Diagnosis Experience of Patients with Cervical, Thoracic and Lumbar Multi-Segment Spinal Stenosis: A Case Report and Literature Review

Background: The incidence of cervical, thoracic and lumbar spinal canal stenosis is low. It is difficult to identify the main focus and responsible segment, and it is also difficult to select the sequence of staging surgery. We report a patient with triple stenosis. Case Presentation: In this paper, we introduced a 61-year-old female patient with cervical, thoracic and lumbar spinal canal stenosis who had previously undergone “lumbar discectomy” in the outer hospital. The postoperative effect was not good and the symptoms were poor. The diagnosis was “cervical spinal stenosis and lumbar postoperative surgery”. The staged spinal canal decompression operation and Duhuo Jisheng Decoction (DHJSD) treatment were conducted in our hospital. After three months of follow-up, the functional and imaging results were satisfactory. Conclusions: The main focus and responsible spinal segment should be determined by the comprehensive analysis of medical history, signs, and images. Surgery combined with Chinese herbal medicine DHJSD therapy may be an effective treatment for this kind of disease.

Percutaneous endoscopic removal of a residual foreign body at the orbital-cranial region after transorbital penetrating injury:a novel minimally invasive technique

Background: The orbit is susceptible to traumatic injuries, and surgical management of transorbital penetrating injury with foreign body retention is challenging due to the associated risks of nervous and vascular injury. Application of multiple imaging modalities is helpful for the preoperative surgical planning, and technical advances in percutaneous endoscopy would render the surgical approach even less invasive. Case presentation: We present a 60-year-old female patient with a transorbital penetrating injury (TPI) caused by a bamboo stick in her right eye. The bamboo stick was initially pulled out at the emergency room but, 1 month later, massive bleeding from her nose and mouth occurred. CT and CTA revealed a foreign body in the right orbito-cranial region and a traumatic aneurysm at the right internal carotid artery. Endovascular embolization was first delivered to treat the aneurysm, and the remains of the bamboo stick were completely removed with a percutaneous endoscope. The patient was discharged 1 week later. Conclusions: A careful preoperative examination by multiple imaging modalities, e.g., CT, MRI, and DSA are essential for the correct diagnosis and surgical planning for the patient with a TPI. We minimised the associated risks of vascular and nervous injuries during foreign body removal by sequential application of the endovascular intervention and percutaneous endoscopic technique.