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Computational AND Spinal Cord

Jia Liu, Shengfa Li, Ke Huang, Xianzhe Lu, Yu Shi, Kegong Xie, Yujing Tang
PURPOSE: Disorders of the upper thoracic spine can lead to serious disability and morbidity. However, operating on the upper thoracic vertebrae T2-T5 remains challenging because of the anatomical features of the thoracic spine. We describe a novel anterolateral upper thoracic approach, which is safe and reproducible and allows direct access to the upper thoracic spine from T2 to T6 inclusive, obviating the risk of damaging complex anatomical structures inherent in the anterior trans-sternal approach...
July 13, 2018: European Spine Journal
Aditya Vedantam, Eduardo Bruera, Kenneth R Hess, Patrick M Dougherty, Ashwin Viswanathan
BACKGROUND: Understanding spinothalamic tract anatomy may improve lesioning and outcomes in patients undergoing percutaneous cordotomy. OBJECTIVE: To investigate somatotopy and anatomical organization of spinothalamic tracts in the human cervical spinal cord. METHODS: Patients with intractable cancer pain undergoing cordotomy underwent preoperative and postoperative quantitative sensory testing for sharp pain and heat pain on day 1 and 7 after cordotomy...
July 13, 2018: Neurosurgery
Simonas Jesmanas, Kristina Norvainytė, Rymantė Gleiznienė, Algirdas Mačionis
A 50-year-old male presented with a one-day history of right leg weakness, numbness, and urinary retention. Weakness was present for two weeks but worsened significantly during the last 24 hours. On the right there was sensory loss in the leg and below the Th8 dermatome. On the left there was sensory loss below the Th10 dermatome and distal loss of temperature sensation. Past medical history revealed a cervical trauma 30 years ago when a glass chip lodged into the left side of the neck. The patient did not seek medical attention after removing it himself...
2018: Case Reports in Neurological Medicine
Mohammadreza Khani, Lucas R Sass, Tao Xing, M Keith Sharp, Olivier Balédent, Bryn A Martin
Cerebrospinal fluid (CSF) dynamics are thought to play a vital role in central nervous system (CNS) physiology. The objective of this study was to investigate the impact of spinal cord (SC) nerve roots (NR) on CSF dynamics. A subject-specific computational fluid dynamics (CFD) model of the complete spinal subarachnoid space (SSS) with and without anatomically realistic NR and nonuniform moving dura wall deformation was constructed. This CFD model allowed detailed investigation of the impact of NR on CSF velocities that is not possible in vivo using magnetic resonance imaging (MRI) or other noninvasive imaging methods...
August 1, 2018: Journal of Biomechanical Engineering
Yi-Ting Tzen, Eileen M Weinheimer-Haus, Thomas F Corbiere, Timothy J Koh
AIM: Investigate the immediate effect of low intensity vibration on skin blood flow and its underlying control mechanisms in healthy human participants. MATERIALS AND METHODS: One-group pre-post design in a university laboratory setting. Nine adults underwent two bouts of 10-minute vibration (30Hz, peak acceleration 0.4g). Outcome measures include skin blood flow, and skin temperature on the right foot. To examine the control mechanisms underlying the vibration-induced blood flow response, SHORT-TIME Fourier analyses were computed to obtain the spectral densities for three frequency bands: metabolic (0...
2018: PloS One
Suliang Chen, Mathew J Gallagher, Marios C Papadopoulos, Samira Saadoun
The injured spinal cord is a complex system influenced by many local and systemic factors that interact over many timescales. To help guide clinical management, we developed a technique that monitors intraspinal pressure from the injury site in patients with acute, severe traumatic spinal cord injuries. Here, we hypothesize that spinal cord injury alters the complex dynamics of the intraspinal pressure signal quantified by computing hourly the detrended fluctuation exponent alpha, multiscale entropy, and maximal Lyapunov exponent lambda...
2018: Frontiers in Neurology
Jirapat Likitlersuang, Ryan Koh, Xinyi Gong, Lazar Jovanovic, Isabel Bolivar-Tellería, Matthew Myers, José Zariffa, César Mérquez-Chin
Background: Functional electrical stimulation therapy (FEST) is a promising intervention for the restoration of upper extremity function after cervical spinal cord injury (SCI). Objectives: This study describes and evaluates a novel FEST system designed to incorporate voluntary movement attempts and massed practice of functional grasp through the use of brain-computer interface (BCI) and computer vision (CV) modules. Methods: An EEG-based BCI relying on a single electrode was used to detect movement initiation attempts...
2018: Topics in Spinal Cord Injury Rehabilitation
Hong Yu, Ruiqing Shi, Zhi-Gang Peng, Bao-Hai Yu, Jian-Ling Cui
RATIONALE: Primary malignancy in giant cell tumor of bone (PMGCTB) is extremely unusual. PMGCTB in the thoracic vertebrae is particularly rare. PATIENTS CONCERNS: A 23-year-old man was admitted with a chief complaint of chest pain associated with cough for approximately 3 days. Physical examination revealed a palpable, immobile, tender, 7 cm mass in the right paravertebral area of the thoracolumbar spine. DIAGNOSIS: Computed tomography images revealed an osteolytic, expansive, and eccentric lesion on the vertebral bodies and right accessory processes with spinal cord compression in the thoracic vertebra, with right rib also having bone destruction...
July 2018: Medicine (Baltimore)
Daniel B Green, Maria C Palumbo, Christopher Lau
Untreated thoracoabdominal aortic aneurysms are associated with an exceedingly high mortality rate, and surgery carries a high complication rate. Crawford's classification system of thoracoabdominal aortic aneurysms describes aneurysm morphology and stratifies patients on the basis of risk of major postoperative complications including mortality, spinal cord injury, and renal failure. Computed tomography and magnetic resonance angiography are essential for classifying thoracoabdominal aortic aneurysms and identifying other important features that impact prognosis and surgical management...
July 3, 2018: Journal of Thoracic Imaging
Byung-Chul Son, Hak-Cheol Ko, Jin-Gyu Choi
OBJECTIVES: To investigate the extent of spinal cord compression and CSF space following T9 paddle lead spinal cord stimulation (SCS) using three-dimensional myelographic CT scans. MATERIALS AND METHODS: Preoperative and postoperative three-dimensional myelographic CT scans were performed in 15 patients with paddle lead SCS at T9 for neuropathic back and leg pain. Four axial levels between each row of the electrodes were selected and the cross-sectional areas of thecal sac and spinal cord, the width of anterior and posterior CSF space, and contact angle of the lead within T9 spinal canal were measured with 12-month pain relief assessment...
June 30, 2018: World Neurosurgery
Kelsey K Cappelle, H Fulton Reaugh
CASE DESCRIPTION A 9-year-old 7.5-kg (16.5-lb) castrated male Dachshund was referred for emergency evaluation of pelvic limb paraplegia of < 24 hours' duration. CLINICAL FINDINGS A spinal cord lesion between T3 and L3 was suspected given the dog's history and neurologic examination results. Computed tomography and myelography spanning T3 through L4 identified an extradural compressive lesion at the L3-4 disk space. Hemilaminectomy was performed, and disk material adhered to and compressing the spinal cord was identified...
July 15, 2018: Journal of the American Veterinary Medical Association
Duan Liu, Hui Zhang, Bao Liu, Jiang Shao, Yue-Xin Chen, Yue-Hong Zheng
PURPOSE: To describe an endovascular technique combining the octopus and periscope techniques for the treatment of a patient with type V thoracoabdominal aortic aneurysm in order to protect the patient's visceral circulation. CASE REPORT: An 84-year-old male patient was hospitalized for type V thoracoabdominal aortic aneurysm involving celiac axis, superior mesenteric artery, and both renal arteries. The patient's aneurysm was successfully treated by combining the octopus technique and periscope techniques...
January 1, 2018: Vascular and Endovascular Surgery
Yuk Law, Tilo Kölbel, Fiona Rohlffs, Christian Behrendt, Franziska Heidemann, Eike Sebastian Debus, Nikolaos Tsilimparis
OBJECTIVE: Manufacturers often recommend the iliac arteries as the distal landing zone in fenestrated or branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aneurysm. It is not uncommon to choose distal landing at the infrarenal aorta for preservation of lumbar arteries or the inferior mesenteric artery (IMA); however, the safety and durability of this procedure have not been verified in the literature. METHODS: Consecutive patients who underwent FB-EVAR with distal landing at the infrarenal aorta were reviewed retrospectively...
June 23, 2018: Journal of Vascular Surgery
Sébastien Mateo, Karen T Reilly, Christian Collet, Gilles Rode
BACKGROUND: Motor imagery (MI) training is often used to improve physical practice (PP), and the functional equivalence between imagined and practiced movements is widely considered essential for positive training outcomes. OBJECTIVE: We previously showed that a 5-week MI training program improved tenodesis grasp in individuals with C6-C7 quadriplegia. Here we investigated whether functional equivalence changed during the course of this training program. METHODS: In this descriptive pilot study, we retrospectively analyzed data for 6 individuals with C6-C7 quadriplegia (spinal cord injured [SCI]) and 6 healthy age-matched controls who trained for 5 weeks in visual and kinesthetic motor imagery or visualization of geometric shapes (controls)...
June 23, 2018: Annals of Physical and Rehabilitation Medicine
Nicole A Pelot, Brandon J Thio, Warren M Grill
Background: Computational modeling provides an important toolset for designing and analyzing neural stimulation devices to treat neurological disorders and diseases. Modeling enables efficient exploration of large parameter spaces, where preclinical and clinical studies would be infeasible. Current commercial finite element method software packages enable straightforward calculation of the potential distributions, but it is not always clear how to implement boundary conditions to appropriately represent metal stimulating electrodes...
2018: Frontiers in Computational Neuroscience
Zhenyu Xiong, Sarath Vijayan, Chao Guo, Stephen Rudin, Daniel R Bednarek
The purpose of this study was to evaluate the effect of patient head size on radiation dose to radiosensitive organs, such as the eye lens, brain and spinal cord in fluoroscopically guided neuro-interventional procedures and CBCT scans of the head. The Toshiba Infinix C-Arm System was modeled in BEAMnrc/EGSnrc Monte-Carlo code and patient organ and effective doses were calculated in DOSxynrc/EGSnrc for CBCT and interventional procedures. X-ray projections from different angles, CBCT scans, and neuro-interventional procedures were simulated on a computational head phantom for the range of head sizes in the adult population and for different pediatric ages...
February 2018: Proceedings of SPIE
Elsa Madeleine Faure, Salma El Batti, Marwan Abou Rjeili, Iannis Ben Abdallah, Pierre Julia, Jean-Marc Alsac
OBJECTIVE: The study objective was to assess the midterm outcomes and aortic remodeling in patients with Marfan syndrome with complicated acute type B aortic dissection treated with stent-assisted, balloon-induced intimal disruption and relamination. METHODS: We reviewed all patients treated with stent-assisted, balloon-induced intimal disruption and relamination for a complicated acute type B aortic dissection associated with Marfan syndrome according to the revised Ghent criteria...
May 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Girard Cua, Neal Holland, Ashleigh Wright
BACKGROUND: Anticoagulation is the mainstay of treatment for pulmonary embolism. However, if bleeding unfortunately occurs, the risks and benefits of anticoagulation present a challenge. Management of one hemorrhagic complication, retroperitoneal hematoma, is rare, difficult, and controversial. CASE PRESENTATION: A 73-year-old white man presented with left lower extremity swelling and dyspnea. He was tachycardic, hypertensive, and demonstrated poor oxygen saturation of 81% on ambient air...
June 22, 2018: Journal of Medical Case Reports
Benoît Combès, Anne Kerbrat, Jean Christophe Ferré, Virginie Callot, Josefina Maranzano, Atef Badji, Emmanuelle Le Page, Pierre Labauge, Xavier Ayrignac, Clarisse Carra Dallière, Nicolas Menjot de Champfleur, Jean Pelletier, Adil Maarouf, Jérôme de Seze, Nicolas Collongues, David Brassat, Françoise Durand-Dubief, Christian Barillot, Elise Bannier, Gilles Edan
BACKGROUND: Studies including patients with well-established multiple sclerosis (MS) have shown a significant and disability-related reduction in the cervical spinal cord (SC) magnetisation transfer ratio (MTR). OBJECTIVES: The objectives are to (1) assess whether MTR reduction is already measurable in the SC of patients with early relapsing-remitting multiple sclerosis (RRMS) and (2) describe its spatial distribution. METHODS: We included 60 patients with RRMS <12  months and 34 age-matched controls at five centres...
June 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Bilgehan Solmaz, Mustafa Görkem Özyurt, Demir Berk Ata, Fulya Akçimen, Mohammed Shabsog, Kemal Sıtkı Türker, Hakkı Dalçik, Oktay Algin, Ayşe Nazlı Başak, Merve Özgür, Safiye Çavdar
Mirror movements are unintended movements occurring on one side of the body that mirror the contralateral voluntary ones. It has been proposed that mirror movements occur due to abnormal decussation of the corticospinal pathways. Using detailed multidisciplinary approach, we aimed to enlighten the detailed mechanism underlying the mirror movements in a case subject who is diagnosed with mirror movements of the hands and we compared the findings with the unaffected control subjects. To evaluate the characteristics of mirror movements, we used several techniques including whole exome sequencing, computed tomography, diffusion tensor imaging and transcranial magnetic stimulation...
June 12, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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