Spinal Neoplasms

Publication Title: 
Wiener Medizinische Wochenschrift (1946)

Pain--which can have a variety of causes--constitutes a severe problem for patients in need of palliative care, because this pain usually dramatically impairs their quality of life. Thus, the more advanced a terminal illness has become, the more hospital staff should focus on holistic treatment, encompassing body, mind and soul of the patient. Apart from conventional medication-based pain therapy, there is also a variety of non-medicinal treatments for pain.

Author(s): 
Peintinger, Christa
Hartmann, Wolfgang
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: This report discusses a patient with a pathologic fracture of the C2 vertebra secondary to osteolytic metastasis from squamous cell carcinoma of the lung. CLINICAL FEATURES: The patient was a 68-year-old man with a chief complaint of neck pain who was referred by his physician to a chiropractic office. The initial onset of neck pain began after a forceful sneeze that resulted in a sensation of "a twig snapping" in the neck. Radiographs revealed osteolytic destruction and pathologic fracture of the C2 spinous process.

Author(s): 
Davis, Matthew A.
Taylor, John A. M.
Publication Title: 
Palliative Medicine

In this case study we describe a dual approach to the palliation of difficult muscle spasms using intrathecal baclofen via a fully implanted system, together with the homeopathic approach to symptom control. The homeopathy is seen to complement rather than to replace conventional prescribing and using both approaches together appears to have avoided the necessity for increasing drug doses and to have minimized side-effects.

Author(s): 
Thompson, E.
Hicks, F.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Metastatic disease of the lumbar spine is a relatively common, but catastrophic cause of low back pain. Because of an increasing role as primary care providers for back pain patients, it is essential that chiropractors keep this possibility in mind. Careful consideration of the patient's history, physical and laboratory findings, and the use of imaging procedures are helpful in establishing a correct diagnosis in those cases where metastasis is suspected.

Author(s): 
Defoyd, W. D.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To present a case in which the initial diagnosis of spinal metastasis secondary to prostate cancer was established from findings of the digital rectal examination (DRE) and serum prostate-specific antigen (PSA) analysis. CLINICAL FEATURES: A 79-yr-old black male was seen after suffering from low back pain for 1 month. Urinary frequency and nocturia were associated symptoms. Abnormal findings on the DRE and serum PSA determination suggested a preliminary diagnosis of spinal metastases secondary to prostate cancer.

Author(s): 
Johnson, T. L.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss a case of cervical spine osteochondroma found incidentally during evaluation of a rib injury. To demonstrate diagnostic imaging, including plain film radiography, radionuclide bone scan, computed tomography and magnetic resonance imaging. CLINICAL FEATURES: This article presents the second reported case of osteochondroma associated with the C6 vertebral body. The classic imaging features of exostosis and a cartilaginous cap were identified. The osteochondroma was confluent with marrow of the C6 articular pillar.

Author(s): 
Eaton, B. A.
Kettner, N. W.
Essman, J. B.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss a case of osteoid osteoma of the vertebral body with extension across the disc space, a very rare location and unique finding. FEATURES: An 18-yr-old man suffered midthoracic pain that was thought to be related to a lifting injury. However, further evaluation revealed an osteoid osteoma of the T6 vertebral body. Special imaging revealed extension of the inflammatory component across the intervertebral disc involving the adjacent vertebral body.

Author(s): 
Hurtgen, K. L.
Buehler, M.
Santolin, S. M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss an unusual presentation of spina bifida occulta (SBO) mimicking an aggressive bone lesion. CLINICAL FEATURES: A 59-yr-old man suffered from intermittent neck pain. The plain film radiographs revealed rarefaction of the C6 spinous process that mimicked an aggressive bone lesion. Computed tomography and previous radiographs of the region confirmed an SBO defect of the C6 level. INTERVENTION AND OUTCOME: Supportive therapy was applied to the patient for his presenting neck complaint.

Author(s): 
DeBono, V.
Marchiori, D. M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To present a case of symptomatic, expansile L1 vertebral hemangioma. CLINICAL FEATURES: A 46-year-old man presented with progressive neurologic changes and insidious onset of low back pain. INTERVENTION AND OUTCOME: After a trial of 3 visits of conservative chiropractic care, no improvement was noted. Magnetic resonance imaging was obtained, revealing an expansile hemangioma with extra-osseous component compromising the conus medullaris at the level of the L1 lumbar vertebra. Neurosurgical intervention resulted in clinical improvement.

Author(s): 
Rich, Jeffrey A.
Donahue, Thomas C.
Mick, Timothy J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To present a case of symptomatic, expansile L1 vertebral hemangioma. CLINICAL FEATURES: A 46-year-old man presented with progressive neurologic changes and insidious onset of low back pain. INTERVENTION AND OUTCOME: After a trial of 3 visits of conservative chiropractic care, no improvement was noted. Magnetic resonance imaging was obtained, revealing an expansile hemangioma with extra-osseous component compromising the conus medullaris at the level of the L1 lumbar vertebra. Neurosurgical intervention resulted in clinical improvement.

Author(s): 
Rich, Jeffrey A.
Donahue, Thomas C.
Mick, Timothy J.

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