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Spinal cord compression

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https://www.readbyqxmd.com/read/28453954/local-delivery-of-chondroitinase-abc-with-or-without-stromal-cell-derived-factor-1%C3%AE-promotes-functional-repair-in-the-injured-rat-spinal-cord
#1
Malgosia M Pakulska, Charles H Tator, Molly S Shoichet
Traumatic spinal cord injury (SCI) is a devastating event for which functional recovery remains elusive. Due to the complex nature of SCI pathology, a combination treatment strategy will likely be required for success. We hypothesized that tissue and functional repair would be achieved in a rat model of impact-compression SCI by combining degradation of the glial scar, using chondroitinase ABC (ChABC), with recruitment of endogenous neural precursor cells (NPCs), using stromal cell-derived factor 1α (SDF)...
April 18, 2017: Biomaterials
https://www.readbyqxmd.com/read/28440087/cervical-dural-calcification-and-cervical-myelopathy-in-x-linked-hypophosphataemic-rickets-a-case-report-and-review-of-the-literature
#2
Ali A Najefi, Daniel B Beder, Shiraz A Sabah, Kia Rezajooi
X-linked hypophosphataemic rickets (XLHR) is a genetic disorder resulting from a genetic mutation in the PHEX gene. This may cause ossification of soft tissue structures risking spinal cord compression. We present the first known case of cervical dural calcification secondary to XLHR to cause myelopathic symptoms due to cord compression.
April 25, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#3
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437208/considerations-for-quality-improvement-in-radiation-oncology-therapy-for-patients-with-uncomplicated-painful-bone-metastases
#4
Anne M Walling, Phillip J Beron, Tania Kaprealian, Patrick A Kupelian, Neil S Wenger, Susan A McCloskey, Christopher R King, Michael Steinberg
BACKGROUND: There is an increasing need for evidence-based efficiency in providing a growing amount of cancer care. One example of a quality gap is the use of multiple-fraction palliative radiation for patients with advanced cancer who have uncomplicated bone metastases; evidence suggests similar pain outcomes for treatment regimens with a lower burden of treatments. METHODS: During the first phase of quality improvement work, we used RAND/UCLA appropriateness methodology to understand how radiation oncologists at one academic medical center rate the appropriateness of different treatment regimens for painful uncomplicated bone metastases...
February 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28435930/spinal-subdural-hematoma-a-rare-case-of-spinal-subdural-hematoma-complicating-routine-minimally-invasive-lumbar-discectomy-and-decompression-and-relevant-literature-review
#5
Chelsea C Boe, Brett A Freedman, Ravi Kumar, Kendall Lee, Robert McDonald, John Port
We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic injury. Hitherto, no case of acute postoperative subdural hematoma has been reported in the postoperative setting in the absence of known iatrogenic dural injury. A 76-year-old male with central and lateral recess spinal stenosis underwent apparently uncomplicated bilateral L3-4 and left sided L4-5 decompressive partial laminectomies and discectomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28434767/extrarenal-rhabdoid-tumor-presented-with-an-immobile-arm-in-a-one-year-old-boy
#6
Chi-Ting Chung, Yen-Lin Liu, Chien-Jui Cheng, Kevin Li-Chun Hsieh, Min-Lan Tsai, Tai-Tong Wong
Infants with an immobile arm may be easily overlooked in primary care settings. Differential diagnoses include injuries, infections, neuropathies, ischemia and rarely, neoplasms. We report the case of a one-year-old boy with weakness in his left arm after minor trauma with a diagnosis of brachial plexus palsy initially. After rehabilitation for 2months, his weakness progressed to unsteady gait and quadriparesis. MRI revealed a huge solid tumor in the left supraclavicular fossa, which also involved the left brachial plexus, upper thoracic cavity, and left paravertebral space with invasion into the spinal canal...
April 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28433844/neurological-decline-in-an-elderly-with-repaired-myelomeningocele-complicated-with-lumbar-canal-stenosis-a-case-report
#7
Shingo Matsuda, Satoshi Yamaguchi, Yosuke Kajihara, Masaaki Takeda, Manish Kolakshyapati, Kaoru Kurisu
BACKGROUND: Tethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear. CASE DESCRIPTION: A 63-year-old man with a repaired MMC presented with a progressive gait disturbance and numbness in both lower limbs. Magnetic resonance images demonstrated that the tethered spinal cord was compressed by severe canal stenosis along the entire lumbar spine...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#8
Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28428927/limitations-of-personalized-medicine-and-gene-assays-for-breast-cancer
#9
David Tiberi, Laura Masucci, Daniel Shedid, Isabelle Roy, Toni Vu, Erica Patocskai, André Robidoux, Philip Wong
Adjuvant systemic treatments reduce the risk of breast cancer recurrence following the local treatment of primary stage I-III breast cancers. For patients with hormone-positive breast cancers receiving hormonal therapy, the risk of distant recurrence is under 20% and therefore, many patients may potentially be spared of chemotherapy. Consequently, several molecular signatures based on gene expression were developed to better determine which breast cancer patients would benefit from chemotherapy. We present the case of a 62-year-old woman diagnosed with an early stage hormone receptor-positive breast cancer that was treated with a partial mastectomy...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28428212/a-novel-mri-biomarker-of-spinal-cord-white-matter-injury-t2-weighted-white-matter-to-gray-matter-signal-intensity-ratio
#10
A R Martin, B De Leener, J Cohen-Adad, D W Cadotte, S Kalsi-Ryan, S F Lange, L Tetreault, A Nouri, A Crawley, D J Mikulis, H Ginsberg, M G Fehlings
BACKGROUND AND PURPOSE: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy. MATERIALS AND METHODS: Fifty-eight patients with degenerative cervical myelopathy and 40 healthy subjects underwent 3T MR imaging, covering C1-C7...
April 20, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28425069/a-prospective-serial-mri-study-following-acute-traumatic-cervical-spinal-cord-injury
#11
Joost P H J Rutges, Brian K Kwon, Manraj Heran, Tamir Ailon, John T Street, Marcel F Dvorak
PURPOSE: In acute traumatic cervical spinal cord injury (SCI) patients, we sought to characterize how objective MRI measures of injury change during the first 3 week post-injury. METHODS: Six MRI scans each were planned in 19 cervical SCI patients within the first 3 week post-injury. Length of cord edema, maximum spinal cord compression, maximum canal compromise, and presence and length of hematoma were measured. RESULTS: Length of spinal cord edema increased in the first 48 h after SCI, followed by a gradual decrease in the 3 weeks after injury...
April 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28421532/matrix-metalloproteinase-8-inhibition-prevents-disruption-of-blood-spinal-cord-barrier-and-attenuates-inflammation-in-rat-model-of-spinal-cord-injury
#12
Hemant Kumar, Min-Jae Jo, Hyemin Choi, Manjunatha S Muttigi, Seil Shon, Byung-Joo Kim, Soo-Hong Lee, In-Bo Han
After spinal cord injury (SCI), tight junction (TJ) protein degradation increases permeability and disrupts the blood-spinal cord barrier (BSCB). The BSCB is primarily formed of endothelial cell, which forms a specialized tight seal due to the presence of TJs. BSCB disruption after SCI allows neutrophil infiltration. Matrix metalloproteinase (MMP)-8 is believed to be mainly expressed by neutrophils and is quickly released upon neutrophil activation. Here, we determined whether MMP-8 is involved in the TJ protein degradation in endothelial cells and also determined its role in the neuroinflammation after SCI...
April 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28416437/the-ct-based-fractal-analysis-of-trabecular-bone-structure-may-help-in-detecting-decreased-quality-of-bone-prior-to-urgent-spinal-procedures
#13
Marcin Czyz, Arion Kapinas, James Holton, Renata Pyzik, Bronek M Boszczyk, Nasir A Quraishi
BACKGROUND CONTEXT: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. PURPOSE: To validate the hypothesis that the CT-based fractal analysis of the trabecular bone structure may help in detecting patients with poor quality of bone prior to urgent spinal procedures...
April 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28413533/persistent-l5-lumbosacral-radiculopathy-caused-by-lumbosacral-trunk-schwannoma
#14
Guive Sharifi, Amin Jahanbakhshi
Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28413094/-pachymeningitis
#15
O Fain, A Mekinian
Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology...
April 13, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#16
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28407704/delayed-epidural-mucin-collection-after-surgery-for-spinal-metastatic-pancreatic-adenocarcinoma
#17
Dong Ha Kim, Dong Hwan Kim, Hwan Soo Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
A rare case of delayed large epidural mucin collection causing neurologic deficit after surgery for metastatic pancreatic cancer is reported. A 65-year-old man presented with intractable upper-thoracic back pain radiating to the chest and gait disturbance. He had a history of subtotal pancreatectomy due to intraductal papillary mucinous neoplasm (IPMN) of the pancreas and concurrent chemotherapy. Eight months after pancreatectomy, multiple thoracic spinal metastasis was diagnosed with routine up positron emission tomography-computed tomography...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28404935/outcomes-of-metastatic-spinal-cord-compression-secondary-to-primary-hepatocellular-carcinoma-with-multidisciplinary-treatments
#18
Shaohui He, Haifeng Wei, Yifei Ma, Jian Zhao, Wei Xu, Jianru Xiao
Few studies have reported progression-free survival (PFS) and overall survival (OS) of Metastatic spinal cord compression (MSCC) patients with primary hepatocellular carcinoma (HCC) following surgery and adjuvant therapies. Enrolled in this study were 155 MSCC patients with primary HCC who received surgery and adjuvant therapies between 2000 and 2015. Kaplan-Meier methods and Cox's proportional hazards regression mode were performed to investigate the clinical features and prognostic factors affecting PFS and OS...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#19
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28402031/evaluation-of-osseous-associated-cervical-spondylomyelopathy-in-dogs-using-kinematic-magnetic-resonance-imaging
#20
Michele Provencher, Amy Habing, Sarah A Moore, Laurie Cook, Gary Phillips, Ronaldo C da Costa
Osseous-associated cervical spondylomyelopathy in dogs is characterized by both static and dynamic spinal cord compression; however, standard MRI methods only assess static compression. In humans with cervical spondylotic myelopathy, kinematic MRI is commonly used to diagnose dynamic spinal cord compressions. The purpose of this prospective, analytical study was to evaluate kinematic MRI as a method for characterizing the dynamic component of osseous-associated cervical spondylomyelopathy in dogs. We hypothesized that kinematic MRI would allow visualization of spinal cord compressions that were not identified with standard imaging...
April 12, 2017: Veterinary Radiology & Ultrasound
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