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Cervical Stenosis

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https://www.readbyqxmd.com/read/28195500/new-developments-in-clinical-ischemic-stroke-prevention-and-treatment-and-their-imaging-implications
#1
Jeremy J Heit, Max Wintermark
Acute ischemic stroke results from blockage of a cerebral artery or impaired cerebral blood flow due to cervical or intracranial arterial stenosis. Ischemic stroke prevention seeks to minimize the risk of developing impaired cerebral perfusion by controlling vascular and cardiac disease risk factors. Similarly, ischemic stroke treatment aims to restore cerebral blood flow through recanalization of an occluded artery or dilation of a severely narrowed artery that supplies cerebral tissue. Stroke prevention and treatment are increasingly informed by imaging studies, and neurovascular and cerebral perfusion imaging has become essential in in guiding ischemic stroke prevention and treatment...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28191625/iatrogenic-vascular-injuries-due-to-spinal-surgeries-endovascular-perspective
#2
Mustafa Gok, Elcin Aydin, Serkan Guneyli, Ali Akay, Celal Cinar, Ismail Oran
AIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. In this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries. MATERIAL AND METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1)...
January 17, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28183145/minimally-invasive-microscopic-posterior-cervical-decompression-simple-safe-and-effective
#3
Pierluigi Vergara
Background and Study Aims Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM. Materials and Methods A retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28176604/c5-nerve-root-palsy-after-posterior-cervical-spine-surgery
#4
Fu-Min Pan, Shan-Jin Wang, Bin Ma, De-Sheng Wu
BACKGROUND: C5 palsy is a serious complication after cervical decompression surgery in which the patient shows a deterioration in power of the deltoid or biceps brachii by at least one grade in the manual muscle test without aggravation of lower extremity function. Although there are several hypotheses regarding the etiology of C5 palsy, the pathogenesis and preventive measures remain unidentified and many other controversies remain. OBJECTIVE: To systematically review the clinical features, risk factors, mechanism, and preventive measures of C5 palsy after posterior cervical decompression surgery...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28176305/what-is-the-impact-of-preconception-abdominal-cerclage-on-fertility-evidence-from-a-randomized-controlled-trial
#5
Nicola J Vousden, Jenny Carter, Paul T Seed, Andrew H Shennan
INTRODUCTION: There is documented concern that cerclage may cause cervical stenosis or changes to the cervical mucus, which may reduce fertility. The aim of this study is to determine whether placement of a preconception abdominal cerclage affects fertility. MATERIAL AND METHODS: This was a planned subgroup analysis of a randomized controlled trial comparing abdominal cerclage, high vaginal or low vaginal cerclage. Women with a history of previous second trimester miscarriage or preterm birth despite having a low vaginal cerclage, presenting to specialist preterm birth services in the UK, were eligible for inclusion...
February 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#6
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio, Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28158155/comparison-of-cervical-sagittal-alignment-and-kinematics-after-posterior-full-endoscopic-cervical-foraminotomy-and-discectomy-according-to-preoperative-cervical-alignment
#7
Samuel Won, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Sung Bae Park, Jung Hyeon Moon, Won Heo, Sung-Mi Kim
BACKGROUND: The progression of cervical kyphosis due to injury to the facet joints and musculature is a major concern for posterior foraminotomy especially for patients with cervical lordosis of less than 10°. However, cervical hypo-lordosis (cervical lordosis < 10°) may be improved with the alleviation of pain and muscle spasms, which corresponds with the disappearance of a positive Spurling's test. When surgery is necessary, the spontaneous recovery of cervical curvature may be minimally offset using minimally invasive surgical techniques, such as posterior percutaneous endoscopic cervical foraminotomy (P-PECF)...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28155678/compression-distraction-reduction-surgical-verification-and-optimization-to-treat-the-basilar-invagination-and-atlantoaxial-dislocation-a-finite-element-analysis
#8
Xuefeng Bo, Weida Wang, Zan Chen, Zhicheng Liu
BACKGROUND: Basilar invagination (BI) combined with atlantoaxial dislocation (AAD) leads to foramen magnum stenosis and medullary spinal cord compression, causing nerve dysfunction. The purpose of the surgery is to remove the bony compression at brainstem ventral side and fix the unstable spinal segment and make it fused stably. Occipital cervical internal fixation system that simultaneously reduces atlantoaxial horizontal and vertical dislocation are established. We propose here a new compression-distraction reduction (CDR) technique...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28126274/pulsatile-tinnitus-and-carotid-artery-dissection
#9
Yuya Shimizu, Masato Yagi
Carotid artery dissection is an uncommon entity associated with head and neck pain, partial Horner's syndrome, amaurosis fugax, and brain ischemia, which may all occur in isolation or in combination. Herein, we report a rare case of cervical artery dissection in which pulsatile tinnitus was the only reported symptom. A 38-years-old man attended our hospital with a 4-days history of left side pulsatile tinnitus which began after stumbling. He had no other symptom. MRA showed luminal stenosis with pseudo lumen of the internal carotid artery...
January 23, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28124515/anatomic-criteria-determining-high-risk-carotid-surgery-patients
#10
Pavlos Tsantilas, Andreas Kuehnl, Erich Brenner, Hans H Eckstein
BACKGROUND: Based on randomized trials, carotid endarterectomy (CEA) is the standard procedure for patients with a 50-99% symptomatic carotid stenosis and carefully selected patients with an asymptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) is a technical alternative for patients with a high surgical risk or difficult anatomic conditions (e.g., recurrent stenosis). This study aims to provide an overview of anatomic factors associated with a higher risk of CEA complications...
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28123921/relief-of-lumbar-symptoms-after-cervical-decompression-in-patients-with-tandem-spinal-stenosis-presenting-with-primarily-lumbar-pain
#11
Daniel R Felbaum, Islam Fayed, Jeffrey J Stewart, Faheem A Sandhu
OBJECTIVE: Tandem cervical and lumbar spinal stenosis (TSS) is classically described as intermittent claudication, gait disturbance, and clinical findings of mixed myelopathy and polyradiculopathy. Rarely, patients can present with TSS manifesting in isolated lumbar pain. Several reports have demonstrated improved lumbar back pain and radiculopathy after decompressive cervical spine procedures. We present six patients with dramatic resolution of lumbar spine related symptoms after decompression of the cervical spinal cord despite presenting solely with lower back complaints...
December 24, 2016: Curēus
https://www.readbyqxmd.com/read/28108424/clinical-and-radiological-findings-after-multilevel-cervical-total-disc-replacement-defining-radiological-changes-to-predict-surgical-outcomes
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#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...
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
#19
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
#20
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)...
January 2017: AJNR. American Journal of Neuroradiology
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