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Ganglion cyst of the ligamentum flavum: a rare cause of cervical spinal cord compression. A case report.
No full textGanglion cysts of the ligamentum flavum are
uncommon degenerative spinal lesions and
are mostly encountered in the lumbar spine.
Cervical localisation is rare and may cause
severe myelopathy. They accompany degenerative
changes of the spine and can be
differentiated from synovial and other
degenerative spinal cysts on the basis of
location and histopathological features.
Ganglion cysts of the ligamentum flavum
are unusual extradural spinal lesions and
most have been reported in the lumbar
region. Cervical localisation is an extremely
rare cause of myelopathy and, to our
knowledge, only three cases have been
reported.1 2 Differentiation of ganglion cysts
of the ligamentum flavum from other
degenerative spinal cysts is still debated.1e4
We report a case of ganglion cyst of the
ligamentum flavum in the cervical spine,
presenting as progressive tetraparesis due to
severe spinal cord compression
Ascesso epidurale cervicale. Esperienza di trattamento microchirurgico in otto pazienti, compresi due casi di infezione mista tubercolare e piogenica
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Microsurgery for recurrent lumbar disk herniation at the same level and side: do patients fare worse? Experience with 95 consecutive cases.
No full textBACKGROUND: In reviewing our experience with reoperation of RLDH, our aim was mainly to determine whether patients fared worse than after primary surgery. We found no uniform answers to this question in the literature.
METHODS: The data of 95 patients (29 women and 66 men) who underwent reoperation for RLDH at the same level and side were analyzed retrospectively. Forty-two patients underwent the first operation in our clinic (recurrence rate, 2.6% of 1586 cases). Gadolinium-enhanced MRI was performed in all patients. Main clinical data of patients, pain-free interval, operation time, surgical complications, duration of hospital stay, and clinical improvement rate were recorded.
RESULTS: The mean pain-free interval was 55 months (range, 3-120 months). Levels of recurrent herniation were L4 through L5 and L5 through S1 (65% and 35% of cases, respectively). Revision surgery lasted longer on average than the previous diskectomy (P < .01) and was complicated by dural tear in 4 cases (4.2% vs 0.9% during primary diskectomy, P < .05). There were no significant differences between revision and previous surgery in terms of hospital stay. However, rates of excellent/good outcomes were significantly less for RLDH (89% vs 95%, P < .05); and the percentage of poor results was higher (2% vs 0.5%, P < .05). Age, sex, smoking, profession, trauma, level and degree of herniation, and pain-free interval were not correlated with clinical outcome.
CONCLUSION: Conventional microsurgery for RLDH showed lightly but significantly worse results than those of primary microdiskectomy. Patients contemplating reoperation should be informed of this fact and of the risk of dural tear and prolonged operation time
The soleus H-reflex recruitment curve: a possible early indicator of S1 root dysfunction
No full textAnterior cervical discectomy without fusion: clinical long-term outcome in a series of 133 patients undegoing surgery 5 to 18 years earlier
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Lombosciatalgia da patologia discale. Utilità della metodica di valutazione Mc Kenzie nella scelta del trattamento
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