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Spinal deterioration

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https://www.readbyqxmd.com/read/29149848/the-patterns-of-loss-of-correction-after-posterior-wedge-osteotomy-in-ankylosing-spondylitis-related-thoracolumbar-kyphosis-a-minimum-of-five-year-follow-up
#1
Mu Qiao, Bang-Ping Qian, Sai-Hu Mao, Yong Qiu, Bin Wang
BACKGROUND: Short-term studies have demonstrated good surgical outcomes after pedicle subtraction osteotomy (PSO) in ankylosing spondylitis (AS) patients, but there is a paucity of literature focused on middle-term results, especially regarding patterns of loss of correction. The objective of this study is to assess the durability of surgical outcomes and the patterns of loss of correction in thoracolumbar kyphosis secondary to AS following lumbar PSO with over 5-year follow-up. METHODS: We performed a retrospective review of 155 consecutive AS patients undergoing lumbar PSO from January 2001 to December 2011...
November 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29131086/intracranial-epidural-haematoma-following-surgical-removal-of-a-giant-lumbosacral-schwannoma-a-case-report-and-literature-review
#2
Jakob Nemir, Vjerislav Peterković, Ines Trninić, Ivan Domazet, Hrvoje Barić, Miroslav Vukić
Postoperative intracranial epidural haematoma (EDH) is an extremely rare complication following spinal surgery, with only a handful of cases described in the literature. We report the case of a 16-year-old girl who underwent a successful subtotal resection of a giant lumbosacral schwannoma (L2-S2 level). Recovery from general anaesthesia was uneventful; however, her neurological status deteriorated rapidly within 24 h after surgery. A head computed tomography scan revealed a large right frontoparietal EDH with midline shift...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29125427/the-surgical-treatment-of-metastatic-spine-tumors-within-the-intramedullary-compartment
#3
Ben A Strickland, Ian E McCutcheon, Indro Chakrabarti, Laurence D Rhines, Jeffrey S Weinberg
OBJECTIVE Metastasis to the spinal cord is rare, and optimal management of this disease is unclear. The authors investigated this issue by analyzing the results of surgical treatment of spinal intramedullary metastasis (IM) at a major cancer center. METHODS The authors retrospectively reviewed the medical records of 13 patients who underwent surgery for IM. Patients had renal cell carcinoma (n = 4), breast carcinoma (n = 3), melanoma (n = 2), non-small cell lung cancer (n = 1), sarcoma (n = 1), adenoid cystic carcinoma (n = 1), and cervical cancer (n = 1)...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125267/treatment-strategies-of-spinal-arteriovenous-fistulas-and-malformations-timing-matters
#4
Wing M Ho, Alice Görke, Ondra Petr, Claudius Thomé
Spinal vascular malformations are a rare heterogenous entity of spinal lesions with abnormal blood vessels. They may occur extra- and intradurally, peri- and intramedullary, with confined or complex configuration, and at various levels of the spine. Associated clinical symptoms are extremely variable and may range from diffuse pain, to progressive myelopathy, and even to acute hemorrhage with severe neurological deficits. Often, the patients present with significant spinal cord injury before the spinal arteriovenous lesions are diagnosed...
November 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29114283/a-method-for-reconstruction-of-severely-damaged-spinal-cord-using-autologous-hematopoietic-stem-cells-and-platelet-rich-protein-as-a-biological-scaffold
#5
Ahmed Sabry Ammar, Yasser Osman, Ahmed Taher Hendam, Mohammed Ahmed Hasen, Fatma Abdullah Al Rubaish, Danya Yaagoub Al Nujaidi, Faisal Mishal Al Abbas
Introduction: There have been attempts to alter the prognosis of severe spinal cord injury in different centers, but none of which have reliably altered the outcome. Some trials use stem cells (SCs) that produced widely differing results. We hereby add our experience in our center of a surgical reconstruction of the damaged spinal cord using a mixture of SCs and Platelet-Rich Protein (PRP) with fibrin coated as a biological scaffold. Materials and Methods: Four cases of severely damaged spinal cord have been operated for neurolysis and reconstruction of the spinal cord using SCs and platelet-rich protein (PRP) with fibrin coated harvested from the peripheral circulation of the patient...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29103927/three-dimensional-gait-analysis-reveals-dynamic-alignment-change-in-a-patient-with-dropped-head-syndrome-a-case-report
#6
Kousei Miura, Hideki Kadone, Masao Koda, Hiroshi Kumagai, Katsuya Nagashima, Kengo Fujii, Hiroshi Noguchi, Toru Funayama, Tetsuya Abe, Takeo Furuya, Masashi Yamazaki
Dropped head syndrome (DHS) is a cervical kyphotic deformity caused by apparent weakness of the neck extensor muscles. We often encounter patients whose symptoms, including impaired forward vision and neck pain, deteriorate while walking. This is the first report of a case of dynamic spinal alignment change in a patient with DHS during walking using three-dimensional gait analysis. A 78-year-old Japanese woman complained of impaired forward vision and neck pain while walking. Her radiograph showed severe cervical kyphosis...
November 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29101668/gut-microbiota-are-disease-modifying-factors-after-traumatic-spinal-cord-injury
#7
REVIEW
Kristina A Kigerl, Klauss Mostacada, Phillip G Popovich
Spinal cord injury (SCI) disrupts the autonomic nervous system (ANS), impairing its ability to coordinate organ function throughout the body. Emerging data indicate that the systemic pathology that manifests from ANS dysfunction exacerbates intraspinal pathology and neurological impairment. Precisely how this happens is unknown, although new data, in both humans and in rodent models, implicate changes in the composition of bacteria in the gut (i.e., the gut microbiota) as disease-modifying factors that are capable of affecting systemic physiology and pathophysiology...
November 3, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29099857/knockout-of-apolipoprotein-e-in-rabbit-promotes-premature-intervertebral-disc-degeneration-a-new-in-vivo-model-for-therapeutic-approaches-of-spinal-disc-disorders
#8
Anja Beierfuß, Hermann Dietrich, Christian Kremser, Monika Hunjadi, Andreas Ritsch, Thomas Rülicke, Claudius Thomé, Demissew Shenegelegn Mern
Intervertebral disc (IVD) degeneration that accelerates the loss of disc structural and functional integrities is recognized as one of the major factors of chronic back pain. Cardiovascular risk factors, such as deficits of apolipoproteins that elevate the levels of cholesterol and triglycerides, are considered critical for the progress of atherosclerosis; notably in the abdominal aorta and its lumbar branching arteries that supply lumbar vertebrae and IVDs. Obstruction of the lumbar arteries by atherosclerosis is presumed to promote lumbar disc degeneration and low back pain...
2017: PloS One
https://www.readbyqxmd.com/read/29097555/lupus-myelopathy
#9
Dominika D Raciborska, Alastair John Noyce, Dev Pyne, Benjamin P Turner
Although neurological manifestations of systemic lupus erythematosus (SLE) are well recognised, myelopathy complicating SLE is rare. A 35-year-old woman presented with non-specific symptoms and a respiratory tract infection but had serological evidence of SLE. She subsequently deteriorated rapidly, developing a catastrophic spinal cord syndrome. Her initial MRI was normal; but after 1 month, her encephalopathy having progressed, repeat imaging showed characteristic myelitic changes. She responded only slowly to a combination of cyclophosphamide and corticosteroids...
November 2, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29095413/segmental-pedicle-screw-instrumentation-and-fusion-only-to-l5-in-the-surgical-treatment-of-flaccid-neuromuscular-scoliosis
#10
Masashi Takaso, Toshiyuki Nakazawa, Takayuki Imura, Michinari Fukuda, Kazuhisa Takahashi, Seiji Ohtori
STUDY DESIGN: A retrospective cohort study was performed. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of stopping segmental pedicle screw instrumentation constructs at L5 in the treatment of neuromuscular scoliosis. SUMMARY OF BACKGROUND DATA: Duchenne muscular dystrophy and spinal muscular atrophy are flaccid neuromuscular disorders in which gradual deterioration is the hallmark and have a lot of characteristics in common despite differences in etiology...
October 31, 2017: Spine
https://www.readbyqxmd.com/read/29071044/chiari-type-i-malformation-with-cervicothoracic-syringomyelia-subterfuge-as-flail-arm-syndrome
#11
Zhi Gang Lan, Seidu A Richard, Jiagang Liu, Chao You
Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44-year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee...
August 29, 2017: Neurology International
https://www.readbyqxmd.com/read/29047318/spontaneous-spinal-epidural-hemorrhage-following-disseminated-intravascular-coagulation-resulting-in-paraplegia-a-case-report
#12
Nazia Dildar, Saeed Bin Ayaz, Muhammad Omer Aamir, Nadeem Ahmad
CONTEXT: Spontaneous spinal epidural hemorrhage (SSEH) mostly presents as low back pain with or without a radiculopathy, and rarely with paraplegia or tetraplegia depending on the site and severity of spinal cord compression. We present here a case who had anemia and developed paraplegia following disseminated intravascular coagulation (DIC) due to a transfusion reaction. FINDINGS: A 65-year-old lady presented with sudden onset chest pain radiating to nape of the neck followed by loss of sensations and power in legs few hours after a blood transfusion...
October 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29037864/can-bladder-fibrosis-in-congenital-urinary-tract-obstruction-be-reversed
#13
REVIEW
Yu Tao Lu, Stine Julie Tingskov, Jens Christian Djurhuus, Rikke Nørregaard, L Henning Olsen
A variety of conditions exists in adults and children in which functional or anatomical urinary tract obstructions cause bladder fibrosis, which reduces the bladder's ability to store and empty urine. Current surgical procedures include removal of the obstructions to facilitate bladder emptying or prompt prenatal or postnatal spinal closure to prevent further neurogenic damage. Bladder fibrosis may occur, and it can get worse if a flow hindrance persists or deteriorates. Anti-fibrotic therapeutic strategies that target a variety of factors have been developed in animal models, but currently there are no anti-fibrotic therapies available for clinical use...
September 28, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29033576/lumbar-spinal-stenosis-attributable-to-tophaceous-gout-case-report-and-review-of-the-literature
#14
Wei Wang, Qingbo Li, Lei Cai, Weijun Liu
OBJECTIVES: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits. METHODS: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature. RESULTS: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29026670/rare-case-of-conus-medullaris-glioblastoma-multiforme-in-a-teenager
#15
Lakhdar Fayçal, Bougrine Mouna, El Abbadi Najia
BACKGROUND: Primary intramedullary spinal glioblastoma multiforme (GBM) lesions are very rare comprising only 1.5% of all spinal cord tumors. These lesions typically result in rapid neurological deterioration and are associated with a very poor prognosis. CASE DESCRIPTION: A 16-year-old male exhibited a slowly progressive paraparesis with urinary incontinence, ultimately resulting in paraplegia. On magnetic resonance (MR), he was diagnosed with an intramedullary GBM of the spinal cord extending from the T9 level through the conus medullaris...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29021680/nondysraphic-cervicomedullary-intramedullary-lipoma
#16
Sujeet Kumar Meher, Laxmi Narayan Tripathy, Harsh Jain, Sunandan Basu
Spinal cord lipomas are usually associated with spinal dysraphism and is most common in lumbosacral region. Spinal intradural lipoma is a rare condition accounting for less than 1% of spinal cord tumours and is most prevalent in cervicodorsal region. Intramedullary spinal cord lipoma of cervical spine not associated with spinal dysraphism is one of the rarest lesions. They usually present insidiously with slowly progressive myelopathic deficits. We present a case of nondysraphic intramedullary spinal cord lipoma with exophytic component and intracranial extension...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28983455/long-term-cognitive-and-somatic-outcomes-of-enzyme-replacement-therapy-in-untransplanted-hurler-syndrome
#17
Julie B Eisengart, Jeanine Jarnes, Alia Ahmed, Igor Nestrasil, Richard Ziegler, Kathleen Delaney, Elsa Shapiro, Chester Whitley
Mucopolysaccharidosis type I (MPS I) was added to the Recommended Uniform Screening Panel for newborn screening in 2016, highlighting recognition that early treatment of MPS I is critical to stem progressive, irreversible disease manifestations. Enzyme replacement therapy (ERT) is an approved treatment for all MPS I phenotypes, but because the severe form (MPS IH, Hurler syndrome) involves rapid neurocognitive decline, the impermeable blood-brain-barrier is considered an obstacle for ERT. Instead, hematopoietic cell transplantation (HCT) has long been recommended, as it is believed to be the only therapy that arrests neurocognitive decline...
December 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28973505/posterior-reversible-encephalopathic-syndrome-in-the-setting-of-induced-elevated-mean-arterial-pressure-in-patients-with-spinal-cord-injury
#18
Alexander C Whiting, Manuel P Fanarjian, Randall J Hlubek, Jakub Godzik, U Kumar Kakarla, Nicholas Theodore
BACKGROUND AND IMPORTANCE: Acute spinal cord injury (SCI) is managed by avoiding hypotension and elevating mean arterial pressure (MAP) to attain optimal perfusion of the spinal cord. Few studies have been published regarding complications related to this treatment paradigm. CLINICAL PRESENTATION: Three patients with SCI developed posterior reversible encephalopathic syndrome (PRES) during treatment with intravenous fluids and vasopressors administered to maintain elevated MAPs...
July 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971046/intraoperative-neurophysiological-monitoring-for-spinal-cord-tumor-surgery-comparison-of-motor-and-somatosensory-evoked-potentials-according-to-tumor-types
#19
Taeha Park, Jinyoung Park, Yoon Ghil Park, Joowon Lee
OBJECTIVE: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. METHODS: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later...
August 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28963161/tuberculosis-of-the-spine-with-severe-angular-kyphosis-mean-34-year-post-operative-follow-up-shows-that-prevention-is-better-than-salvage
#20
Y W Wong, D Samartzis, K M C Cheung, K Luk
AIMS: To address the natural history of severe post-tuberculous (TB) kyphosis, with focus upon the long-term neurological outcome, occurrence of restrictive lung disease, and the effect on life expectancy. PATIENTS AND METHODS: This is a retrospective clinical review of prospectively collected imaging data based at a single institute. A total of 24 patients of Southern Chinese origin who presented with spinal TB with a mean of 113° of kyphosis (65° to 159°) who fulfilled inclusion criteria were reviewed...
October 2017: Bone & Joint Journal
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