Spinal Tumor Syndrome with Pericardial Effusion

Vol. 10 | Issue 2 | August-September 2022 | Page: 40-43 | Srivatsa Nagaraja Rao, Krishnakumar R

DOI: https://doi.org/10.13107/jkoa.2022.v10i02.052

Authors: Srivatsa Nagaraja Rao [1], Krishnakumar R [2]

[1] Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
[2] Department of Orthopaedics, Spine Surgery Division, Medical Trust Hospital, Kochi, Kerala, India.

Address of Correspondence

Dr. Srivatsa Nagaraja Rao,
Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
E-mail: srivatsa18@gmail.com

Abstract

Spinal tumor syndrome is a condition caused due to extradural granuloma or abscess causing cord compression and neurological deficits. Spinal tumor syndrome with a concurrent pericardial effusion is a very rare presentation and presents a challenge regarding surgical management due to the high perioperative risks.
A rare case of spinal tumor syndrome with pericardial effusion was treated with pericardiocentesis followed by surgical decompression of the spinal cord. A 73 year old lady with history of low back ache and fever presented with recent onset paraparesis. She was diagnosed to have Spinal Tumor Syndrome secondary to an epidural abscess with a paraspinal abscess. She was also incidentally detected to have a concurrent pericardial effusion with impending cardiac tamponade, which was likely a reactive pericardial effusion secondary to an Enterococcus faecium urinary tract infection. She was successfully treated by doing a pericardiocentesis, followed by a laminectomy of T12, L1 and laminotomy of T11. To the best of our knowledge, a case of Spinal Tumor Syndrome with concurrent pericardial effusion has not been reported in literature. Approach to such a case should be a multidisciplinary one. We found that an early intervention to stabilise the cardiac status followed by surgical decompression led to best results for the patient with gradual recovery of neurological status to near normal.
Keywords: Spinal Tumor Syndrome, pericardial effusion, pericardiocentesis, extradural granuloma, epidural abscess, paraspinal abscess.

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