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Severe progression of ALS/MND after intervertebral discectomy
M Sostarko1, D Vranjes, V Brinar
1Department of Neurology, University Hospital Rebro, Zagreb, Croatia. marija.sostarko@zg.tel.hr
Journal of the Neurological Sciences
|December 16, 1998
Summary
This study observed seven patients with motor neuron disease and intervertebral disc issues. Surgical treatment for radiculopathy led to rapid muscle wasting and severe outcomes, including death in most cases.
Area of Science:
- Neurology
- Neurosurgery
- Spinal Surgery
Background:
- Motor neuron disease (MND) is a progressive neurodegenerative condition.
- Intervertebral disc protrusion/prolapse can cause compressive radiculopathy.
- The co-occurrence of MND and disc pathology is rare.
Observation:
- Seven patients (1 female, 6 male, aged 55-67) presented with initial motor neuron disease symptoms and signs of intervertebral disc protrusion.
- Patients reported cervical or low back pain, with initial symptoms including foot muscle weakness or hand muscle wasting.
- Neurological examination revealed paresthesia and pain consistent with cervical or lumbar radiculopathy.
Findings:
- Following surgical decompression for suspected compressive radiculopathy, all patients experienced rapid and severe progression of muscle wasting.
- This progression affected limb, trunk, and bulbar muscles, indicating both lower and upper motor neuron involvement.
- Five patients died within 12-15 months post-surgery; two survived.
Implications:
- Surgical intervention for compressive radiculopathy in patients with concurrent early motor neuron disease may accelerate neurodegeneration.
- This suggests a potential adverse interaction between surgical decompression and underlying motor neuron disease.
- Further research is needed to understand this association and guide treatment strategies.