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compressive cervical spondylotic myelopathy

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https://www.readbyqxmd.com/read/29705168/stenosis-and-neurological-level-discrepancies-in-cervical-spondylotic-myelopathy
#1
Young-Ah Choi, Keewon Kim
BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most common cause of cord dysfunction in older individuals. CSM involves either the upper motor neuron or lower motor neuron (LMN) in the cervical spine. The neurological level of the LMN lesion does not usually correspond with the structural level detected via magnetic resonance imaging (MRI) OBJECTIVE: To examine the relationship between the structural level of stenosis and the neurological level of LMN involvement in patients with CSM DESIGN: Retrospective descriptive study SETTING: Tertiary hospital PATIENTS: Patients with cervical spondylotic myelopathy, aged 41 to 79 years METHODS: We reviewed electromyography (EMG) and magnetic resonance imaging (MRI) findings from 17 patients with CSM to objectively show the relationship between the structural level of stenosis and the neurological level with lower motor neuron involvement...
April 26, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29651521/-spondylotic-cervical-myelopathy-indication-of-surgical-treatment
#2
REVIEW
W Pepke, H Almansour, M Richter, M Akbar
BACKGROUND: The pathogenesis of cervical spondylotic myelopathy (CSM) is often multifactorial. Hence, the treatment of this disease requires a differentiated surgical approach in order to adequately address the underlying pathology. PURPOSE: The aim of this review is to identify factors that influence the choice of treatment strategy and to summarize them in an algorithm that serves as a decision aid in choosing the optimal indication for surgical treatment. An attempt is made to define the threshold values for the indication of surgical treatment and to discuss the ideal timing for performing surgery...
April 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29649642/is-cervical-anterior-spinal-artery-compromised-in-cervical-spondylotic-myelopathy-patients-dual-energy-computed-tomography-analysis-of-cervical-anterior-spinal-artery
#3
Wu Shiyang, Chandoo Suraj, Zhu Minyu, Huang Kelun, Wang Yu, Wang Zhenzhang, Teng Honglin
OBJECTIVE: Cervical myelopathy is a common acquired cause of spinal cord dysfunction in elderly. It is postulated that hypoxic/ischemic environment secondary to chronic spinal cord compression plays an important role in the pathogenesis of myelopathy. This study aims to assess the altered blood flow to spinal cord in Cervical spondylotic myelopthy patients using Dual-Energy Computed Tomography. To our knowledge, this is the first study to utilize DECT in identifying comprised Anterior Spinal Artery blood flow in CSM patients...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649085/tract-specific-volume-loss-on-3t-mri-in-patients-with-cervical-spondylotic-myelopathy
#4
Benjamin S Hopkins, Kenneth A Weber, Michael Brendan Cloney, Monica Paliwal, Todd B Parrish, Zachary A Smith
STUDY DESIGN: Case-control. OBJECTIVE: The aim of this study was to understand the role of high-resolution magnetic resonance (MR) in identifying regional cord volume loss in cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA: Preliminary studies suggest that compression of the ventral region of the cord may contribute disproportionately to CSM symptomology; however, tract-specific data are lacking in the CSM population. The current study is the first to use 3T MR imaging (MRI) images of CSM patients to determine specific volume loss at the level of detail of individual descending white matter tracts...
April 11, 2018: Spine
https://www.readbyqxmd.com/read/29619562/a-preliminary-study-of-3-0-t-magnetic-resonance-diffusion-tensor-imaging-in-cervical-spondylotic-myelopathy
#5
Fulong Dong, Yuanyuan Wu, Peiwen Song, Yinfeng Qian, Ying Wang, Liyan Xu, Minmin Yin, Renjie Zhang, Hui Tao, Peng Ge, Chang Liu, Huaqing Zhang, Jinwen Zhu, Cailiang Shen, Yongqiang Yu
PURPOSE: To compare diffusion tensor imaging (DTI) parameters of the spinal cord between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and investigate their significance in the clinical diagnosis, surgical planning and post-operative evaluation of CSM. METHODS: Routine sequence magnetic resonance imaging (MRI) and DTI scans were performed in 50 normal subjects and 60 cases of CSM with 3.0-T MR. DTI images, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) colormaps corresponding to spinal cord cross-sections were obtained...
April 4, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29599828/age-related-changes-of-the-spinal-cord-a-biomechanical-study
#6
Tomoya Okazaki, Tsukasa Kanchiku, Norihiro Nishida, Kazuhiko Ichihara, Itsuo Sakuramoto, Junji Ohgi, Masahiro Funaba, Yasuaki Imajo, Hidenori Suzuki, Xian Chen, Toshihiko Taguchi
Although it is known that aging plays an important role in the incidence and progression of cervical spondylotic myelopathy (CSM), the underlying mechanism is unclear. Studies that used fresh bovine cervical spinal cord report the gray matter of the cervical spinal cord as being more rigid and fragile than the white matter. However, there are no reports regarding the association between aging an tensile and Finite Element Method (FEM). Therefore, FEM was used based on the data pertaining to the mechanical features of older bovine cervical spinal cord to explain the pathogenesis of CSM in elderly patients...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29574593/longitudinal-brain-activation-changes-related-to-electrophysiological-findings-in-patients-with-cervical-spondylotic-myelopathy-before-and-after-spinal-cord-decompression-an-fmri-study
#7
Lumír Hrabálek, Pavel Hok, Petr Hluštík, Eva Čecháková, Tomáš Wanek, Pavel Otruba, Miroslav Vaverka, Petr Kaňovský
BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction, potentially leading to severe disability. Abnormal cervical spine magnetic resonance imaging (MRI) and motor evoked potentials (MEPs) are independent predictors of disease progression. Abnormal MRI is accompanied by various activation changes in functional brain MRI (fMRI), whereas preoperative and postoperative fMRI adaptations associated with abnormal preoperative MEP remain unknown...
March 25, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29563801/predictive-factors-of-symptomatic-lumbar-canal-stenosis-in-patients-after-surgery-for-cervical-spondylotic-myelopathy
#8
Lingde Kong, Jiangbo Bai, Bing Zhang, Yong Shen, Dehu Tian
Background: The aim of this study was to determine the incidence of coexisting symptomatic lumbar canal stenosis (LCS) in patients after surgery for cervical spondylotic myelopathy (CSM) and identify possible predictive factors associated with it. Materials and methods: We retrospectively reviewed patients with CSM at our institution between January 2005 and December 2015. Clinical and radiographic factors including age, gender, body mass index, Japanese Orthopedic Association scores, cervical alignment, anteroposterior diameter of cervical canal, number of levels with CSM, and percentage of cervical cord compression were investigated...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29533034/-clinical-study-on-spinal-cord-decompression-combined-with-traditional-chinese-medicine-for-the-treatment-of-cervical-spondylotic-myelopathy
#9
Feng Yang, Ming-Sheng Tan, Ping Yi, Xiang-Sheng Tang, Qing-Ying Hao, Ying-Na Qi
OBJECTIVE: To compare the clinical effect between spinal card decompression combined with traditional Chinese medicine and simple spinal card decompression for cervical spondylotic myelopathy. METHODS: From June 2012 to June 2015, 73 patients with cervical spondylotic myelopathy were treated, including 42 males and 31 females, aged from 29 to 73 years old with a mean of 50.9 years old. The patients were divided into the simple operation group (34 cases) and the operation combined with traditional Chinese medicine group(39 cases) according to the idea of themselves...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29529304/diffusion-tensor-imaging-in-a-large-longitudinal-series-of-patients-with-cervical-spondylotic-myelopathy-correlated-with-long-term-functional-outcome
#10
Avinash Rao, Hesham Soliman, Mayank Kaushal, Oleysa Motovylak, Aditya Vedantam, Matthew D Budde, Brian Schmit, Marjorie Wang, Shekar N Kurpad
BACKGROUND: Fractional anisotropy (FA) of the high cervical cord correlates with upper limb function in acute cervical cord injury. We investigated the correlation between preoperative FA at the level of maximal compression and functional recovery in a group of patients after decompressive surgery for cervical spondylotic myelopathy (CSM). OBJECTIVE: To determine the usefulness of FA as a biomarker for severity of CSM and as a prognostic biomarker for improvement after surgery...
February 23, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29524700/analysis-of-morphometric-parameters-in-cervical-canal-stenosis-on-neutral-and-dynamic-magnetic-resonance-imaging
#11
Tomasz Tykocki, Johannes du Plessis, Guy Wynne-Jones
OBJECTIVE: A dynamic compression injury of the cervical spinal cord (SC) is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension magnetic resonance imaging (MRI) provides information on the dynamic cervical injury. We sought to compare morphometric parameters on neutral and flexion/extension MRI in cervical spondylotic myelopathy. METHODS: Patients with cervical canal stenosis who had MRI in neutral, flexion, and extension positions were reviewed retrospectively...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452319/-white-cord-syndrome-of-acute-hemiparesis-after-posterior-cervical-decompression-and-fusion-for-chronic-cervical-stenosis
#12
Prince Antwi, Ryan Grant, Gregory Kuzmik, Khalid Abbed
BACKGROUND: "White cord syndrome" is a very rare condition thought to be due to acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted magnetic resonance imaging sequences in a patient with unexplained neurologic deficits following spinal cord decompression surgery. The syndrome is rare and has been reported previously in 2 patients following anterior cervical decompression and fusion...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29424671/reproducibility-temporal-stability-and-functional-correlation-of-diffusion-mr-measurements-within-the-spinal-cord-in-patients-with-asymptomatic-cervical-stenosis-or-cervical-myelopathy
#13
Benjamin M Ellingson, Noriko Salamon, Davis C Woodworth, Hajime Yokota, Langston T Holly
OBJECTIVE The purpose of this study was to quantify the reproducibility, temporal stability, and functional correlation of diffusion MR characteristics in the spinal cord in patients with cervical stenosis with or without myelopathy. The association between longitudinal diffusion tensor imaging (DTI) measurements and serial neurological function assessment was explored at both the group and individual level. METHODS Sixty-six nonoperatively treated patients with cervical stenosis were prospectively followed (3 months to > 5 years) using synchronous serial MRI and functional outcome assessment...
May 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29279758/the-role-of-dynamic-magnetic-resonance-imaging-in-cervical-spondylotic-myelopathy
#14
REVIEW
John Paul Kolcun, Lee Onn Chieng, Karthik Madhavan, Michael Y Wang
Dynamic spinal cord compression has been investigated for several years, but until the advent of open MRI, the use of dynamic MRI (dMRI) did not gain popularity. Several publications have shown that cervical cord compression is both static and dynamic. On many occasions the evaluation of cervical spondylotic myelopathy (CSM) is straightforward, but patients are frequently encountered with a significantly worse clinical examination than would be suggested by radiological images. In this paper, we present an extensive review of the literature in order to describe the importance of dMRI in various settings and applications...
December 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29200481/cervical-laminectomy-with-lateral-mass-screw-fixation-in-cervical-spondylotic-myelopathy-neurological-and-sagittal-alignment-outcome-do-we-need-lateral-mass-screws-at-each-segment
#15
Manoj Dayalal Singrakhia, Nikhil Ramdas Malewar, Sonal Manoj Singrakhia, Shivaji Subhash Deshmukh
Background: Anterior cervical decompression and fusion is the standard procedure used for treating patients with cervical myelopathy. However, these procedures are associated with complications such as pseudarthrosis, construct failure, and neurological complications. Posterior cervical laminectomy and instrumentation is an alternative procedure to treat multilevel cervical myelopathy. In this study, we raised questions whether instrumentation is required at all levels and whether stabilizing the spine in neutral or lordotic contour with indirect decompression leads to neurological improvement with radiological evidence of anterior decompression...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29028790/imaging-factors-that-distinguish-between-patients-with-asymptomatic-and-symptomatic-cervical-spondylotic-myelopathy-with-mild-to-moderate-cervical-spinal-cord-compression
#16
Jun Ming Cao, Jing Tao Zhang, Da Long Yang, Yi Peng Yang, He Huan Xia, Liu Yang
BACKGROUND Not all patients with spinal cord compression due to cervical spondylotic myelopathy (CSM) have clinical symptoms and signs. The aim of this study was to investigate and compare the imaging findings in asymptomatic and symptomatic patients with CSM with mild to moderate cervical spinal cord compression. MATERIAL AND METHODS A retrospective clinical study included 68 patients. Group A (n=30) had no symptoms and signs; group B (n=38) had symptoms and signs of cervical myelopathy. The age, sex, body mass index (BMI), history of steroid treatment, duration of symptoms, number of spondylotic cervical segments, Torg ratio, range of motion (ROM), incidence of cervical segmental instability, overall curvature of the cervical spine, direction of spinal cord compression, and spinal cord magnetic resonance imaging (MRI) signal intensity were compared...
October 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28765801/regression-of-disc-osteophyte-complexes-following-laminoplasty-versus-laminectomy-with-fusion-for-cervical-spondylotic-myelopathy
#17
Remi M Ajiboye, Stephen D Zoller, Adedayo A Ashana, Akshay Sharma, William Sheppard, Langston T Holly
BACKGROUND: Laminectomy with fusion (LF) and laminoplasty are two posterior-based surgical approaches for the surgical treatment of cervical spondylotic myelopathy (CSM). The decompressive effect of these approaches is thought to be primarily related to the dorsal drift of the spinal cord away from ventral compressive structures. A lesser known mechanism of spinal cord decompression following cervical LF is regression of the ventral disc osteophyte complexes which is postulated to result from the alteration of motion across the fused motion segment...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28761535/prognostication-in-cervical-spondylotic-myelopathy-proposal-for-a-new-simple-practical-scoring-system
#18
Vengalathur Ganesan Ramesh, Manianandan Ganapathi Vel Kannan, Kuchalmbal Sriram, Chandramouli Balasubramanian
CONTEXT: The ability to preoperatively predict the outcome in cervical spondylotic myelopathy (CSM) helps in planning management and counseling the patient and family. AIMS: A simple prognostic scale, namely, the Madras Institute of Neurology Prognostic Scale (MINPS) for CSM has been proposed. SETTINGS AND DESIGN: Six well-known prognostic factors, namely, age, duration of symptoms, neurological disability (Nurick's grade), number of levels of compression, effective canal diameter, and intrinsic cord changes, have been taken into account...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28746221/diagnosis-and-treatment-of-hidden-lesions-in-mild-cervical-spondylotic-myelopathy-patients-with-apparent-symptoms
#19
Yaning Sun, Kunlun Yu, Haonan Wang, Yong Shen, Lingde Kong, Jingtao Zhang
Patients with apparent symptoms of cervical spondylotic myelopathy (CSM) may only show a mild compressive lesion in ordinary magnetic resonance imaging (MRI). The aim of this study was to investigate the characteristics of CSM patients with "hidden" lesions on kinetic MRI and to determine an effective treatment.Thirty-one patients with obvious spinal cord compression only on kinetic MRI were included in our study. A variety of parameters were calculated from MRI of the cervical spine at different postures. The anterior cervical decompression and fusion (ACDF) procedure were used for treatment of CSM...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28711563/application-of-neurite-orientation-dispersion-and-density-imaging-or-diffusion-tensor-imaging-to-quantify-the-severity-of-cervical-spondylotic-myelopathy-and-to-assess-postoperative-neurologic-recovery
#20
Genki Okita, Tetsuro Ohba, Tomohiro Takamura, Shigeto Ebata, Ryo Ueda, Hiroshi Onishi, Hirotaka Haro, Masaaki Hori
BACKGROUND CONTEXT: Surgical outcome and the severity of cervical spondylotic myelopathy (CSM) are unpredictable and cannot be estimated by conventional anatomical magnetic resonance imaging (MRI). The utility of diffusion tensor imaging (DTI) to quantify the severity of CSM and to assess postoperative neurologic recovery has been investigated. However, whether conventional DTI should be applied in a clinical setting remains controversial. Neurite orientation dispersion and density imaging (NODDI) is a recently introduced model-based diffusion-weighted MRI technique that quantifies specific microstructural features related directly to neuronal morphology...
February 2018: Spine Journal: Official Journal of the North American Spine Society
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