Computational AND Spinal Cord

Accelerated fracture healing in patients with spinal cord injuries (SCI) is often encountered in clinical practice. However, there is no distinct evidence in the accelerated fracture healing, and the mechanisms of accelerated fracture healing in SCI are poorly understood. We aimed to determine whether SCI accelerated fracture healing in morphology and strength, to characterize the healing process with SCI, and to clarify the factors responsible for accelerated fracture healing. In total, 39 male Wistar rats were randomly divided into healthy control without intervention, SCI only, fracture with SCI, botulinum toxin (BTX) A-treated fracture with SCI, and propranolol-treated fracture with SCI groups...

STUDY DESIGN: A radiographic analysis of the anatomy of the C1 lateral mass using computed tomography (CT) scans and Mimics software. OBJECTIVE: To define the anatomy of the C1 lateral mass and make recommendations for optimal entry point and trajectory for anterior C1 lateral mass screws. SUMMARY OF BACKGROUND DATA: Although various posterior insertion angles and entry points for screw insertion have been proposed for posterior C1 lateral mass screws, no large series have been performed to assess the ideal entry point and optimal trajectory for anterior C1 lateral mass screw placement...

Traumatic brain injury (TBI) has become a recent focus of biomedical research with a growing international effort targeting material characterization of brain tissue and simulations of trauma using computer models of the head and brain to try to elucidate the mechanisms and pathogenesis of TBI. The meninges, a collagenous protective tri-layer which encloses the entire brain and spinal cord has been largely overlooked in these material characterization studies. This has resulted in a lack of accurate constitutive data for the cranial meninges, particularly under dynamic conditions such as those experienced during head impacts...

BACKGROUND: Motor vehicle-related injuries (including off-road) are the leading cause of traumatic brain injury (TBI) and acute traumatic spinal cord injury in the United States. OBJECTIVES: To describe motocross-related head and spine injuries of adult patients presenting to an academic emergency department (ED). METHODS: We performed an observational cohort study of adult ED patients evaluated for motocross-related injuries from 2010 through 2015...

PURPOSE: To study the impact on radiotherapy planning of an automatically segmented target volume delineation based on ((18)F)-fluorodeoxy-D-glucose (FDG)-hybrid positron emission tomography-computed tomography (PET-CT) compared to a manually delineation based on computed tomography (CT) in oesophageal carcinoma patients. METHODS AND MATERIALS: Fifty-eight patients diagnosed with oesophageal cancer between September 2009 and November 2014 were included. The majority had squamous cell carcinoma (84...

Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal cavity, septum, turbinates, paranasal sinuses, optic nerve, pituitary gland, carotid artery, cervical vertebrae, atlanto-axial joint, cervical spinal cord, cervical nerve root, and vertebral artery that can be used to teach clinical trainees (students, residents, and fellows) approaches for trans-sphenoidal pituitary surgery and cervical spine injection procedure...

Calcinosis in CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome can affect the spinal and paraspinal areas. We present the first case to our knowledge where a CREST syndrome patient required surgery for spinal calcinosis in both the cervical and lumbar areas. A 66-year-old female with a history of CREST syndrome presented with right-sided lower extremity radicular pain. A computed tomography (CT) scan showed bilateral lumbar masses (5.8 cm on the right, 3...

PURPOSE: To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection. METHODS: A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow)...

Corticomotor coherence in the beta and/or gamma bands has been described in different motor tasks but the role of descending brain oscillations on force control has been elusive. Large-scale computational models of a motoneuron pool and the muscle it innervates have been used as tools to advance the knowledge of how neural elements may influence force control. Here we present a frequency domain analysis of a NARX model fitted to a large-scale neuromuscular model by means of generalized frequency response functions (GFRF)...

The contained rupture of thoracic aortic aneurysm and related bone deformities is a rare condition. The diagnosis is critical due to potential and fatal complications. Radiologic evaluation is required to show the location, extension, and complications. Herein we present the X-ray radiography, ultrasonography, computed tomography, and magnetic resonance images of a giant dissected and contained rupture of the thoracic aortic aneurysm. The aneurysm destructed the adjacent vertebrae and rib, resulting in compression of dural sac and spinal cord, and obliteration of the neural foramina...

INTRODUCTION: Modern radiotherapy with 4-dimensional computed tomographic (4D-CT) image acquisition for non-small cell lung cancer (NSCLC) captures respiratory-mediated tumor motion to provide more accurate target delineation. This study compares conventional 3-dimensional (3D) conformal radiotherapy (3DCRT) plans generated with standard helical free-breathing CT (FBCT) with plans generated on 4D-CT contoured volumes to determine whether target volume coverage is affected. MATERIALS AND METHODS: Fifteen patients with stage I to IV NSCLC were enrolled in the study...

INTRODUCTION: Neck pain is a common musculoskeletal problem that up to 70% of the world population will experience at some point in their lives. Intramedullary spinal cord metastasis is an exceedingly rare complication of malignancy that affects less than 1% of all patients with cancer. CASE REPORT: We report a case of a 61-year-old man who presented to primary care clinic with 1-month history of worsening neck pain with associated neurologic deficits. Despite initial conservative management, the patient continued to have progressive worsening of sensory and motor deficits...

BACKGROUND: Accurate patient positioning is crucial in stereotactic body radiation therapy (SBRT) due to a high dose regimen. Cone-beam computed tomography (CBCT) is often used for patient positioning based on radio-opaque markers. We compared six CBCT-based set-up strategies with or without rotational correction. MATERIAL AND METHODS: Twenty-nine patients with three implanted markers received 3-6 fraction liver SBRT. The markers were delineated on the mid-ventilation phase of a 4D-planning-CT...

We describe a patient with ankylosing spondylitis (AS) with cervical spinal fracture treated with cervical pedicle screw placement (CPS) through a single posterior approach. A 43-year-old male patient with AS visited our emergency centre due to paralysis following a trauma. Coronal reconstructed cervical spine computed tomography (CT) scan showed a C5 oblique fracture, and the bilateral pedicles were separated superiorly and inferiorly. The sagittal reconstructed CT image revealed bamboo spine and C5 vertebrae body fracture...

Remote grey matter pathology has been suggested rostral to the compression site in cervical spondylotic myelopathy (CSM). We used computational neuroimaging to assess in-vivo the extent and functional relevance of neurodegeneration in ventral and dorsal horns above the site of compression in the cervical cord of CSM patients. Twenty patients with CSM and eighteen healthy subjects underwent a high-resolution structural and diffusion MRI protocol at vertebra C2/C3. Patients received comprehensive clinical assessments...

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcifications and ossification of ligaments and tendon insertions. The patients with DISH are susceptible to spinal column injury with trivial trauma due to immobilization of vertebrae and this easily leads to spinal cord injury. However, only few reports on hyperextension injuries of the thoracolumbar spine with DISH exist. Here we report three cases of those who developed delayed leg paraplegia after hyperextension injuries of the thoracolumbar spine with DISH...

OBJECTIVE: To compare the radiobiological response between simultaneously dose-escalated and non-escalated intensity-modulated radiation therapy (DE-IMRT and NE-IMRT) for patients with upper thoracic esophageal cancer (UTEC) using radiobiological evaluation. METHODS: Computed tomography simulation data sets for 25 patients pathologically diagnosed with primary UTEC were used in this study. DE-IMRT plan with an escalated dose of 64.8 Gy/28 fractions to the gross tumor volume (GTV) and involved lymph nodes from 25 patients pathologically diagnosed with primary UTEC, was compared to an NE-IMRT plan of 50...

BACKGROUND: Heterotopic Ossification (HO) is a known complication especially in people suffering traumatic spinal cord injury (SCI). Though some risk factors have already been described, the pathophysiology of HO is still unknown. The pelvis is the most common region for HO occurrence. However, the prevalence of HO by muscle groups about the hip is not well described. PURPOSE: To analyze the prevalence of early HO in muscle groups about the hip in 267 patients with SCI...

STUDY DESIGN: Retrospective cohort study of prospectively collected data. OBJECTIVE: To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery. METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury...

INTRODUCTION: Thoracic ossification of the ligamentum flavum (TOLF) is a common cause of progressive thoracic myelopathy. Surgical decompression is commonly used to treat TOLF. AIM: To evaluate the clinical outcomes of microsurgical decompression of TOLF via a paraspinal approach, using a percutaneous tubular retractor system. MATERIAL AND METHODS: First, three-dimensional (3D) image reconstruction and printed models were made from thin computed tomography scans for each patient...