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spinal pathology

Kyle Mueller, David Zhao, Osiris Johnson, Faheem A Sandhu, Jean-Marc Voyadzis
BACKGROUND: Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery. OBJECTIVE: To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques. METHODS: A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease...
August 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Simone E Dekker, Chad A Glenn, Thomas A Ostergard, Brian D Rothstein, Nicholas C Bambakidis
This operative video illustrates resection of a cervical ependymoma in a 40-yr-old female with numbness of upper and lower extremities and ataxia. Magnetic resonance imaging (MRI) demonstrated an enhancing intramedullary intradural spinal mass at C2-3. The patient underwent a posterior cervical laminoplasty for tumor resection. This video highlights the natural history of this disease, treatment options, surgical procedure, potential risks and complications, and postoperative management of ependymomas. A posterior midline skin incision was made from the inion to the level of C4 which exposed the posterolateral elements of C1-3...
August 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
Simone E Dekker, Thomas A Ostergard, Chad A Glenn, Efrem Cox, Nicholas C Bambakidis
This operative video demonstrates a posterior cervical laminoplasty for the resection of a cervical intradural extramedullary meningioma. In addition, the natural history, treatment options, and potential complications are discussed. The patient is a 68-yr-old male who presented with left-hand grip weakness and paresthesias. Magnetic resonance imaging (MRI) demonstrated an enhancing mass that displacing the spinal cord anteriorly and causing severe flattening of the cord at C4 and C5. The patient underwent a posterior cervical laminoplasty for tumor resection...
August 11, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nicholas T Gamboa, Michael Karsy, Joseph T Gamboa, Nam K Yoon, Meghan J Driscoll, Joshua A Sonnen, Karen L Salzman, Randy L Jensen
Background: Ependymomas are rare neuroepithelial tumors thought to arise from radial glial precursor cells lining the walls of the ventricles and central canal of the brain and spinal cord, respectively. Histopathological classification, according to World Health Organization criteria, has only recently defined the RELA-fusion positive ependymoma. These tumors may account for 70% of supratentorial ependymomas in children and represent an aggressive entity distinct from other ependymomas...
2018: Surgical Neurology International
Merrick C Strotton, Andrew J Bodey, Kazimir Wanelik, Michele C Darrow, Esau Medina, Carl Hobbs, Christoph Rau, Elizabeth J Bradbury
Synchrotron radiation microtomography (SRμCT) is a nominally non-destructive 3D imaging technique which can visualise the internal structures of whole soft tissues. As a multi-stage technique, the cumulative benefits of optimising sample preparation, scanning parameters and signal processing can improve SRμCT imaging efficiency, image quality, accuracy and ultimately, data utility. By evaluating different sample preparations (embedding media, tissue stains), imaging (projection number, propagation distance) and reconstruction (artefact correction, phase retrieval) parameters, a novel methodology (combining reversible iodine stain, wax embedding and inline phase contrast) was optimised for fast (~12 minutes), high-resolution (3...
August 13, 2018: Scientific Reports
Kenyu Ito, Kei Ando, Kazuyoshi Kobayashi, Mikito Tsushima, Masaaki Machino, Kyotaro Ota, Masayoshi Morozumi, Satoshi Tanaka, Naoki Ishiguro, Shiro Imagama
BACKGROUND: Spinal myxopapillary ependymomas (MPEs) and schwannomas (SCHs) are both frequently located at the conus and caudal regions. The differentiation between MPEs and SCHs before surgery is crucial. Signal patterns of MPEs and SCHs on T2-weighted (T2W) magnetic resonance imaging (MRI) are diverse. Gadolinium (Gd+)-enhanced areas in MRI scans areas are areas where tumor cells are abundant. Therefore, investigating these enhanced areas should facilitate the differentiation. This study aimed to evaluate Gd+ areas in MRI scans in spinal MPEs and SCHs...
August 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Takuji Nakamura, Masanori Nishi, Mihoko Rikitake, Daisuke Koga, Junya Eto, Daisuke Tajima, Shuji Toda, Muneaki Matsuo
Subacute combined degeneration of the spinal cord (SACD) is a rare neurologic disorder manifesting progressive symptoms of paresthesia and spastic paralysis. Herein we present an autopsy case of SACD caused by folic acid and copper deficiency. A 16-year-old male presented with gradually worsening unsteady gait, and bladder and rectal dysfunction. He had a medical history of T-cell acute lymphoblastic leukemia (T-ALL), diagnosed 1.5 years previously. The patient had undergone chemotherapy, including methotrexate, as well as allogeneic bone mallow transplantation...
August 10, 2018: Brain & Development
Mushfiquddin Khan, Tajinder S Dhammu, Inderjit Singh, Avtar K Singh
BACKGROUND: Spinal cord injury (SCI) is one of the leading causes of disability and chronic pain. In SCI-induced pathology, homeostasis of the nitric oxide (NO) metabolome is lost. Major NO metabolites such as S-nitrosoglutathione (GSNO) and peroxynitrite are reported to play pivotal roles in regulating the activities of key cysteine proteases, calpains. While peroxynitrite (a metabolite of NO and superoxide) up regulates the activities of calpains leading to neurodegeneration, GSNO (a metabolite of NO and glutathione) down regulates the activities of calpains leading to neuroprotection...
August 13, 2018: BMC Neuroscience
Suliang Chen, Mathew J Gallagher, Florence Hogg, Marios C Papadopoulos, Samira Saadoun
To guide management of patients with acute spinal cord injuries, we developed intraspinal pressure monitoring from the injury site. Here, we examine the complex fluctuations in the intraspinal pressure signal using network theory. We analyzed 7,097 hours of intraspinal pressure data from 58 patients with severe cord injuries. Intraspinal pressure signals were split into hourly windows. Each window was mapped into a visibility graph as follows: Vertical bars were drawn at 0.1 Hz representing signal amplitudes...
August 13, 2018: Journal of Neurotrauma
Yixiao Mei, James E Barrett, Huijuan Hu
Calcium release-activated calcium (CRAC) channels are unique among ion channels that are activated in response to depletion of intracellular calcium stores and are highly permeable to Ca2+ compared to other cations. CRAC channels mediate an important calcium signal for a wide variety of cell types and are well studied in the immune system. They have been implicated in a number of disorders such as immunodeficiency, musculosketal disorders and cancer. There is growing evidence showing that CRAC channels are expressed in the nervous system and are involved in pathological conditions including pain...
July 29, 2018: Cell Calcium
Mariam Ishaque, Michael J McGinity, Samon G Tavakoli, James M Henry, Alexander M Papanastassiou
BACKGROUND: Hydrocephalus and intracranial hypertension are rare signs of spinal tumors when presenting in isolation, particularly with benign tumors. CASE DESCRIPTION: Herein reported is a case of a 53-year-old woman who presented with headache, blurry vision, communicating hydrocephalus, and intracranial hypertension. No primary intracranial pathology was identified, and there were no clinical signs or symptoms of intraspinal pathology. Lumbar puncture revealed elevated opening pressure, CSF protein, and suspected tumor cells in the CSF, thus prompting spinal imaging...
August 7, 2018: World Neurosurgery
Aditya V Karhade, Quirina Thio, Paul Ogink, Jason Kim, Santiago Lozano-Calderon, Kevin Raskin, Joseph Schwab
INTRODUCTION: Chordomas are locally invasive slow-growing tumors that are difficult to study because of the rarity of the tumors and the lack of significant volumes of patients with longitudinal follow-up. As such, there are currently no machine learning studies in the chordoma literature. The purpose of this study was to develop machine learning models for survival prediction and deploy them as open access web applications as a proof of concept for machine learning in rare nervous system lesions...
August 7, 2018: World Neurosurgery
Ruth Prieto, Xavier Santander, José Manuel Naranjo, Esperanza Marín, Cesáreo Corbacho
BACKGROUND: Dumbbell-shaped schwannomas involving the spinal canal, the intervertebral foramen and the thoracic cavity are rare lesions. Their surgical treatment represents a challenge and there is no consensus regarding their ideal management. Two major surgical routes have been used: a combined laminectomy and open thoracotomy, or a posterolateral extrapleural approach with wide bone removal. This report describes a relatively easy surgical strategy, the combined laminectomy and thoracoscopy, which allows a safe resection under an adequate view with low risk of spinal instability, pain or respiratory problems...
August 6, 2018: World Neurosurgery
Samila Alves Silva, Patrícia Silva Cunha, Araceli Santos Brito, Rosana Barros Souza, Sandra Lúcia Euzébio Ribeiro
Devic's disease or neuromyelitis optica (NMO) is an autoimmune, inflammatory and demyelinating pathology of the central nervous system that affects the optic nerve and the spinal cord. Diagnosis confirmed by imaging, magnetic resonance (MR) and the presence of the anti-aquaporin 4 antibody (anti-AQP4). We describe two cases of patients with mixed connective tissue disease (MCTD) and Devic's disease, who had anti-AQP4 positive and areas with neuroaxis MR abnormalities, showing this rare association.
April 2018: Acta Reumatológica Portuguesa
Romain Perolat, Adrian Kastler, Benjamin Nicot, Jean-Michel Pellat, Florence Tahon, Arnaud Attye, Olivier Heck, Kamel Boubagra, Sylvie Grand, Alexandre Krainik
Low back pain (LBP) is the most common pain syndrome, and is an enormous burden and cost generator for society. Lumbar facet joints (FJ) constitute a common source of pain, accounting for 15-45% of LBP. Facet joint degenerative osteoarthritis is the most frequent form of facet joint pain. History and physical examination may suggest but not confirm facet joint syndrome. Although imaging (radiographs, MRI, CT, SPECT) for back pain syndrome is very commonly performed, there are no effective correlations between clinical symptoms and degenerative spinal changes...
August 8, 2018: Insights Into Imaging
Vayara P Vinodh, Senthil K Rajapathy, Pulivendhan Sellamuthu, Regunath Kandasamy
Background: Reperfusion injury of the spinal cord or "white cord syndrome" refers to the sudden onset of neurological deterioration after spinal decompressive surgery. Associated magnetic resonance (MR) findings only include focal hyperintensity on T2-weighted images without any other pathological changes. Case Description: A patient with cervical stenosis secondary to metastatic tumor in the intradural and extradural compartments presented with lower limb paraparesis...
2018: Surgical Neurology International
Gokhan Canaz, Nesrin Akkoyun, Erhan Emel, Orhun M Cevik, Serdar Baydin, Akın Gokcedag
Human tail might be the most interesting cutaneous sign of neural tube defects. From little cutaneous appendixes to 20-cm-long taillike lesions were reported in the literature. They may occur connected to an underlying pathology such as lipoma or teratoma, but most of the time, they conceal an underlying spinal dysraphism. Many classifications about human tails have been suggested in history, but the main approach to these lesions is, independent of the classification, always the same: investigating the possible spinal dysraphism with concomitant pathologies and planning the treatment on the patient basis...
April 2018: Journal of Pediatric Neurosciences
Mirjana Nacka-Aleksić, Marija Stojanović, Ivan Pilipović, Zorica Stojić-Vukanić, Duško Kosec, Gordana Leposavić
An accumulating body of evidence suggests that development of autoimmune pathologies leads to thymic dysfunction and changes in peripheral T-cell compartment, which, in turn, perpetuate their pathogenesis. To test this hypothesis, thymocyte differentiation/maturation in rats susceptible (Dark Agouti, DA) and relatively resistant (Albino Oxford, AO) to experimental autoimmune encephalomyelitis (EAE) induction was examined. Irrespective of strain, immunization for EAE (i) increased the circulating levels of IL-6, a cytokine causally linked with thymic atrophy, and (ii) led to thymic atrophy reflecting partly enhanced thymocyte apoptosis associated with downregulated thymic IL-7 expression...
2018: PloS One
Antonio Mazzotti, Patrizia Tomba, Fabrizio Perna, Niccolo Stefanini, Anna Viganò, Cesare Faldini
STUDY DESIGN: The manuscript describes the testimony of the Rizzoli Orthopedic Institute about Wilhelm Schulthess, a pioneer in the treatment of spinal deformities. OBJECTIVE: To describe the intuitions of Wilhelm Schulthess through the documentation still preserved at the Rizzoli institute in Bologna. SUMMARY OF BACKGROUND DATA: Wilhelm Schulthess was a great pioneer in the treatment of spinal deformities. The Rizzoli Orthopedic Institute in Bologna, Italy, awarded the Swiss Clinician in 1911 for his work: "pathology and treatment of spinal deformities" and has always maintained a deep relationships with him...
August 6, 2018: Spine
Matthew Goodus, Andrew David Sauerbeck, Phillip G Popovich, Richard S Bruno, Dana M McTigue
Spinal cord injury (SCI) disrupts autonomic regulation of visceral organs. As a result, a leading cause of mortality in the SCI population is metabolic dysfunction, and an organ central to metabolic control is the liver. Our recent work showed that rodent SCI promotes Kupffer cell (hepatic macrophage) activation, pro-inflammatory cytokine expression and liver steatosis. These are symptoms of nonalcoholic steatohepatitis (NASH), the hepatic manifestation of metabolic syndrome, and these pre-clinical data replicate aspects of post-SCI human metabolic dysfunction...
August 7, 2018: Journal of Neurotrauma
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