Document Detail


A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.
MedLine Citation:
PMID:  16227878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Case report with review of the literature. OBJECTIVES: To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy. SUMMARY OF BACKGROUND DATA: Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature. METHODS: Case study with extensive review of the literature. RESULTS: The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement. CONCLUSIONS: Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.
Authors:
Rob D Dickerman; Michael Lefkowitz; Joseph A Epstein
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Spine     Volume:  30     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-17     Completed Date:  2006-03-23     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E611-3     Citation Subset:  IM    
Affiliation:
North Texas Neurosurgical Associates, Department of Neurosurgery, HCA Medical Center of Plano, Plano, TX, USA. drrdd@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls*
Aged
Braces
Cervical Vertebrae*
Decompression, Surgical*
Female
Humans
Laminectomy
Magnetic Resonance Imaging
Postoperative Complications*
Spinal Cord Diseases / etiology*,  therapy
Spondylolysis / complications*,  diagnosis,  surgery*
Syndrome
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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