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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/29206327/pharyngeal-perforation-after-anterior-cervical-spine-surgery-treated-by-transoral-endoscopic-surgery
#1
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
#2
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
https://www.readbyqxmd.com/read/29173427/management-of-the-patient-with-cervical-cord-compression-but-no-evidence-of-myelopathy-what-should-we-do
#3
REVIEW
Kentaro Naito, Toru Yamagata, Kenji Ohata, Toshihiro Takami
Degenerative cervical myelopathy (DCM) eventually affects not only activities of daily living but also quality of life. DCM is usually a gradually progressive, sometimes irreversible, disease of the cervical spinal cord, although there is always a risk of acute deterioration caused by minor trauma. There is still not enough evidence regarding the prognosis of mild DCM without surgical treatment, and conservative treatment seems a reasonable option, although patients need to be followed closely because some do deteriorate over time...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29173425/pathobiology-of-degenerative-cervical-myelopathy
#4
REVIEW
Farhana Akter, Mark Kotter
Degenerative cervical myelopathy (DCM) is a common spinal cord disease caused by chronic mechanical compression of the spinal cord. The mechanism by which mechanical stress results in spinal cord injury is poorly understood. The most common mechanisms involved in the pathobiology of DCM include apoptosis, inflammation, and vascular changes leading to loss of neurons, axonal degeneration, and myelin changes. However, the exact pathophysiologic mechanisms of DCM are unclear. A better understanding of the pathogenesis of DCM is required for the development of treatments to improve outcomes...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29173424/neurologic-complications-in-managing-degenerative-cervical-myelopathy-pathogenesis-prevention-and-management
#5
REVIEW
Taku Sugawara
Degenerative cervical myelopathy is a common neurologic condition induced by compression of the spinal cord due to degenerative changes of the cervical spine. It is one of the leading causes of acquired disability in adults and manifests as a slow deterioration of the symptoms in a majority of the patients. A variety of nonsurgical and surgical treatments have been performed to ameliorate or halt the symptoms, and a number of articles describe their methods, efficacy, and complications. In this article, the pathogenesis, prevention, and management of the neurologic complications are reviewed...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29164035/a-clinical-practice-guideline-for-the-management-of-patients-with-degenerative-cervical-myelopathy-recommendations-for-patients-with-mild-moderate-and-severe-disease-and-nonmyelopathic-patients-with-evidence-of-cord-compression
#6
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Bizhan Aarabi, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Simon Carette, Robert Chen, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop, Langston T Holly, Sukhvinder Kalsi-Ryan, Mark Kotter, Brian K Kwon, Allan R Martin, James Milligan, Hiroaki Nakashima, Narihito Nagoshi, John Rhee, Anoushka Singh, Andrea C Skelly, Sumeet Sodhi, Jefferson R Wilson, Albert Yee, Jeffrey C Wang
Study Design: Guideline development. Objectives: The objective of this study is to develop guidelines that outline how to best manage (1) patients with mild, moderate, and severe myelopathy and (2) nonmyelopathic patients with evidence of cord compression with or without clinical symptoms of radiculopathy. Methods: Five systematic reviews of the literature were conducted to synthesize evidence on disease natural history; risk factors of disease progression; the efficacy, effectiveness, and safety of nonoperative and surgical management; the impact of preoperative duration of symptoms and myelopathy severity on treatment outcomes; and the frequency, timing, and predictors of symptom development...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164027/a-clinical-practice-guideline-for-the-management-of-degenerative-cervical-myelopathy-introduction-rationale-and-scope
#7
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Jeffrey C Wang
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29115099/spinal-meningiomas-61-cases-with-predictors-of-early-postoperative-surgical-outcomes
#8
Ahmed B Bayoumi, Yosef Laviv, Ceren N Karaali, Kemal Ertilav, Umit Kepoglu, Zafer O Toktas, Deniz Konya, Ekkehard M Kasper
BACKGROUND: Spinal meningiomas are benign, well-circumscribed and slowly growing intradural tumors that compress the spinal cord. Hereby, a retrospective review of 61 spinal meningioma cases evaluated in terms of demographic, clinical, pathological and radiological features to predict the early postoperative functional outcomes. METHODS: Patients' records and MRI images of all the histologically confirmed spinal meningioma cases that underwent surgical resection at two university hospitals from January 2005 to June 2016 were retrospectively reviewed...
November 7, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29104151/high-cervical-spinal-cord-compression-associated-with-anomaly-of-bilateral-vertebral-arteries
#9
Saeko Hayashi, Ryuichi Kanai, Jun Shinoda
BACKGROUND: Anomalies of vertebral arteries are rare, and usually detected incidentally. However, very rarely, they can manifest clinical symptoms. We describe such a symptomatic case of high cervical spinal cord compression associated with persistent C2 segmental arteries. CASE DESCRIPTION: A 67-year-old man presented with a 5-year history of worsening left-sided weakness and gait disturbance. Magnetic resonance imaging, 3D-computed tomography and digital subtraction angiography revealed anomalous courses of vertebral arteries, compressing the cervical spinal cord at C1 level from both sides...
November 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29102447/predictive-factors-for-acute-exacerbation-of-cervical-compression-myelopathy
#10
Toshiya Tachibana, Keishi Maruo, Fumihiro Arizumi, Kazuki Kusuyama, Kazuya Kishima, Shinichi Yoshiya
No abstract text is available yet for this article.
November 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29081513/localization-of-the-primary-sites-of-involvement-in-the-spinal-sensory-and-motor-pathways-for-multilevel-mri-abnormalities-in-degenerative-cervical-myelopathy
#11
Nobuaki Tadokoro, Toshikazu Tani, Kazunobu Kida, Katsuhito Kiyasu, Yusuke Kasai, Masashi Kumon, Ryuichi Takemasa, Masahiko Ikeuchi
STUDY DESIGN: Exploratory clinical study. OBJECTIVES: To localize the sites of conduction block in the spinal sensory and motor pathways for minimizing the level of surgical intervention despite MRI evidence of compression at several levels in degenerative cervical myelopathy (DCM). SETTING: Kochi Medical School Hospital, Japan. METHODS: We analyzed 83 DCM patients (69 ± 12 years) who underwent serial intervertebral recording of both ascending (A-SCEPs) and descending spinal cord-evoked potentials (D-SCEPs) after epidural and transcranial stimulation, respectively, during surgery before decompression procedures...
October 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29057363/congenital-malformed-posterior-arch-of-atlas-with-fusion-defect-a-case-of-developmental-canal-stenosis-causing-cervical-myelopathy
#12
Siddharth Shah, Samir Dalvie, Ravi Ranjan Rai
Congenital anomalies of the posterior arch of the atlas (PAA) are usually asymptomatic and diagnosed incidentally. Very rarely, they present with cervical myelopathy, usually being associated with partial aplasia or agenesis of PAA. We describe a 44-year-old lady with cervical myelopathy secondary to a malformed PAA with developmental atlas-level spinal stenosis and a congenital posterior fusion defect with persistent midline cleft showing significant non-osseous fibro-cartilaginous hypertrophy, causing critical cord compression...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29031141/analysis-of-spastic-gait-in-cervical-myelopathy-linking-compression-ratio-to-spatiotemporal-and-pedobarographic-parameters
#13
Taro Nagai, Yasuhito Takahashi, Kenji Endo, Ryo Ikegami, Ryuichi Ueno, Kengo Yamamoto
BACKGROUND: Gait dysfunction associated with spasticity and hyperreflexia is a primary symptom in patients with compression of cervical spinal cord. The objective of this study was to link maximum compression ratio (CR) to spatiotemporal/pedobarographic parameters. METHODS: Quantitative gait analysis was performed by using a pedobarograph in 75 elderly males with a wide range of cervical compression severity. CR values were characterized on T1-weighted magnetic resonance imaging (MRI)...
October 10, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29028790/imaging-factors-that-distinguish-between-patients-with-asymptomatic-and-symptomatic-cervical-spondylotic-myelopathy-with-mild-to-moderate-cervical-spinal-cord-compression
#14
Jun Ming Cao, Jing Tao Zhang, Da Long Yang, Yi Peng Yang, He Huan Xia, Liu Yang
BACKGROUND Not all patients with spinal cord compression due to cervical spondylotic myelopathy (CSM) have clinical symptoms and signs. The aim of this study was to investigate and compare the imaging findings in asymptomatic and symptomatic patients with CSM with mild to moderate cervical spinal cord compression. MATERIAL AND METHODS A retrospective clinical study included 68 patients. Group A (n=30) had no symptoms and signs; group B (n=38) had symptoms and signs of cervical myelopathy. The age, sex, body mass index (BMI), history of steroid treatment, duration of symptoms, number of spondylotic cervical segments, Torg ratio, range of motion (ROM), incidence of cervical segmental instability, overall curvature of the cervical spine, direction of spinal cord compression, and spinal cord magnetic resonance imaging (MRI) signal intensity were compared...
October 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#15
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28993348/delayed-spinal-cord-infarction-following-anterior-cervical-surgical-decompression
#16
Muhammad Faheem Khan, Rashid Jooma, Fauzan Alam Hashmi, Muhammad Faraz Raghib
Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5-6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5-6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28991689/intraoperative-neuromonitoring-loss-in-abnormal-magnetic-resonance-imaging-signal-intensity-from-patients-with-cervical-compressive-myelopathy
#17
Xiangquan Lin, Chaoxiong Li, Qin Lin, Zhong Zheng
PURPOSE: Our objective of this study was to evaluate if cervical compressive myelopathy (CCM) patients with preoperative abnormal magnetic resonance imaging (MRI) might easily lead to intraoperative neuromonitoring (IONM) loss. METHOD: A consecutive series of 152 CCM patients who underwent cervical cord decompression were enrolled in this study between December 2013 and February 2017. All patients with abnormal MRI signal intensity were divided into 2 groups (group 1: T2-WIs hyperintensity; group 2: both T2-WIs hyperintensity and T1-WIs hypointensity)...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28957944/experimental-rat-model-for-cervical-compressive-myelopathy
#18
Yasushi Ijima, Takeo Furuya, Masao Koda, Yusuke Matsuura, Junya Saito, Mitsuhiro Kitamura, Takuya Miyamoto, Sumihisa Orita, Kazuhide Inage, Takane Suzuki, Masashi Yamazaki, Seiji Ohtori
Previously, a rat model of chronic compressive myelopathy that uses a water-absorbing polymer inserted under a spinal lamina was reported. However, the best size and coefficient of expansion of the polymer sheet have not yet been established. The aim of the present study was to optimize these properties in an ideal rat model of cervical compressive myelopathy. Thirty rats were used in this study. A sheet of water-absorbing polymer was inserted under the cervical laminae. Rats were divided randomly into five experimental groups by the expansion rate (350 or 200%) and thickness (0...
December 13, 2017: Neuroreport
https://www.readbyqxmd.com/read/28948090/predictors-of-symptomatic-myelopathy-in-degenerative-cervical-spinal-cord-compression
#19
Zdenek Kadanka, Blanka Adamova, Milos Kerkovsky, Zdenek Kadanka, Ladislav Dusek, Barbora Jurova, Eva Vlckova, Josef Bednarik
OBJECTIVES: To update a previously established list of predictors for neurological cervical cord dysfunction in nonmyelopathic degenerative cervical cord compression (NMDCCC). MATERIAL AND METHODS: A prospective observational follow-up study was performed in a cohort of 112 consecutive NMDCCC subjects (55 women and 57 men; median age 59 years, range 40-79 years), either asymptomatic (40 subjects) or presenting with cervical radiculopathy or cervical pain (72 subjects), who had completed a follow-up of at least 2 years (median duration 3 years)...
September 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28894681/preoperative-computed-tomography-myelography-parameters-as-predictors-of-outcome-in-patients-with-degenerative-cervical-myelopathy-results-of-a-systematic-review
#20
Feras J Waly, Fahad H Abduljabbar, Maryse Fortin, Anas Nooh, Michael Weber
STUDY DESIGN: Systematic review. OBJECTIVES: To determine the preoperative computed tomography (CT) myelogram imaging parameters in patients diagnosed with degenerative cervical myelopathy (DCM) that correlate with severity of DCM and predict postoperative patients' functional outcome. METHODS: An electronic database search was performed using Ovid Medline and Embase. CT myelogram studies investigating the correlation between imaging characteristics and DCM severity or postoperative outcomes were included...
September 2017: Global Spine Journal
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