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https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#1
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28323689/intradural-intramedullary-cervicothoracic-tumor-with-long-segmental-localization-a-case-report-with-step-by-step-surgical-treatment-strategy-with-neuromonitorization
#2
Askin E Hasturk, Teoman Etikcan, Suat Canbay
Ependymomas are the most common gliomas of the conus and lower cord, with the cervical cord being the second most common location. These tumors can extend upward 3-4 vertebra, and some ependymomas can extend up over 15 segments. Depending on many factors, such as tumor size, lateralization, kyphotic deformity, and lordosis state, there are several posterior surgical options, including laminectomy, laminectomy and lateral mass screw-plate, and laminoplasty. In this study, we discuss a case of intradural intramedullary cervicothoracic ependymoma with long-segmental localization, as well as the general surgical principles of its excision with step-by-step demonstrative figures...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28265259/remodeling-brain-activity-by-repetitive-cervicothoracic-transspinal-stimulation-after-human-spinal-cord-injury
#3
Lynda M Murray, Maria Knikou
Interventions that can produce targeted brain plasticity after human spinal cord injury (SCI) are needed for restoration of impaired movement in these patients. In this study, we tested the effects of repetitive cervicothoracic transspinal stimulation in one person with cervical motor incomplete SCI on cortical and corticospinal excitability, which were assessed via transcranial magnetic stimulation with paired and single pulses, respectively. We found that repetitive cervicothoracic transspinal stimulation potentiated intracortical facilitation in flexor and extensor wrist muscles, recovered intracortical inhibition in the more impaired wrist flexor muscle, increased corticospinal excitability bilaterally, and improved voluntary muscle strength...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28257617/examination-of-the-validity-of-a-clinical-prediction-rule-to-identify-patients-with-shoulder-pain-likely-to-benefit-from-cervicothoracic-manipulation
#4
Paul E Mintken, Amy W McDevitt, Lori A Michener, Robert E Boyles, Amber R Beardslee, Scott A Burns, Matthew D Haberl, Lauren A Binder, Joshua A Cleland
Study Design Secondary analysis of a randomized controlled trial. Background Prognostic variables identifying patients with shoulder pain who are likely to respond to cervicothoracic (CT) manipulation have been reported, however they have yet to be validated. Objective To examine the validity of previously reported prognostic variables in predicting which patients with shoulder pain will respond to cervicothoracic manipulation. Methods Participants (n=140) with a report of shoulder pain were randomly assigned to receive either 2 sessions of range of motion (ROM) exercises plus 6 sessions of stretching and strengthening exercises (Ex group), or 2 sessions of CT manipulation and ROM exercises followed by 6 sessions of stretching and strengthening exercise (MT+Ex group)...
March 3, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28250864/unusual-horner-s-syndrome-in-recurrent-breast-cancer-evaluation-using-18-f-fdg-pet-ct
#5
Sohyun Park, Tae Sung Kim, Seok-Ki Kim
(18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a widely used imaging modality in the initial diagnosis of cancer, treatment response evaluation and detection of recurrence. Herein, we present the case of a 39-year-old female who presented right ptosis on the follow-up of breast cancer after surgery. Clinicians suspected Horner's syndrome, and the patient underwent FDG PET/CT for the evaluation of recurrence that could cause Horner's syndrome. FDG PET/CT demonstrated a focal hypermetabolic lesion in the right cervicothoracic junction area, corresponding to the preganglionic cervical sympathetic trunk...
March 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28248611/age-related-variations-in-global-spinal-alignment-and-sagittal-balance-in-asymptomatic-japanese-adults
#6
Kunio Yokoyama, Masahiro Kawanishi, Makoto Yamada, Hidekazu Tanaka, Yutaka Ito, Shinji Kawabata, Toshihiko Kuroiwa
OBJECTIVES: The global spinal sagittal alignment varies widely among healthy individuals as it is affected by not only race, but also aging. We investigated age-related changes in the spinal alignment in asymptomatic Japanese individuals. METHODS: The subjects comprised 220 individuals without any spine-related neurological symptoms or treatment history thereof who visited our outpatient clinic. Lateral radiographs of the whole spine were taken for all subjects in the standing position...
March 1, 2017: Neurological Research
https://www.readbyqxmd.com/read/28244892/3d-navigation-guided-resection-of-giant-ventral-cervical-intradural-schwannoma-with-360-degree-stabilization
#7
Ibrahim Hussain, Rodrigo Navarro-Ramirez, Gernot Lang, Roger Härtl
Giant schwannomas are defined as intradural extramedullary tumors that span >2 vertebral body lengths. Although uncommon, these lesions can cause significant mass effect on the spinal cord and subsequent neurologic compromise. Gross total resection is the goal of operative intervention, however, is extremely challenging in cases where the tumor occupies a ventral, midline position within the lower cervical thecal sac. Using a representative case presentation, we describe an adult male with insidious progression of upper extremity radicular pain and paresthesias, found to have a ventral, solid/cystic C5-C7 giant schwannoma...
February 27, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28196468/posterior-pedicle-screw-fixation-to-treat-lower-cervical-fractures-associated-with-ankylosing-spondylitis-a-retrospective-study-of-35-cases
#8
Liang Yan, Zhenguo Luo, Baorong He, Jijun Liu, Dingjun Hao
BACKGROUND: The most common site of fractures in patients with ankylosing spondylitis (AS) is the cervical spine, especially the lower cervical spine and cervicothoracic junction. The optimal treatment for cervical spine fractures secondary to AS is controversial. This study aimed to explore the effects of posterior pedicle screw fixation alone on fractures of the lower cervical spine in patients with AS. METHODS: From January 2006 to January 2013, a total of 35 patients with AS and a lower cervical spine fracture were treated using only posterior cervical/thoracic pedicle screw fixation...
February 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28166919/a-lengthy-primary-intramedullary-tuberculoma-of-the-spinal-cord-extending-from-c4-to-d8-a-case-report
#9
V Chandramouleeswaran, Hazeena P Philo, D Balasubramaniam, Rajeswari Ramachandran
Spinal intramedullary tuberculoma is a rare cause of spinal cord compression. We report a case that had an intramedullary spinal cord tuberculomas where the diagnosis was made by MRI and biopsy. The clinical presentation was that of a cord compression in a 30-year-old male febrile patient. This case of intramedullary spinal tuberculoma with a longitudinally extending lesion of the cervicothoracic spine from C4 to D8 is presented for the rarity of its presentation.
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28143419/t2-relaxation-time-for-intervertebral-disc-degeneration-in-patients-with-upper-back-pain-initial-results-on-the-clinical-use-of-3-0-tesla-mri
#10
Raoying Xie, Linhui Ruan, Lei Chen, Kai Zhou, Jiandong Yuan, Wei Ji, Guangjian Jing, Xiaojing Huang, Qinglei Shi, Chun Chen
BACKGROUND: Magnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs. However, there are few studies which applied functional MRI techniques to investigate degenerative changes in cervical and cervicothoracic junction (CTJ) spine among adults. The aim of this study was to compare T2 relaxation time measurement evaluation with morphological grading for assessing cervical and CTJ intervertebral discs (IVD) in the patients suffering neck, shoulder, and upper back pain...
January 31, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28097251/management-of-progressive-late-onset-scoliosis-with-magnetic-growth-rod-insertion-leading-to-improvement-of-neural-anomalies-a-case-report
#11
Amit Zaveri, Valerio Pace, Dimpu Bhagawati, Vijay Rajamani, Thillainayagam Muthukumar, Hilali Noordeen
BACKGROUND: To present the first known reported case of late onset idiopathic scoliosis with concomitant neural anomalies, treated with sequential distraction using magnetic growth rod, had significant improvement in both cranio-cervical and intraspinal anomaly. METHODS: A caucasian, growing female child (at the age of ten) presented with moderately progressive late onset right thoracic scoliosis. She was found to have Chiari type I malformation and a cervicothoracic syrinx on routine pre-operative MRI scanning...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28072809/optimal-angle-of-contralateral-oblique-view-in-cervical-interlaminar-epidural-injection-depending-on-the-needle-tip-position
#12
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/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#13
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28034746/new-imaging-characteristics-for-predicting-postoperative-neurologic-status-in-patients-with-metastatic-epidural-spinal-cord-compression-a-retrospective-analysis-of-81-cases
#14
Mingxing Lei, Shubin Liu, Shaoxing Yang, Yaosheng Liu, Cheng Wang, Hongjun Gao
BACKGROUND CONTEXT: Several clinical features have been proposed for the prediction of postoperative functional outcome in patients with metastatic epidural spinal cord compression (MESCC). However, few articles address the relationship between preoperative imaging characteristics and the postoperative neurologic status. PURPOSE: This study aims to analyze the postoperative functional outcome and to identify new imaging parameters for predicting postoperative neurologic status in patients with MESCC...
December 26, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28033219/68ga-psma-hbed-uptake-on-cervicothoracic-stellate-ganglia-a-common-pitfall-on-pet-ct
#15
Mohsen Beheshti, Alireza Rezaee, Werner Langsteger
Ga-PSMA-HBED PET/CT showed promising results in staging and restaging of prostate cancer. However, nonspecific uptake has been reported in the celiac ganglia. In this case series, we showed faint radiotracer uptake on upper thoracic region in the location of cervicothoracic (stellate) ganglia. This ganglion is located anterior to the transverse process of C7 vertebra, inferior to subclavian artery, and superior to the neck of the first rib.
March 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28018464/a-pediatric-case-of-idiopathic-harlequin-syndrome
#16
Ju Young Kim, Moon Souk Lee, Seung Yeon Kim, Hyun Jung Kim, Soo Jin Lee, Chur Woo You, Jon Soo Kim, Ju Hyung Kang
Harlequin syndrome, which is a rare disorder caused by dysfunction of the autonomic system, manifests as asymmetric facial flushing and sweating in response to heat, exercise, or emotional factors. The syndrome may be primary (idiopathic) with a benign course, or can occur secondary to structural abnormalities or iatrogenic factors. The precise mechanism underlying idiopathic harlequin syndrome remains unclear. Here, we describe a case of a 6-year-old boy who reported left hemifacial flushing and sweating after exercise...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28005137/adverse-fetal-and-neonatal-outcome-and-an-abnormal-vertebral-pattern-a-systematic-review
#17
REVIEW
Pauline Christine Schut, Titia E Cohen-Overbeek, Frietson Galis, Clara M A Ten Broek, Eric A Steegers, Alex J Eggink
Importance: The human vertebral column has a stable number of vertebrae and ribs, which is presumably the result of evolutionary selection. An association between an abnormal vertebral pattern, especially in the cervical region, and congenital anomalies or adverse fetal outcome has been reported. Objective: The aim of this study was to review the current literature concerning an abnormal vertebral pattern and prevalence of cervical ribs in healthy subjects and in subjects with adverse outcome...
December 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27990302/does-deep-cervical-flexor-muscle-training-affect-pain-pressure-thresholds-of-myofascial-trigger-points-in-patients-with-chronic-neck-pain-a-prospective-randomized-controlled-trial
#18
Pavlos Bobos, Evdokia Billis, Dimitra-Tania Papanikolaou, Constantinos Koutsojannis, Joy C MacDermid
Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle...
2016: Rehabilitation Research and Practice
https://www.readbyqxmd.com/read/27951615/endoscopic-management-of-spinal-intradural-extramedullary-tumors
#19
Vijay Singh Parihar, Nishtha Yadav, Yad Ram Yadav, Shailendra Ratre, Jitin Bajaj, Yatin Kher
Introduction Posterior midline laminectomy is associated with risks of postoperative instability, spinal deformity, extensive bilateral subperiosteal muscle stripping, partial or total facetectomy especially in foraminal tumor extension, increased cerebrospinal fluid leakage, and wound infection. Minimally invasive approaches with the help of a microscope or endoscope using hemilaminectomy have been found to be safe and effective. We report our initial experience of 18 patients using the endoscopic technique...
December 12, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27933388/digital-tomosynthesis-as-a-new-diagnostic-tool-for-evaluation-of-spine-damage-in-patients-with-ankylosing-spondylitis
#20
Young Bin Joo, Tae-Hwan Kim, Jina Park, Kyung Bin Joo, Yoonah Song, Seunghun Lee
We aimed to compare digital tomosynthesis (DTS) with radiographs for the assessment of spinal bone damage in patients with ankylosing spondylitis (AS). The study comprised 68 patients with AS who underwent both DTS and radiographs of the cervical and lumbar spine on the same day. Spinal bone damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and the presence of facet joint damage. The Wilcoxon signed-rank test and McNemar's test were used to compare spinal bone damage between the two modalities...
February 2017: Rheumatology International
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