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https://www.readbyqxmd.com/read/28781916/nursing-review-section-of-surgical-neurology-international-part-2-lumbar-spinal-stenosis
#1
REVIEW
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: The lumbar spine includes 5 lumbar vertebral bodies, L1, L2, L3, L4, and L5. At each level, there is a disc space defined by the two bones (vertebral bodies) in the back; for example, there is a disc space at the L5-S1 level etc. The normal front to back (anterior to posterior or AP diameter) measurement of the spinal canal is typically 18-20 mm, but some patients have narrowing called spinal stenosis. METHODS: Lumbar stenosis is defined by two major types...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28770547/analysis-of-dural-sac-thickness-in-the-human-cervical-spine
#2
Soonwook Kwon, Seung-Woo Suh, Dasom Kim, Im Joo Rhyu, Hyunung Yu, Seung Woo Han, Jae-Young Hong
The thickness of the dura mater in the human cervical spine can vary between individuals and by vertebral level; these differences can result in various clinical outcomes. The purpose was to measure and analyze cervical dura mater thickness. Microscopic measurements were made of tissue from human cadavers. The subjects were nine human cadavers with no previous history of spinal deformity or surgery. Fourteen segments of both anterior and posterior dura mater from the C1 to C7 cervical vertebrae were obtained...
August 2, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/28736354/novel-technique-of-percutaneous-fat-graft-for-repair-of-persistent-large-pseudomeningocele
#3
Gabrielle Santangelo, Tyler Schmidt, Mithra Gonzalez, Per-Lennart Westesson, Howard Silberstein
BACKGROUND: Pseudomeningocele is an uncommon but problematic complication in lumbar spine surgery. Initial conservative measures are frequently successful but persistence requires additional management. The current surgical approach can involve a range of techniques, including blood patches, hydrogel/fibrin sealants, drains, open surgical repair of the dura or a combination of the above if symptoms persist. This report demonstrates a novel technique for repair using a percutaneous approach to deliver an autologous fat graft into the pseudomeningocele...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602497/anatomical-localization-of-the-cavernous-sinus-dural-fistula-by-3d-rotational-angiography-with-emphasis-on-clinical-and-therapeutic-implications
#4
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sankara P Sarma
BACKGROUND AND PURPOSE: Carotid cavernous sinus dural arteriovenous fistulas (CSDAVFs) are presumed to be located within the walls of the cavernous sinus, however the exact fistulous site has not yet been studied by angiographic or anatomical methods. The present study aimed to localize CSDAVFs with the help of 3D rotational angiography (RA) and correlated the observations with clinical and angiographic findings. MATERIALS AND METHODS: The CSDAVFs were categorized as dural, extradural or osseous based on the site of convergence of feeders into the venous sac...
June 8, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28524124/-endoscopic-endonasal-diagnosis-and-treatment-of-skull-base-meningoencephalocele
#5
D N Kapitanov, E V Shelesko, A A Potapov, A D Kravchuk, D N Zinkevich, M V Nersesyan, L A Satanin, A V Sakharov, G V Danilov
PURPOSE: The study purpose was to determine the successful outcome rate of endoscopic endonasal reconstruction of skull base CSF fistulas with removal of meningocele as well as analyze disease relapses. The second purpose of the study was to describe the treatment outcomes, depending on the type, location, and size of meningocele as well as on a technique used to reconstruct the skull base defect. MATERIAL AND METHODS: Three hundred and eleven patients diagnosed with cerebrospinal fluid (CSF) rhinorrhea who underwent surgery at the Burdenko Neurosurgical Institute in the period between 2007 and 2014 were retrospectively analyzed...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28458825/a-locally-destructive-completely-asymptomatic-c1-root-schwannoma-with-base-of-skull-invasion-a-case-report
#6
David Pisani, Christian Camenzuli, Josephine Psaila, Snežana Božanić, Jean Calleja-Agius
Patients with C1 nerve root schwannomas usually present with signs relating to nerve root compression. However, asymptomatic presentations have never been reported. A healthy, 37-year-old female was referred in view of a slow-growing lump in the left posterosuperior aspect of the neck. The lump was asymptomatic and neurological examination was normal. Magnetic resonance imaging revealed a left C1 nerve root tumour, extending around the C1 vertebra and compressing the thecal sac. The tumour had invaded the basiocciput and was impinging on the left cerebellar hemispheric dura...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28414692/neuronal-fibers-and-neurotransmitter-receptor-expression-in-the-human-endolymphatic-sac
#7
Martin Nue Møller, Svend Kirkeby, Jonas Vikeså, Finn Cilius Nielsen, Per Cayé-Thomasen
INTRODUCTION: Recent studies suggest that the human endolymphatic sac (ES) may have multiple functions, including an ion-transport capacity comparable to the kidney, an immunological capacity and a possible natriuretic capacity. Further, there have been speculations of a yet undefined role in intracranial pressure homeostasis. The anatomical location towards the sigmoid sinus would suggest a possible endo- and/or paracrine signaling. However, neuronal connections may also apply, but it remains very scarcely explored in the human ES...
June 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28327939/a-new-classification-for-pathologies-of-spinal-meninges-part-1-dural-cysts-dissections-and-ectasias
#8
Jörg Klekamp
BACKGROUND: The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. OBJECTIVE: To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. METHODS: Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. RESULTS: Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished...
July 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28115269/stretching-of-roots-contributes-to-the-pathophysiology-of-radiculopathies
#9
Jean-Marie Berthelot, Jean-Denis Laredo, Christelle Darrieutort-Laffite, Yves Maugars
PURPOSE: To perform a synthesis of articles addressing the role of stretching on roots in the pathophysiology of radiculopathy. METHODS: Review of relevant articles on this topic available in the PubMed database. RESULTS: An intraoperative microscopy study of patients with sciatica showed that in all patients the hernia was adherent to the dura mater of nerve roots. During the SLR (Lasègue's) test, the limitation of nerve root movement occurs by periradicular adhesive tissue, and temporary ischemic changes in the nerve root induced by the root stretching cause transient conduction disturbances...
January 20, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28024891/transdural-herniated-lumbar-disc-disease-with-muscle-patch-for-closure-of-durotomy-a-brief-review-of-literature
#10
REVIEW
Harsha A Huliyappa, Rakesh Kumar Singh, Sunil Kumar Singh, Manish Jaiswal, Somil Jaiswal, Chhitij Srivastava, Balkrishna Ojha, Anil Chandra, Satnam Chhabra
PURPOSE: Intradural migration of disc (IDMD) is a rare clinical entity accounting for 0.27-0.33% of all herniated disc diseases. Flimsy or dense adhesion between the ventral dural surface and the opposing posterior longitudinal ligament (PLL) is the principal pathology for intradural migrated disc. The most commonly affected lumbar segments are L4-5 (55%), L3-4 (16%), L5-S1 (10%) and less commonly L2L3 and L1L2. No imaging feature is characteristic and the management protocol of durotomy via an endoscopic method is unclear...
March 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27817138/tophaceous-gout-of-the-lumbar-spine-mimicking-a-spinal-meningioma
#11
Pedro Ribeiro da Cunha, António Judice Peliz, Marcos Barbosa
PURPOSE: Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. METHODS: A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal...
November 5, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27693825/transforaminal-endoscopic-system-technique-for-discogenic-low-back-pain-a-prospective-cohort-study
#12
Fumin Pan, Bin Shen, Surendra K Chy, Zhiyao Yong, Xiaoming Liu, Zhaoyu Ba, Zhonghan Liu, Jianguang Zhu, Desheng Wu
OBJECTIVE: To investigate the clinical outcomes of transforaminal endoscopic system(TESSYS) for discogenic low back pain(DLBP). METHODS: 62 consecutive patients with one-level DLBP applying to the including criteria underwent TESSYS from January 2010 to December 2013. These patients included 38 males and 24 females with a mean age of 42.7 ± 5.4 years (range, 18-73 yr) and a mean follow-up of 26.8 ± 4.2 months (range, 12-48 months). The visual analog scale (VAS) were used for back pain, the Oswestry Disability Index (ODI) for lumbar function, and the modified MacNab criteria for clinical global outcomes...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27415595/epidural-fibrosis-seen-from-a-different-angle-extraforaminal-lumbar-interbody-fusion
#13
Arthur Robert Kurzbuch, Didier Recoules-Arche
Background Postoperative epidural fibrosis (PEF) localized around the exposed dura and nerve roots is a known radiologic entity seen after lumbar surgery. Although excessive PEF is associated with residual and new lumbar pain and radiculopathy, its role as the generator of the pain is still discussed. Various materials acting as an adhesion barrier have been tested. There is no undebated class I evidence that any one of them is suitable to reduce or avoid PEF and provide a better clinical outcome. In revision surgery, the dissection of epidural scar tissue is time consuming and related to an elevated risk of dural tear and nerve damage...
January 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27307901/endolymphatic-sac-tumor
#14
Manoj Kumar, Raghu Ramakrishnaiah, Yousaf Muhhamad, Rudy Van Hemert, Edgardo Angtuaco
Endolymphatic sac tumor is an uncommon, locally aggressive tumor. The tumor is located in the medial and posterior petrosal bone region and may involve the dura. A hypervascular tumor involving the endolymphatic sac with destructive changes, it involves the bone and may show reactive new bone formation. Diagnosis is based on clinical, radiological, and pathological correlation. We present a case of endolymphatic sac tumor in a 24-year-old female who presented with a chief complaint of hearing loss.
2011: Radiology case reports
https://www.readbyqxmd.com/read/27194987/simultaneous-spinal-and-intracranial-chronic-subdural-hematoma-cured-by-craniotomy-and-laminectomy-a-video-case-report
#15
Hideki Kanamaru, Kenji Kanamaru, Tomohiro Araki, Kazuhide Hamada
Simultaneous spinal and intracranial chronic subdural hematoma (CSDH) is a rare entity. A 67-year-old man visited our hospital due to headache after diving into a river 2 weeks before. Non-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) revealed bilateral intracranial CSDH. The bilateral CSDH was evacuated and his symptoms improved. Three days after craniotomy, he complained of sensory disturbance on his buttocks. Lumbar MRI showed a space-occupying lesion behind the thecal sac at L5...
January 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27169092/middle-meningeal-artery-embolization-in-recurrent-chronic-subdural-hematoma-combined-with-arachnoid-cyst
#16
Jiin Kang, Kum Whang, Soon-Ki Hong, Jin-Soo Pyen, Sung-Min Cho, Jong-Yeon Kim, So-Hyun Kim, Ji-Woong Oh
Chronic subdural hematoma (CSDH) is a collection of old blood and its breakdown products between the surface of the brain parenchyma and the outermost layer called the dura. The most common treatment option for primary CSDH is burr-hole trephination; however, the treatment method for recurrent CSDH is still widely debated. An arachnoid cyst (AC) is a sac filled with cerebrospinal fluid located between the brain or spinal cord and the arachnoid membrane, which is one of the three meninges covering the brain or spinal cord...
October 2015: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27046576/a-framework-for-patient-specific-spinal-intervention-simulation-application-to-lumbar-spinal-durotomy-repair
#17
Jonathan C Lau, Lynn Denning, Stephen P Lownie, Terry M Peters, Elvis C S Chen
We present a functional and patient-specific lumbar phantom for the training of spinal durotomy and dura closure under microscopic view, consisting of a lumbar model, pressurized dural surrogate, together immersed in a tissue-mimicking layer simulating fat, muscle and skin. The lumbar model was derived from a patient computed tomography scan, preserving the natural shape and curvature of the lumbar column. The inclusion of the simulated soft-tissue layer was critical for preserving the surgical ergonomics and presented a realistic view under the surgical microscope...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/27003811/usefulness-of-the-radiological-planning-for-hearing-preservation-surgery-in-vestibular-schwannoma
#18
Kamil Krystkiewicz, Tymon Skadorwa, Paweł Szaro, Bogdan Ciszek
PURPOSE: During vestibular schwannoma surgery there is a risk of endolymphatic duct and sac injury, which may cause a loss or a deterioration of hearing. The goal of the study was to evaluate the empirical utility of presurgical planning using CT with the bone window for the hearing preservation surgery. METHODS: The study was performed on 14 human temporal bones. CT scans with the bone window were obtained in the standard position. Safe drilling line was evaluated and after that drilling distances were analysed: the lateral drilling distance, total length of internal acoustic meatus, drilled length of internal acoustic meatus...
November 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/26933371/imaging-in-hirayama-disease
#19
Keshav Gupta, Shashank Sood, Jayesh Modi, Rajiv Gupta
Hirayama disease, also known as Sobue disease is a rare nonprogressive spinal muscular atrophy. Here, we report a case series of three young males presenting with atrophy of distal upper limb and Hirayama disease as their clinico-radiological diagnosis. Magnetic resonance imaging (MRI) revealed loss of cervical lordosis with focal areas of lower cervical cord atrophy in a neutral position. MRI in flexion position revealed, anterior displacement of the detached posterior dura from the underlying lamina compressing the thecal sac and widened posterior epidural space with flow voids seen better on 3D-CISS images...
January 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/26921138/migrating-bullet-in-the-thecal-sac-at-the-level-of-the-conus-medullaris-without-neurological-deficit
#20
Orkun Koban, Hasan Çal, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Ahmet Öğrenci
Bullets can lodge in the organs, blood vessels or thecal sac. To our knowledge, a migrating bullet at the level of the conus medullaris without neurological deficit has never been reported. We present our patient along with a discussion of bullet migration in the spinal canal and its mechanisms, diagnosis and treatment. A 29-year-old man was admitted to the emergency department due to a gunshot wound in the right upper quadrant of his abdomen. He had no neurological deficit. Spinal CT scan and plain radiography showed the bullet had passed through the L2 vertebral body and had migrated downwards until it had lost its energy and come to rest in the spinal canal at the L3 vertebra level...
July 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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