• Sharp or burning pain referred to a lower extermity and unexplained by extraspinal findings must be investigated for possible intraspinal causation. Six cases in which the explanation was found in lesions of the thoracic and cervical parts of the spinal cord illustrate this principle.
The patients were all females over 50 years of age. In one, 16 years elapsed between first symptoms and ultimate diagnosis; in another, 5 1/2 years of severe symptoms and varied disabilities were accompanied by so much anxiety and functional overlay that examination became difficult. The pain may be confused with that caused by herniated intervertebral disk or an intraspinal or extraspinal lesion involving the roots of the cauda equina or peripheral portion of the sciatic nerve.
Investigation of such cases is incomplete without a myelogram. It may be necessary to run the contrast medium through the entire thoracic canal and, if this is inconclusive, through the entire cervical canal to rule out tumors in these areas. The cases here collected are unusual in that they were explained by the finding of benign, slow-growing tumors so high up in the spinal cord.
Scott M. LOWER EXTREMITY PAIN SIMULATING SCIATICATUMORS OF THE HIGH THORACIC AND CERVICAL CORD AS CAUSES. JAMA. 1956;160(7):528–534. doi:10.1001/jama.1956.02960420008002
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