Myelopathy

Clinical Presentation of a Patient with Thoracic Myelopathy

Clinical Presentation of a Patient with Thoracic Myelopathy at a Chiropractic Clinic

SOURCE: J Chiropractic Medicine 2012 (Sep); 11 (2): 115–120

Charles W. Gay, Mark D. Bishop, and Jacqueline L. Beres

Graduate Research Assistant,
Rehabilitation Science Doctoral Program,
University of Florida, Gainesville, FL.

INTRODUCTION: The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic.

CASE REPORT/METHODS: After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult.

RESULTS: Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement.

CONCLUSION: It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment.

KEYWORDS: Spinal stenosis; Thoracic vertebrae

From the FULL TEXT Article:

Introduction

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Do Omega 3 and Turmeric Have a Role in Promoting Neuroprotection?

By Frank M. Painter|August 1, 2012|Myelopathy, Omega-3 Fatty Acids|

Do Omega 3 and Turmeric Have a Role in Promoting Neuroprotection?

The Chiro.Org Blog

SOURCE: BIBA Spinal News

“In an animal model of myelopathy, we have demonstrated that DHA and curcumin can counteract the effects of chronic spinal cord compression through several molecular mechanisms, resulting in the preservation of neurological function.”

A study published in the Journal of Neurosurgery: Spine indicates, in an animal model, a diet rich in docsahexaenoic acid (DHA; an omega-3 fatty acid) and curcumin (one of the principle components of turmeric) can neutralise the clinical and biochemical effects of myelopathy.

Langston Holly, Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, USA, and others reported that they examined the effects of a DHA and curcumin rich diet in promoting neuroprotection in an animal model of myelopathy because while several studies have shown dietary supplementation to have beneficial effects on cerebral function, “comparatively little information has been published regarding the use of dietary supplementation to enhance neural repair in disorders affecting the spine, and this represents a fertile area for study.”

In the study, 27 rats were equally divided into three groups: spinal compression (via surgical placement of thin epidural non-resorbable polymer in the mid-thoracic spine, designed to induce delayed neurological deficit) and a “Western society diet” (ie, one rich in saturated fats); spinal compression and a diet rich in DHA and curcumin; and no spinal compression and a standard diet.

Twenty-one days after the spinal compression procedure, using CatWalk XT software analysis (Noldus Information Technology), the rats in the Western diet group showed significant worsening in ambulatory parameters compared with the other two groups (such as cadence, p<0.02; mean stepping intensity, p<0.03; and print width, p<0.04). Rats in the Western diet group also had significantly worse gait at 21 days and 42 days (the end of the study) after surgery compared with their baseline levels, but there were no significant differences between postoperative gait parameters (at 42 days) and baseline gait parameters for rats in the DHA and curcumin group. Holly et al wrote: “Additionally, although the two groups started with statistically equivalent performance in these parameters, the DHA and curcumin group had significantly better gait function than the Western diet group at the final postoperative day 42 time point (p<0.05).”

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