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Spinal deterioration

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https://www.readbyqxmd.com/read/28516804/spinal-cord-atrophy-as-a-primary-outcome-measure-in-phase-ii-trials-of-progressive-multiple-sclerosis
#1
Niamh Cawley, Carmen Tur, Ferran Prados, Domenico Plantone, Hugh Kearney, Khaled Abdel-Aziz, Sebastian Ourselin, Claudia Am Gandini Wheeler-Kingshott, David H Miller, Alan J Thompson, Olga Ciccarelli
OBJECTIVES: To measure the development of spinal cord (SC) atrophy over 1 year in patients with progressive multiple sclerosis (PMS) and determine the sample sizes required to demonstrate a reduction in spinal cord cross-sectional area (SC-CSA) as an outcome measure in clinical trials. METHODS: In total, 44 PMS patients (26 primary progressive multiple sclerosis (PPMS), 18 secondary progressive multiple sclerosis (SPMS)) and 29 healthy controls (HCs) were studied at baseline and 12 months...
May 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28515929/clinical-outcome-of-posterior-fixation-surgery-in-patients-with-vertebral-metastasis-of-lung-cancer
#2
Tomoyuki Igarashi, Keigo Okamoto, Koji Teramoto, Ryosuke Kaku, Keiko Ishida, Keiko Ueda, Yo Kawaguchi, Tetsuo Hori, Masayuki Hashimoto, Shoji Kitamura, Noriaki Tezuka, Jun Hanaoka
Vertebral metastasis of non-small-cell lung cancer (NSCLC) often leads to neurological paralysis, with deterioration of the patients' activities of daily living (ADL). Surgical treatments for the symptoms are unlikely to be recommended due to the poor prognosis of patients with advanced NSCLC. The aim of the present study was to retrospectively evaluate the clinical outcome of posterior spinal fixation surgery in patients with neurological paralysis resulting from vertebral metastasis of NSCLC. Between April, 2007 and March, 2012, 4 patients (3 men and 1 woman; median age, 56...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28502567/myelopathy-secondary-to-a-spinal-cord-compression-induced-by-c2-nerve-tumors-during-head-rotation
#3
P Finet, C Raftopoulos
INTRODUCTION: It is well known that nerve root tumors developing in the spinal canal can be responsible for spinal cord compression leading to myelopathy and neurological deficits. We report the case of a patient with bilateral C2 neurofibromas presenting with a myelopathy of the upper cervical spine with no spinal cord compression on standard magnetic resonance imaging. The spinal cord compression occurred between the cervical neurofibromas only during head rotation. CASE REPORT: A patient with bilateral neurofibromas of the C2 nerve roots showed a progressive neurological deterioration with an intramedullary MRI hypersignal without visible compression...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28497928/effects-of-dual-and-complex-task-on-walking-ability-of-ambulatory-individuals-with-spinal-cord-injury
#4
Kitiyawadee Srisim, Thiwabhorn Thaweewannakij, Preeda Arrayawichanon, Pipatana Amatachaya, Lugkana Mato, Sugalya Amatachaya
BACKGROUND: Attempting to perform dual- and complex-tasks obviously reduces the walking ability of individuals with impaired cognitive functions. However, there is no clear evidence describing the effects of dual- and complex-tasks on the walking ability of ambulatory individuals with a spinal cord injury (SCI) who have intact cognitive functions, but suffer from various degrees of sensorimotor deterioration. AIM: To primarily investigate the effects of dual- and complex-task on the walking ability of ambulatory subjects with SCI as compared to healthy individuals...
May 12, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28489576/intraoperative-contrast-enhanced-ultrasonography-for-microcirculatory-evaluation-in-rhesus-monkey-with-spinal-cord-injury
#5
Lin Huang, Keng Chen, Fu-Chao Chen, Hui-Yong Shen, Ji-Chao Ye, Zhao-Peng Cai, Xi Lin
This study tried to quantify spinal cord perfusion by using contrast-enhanced ultrasound (CEUS) in rhesus monkey models with acute spinal cord injury. Acute spinal cord perfusion after injury was detected by CEUS, coupling with conventional ultrasound (US) and Color Doppler US (CDFI). Time-intensity curves and perfusion parameters were obtained by autotracking contrast quantification (ACQ) software in the epicenter and adjacent regions of injury, respectively. Neurological and histological examinations were performed to confirm the severity of injury...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28457929/cervical-spondylodiscitis-presentation-timing-and-surgical-management-in-59-patients
#6
George M Ghobrial, Daniel Franco, Thana Theofanis, Philip J Margiotta, Edward Andrews, Jefferson Wilson, James S Harrop, Joshua E Heller
BACKGROUND: Cervical spondylodiscitis is thought to carry a significant risk for rapid neurologic deterioration with a poor response to nonsurgical management. METHODS: A retrospective surgical case series of the acute surgical management of cervical spondylodiscitis is reviewed to characterize the neurologic presentation and postoperative neurologic course in a relatively uncommon disease. RESULTS: 59 patients were identified (mean age 59 yrs, range 18-83yrs, SD ±13...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28454778/decision-analysis-to-identify-the-ideal-treatment-for-adult-spinal-deformity-what-is-the-impact-of-complications-on-treatment-outcomes
#7
Emre Acaroglu, Umit Ozgur Guler, Aysun Cetinyurek-Yavuz, Selcen Yuksel, Yasemin Yavuz, Selim Ayhan, Montse Domingo-Sabat, Ferran Pellise, Ahmet Alanay, Francesco S Perez Grueso, Frank Kleinstück, Ibrahim Obeid
OBJECTIVE: The aim of this study was to analyze the impact of treatment complications on outcomes in adult spinal deformity (ASD) using a decision analysis (DA) model. METHODS: The study included 535 ASD patients (371 with non-surgical (NS) and 164 with surgical (S) treatment) from an international multicentre database of ASD patients. DA was structured in two main steps; 1) Baseline analysis (Assessing the probabilities of outcomes, Assessing the values of preference -utilities-, Combining information on probability and utility and assigning the quality adjusted life expectancy (QALE) for each treatment) and 2) Sensitivity analysis...
April 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28437354/complete-spondylectomy-using-orthogonal-spinal-fixation-and-combined-anterior-and-posterior-approaches-for-thoracolumbar-spinal-reconstruction-technical-nuances-and-clinical-results
#8
Hasan A Zaidi, Al-Wala Awad, Curtis A Dickman
STUDY DESIGN: Retrospective chart review. OBJECTIVE: To determine the long-term efficacy of 2-stage total en bloc spondylectomy (TES). SUMMARY OF BACKGROUND DATA: TES is a well-described technique to achieve tumor-free margins, but it is a highly destabilizing procedure that necessitates spinal reconstruction. A 2-stage anterior/posterior approach for tumor resection and instrumentation has been shown to be biomechanically superior to the single-stage approach in achieving rigid fixation, but few clinical studies with long-term outcomes exist...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435930/spinal-subdural-hematoma-a-rare-case-of-spinal-subdural-hematoma-complicating-routine-minimally-invasive-lumbar-discectomy-and-decompression-and-relevant-literature-review
#9
Chelsea C Boe, Brett A Freedman, Ravi Kumar, Kendall Lee, Robert McDonald, John Port
We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic injury. Hitherto, no case of acute postoperative subdural hematoma has been reported in the postoperative setting in the absence of known iatrogenic dural injury. A 76-year-old male with central and lateral recess spinal stenosis underwent apparently uncomplicated bilateral L3-4 and left sided L4-5 decompressive partial laminectomies and discectomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28432520/unexpected-death-after-occipital-condylar-fracture
#10
Vincent J Bulthuis, E M J Cornips, J Dings, H van Santbrink, A A Postma
We present a rare fatal complication of an occipital condylar fracture. The patient was initially neurologically intact, but showed secondary clinical deterioration. Imaging revealed extensive extra-axial hemorrhage at the craniocervical junction and an acute obstructive hydrocephalus. MR imaging demonstrated a T2 hyperintens signal in both the lower brainstem and upper cervical spinal cord, likely caused by the extra-axial hemorrhage. As prognosis was estimated infaust, supportive treatment was discontinued and the patient died soon thereafter...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28426173/spinal-arachnoid-diverticula-outcome-in-96-medically-or-surgically-treated-dogs
#11
D A Mauler, S De Decker, L De Risio, H A Volk, R Dennis, I Gielen, E Van der Vekens, K Goethals, L Van Ham
BACKGROUND: Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. OBJECTIVES: To describe the outcome of 96 dogs treated medically or surgically for SAD. ANIMALS: Ninety-six dogs with SAD. METHODS: Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28417614/spinal-epidural-abscess-caused-by-brucella-species-a-review-of-17-cases
#12
Qin Zhang, Xiaohui Yang, Honglin Yu, Benrang Jia, Bin Meng
BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient...
June 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28417234/central-lumbar-spinal-stenosis-natural-history-of-non-surgical-patients
#13
Per Wessberg, Karin Frennered
PURPOSE: The aim of the present study was to examine the natural history in patients with lumbar spinal stenosis. The incidence of surgery for this condition has increased considerably during the past decades in spite of a fairly favorable natural history in previous studies. METHODS: 146 consecutive patients with clinical signs and image findings of lumbar spinal stenosis, who were not recommended surgical treatment, were followed; the reason as to why surgery was not recommended was a moderate symptom level...
April 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28411110/impaired-wnt-signaling-and-the-spine-heterozygous-wnt1-mutation-causes-severe-age-related-spinal-pathology
#14
Riikka E Mäkitie, Tuukka Niinimäki, Miika T Nieminen, Camilla Schalin-Jäntti, Jaakko Niinimäki, Outi Mäkitie
BACKGROUND: WNT signaling plays a major role in bone and cartilage metabolism. Impaired WNT/β-catenin signaling leads to early-onset osteoporosis, but specific features in bone and other tissues remain inadequately characterized. We have identified two large Finnish families with early-onset osteoporosis due to a heterozygous WNT1 mutation c.652T>G, p.C218G. This study evaluated the impact of impaired WNT/β-catenin signaling on spinal structures. METHODS: Altogether 18 WNT1 mutation-positive (age range 11-76years, median 49years) and 14 mutation-negative subjects (10-77years, median 43years) underwent magnetic resonance imaging (MRI) of the spine...
April 11, 2017: Bone
https://www.readbyqxmd.com/read/28410482/cheiro-pedal-syndrome-a-revisit-of-etiology-localization-and-outcome
#15
Wei-Hsi Chen, Hung-Sheng Lin, Chi Chui, Hsin-Ling Yin
OBJECTIVE: Cheiro-pedal syndrome (CPS) is an incomplete sensory disorder confined to hand and foot and is generally considered a benign entity. However, knowledge comes from case report or case series only. The aim of this study is to clarify the etiology, localization and outcome of CPS. PATIENT AND METHOD: A total of 21 CPS patients from our database and another 9 patients from literature were reviewed. CPS was classified into 4 types, namely unilateral and ipsilateral (Type I), bilateral (Type II), incomplete bilateral (Type III), and crossed (Type IV)...
April 7, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28407706/gas-containing-cervical-epidural-abscess-accompanying-bacterial-meningitis-in-an-adult
#16
Dong Min Kim, Seok Won Kim
Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. In spite of aggressive fluid and continuous antibiotic therapy after the isolation of Streptococcus anginosus and Streptococcus constellatus in the cerebrospinal fluid cultures, the patient showed remaining motor dysfunction and bladder involvement. Our experience suggests that the effort to prevent neurologic deterioration by emergent surgical decompression and drainage of pus is mandatory to avoid additional spinal cord dysfunction in patients with spinal epidural abscesses accompanying bacterial meningitis...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28405771/sacral-epidural-arteriovenous-fistulas-imitators-of-spinal-dural-arteriovenous-fistulas-with-different-pathologic-anatomy-report-of-three-cases-and-review-of-the-literature
#17
Jan-Karl Burkhardt, Michael M Safaee, Aaron J Clark, Michael T Lawton
BACKGROUND: Sacral epidural arteriovenous fistulas (eAVFs) are rare and often misdiagnosed because of the incongruence between the thoracic level of clinical deficits and the sacral location of the offending pathology. Failure to diagnose this lesion delays treatment, resulting in prolonged venous hypertension in the cord, progressive neurological deterioration, and decreased chances of recovery. METHODS: A single-institution case series and the published literature were reviewed...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28402031/evaluation-of-osseous-associated-cervical-spondylomyelopathy-in-dogs-using-kinematic-magnetic-resonance-imaging
#18
Michele Provencher, Amy Habing, Sarah A Moore, Laurie Cook, Gary Phillips, Ronaldo C da Costa
Osseous-associated cervical spondylomyelopathy in dogs is characterized by both static and dynamic spinal cord compression; however, standard MRI methods only assess static compression. In humans with cervical spondylotic myelopathy, kinematic MRI is commonly used to diagnose dynamic spinal cord compressions. The purpose of this prospective, analytical study was to evaluate kinematic MRI as a method for characterizing the dynamic component of osseous-associated cervical spondylomyelopathy in dogs. We hypothesized that kinematic MRI would allow visualization of spinal cord compressions that were not identified with standard imaging...
April 12, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28401686/axonal-loss-in-the-multiple-sclerosis-spinal-cord-revisited
#19
Natalia Petrova, Daniele Carassiti, Daniel R Altmann, David Baker, Klaus Schmierer
Preventing chronic disease deterioration is an unmet need in people with multiple sclerosis, where axonal loss is considered a key substrate of disability. Clinically, chronic multiple sclerosis often presents as progressive myelopathy. Spinal cord cross-sectional area (CSA) assessed using MRI predicts increasing disability and has, by inference, been proposed as an indirect index of axonal degeneration. However, the association between CSA and axonal loss, and their correlation with demyelination, have never been systematically investigated using human post mortem tissue...
April 12, 2017: Brain Pathology
https://www.readbyqxmd.com/read/28399050/veptr-are-we-reducing-respiratory-assistance-requirements
#20
Sarah B Nossov, Evan Curatolo, Robert M Campbell, Oscar H Mayer, Sumeet Garg, Patrick J Cahill
BACKGROUND: The assisted ventilation rating (AVR) indicates the degree of external respiratory support required in children with thoracic insufficiency syndrome (TIS) and early onset scoliosis. For skeletally immature patients with TIS, the vertical expandable prosthetic titanium rib (VEPTR) device can be used to improve lung volume and growth. We hypothesized that patients who underwent early thoracic reconstruction by VEPTR treatment had an improved respiratory status. METHODS: Preoperative and postoperative AVR ratings were prospectively collected in a multicenter study group and compared with determine change after VEPTR treatment...
April 10, 2017: Journal of Pediatric Orthopedics
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