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Tethered spinal cord

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https://www.readbyqxmd.com/read/28619063/more-preoperative-flexibility-implies-adequate-neural-pliability-for-curve-correction-without-prophylactic-untethering-in-scoliosis-patients-with-asymptomatic-tethered-spinal-cord-a-retrospective-study
#1
Zhenhai Zhou, Hongqi Zhang, Chaofeng Guo, Honggui Yu, Longjie Wang, Qiang Guo
BACKGROUND: Tethered spinal cord is frequently associated with scoliosis. It is still controversial whether a prophylactic untethering is necessary before correction procedure in scoliosis patients with tethered spinal cord. In this study we determined the clinical outcome of a one-stage posterior scoliosis correction without a prophylactic untethering for treating scoliosis with an asymptomatic tethered spinal cord. METHODS: Seventeen (5 males and 12 females) scoliosis patients with tethered spinal cords were retrospectively reviewed...
June 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28614284/cervical-spine-deformities-in-children-with-rhizomelic-chondrodysplasia-punctata
#2
Oussama Abousamra, Vinay Kandula, Angela L Duker, Kenneth J Rogers, Michael B Bober, William G Mackenzie
BACKGROUND: Cervical spine deformity in rhizomelic chondrodysplasia punctata (RCDP) has been described with different findings reported in the literature. However, available literature provides limited data from a few cases with magnetic resonance imaging (MRI) of the cervical spine. Our report describes the MRI findings in a group of children with RCDP, aiming to reach a better understanding of this pathology. METHODS: An Institutional Review Board-approved RCDP Registry was created at our institution with the goal of identifying pertinent medical issues over the lifespan of individuals with RCDP...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28598297/the-neuronal-differentiation-microenvironment-is-essential-for-spinal-cord-injury-repair
#3
Yannan Zhao, Zhifeng Xiao, Bing Chen, Jianwu Dai
Spinal cord injury (SCI) often leads to substantial disability due to loss of motor function and sensation below the lesion. Neural stem cells (NSCs) are a promising strategy for SCI repair. However, NSCs rarely differentiate into neurons; they mostly differentiate into astrocytes because of the adverse microenvironment present after SCI. We have shown that myelin-associated inhibitors (MAIs) inhibited neuronal differentiation of NSCs. Given that MAIs activate epidermal growth factor receptor (EGFR) signaling, we used a collagen scaffold-tethered anti-EGFR antibody to attenuate the inhibitory effects of MAIs and create a neuronal differentiation microenvironment for SCI repair...
June 9, 2017: Organogenesis
https://www.readbyqxmd.com/read/28553382/klippel-feil-syndrome-associated-with-sacral-agenesis-low-lying-cord-lipomyelomeningocele-and-split-cord-malformation-presenting-with-tethered-cord-syndrome-pentads-neural-tube-defects-spread-along-whole-spinal-axis
#4
Guru Dutta Satyarthee, Amandeep Kumar
Neural tube defects are congenital development anomaly of the central nervous system and usually have relatively more predilection to affect at anterior and posterior neuropore embryological development sites, so usually one or two defects are commonly encountered. However, occurrence of simultaneous multiple neural tube defects is very rare, presence of constellation of five neural defects is extremely rare, and all defects add up together to produce gross neurological deficit. We present an interesting case of a 23-year-old male who presented with history of lower backache and noticed wasting and weakness of lower limbs associated with difficulty in walking for the last 2 years but had no associated sphincter disturbances...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28553379/noncontiguous-double-spinal-lipoma-with-tethered-cord-and-polydactyly-two-different-embryological-events-in-one-patient
#5
Shashank Ravindra Ramdurg
Lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients. Sixty-six percent of lipomyelomeningocele in young patients have accompanied by hypertrophic filum terminale. It is rare to find two isolated spinal lipomas simultaneously. Embryological origin of dorsal and filar lipomas is different from each other and hence rarer to find them together. Radical resection is now being preferred for better long-term progression-free survival. We report an interesting case of spinal dysraphism in a 4-month-old female child with protruding, nontender, soft, subcutaneous 5 cm × 7 cm mass of the lumbosacral area that had been present since birth...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28546867/tethered-cord-syndrome-with-spina-bifida-aperta-in-cats-two-case-reports-of-different-types
#6
Masahiro Tamura, Takashi Oji, Satoshi Une, Makiko Mukaino, Tatsuro Bekki, Masaki Tado, Hiromi Koyama, Yumiko Kagawa, Mutsumi Kawata
CASE SUMMARY: Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally...
January 2017: JFMS open reports
https://www.readbyqxmd.com/read/28534605/diastematomyelia-and-late-onset-presentation-a-case-report-of-a-72-year-old-woman
#7
Hanne Maebe, Annick Viaene, Martine DE Muynck
BACKGROUND: We would like to present the case of a 72-year-old woman, in whom diastematomyelia was surprisingly discovered when looking for an explanation for her neurological and urological complaints. Diastematomyelia is a rare disease in the group of 'spinal dysraphisms', mostly discovered at birth and very rare at advanced age. The clinical pattern could be seen in the general presentation of 'tethered cord' and there are 2 types of presentation with a different treatment. CASE REPORT: In our case report the two dominant complaints were pain in the right foot and sphincter problems...
May 23, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28463829/prenatal-sacral-anomalies-leading-to-the-detection-of-associated-spinal-cord-malformations
#8
Baptiste Morel, Stéphanie Friszer, Jean-Marie Jouannic, Hubert Ducou Le Pointe, Eléonore Blondiaux, Catherine Garel
INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly. MATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies...
May 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28433844/neurological-decline-in-an-elderly-with-repaired-myelomeningocele-complicated-with-lumbar-canal-stenosis-a-case-report
#9
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/28387433/neurosurgical-management-and-pathology-of-lumbosacral-lipomas-with-tethered-cord
#10
REVIEW
Takato Morioka, Nobuya Murakami, Takafumi Shimogawa, Nobutaka Mukae, Kimiakai Hashiguchi, Satoshi O Suzuki, Koji Iihara
Lumbosacral lipomas are the most common form of occult spinal dysraphism. The development of lumbosacral lipomas is from the premature disjunction of the neural tube from the surrounding ectoderm, leaving the neural plate open posteriorly and allowing for the infiltration of mesodermal tissue, including fatty tissue. Since lumbosacral lipomas are a common cause of spinal cord tethering that can lead to progressive neurological deficits, prophylactic neurosurgery for lumbosacral lipomas, including untethering of the spinal cord, is recommended...
April 7, 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/28362188/spinal-column-shortening-for-tethered-cord-syndrome-associated-with-myelomeningocele-lumbosacral-lipoma-and-lipomyelomeningocele-in-children-and-young-adults
#11
Guillermo Aldave, Daniel Hansen, Steven W Hwang, Amee Moreno, Valentina Briceño, Andrew Jea
OBJECTIVE Tethered cord syndrome is the clinical manifestation of an abnormal stretch on the spinal cord, presumably causing mechanical injury, a compromised blood supply, and altered spinal cord metabolism. Tethered cord release is the standard treatment for tethered cord syndrome. However, direct untethering of the spinal cord carries potential risks, such as new neurological deficits from spinal cord injury, a CSF leak from opening the dura, and retethering of the spinal cord from normal scar formation after surgery...
June 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28343240/childhood-angular-kyphosis-a-plea-for-involvement-of-the-pediatric-neurosurgeon
#12
E Cornips, S Koudijs, J Vles, L van Rhijn
INTRODUCTION: Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. CASE SERIES: We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners...
March 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28342118/somatosensory-evoked-potentials-as-a-screening-tool-for-diagnosis-of-spinal-pathologies-in-children-with-treatment-refractory-overactive-bladder
#13
David Terence Thomas, Sevim Yener, Aybegum Kalyoncu, Kayihan Uluc, Yasar Bayri, Adnan Dagcinar, Tolga Dagli, Halil Tugtepe
PURPOSE: To evaluate the usefulness of somatosensory evoked potential as a screening tool for spinal pathologies in patients with treatment refractory overactive bladder. METHODS: This prospective study was performed between January 2011 and January 2014. Children >5 years old with treatment refractory overactive bladder were enrolled after exclusion of anatomical and neurological causes of incontinence. All patients underwent urodynamic studies, spinal MRI, and somatosensory evoked potential (SEP)...
March 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28285942/small-molecule-inhibitors-of-psd95-nnos-protein-protein-interactions-suppress-formalin-evoked-fos-protein-expression-and-nociceptive-behavior-in-rats
#14
Lawrence M Carey, Wan-Hung Lee, Tannia Gutierrez, Pushkar M Kulkarni, Ganesh A Thakur, Yvonne Y Lai, Andrea G Hohmann
Excessive activation of NMDA receptor (NMDAR) signaling within the spinal dorsal horn contributes to central sensitization and the induction and maintenance of pathological pain states. However, direct antagonism of NMDARs produces undesirable side effects which limit their clinical use. NMDAR activation produces central sensitization, in part, by initiating a signaling cascade that activates the enzyme neuronal nitric oxide synthase (nNOS) and generates the signaling molecule nitric oxide. NMDAR-mediated activation of nNOS requires a scaffolding protein, postsynaptic density protein 95kDa (PSD95), which tethers nNOS to NMDARs...
May 4, 2017: Neuroscience
https://www.readbyqxmd.com/read/28247109/junctional-neural-tube-defect-in-a-newborn-report-of-a-fourth-case
#15
Cameron Schmidt, Vlad Voin, Joe Iwanaga, Fernando Alonso, Rod J Oskouian, Nitsa Topale, R Shane Tubbs, W Jerry Oakes
INTRODUCTION: A discontinuous, functionally disconnected spinal cord is an extremely rare finding, with only three known reports in the literature. Titled junctional neural tube defect (JNTD), this newly reported dysraphism is believed to arise from a developmental error occurring during junctional neurulation, a transitory stage of development marked by the end of primary neurulation and the beginning of secondary neurulation. Herein, we report a newborn case of JNTD. CASE REPORT: We report a newborn boy born with anorectal atresia...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28247108/lateral-lipomyelomeningocele-of-the-hemicord-with-split-cord-malformation-type-i-revealed-by-3d-heavily-t2-weighted-mr-imaging
#16
Nobuya Murakami, Takato Morioka, Masako Ichiyama, Ryoko Nakamura, Nobuko Kawamura
BACKGROUND: Lipomyelomeningocele (LMMC) is defined by a low-lying tethered spinal cord protruding posteriorly from the spinal canal and terminating in a lipomatous mass in the subcutaneous meningeal sac. The coexistence of LMMC with split cord malformation (SCM) is rare. CLINICAL PRESENTATION: We report on a patient with laterally protruded LMMC arising from the hemicord of SCM type I. Direct coronal and axial views (instead of sagittal views) of 3D heavily T2-weighted MR imaging (3D-hT2WI) clearly demonstrated the topographical relationship between both of the hemicords, the bony septum, and nerve roots in the right subcutaneous meningeal sac...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28223250/dorsal-cervical-spinal-cord-herniation-precipitated-by-kyphosis-deformity-correction-for-spinal-cord-tethering
#17
Robert S Heller, Steven W Hwang, Ron I Riesenburger
INTRODUCTION: Cervical spinal cord herniation is a rare clinical entity. Reported after previous intradural surgery or surgery complicated by durotomy, patients return several months to years later with symptoms of worsening myelopathy. Herein is presented a case of a 51-year-old female patient with spinal cord herniation in the cervical spine after kyphosis deformity correction. CASE DESCRIPTION: A 51-year old female patient presented to the neurosurgery clinic with worsening cervical myelopathy due to cervical spinal cord tethering and adhesions from previous intradural surgery for Chiari malformation...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28220607/neurological-and-spinal-manifestations-of-the-ehlers-danlos-syndromes
#18
Fraser C Henderson, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin extensibility, and tissue fragility. This communication briefly reports upon the neurological manifestations that arise including the weakness of the ligaments of the craniocervical junction and spine, early disc degeneration, and the weakness of the epineurium and perineurium surrounding peripheral nerves. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression...
February 21, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28065719/the-currarino-triad-what-pediatric-surgeons-need-to-know
#19
Amr Abdelhamid AbouZeid, Shaimaa Abdelsattar Mohammad, Mohammad Abolfotoh, Ahmed Bassiouny Radwan, Mohamed Mohamed ElSayed Ismail, Tarek Ahmed Hassan
PURPOSE: We report our experience in managing a group of patients with Currarino syndrome, highlighting diagnostic challenges, surgical techniques, in addition to a review of current neurosurgical options. PATIENTS AND METHODS: The study included patients with Currarino syndrome who presented to our pediatric surgery department during the period 2010 through 2016. The 'sacral scimitar' in plain X-ray provided the clue for the diagnosis; while MRI examination was essential to define the nature of the presacral mass and associated spinal anomalies...
December 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28059708/impact-of-mr-neurography-in-patients-with-chronic-cauda-equina-syndrome-presenting-as-chronic-pelvic-pain-and-dysfunction
#20
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
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