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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/29664964/monitoring-for-myelopathic-progression-with-multiparametric-quantitative-mri
#1
Allan R Martin, Benjamin De Leener, Julien Cohen-Adad, Sukhvinder Kalsi-Ryan, David W Cadotte, Jefferson R Wilson, Lindsay Tetreault, Aria Nouri, Adrian Crawley, David J Mikulis, Howard Ginsberg, Eric M Massicotte, Michael G Fehlings
BACKGROUND: Patients with mild degenerative cervical myelopathy (DCM) are often managed non-operatively, and surgery is recommended if neurological progression occurs. However, detection of progression is often subjective. Quantitative MRI (qMRI) directly measures spinal cord (SC) tissue changes, detecting axonal injury, demyelination, and atrophy. This longitudinal study compared multiparametric qMRI with clinical measures of progression in non-operative DCM patients. METHODS: 26 DCM patients were followed...
2018: PloS One
https://www.readbyqxmd.com/read/29660552/cervical-spine-and-cord-angle-mismatch-in-the-pathogenesis-of-myelopathy
#2
Tomasz Tykocki, Johannes du Plessis, Guy Wynne-Jones
BACKGROUND: Cervical myelopathy is a complex pathology and dynamic compression of the tethered cervical cord may be responsible for clinical symptoms METHODS: Patients with cervical canal stenosis who had magnetic resonance imaging (MRI) in flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick grade. Based on MRI following cervical parameters were measured: cervical cord angle (CCA), cervical lordosis (C lordosis), spine/cord (S/C) angle ratio...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29651521/-spondylotic-cervical-myelopathy-indication-of-surgical-treatment
#3
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/29649650/assessment-of-myelopathy-in-cervical-ossification-of-the-posterior-longitudinal-ligament-by-mri-assisted-3d-measurement
#4
Zhiwei Wang, Yanqing Sun, Yifan Tang, Bo Yuan, Shengyuan Zhou, Xiongsheng Chen, Lianshun Jia
OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) is a three-dimensional (3D) disease that causes cervical myelopathy. The conventional two-dimensional(2D) measurement of OPLL has limitations in estimating cord-compression and myelopathy. In this study, we attempted to use three-dimensional computed tomography(3D CT) and magnetic resonance imaging(MRI) to measure the 3D occupying ratio of OPLL and investigate its significance in assessment of spinal cord myelopathy...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649642/is-cervical-anterior-spinal-artery-compromised-in-cervical-spondylotic-myelopathy-patients-dual-energy-computed-tomography-analysis-of-cervical-anterior-spinal-artery
#5
Wu Shiyang, Chandoo Suraj, Zhu Minyu, Huang Kelun, Wang Yu, Wang Zhenzhang, Teng Honglin
OBJECTIVE: Cervical myelopathy is a common acquired cause of spinal cord dysfunction in elderly. It is postulated that hypoxic/ischemic environment secondary to chronic spinal cord compression plays an important role in the pathogenesis of myelopathy. This study aims to assess the altered blood flow to spinal cord in Cervical spondylotic myelopthy patients using Dual-Energy Computed Tomography. To our knowledge, this is the first study to utilize DECT in identifying comprised Anterior Spinal Artery blood flow in CSM patients...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649608/standalone-cranio-cervical-decompression-is-feasible-in-children-with-mucopolysaccharidosis-type-i-iva-and-vi
#6
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/29649085/tract-specific-volume-loss-on-3t-mri-in-patients-with-cervical-spondylotic-myelopathy
#7
Benjamin S Hopkins, Kenneth A Weber, Michael Brendan Cloney, Monica Paliwal, Todd B Parrish, Zachary A Smith
STUDY DESIGN: Case-control. OBJECTIVE: The aim of this study was to understand the role of high-resolution magnetic resonance (MR) in identifying regional cord volume loss in cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA: Preliminary studies suggest that compression of the ventral region of the cord may contribute disproportionately to CSM symptomology; however, tract-specific data are lacking in the CSM population. The current study is the first to use 3T MR imaging (MRI) images of CSM patients to determine specific volume loss at the level of detail of individual descending white matter tracts...
April 11, 2018: Spine
https://www.readbyqxmd.com/read/29625309/risk-factors-for-significant-intraoperative-blood-loss-during-unilateral-expansive-open-door-cervical-laminoplasty-for-cervical-compressive-myelopathy
#8
Yang Meng, Xiaofei Wang, Hua Chen, Ying Hong, Tingkui Wu, Beiyu Wang, Yuxiao Deng, Hao Liu
OBJECTIVE: Unilateral expansive open-door cervical laminoplasty is an effective and safe procedure for cervical compressive myelopathy, but occasionally is accompanied with significant intraoperative blood loss (SIBL). The aim of the present study was to elucidate the risk factors for SIBL in patients undergoing cervical laminoplasty for multilevel cervical compressive myelopathy, and to identify the effect of SIBL on neurological complication. METHODS: A total of 215 patients who received cervical laminoplasty between January 2010 and August 2016 were enrolled in the study...
April 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29619562/a-preliminary-study-of-3-0-t-magnetic-resonance-diffusion-tensor-imaging-in-cervical-spondylotic-myelopathy
#9
Fulong Dong, Yuanyuan Wu, Peiwen Song, Yinfeng Qian, Ying Wang, Liyan Xu, Minmin Yin, Renjie Zhang, Hui Tao, Peng Ge, Chang Liu, Huaqing Zhang, Jinwen Zhu, Cailiang Shen, Yongqiang Yu
PURPOSE: To compare diffusion tensor imaging (DTI) parameters of the spinal cord between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and investigate their significance in the clinical diagnosis, surgical planning and post-operative evaluation of CSM. METHODS: Routine sequence magnetic resonance imaging (MRI) and DTI scans were performed in 50 normal subjects and 60 cases of CSM with 3.0-T MR. DTI images, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) colormaps corresponding to spinal cord cross-sections were obtained...
April 4, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29619535/-operative-treatment-of-the-degenerative-cervical-spine
#10
REVIEW
A Tschugg, B Meyer, M Stoffel, P Vajkoczy, F Ringel, S-O Eicker, V Rhode, C Thomé
BACKGROUND: Degenerative alterations of the cervical spine often entail disc herniations and stenoses of the spinal canal and/or neural foramen. Mediolateral or lateral compression of nerve roots causes cervical radiculopathy, which is an indication for surgery in cases of significant motor deficits or refractory pain. Median canal encroachment may result in compression of the spinal cord and cervical myelopathy. Its natural history is typically characterized by episodic deterioration, so that surgical decompression is indicated in cases of clear myelopathic signs...
April 4, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29599828/age-related-changes-of-the-spinal-cord-a-biomechanical-study
#11
Tomoya Okazaki, Tsukasa Kanchiku, Norihiro Nishida, Kazuhiko Ichihara, Itsuo Sakuramoto, Junji Ohgi, Masahiro Funaba, Yasuaki Imajo, Hidenori Suzuki, Xian Chen, Toshihiko Taguchi
Although it is known that aging plays an important role in the incidence and progression of cervical spondylotic myelopathy (CSM), the underlying mechanism is unclear. Studies that used fresh bovine cervical spinal cord report the gray matter of the cervical spinal cord as being more rigid and fragile than the white matter. However, there are no reports regarding the association between aging an tensile and Finite Element Method (FEM). Therefore, FEM was used based on the data pertaining to the mechanical features of older bovine cervical spinal cord to explain the pathogenesis of CSM in elderly patients...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29599656/degenerative-cervical-myelopathy-a-clinical-review
#12
REVIEW
Justin Gibson, Aria Nouri, Bryan Krueger, Nikita Lakomkin, Rani Nasser, David Gimbel, Joseph Cheng
Degenerative Cervical Myelopathy (DCM) is the most common form of spinal cord impairment in adults and results in disability and reduced quality of life. DCM can present with a wide set of clinical and imaging findings, including: 1) pain and reduced range of motion of the neck, and motor and sensory deficits on clinical exam, and 2) cord compression due to static and dynamic injury mechanisms resulting from degenerative changes of the bone, ligaments, and intervertebral discs on MRI. The incidence and prevalence of DCM has been estimated at a minimum of 4...
March 2018: Yale Journal of Biology and Medicine
https://www.readbyqxmd.com/read/29598841/narrow-width-of-muscle-preserving-selective-laminectomy-demonstrated-sufficient-surgical-outcomes-and-reduced-surgical-invasiveness
#13
Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda
Sufficient width of laminectomy or laminoplasty is considered a criterion for successful surgical outcomes following posterior cervical decompression. No previous study has focused on surgical outcomes achieved by wide versus narrow decompression. This study examined whether narrow laminectomy width (LW) affected surgical outcomes in cervical compressive myelopathy (CCM). Between 2005 and 2010, we performed muscle-preserving selective laminectomy (SL) with decompression between the bilateral medial margin of the facet joints (wide SL)...
March 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29584512/acute-prevertebral-abscess-secondary-to-intradiscal-oxygen-ozone-chemonucleolysis-for-treatment-of-a-cervical-disc-herniation
#14
Chun-Sheng Yang, Lin-Jie Zhang, Zhi-Hua Sun, Li Yang, Fu-Dong Shi
Objective We herein present a case involving a prevertebral abscess complicated by a spinal epidural abscess (SEA) secondary to intradiscal oxygen-ozone chemonucleolysis for treatment of a cervical disc herniation. Methods A 67-year-old woman with a history of intradiscal oxygen-ozone chemonucleolysis developed numbness and weakness in her right upper and bilateral lower extremities followed by urinary retention. Her symptoms did not respond to intravenous antibiotics alone. Magnetic resonance imaging of the cervical region revealed an extensive SEA anterior to the spinal cord, spinal cord myelopathy due to anterior compression by the lesion, and a prevertebral abscess extending from C2 to T1...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29574593/longitudinal-brain-activation-changes-related-to-electrophysiological-findings-in-patients-with-cervical-spondylotic-myelopathy-before-and-after-spinal-cord-decompression-an-fmri-study
#15
Lumír Hrabálek, Pavel Hok, Petr Hluštík, Eva Čecháková, Tomáš Wanek, Pavel Otruba, Miroslav Vaverka, Petr Kaňovský
BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction, potentially leading to severe disability. Abnormal cervical spine magnetic resonance imaging (MRI) and motor evoked potentials (MEPs) are independent predictors of disease progression. Abnormal MRI is accompanied by various activation changes in functional brain MRI (fMRI), whereas preoperative and postoperative fMRI adaptations associated with abnormal preoperative MEP remain unknown...
March 25, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29570047/painless-motor-radiculopathy-of-the-cervical-spine-clinical-and-radiological-characteristics-and-long-term-outcomes-after-operative-decompression
#16
Sebastian Siller, Rami Kasem, Thomas-Nikolaus Witt, Joerg-Christian Tonn, Stefan Zausinger
OBJECTIVE Various neurological diseases are known to cause progressive painless paresis of the upper limbs. In this study the authors describe the previously unspecified syndrome of compression-induced painless cervical radiculopathy with predominant motor deficit and muscular atrophy, and highlight the clinical and radiological characteristics and outcomes after surgery for this rare syndrome, along with its neurological differential diagnoses. METHODS Medical records of 788 patients undergoing surgical decompression due to degenerative cervical spine diseases between 2005 and 2014 were assessed...
March 23, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29563801/predictive-factors-of-symptomatic-lumbar-canal-stenosis-in-patients-after-surgery-for-cervical-spondylotic-myelopathy
#17
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/29557051/axonal-damage-is-remarkable-in-patients-with-acutely-worsening-symptoms-of-compression-myelopathy-biomarkers-in-cerebrospinal-fluid-samples
#18
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/29547169/endoscopic-partial-corpectomy-using-anterior-decompression-for-cervical-myelopathy
#19
Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
https://www.readbyqxmd.com/read/29538039/endoscopic-endonasal-approach-to-the-upper-cervical-spine-for-decompression-of-the-cervicomedullary-junction-following-occipitocervical-fusion
#20
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
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