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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/29057363/congenital-malformed-posterior-arch-of-atlas-with-fusion-defect-a-case-of-developmental-canal-stenosis-causing-cervical-myelopathy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
September 27, 2017: Neuroreport
https://www.readbyqxmd.com/read/28948090/predictors-of-symptomatic-myelopathy-in-degenerative-cervical-spinal-cord-compression
#8
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
#9
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
https://www.readbyqxmd.com/read/28890806/postlaminectomy-membrane-with-dynamic-spinal-cord-compression-disclosed-with-computed-tomographic-myelography-a-case-report-and-literature-review
#10
Takahiro Kitahara, Junya Hanakita, Toshiyuki Takahashi
INTRODUCTION: It has been hypothesized that postoperative epidural scar, postlaminectomy membrane, may be responsible for late neurological deterioration after cervical laminectomy in some cases, but there is a lack of radiological studies in the literature showing the clinical significance of postlaminectomy membrane. We describe a rare case with radiological evidence of dynamic spinal cord compression caused by the postlaminectomy membrane, which may have been related to neurological deterioration...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28867317/extensive-mirror-image-neurofibromas-of-entire-spine-resulting-in-spastic-tetraplegia
#11
Mark Bigder, Paul Szelemej, Neil Berrington
Neurofibromatosis 1 (NF1) is associated with increased incidence of spinal tumors including neurofibromas. The majority of NF1-associated spine neurofibromas are asymptomatic; however, a minority of patients will experience neurologic symptoms that can range from mild paresthesia, radiculopathy, myelopathy, and focal weakness to quadriplegia in extreme cases. We present a 21-year-old male diagnosed with NF1 in infancy and followed for multiple mirror-image neurofibromas involving the entire spine. He was asymptomatic until age 14 when he developed neck pain and progressive tetraplegia with magnetic resonance imaging showing severe cord compression secondary to bilateral C2 neurofibromas...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28859596/cervical-myelopathy-presenting-as-bilateral-upper-extremity-weakness
#12
Sean McInerney, Aaron Keil, Jin Suh Kim
A 57-year-old man with insidious onset of progressive bilateral upper extremity weakness was referred to physical therapy by his primary care physician. Following examination, the physical therapist referred the patient back to his primary care physician with a request for cervical magnetic resonance imaging (MRI) and neurology consultation. Cervical radiographs demonstrated multilevel degenerative changes, while cervical spine MRI revealed compressive myelopathy, significant spinal canal stenosis, and severe spondylosis J Orthop Sports Phys Ther 2017;47(9):691...
September 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28835868/anterior-cervical-discectomy-with-fusion-using-a-local-source-for-cancellous-autograft-a-biomechanical-analysis-of-vertebral-body-stability-in-an-osteopenic-bone-model
#13
Zakk Walterscheid, Conor O'Neill, Alex Ochs, Adrian D'Averso, Christopher Dew, Alyssa Huntington, Grace Ma, Caleb Behrend, Rafaella De Vita, Jonathan Carmouche
BACKGROUND: Anterior cervical discectomy with fusion is an effective treatment for patients having cervical radiculopathy and myelopathy. To reduce morbidity associated with autograft taken from the iliac crest without sacrificing high fusion rates, a novel technique that harvests bone from the vertebral body adjacent to the operative disc space has been proposed. The effects of square and round bone graft harvest techniques on the mechanical stability of the osteopenic donor vertebrae are unknown...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28831319/bilateral-ganglion-cysts-of-the-ligamentum-flavum-in-the-cervical-spine-causing-a-progressive-cervical-radiculomyelopathy-and-literature-review
#14
Juneki Kim, Jin-Gyu Choi, Byung-Chul Son
Here we report a unique case of bilateral ganglion cysts originating from the ligamentum flavum in the cervical spine. Degenerative cysts of the ligamentum flavum are rare lesions, and most had been reported in the lumbar spine. Its occurrence in the cervical spine is extremely rare: only eight have been reported. A 66-year-old male patient presented with progressive paraparesis, pain, and paresthesia in his bilateral T1 dermatomes that had lasted for three weeks. Magnetic resonance imaging of the cervical spine demonstrated a well-demarcated cystic lesion in the bilateral dorsolateral aspects of the C7/T1 segment and significant compression of the cervical cord...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28819680/quantitative-approach-to-the-posterior-cranial-fossa-and-craniocervical-junction-in-asymptomatic-children-with-achondroplasia
#15
Rosalinda Calandrelli, Marco Panfili, Gabriella D'Apolito, Giuseppe Zampino, Alessandro Pedicelli, Fabio Pilato, Cesare Colosimo
PURPOSE: We propose an magnetic resonance imaging (MRI)-based quantitative morphovolumetric approach to the posterior cranial fossa (PCF) and craniocervical junction (CCJ) changes in achondroplastic patients investigating possible associations with ventriculomegaly and medullary compression. METHODS: We analyzed MRI of 13 achondroplastic children not treated by surgery. 3D FSPGR T1-weighted images were used to analyze (1) PCF synchondroses; (2) PCF volume (PCFV), PCF brain volume (PCFBV), PCFV/PCFBV ratio, cerebellar volume, cerebrospinal fluid (CSF) spaces volume, and IV ventricle volume; (3) PCF (clivus, supraocciput, exocciput lengths, tentorial angle) and CCJ (AP and LL diameters of foramen magnum (FM)) morphometry; (4) measurements of FM and jugular foramina (JF) areas; and (5) supratentorial ventricular volume...
August 17, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28807778/cervical-cord-canal-mismatch-a-new-method-for-identifying-predisposition-to-spinal-cord-injury
#16
REVIEW
Aria Nouri, Julio Montejo, Xin Sun, Justin Virojanapa, Luis E Kolb, Khalid M Abbed, Joseph Cheng
The risk for spinal cord injuries (SCIs) ranging from devastating traumatic injuries, compression due to degenerative pathology, and neurapraxia is increased in patients with congenital spinal stenosis. Classical diagnostic criteria include an absolute anteroposterior diameter of <12-13mm or a Torg-Pavlov Ratio of <0.80-0.82; however, these factors do not take into account the size of the spinal cord, which varies across patients independent of canal size. Recent large MRI studies of population cohorts have allowed newer methods to emerge that account for both cord and canal size by measuring a spinal cord occupation ratio (SCOR)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28781913/nursing-review-section-of-surgical-neurology-international-evaluation-of-cervical-disc-disease-and-when-surgery-is-warranted
#17
REVIEW
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with cervical disc disease may present with radiculopathy (root compression), myelopathy (cord compression), or myeloradiculopathy. These complaints must be correlated with x-ray, magnetic resonance (MR) imaging, and computed tomographic (CT) scans. Although most patients can be managed nonsurgically, those with significant neurological deficits and larger disc herniations may require surgery. METHODS: The symptoms of cervical radiculopathy include pain radiating down one or both arms, while myelopathy may result in more diffuse numbness tingling or weakness in the upper and/or lower extremities...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28767627/muscle-preserving-selective-laminectomy-maintained-the-compensatory-mechanism-of-cervical-lordosis-after-surgery
#18
Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda
STUDY DESIGN: A retrospective single-center study. OBJECTIVE: To evaluate the compensatory mechanism of cervical lordosis (CL), the changes in cervical sagittal alignment and range of motion (ROM) after muscle-preserving selective laminectomy (SL). SUMMARY OF BACKGROUND DATA: CL increases as a compensatory mechanism for the adjustment of cervical sagittal balance or horizontal gaze. However, laminoplasty invades this mechanism and causes kyphosis in higher T1 (C7) slope patients...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28765801/regression-of-disc-osteophyte-complexes-following-laminoplasty-versus-laminectomy-with-fusion-for-cervical-spondylotic-myelopathy
#19
Remi M Ajiboye, Stephen D Zoller, Adedayo A Ashana, Akshay Sharma, William Sheppard, Langston T Holly
BACKGROUND: Laminectomy with fusion (LF) and laminoplasty are two posterior-based surgical approaches for the surgical treatment of cervical spondylotic myelopathy (CSM). The decompressive effect of these approaches is thought to be primarily related to the dorsal drift of the spinal cord away from ventral compressive structures. A lesser known mechanism of spinal cord decompression following cervical LF is regression of the ventral disc osteophyte complexes which is postulated to result from the alteration of motion across the fused motion segment...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28761535/prognostication-in-cervical-spondylotic-myelopathy-proposal-for-a-new-simple-practical-scoring-system
#20
Vengalathur Ganesan Ramesh, Manianandan Ganapathi Vel Kannan, Kuchalmbal Sriram, Chandramouli Balasubramanian
CONTEXT: The ability to preoperatively predict the outcome in cervical spondylotic myelopathy (CSM) helps in planning management and counseling the patient and family. AIMS: A simple prognostic scale, namely, the Madras Institute of Neurology Prognostic Scale (MINPS) for CSM has been proposed. SETTINGS AND DESIGN: Six well-known prognostic factors, namely, age, duration of symptoms, neurological disability (Nurick's grade), number of levels of compression, effective canal diameter, and intrinsic cord changes, have been taken into account...
July 2017: Asian Journal of Neurosurgery
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