Spine
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A double, contiguous disc herniation in the thoracic spine (T7-T8, T8-T9) in a 44-year-old man is reported. The patient complained of intermittent episodes of weakness and numbness in the lower extremities, paraesthesias radiating to the anterior and medial surfaces of the thigh and the leg (mostly on the left side), and mild sexual and urinary dysfunction. ⋯ In this case, a transthoracic approach was safe and effective for disc excision and cord decompression via hemicorporectomy.
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Comparative Study
The effect of neck and leg flexion and their sequence on the lumbar spinal cord. Implications in low back pain and sciatica.
Fresh cadavers of five baboons were used to assess lumbar spinal cord movement. Window dissection at the L3 level was performed to observe the relative displacement of the cord to bony landmark, when the neck and hip were moved. ⋯ These findings would advocate that a test that comprises both neck and hip movements would be more sensitive in assessing nerve root movements than one that only uses neck or hip movements. Such a test should also consider the use of various sequences of neck and hip movements.
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The relationship between areas of thermal deficit and areas exhibiting other symptoms and neurologic signs, and the significance of the magnitude of thermal deficit in lumbar radiculopathy were analyzed. ⋯ Thermal deficit should be considered an independent sign of lumbar radiculopathy. The relatively high specificity suggests that a normal temperature may indicate an asymptomatic region. Symptomatic severity of lumbar radiculopathy may be assessed by measuring the magnitude of thermal deficit in the affected limb.