Bilateral Lumbar Radiculopathy Secondary to Myxopapillary Ependymoma: A Case Report

TY - JOUR

T1 - Bilateral Lumbar Radiculopathy Secondary to Myxopapillary Ependymoma

T2 - A Case Report

AU - D'Angiolillo, Joseph C.

AU - Patel, Nitesh V.

AU - Hernandez, R. Nick

AU - Hanft, Simon

N1 - Publisher Copyright: © 2022

PY - 2021/9

Y1 - 2021/9

N2 - Objective: The purpose of this case report is to describe the presentation of a patient with bilateral lumbar radiculopathy secondary to myxopapillary ependymoma. Clinical Features: A 45-year-old man presented to a chiropractic office for evaluation and treatment of chronic lower back pain with bilateral lower extremity radiation. The initial onset of pain was related to a lifting injury 6 years prior that never fully resolved. Over the year before presentation, the symptomatology intensified, as the patient's activities now included a 1.5-hour commute to and from work. Intervention and Outcome: In the interim of waiting for the magnetic resonance imaging (MRI) to be performed, chiropractic manual therapy was initiated using the Cox technique. The patient had 7 treatments, in which lumbar spine pain was reduced from 7 out of 10 to 5 out of 10 on a numeric pain scale and leg pain was reduced from 7 out of 10 to 0 out of 10. The patient obtained an MRI with contrast, which demonstrated a mass at the conus medullaris. An immediate consultation was made with a neurosurgeon. Surgical resection revealed a myxopapillary ependymoma. He was then followed up with by the neurosurgeon at 3 months and 1 year, with sustained improvements and no further symptoms. After surgery, the patient did well without complications. Conclusion: A patient with an intradural mass at the level of the conus medullaris presented for chiropractic care and responded positively to treatment but had an underlying condition that was corrected with surgery. For this patient, MRI assisted with evaluation and early diagnosis, and surgical resection facilitated a beneficial outcome.

AB - Objective: The purpose of this case report is to describe the presentation of a patient with bilateral lumbar radiculopathy secondary to myxopapillary ependymoma. Clinical Features: A 45-year-old man presented to a chiropractic office for evaluation and treatment of chronic lower back pain with bilateral lower extremity radiation. The initial onset of pain was related to a lifting injury 6 years prior that never fully resolved. Over the year before presentation, the symptomatology intensified, as the patient's activities now included a 1.5-hour commute to and from work. Intervention and Outcome: In the interim of waiting for the magnetic resonance imaging (MRI) to be performed, chiropractic manual therapy was initiated using the Cox technique. The patient had 7 treatments, in which lumbar spine pain was reduced from 7 out of 10 to 5 out of 10 on a numeric pain scale and leg pain was reduced from 7 out of 10 to 0 out of 10. The patient obtained an MRI with contrast, which demonstrated a mass at the conus medullaris. An immediate consultation was made with a neurosurgeon. Surgical resection revealed a myxopapillary ependymoma. He was then followed up with by the neurosurgeon at 3 months and 1 year, with sustained improvements and no further symptoms. After surgery, the patient did well without complications. Conclusion: A patient with an intradural mass at the level of the conus medullaris presented for chiropractic care and responded positively to treatment but had an underlying condition that was corrected with surgery. For this patient, MRI assisted with evaluation and early diagnosis, and surgical resection facilitated a beneficial outcome.

KW - Chiropractic

KW - Ependymoma

KW - Neoplasms

KW - Spinal Cord

UR - https://www.scopus.com/pages/publications/85127519685

U2 - 10.1016/j.jcm.2022.01.004

DO - 10.1016/j.jcm.2022.01.004

M3 - Article

SN - 1556-3707

VL - 20

SP - 170

EP - 175

JO - Journal of Chiropractic Medicine

JF - Journal of Chiropractic Medicine

IS - 3

ER -