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Cervical Stenosis

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https://www.readbyqxmd.com/read/28108424/clinical-and-radiological-findings-after-multilevel-cervical-total-disc-replacement-defining-radiological-changes-to-predict-surgical-outcomes
#1
Jung Hwan Lee, Sang-Ho Lee, Jun Ho Lee
OBJECTIVE: This study compared the radiological parameters between preoperation and postoperation for patients who underwent multilevel cervical total disc replacement (MCTDR) and assessed which parameters were related to successful clinical outcomes after MCTDR. METHODS: The study included a consecutive series of 24 patients who were treated with MCTDR following the diagnosis of multilevel cervical disc herniation or stenosis. Numeric Rating Scale (NRS), C2-7 sagittal vertical axis (SVA), range of motion (ROM) of C2-7 segment and TDR implanted levels were evaluated at pre- and post-TDR...
January 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28104281/-results-to-4-year-follow-up-of-the-treatment-of-the-cervical-stenosis-by-corpectomy-titanium-mesh-cage-and-anterior-plate-fixation
#2
Alejandro Antonio Reyes Sánchez, Luis Alberto Gameros Castañeda, Claudia Obil Chavarría, Armando Alpizar Aguirre, Barón Zárate Kalfópulos, Luis Miguel Rosales-Olivares
BACKGROUND: Cervical spondylotic myelopathy is caused by cervical stenosis. Several techniques have been described for the treatment of multilevel disease, such as the anterior corpectomy with titanium mesh cage and anterior cervical plate placement, which has the advantage of performing a wider decompression and using the same bone as graft. However, it has caused controversy since the collapse of the mesh cage continues being a major limitation of this procedure. MATERIAL AND METHOD: A prospective 4-year follow-up study was conducted in 7 patients diagnosed with cervical stenosis, who were treated surgically by one level corpectomy with titanium mesh cage and anterior cervical plate placement, evaluating them by radiographs and clinical scales...
January 16, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28104259/utility-of-extension-views-in-spondylotic-myelopathy-mimicking-transverse-myelitis
#3
Brittani L Conway, Michelle J Clarke, Timothy J Kaufmann, Eoin P Flanagan
Cervical spondylotic myelopathy is a common cause of myelopathy and may mimic transverse myelitis. We report a 55 year-old lady with subacute myelopathy initially treated with glatiramer acetate for suspected clinically isolated syndrome. MRI head and spine revealed a single short cervical cord T2-hyperintense lesion with enhancement just below a region of moderate stenosis. Cerebrospinal fluid revealed elevated oligoclonal bands. Repeat MRI 7 months later showed persistent enhancement. Dynamic MRI revealed cord compression during extension...
January 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28103879/a-comparison-of-cervical-delta-shaped-anastomosis-and-circular-stapled-anastomosis-after-esophagectomy
#4
Chen Huang, Xunhai Xu, Binbin Zhuang, Wenshu Chen, Xunyu Xu, Chao Wang, Shengmei Lin
BACKGROUND: The delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade. However, little has been written comparing this technique with the circular stapler technique. The objective of this retrospective study was to assess the safety and efficacy of cervical delta-shaped anastomosis after esophagectomy. METHODS: Medical records of patients with esophageal squamous cell carcinoma who underwent McKeown (three-incision) esophagectomy between September 2013 and June 2015 were reviewed...
January 19, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28073140/-clinical-and-radiological-results-after-anterior-cervical-corpectomy-with-cage-fusion-a-retrospective-comparison-of-peek-vs-titanium-cages
#5
Chris Schulz, Uwe Max Mauer, René Mathieu
Background Anterior cervical corpectomy and fusion (ACCF) has become a standard procedure for patients with spondylotic myelopathy due to multisegmental stenosis of the cervical canal. Beside the fusion technique using autogenous bone grafts, synthetic cages have been increasingly used in recent years. Published information on the clinical and radiological results of different cage materials for ACCF is still limited. The study presented here is the largest series to date reporting clinical and radiological outcomes and complication rates after one- to three-level ACCF using structural polyetheretherketone (PEEK) or titanium cages augmented by anterior plate-screw osteosynthesis...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28072809/optimal-angle-of-contralateral-oblique-view-in-cervical-interlaminar-epidural-injection-depending-on-the-needle-tip-position
#6
Jun Young Park, Myung-Hwan Karm, Doo Hwan Kim, Jae-Young Lee, Hye-Joo Yun, Jeong Hun Suh
BACKGROUND: Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES: We aimed to determine the optimal needle tip visualization, in order to minimize CILESIs-induced complications. STUDY DESIGN: Retrospective observational study...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28062802/moving-target-transient-rotational-stenosis-precipitating-jugular-bow-hunter-s-syndrome
#7
Waleed Brinjikji, Christopher S Graffeo, Avital Perry, Terence Zimmerman, Jeffrey R Janus, Pearce P Morris, Gregory D Cascino, Giuseppe Lanzino
A 60-year-old man presented with a 10-month history of of stereotypical spells characterized by vertigo, tinnitus, blurred vision, left hemibody numbness, and occasional syncope, precipitated by turning his head leftwards. Cerebral angiography and CT angiography of the head and neck with provocative maneuvers did not demonstrate vertebral artery narrowing. However, there was narrowing of the left internal jugular vein due to extrinsic compression from the sternocleidomastoid with leftward head rotation in the setting of hypoplasia of the right internal jugular vein...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28061015/impact-of-vessel-wall-lesions-and-vascular-stenoses-on-cerebrovascular-reactivity-in-patients-with-intracranial-stenotic-disease
#8
Petrice M Cogswell, Taylor L Davis, Megan K Strother, Carlos C Faraco, Allison O Scott, Lori C Jordan, Matthew R Fusco, Blaise deB Frederick, Jeroen Hendrikse, Manus J Donahue
PURPOSE: To compare cerebrovascular reactivity (CVR) and CVR lagtimes in flow territories perfused by vessels with vs. without proximal arterial wall disease and/or stenosis, separately in patients with atherosclerotic and nonatherosclerotic (moyamoya) intracranial stenosis. MATERIALS AND METHODS: Atherosclerotic and moyamoya patients with >50% intracranial stenosis and <70% cervical stenosis underwent angiography, vessel wall imaging (VWI), and CVR-weighted imaging (n = 36; vessel segments evaluated = 396)...
January 6, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#9
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28057652/study-protocol-for-a-randomised-controlled-multicentre-study-the-foraminotomy-acdf-cost-effectiveness-trial-facet-in-patients-with-cervical-radiculopathy
#10
A E H Broekema, J M A Kuijlen, G A T Lesman-Leegte, R H M A Bartels, A D I van Asselt, P C A J Vroomen, J M C van Dijk, M F Reneman, R Soer, R J M Groen
INTRODUCTION: Cervical radiculopathy due to discogenic or spondylotic stenosis of the neuroforamen can be surgically treated by an anterior discectomy with fusion (ACDF) or a posterior foraminotomy (FOR). Most surgeons prefer ACDF, although there are indications that FOR is as effective as ACDF, has a lower complication rate and is less expensive. A head-to-head comparison of the 2 surgical techniques in a randomised controlled trial has not yet been performed. The study objectives of the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) study are to compare clinical outcomes, complication rates and cost-effectiveness of FOR to ACDF...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28053621/clinical-and-magnetic-resonance-imaging-features-of-compressive-cervical-myelopathy-with-traumatic-intervertebral-disc-herniation-in-cynomolgus-macaque-macaca-fascicularis
#11
Yun-Jung Choi, Hye-Jin Park, Chul-Ho Sohn, Kyeong Cheon Jung, Seong Hoe Park, Jae-Il Lee
Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord...
December 2016: Laboratory Animal Research
https://www.readbyqxmd.com/read/28042726/hybrid-cervical-disc-arthroplasty
#12
Tsung-Hsi Tu, Jau-Ching Wu, Henrich Cheng, Praveen V Mummaneni
For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042408/an-unusual-cause-of-postabortal-fever-requiring-prompt-surgical-intervention-a-pyomyoma-and-its-imaging-features
#13
Rashmi Bagga, Rakhi Rai, Jasvinder Kalra, Pradip K Saha, Tulika Singh
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28040874/prevention-of-spinal-cord-injury-using-brain-evoked-muscle-action-potential-br-e-msep-monitoring-in-cervical-spinal-screw-fixation
#14
Kazuyoshi Kobayashi, Shiro Imagama, Zenya Ito, Kei Ando, Tetsuro Hida, Naoki Ishiguro
PURPOSE: The goal of the study was to examine waveform deterioration in intraoperative monitoring during posterior fusion with a cervical screw. This surgery is useful for alignment correction, but worsening of neurological symptoms may occur in association with screw insertion and rod installation. Therefore, spinal cord monitoring is important for safe surgery. METHODS: The study included 25 cases treated with posterior fusion with a cervical screw. Waveform deterioration was defined as an intraoperative amplitude <50% of the control waveform...
December 31, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28028407/endoscopic-anatomy-and-features-of-anterior-cervical-foraminotomy-by-destandau-technique
#15
Keyvan Mostofi, Reza Karimi Khouzani
BACKGROUND: Minimally invasive spine surgery limits surgical trauma and avoids traditional open surgery so in the majority of cases, recovery is much quicker and patients have less pain after surgery. AIM: The authors describe an endoscopic approach to anterior cervical foraminotomy (ACF) by Destandau's method. MATERIAL AND METHODS: Anterior cervical foraminotomy by Destandau's method is carried out under general anaesthesia. A 3 cm transverse skin incision is used just slightly past the anterior border of the sternocleidomastoid's muscle laterally...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28018501/regional-anesthesia-with-dexmedetomidine-infusion-a-feasible-method-for-the-awake-test-during-carotid-endarterectomy
#16
Jonggeun Lee, Up Huh, Seunghwan Song, Sung Woon Chung, Sang Min Sung, Han Jin Cho
Background: Carotid endarterectomy (CEA) is the standard treatment modality for the prevention of stroke in patients with carotid stenosis. This study reports our experiences during CEA with routine awake tests under regional anesthesia (RA) combined with light sedation by dexmedetomidine infusion. Materials and Methods: We retrospectively reviewed 23 patients who had undergone CEA between April 2013 and June 2015. All patients underwent the awake test during CEA with cervical plexus block and light sedation by continuous dexmedetomidine infusion...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28001265/management-of-degenerative-cervical-myelopathy-an-update
#17
Andrei F Joaquim, Enrico Ghizoni, Helder Tedeschi, Wellington K Hsu, Alpesh A Patel
Introduction: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adult patients. Patients generally present with a slow, progressive neurological decline or a stepwise deterioration pattern. In this paper, we discuss the most important factors involved in the management of DCM, including a discussion about the surgical approaches. Method: The authors performed an extensive review of the peer-reviewed literature addressing the aforementioned objectives...
December 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27999126/moving-target-transient-rotational-stenosis-precipitating-jugular-bow-hunter-s-syndrome
#18
Waleed Brinjikji, Christopher S Graffeo, Avital Perry, Terence Zimmerman, Jeffrey R Janus, Pearce P Morris, Gregory D Cascino, Giuseppe Lanzino
A 60-year-old man presented with a 10-month history of of stereotypical spells characterized by vertigo, tinnitus, blurred vision, left hemibody numbness, and occasional syncope, precipitated by turning his head leftwards. Cerebral angiography and CT angiography of the head and neck with provocative maneuvers did not demonstrate vertebral artery narrowing. However, there was narrowing of the left internal jugular vein due to extrinsic compression from the sternocleidomastoid with leftward head rotation in the setting of hypoplasia of the right internal jugular vein...
December 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27995806/etiologies-of-internal-carotid-artery-pseudo-occlusions-in-acute-stroke-patients-what-neurointerventionalists-can-expect
#19
Süha Akpınar, Pınar Gelener, Güliz Yilmaz
In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although computed tomography angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in acute stroke patients. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography (DSA). 11 out of 72 patients had pseudo-occlusion on CTA...
December 20, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27979610/salivary-bypass-tube-placement-in-esophageal-stricture-a-technical-note-and-report-of-three-cases
#20
Giancarlo Tirelli, Roberto Baruca, Francesca Boscolo Nata
Hypopharyngeal and cervical esophageal strictures can be caused by advanced malignancies, ingestion of caustic materials, or can follow surgery or radiation therapy. They cause marked dysphagia and consequently patients need nasogastric or gastrostomy tube feeding, with a remarkable impact on quality of life. To restore oral feeding, the stenosis can be progressively dilated by using rubber bougies of increasing diameter, and a Montgomery(®) Salivary Bypass Tube can then be inserted to maintain the obtained calibre...
December 12, 2016: Auris, Nasus, Larynx
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