Subacute Meningomyelitis Simulating Spinal Cord Tumor

Abstract

Inasmuch as surgery is the primary form of treatment of spinal cord tumors, but is definitely contraindicated in the presence of inflammatory or degenerative lesions of the cord, it seems worthwhile to review the case of a patient who died soon after a laminectomy for suspected spinal cord tumor. This clinical diagnosis proved to be wrong, and post-mortem examination revealed a definite subacute meningomyelitis. The operation undoubtedly hastened the patient’s death, and for that reason, in spite of the apparent justifiability of laminectomy as viewed in retrospect, the clinical features of the case deserve a searching analysis in order to determine if possible the reasons for the erroneous diagnosis and thus to avoid surgery in similar cases in the future.

Case Report

Chief complaint—The patient, a 53 year old white housewife, who had been in previous good health except for menopausal symptoms, stated that during the year prior to coming to the Clinic she had experienced occasional pain between the shoulder blades radiating around the chest to its anterior aspect. The pain was more noticeable at night. No other symptoms were noted until eleven weeks before entrance to the Clinic, when she felt a sudden pain in the lower back while stooping over; this pain lasted for two or three days. During the next two weeks her legs gradually became numb and stiff, more markedly so on the right side. She began to stumble and fall when she walked, she was unable to feel a hypodermic needle in her. . .