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Spine cord

Xiao-Kang Liu, Hao Li, Jian-Guang Xu, Er-Zhu Yang, Tie-Sheng Hou, Bing-Fang Zeng, Xiao-Feng Lian
OBJECTIVE: To determine the necessity of circumferential decompression and fusion in patients with severe multilevel cervical spondylotic myelopathy with circumferential cord compression. METHODS: This prospective study involved 51 patients with severe multilevel circumferential cervical myelopathy underwent two-stage circumferential procedure between July 2008 and June 2010. VAS scores, satisfaction surveys and JOA scores and imaging studies were obtained. Twenty-three patients (45...
January 11, 2017: British Journal of Neurosurgery
Sergio B Sesia, Friederike Prüfer, Michael Walther, Daniel Studer
A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture)...
January 10, 2017: BMJ Case Reports
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
Deting Xue, Qixin Chen, Gang Chen, Wenhai Zhuo, Fangcai Li
BACKGROUND: Multiple fractures of the atlas and axis are rare. The management of multiple fragment axis fractures and unstable atlas fractures is still challenging for the spinal surgeon. There are no published reports of similar fractures with 3-part fracture of axis associated with an unstable atlas fracture. CASE SUMMARY: We present a patient with concurrent axis and atlas fractures, which have not been reported. The patient suffered hyperextension injury with neck pain and numbness of the bilateral upper extremity associated with weakness after a 2-m fall...
January 2017: Medicine (Baltimore)
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
J R Petrasic, A Chhabra, K M Scott
BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome...
November 10, 2016: AJNR. American Journal of Neuroradiology
Turky Almouhissen, Hattan Badr, Bassam AlMatrafi, Noor Alessa, Anmar Nassir
A 22-year-old male patient with Down syndrome was referred to our hospital with a vast left testicular mass. He underwent a left radical inguinal orchiectomy, and a histopathological examination of the mass showed a yolk sac tumor invading the epididymis. The patient was discharged in a satisfactory condition. Sixteen days later, the patient presented again complaining of lower limb weakness. Magnetic resonance imaging of the spine showed metastatic lesions compressing the dorsal spine, and he underwent emergency surgical decompression...
October 2016: Urology Annals
Shuai Zhang, Ting-Bin Yan
BACKGROUND: Fracture-dislocations of the thoracic spine without spinal cord injury are very rare. CASE PRESENTATION: A 35-year-old woman presented to our emergency department with complete T6-7 fracture-dislocation without any neurological loss had undergone a surgical reduction and fixation. CONCLUSIONS: The radiological severity of fracture-dislocation pattern doesn't correlate sometimes with the clinical manifestation.
January 5, 2017: World Journal of Surgical Oncology
H Acar, M Cebe, H Mabhouti, G Codel, P Pacaci, E Serin, E Sanli, N Kucuk, E Kucukmorkoc, M Doyuran, D Canoglu, A Altinok, H Caglar
PURPOSE: Stereotactic body radiosurgery (SBRT) for spine metastases involves irradiation using a single high dose fraction. The purpose of this study was to investigate a Hybrid VMAT/IMRT technique which combines volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) for spine SBRT in terms of its dosimetric quality and treatment efficiency using Radiation Therapy Oncology Group (RTOG) 0631 guidelines. METHODS: 7 fields IMRT, 2 full arcs VMAT and Hybrid VMAT/IMRT were created for ten previously treated patients...
June 2016: Medical Physics
T Chiu, T Long, A Modiri, Z Tian, A Sawant, Y Yan, S Jiang, X Gu
PURPOSE: To develop an efficient and effective trajectory optimization methodology for 4π dynamic conformal arc treatment (4π DCAT) with synchronized gantry and couch motion; and to investigate potential clinical benefits for stereotactic body radiation therapy (SBRT) to breast, lung, liver and spine tumors. METHODS: The entire optimization framework for 4π DCAT inverse planning consists of two parts: 1) integer programming algorithm and 2) particle swarm optimization (PSO) algorithm...
June 2016: Medical Physics
L Ma, S Braunstein, J Chiu, A Sahgal
PURPOSE: Spinal cord tolerance for SBRT has been recommended for the maximum point dose level or at irradiated volumes such as 0.35 mL or 10% of contoured volumes. In this study, we investigated an inherent functional relationship that associates these dose surrogates for irradiated spinal cord volumes of up to 3.0 mL. METHODS: A hidden variable termed as Effective Dose Radius (EDR) was formulated based on a dose fall-off model to correlate dose at irradiated spinal cord volumes ranging from 0 mL (point maximum) to 3...
June 2016: Medical Physics
N Sperling, J Bogue, E Parsai
PURPOSE: Traditional Craniospinal Irradiation (CSI) planning techniques require careful field placement to allow optimal divergence and field overlap at depth, and measurement of skin gap. The result of this is a necessary field overlap resulting in dose heterogeneity in the spinal canal. A novel, nondivergent field matching method has been developed to allow simple treatment planning and delivery without the need to measure skin gap. METHODS: The CSI patient was simulated in the prone, and a plan was developed...
June 2016: Medical Physics
R Badkul, W Nicolai, D Pokhrel, T Ramanjappa, H Jiang, F Wang, C Lominskac
PURPOSE: To compare the impact of Pencil Beam(PB) and Anisotropic Analytic Algorithm(AAA) dose calculation algorithms on OARs and planning target volume (PTV) in thoracic spine stereotactic body radiation therapy (SBRT). METHODS: Ten Spine SBRT patients were planned on Brainlab iPlan system using hybrid plan consisting of 1-2 non-coplanar conformal-dynamic arcs and few IMRT beams treated on NovalisTx with 6MV photon. Dose prescription varied from 20Gy to 30Gy in 5 fractions depending on the situation of the patient...
June 2016: Medical Physics
Mohammadi Gh Fallal, Alam N Riyahi, Gh Graily, R Paydar
PURPOSE: Clinical use of multi detector computed tomography(MDCT) in diagnosis of diseases due to high speed in data acquisition and high spatial resolution is significantly increased. Regarding to the high radiation dose in CT and necessity of patient specific radiation risk assessment, the adoption of new method in the calculation of organ dose is completely required and necessary. In this study by introducing a conversion factor, patient organ dose in thorax region based on CT image data using MC system was calculated...
June 2016: Medical Physics
C Venencia, M Pino, L Caussa, A Molineu, E Garrigo
PURPOSE: The purpose of this work was to quantify the dosimetric impact of Monte Carlo (MC) dose calculation algorithm compared to Pencil Beam (PB) on Spine SBRT with HybridARC (HA) and sliding windows IMRT (dMLC) treatment modality. METHODS: A 6MV beam (1000MU/min) produced by a Novalis TX (BrainLAB-Varian) equipped with HDMLC was used. HA uses 1 arc plus 8 IMRT beams (arc weight between 60-40%) and dIMRT 15 beams. Plans were calculated using iPlan v.4.5.3 (BrainLAB) and the treatment dose prescription was 27Gy in 3 fractions...
June 2016: Medical Physics
V Ulizio, M Taylor
PURPOSE: Spine metastases have traditionally been treated using a parallel opposed 3-D technique: an anterior field and a posterior field (AP/PA). This has proven to give the lesions adequate coverage. The downside to this type of treatment is that the full prescription dose covers a large area of the patient and can go through critical organs such as the heart, spine, lungs, bowel, and others depending on the vertebrae being treated. Conformal arc therapy can also be used for this type of treatment...
June 2016: Medical Physics
S Yu, D Rosenzweig, M Pacella
PURPOSE: This study evaluates the dosimetric differences between dose-to-medium (Dm) and conventional dose-to-water (Dw) reporting using Varian's Acuros XB (AXB) dose calculation algorithm with actual patient treatment plans. METHODS: Twelve patients were selected: four head-and-neck (HN) (2 Gy × 33-35 fractions), four lung SBRT (10-12 Gy × 5 fractions) and four spine SBRT (6-8 Gy × 5 fractions) cases. All treatment plans were optimized using the Varian Eclipse Progressive Resolution Optimizer (version 13...
June 2016: Medical Physics
V Yu, A Tran, D Nguyen, K Woods, M Cao, T Kaprealian, R Chin, D Low, K Sheng
PURPOSE: To demonstrate significant organ-at-risk (OAR) sparing achievable with 4π non-coplanar radiotherapy on spine SBRT and SRS patients. METHODS: Twenty-five stereotactic spine cases previously treated with VMAT (n = 23) or IMRT (n = 2) were included in this study. A computer-aided-design model of a Linac with a 3D-scanned human surface was utilized to determine the feasible beam space throughout the 4π steradian and beam specific source-to-target-distances (STD) required for collision avoidance...
June 2016: Medical Physics
K N Papanikolaou, L T Watts, E Pappas, T Maris, C Ha, N Kirby, K Rasmussen, A N Gutierrez, S Stathakis
PURPOSE: SBRT is proving to be a very efficacious treatment modality for an increasing number of indications, including spine lesions. We have developed a novel phantom to serve as an end-to-end QA tool for either patient specific QA or commissioning QA of SBRT for spine lesions. METHODS: In this feasibility study, we have selected a patient with a single metastatic lesion in the L5 vertebral body. The patient's CT simulation scan was used to develop a VMAT treatment plan delivering 18Gy to at least 90% of the target volume, following the guidelines of RTOG 0631...
June 2016: Medical Physics
A Magnelli, A Smith, S Chao, J Suh, P Xia
PURPOSE: Spinal stereotactic body radiotherapy (SBRT) involves highly conformal dose distributions and steep dose gradients due to the proximity of the spinal cord to the treatment volume. To achieve the planning goals while limiting the spinal cord dose, patients are setup using kV cone-beam CT (kV-CBCT) with 6 degree corrections. The kV-CBCT registration with the reference CT is dependent on a user selected region of interest (ROI). The objective of this work is to determine the dosimetric impact of ROI selection...
June 2016: Medical Physics
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