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Compressive Cervical Myelopathy

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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
#1
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
#2
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-assess-postoperative-neurological-recovery
#3
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 MRI. The utility of diffusion tensor imaging (DTI) to quantify the severity of CSM and assess postoperative neurological 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
#4
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)...
July 12, 2017: Neurology
https://www.readbyqxmd.com/read/28690960/complete-atlantooccipital-assimilation-with-basilar-invagination-and-atlantoaxial-subluxation-treated-non-surgically-a-case-report
#5
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
#6
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
#7
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...
June 1, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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 1 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, which improved after surgical removal of the implant...
August 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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