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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/28819680/quantitative-approach-to-the-posterior-cranial-fossa-and-craniocervical-junction-in-asymptomatic-children-with-achondroplasia
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28746221/diagnosis-and-treatment-of-hidden-lesions-in-mild-cervical-spondylotic-myelopathy-patients-with-apparent-symptoms
#7
Yaning Sun, Kunlun Yu, Haonan Wang, Yong Shen, Lingde Kong, Jingtao Zhang
Patients with apparent symptoms of cervical spondylotic myelopathy (CSM) may only show a mild compressive lesion in ordinary magnetic resonance imaging (MRI). The aim of this study was to investigate the characteristics of CSM patients with "hidden" lesions on kinetic MRI and to determine an effective treatment.Thirty-one patients with obvious spinal cord compression only on kinetic MRI were included in our study. A variety of parameters were calculated from MRI of the cervical spine at different postures. The anterior cervical decompression and fusion (ACDF) procedure were used for treatment of CSM...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28740536/loca-lopa-myelopathy-is-prevention-better-than-cure
#8
Kamal Kishore Pandita, Sushil Razdan, Sarla Pandita
Manifestations of primary hypoparathyroidism are produced by neuromuscular irritability or by extraosseous calcifications. We present a patient of primary hypoparathyroidism who had extensive calcification of brain parenchyma, and was suffering from chronic, generalised and progressive stiffness of body due to cervical compressive myelopathy, caused by calcification of posterior longitudinal ligament and ligamentum flavum. By presenting this case we wanted to emphasize the usefulness of meticulous clinical examination to differentiate the stiffness caused by myelopathy from that which is caused by possible coexisting extrapyramidal disorder...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28721000/roentgenographic-and-computerized-tomography-based-morphometric-analysis-of-cervical-spinal-canal-diameters-to-establish-normative-measurements-in-an-indian-population
#9
Kapil A Pawar, Arya S Mishra, Gokul Bandagi, Sudhir K Srivastava
Compressive cervical myelopathy secondary to degenerative changes in the cervical spine is a common cause of neurologic morbidity in the elderly. Identification of canal stenosis and addressing it surgically in addition to the obvious compressive lesions is essential to obtain satisfactory results. We attempt to define the saggital and transverse diameters in a normal adult population presenting at our centre with head injuries. We found that the values were lower than those reported in comparable studies for a western population, and also that the dimensions in women are significantly lower than in men...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28714054/the-functional-relevance-of-diffusion-tensor-imaging-in-comparison-to-conventional-mri-in-patients-with-cervical-compressive-myelopathy
#10
Young-Mi Yang, Woo-Kyoung Yoo, Je Hyun Yoo, Yoon Hae Kwak, Jae-Keun Oh, Ji-Sun Song, Seok Woo Kim
OBJECTIVE: To determine the functional relevance of diffusion tensor imaging (DTI) metrics and conventional MRI (signal intensity change in T2, compression ratio) by measuring the correlation of these parameters with clinical outcome measured by the modified Japanese Orthopedic Association (mJOA) score. MATERIALS AND METHODS: A total of 20 cervical myelopathy (CM) patients participated in this prospective cohort study. The severities of CM were assessed using the mJOA score...
July 17, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28711563/application-of-neurite-orientation-dispersion-and-density-imaging-or-diffusion-tensor-imaging-to-quantify-the-severity-of-cervical-spondylotic-myelopathy-and-to-assess-postoperative-neurologic-recovery
#11
Genki Okita, Tetsuro Ohba, Tomohiro Takamura, Shigeto Ebata, Ryo Ueda, Hiroshi Onishi, Hirotaka Haro, Masaaki Hori
BACKGROUND CONTEXT: Surgical outcome and the severity of cervical spondylotic myelopathy (CSM) are unpredictable and cannot be estimated by conventional anatomical magnetic resonance imaging (MRI). The utility of diffusion tensor imaging (DTI) to quantify the severity of CSM and to assess postoperative neurologic recovery has been investigated. However, whether conventional DTI should be applied in a clinical setting remains controversial. Neurite orientation dispersion and density imaging (NODDI) is a recently introduced model-based diffusion-weighted MRI technique that quantifies specific microstructural features related directly to neuronal morphology...
July 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28701500/assessing-structure-and-function-of-myelin-in-cervical-spondylotic-myelopathy-evidence-of-demyelination
#12
Hanwen Liu, Erin L MacMillian, Catherine R Jutzeler, Emil Ljungberg, Alex L MacKay, Shannon H Kolind, Burkhard Mädler, David K B Li, Marcel F Dvorak, Armin Curt, Cornelia Laule, John L K Kramer
PURPOSE: To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques. METHODS: Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC)...
August 8, 2017: Neurology
https://www.readbyqxmd.com/read/28690960/complete-atlantooccipital-assimilation-with-basilar-invagination-and-atlantoaxial-subluxation-treated-non-surgically-a-case-report
#13
Ali J Electricwala, Amita Harsule, Vishwajeet Chavan, Jaffer T Electricwala
Atlantooccipital assimilation is a partial or complete congenital fusion between the atlas and the base of the occiput. Most patients with atlas assimilation are asymptomatic, but some may present with neurological problems such as myelopathy. We present the case of a 37-year-old woman who presented with neck and occipital pain, episodic neck stiffness, and dizziness. Medical imaging revealed complete atlantooccipital assimilation associated with basilar invagination, atlantoaxial subluxation, and predisposing anterior spinal cord compression...
June 9, 2017: Curēus
https://www.readbyqxmd.com/read/28676461/cervical-burst-fracture-in-a-patient-with-contiguous-two-level-cervical-stand-alone-cages-a-case-report
#14
Rui Feng, Joshua Loewenstern, John Caridi
BACKGROUND: Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multi-level ACDF, however, has remained controversial. CASE DESCRIPTION: This report discusses a burst fracture seen as a complication in multi-level cervical stand-alone cage use...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28660796/increased-stress-and-strain-on-the-spinal-cord-due-to-ossification-of-the-posterior-longitudinal-ligament-in-the-cervical-spine-under-flexion-after-laminectomy
#15
Batbayar Khuyagbaatar, Kyungsoo Kim, Won Man Park, SuKyoung Lee, Yoon Hyuk Kim
Myelopathy in the cervical spine due to cervical ossification of the posterior longitudinal ligament could be induced by static compression and/or dynamic factors. It has been suggested that dynamic factors need to be considered when planning and performing the decompression surgery on patients with the ossification of the posterior longitudinal ligament. A finite element model of the C2-C7 cervical spine in the neutral position was developed and used to generate flexion and extension of the cervical spine...
September 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28660373/cervical-laminectomy-of-limited-width-prevents-postoperative-c5-palsy-a-multivariate-analysis-of-263-muscle-preserving-posterior-decompression-cases
#16
Satoshi Nori, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda, Tateru Shiraishi
PURPOSE: Between 2006 and 2010, we performed wide laminectomy (wide LAM) alone, with decompression performed between the bilateral medial margin of the zygapophyseal joints, or double-door laminoplasty (DL) combined with wide LAM for cervical compressive myelopathy (CCM). From 2010, instead of wide LAM and DL, we began to perform narrow LAM, where the laminectomy width was no more than 2-3 mm wider than the spinal cord width (SW). This study aimed to elucidate the risk factors for C5 palsy by reviewing surgical outcomes...
June 28, 2017: European Spine Journal
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
#17
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
#18
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
#19
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
#20
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
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