Index to Chiropractic Literature
Index to Chiropractic Literature
My ICL     Sign In
Friday, October 11, 2024
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature
Share:


For best results switch to Advanced Search.
Article Detail
Return to Search Results
ID 25480
  Title Benign lower thoracic intradural schwannoma compressing the conus medullaris and mimicking thoracolumbar myofascial trigger point pain: A case report
URL https://ianmmedicine.org/wp-content/uploads/2023/01/JACO-June-2017.pdf
Journal J Acad Chiropr Orthoped (JACO). 2017 Jun;14(2):Online access only p 3-20
Author(s)
Subject(s)
Peer Review Yes
Publication Type Case Report
Abstract/Notes

Background: The purpose of this report was to describe the clinical course, management, and outcomes of a male with thoracolumbar spine pain associated with an intradural schwannoma.

Case presentation: A 49-year-old male sought care at an interdisciplinary medical clinic with rapid onset of paraspinal pain to the left of the thoracolumbar junction. The initial examination indicated myofascial trigger point pain of the left quadratus lumborum. The patient's management included manual myofascial trigger point pressure release, active and passive muscle stretching, trigger point injections, prescription anti-inflammatory medication, prescription muscle relaxant medication, and narcotic pain medications over an 8-week period with a moderate reduction in pain. Following sixtreatment sessions, the patient reported a progression of left thoracolumbar paraspinal pain intensity, nocturnal low back pain, left hip and thigh pain, and bilateral leg weakness. The patient was referred for thoracolumbar spine magnetic resonance imaging, which demonstrated a lower thoracic spine intradural tumor effacing the conus medullaris. The patient was immediately referred for neurosurgical excision. Following surgery, the patient experienced complete remission of thoracolumbar spine pain and recovered his lower extremity strength. Histological evaluation later revealed the mass to be a lower thoracic intradural extramedullary schwannomacausing compression of the conus medullaris.

Discussion: Clinicians managing persistent paraspinal trigger points with progressive pain and neurological dysfunction should be aware of the possibility of undiagnosed co-morbidities as complicating factors in clinical presentation. Progressive pain and neurological findings warrant referral for advanced imaging to screen for undiagnosed complicating conditions, such as an intradural mass. In this case, conus medullaris compression mimicked the clinical presentation of myofascial trigger point syndrome within the quadratus lumborum musculature and was later discovered to be associated with a lower thoracic benign intradural schwannoma.

Conclusion: This case report describes the clinical presentation of a lower thoracic benign intradural schwannoma initially presenting with characteristics of myofascial pain. Serious neurological conditions may present with symptoms mimicking common musculoskeletal disorders.

Author keywords: Spinal Cord Tumor; Compression, Spinal Cord; Myelopathy, Compressive; Myofascial Pain Syndrome; Trigger Point; Chiropractic

Author affiliations: CBR: Assistant Professor, Palmer College of Chiropractic Life Science & Foundations Department; GAA: Adjunct Instructor, Kirkwood Community College; CSO: Doctor of Chiropractic, VA Medical Center Minneapolis, MN; MJR: Medical Doctor and Doctor of Chiropractic, Hiawatha, IA

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text at the publisher’s site.



 

   Text (Citation) Tagged (Export) Excel
 
Email To
Subject
 Message
Format
HTML Text     Excel



To use this feature you must register a personal account in My ICL. Registration is free! In My ICL you can save your ICL searches in My Searches, and you can save search results in My Collections. Be sure to use the Held Citations feature to collect citations from an entire search session. Read more search tips.

Sign Into Existing My ICL Account    |    Register A New My ICL Account
Search Tips
  • Enclose phrases in "quotation marks".  Examples: "low back pain", "evidence-based"
  • Retrieve all forms of a word with an "asterisk*", also called a wildcard or truncation.  Example: "chiropract*" retrieves chiropractic, chiropractor, chiropractors
  • Register an account in My ICL to save search histories (My Searches) and collections of records (My Collections)
Advanced Search Tips

:)