[Spinal cord compression by a cervical oseteocartilaginous exostosis: surgical strategy aspects]. / Rückenmarkskompression durch eine zervikale osteokartilaginäre Exostose: Operationsstrategische Aspekte.
Z Orthop Ihre Grenzgeb
; 142(2): 179-83, 2004.
Article
em De
| MEDLINE
| ID: mdl-15106063
ABSTRACT
AIM:
The authors present the therapeutic management of a 12-year-old boy with known hereditary multiple exostosis syndrome (HME), who developed spinal cord compression symptoms caused by an exostosis of the C2 lamina. A perinatal brain lesion with tetraparesis delayed the recognition of the spinal cord compression substantially, which resulted in an extensive spur-like growth of the exostosis.METHOD:
In comparison with already published cases, this growth pattern was rather unique and required consideration on the best surgical management. We decided to monitor the spinal cord function from positioning of the patient to skin closure and to modify the surgical steps of the laminectomy with initial lateral cutting of both hemilaminae.RESULTS:
Electrophysiological monitoring helped to avoid spinal cord compression by inadequate head anteflexion during positioning. Lateral cutting of the hemilaminae C2 resulted in spontaneous extrusion of the exostosis with immediate improvement of the electrophysiological findings. The boy experienced a prompt improvement of his neurological deficits.CONCLUSION:
The good surgical and clinical result confirm the value of the applied management concept.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Compressão da Medula Espinal
/
Exostose Múltipla Hereditária
/
Deslocamento do Disco Intervertebral
/
Cuidados Intraoperatórios
/
Laminectomia
Tipo de estudo:
Etiology_studies
Limite:
Child
/
Humans
/
Male
Idioma:
De
Revista:
Z Orthop Ihre Grenzgeb
Ano de publicação:
2004
Tipo de documento:
Article