Abstract
Study design: A case report.
Objectives: To report a case of swelling of the spinal cord and an intramedullary lesion occurring after expansive laminoplasty for cervical spondylotic myelopathy.
Setting: A university hospital in Japan.
Methods: Clinical evaluation, radiography, MR imaging.
Results: A 65-year-old man with a cervical spondylotic myelopathy in whom symptoms were improved immediately after expansive laminoplasty, but became aggravated 2 weeks later. Magnetic resonance images demonstrated swelling of the spinal cord and an intramedullary lesion that extended from the medulla oblongata to C7. Nine months after surgery, the lesion was reduced to C2–6, but neurological deterioration had not improved. Six years after surgery, the patient remains confined to bed.
Conclusion: Patients with such disease conditions are rare, and it is difficult to predict postoperative swelling of the spinal cord before surgery. Spine surgeons should be aware of such rare disease conditions involving the spinal cord.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Satomi K, Hirabayashi K . Ossification of the posterior longitudinal ligament In: Rothman RH, Simeone FA (eds) The Spine 3rd edn Philadelphia: WB Saunders 1992 pp 639–654
Itoh T et al. Two cases of cervical myelopathy showing spinal cord swelling after operation in MRI Rinshoseikeigeka (Jpn.) 1995 30: 755–759
Kato Y, Itoh T . En bloc laminoplasty for cervical myelopathy and acute diffuse spinal cord edema: Rapid decompression induces spinal cord edema? Cervical Spine Research Society (Program of 26th annual meeting) 1998 122–123 Abstract
Okumura H, Homma T . Tumor-like finding in MRI after decompression for cervical spondylotic myelopathy Seikeigeka (Jpn.) 1992 43: 41–46
Ono K et al. Myelopathy hand: New clinical signs of cervical cord damage J Bone Joint Surg 1987 69-B: 215–219
Falcone S et al. Progressive posttraumatic myelomalacic myelopathy: Imaging and clinical features Am J Neuroradiol 1994 15: 747–754
Fox JL et al. Central spinal cord injury: Magnetic resonance imaging confirmation and operative considerations Neurosurgery 1988 22: 340–347
Gebarski SS et al. Posttraumatic progressive myelopathy: Clinical and radiologic correlation employing MR imaging, delayed CT metrizamide myelography, and intraoperative sonography Radiology 1985 157: 379–385
MacDonald RL, Findlay JM, Tator CH . Microcystic spinal cord degeneration causing posttraumatic myelopathy: Report of two cases J Neurosurg 1988 68: 466–471
Ragnarsson TS, Durward QJ, Nordgren RE . Spinal cord tethering after traumatic paraplegia with late neurological deterioration J Neurosurg 1986 64: 397–401
Schwartz ED, Falcone SF, Quencer RM, Green BA . Posttraumatic syringomyelia: Pathogenesis, imaging, and treatment AJR 1999 173: 487–492
Lee TT et al. Progressive posttraumatic myelomalacic myelopathy: Treatment with untethering and expansive duraplasty J Neurosurg 1997 86: 624–628
Mehalic TF, Pezzuti RT, Applebraum BI . Magnetic resonance imaging and cervical spondylotic myelopathy Neurosurgery 1990 26: 217–227
Ohshio I et al. Correlation between histopathologic features and magnetic resonance images of spinal cord lesions Spine 1993 18: 1140–1149
Takahashi M, Yamashita Y, Sakamoto Y, Kojima R . Chronic cervical cord compression: Clinical significance of increased signal intensity on MR images Radiology 1989 173: 219–224
Fischbein NJ, Dillon WP, Cobbs C, Weinstein PR . The ’’presyrinx‘‘ state: A reversible myelopathic condition that may precede syringomyelia Am J Neuroradiol 1999 20: 7–20
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nagashima, H., Morio, Y. & Teshima, R. Re-aggravation of myelopathy due to intramedullary lesion with spinal cord enlargement after posterior decompression for cervical spondylotic myelopathy: serial magnetic resonance evaluation. Spinal Cord 40, 137–141 (2002). https://doi.org/10.1038/sj.sc.3101262
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.sc.3101262
Keywords
This article is cited by
-
Assessment of the treatment response of spinal meningiomas after radiosurgery focusing on serial MRI findings
Japanese Journal of Radiology (2015)
-
Do intramedullary spinal cord changes in signal intensity on MRI affect surgical opportunity and approach for cervical myelopathy due to ossification of the posterior longitudinal ligament?
European Spine Journal (2011)
-
Clinical significance of intramedullary Gd-DTPA enhancement in cervical myelopathy
Spinal Cord (2010)


