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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/29452319/-white-cord-syndrome-of-acute-hemiparesis-after-posterior-cervical-decompression-and-fusion-for-chronic-cervical-stenosis
#1
Prince Antwi, Ryan Grant, Gregory Kuzmik, Khalid Abbed
BACKGROUND: "White cord syndrome" is a very rare condition thought to be the result of acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted MRI sequences in a patient with unexplained neurologic deficits following a spinal cord decompression. The syndrome is rare and has been reported previously in two patients following anterior cervical decompression and fusion. CASE DESCRIPTION: Here, we report an additional case of this complication in a 68-year-old man who developed acute left-sided hemiparesis after posterior cervical decompression and fusion for cervical spondylotic myelopathy...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29450629/congenital-cervical-kyphosis-in-an-infant-with-ehlers-danlos-syndrome
#2
Andrew J Kobets, Daniel Komlos, John K Houten
BACKGROUND: Ehler-Danlos syndome (EDS) refers to a group of heritable connective tissue disorders; rare manifestations of which are cervical kyphosis and clinical myelopathy. Surgical treatment is described for the deformity in the thoracolumbar spine in adolescents but not for infantile cervical spine. Internal fixation for deformity correction in the infantile cervical spine is challenging due to the diminutive size of the bony anatomy and the lack of spinal instrumentation specifically designed for young children...
February 15, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29439907/posterior-spinal-cord-shift-does-not-affect-surgical-outcomes-after-muscle-preserving-selective-laminectomy
#3
Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda
Postoperative posterior spinal cord shift (PSS) has been considered a required radiographic endpoint of posterior decompression procedures. To achieve PSS, laminoplasty for cervical compressive myelopathy (CCM) has been consecutively performed on four or more laminae (C2-C7, C3-C7, or C3-C6). However, the clinical significance of PSS remains controversial. By selecting the surgically treated laminae, selective laminectomy (SL) can achieve adequate decompression without disturbing the extensor musculature and facet joints...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29424671/reproducibility-temporal-stability-and-functional-correlation-of-diffusion-mr-measurements-within-the-spinal-cord-in-patients-with-asymptomatic-cervical-stenosis-or-cervical-myelopathy
#4
Benjamin M Ellingson, Noriko Salamon, Davis C Woodworth, Hajime Yokota, Langston T Holly
OBJECTIVE The purpose of this study was to quantify the reproducibility, temporal stability, and functional correlation of diffusion MR characteristics in the spinal cord in patients with cervical stenosis with or without myelopathy. The association between longitudinal diffusion tensor imaging (DTI) measurements and serial neurological function assessment was explored at both the group and individual level. METHODS Sixty-six nonoperatively treated patients with cervical stenosis were prospectively followed (3 months to > 5 years) using synchronous serial MRI and functional outcome assessment...
February 9, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29421491/development-of-a-finite-element-model-of-the-ligamentous-cervical-vertebral-column-of-a-great-dane
#5
Marília de Albuquerque Bonelli, Anoli Shah, Vijay Goel, Fabiano Séllos Costa, Ronaldo Casimiro da Costa
Cervical spondylomyelopathy (CSM), also known as wobbler syndrome, affects mainly large and giant-breed dogs, causing compression of the cervical spinal cord and/or nerve roots. Structural and dynamic components seem to play a role in the development of CSM; however, pathogenesis is not yet fully understood. Finite element models have been used for years in human medicine to study the dynamic behavior of structures, but it has been mostly overlooked in veterinary studies. To our knowledge, no specific ligamentous spine models have been developed to investigate naturally occurring canine myelopathies and possible surgical treatments...
January 29, 2018: Research in Veterinary Science
https://www.readbyqxmd.com/read/29403257/idiopathic-hypertrophic-pachymeningitis-as-a-rare-cause-of-cervical-compressive-myelopathy
#6
Aya Fukuda, Elizabete Punaro, Fábio Rogério, Luciano de Souza Queiroz, Fabiano Reis
The spinal form of idiopathic hypertrophic pachymeningitis (IHP) is a rare condition characterized by a chronic progressive diffuse inflammatory fibrosis of the dura mater, which may evolve to the compression of the spinal cord. We present a case report about IHP focusing on its features in magnetic resonance imaging, which are determined by an intradural extramedullary mass in the cervical spine showing hypointensity on T2-weighted images and peripheral enhancement, causing compression of the spinal cord. Histological analysis showed a nonspecific chronic inflammatory process in dense fibrous tissue...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29402760/lessons-from-recruitment-to-an-internet-based-survey-for-degenerative-cervical-myelopathy-comparison-of-free-and-fee-based-methods
#7
Benjamin Davies, Mark Kotter
BACKGROUND: Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM...
February 5, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29399376/isolated-ligamentum-flavum-ossification-in-primary-hypoparathyroidism
#8
Amir H Sohail, Muhammad A A Maan, Muhammad S Khan, Qamar Masood
Background: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentum flavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented with ligamentum flavum ossification causing both cervical and thoracic myelopathy. Case Description: A 43-year-old male presented with backache, urinary retention, and lower limb weakness for the last few days...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29394951/analysis-of-c5-palsy-in-cervical-myelopathy-with-massive-anterior-compression-following-laminoplasty
#9
Guangdong Chen, Yifan Wang, Zhidong Wang, Ruofu Zhu, Huilin Yang, Zongping Luo
BACKGROUND: Little data is available about comparison of the incidence and clinical characteristics of the C5 palsy between patients of cervical myelopathy with occupying ratio greater than 50% and those with occupying ratio less than 50% following laminoplasty. METHODS: One-hundred eighteen patients with cervical myelopathy who underwent open door laminoplasty were reviewed in this study. The patients were divided into two groups: group A comprising 55 patients with an anterior occupying ratio greater than 50% and group B comprising 63 patients with an anterior occupying less than 50%...
February 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29390447/cervical-myelopathy-caused-by-invaginated-laminae-of-the-axis-associated-with-occipitalizaion-of-the-atlas-case-report-and-literature-review
#10
Jian-Xiang Xu, Cheng-Gui Wang, Cheng-Wei Zhou, Qian Tang, Jia-Wei Li, Hua-Zi Xu, Fang-Min Mao, Nai-Feng Tian
RATIONALE: In previous studies, few cases of cervical myelopathy caused by invaginated anomalous laminae of the axis have been reported, and none of them was combined with occipitalization of the atlas. PATIENT CONCERNS: A 28-year-old male was brought to our hospital with motor and sensory impairments of the extremities after a car accident. DIAGNOSES: MRI showed the spinal cord was markedly compressed at the C2/3 level. Reconstructed CT scans revealed an invaginated laminae of axis into the spinal canal as well as atlas assimilation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29380380/cervical-myelopathy-due-to-complex-atlanto-axial-malformation-including-partial-atlantal-dorsal-arch-aplasia-in-a-domestic-rabbit
#11
J N Nessler, F Attig, M Thöle, B Raddatz, A Beineke, M Fehr, A Tipold, V M Stein
A 1-year-old dwarf rabbit was presented with sub-acute progressive tetraparesis. Radiography, CT and MRI revealed compressive cervical myelopathy secondary to a complex atlanto-axial malformation including partial aplasia of the atlantal dorsal arch, dens malformation, malarticulation and lateral atlanto-occipital displacement. Owners decided against surgical treatment and elected conservative treatment including analgesia with non-steroidal anti-inflammatory drugs, cage rest and physiotherapy. Within 2 months clinical signs deteriorated and the owner elected euthanasia...
January 29, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29376740/evaluation-of-spinal-involvement-in-children-with-mucopolysaccharidosis-vi-the-role-of-mri
#12
Elif Bulut, Emine Pektas, Hatice S Sivri, Burcak Bilginer, Mumtaz M Umaroglu, Burce Ozgen
PURPOSE: To evaluate spinal MRI features of mucopolysaccharidosis (MPS) VI and to assess the correlation with clinical findings. METHODS: We retrospectively evaluated spinal MRI scans and clinical findings at the time of imaging in 14 patients (8 male, 6 female) with MPS VI. Craniometric measurements were performed and the images were assessed for bony anomalies, spinal stenosis and spinal cord compression. The degree of cervical cord compression was scored and correlated with neurological examination findings at the time of imaging...
January 29, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29332032/value-of-conventional-mri-and-diffusion-tensor-imaging-parameters-in-predicting-surgical-outcome-in-patients-with-degenerative-cervical-myelopathy
#13
Canghai Shen, Haiwei Xu, Baoshan Xu, Xiaoguang Zhang, Xiaofeng Li, Qiang Yang, Xinlong Ma
BACKGROUND: In addition to conventional magnetic resonance imaging (cMRI), diffusion tensor imaging (DTI) has been investigated as a potential diagnostic and prognostic tool for patients with degenerative cervical myelopathy (DCM). OBJECTIVE: To assess the efficacy of cMRI and DTI parameters in prediction of surgical outcome in DCM patients. METHODS: One hundred and forty-two patients with DCM who underwent presurgical cMRI and DTI of the cervical spine were included...
December 29, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/29325524/posterior-decompression-and-occipitocervical-fixation-followed-by-intraoperative-vertebroplasty-for-metastatic-involvement-of-the-axis
#14
Xinjie Wu, Mingsheng Tan, Yingna Qi, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
BACKGROUND: Metastases to the upper cervical spine were rarely reported in the literature. However, metastases to this area may cause spinal instability and cord compression, which in turn can result in respiratory failure and neurological dysfunction. The present study investigated the efficacy and safety of posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for this disease. METHODS: This was a retrospective study that included 10 patients with metastatic involvement of the axis from March 2002 to May 2014...
January 11, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29322309/the-global-spine-care-initiative-a-summary-of-guidelines-on-invasive-interventions-for-the-management-of-persistent-and-disabling-spinal-pain-in-low-and-middle-income-communities
#15
REVIEW
Emre Acaroğlu, Margareta Nordin, Kristi Randhawa, Roger Chou, Pierre Côté, Tiro Mmopelwa, Scott Haldeman
PURPOSE: The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS: We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain...
January 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29285560/anterior-controllable-antidisplacement-and-fusion-surgery-for-the-treatment-of-multilevel-severe-ossification-of-the-posterior-longitudinal-ligament-with-myelopathy-preliminary-clinical-results-of-a-novel-technique
#16
Jingchuan Sun, Jiangang Shi, Ximing Xu, Yong Yang, Yuan Wang, Qingjie Kong, Haisong Yang, Yongfei Guo, Dan Han, Jingjing Jiang, Guodong Shi, Wen Yuan, Lianshun Jia
PURPOSE: Although anterior and posterior decompression surgery are both reported to treat patients with myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). The surgical strategy of the disease is still controversial when the OPLL is multilevel and severe. This present study reports the preliminary clinical results of a novel technique named anterior controllable antidisplacement and fusion (ACAF) for the treatment of multilevel-severe OPLL with myelopathy...
December 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29279758/the-role-of-dynamic-magnetic-resonance-imaging-in-cervical-spondylotic-myelopathy
#17
REVIEW
John Paul Kolcun, Lee Onn Chieng, Karthik Madhavan, Michael Y Wang
Dynamic spinal cord compression has been investigated for several years, but until the advent of open MRI, the use of dynamic MRI (dMRI) did not gain popularity. Several publications have shown that cervical cord compression is both static and dynamic. On many occasions the evaluation of cervical spondylotic myelopathy (CSM) is straightforward, but patients are frequently encountered with a significantly worse clinical examination than would be suggested by radiological images. In this paper, we present an extensive review of the literature in order to describe the importance of dMRI in various settings and applications...
December 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29273822/management-of-idiopathic-spinal-epidural-lipomatosis-a-case-report-and-review-of-the-literature
#18
Steven T Papastefan, Abhiraj D Bhimani, Steven Denyer, Sajeel R Khan, Darian R Esfahani, Demetrios C Nikas, Ankit I Mehta
BACKGROUND: Spinal epidural lipomatosis (SEL) is a rare pathologic growth of histologically normal unencapsulated adipose tissue in the epidural space. Although rare, SEL can compress the spinal cord or nerve roots causing myelopathy or radiculopathy. While SEL has been associated with long-term exposure to endogenous or exogenous steroids and obesity, idiopathic forms of SEL are much rarer. CASE REPORT: In this report, we present the first case of SEL isolated to the cervical region compressing the spinal cord in a healthy, non-obese, preadolescent patient...
December 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29206327/pharyngeal-perforation-after-anterior-cervical-spine-surgery-treated-by-transoral-endoscopic-surgery
#19
Julio Rama-López, Meritxell Tomás-Fernandez, César García-Garza, Milton Martínez-Madrigal
BACKGROUND: Anterior cervical fixation has been used since 1967 for multiple pathologies like traumatism, compressive myelopathy, or spinal infections. METHODS: We report the case of a patient who had undergone cervical spine surgery 10 years previously and presented to our clinic with a pharyngeal fistula due to surgical screw displacement that was treated by transoral endoscopic surgery. RESULTS: The immediate postoperative period occurred without incidence and complete odynophagia resolution...
December 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/29200481/cervical-laminectomy-with-lateral-mass-screw-fixation-in-cervical-spondylotic-myelopathy-neurological-and-sagittal-alignment-outcome-do-we-need-lateral-mass-screws-at-each-segment
#20
Manoj Dayalal Singrakhia, Nikhil Ramdas Malewar, Sonal Manoj Singrakhia, Shivaji Subhash Deshmukh
Background: Anterior cervical decompression and fusion is the standard procedure used for treating patients with cervical myelopathy. However, these procedures are associated with complications such as pseudarthrosis, construct failure, and neurological complications. Posterior cervical laminectomy and instrumentation is an alternative procedure to treat multilevel cervical myelopathy. In this study, we raised questions whether instrumentation is required at all levels and whether stabilizing the spine in neutral or lordotic contour with indirect decompression leads to neurological improvement with radiological evidence of anterior decompression...
November 2017: Indian Journal of Orthopaedics
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