| Autor: |
Feng Wang, Shi-wei Ren, Xin Zhou, Dachuan Wang, Qing-run Zhu |
| Rok vydání: |
2021 |
| Předmět: |
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| DOI: |
10.21203/rs.3.rs-960288/v1 |
| Popis: |
Purpose We report the case of a young man with a slow progression of cervical spondyloticmyelopathy (CSM). Cervical magnetic resonance imaging (MRI) revealed a mild cervical discbulgingat C5–C6 and an area of atypically enlarged intramedullary high signal intensity extending from C4–C7 (T2-weighted) with contrast enhancement at C5–C6 (T1-weighted). Therefore, neurologic and radiologic diagnoses favored demyelinating diseases. Interference occurred to the diagnosis of CSM.Methods This was a retrospective case study with follow-up examination and MRI at 3 months, 1 year and 2 years postoperatively.Results Thepatient’s symptoms improved immediately postoperatively. The functional result according to the modified Japanese Orthopedic Association (JOA) score improved from 10 to 13 within 3 months. He continued to improve neurologically over the first postoperative year. Two years postoperatively, a T2-weighted MRI showed that the edema signal had disappeared completely , and a fat-saturated T2-weighted MRI showed only slight abnormal signal. The numbness and weakness of the extremities had improved, and his JOA score was 16. Conclusions Spinal cord edema is occasionally seen with CSM. In the case presented, the contrast enhancement was localized at the site of the greatest narrowing of the spinal canal and compression of the spinal cord. This coincidence was the best indicator of a mechanical cause of the spinal cord changes. This feature should increase physician’s confidence in distinguishing CSM from intramedullary tumors and myelitis. Surgical decompression may be beneficial in improving neurologic outcomes. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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