BACKGROUND Primary intraspinal malignant melanoma is a very rare tumor that most often occurs in the cervical,thoracic,or thoracolumbar segment.CASE SUMMARY A rare case of primary thoracolumbar malignant melanoma is d...BACKGROUND Primary intraspinal malignant melanoma is a very rare tumor that most often occurs in the cervical,thoracic,or thoracolumbar segment.CASE SUMMARY A rare case of primary thoracolumbar malignant melanoma is described.A 45-year-old female patient complained of low back pain with numbness and fatigue in both lower limbs.MR revealed an intradural space-occupying lesion at the thoracic 12 to lumbar 1 level.The tumor was partially excised,and a malignant melanoma was confirmed by histopathology.CONCLUSION Primary intraspinal malignant melanoma has rarely been reported,and surgical resection and related characteristics and diagnoses have been discussed.展开更多
Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence ...Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence of the tumor and occurrence of kyphotic deformities. Preoperative clinical manifestations, imaging data, surgical records and follow-up results were comprehensively analyzed. The follow-up duration was 12-60 months with an average of 32.0 months. Out of the 73 cases enrolled, 69 had gradual recovery of sensation, motor and sphincter functions 1 week to 3 months after operation. Forty-six cases had incomplete paralysis, whose American Spinal Injury Association （ASIA） grades, however, were gradually increased during the follow-up period, 4 cases had no significant improvement of the clinical symptoms and no change in ASIA grades during the follow-up period. Two cases had postoperative recurrence of the tumor. There were no deaths, no spinal instability, and no kyphotic malformations fotmd in any cases. Our study indicated that complete removal of the tumor is important for good recovery, and an ideal surgical method may reduce the recurrence of the tumor or the occurrence of complications.展开更多
The currently recommended management for acute traumatic spinal cord injury aims to reduce the incidence of secondary injury and promote functional recovery.Elevated intraspinal pressure(ISP)likely plays an important ...The currently recommended management for acute traumatic spinal cord injury aims to reduce the incidence of secondary injury and promote functional recovery.Elevated intraspinal pressure(ISP)likely plays an important role in the processes involved in secondary spinal cord injury,and should not be overlooked.However,the factors and detailed time course contributing to elevated ISP and its impact on pathophysiology after traumatic spinal cord injury have not been reviewed in the literature.Here,we review the etiology and progression of elevated ISP,as well as potential therapeutic measures that target elevated ISP.Elevated ISP is a time-dependent process that is mainly caused by hemorrhage,edema,and blood-spinal cord barrier destruction and peaks at 3 days after traumatic spinal cord injury.Duraplasty and hypertonic saline may be promising treatments for reducing ISP within this time window.Other potential treatments such as decompression,spinal cord incision,hemostasis,and methylprednisolone treatment require further validation.展开更多
BACKGROUND Spontaneous spinal epidural hematoma is a rare neurosurgical emergency.CASE SUMMARY A 53-year-old healthy woman suffered from complete paraplegia in both legs and loss of all sensation below the xiphoid pro...BACKGROUND Spontaneous spinal epidural hematoma is a rare neurosurgical emergency.CASE SUMMARY A 53-year-old healthy woman suffered from complete paraplegia in both legs and loss of all sensation below the xiphoid process.She was diagnosed as acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma.The primary lab survey showed all within normal limits.Presence of a posteriorly epidural space-occupying lesion at the T4-T8 level of the spinal canal was confirmed on magnetic resonance imaging.A decompressive laminectomy was performed from the T4 to T7 levels at the sixth hour following abrupt onset of complete paraplegia.The lesion was confirmed as lymphangioma.This patient recovered well within one month.CONCLUSION This study reports a case of acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma with well recovery after surgical intervention.展开更多
Nonspecific neuronal activity elicited by intraspinal microstimulation in the intermediate and ventral gray matter of thoracic spinal segments caudal to a complete spinal cord transection significantly increased the r...Nonspecific neuronal activity elicited by intraspinal microstimulation in the intermediate and ventral gray matter of thoracic spinal segments caudal to a complete spinal cord transection significantly increased the rat hindlimb Basso, Beattie, Bresnahan locomotor score by activating the central pattem generator located in the lumbar spinal cord. However, the best region for intraspinal microstimulation is unclear. Using an incomplete spinal cord injury model at T8, we compared the use of intraspinal microstimulation to activate the spinal cord in rats with a spontaneous recovery group. The intraspinal microstimulation group recovered sooner and showed three kinds of movement： the left hindlimb, the left hindlimb toes, and the paraspinal muscles and tails. These had different microstimulation thresholds. There was mild hyperplasia of the astrocytes surrounding the tips of the microelectrodes and slight inflammatory reactions nearby. These results indicate that implantation of microelectrodes was relatively safe and induced minimal damage to the lumbar-sacral spinal cord. Intraspinal microstimulation in the lumbar sacral spinal cord may improve leg movements after spinal cord injury. Non-specific intraspinal microstimulation may be a novel technique for the recovery of spinal cord injuries.展开更多
目的探讨Intraspine椎板间动态稳定系统治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效。方法本研究对象为2016年4月~2018年4月本院收治的80例LDH患者,男48例,女32例;年龄(51.67±4.89)岁,L_(3~4)10例,L_(4~5)48例,L_(5)~S_...目的探讨Intraspine椎板间动态稳定系统治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效。方法本研究对象为2016年4月~2018年4月本院收治的80例LDH患者,男48例,女32例;年龄(51.67±4.89)岁,L_(3~4)10例,L_(4~5)48例,L_(5)~S_(1)22例,均采用髓核摘除联合Intraspine治疗,随访(34.12±6.35)个月。结果80例患者均完成手术,手术出血量(41.82±8.71)mL,手术时间(58.71±9.29)min,住院时间(4.88±0.68)d;术中无硬脊膜、神经损伤,随访期无残留腰腿痛;2例患者复发。术后3个月、末次随访时,患者的患病椎间隙高度(intervertebral space height,ISH)和节段活动度(range of motion,ROM)均较术前显著升高,腰、腿痛VAS评分和ODI指数较术前显著降低(P<0.05);患者末次随访时的ISH、ROM与术后3个月相比较,差异无统计学意义(P>0.05)。结论Intraspine治疗LDH操作简便,出血量少,并发症发生率低,近期疗效确切,能够提升并维持椎间隙高度,降低术后LDH复发率。展开更多
文摘BACKGROUND Primary intraspinal malignant melanoma is a very rare tumor that most often occurs in the cervical,thoracic,or thoracolumbar segment.CASE SUMMARY A rare case of primary thoracolumbar malignant melanoma is described.A 45-year-old female patient complained of low back pain with numbness and fatigue in both lower limbs.MR revealed an intradural space-occupying lesion at the thoracic 12 to lumbar 1 level.The tumor was partially excised,and a malignant melanoma was confirmed by histopathology.CONCLUSION Primary intraspinal malignant melanoma has rarely been reported,and surgical resection and related characteristics and diagnoses have been discussed.
文摘Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence of the tumor and occurrence of kyphotic deformities. Preoperative clinical manifestations, imaging data, surgical records and follow-up results were comprehensively analyzed. The follow-up duration was 12-60 months with an average of 32.0 months. Out of the 73 cases enrolled, 69 had gradual recovery of sensation, motor and sphincter functions 1 week to 3 months after operation. Forty-six cases had incomplete paralysis, whose American Spinal Injury Association （ASIA） grades, however, were gradually increased during the follow-up period, 4 cases had no significant improvement of the clinical symptoms and no change in ASIA grades during the follow-up period. Two cases had postoperative recurrence of the tumor. There were no deaths, no spinal instability, and no kyphotic malformations fotmd in any cases. Our study indicated that complete removal of the tumor is important for good recovery, and an ideal surgical method may reduce the recurrence of the tumor or the occurrence of complications.
基金supported by a grant from Chongqing Yingcai Plan Project,No.cstc2021ycjh-bgzxm0041(to ZXQ).
文摘The currently recommended management for acute traumatic spinal cord injury aims to reduce the incidence of secondary injury and promote functional recovery.Elevated intraspinal pressure(ISP)likely plays an important role in the processes involved in secondary spinal cord injury,and should not be overlooked.However,the factors and detailed time course contributing to elevated ISP and its impact on pathophysiology after traumatic spinal cord injury have not been reviewed in the literature.Here,we review the etiology and progression of elevated ISP,as well as potential therapeutic measures that target elevated ISP.Elevated ISP is a time-dependent process that is mainly caused by hemorrhage,edema,and blood-spinal cord barrier destruction and peaks at 3 days after traumatic spinal cord injury.Duraplasty and hypertonic saline may be promising treatments for reducing ISP within this time window.Other potential treatments such as decompression,spinal cord incision,hemostasis,and methylprednisolone treatment require further validation.
文摘BACKGROUND Spontaneous spinal epidural hematoma is a rare neurosurgical emergency.CASE SUMMARY A 53-year-old healthy woman suffered from complete paraplegia in both legs and loss of all sensation below the xiphoid process.She was diagnosed as acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma.The primary lab survey showed all within normal limits.Presence of a posteriorly epidural space-occupying lesion at the T4-T8 level of the spinal canal was confirmed on magnetic resonance imaging.A decompressive laminectomy was performed from the T4 to T7 levels at the sixth hour following abrupt onset of complete paraplegia.The lesion was confirmed as lymphangioma.This patient recovered well within one month.CONCLUSION This study reports a case of acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma with well recovery after surgical intervention.
基金the National Natural Science Foundation of China,No.30770744
文摘Nonspecific neuronal activity elicited by intraspinal microstimulation in the intermediate and ventral gray matter of thoracic spinal segments caudal to a complete spinal cord transection significantly increased the rat hindlimb Basso, Beattie, Bresnahan locomotor score by activating the central pattem generator located in the lumbar spinal cord. However, the best region for intraspinal microstimulation is unclear. Using an incomplete spinal cord injury model at T8, we compared the use of intraspinal microstimulation to activate the spinal cord in rats with a spontaneous recovery group. The intraspinal microstimulation group recovered sooner and showed three kinds of movement： the left hindlimb, the left hindlimb toes, and the paraspinal muscles and tails. These had different microstimulation thresholds. There was mild hyperplasia of the astrocytes surrounding the tips of the microelectrodes and slight inflammatory reactions nearby. These results indicate that implantation of microelectrodes was relatively safe and induced minimal damage to the lumbar-sacral spinal cord. Intraspinal microstimulation in the lumbar sacral spinal cord may improve leg movements after spinal cord injury. Non-specific intraspinal microstimulation may be a novel technique for the recovery of spinal cord injuries.
文摘目的探讨Intraspine椎板间动态稳定系统治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效。方法本研究对象为2016年4月~2018年4月本院收治的80例LDH患者,男48例,女32例;年龄(51.67±4.89)岁,L_(3~4)10例,L_(4~5)48例,L_(5)~S_(1)22例,均采用髓核摘除联合Intraspine治疗,随访(34.12±6.35)个月。结果80例患者均完成手术,手术出血量(41.82±8.71)mL,手术时间(58.71±9.29)min,住院时间(4.88±0.68)d;术中无硬脊膜、神经损伤,随访期无残留腰腿痛;2例患者复发。术后3个月、末次随访时,患者的患病椎间隙高度(intervertebral space height,ISH)和节段活动度(range of motion,ROM)均较术前显著升高,腰、腿痛VAS评分和ODI指数较术前显著降低(P<0.05);患者末次随访时的ISH、ROM与术后3个月相比较,差异无统计学意义(P>0.05)。结论Intraspine治疗LDH操作简便,出血量少,并发症发生率低,近期疗效确切,能够提升并维持椎间隙高度,降低术后LDH复发率。
