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spinal cord monitoring

Steven M Falowski, Ashwini Sharan, James McInerney, Darren Jacobs, Lalit Venkatesan, Filippo Agnesi
BACKGROUND: Spinal cord stimulation (SCS) is a common intervention for managing intractable pain. Generally, leads are implanted in a minimally invasive procedure with verbal feedback regarding the location and nature of generated paresthesias by active stimulation; in this way their optimal location can be confirmed. However, lead placement under general anesthesia can have additional benefits. OBJECTIVE: To investigate the outcomes of awake vs asleep lead placement procedures...
March 14, 2018: Neurosurgery
SeungHwan Lee, Xiang Qun Shi, Anni Fan, Brian West, Ji Zhang
Introduction Neuropathic pain is a debilitating condition. The importance of neuroimmune interactions in neuropathic pain has been evidenced by the involvement of different immune cells in peripheral and central sensitization of pathological pain. Macrophages and microglia are the most abundant immune cells activated in injured nerves and spinal cord, respectively. Several lines of evidence showed that macrophage/microglia survival, activation, proliferation, and differentiation require the involvement of macrophage-colony stimulating factor...
January 2018: Molecular Pain
V S Klimov, V V Kel'makov, N V Chishchina, A V Evsyukov
AIM: The study aim was to evaluate the effectiveness of intraoperative monitoring of motor evoked potentials (MEPs) for predicting changes in the neurological status of patients with cervical spinal cord tumors in the early postoperative period. MATERIAL AND METHODS: The study included 74 patients with intradural cervical spinal cord tumors who were operated on using motor evoked potential monitoring in the period from 2013 to 2016. There were 29 (39%) males and 46 (61%) females...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
Chandrasekaran Jayaraman, Chaithanya Krishna Mummidisetty, Alannah Mannix-Slobig, Lori McGee Koch, Arun Jayaraman
BACKGROUND: Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI)...
March 13, 2018: Journal of Neuroengineering and Rehabilitation
Patrick M Sonner, David R Ladle
Reciprocal inhibition of motor neurons via Ia inhibitory interneurons recruited by stimulation of proprioceptive afferents supplying antagonist muscles has been well described. Changes in the efficacy of inhibition, and sometimes even a switch from inhibition to facilitation, have been reported in the literature after disruption of descending pathways. We sought to test whether such facilitation could be expressed in normal animals by evaluating the presence of facilitation in acute preparations from uninjured animals...
March 8, 2018: Neuroscience Letters
Elena Gallio, Francesca Romana Giglioli, Andrea Girardi, Alessia Guarneri, Umberto Ricardi, Roberto Ropolo, Riccardo Ragona, Christian Fiandra
PURPOSE: Automated treatment planning is a new frontier in radiotherapy. The Auto-Planning module of the Pinnacle3 treatment planning system (TPS) was evaluated for liver stereotactic body radiation therapy treatments. METHODS: Ten cases were included in the study. Six plans were generated for each case by four medical physics experts. The first two planned with Pinnacle TPS, both with manual module (MP) and Auto-Planning one (AP). The other two physicists generated two plans with Monaco TPS (VM)...
February 2018: Physica Medica: PM
Anja Püschel, Rasmus Ebel, Patricia Fuchs, Janet Hofmann, Jochen K Schubert, Jan P Roesner, Stefan Bergt, Andreas Wree, Brigitte Vollmar, Ernst Klar, Carsten M Bünger, Sabine Kischkel
BACKROUND: Paraplegia due to spinal cord ischemia (SCI) is a serious complication after repair of thoraco-abdominal aortic aneurysms. For prevention and early treatment of spinal ischemia intraoperative monitoring of spinal cord integrity is essential. This study was intended to improve recognition of SCI through a combination of transcranial motor-evoked potentials (tc-MEPs), serum markers and innovative breath analysis. METHODS: In nine female German landrace pigs, tc-MEPs were captured, markers of neuronal damage were determined in blood and volatile organic compounds (VOCs) were analysed in exhaled air...
March 5, 2018: Annals of Vascular Surgery
Tong Yu, Yao Wang, Xi-Wen Zhang, Zhen-De Jiang, Xiu-Jie Zhu, Qi-Yao Jiang, Jian-Wu Zhao
This study aims to evaluate the application of multimodal intraoperative monitoring (MIOM) in surgical treatment for spine burst fracture and dislocation (SBFD) patients.Eleven patients who underwent posterior reduction and instrumentation (PRI) for SBFD from June 2014 to July 2016 were included into the study. The function of the spinal cord was monitored by MIOM. The muscle strength of the lower extremities and American Spinal Injury Association (ASIA) scores were, respectively, evaluated (before surgery, and at 1, 3, 6, and 12 months after surgery)...
March 2018: Medicine (Baltimore)
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Min Yin Goh, Melinda S Millard, Edmund C K Wong, David J Berlowitz, Marnie Graco, Rachel M Schembri, Douglas J Brown, Albert G Frauman, Christopher J O'Callaghan
STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS: Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers...
March 2, 2018: Spinal Cord
Anu Paul, Manuel Comabella, Roopali Gandhi
Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease with a complex clinical course characterized by inflammation, demyelination, and axonal degeneration. Diagnosis of MS most commonly includes finding lesions in at least two separate areas of the central nervous system (CNS), including the brain, spinal cord, and optic nerves. In recent years, there has been a remarkable increase in the number of available treatments for MS. An optimal treatment is usually based on a personalized approach determined by an individual patient's prognosis and treatment risks...
March 2, 2018: Cold Spring Harbor Perspectives in Medicine
Takehiro Shiinoki, Ryota Onizuka, Daisuke Kawahara, Tatsuhiko Suzuki, Yuki Yuasa, Koya Fujimoto, Takuya Uehara, Hideki Hanazawa, Keiko Shibuya
<u>Purpose: </u>To quantify the patient-specific imaging dose for real-time tumor monitoring in the lung during respiratory-gated stereotactic body radiotherapy (SBRT) in clinical cases using SyncTraX.
 <u>Methods and Materials:</u> Ten patients who underwent respiratory-gated SBRT with SyncTraX were enrolled in this study. The imaging procedure for real-time tumor monitoring using SyncTraX was simulated using Monte Carlo. We evaluated the dosimetric effect of a real-time tumor monitoring in a critical organ at risk (OAR) and the planning target volume (PTV) over the course of treatment...
February 26, 2018: Physics in Medicine and Biology
E Lucas, T Whyte, J Liu, W Tetzlaff, P A Cripton
Little is known about the internal mechanics of the in vivo spinal cord during injury. The objective of this study was to develop a method of tracking internal and surface deformation of in vivo rat spinal cord during compression using radiography. Since neural tissue is radio-translucent, radio-opaque markers were injected into the spinal cord. Two tantalum beads (260 µm) were injected into the cord (dorsal and ventral) at C5 of nine anesthetized rats. Four beads were glued to the lateral surface of the cord, caudal and cranial to the injection site...
February 8, 2018: Journal of Biomechanics
Aileen Hoehne, Michelle L James, Israt S Alam, John A Ronald, Bernadette Schneider, Aloma D'Souza, Timothy H Witney, Lauren E Andrews, Haley C Cropper, Deepak Behera, Gayatri Gowrishankar, Zhaoqing Ding, Tony Wyss-Coray, Frederick T Chin, Sandip Biswal, Sanjiv S Gambhir
BACKGROUND: The cystine/glutamate antiporter (xc-) has been implicated in several neurological disorders and, specifically, in multiple sclerosis (MS) as a mediator of glutamate excitotoxicity and proinflammatory immune responses. We aimed to evaluate an xc-specific positron emission tomography (PET) radiotracer, (4S)-4-(3-[18 F]fluoropropyl)-L-glutamate ([18 F]FSPG), for its ability to allow non-invasive monitoring of xc- activity in a mouse model of MS. METHODS: Experimental autoimmune encephalomyelitis (EAE) was induced in C57BL/6 mice by subcutaneous injection of myelin oligodendrocyte glycoprotein (MOG35-55 ) peptide in complete Freund's adjuvant (CFA) followed by pertussis toxin...
February 22, 2018: Journal of Neuroinflammation
Ryu Kurokawa, Phyo Kim, Kazushige Itoki, Shinji Yamamoto, Tetsuro Shingo, Toshiki Kawamoto, Shunsuke Kawamoto
BACKGROUND: Motor evoked potential (MEP) recording is used as a method to monitor integrity of the motor system during surgery for intramedullary tumors (IMTs). Reliable sensitivity of the monitoring in predicting functional deterioration has been reported. However, we observed false positives and false negatives in our experience of 250 surgeries of IMTs. OBJECTIVE: To delineate specificity and sensitivity of MEP monitoring and to elucidate its limitations and usefulness...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Joseph L Laratta, Alex Ha, Jamal N Shillingford, Melvin C Makhni, Joseph M Lombardi, Earl Thuet, Ronald A Lehman, Lawrence G Lenke
Study Design: Literature review. Objective: The aim of this study was to provide an overview of the available intraoperative monitoring techniques and the evidence around their efficacy in vertebral column resection. Methods: The history of neuromonitoring and evolution of the modalities are reviewed and discussed. The authors' specific surgical techniques and preferred methods are outlined in detail. In addition, the authors' experience and the literature regarding vertebral column resection and surgical mitigation of neurologic alarms are discussed at length...
February 2018: Global Spine Journal
Alka Singh, Rajeshwar Nath Srivastava, Ashok Agrahari, Suruchi Singh, Saloni Raj, Tanushri Chatterji, Abbas Ali Mahdi, Ravindra Kumar Garg, Raja Roy
BACKGROUND: Acute Spinal Cord Injury (ASCI) is still having substantial morbidity and mortality despite of advanced therapeutics. Major obstacles are paucity of monitoring tools or biomarkers for severity determination, recovery and prognostication. A prospective case control pilot study with serum 1 H NMR spectroscopic metabolic profiling was carried out to evaluate metabolites perturbations and its relationship with recovery and to see role of stem cells in facilitating neurological recovery...
February 14, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Lisa Burrows
Benign paroxysmal positional vertigo (BPPV) occurs in 14.5% of patients with spinal cord injury (SCI) and may require intervention on intensive care unit (ICU). A 61-year-old man was admitted to a spinal injury ICU with a traumatic C3 complete SCI following a mountain bike accident. Ventilated but stable he complained of severe dizziness on rolling, during personal cares, which lasted for 40 s. Clinical examination was limited due to the injury and ventilation. Subjective questioning, visio-ocular control and a modified Dix-Hallpike and roll tests confirmed a right posterior canalithiasis BPPV...
February 8, 2018: BMJ Case Reports
Hidehiko Koizumi, Tibin T John, Justine X Chia, Mohammad F Tariq, Ryan S Phillips, Bryan Mosher, Yonghua Chen, Ryan Thompson, Ruli Zhang, Naohiro Koshiya, Jeffrey C Smith
Transient receptor potential channel, TRPM4, the putative molecular substrate for Ca2+-activated nonselective cation current (ICAN), is hypothesized to generate bursting activity of pre-Bötzinger complex (pre-BötC) inspiratory neurons and critically contribute to respiratory rhythmogenesis. Another TRP channel, TRPC3, which mediates Na+/Ca2+ fluxes, may be involved in regulating Ca2+-related signaling, including affecting TRPM4/ICAN in respiratory pre-BötC neurons. However, TRPM4 and TRPC3 expression in pre-BötC inspiratory neurons and functional roles of these channels remain to be determined...
January 2018: ENeuro
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