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Sciatic nerve damage due to toilet seat entrapment: another Saturday night palsy.

1989; BMJ; Volume: 52; Issue: 9 Linguagem: Inglês

10.1136/jnnp.52.9.1113-a

1468-330X

Pippa Tyrrell, Msn Feher, Martin N. Rossor,

Nerve Injury and Rehabilitation

Intradural berniated cervical disc associated with chiropractic spinal manipulation Sir: We read with interest the report by Parnell,' on cervical intradural disc protrusion, and describe a new case in which severe myelopathy followed spinal manipulation.A 31 year old man developed torticollis followed by right cervico-brachial neuralgia at C8-TI level.Cervical spine manipulation was performed on 7 May and 14 May 1985.On 17 May he developed a sensory-motor deficit in the lower limbs, then the upper limbs, and sphincteric dysfunction.There was a spastic tetraparesis, worse in the lower limbs, with a bilateral Babinski sign.The response of the right triceps reflex was rever- sed.There was hypoaesthesia below the T6 level and superficial sensation was blunted at the extremities of the upper limbs.There was also bladder paralysis and retention ofurine.Myelography with contrast showed a lateral defect of extra-dural type at C5-C6 disc level and a complete block in front of the lower part of the C6 body.A CT scan, performed immediately afterwards, confirmed a pos- teromedial protrusion of the C5-C6 disc.At that level, the premedullary space was not visible.At C6-C7 level (fig), the subarach- noid spaces were interrupted by a right postero-lateral disc herniation which pushed back the spinal cord.After myelography, the spasticity of the lower limbs and the motor deficit in the upper limbs increased.Surgical treatment was performed urgently through an anterior approach.At C5-C6 level, the protrusion was curetted; at C6-C7 level, there was an extra-intradural stud-like herniated disc; removal of this was