Document Detail

Cervical intradural disc herniation after spinal manipulation therapy in a patient with ossification of posterior longitudinal ligament: a case report and review of the literature.
MedLine Citation:
PMID:  20190620     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Case report and review of the literature. OBJECTIVE: To report a patient presenting with Brown-Sequard syndrome due to cervical intradural disc herniation after spinal manipulation therapy. SUMMARY OF BACKGROUND DATA: Spinal manipulation therapy (SMT) is often used by people with neck pain or discomfort as an alternative therapy due to its claimed less invasiveness and comparable efficacy. However, excessive manipulations are reported to cause rare but serious complications such as tetraplegia, vertebral artery dissection, epidural hematoma, and phrenic nerve injury. METHODS: Clinical history, physical examination, and radiographic findings of the patient were described. Anterior cervical discectomy at the C3/C4 level and interbody fusion with a Caspar plate-screw system for fixation, were performed. RESULTS: A favorable surgical outcome was obtained. The Brown-Sequard syndrome improved and the patient regained full muscle power at a 3-months follow-up. CONCLUSION: Cervical intradural disc herniation after SMT is rare and most often cause Brown-Sequard syndrome. Definite diagnosis and prompt surgery usually achieves a satisfactory outcome. Anterior discectomy with interbody fusion is recommended. The OPLL associated with degenerative disc reminds us of the increased risk of intradural disc herniation. Those high-risk groups should be more cautious with spinal manipulation therapy due to its serious sequelae.
Jung-Hao Hsieh; Chieh-Tsai Wu; Shih-Tseng Lee
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-05-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E149-51     Citation Subset:  IM    
Department of Neurosurgery, Chang Gung Memorial Hospital, Change Gung University, Taoyuan, Taiwan, Republic of China.
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MeSH Terms
Brown-Sequard Syndrome / diagnosis*,  etiology,  surgery
Cervical Vertebrae
Intervertebral Disk Displacement / complications,  diagnosis*,  surgery
Manipulation, Spinal / adverse effects*
Middle Aged
Ossification of Posterior Longitudinal Ligament / complications*,  radiography
Spinal Fusion
Treatment Outcome

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