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Cervical spinal stenosis

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https://www.readbyqxmd.com/read/29729950/an-algorithmic-strategy-of-surgical-intervention-for-cervical-degenerative-kyphosis
#1
Hiroshi Miyamoto, Terumasa Ikeda, Kazuki Hashimoto, Masao Akagi
PURPOSE: Correction surgery for cervical degenerative kyphosis (CDK) may carry a greater risk of causing neural complications such as spinal cord injury and C5 nerve palsy because spinal canal stenosis, osteoarthritis of the facet, and consequent foraminal stenosis may coexist with CDK. We have produced an algorithmic strategy of surgical intervention for CDK, and report the outcome. METHODS: Thirty-one patients who underwent correction surgery for CDK, with a kyphotic angle of 20° or more (from 20 to 74) were involved...
May 2, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29689396/in-situ-decompression-to-spinal-cord-during-anterior-controllable-antedisplacement-fusion-treating-degenerative-kyphosis-with-stenosis-surgical-outcomes-and-analysis-of-c5-nerve-palsy-based-on-49-patients
#2
Haisong Yang, Jingchuan Sun, Jiangang Shi, Yong Yang, Yongfei Guo, Bing Zheng, Yuan Wang
OBJECTIVE: To observe outcomes of anterior controllable antedisplacement fusion (ACAF) in the treatment for degenerative kyphosis with stenosis (DKS) and analyze the probability of C5 nerve palsy. METHODS: In the period from 2016 to 2017, a consecutive cohort of adults with DKS underwent ACAF. All these patients were performed cervical plain films, CT and MRI. The operation duration, blood loss and hospital stay was estimated. Radiologic assessment included kyphotic correction, decompression width and spinal canal area...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29688066/high-field-structural-mri-in-the-management-of-degenerative-cervical-myelopathy
#3
Dan Wright, Sean Martin, Erlick Ac Pereira, Yazhuo Kong, Irene Tracey, Thomas Cadoux-Hudson
INTRODUCTION: This is a narrative overview of the pathophysiology, investigation and management of Degenerative Cervical Myelopathy (DCM). This review article also takes a look ahead to the impact high resolution MRI may have on treatment. BACKGROUND: DCM is the most common cause of spinal dysfunction and yet it remains poorly understood. It is becoming increasingly common in our ageing population. Disc and facet joint abnormalities, osteophytes, spondylothisthesis and ligamentous hypertrophy all act together to produce spinal canal and neuronal foramina stenosis which in turn causes neural compromise...
April 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29687255/correlation-between-the-severity-of-myelopathy-and-cervical-morphometric-parameters-on-dynamic-magnetic-resonance-imaging
#4
Tomasz Tykocki, Johannes du Plessis, Guy Wynne-Jones
BACKGROUND: To compare morphometric factors of cervical spine in the cervical stenosis on dynamic and static magnetic resonance imaging. To analyse the relationship between the severity of myelopathy and morphometric parameters. METHODS: Patients with cervical canal stenosis scanned with MRI in neutral (N), flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick and Muhle grades. Following parameters were measured: anterior and posterior length of the cervical cord (aLCC, pLCC), mid-cord distance (L value), cervical cord angle (CCA), cervical lordosis, spine/cord (S/C) angle ratio, spinal cord (SC) area, cerebrospinal fluid (CSF) area, and CSF reserve ratio (CSF/CSF plus SC)...
April 23, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29678703/anterior-controllable-antedisplacement-fusion-acaf-for-severe-cervical-ossification-of-the-posterior-longitudinal-ligament-comparison-with-anterior-cervical-corpectomy-with-fusion-accf
#5
Haisong Yang, Jingchuan Sun, Jiangang Shi, Guodong Shi, Yongfei Guo, Yong Yang
OBJECTIVE: Anterior cervical corpectomy and fusion (ACCF), in which a ventral constriction is resected, can decompress myelopathy and is considered the optimal treatment for ossification of the posterior longitudinal ligament (OPLL) up to now. However, its disadvantages are incomplete decompression, high surgery- and implant-related complication rates, and extremely surgical technique demanding. Our object was to introduce anterior controllable antedisplacement fusion (ACAF), a new surgical technique to treat OPLL, and compare it with ACCF...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29663022/-diagnostics-and-conservative-treatment-of-cervical-and-lumbar-spinal-stenosis
#6
REVIEW
A Hug, S Hähnel, N Weidner
BACKGROUND: Degenerative stenotic spondylosis is not an uncommon cause of cervical spondylotic myelopathy (CSM) and cauda equina lesions in the aged population. Limited standardization exists with respect to diagnostic and therapeutic procedures. OBJECTIVE: Literature review with respect to diagnostic and therapeutic procedures for neurologically relevant cervical and lumbar spinals stenosis. MATERIAL AND METHODS: Comprehensive literature review...
April 16, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29651521/-spondylotic-cervical-myelopathy-indication-of-surgical-treatment
#7
REVIEW
W Pepke, H Almansour, M Richter, M Akbar
BACKGROUND: The pathogenesis of cervical spondylotic myelopathy (CSM) is often multifactorial. Hence, the treatment of this disease requires a differentiated surgical approach in order to adequately address the underlying pathology. PURPOSE: The aim of this review is to identify factors that influence the choice of treatment strategy and to summarize them in an algorithm that serves as a decision aid in choosing the optimal indication for surgical treatment. An attempt is made to define the threshold values for the indication of surgical treatment and to discuss the ideal timing for performing surgery...
April 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29649608/standalone-cranio-cervical-decompression-is-feasible-in-children-with-mucopolysaccharidosis-type-i-iva-and-vi
#8
Harald Krenzlin, Ta-Chih Tan, Christina Lampe, Christian Lampe, Markus Knuf, Peter Horn, Manfred Schwarz
BACKGROUND CONTEXT: In patients with Mucopolysaccharidosis (MPS), glycosaminoglycans deposits in the dura mater and supporting ligaments cause spinal cord compression and consecutive myelopathy, predominantly of the cranio-cervical junction. Disease characteristics of cranio-cervical stenosis (CCS) in MPS patients differ profoundly from other hereditary and degenerative forms. Due to high peri-procedural morbidity and mortality, MPS patients pose a substantial challenge to the unexperienced medical care provider...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29600206/a-unique-case-of-cervical-myelopathy-in-an-adult-patient-with-scheie-syndrome
#9
Farzam Vazifehdan, Vasilios G Karantzoulis, Robert Ebner, Vasilios G Igoumenou
Introduction: Scheie syndrome is an extremely rare systematic disease that represents the most attenuated form of mucopolysaccharidosis Type I disorder. Although associated with a variety of manifestations, Scheie syndrome leading to the development of cervical myelopathyis yet to be reported. Our purpose was to present a unique case of a Scheie syndrome patient, who underwent surgery due to cervical myelopathy, and to discuss the clinical and imaging findings, as well as the challenges and outcomes of surgical treatment...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29581933/cervical-stenosis-in-adult-arthrogryposis-a-case-report-and-review-of-the-literature
#10
Allen L Ho, Jyodi Mohole, Eric S Sussman, Arjun V Pendharkar, Harminder Singh
Arthrogryposis multiplex congenita is a rare, nonprogressive congenital disorder that describes a constellation of conditions characterized by multiple joint contractures. Spinal pathology and deformity are common; however, the majority of the literature on arthrogryposis is focused on pediatric management. There exist very few reports on long-term outcomes and management of adults with arthrogryposis. We present a case of cervical spinal stenosis in an adult female with arthrogryposis that underwent posterior cervical decompression and fusion...
January 2018: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29565961/detection-of-intravascular-injection-during-cervical-transforaminal-epidural-injection-a-comparison-of-digital-subtraction-angiography-and-real-time-fluoroscopy
#11
Younghoon Jeon, Saeyoung Kim
BACKGROUND: Transforaminal epidural injection (TFEI) with local anesthetics and steroids are effective in treating spinal radicular pain. However, inadvertent intravascular injection can lead to severe neurologic complications. To reduce complications of intravascular injection, use of imaging modality, such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA), has been recommended. DSA is an imaging technique that can clearly visualize the blood vessels from surrounding bones or dense soft tissues by subtracting the pre-contrast image from the image after injecting contrast medium...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29563801/predictive-factors-of-symptomatic-lumbar-canal-stenosis-in-patients-after-surgery-for-cervical-spondylotic-myelopathy
#12
Lingde Kong, Jiangbo Bai, Bing Zhang, Yong Shen, Dehu Tian
Background: The aim of this study was to determine the incidence of coexisting symptomatic lumbar canal stenosis (LCS) in patients after surgery for cervical spondylotic myelopathy (CSM) and identify possible predictive factors associated with it. Materials and methods: We retrospectively reviewed patients with CSM at our institution between January 2005 and December 2015. Clinical and radiographic factors including age, gender, body mass index, Japanese Orthopedic Association scores, cervical alignment, anteroposterior diameter of cervical canal, number of levels with CSM, and percentage of cervical cord compression were investigated...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29558952/surgical-outcomes-for-lumbar-spinal-canal-stenosis-with-coexisting-cervical-stenosis-tandem-spinal-stenosis-a-retrospective-analysis-of-565-cases
#13
Tsuyoshi Yamada, Toshitaka Yoshii, Naoki Yamamoto, Takashi Hirai, Hiroyuki Inose, Atsushi Okawa
BACKGROUND: Concurrent cervical and lumbar spinal canal stenosis is known as tandem spinal stenosis (TSS). As research on TSS is limited, there is no consensus on the optimal surgical approach to this problem. We evaluated the prevalence and clinical characteristics of TSS in patients with symptomatic lumbar spinal canal stenosis (LCS). METHODS: The authors performed a retrospective analysis of the outcomes of 565 patients who underwent lumbar surgeries performed for symptomatic LCS...
March 20, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29557051/axonal-damage-is-remarkable-in-patients-with-acutely-worsening-symptoms-of-compression-myelopathy-biomarkers-in-cerebrospinal-fluid-samples
#14
Hiroshi Takahashi, Yasuchika Aoki, Arata Nakajima, Masato Sonobe, Fumiaki Terajima, Masahiko Saito, Takuya Miyamoto, Keita Koyama, Keiichiro Yamamoto, Takeo Furuya, Masao Koda, Seiji Ohtori, Masashi Yamazaki, Koichi Nakagawa
PURPOSE: To determine levels of biomarkers reflecting damage to axon, myelin, astrocytes, and neuron in cerebrospinal fluid (CSF) of patients with cervical compression myelopathy. METHODS: We collected 69 CSF samples from patients before spinal surgery for acutely worsening compression myelopathy (AM, 20), chronic compression myelopathy (CM, 20), and lumbar canal stenosis (LCS 29; control). We measured levels of phosphorylated neurofilament subunit H (pNF-H), tau (reflecting axonal damage), myelin basic protein (MBP) (reflecting demyelination), S100b (reflecting astrocyte damage), and neuron-specific enolase (NSE) (reflecting neuronal damage)...
March 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29548949/predictive-factors-of-successful-percutaneous-cervical-nucleoplasty-for-the-treatment-of-pain-with-cervical-herniated-disk
#15
Min Kyoung Kim, Sung Eun Sim, Yong-Chul Kim, Jung Soo Kim, Seok Min Kwon, Yongjae Yoo, Chang-Soon Lee, Jee Youn Moon
BACKGROUND: Percutaneous cervical nucleoplasty (PCN) is an effective treatment for cervical herniated intervertebral disc (C-HIVD). In this retrospective study, we evaluated clinical predictors that affect the successful outcome of PCN. METHODS: Fluoroscopy-guided PCN was conducted for C-HIVD by one pain physician. Successful outcome was defined as a combination of > 50% pain relief on the numerical rating scale (NRS) pain score, no increase in analgesics, and no cervical epidural steroid injection during the 3-month follow-up period...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29535014/clinical-effectiveness-of-treatment-of-combined-upper-thoracic-spinal-stenosis-and-multilevel-cervical-spinal-stenosis-with-different-posterior-decompression-surgeries
#16
Bao-Lin Zhao, Cheng Ji, Jia-Jia Jiang, Ruo-Feng Yin
OBJECTIVE: To explore the clinical effectiveness of various posterior decompression surgeries in the treatment of upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis. METHODS: From January 2010 to December 2015, 22 consecutive patients with combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis were treated with two different approaches of posterior decompression surgeries. In group A with 10 patients, both cervical and thoracic spinal decompression surgeries were performed simultaneously (one-stage surgery); in group B with 8 patients, cervical and thoracic spinal decompression surgeries were performed separately within three months (two-stage surgery)...
March 10, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29524700/analysis-of-morphometric-parameters-in-cervical-canal-stenosis-on-neutral-and-dynamic-magnetic-resonance-imaging
#17
Tomasz Tykocki, Johannes du Plessis, Guy Wynne-Jones
OBJECTIVE: A dynamic compression injury of the cervical spinal cord (SC) is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension magnetic resonance imaging (MRI) provides information on the dynamic cervical injury. We sought to compare morphometric parameters on neutral and flexion/extension MRI in cervical spondylotic myelopathy. METHODS: Patients with cervical canal stenosis who had MRI in neutral, flexion, and extension positions were reviewed retrospectively...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29521698/cervical-laminoplasty-indications-surgical-considerations-and-clinical-outcomes
#18
Samuel K Cho, Jun S Kim, Samuel C Overley, Robert K Merrill
Cervical laminoplasty was initially described for the management of cervical myelopathy resulting from multilevel stenosis secondary to ossification of the posterior longitudinal ligament. The general concepts are preservation of the dorsal elements, preservation of segmental motion, and expansion of the spinal canal via laminar manipulation. No clear evidence suggests that laminoplasty is superior to either posterior laminectomy or anterior cervical diskectomy and fusion. However, laminoplasty has its own advantages, indications, and complications...
April 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29517667/aggravation-and-subsequent-disappearance-of-cervical-disc-herniation-after-cervical-open-door-laminoplasty-a-case-report
#19
Yang Meng, Xiaofei Wang, Beiyu Wang, Tingkui Wu, Hao Liu
RATIONALE: Cervical open-door laminoplasty can enlarge the volume of the cervical vertebral canal and thus has become an effective and safe treatment for multilevel cervical disc herniation and cervical stenosis. Some post-surgery complications exist, such as reduction of cervical alignment and local kyphosis. However, aggravation of cervical disc herniation at the surgical level during short-term follow-up has not been discussed. Additionally, spontaneous disappearance of herniated disc pulposus is a common phenomenon in the lumbar region but is relatively rare in the cervical region...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29516348/three-dimensional-visualization-of-internal-vertebral-venous-plexuses-relative-to-dural-sac-and-spinal-nerve-root-of-spinal-canal-stenosis-using-mri
#20
Junji Kamogawa, Osamu Kato, Tatsunori Morizane
PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection...
May 2018: Japanese Journal of Radiology
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