C7
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FIG3: Postoperative sagittal cervical spine CTIntrumentation from C2-C7

Mentions: No thoracic or lumbar spine fractures were noted. However, the patient did have scattered anterior thoracic osteophytic processes as well as very thickened ligamentum flavum at multiple regions posteriorly. Upon admission to the surgical intensive care unit, he was started on a methylprednisolone drip. The patient’s upper extremity function continued to decline, and we opted to intervene with surgical intervention. We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws. Intraoperatively, there was evident hypermobility between C3 and C4. Obvious distraction was visualized between the right C3 inferior articulating process and C4 superior articulating process. Postoperative CT and MRI scans showed adequate hardware placement (Figure 3).


Central Cord Syndrome in a Young Patient with Early Diffuse Idiopathic Skeletal Hyperostosis and Ossification of the Posterior Longitudinal Ligament after Minor Trauma: A Case Report and Review.

Galgano M, Chin LS - Cureus (2015)

Postoperative sagittal cervical spine CTIntrumentation from C2-C7
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4503412&req=5

FIG3: Postoperative sagittal cervical spine CTIntrumentation from C2-C7
Mentions: No thoracic or lumbar spine fractures were noted. However, the patient did have scattered anterior thoracic osteophytic processes as well as very thickened ligamentum flavum at multiple regions posteriorly. Upon admission to the surgical intensive care unit, he was started on a methylprednisolone drip. The patient’s upper extremity function continued to decline, and we opted to intervene with surgical intervention. We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws. Intraoperatively, there was evident hypermobility between C3 and C4. Obvious distraction was visualized between the right C3 inferior articulating process and C4 superior articulating process. Postoperative CT and MRI scans showed adequate hardware placement (Figure 3).

Bottom Line: The patient presented with tetraparesis, predominating with significant distal upper extremity weakness and hyperpathia.We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws.An increased risk of spinal cord injury is a known risk in individuals with pre-existing spinal ankylosing.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurosurgery, SUNY Upstate Medical University.

ABSTRACT
This paper is a case report and literature review. The objective of this article is to address a rather unusual case of central cord syndrome in a patient with diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament. We also discuss the mechanism of injury in central cord syndrome, as well as that specific to involvement of diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL). This case took place at SUNY Upstate Medical University. We report a case of a 39-year-old male with early diffuse idiopathic skeletal hyperostosis and focal ossification of the posterior longitudinal ligament, presenting with central cord syndrome after minor trauma. The patient presented with tetraparesis, predominating with significant distal upper extremity weakness and hyperpathia. We performed a C3-6 decompressive laminectomy, with C2 pars screws, and C3-7 lateral mass screws. Since surgery, the patient has had a steady progressive improvement in neurological function and is currently ambulating with a good functional use of his upper extremities. An increased risk of spinal cord injury is a known risk in individuals with pre-existing spinal ankylosing. Few reports are present citing the contribution of focal OPLL with DISH in this age group within the cervical spine contributing to the central cord syndrome.

No MeSH data available.


Related in: MedlinePlus