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Cervical Stenosis

Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Bao-Lin Zhao, Cheng Ji, Jia-Jia Jiang, Ruo-Feng Yin
OBJECTIVE: To explore the clinical effectiveness of various posterior decompression surgeries in the treatment of upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis. METHODS: From January 2010 to December 2015, 22 consecutive patients with combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis were treated with two different approaches of posterior decompression surgeries. In group A with 10 patients, both cervical and thoracic spinal decompression surgeries were performed simultaneously (one-stage surgery); in group B with 8 patients, cervical and thoracic spinal decompression surgeries were performed separately within three months (two-stage surgery)...
March 10, 2018: International Journal of Surgery
Kazuchika Suzuki, Hiroaki Sakai, Kenji Takahashi
We herein report anesthetic management during aortic valve replacement for aortic valve regurgitation in a patient with adult mucopolysaccharidosis type II (MPS type 2) (Hunter syndrome). This disorder is rare and related to the accumulation of a mucopolysaccharide in lysosomes. It affects various organs, including the airways, heart, and central nerves. In children with MPS type 2, the risk of airway obstruction during anesthesia/sedation is high, and the degree of difficulty increases with aging. The patient described herein was a 33-year-old male without mental retardation...
2018: JA Clin Rep
Tomasz Tykocki, Johann du Plessis, Guy Wynne-Jones
OBJECTIVE: A dynamic compression injury of the cervical spinal cord is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension MRI provides information on the dynamic cervical injury. To compare morphometric parameters on neutral, flexion/extension MRI in cervical spondylotic myelopathy METHODS: Patients with cervical canal stenosis who had MRI in neutral, flexion and extension positions were retrospectively reviewed. A morphometric comparison of following parameters at compression level was performed: Spinal cord (SC) area, cerebrospinal fluid (CSF) area, CSF reserve ratio (CSF/CSF plus SC)...
March 7, 2018: World Neurosurgery
Samuel K Cho, Jun S Kim, Samuel C Overley, Robert K Merrill
Cervical laminoplasty was initially described for the management of cervical myelopathy resulting from multilevel stenosis secondary to ossification of the posterior longitudinal ligament. The general concepts are preservation of the dorsal elements, preservation of segmental motion, and expansion of the spinal canal via laminar manipulation. No clear evidence suggests that laminoplasty is superior to either posterior laminectomy or anterior cervical diskectomy and fusion. However, laminoplasty has its own advantages, indications, and complications...
March 7, 2018: Journal of the American Academy of Orthopaedic Surgeons
H Y Zhao, Z C Jia, D S Fan
Objective: To analyze the incidence of intracranial unruptured aneurysms in patients with internal carotid artery (ICA) stenosis (≥30%), the characteristics of aneurysms and risk factors in patients with ICA stenosis and intracranial aneurysm. Methods: Clinical data of patients receiving digital subtraction angiography (DSA) at Peking University Third Hospital between January 2012 and June 2015 were retrospectively reviewed to identify patients with ICA stenosis and unruptured intracranial aneurysm. Results: Among 247 patients with ICA stenosis, 16 patients (6...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Yang Meng, Xiaofei Wang, Beiyu Wang, Tingkui Wu, Hao Liu
RATIONALE: Cervical open-door laminoplasty can enlarge the volume of the cervical vertebral canal and thus has become an effective and safe treatment for multilevel cervical disc herniation and cervical stenosis. Some post-surgery complications exist, such as reduction of cervical alignment and local kyphosis. However, aggravation of cervical disc herniation at the surgical level during short-term follow-up has not been discussed. Additionally, spontaneous disappearance of herniated disc pulposus is a common phenomenon in the lumbar region but is relatively rare in the cervical region...
March 2018: Medicine (Baltimore)
Junji Kamogawa, Osamu Kato, Tatsunori Morizane
PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection...
March 7, 2018: Japanese Journal of Radiology
Alexandru-Dan Sabău, Noor Hassan, Cătălin Gabriel Smarandache, Alin Miheţiu, Ștefan Ţîţu, Dan Sabău
PURPOSE: An original technique using laparoscopic instruments in a gastric endocavitary work chamber with potential for esophagus, stomach and D1 vizualisation. The main purpose of laparagastroscopy is to improve the quality of life of the patient disabling by the esophageal tumor. This method has several advantages: providing physiological feeding, harvesting materials for histopathological examination, solving eso-tracheal fistulas concurrently with the proposed operation and hemostatic role through compression, low energy and plastic consumption, rapid socio-economic reintegration, mental psychological care of the patient...
January 2018: Chirurgia
Daniel C Sacchetti, Shawna M Cutting, Ryan A McTaggart, Andrew D Chang, Morgan Hemendinger, Brian Mac Grory, Matthew S Siket, Tina Burton, Bradford Thompson, Sara K Rostanski, Shyam Prabhakaran, Joshua Z Willey, Randolph S Marshall, Mitchell Sv Elkind, Pooja Khatri, Karen L Furie, Mahesh V Jayaraman, Shadi Yaghi
Background Large vessel disease stroke subtype carries the highest risk of early recurrent stroke. In this study we aim to look at the association between impaired perfusion and early stroke recurrence in patients with intracranial atherosclerotic disease or total cervical carotid occlusion. Methods This is a retrospective study from a comprehensive stroke center where we included consecutive patients 18 years or older with intracranial atherosclerotic disease or total cervical carotid occlusion admitted with a diagnosis of ischemic stroke within 24 h from symptom onset with National Institute Health Stroke Scale < 15, between 1 December 2016 and 30 June 2017...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Sombat Kunakornsawat, Letho, Tinnakorn Pluemvitayaporn, Pritsanai Pruttikul, Chaiwat Piyasakulkaew, Kanthika Wasinpongwanich, Piyabuth Kittithamvongs
BACKGROUND: The variation of C1 spinolaminar line in normal population is not fully understood. The relative position of C1 lamina to C3-C2 spinolaminar line is reported as good screening tool for determination of C1 canal stenosis. OBJECTIVE: To determine the variation of C1 spinolaminar line and find the prevalence of C1 canal stenosis in normal population using C3-C2 spinolaminar test. MATERIALS AND METHODS: Three hundred and fifteen lateral cervical radiographs from 315 volunteers without neurological symptoms were analyzed...
March 3, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
Katharina Wolf, Markus Hupp, Susanne Friedl, Reto Sutter, Markus Klarhöfer, Patrick Grabher, Patrick Freund, Armin Curt
STUDY DESIGN: Level-, age-, and gender-matched controlled cross-sectional cohort study. OBJECTIVES: To investigate alterations of spinal cord (SC) motion within cervical spondylotic myelopathy (CSM) across the cervical spinal segments and its relation to cerebrospinal fluid (CSF)-flow, anatomic conditions, and clinical parameters. SETTING: University Hospital Balgrist, Zurich, Switzerland. METHODS: Overall, 12 patients suffering from CSM at level C5 and 12 controls underwent cardiac-gated 2D phase-contrast-MRI at level C2 and C5 and standard MRI sequences...
March 1, 2018: Spinal Cord
A Taha, S L M Bakker
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
Céline Thomet, Ali Modarressi, Eva Meia Rüegg, Pavel Dulguerov, Brigitte Pittet-Cuénod
Long-segment tracheal reconstruction remains a challenge. The ideal tracheal substitute should be an epithelialized tube to prevent stenosis and sufficiently rigid to maintain airflow patency. An autologous technique using a radial forearm free flap reinforced by rib cartilage has been recently described for tracheal reconstruction. We report here two cases of complex tracheal reconstruction with a modification of this technique, which consists of the creation of two independent skin paddles to allow the reconstruction of the trachea and a second adjacent defect (eg, cervical skin, esophagus)...
February 27, 2018: Annals of Plastic Surgery
Se-Il Jeon, Seung-Jae Hyun, Sanghyun Han, Byoung Hun Lee, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
BACKGROUND: T1 slope minus C2-C7 lordosis (TS-CL) and cervical sagittal alignment reportedly affect health-related quality-of-life (HRQOL) scores following multilevel posterior cervical fusion surgery. There are no reports of a relationship between cervical alignment and patient outcomes after anterior cervical discectomy and fusion (ACDF) involving three or more levels. This study aimed to investigate the relationship between cervical sagittal alignment and patient-reported HRQOL after three-or-more-level ACDF...
February 21, 2018: World Neurosurgery
Cody J Mansfield
INTRODUCTION: The patient was referred to an outpatient physical therapy clinic for lumbar radiculopathy by a primary care physician and subsequently referred for imaging due to suspicion of cervical myelopathy. The case highlights the clinical reasoning of the physical therapist differentiating between lumbar stenosis, cervical myelopathy, and upper cervical instability. To the author's knowledge, this is the only case report in the literature to describe the mechanism that could underpin a false positive Sharp-Purser test (SPT)...
February 23, 2018: Physiotherapy Theory and Practice
Jun Won Kim, Tae Hyung Kim, Jie-Hyun Kim, Ik Jae Lee
AIM: To evaluate toxicity and treatment outcome of high-dose radiotherapy (RT) for cervical esophageal cancer (CEC). METHODS: We reviewed a total of 62 consecutive patients who received definitive RT for stage I to III cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded...
February 21, 2018: World Journal of Gastroenterology: WJG
Yinze Diao, Yu Sun, Shaobo Wang, Fengshan Zhang, Shengfa Pan, Zhongjun Liu
RATIONALE: The typical intraoperative presentation of vertebral artery injury (VAI) usually involves profuse bleeding and requires immediate treatment. However, an occult VAI may occur intraoperatively and result in delayed life-threatening epidural pseudoaneurysm several days postoperatively. PATIENT CONCERNS: A 21-year-old man with compressive cervical myelopathy resulting from canal stenosis of skeletal fluorosis underwent decompression of C1 to C7 and instrumentation from C2 to C7...
February 2018: Medicine (Baltimore)
Aria Nouri, Lindsay Tetreault, Satoshi Nori, Allan R Martin, Anick Nater, Michael G Fehlings
BACKGROUND: Congenital spinal stenosis (CSS) of the cervical spine is a risk factor for acute spinal cord injury and development of degenerative cervical myelopathy (DCM). OBJECTIVE: To develop magnetic resonance imaging (MRI)-based criteria to diagnose preexisting CSS and evaluate differences between patients with and without CSS. METHODS: A secondary analysis of international prospectively collected data between 2005 and 2011 was conducted...
February 16, 2018: Neurosurgery
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