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Intramuscular myxoma causing lumbar radiculopathy

Case report and review of the literature

Kern H. Guppy, Franklin Wagner, Rabih Tawk and Lisbeth Gallagher

pain (both described in the French-language literature) derived from invasion from paraspinal muscle myxomas have been reported. 11, 14 In this paper we report the third case (first in the English-language literature) of a myxoma of the lumbar paraspinal muscle, which was found in an 80-year-old woman with a 20-year history of low-back pain with recent association of a left L-5 radiculopathy. Case Report Presentation and History This 80-year-old right-handed woman had a medical history significant for hypertension, hyperthyroidism, hyperlipidemia

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William H. Cooper, Steven P. Ringel, Marc M. Treihaft and Karen A. Hall

R adiculopathy usually presents as a pain syndrome, often associated with weakness and atrophy of muscles in the appropriate root distribution. Occasionally, a patient may develop paradoxical hypertrophy rather than atrophy of these same muscles, misleading the physician and delaying proper diagnosis and treatment. In this report, we review the cases of two patients with an S-1 radiculopathy, both of whom developed painless hypertrophy of one calf and had abnormal spontaneous electrical activity on electromyography (EMG). Possible mechanisms for the

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High cervical disc herniation presenting with C-2 radiculopathy

Case report and review of the literature

Vivek R. Deshmukh, Harold L. Rekate and Volker K. H. Sonntag

T he most common locations for disc herniation in the cervical spine are C5–6 and C6–7. 2, 6 High cervical disc herniations (C2–3) are extremely rare 3, 7, 10 but appear to have a predilection for elderly patients. 7 They usually cause myelopathy. 1, 3, 7, 10 We report on a patient with a C2–3 disc herniation that caused isolated C-2 radiculopathy and who underwent surgery via a posterior extradural approach. Case Report History and Presentation This 78-year-old, right-handed man with progressive gait ataxia, urinary incontinence, and mild

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Eric L. Zager, Samantha M. Pfeifer, Mark J. Brown, Michael H. Torosian and David B. Hackney

or by open exploration for lesions involving the sciatic nerve distal to the sciatic notch. We report on five patients who experienced cyclic neuropathic lower-extremity symptoms caused by endometriosis. The clinical presentations, imaging studies, therapeutic interventions, and outcomes are described in this report. Illustrative Cases We identified five patients with biopsy-proven endometriosis that caused catamenial neuropathy or radiculopathy. Case 1 This 45-year-old woman presented with a 5-year history of progressive pain, weakness, and numbness

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Burak M. Ozgur and Lawrence F. Marshall

D egenerative disease of the cervical spine presents in myriad ways. The predominant radicular complaints are primarily those of numbness, pain, and atrophy in a specific dermatomal distribution. Thus, for example, patients with C-6 nerve root compression often present with radicular pain in the distribution of the biceps muscle in conjunction with numbness or dysesthesias in the thumb. Patients with C-7 radiculopathy often complain of severe triceps muscle pain that they describe as penetrating and complain of numbness in the second and third digits of the

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Paul G. Matz, Timothy C. Ryken, Michael W. Groff, Edward J. Vresilovic, Paul A. Anderson, Robert F. Heary, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Tanvir F. Choudhri and Daniel K. Resnick

evidence, Class II; strength of recommendation, B). Methods: Cervical Arthroplasty Cervical arthroplasty is recommended as an alternative to ACDF in selected patients for control of neck and arm pain (quality of evidence, Class II; strength of recommendation, B). Timing There is insufficient evidence to make a recommendation on timing. Rationale Anterior cervical surgery to address radiculopathy has several variations. Described approaches include ACD, ACDF, and ACDFI. The surgeon may achieve interbody fusion (or arthrodesis) using a variety of

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James S. Harrop, Marco T. Silva, Ashwini D. Sharan, Steven J. Dante and Frederick A. Simeone

A nterior cervical decompression with fusion has become the chosen surgical therapy for the treatment of cervical radiculopathy after failure of conservative therapy. An anterior cervical exposure is more difficult at the extremes of the cervical spine. In particular, the caudal cervical spine is confined by large vascular structures, the esophagus, pharynx, trachea, sternum, and the thoracic rib cage. This region is also the transition zone from the thoracic kyphosis to the cervical lordosis, making bone fusion difficult because of a biomechanical

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Paul W. Detwiler, Randall W. Porter, Timothy R. Harrington, Volker K. H. Sonntag and Robert F. Spetzler

Vertebral artery tortuosity and loop formation rarely produce cervical radiculopathy. 3, 10, 17, 23, 38, 39, 41 Other infrequent causes of cervical radiculopathy include vascular malformations, tumors, cysts, meningoceles, hypertrophic interstitial polyneuritis, and congenital absence of the pedicle. 4, 6, 7, 10–12, 14, 15, 20, 21, 27, 29, 30, 32, 35, 36, 40, 43, 45, 46 We present the third case report of the successful treatment of cervical radiculopathy caused by vascular compression of a nerve root by a vertebral artery loop. Case Report History This 70

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Robert F. Heary, Timothy C. Ryken, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

Recommendations Posterior laminoforaminotomy is recommended as a surgical treatment option for symptomatic cervical radiculopathy resulting from soft lateral cervical disc displacement or cervical spondylosis with resultant narrowing of the lateral recess (quality of evidence, Class III; strength of recommendation, D). Posterior laminoforaminotomy is recommended as a surgical method to decompress a compressed cervical nerve root resulting from soft lateral cervical disc displacement or cervical spondylosis with resultant narrowing of the lateral

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Jeffrey A. Steinberg, David D. Gonda, Karra Muller and Joseph D. Ciacci

I ntramedullary spinal cord hematomas are rarely encountered in neurosurgery, presenting with back pain, radiculopathies, and bowel/bladder dysfunction. Hemorrhages of this nature typically arise secondarily to underlying pathological conditions, although spontaneous hematomas have been reported. 34 The most common causes of spinal cord hematomas are vascular and neoplastic lesions, with other less commonly encountered sources related to trauma, coagulopathies, iatrogenic injuries, or collagen vascular disorders. 34 The most frequently encountered