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Cervical spinal stenosis

Malte Mohme, Klaus Christian Mende, Theresa Krätzig, Rosemarie Plaetke, Kerim Beseoglu, Julian Hagedorn, Hans-Jakob Steiger, Frank W Floeth, Sven O Eicker
Spinal cord or cauda equina compression (SCC) is an increasing challenge in clinical oncology due to a higher prevalence of long-term cancer survivors. Our aim was to determine the clinical relevance of SCC regarding patient outcome depending on different tumor entities and their anatomical localization (extradural/intradural/intramedullary). We retrospectively analyzed 230 patients surgically treated for SCC. Preoperative status for pain and neurological impairment were correlated to the degree of compression, tumor location, and early as well as short-term follow-up outcome parameters...
October 7, 2016: Neurosurgical Review
Hideki Shigematsu, Jason Pui Yin Cheung, Kin-Cheung Mak, Mauro Bruzzone, Keith D K Luk
PURPOSE: Patients with pre-existing cervical spinal canal stenosis (CSCS) may have minimal or no symptoms. However, performing preventive decompression is controversial as the incidence of CSCS leading to severe cord injury is unknown. Hence, this study aims to revisit the threshold for surgery in "silent" CSCS by reviewing the neurologic outcomes of patients with undiagnosed CSCS who sustained a cervical spinal cord injury (CSCI). METHODS: Two groups of subjects were recruited for analysis...
October 3, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Hua Zhou, Zhong-Jun Liu, Shao-Bo Wang, Sheng-Fa Pan, Ming Yan, Feng-Shan Zhang, Yu Sun
Although several studies report various treatment solutions for cervical spondylotic myelopathy in patients with athetoid cerebral palsy, long-term follow-up studies are very rare. None of the reported treatment solutions represent a gold standard for this disease owing to the small number of cases and lack of long-term follow-up. This study aimed to evaluate the outcomes of laminoplasty with lateral mass screw fixation to treat cervical spondylotic myelopathy in patients with athetoid cerebral palsy from a single center...
September 2016: Medicine (Baltimore)
Güliz Acker, Ulf C Schneider, Zarko Grozdanovic, Peter Vajkoczy, Johannes Woitzik
BACKGROUND: Disc herniations are only reported in few case reports as a rare cause of acute spinal ischemia. A surgical treatment has not been described so far in these reports with analysis of diffusion weighted magnetic resonance imaging (DWI/MRI) before and after surgery. The aim of our study is to report a case of cervical spinal cord ischemia caused by cervical disc herniation and discuss the literature concerning diagnostic and treatment options. METHODS: A 72-year-old female patient developed an acute progressive tetraparesis with emphasis on the upper extremities...
June 2016: J Spine Surg
Yun-Joung Han, Myoung No Lee, Min Ji Cho, Hue Jung Park, Dong Eon Moon, Young Hoon Kim
BACKGROUND: Epidural neuroplasty using a Racz catheter has a therapeutic effect. Studies have found no correlation between foraminal stenosis and the outcome of epidural neuroplasty, which is thought to depend on contrast runoff. OBJECTIVE: To examine the correlation between the contrast spread pattern and pain reduction in cervical epidural neuroplasty using a Racz catheter. STUDY DESIGN: Retrospective study. SETTING: An interventional pain-management practice in a university hospital...
September 2016: Pain Physician
Yoshifumi Kudo, Tomoaki Toyone, Toshiyuki Shirahata, Tomoyuki Ozawa, Akira Matsuoka, Yoichi Jin, Katsunori Inagaki
We report a very rare (5~7%) case of bilateral C5 palsy after cervical surgery. A 71-year-old male patient with cervical ossification of posterior longitudinal ligament (OPLL) with foraminal stenosis at bilateral C4/5 underwent posterior decompression and fusion surgery. After surgery, muscle weakness in his both deltoid and biceps was detected and gradually deteriorated to complete paralysis. Postoperative MRI showed sufficient decompression of the spinal cord and posterior shifting. Subsequently, an additional bilateral foraminotomy at C4/5 was performed, with a suspicion that bilateral foraminal stenosis at C4/5 may have been the cause of the paresis...
2016: Case Reports in Orthopedics
Vaidehi S Dedania, Devon H Ghodasra, Christine N Kay, Robert Roseman, Mark W Johnson
PURPOSE: To report an unusual case of ciliochoroidal effusion and presumed acute macular neuroretinopathy associated with cervical traction therapy for the treatment of cervical spinal stenosis. METHODS: Case report. RESULTS: A 75-year-old man reported sudden onset of a wedge-shaped paracentral scotoma in the right eye. Fundus examination showed a ciliochoroidal effusion in the right eye. Optical coherence tomography revealed intraretinal fluid in both eyes without leakage on fluorescein angiography...
September 23, 2016: Retinal Cases & Brief Reports
Yuanyuan Chen, Yang Liu, Huajiang Chen, Peng Cao, Wen Yuan
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare clinical and radiologic outcomes of 3-level anterior cervical discectomy and fusion between a zero-profile (Zero-P) spacer and a traditional plate in cases of symptomatic cervical spine spondylosis. SUMMARY OF BACKGROUND DATA: Anterior cervical decompression and fusion is indicated for patients with anterior compression or stenosis of the spinal cord. The Zero-P spacers have been used for anterior cervical interbody fusion of 1 or 2 segments...
September 16, 2016: Clinical Spine Surgery
Stefania Fornarino, Daniela Paola Rossi, Mariasavina Severino, Angela Pistorio, Anna Elsa Maria Allegri, Simona Martelli, Laura Doria Lamba, Paola Lanteri
AIM: To evaluate the contribution of somatosensory evoked potentials after median nerve (MN-SEPs) and posterior tibial nerve (PTN-SEPs) stimulation in functional assessment of cervical and lumbar spinal stenosis in children with achondroplasia. METHOD: We reviewed MN-SEPs, PTN-SEPs, and spinal magnetic resonance imaging (MRI) examinations performed in 58 patients with achondroplasia (25 males, 33 females; age range 21d-16y 10mo; mean age 4y 3mo [SD 4y 1mo]). Patients were subdivided into four age categories: <2 years, between 2 to 4 years, between 4 to 8 years, and ≥8 years...
September 16, 2016: Developmental Medicine and Child Neurology
Roberta Reichert, Lillian Gonçalves Campos, Filippo Vairo, Carolina Fischinger Moura de Souza, Juliano Adams Pérez, Juliana Ávila Duarte, Fernando Araujo Leiria, Maurício Anés, Leonardo Modesti Vedolin
Mucopolysaccharidosis (MPS) is an inherited metabolic disease and a member of the group of lysosomal storage disorders. Its hallmark is a deficiency of lysosomal enzymes involved in the degradation of mucopolysaccharides, also known as glycosaminoglycans (GAGs). The products of GAG degradation accumulate within lysosomes and in the extracellular space, thereby interfering with the degradation of other macromolecules. This process leads to chronic degeneration of cells, which in turn affects multiple organs and systems...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Toshinari Kawasaki, Hitoshi Fukuda, Yoshitaka Kurosaki, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: The patient with SAH by hemorrhagic AVFs usually presents with meningeal signs including headache and nausea, and focal neurological deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CLINICAL DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head CT showed subarachnoid hemorrhage (SAH) exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH...
August 24, 2016: World Neurosurgery
Gregory D Schroeder, Alexander R Vaccaro
Cervical spine injuries are extremely common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as American football and rugby, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Huang-Chou Chang, Tsung-Hsi Tu, Hsuan-Kan Chang, Jau-Ching Wu, Li-Yu Fay, Peng-Yuan Chang, Ching-Lan Wu, Wen-Cheng Huang, Henrich Cheng
INTRODUCTION: Combination of ACDF and ACCF (Anterior cervical discectomy or corpectomy with fusion) has been demonstrated to be effective for multi-level CSM (cervical spondylotic myelopathy). However, the combination of ACCF and cervical disc arthroplasty (CDA) for three-level CSM has never been addressed. METHODS: Consecutive patients (>18 years old) with CSM caused by segmental ossification of posterior longitudinal ligament (OPLL) and degenerative disc disease (DDD) were reviewed...
July 26, 2016: World Neurosurgery
Y Z Yao, R F Yin, J Huang, D L Liu, H Zang
OBJECTIVE: To retrospectively investigate the clinical manifestation of patients with spinal stenosis in the upper thoracic and cervical spine by posterior decompression in different ways. METHODS: From January 2010 to December 2015, 18 patients of that complicated phenomenon were studied in Department of Orthopaedic Surgery, China-Japan Union Hospital, Jilin University.Ten patients received one-stage combined decompression (group A); while the other 8 received multi-stage posterior decompression(group B)...
July 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Juneyoung Heo, Jae Chil Chang, Hyung-Ki Park
OBJECTIVE: A modified surgical technique of posterior cervical foramintomy called posterior cervical inclinatory foraminotomy (PCIF) was introduced in previous preliminary article. PCIF allows better preservation of facet joint and capsule than conventional techniques. The authors conducted a study to investigate long-term outcomes of PCIF. METHODS: We retrospectively reviewed demographic, radiologic, and clinical data from the patients who underwent PCIFs at our institution...
July 2016: Journal of Korean Neurosurgical Society
Jung Hwan Lee, Sang-Ho Lee
Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated...
July 2016: Medicine (Baltimore)
Phillip H Horne, Lukas P Lampe, Joseph T Nguyen, Richard J Herzog, Todd J Albert
BACKGROUND: Developmental cervical stenosis of the spinal canal predisposes patients to neural compression and loss of function. The Torg-Pavlov ratio has been shown to provide high sensitivity but low specificity for identifying developmental cervical stenosis. A more sensitive and specific radiographic index has not been reported to our knowledge. The objective of this study was to develop and provide an objective, sensitive, and specific radiographic index to assess for developmental cervical stenosis...
July 20, 2016: Journal of Bone and Joint Surgery. American Volume
Peter Cowley
Spinal stenosis is common and presents in a variety of forms. Symptomatic lumbar stenosis occurs in approximately 10% of the population and cervical stenosis in 9% over age 70. Imaging is central to the management decision process and first-choice MR imaging may be substituted with CT and CT myelography. A review of the literature is presented with particular emphasis on the clinical-radiologic correlation in both neurogenic intermittent claudication and cervical spondylotic myelopathy. Advanced techniques promise improvements, particularly with radicular compressive lesions, but remain underutilized in routine clinical practice...
August 2016: Magnetic Resonance Imaging Clinics of North America
Ghassan Kerry, Alexander Hammer, Claus Ruedinger, Gholamreza Ranaie, Hans-Herbert Steiner
BACKGROUND: An unsettled controversy over the appropriate surgical approach in cases of cervical radiculopathy caused by degenerative vertebrae and intervertebral discs is still present. The purpose of this study is to examine the efficacy of microsurgical posterior foraminotomy in the treatment of cervical radiculopathy and to find out whether the underlying pathology (soft disc herniation/spondylosis) is of value in predicting long-term outcome after this procedure. METHODS: Patients, who underwent posterior cervical foraminotomy (PCF) at our department between 2006 and 2013 for unilateral mono-segmental lateral soft disc herniation, or spondylosis, or both, were enrolled in this study...
July 11, 2016: British Journal of Neurosurgery
Aria Nouri, Allan R Martin, Lindsay Tetreault, Anick Nater, So Kato, Hiroaki Nakashima, Narihito Nagoshi, Hamed Reihani-Kermani, Michael G Fehlings
INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported. METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change...
August 2016: Neurosurgery
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