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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/28632590/comparison-of-anterior-and-posterior-surgery-for-degenerative-cervical-myelopathy-an-mri-based-propensity-score-matched-analysis-using-data-from-the-prospective-multicenter-aospine-csm-north-america-and-international-studies
#1
So Kato, Aria Nouri, Dongjin Wu, Satoshi Nori, Lindsay Tetreault, Michael G Fehlings
BACKGROUND: Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28625905/the-influence-of-mri-features-on-surgical-decision-making-in-degenerative-cervical-myelopathy-results-from-a-global-survey-of-aospine-international-members
#2
Aria Nouri, Allan R Martin, Anick Nater, Christopher D Witiw, So Kato, Lindsay Tetreault, Hamed Reihani-Kermani, Carlo Santaguida, Michael G Fehlings
OBJECTIVE: We conducted a survey to understand how specific pathologic features on MRI influence surgeons toward an anterior or posterior surgical approach in Degenerative Cervical Myelopathy (DCM) . METHODS: A questionnaire was sent out to 6,179 AOSpine International members via email. This included 18 questions on a 7-point Likert scale regarding how MRI features influence the respondent's decision to perform an anterior or posterior surgical approach. Influence was classified based on the mean and mode...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28623403/diffusion-tensor-imaging-can-predict-surgical-outcomes-of-patients-with-cervical-compression-myelopathy
#3
Satoshi Maki, Masao Koda, Mitsuhiro Kitamura, Taigo Inada, Koshiro Kamiya, Mitsutoshi Ota, Yasushi Iijima, Junya Saito, Yoshitada Masuda, Koji Matsumoto, Masatoshi Kojima, Takayuki Obata, Kazuhisa Takahashi, Masashi Yamazaki, Takeo Furuya
PURPOSE: The aim of this study was to assess the potential role of diffusion tensor imaging (DTI) as a predictor of surgical outcomes in patients with cervical compressive myelopathy (CCM). Surgical decompression is often recommended for symptomatic CCM. It is important to know the prognosis of surgical outcomes and to recommend appropriate timing for surgery. METHODS: We enrolled 26 patients with CCM who underwent surgery. The Japanese Orthopaedic Association (JOA) score for cervical myelopathy was evaluated before and 6 months after surgery...
June 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28620788/comparison-of-intraoperative-neurophysiologic-monitoring-outcomes-between-cervical-and-thoracic-spine-surgery
#4
Shujie Wang, Yuan Tian, Xiangquan Lin, Zhifu Ren, Yu Zhao, Jiliang Zhai, Xiaojuan Zhang, Yanwei Zhao, Yingyue Dong, Congran Zhao, Ye Tian
PURPOSE: The objective is to compare the intraoperative monitoring (IOM) outcomes between degenerative cervical and thoracic spine decompression surgery. METHOD: A total of 97 patients with cervical compression myelopathy (CCM) and 75 patients with thoracic compression myelopathy (TCM) were prospectively collected between December 2012 and June 2015 in our spine center. Somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP) were used for IOM. The postoperative neurologic status of each patient was assessed immediately after surgery...
June 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28591038/indication-for-hypertrophy-posterior-longitudinal-ligament-removal-in-anterior-decompression-for-cervical-spondylotic-myelopathy
#5
Chengrui Bai, Kanghua Li, Ai Guo, Qi Fei, Dong Li, Jinjun Li, Bingqiang Wang, Yong Yang
The retrospective study aimed to investigate the indication for hypertrophy posterior longitudinal ligament (HPLL) removal in anterior decompression for cervical spondylotic myelopathy (CSM). A total of 138 consecutive patients with CSM were divided into 2 groups with developmental cervical stenosis (DCS) (group S) and non-DCS (group N), according to the Pavlov ratio. These 2 groups were subdivided into 2 further subgroups, according to whether HPLL was removed or preserved: group SR (49 patients) and group SP (32 patients) in group S, group NR (21 patients) and group NP (36 patients) in group N...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28583460/spinal-cord-compression-secondary-to-epidural-fibrosis-associated-with-percutaneously-placed-spinal-cord-stimulation-electrodes-case-report-and-review-of-the-literature
#6
Mazin Al Tamimi, Salah G Aoun, Wayne Gluf
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed, either surgically by creating a laminectomy defect for paddle leads, or percutaneously by inserting electrodes. They are usually not associated with major complications. There have been several reports of epidural fibrosis formation after paddle lead placement but only one case of excessive fibrosis following percutaneous lead placement. We describe the unique case of excessive cervical fibrosis formation with creation of tolerance phenomenon, clinically significant stenosis, cord compression, and myelopathy after percutaneous lead placement, that improved after surgical removal of the implant...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28580859/isolated-spinal-cord-compression-syndrome-revealing-delayed-extensive-superficial-siderosis-of-the-central-nervous-system-secondary-to-cervical-root-avulsion
#7
Amina Nasri, Imen Kacem, Youssef Sidhom, Mouna Ben Djebara, Amina Gargouri, Riadh Gouider
CONTEXT: Cervical root avulsion secondary to traumatic plexus injury is a rare etiology of superficial siderosis (SS) of the central nervous system (CNS). We describe the case of an isolated progressive compressive myelopathy revealing this complication and discuss the pathogenesis of such a presentation, its clinical and imaging peculiarities with a literature review. FINDINGS: We report on the case of a 48-year-old man with history of left brachial plexus injury at the age of 2 years...
June 5, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28570271/delayed-decompression-exacerbates-ischemia-reperfusion-injury-in-cervical-compressive-myelopathy
#8
Pia M Vidal, Spyridon K Karadimas, Antigona Ulndreaj, Alex M Laliberte, Lindsay Tetreault, Stefania Forner, Jian Wang, Warren D Foltz, Michael G Fehlings
Degenerative cervical myelopathy (DCM) is the most common progressive nontraumatic spinal cord injury. The most common recommended treatment is surgical decompression, although the optimal timing of intervention is an area of ongoing debate. The primary objective of this study was to assess whether a delay in decompression could influence the extent of ischemia-reperfusion injury and alter the trajectory of outcome in DCM. Using a DCM mouse model, we show that decompression acutely led to a 1.5- to 2-fold increase in levels of inflammatory cytokines within the spinal cord...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28566610/an-autopsy-case-of-respiratory-failure-induced-by-repetitive-cervical-spinal-cord-damage-due-to-abnormal-movement-of-the-neck-in-athetoid-cerebral-palsy
#9
Yo-Ichi Takei, Hiroshi Koshihara, Kenya Oguchi, Kiyomitsu Oyanagi, Shinji Ohara
We herein report the clinical and autopsy findings of a 48-year-old right-handed man with athetoid cerebral palsy who suffered from cervical myelopathy due to abnormal neck movement, and who died of respiratory failure. Pathologically, the external appearance of the ventral surface of the cervical spinal cord revealed a linear indentation running obliquely at the level between the C4 and C5 segments. In the most severely compressed lesion, the gray matter was predominantly affected and severely atrophic. Microscopically, clusters of oligodendrocytes associated with thinly myelinated axons were also observed in the lateral funiculus...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28525491/surgery-for-chronic-traumatic-atlantoaxial-dislocation-associated-with-myelopathy
#10
Lingjun Wang, Yong Gu, Liang Chen, Huilin Yang
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the outcomes of myelopathy caused by atlantoaxial dislocation (AAD). SUMMARY OF BACKGROUND DATA: No reports to date have accurately evaluated the results of surgery for delayed myelopathy for patients with chronic AAD. Thus, the appropriate surgical time and methods of decompression and fusion remain a hot debate. MATERIALS AND METHODS: In our study, 18 patients underwent decompression, fixation, and fusion...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28514903/utility-of-the-central-motor-conduction-time-recorded-from-the-abductor-pollicis-brevis-and-the-abductor-digiti-minimi-muscles-in-patients-with-c6-7-myelopathy
#11
Yasuaki Imajo, Tsukasa Kanchiku, Hidenori Suzuki, Masahiro Funaba, Norihiro Nishida, Toshihiko Taguchi
OBJECTIVE: Central motor conduction time (CMCT) recorded from the abductor pollicis brevis (CMCT-APB) and abductor digiti minimi (CMCT-ADM) muscles may enable the evaluation of patients with C6-7 myelopathy. CMCT is more useful for the evaluation of the function of spinal cord than magnetic resonance imaging (MRI) findings. CMCT may be associated with age and height. However, there are few reports regarding CMCT-APB in normal subjects. This study aimed to investigate the relationships between age, height, and conduction parameters in normal subjects to assess the effectiveness of using CMCT-APB and CMCT-ADM for the evaluation of patients with C6-7 and C7-T1 myelopathy...
May 17, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28508100/cervical-radiculopathy-combined-with-cervical-myelopathy-prevalence-and-characteristics
#12
Byung-Wan Choi, Sung-Soo Kim, Dong-Hyun Lee, Ji-Wan Kim
Patients with cervical myelopathy may experience symptoms of radiculopathy, and it is not easy to determine whether these symptoms are caused by the myelopathy itself or by a radiculopathy accompanied by root compression. Therefore, we aimed to investigate the prevalence of radiculopathy combined with cervical myelopathy and to evaluate the characteristics of cervical myelopathy with or without radiculopathy. We enrolled 127 patients with cervical myelopathy in this retrospective study and reviewed their medical records and magnetic resonance imaging findings...
May 15, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28502567/myelopathy-secondary-to-a-spinal-cord-compression-induced-by-c2-nerve-tumors-during-head-rotation
#13
P Finet, C Raftopoulos
INTRODUCTION: It is well known that nerve root tumors developing in the spinal canal can be responsible for spinal cord compression leading to myelopathy and neurological deficits. We report the case of a patient with bilateral C2 neurofibromas presenting with a myelopathy of the upper cervical spine with no spinal cord compression on standard magnetic resonance imaging. The spinal cord compression occurred between the cervical neurofibromas only during head rotation. CASE REPORT: A patient with bilateral neurofibromas of the C2 nerve roots showed a progressive neurological deterioration with an intramedullary MRI hypersignal without visible compression...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28495424/clinical-and-radiographic-outcomes-following-hinge-fracture-during-open-door-cervical-laminoplasty
#14
Dong-Ho Lee, Hyoungmin Kim, Choon Sung Lee, Chang-Ju Hwang, Jae-Hwan Cho, Samuel K Cho
To investigate the clinical and radiographic fate of fractured hinges in open-door cervical laminoplasty, 135 segments of 36 patients who had undergone follow-up for more than two years after open-door cervical laminoplasty due to compressive cervical myelopathy were reviewed clinically and radiographically. Hinge fractures were identified by the intraoperative finding of obvious instability or click sounds (an obvious fracture), or by immediate postoperative computed tomography (CT) images showing a discontinuity of both the inner and outer cortex or a displacement of more than 1mm at the lamina hinge site (an occult fracture)...
May 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28489796/leptomeningeal-metastasis-of-poorly-differentiated-uterine-cervical-adenosquamous-carcinoma-following-reirradiation-to-metastatic-vertebrae-a-case-report
#15
Yueh-Feng Lu, Vai Hong Fong, Wen-Yih Wu, Li-Ying Wang, Chen-Hsi Hsieh
RATIONALE: Leptomeningeal metastasis from cervical adenosquamous carcinoma is extremely rare especially after radiotherapy for vertebral metastasis. PATIENT CONCERNS: A 52-year-old woman with International Federation of Gynecology and Obstetrics (FIGO) stage IIB adenosquamous carcinoma of cervix presented with bilateral lower limbs weakening after 2 courses radiotherapy to thoracic vertebral metastases. DIAGNOSES: Initial spine magnetic resonance imaging (MRI) showed no obvious nerve compression, and radiation myelopathy was suspected by the clinician...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28462691/neurodegeneration-in-the-spinal-ventral-horn-prior-to-motor-impairment-in-cervical-spondylotic-myelopathy
#16
Patrick Grabher, Siawoosh Mohammadi, Gergely David, Patrick Freund
Remote grey matter pathology has been suggested rostral to the compression site in cervical spondylotic myelopathy (CSM). We used computational neuroimaging to assess in-vivo the extent and functional relevance of neurodegeneration in ventral and dorsal horns above the site of compression in the cervical cord of CSM patients. Twenty patients with CSM and eighteen healthy subjects underwent a high-resolution structural and diffusion MRI protocol at vertebra C2/C3. Patients received comprehensive clinical assessments...
May 2, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28457932/the-role-of-conventional-myelography-in-the-diagnosis-and-treatment-of-degenerative-spine-diseases-in-low-income-communities-a-prospective-study
#17
David Kitya, Maria Punchak, Francis Bajunirwe
INTRODUCTION: Chronic back pain is a common problem and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to MRI and CT. This study was conducted to re-examine the diagnostic reliability, effectiveness for surgical decision making and safety of conventional myelography. METHODS: The study was conducted at Tenwek Mission Hospital during June 2009 and March 2010. New patients who presented with features of radiculopathy and/or myelopathy were eligible...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28440087/cervical-dural-calcification-and-cervical-myelopathy-in-x-linked-hypophosphataemic-rickets-a-case-report-and-review-of-the-literature
#18
Ali A Najefi, Daniel B Beder, Shiraz A Sabah, Kia Rezajooi
X-linked hypophosphataemic rickets (XLHR) is a genetic disorder resulting from a genetic mutation in the PHEX gene. This may cause ossification of soft tissue structures risking spinal cord compression. We present the first known case of cervical dural calcification secondary to XLHR to cause myelopathic symptoms due to cord compression.
April 25, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28435929/megacolon-as-an-atypical-presentation-of-cervical-myelopathy
#19
Jacob Y L Oh, Kevin J H Kwek, Seh-Wee Tee, Mark Tan
A 61-year-old gentleman was admitted with progressive symptoms of cervical myelopathy. An MRI performed showed severe compression from C3-6 with cord signal changes. He was offered surgical intervention but the operation had to be delayed because of worsening abdominal distension. X-rays performed showed a severely dilated colon measuring >12 cm. A CT did not show any obstructive cause. He was managed conservatively for more than 2 weeks but did not improve. As his symptoms continued to worsen, a decision was made to proceed with a C3-6 posterior decompression and fusion, despite the theoretical risk of bacterial translocation predisposing him to infection...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28428212/a-novel-mri-biomarker-of-spinal-cord-white-matter-injury-t2-weighted-white-matter-to-gray-matter-signal-intensity-ratio
#20
A R Martin, B De Leener, J Cohen-Adad, D W Cadotte, S Kalsi-Ryan, S F Lange, L Tetreault, A Nouri, A Crawley, D J Mikulis, H Ginsberg, M G Fehlings
BACKGROUND AND PURPOSE: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy. MATERIALS AND METHODS: Fifty-eight patients with degenerative cervical myelopathy and 40 healthy subjects underwent 3T MR imaging, covering C1-C7...
April 20, 2017: AJNR. American Journal of Neuroradiology
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