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https://www.readbyqxmd.com/read/28433844/neurological-decline-in-an-elderly-with-repaired-myelomeningocele-complicated-with-lumbar-canal-stenosis-a-case-report
#1
Shingo Matsuda, Satoshi Yamaguchi, Yosuke Kajihara, Masaaki Takeda, Manish Kolakshyapati, Kaoru Kurisu
BACKGROUND: Tethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear. CASE DESCRIPTION: A 63-year-old man with a repaired MMC presented with a progressive gait disturbance and numbness in both lower limbs. Magnetic resonance images demonstrated that the tethered spinal cord was compressed by severe canal stenosis along the entire lumbar spine...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433524/an-analysis-of-knowledge-based-planning-for-stereotactic-body-radiation-therapy-of-the-spine
#2
Joseph J Foy, Robin Marsh, Randall K Ten Haken, Kelly C Younge, Matthew Schipper, Yilun Sun, Dawn Owen, Martha M Matuszak
PURPOSE: Planning for spine stereotactic body radiation therapy (SBRT) is time consuming, and differences in planner experience and technique result in discrepancies in plan quality between facilities. Here, knowledge-based planning is analyzed to determine if it may be effective in improving the quality and efficiency of spine SBRT planning. MATERIALS AND METHODS: Thirty-eight spine SBRT cases were collected from the University of Michigan database and inverse planned to deliver 3 10-Gy fractions to the planning target volume (PTV)...
March 2, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#3
Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28428927/limitations-of-personalized-medicine-and-gene-assays-for-breast-cancer
#4
David Tiberi, Laura Masucci, Daniel Shedid, Isabelle Roy, Toni Vu, Erica Patocskai, André Robidoux, Philip Wong
Adjuvant systemic treatments reduce the risk of breast cancer recurrence following the local treatment of primary stage I-III breast cancers. For patients with hormone-positive breast cancers receiving hormonal therapy, the risk of distant recurrence is under 20% and therefore, many patients may potentially be spared of chemotherapy. Consequently, several molecular signatures based on gene expression were developed to better determine which breast cancer patients would benefit from chemotherapy. We present the case of a 62-year-old woman diagnosed with an early stage hormone receptor-positive breast cancer that was treated with a partial mastectomy...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28427722/biomechanical-investigation-of-post-operative-c5-palsy-due-to-ossification-of-the-posterior-longitudinal-ligament-in-different-types-of-cervical-spinal-alignment
#5
Batbayar Khuyagbaatar, Kyungsoo Kim, Won Man Park, Yoon Hyuk Kim
Post-operative C5palsies are among the most common complications seen after cervical surgery for ossification of the posterior longitudinal ligament (OPLL). Although C5 palsy is a well-known complication of cervical spine surgery, its pathogenesis is poorly understood and depends on many other factors. In this study, a finite element model of the cervical spine and spinal cord-nerve roots complex structures was developed. The changes in stress in the cord and nerve roots, posterior shift of the spinal cord, and displacement and elongation of the nerve roots after laminectomy for cervical OPLL were analyzed for three different cervical sagittal alignments (lordosis, straight, and kyphosis)...
April 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28425137/three-dimensional-printing-an-aid-to-epidural-access-for-neuromodulation
#6
Murray G Taverner, John P Monagle
OBJECTIVE: The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. METHODS: A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. RESULTS: Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine...
April 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28419784/four-extremity-neurostimulation-using-two-cervical-octapolar-leads-and-high-frequency-of-10-khz
#7
Shervin Harandi, Leonardo Kapural
OBJECTIVES AND METHODS: A few published reports describe successful clinical use of low-frequency spinal cord stimulation (SCS) in the cervical spine resulting in bilateral upper and lower extremity pain relief. Major side-effect when using this modality of SCS is the uneven intensity of paresthesias which are frequently excessive in upper extremities while attempting to achieve optimal paresthesia coverage in all four extremities. RESULTS AND CONCLUSIONS: Here we describe a successful case of high frequency SCS at 10 kHz where profound control of neuropathic pain of all four extremities was achieved without the complication of paresthesias...
April 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28416437/the-ct-based-fractal-analysis-of-trabecular-bone-structure-may-help-in-detecting-decreased-quality-of-bone-prior-to-urgent-spinal-procedures
#8
Marcin Czyz, Arion Kapinas, James Holton, Renata Pyzik, Bronek M Boszczyk, Nasir A Quraishi
BACKGROUND CONTEXT: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. PURPOSE: To validate the hypothesis that the CT-based fractal analysis of the trabecular bone structure may help in detecting patients with poor quality of bone prior to urgent spinal procedures...
April 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28413557/c2-primary-leiomyoma-in-an-immunocompetent-woman-a-case-report-and-review-of-literature
#9
Mohana Rao Patibandla, Madhukar T Nayak, A K Purohit, Megha Uppin, Sundaram Challa, Gokul Chowdary Addagada, Manisha Nukavarapu
Clinical case report and review of the literature. This is the first case of primary leiomyoma in an immunocompetent woman without previous history of uterine leiomyoma being reported in the literature to the best of our knowledge. Leiomyoma, a type of smooth muscle cell tumor, involving the vertebra is extremely rare. There were very few primary leiomyoma in patients with AIDS or in the immune-suppressed patients. This 48-year-old female came with H/o neck pain, weakness and bladder retention. On examination, tone increased in all four limbs, power on the right side of the limbs 4/5, power on the left upper limb 0/5, lower limb 3/5, left plantar was up going, decreased sensation over the left second cervical vertebra (C2) dermatome and all modalities decreased below C2...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28412561/metastatic-human-breast-cancer-to-the-spine-produces-mechanical-hyperalgesia-and-gait-deficits-in-rodents
#10
Rachel Sarabia-Estrada, Alejandro Ruiz-Valls, Hugo Guerrero-Cazares, Ana M Ampuero, Ismael Jimenez-Estrada, Samantha De Silva, Lydia J Bernhardt, C Rory Goodwin, A Karim Ahmed, Yuxin Li, Neil A Phillips, Ziya L Gokaslan, Alfredo Quiñones-Hinojosa, Daniel M Sciubba
BACKGROUND CONTEXT: Metastases to the spine are a common source of severe pain in cancer patients. The secondary effects of spinal metastases include pain, bone fractures, hypercalcemia, and neurological deficits. As the disease progresses, pain severity can increase until it becomes refractory to medical treatments and leads to a decreased quality of life for patients. A key obstacle in the study of pain-induced spinal cancer is the lack of reliable and reproducible spine cancer animal models...
April 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#11
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28409289/expert-s-comment-concerning-grand-rounds-case-entitled-acute-complete-paraplegia-of-a-8-year-old-girl-caused-by-spinal-cord-infarction-following-minor-trauma-complicated-with-longitudinal-signal-change-of-spinal-cord-by-k-nagata-et-al-eur-spine-j-2017-doi-10
#12
https://www.readbyqxmd.com/read/28405532/spinal-schwannoma-with-intradural-intramedullary-hemorrhage
#13
Muhammad Nadeem, Salman Mansoor, Salman Assad, Fariha Ilyas, Ahmed H Qavi, Shoab Saadat
Patients with spinal abnormalities infrequently present with intradural intramedullary bleeding. The more common causes include spinal trauma, arteriovenous malformations and saccular aneurysms of spinal arteries. On occasion, spinal cord tumors either primary or metastatic may cause intramedullary bleed with ependymoma of the conus medullaris. Spinal nerve sheath tumors such as schwannomas only rarely cause intradural intramedullary bleed, especially in the absence of spinal cord or nerve root symptoms. We report a case of spinal intradural schwannoma presenting with acute onset of quadriparesis...
March 6, 2017: Curēus
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#14
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28394776/correlation-analysis-between-modic-change-of-cervical-vertebrae-and-intramedullary-high-signal-intensity
#15
Hao Zhou, Jin Fan, Peng Sun, Wei Zhou, Qingqing Li, Lipeng Yu, Guoyong Yin
PURPOSE: Clinical studies have shown that endplate Modic change in the cervical spine and intramedullary high signal intensity often occurs simultaneously. We aimed to investigate whether there is a correlation between Modic change and intramedullary high signal intensity, and to explore the possible risk factors. MATERIALS AND METHODS: In total, 133 patients with cervical spondylotic myelopathy treated at the First Affiliated Hospital of Nanjing Medical University between May 2009 and March 2013 were enrolled in the study...
April 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#16
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
RATIONALE AND OBJECTIVES: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28382220/abnormal-central-motor-conduction-at-the-upper-but-not-lower-limbs-correlates-with-severe-cervical-spondylosis-discussion-of-an-unexpected-observation
#17
Spyros N Deftereos
INTRODUCTION: A novel pattern of transcranial magnetic stimulation (TMS) abnormalities in cervical spondylotic myelopathy (CSM) comprising abnormal central motor conduction time (CMCT) to the upper limbs and normal CMCT to the lower limbs was observed. CSM was more severe radiologically and tended to be more severe clinically when this pattern was encountered. CASE PRESENTATION: To further characterize this observation, 414 consecutive TMS evaluations of cervical spondylosis were reviewed...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28382215/central-cord-syndrome-from-blast-injury-after-gunshot-wound-to-the-spine-a-case-report-and-a-review-of-the-literature
#18
Juan Galloza, Juan Valentin, Edwardo Ramos
INTRODUCTION: Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. CASE PRESENTATION: A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28378287/pediatric-thoracic-sciwora-after-back-bend-during-dance-practice-a-retrospective-case-series-and-analysis-of-trauma-mechanisms
#19
Jian Ren, Gao Zeng, Yong-Jie Ma, Nan Chen, Zan Chen, Feng Ling, Hong-Qi Zhang
PURPOSE: The purpose of the study was to describe a unique type of low-energy traumatic pediatric thoracic spinal cord injury without radiographic abnormality (SCIWORA) after a back bend during dance practice and analyze the trauma mechanisms and treatment protocols. METHODS: This was a retrospective case series from September 2007 to August 2016. The study was conducted at a tertiary medical center in Beijing, China (Xuanwu Hospital, China International Neuroscience Institute [China-INI], Capital Medical University)...
April 4, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28377974/an-arthrogrypotic-medical-doctor-with-cervical-kyphosis-and-thoracic-lordoscoliosis
#20
Manouchehr Safdarian, Mahdi Safdarian
Management of spinal deformities in a patient with arthrogryposis can be challenging for spine surgeons. The literature about the accompaniment of scoliosis; the most common spine deformity reported in arthrogryposis, is still poor. Moreover, the development of cervical kyphosis and thoracic lordoscoliosis in a patient with arthrogryposis is much rare. This paper reports a 26-year-old medical doctor with arthrogryposis who had underwent thoracic lordoscoliosis surgery about ten years ago with T6-L1 internal rods and is now presented with cervical kyphosis and C3-C4 cord stenosis, which made him a candidate for cervical cord decompression surgery...
June 2017: Bone Reports
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