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Cervical spinal cord injury

Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
Duncan R Morhardt, Miriam Hadj-Moussa, He Chang, J Stuart Wolf, William W Roberts, John T Stoffel, Gary J Faerber, Anne P Cameron
OBJECTIVE: To evaluate the association of clinical factors on outcomes in SCI patients undergoing ureteroscopy. Immobility, recurrent urinary tract infection, and lower urinary tract dysfunction contribute to renal stone formation in spinal cord injury (SCI) patients. Ureteroscopy is a commonly utilized treatment modality, however, surgical complication rates and outcomes have been poorly defined. Evidence guiding safe and effective treatment of stones in this cohort remains scarce. METHODS: Records were retrospectively reviewed for SCI patients who underwent ureteroscopy for kidney stones from 1996-2014 at a single institution...
March 12, 2018: Urology
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Tanziyah Muqeem, Biswarup Ghosh, Vitor Pinto, Angelo C Lepore, Manuel Covarrubias
Presynaptic voltage-gated K+ (Kv) channels in dorsal root ganglion (DRG) neurons are thought to regulate nociceptive synaptic transmission in the spinal dorsal horn. However, the Kv channel subtypes responsible for this critical role have not been identified. The Kv3.4 channel is particularly important because it is robustly expressed in DRG nociceptors, where it regulates action potential (AP) duration. Furthermore, Kv3.4 dysfunction is implicated in the pathophysiology of neuropathic pain in multiple pain models...
March 14, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Daniela G L Terson de Paleville, Susan J Harkema, Claudia A Angeli
CONTEXT: Four individuals with motor complete SCI with an implanted epidural stimulator who were enrolled in another study were assessed for cardiovascular fitness, metabolic function and body composition at four time points before, during, and after task specific training. Following 80 locomotor training sessions, a 16-electrode array was surgically placed on the dura (L1-S1 cord segments) to allow for electrical stimulation. After implantation individuals received 160 sessions of task specific training with epidural stimulation (stand and step)...
March 14, 2018: Journal of Spinal Cord Medicine
Xinwei Shao, Jican Zeng, Yuchun Chen, Lixian Wu, Xinjia Wang
OBJECTIVE: To analyze the mechanism of the halo vest-assisted Z-shape elevating-pulling reduction technique for cervical unilateral locked facets, and confirm the safety of the spinal cord under the epidural pressure that occurs during the reduction process. METHODS: Eleven osteoligamentous whole coronal and cervical spine specimens were established as skull-neck-thorax models of cervical unilateral locked facets at the C5/6 level. The halo vest-assisted Z-shape elevating-pulling reduction technique was then applied to reduce the locked facets...
March 14, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Ying-Na Qi, Ming-Sheng Tan, Yan-Lei Wang, Wei Wang, Xin-Jie Wu, Qing-Ying Hao, Ping Yi, Feng Yang, Xiang-Sheng Tang
OBJECTIVE: To investigate the effect and mechanism of Buyanghuanwu decoction on platelet activating factor expression in spinal cord tissue of model of acute upper cervical spinal cord injury in rats. METHODS: Sixty SPF grade 3-month-old female Wistar rats were randomly divided into sham operation group, model group, methylprednisolone group and Buyanghuanwu decoction (Traditional Chinese Medicine group, TCM), with 15 rats in each group. The first day after the modeling, the methylprednisolone group were treated by injection of the tail vein for a total of 24 h, the first dose of 30 mg/kg, followed by a dose of 5...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
Patrick D Ganzer, Michael J Darrow, Eric C Meyers, Bleyda R Solorzano, Andrea D Ruiz, Nicole M Robertson, Katherine S Adcock, Justin T James, Han S Jeong, April M Becker, Mark P Goldberg, David T Pruitt, Seth A Hays, Michael P Kilgard, Robert L Rennaker
Recovery from serious neurological injury requires substantial rewiring of neural circuits. Precisely-timed electrical stimulation could be used to restore corrective feedback mechanisms and promote adaptive plasticity after neurological insult, such as spinal cord injury (SCI) or stroke. This study provides the first evidence that closed-loop vagus nerve stimulation (CLV) based on the synaptic eligibility trace leads to dramatic recovery from the most common forms of SCI. The addition of CLV to rehabilitation promoted substantially more recovery of forelimb function compared to rehabilitation alone following chronic unilateral or bilateral cervical SCI in a rat model...
March 13, 2018: ELife
Ming-Sheng Tan, Yan-Lei Wang, Ying-Na Qi, Chun-Ke Dong, Wei Wang, Ping Yi, Feng Yang, Xiang-Sheng Tang, Qing-Ying Hao
OBJECTIVE: To explore the effect and underlying mechanism of decompression(DE)combined with Governor Vessel(GV)electro-acupuncture(EA) on rats with acute severe upper cervical spinal cord compression injury. METHODS: Thirty SPF rats were randomly divided into 5 groups(control group A, B and experiment group C, D, E), 6 rats in each group. The model of acute severe upper cervical spinal cord compression injury were made by forcing a balloon catheter put in atlas pillow clearance...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Feng Yang, Ming-Sheng Tan, Ping Yi, Xiang-Sheng Tang, Qing-Ying Hao, Ying-Na Qi
OBJECTIVE: To compare the clinical effect between spinal card decompression combined with traditional Chinese medicine and simple spinal card decompression for cervical spondylotic myelopathy. METHODS: From June 2012 to June 2015, 73 patients with cervical spondylotic myelopathy were treated, including 42 males and 31 females, aged from 29 to 73 years old with a mean of 50.9 years old. The patients were divided into the simple operation group (34 cases) and the operation combined with traditional Chinese medicine group(39 cases) according to the idea of themselves...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Tiina Ihalainen, Teemu M Luoto, Irina Rinta-Kiikka, Antti Ronkainen, Anna-Maija Korpijaakko-Huuhka
STUDY DESIGN: Prospective cohort study. OBJECTIVES: This prospective cohort study aims to evaluate the recovery of penetration/aspiration and functional feeding outcome in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland METHODS: Forty-six patients with TCSCI were enrolled. All the patients received speech therapeutic interventions based on their clinical needs and were examined with a videofluoroscopic swallowing study (VFSS) at enrollment...
March 12, 2018: Spinal Cord
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
Joseph Marcotte, Joshua Hazelton, Chirag Arya, Michael Dalton, Amber Batool, John Gaughan, Linh Nguyen, John Porter, Nicole Fox
BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Figen Govsa, Mehmet Asim Ozer, Huseyin Biceroglu, Asli Beril Karakas, Sedat Cagli, Cenk Eraslan, Ahmet Kemal Alagoz
BACKGROUND: Transarticular screw fixation has fatal complications such as vertebral artery (VA), carotid artery and spinal cord injuries. The landmarks for deciding the entry point for C1 lateral mass screws were clarified by using life-size three dimensional (3D) patient specific spine models. METHODS: This study included a total of 10 patients with C1 fractures. Dual CT scan data from C1 pre and post screwing of them were modified into 3D patient specific life-size cervical spine models...
March 3, 2018: World Neurosurgery
Taylor E Purvis, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, C Rory Goodwin, Mari L Groves, Michael C Ain, Daniel M Sciubba
OBJECTIVE: To compare in-hospital complication rates in pediatric patients with atlantoaxial and subaxial injuries undergoing either external fixation or surgical fusion. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2002-2011 Nationwide Inpatient Sample (NIS) for patients under the age of 18 with a diagnosis of cervical spine fracture without spinal cord injury or cervical spine subluxation. Patients who underwent external immobilization or internal fixation were included for analysis...
February 5, 2018: Clinical Neurology and Neurosurgery
Rantaro Kamimura, Mohammad Z Hossain, Shumpei Unno, Hiroshi Ando, Yuji Masuda, Kojiro Takahashi, Masanori Otake, Isao Saito, Junichi Kitagawa
Current therapeutics are not effective for orofacial neuropathic pain, and better options are needed. The present study used inferior orbital nerve (ION)-injured mice to investigate the effect of inhibiting monoacylglycerol lipase (MAGL), an enzyme that degrades the major endocannabinoid 2-arachydonoylgycerol (2-AG) in orofacial neuropathic pain. The head-withdrawal threshold to mechanical stimulation of the whisker pad was reduced on days 3, 5, and 7 after ION injury. Injection of JZL184, a selective inhibitor of MAGL, on day 7 after ION injury attenuated the reduction in head-withdrawal threshold at 2 h after administration...
March 2, 2018: Journal of Oral Science
S Shekar Dukkipati, Teresa L Garrett, Sherif M Elbasiouny
Alpha-motoneuron soma size is correlated with the cell's excitability and function, and has been posited as a plastic property that changes during cellular maturation, injury, and disease. This study examined whether alpha-motoneuron somas change in size over disease progression in the G93A mouse model of amyotrophic lateral sclerosis (ALS), a disease characterized by progressive motoneuron death. We used 2D- and 3D-morphometric analysis of motoneuron size and measures of cell density at four key disease stages: Neonatal, P10 - with earliest known disease changes; young adult, P30 - presymptomatic with early motoneuron death; symptom onset, P90 - with death of 70-80% of motoneurons; and end-stage, P120+ - with full paralysis of hindlimbs...
March 4, 2018: Journal of Physiology
Gen-Long Jiao, Yong-Bao Fan, De-Jun Deng, Jian-Li Shao, Guo-Dong Sun, Zhi-Zhong Li
OBJECTIVE: To analyze the clinical effect of spinal cord decompression and lavage therapy on chronic cervical spinal cord injury and explore the possible mechanism. METHODS: Fifty-seven patients with chronic cervical spinal cord injury treated in our hospital from January, 2008 to January, 2015 were enrolled, including 17 with multilevel cervical disc herniation, 25 with long segmental ossification of the posterior longitudinal ligament, 13 with hypertrophy or calcification of neck ligamentum flavum, and 2 with old cervical fractures...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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