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Compressive Cervical Myelopathy

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https://www.readbyqxmd.com/read/28304238/remote-motor-system-metabolic-profile-and-surgery-outcome-in-cervical-spondylotic-myelopathy
#1
Sorin C Craciunas, Mircea R Gorgan, Bogdan Ianosi, Phil Lee, Joseph Burris, Carmen M Cirstea
OBJECTIVE In patients with cervical spondylotic myelopathy (CSM), the motor system may undergo progressive functional/structural changes rostral to the lesion, and these changes may be associated with clinical disability. The extent to which these changes have a prognostic value in the clinical recovery after surgical treatment is not yet known. In this study, magnetic resonance spectroscopy (MRS) was used to test 2 primary hypotheses. 1) Based on evidence of corticospinal and spinocerebellar, rubro-, or reticulospinal tract degeneration/dysfunction during chronic spinal cord compression, the authors hypothesized that the metabolic profile of the primary motor cortices (M1s) and cerebellum, respectively, would be altered in patients with CSM, and these alterations would be associated with the extent of the neurological disabilities...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28297693/-a-case-of-central-type-disc-herniation-at-the-c7-t1-level-presenting-with-myelopathy
#2
Masatoshi Yunoki, Takahiro Kanda, Kenta Suzuki, Atsuhito Uneda, Koji Hirashita, Kimihiro Yoshino
In contrast to other levels of upper disc spaces, the Luschka joints are usually absent at the C7/T1 disc space. Therefore, it has been reported that the C7/T1 disc herniation is prone to herniate laterally rather than centrally. In this manuscript, we describe an extremely rare central-type disc herniation at the C7/T1 level presented with myelopathy. A 76-year-old man presented with a 20-day history of progressive gait disturbance. Physical examination revealed bilateral lower extremity hyperreflexia and mild foot numbness with no upper extremity motor weakness or sensory disturbance...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28289891/selective-laminectomy-for-cervical-spondylotic-myelopathy-a-comparative-analysis-with-laminoplasty-technique
#3
Han Chang, Choll Kim, Byung-Wan Choi
INTRODUCTION: The purpose of this study was to evaluate the effectiveness of selective laminectomy compared with laminoplasty for patients with multilevel cervical spondylotic myelopathy (CSM) by evaluating the radiological and clinical outcomes. METHODS: We retrospectively reviewed 67 patients with who underwent posterior laminectomy (LN) or laminoplasty (LP). LN was performed in 32 cases and LP in 35 cases. Radiologically, we evaluated the neutral C2-7 Cobb angle and range of motion (ROM) preoperatively and at final follow-up...
March 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28285113/ayurvedic-management-in-cervical-spondylotic-myelopathy
#4
Sarvesh Kumar Singh, Kshipra Rajoria
The age related spondylotic changes may result in direct compressive and ischemic dysfunction of the spinal cord known as cervical spondylotic myelopathy (CSM). Symptoms often develop insidiously and are characterized by neck stiffness, unilateral or bilateral deep aching neck, arm and shoulder pain, and possibly stiffness or clumsiness while walking. The management available in current mainstream medicine is not satisfactory. Various Ayurvedic treatments have been in use for these manifestations. We present a case of CSM, which was treated with a combination of Panchakarma procedures and Ayurvedic oral drugs...
March 8, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28260398/improved-diagnosis-of-cervical-spondylotic-myelopathy-with-contact-heat-evoked-potentials
#5
Catherine Jutzeler, Anett Ulrich, Barbara Huber, Jan Rosner, John Kramer, Armin Curt
The aim of this study was to reveal the sensitivity and responsiveness of contact heat evoked potentials (CHEPs) to assess cervical spondylotic myelopathy (CSM). A total of 81 patients with clinically and radiologically confirmed spinal cord compression were reviewed. All patients underwent full clinical examinations with combined recordings of segmental CHEPs and somatosensory evoked potentials (dSSEPs) compared to healthy controls. Cross-sectional area, maximal canal compression, and maximal spinal cord compression were determined based on T2-weighted magnetic resonance images (MRI)...
March 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28254542/role-of-atlantoaxial-and-subaxial-spinal-instability-in-pathogenesis-of-spinal-degeneration-related-cervical-kyphosis
#6
Atul Goel, Amol Kaswa, Abhidha Shah
AIM: The role of subaxial and atlantoaxial instability in the pathogenesis of 'degeneration' related cervical kyphosis is evaluated. MATERIAL AND METHODS: During the period 2013 to 2016, the authors treated 21 patients having cervical kyphosis that was related to degenerative spinal disease. The patients presented with symptoms related to cervical myelopathy. Kyphosis was diagnosed on the basis of described radiological parameters. The patients were divided into three groups...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28247081/extraordinary-positional-cervical-spinal-cord-compression-in-extension-position-as-a-rare-cause-of-postoperative-progressive-myelopathy-after-cervical-posterior-laminoplasty-detected-using-the-extension-flexion-positional-ct-myelography-one-case-after-laminectomy
#7
Yasushi Fujiwara, Hideki Manabe, Takahiro Harada, Bunichiro Izumi, Nobuo Adachi
PURPOSE: Posterior cervical laminectomies and laminoplasties are common treatments for cervical spondylotic myelopathy. However, recent studies demonstrated that positional spinal cord compression occurred after cervical laminectomies and caused postoperative progressive myelopathy. Although there were no such reports after laminoplasties, we report two cases in which symptomatic extraordinary positional spinal cord compression occurred after laminoplasties in this paper. METHODS: This study included two patients who showed progressive myelopathy: one case after a laminectomy following failure of a single-door laminoplasty and one case after a double-door laminoplasty without interlaminar spacers...
February 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28243365/does-segmental-kyphosis-affect-surgical-outcome-after-a-posterior-decompressive-laminectomy-in-multisegmental-cervical-spondylotic-myelopathy
#8
Akshay Jain, Tarush Rustagi, Gautam Prasad, Tushar Deore, Shekhar Y Bhojraj
STUDY DESIGN: Retrospective analysis. PURPOSE: To compare results of laminectomy in multisegmental compressive cervical myelopathy (CSM) with lordosis versus segmental kyphosis. OVERVIEW OF LITERATURE: Laminectomy is an established procedure for decompression in CSM with cervical lordosis. However in patients with segmental kyphosis, it is associated with risk of progression of kyphosis and poor outcome. Whether this loss of sagittal alignment affects functional outcome is not clear...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28225364/preoperative-risk-factors-of-c5-nerve-root-palsy-after-laminectomy-and-fusion-in-patients-with-cervical-myelopathy-analysis-of-70-consecutive-patients
#9
Kyung-Soo Suk, Kyung-Chung Kang, Hak-Sun Kim, Seong-Hwan Moon, Hwan-Mo Lee, Jung-Ho Seo, Sung-Min Kim, Sung-Yub Jin, Pierre Mella
STUDY DESIGN: A retrospective study. OBJECTIVE: To identify preoperative risk factors causing cervical fifth nerve root palsy (C5 palsy) after laminectomy and fusion (LF). SUMMARY OF BACKGROUND DATA: It is well known that postoperative C5 palsy is not rare after cervical surgery. Although there remains controversy, C5 palsy is considered to be more common in patients who had LF than in those who had laminoplasty. However, the reason for the higher incidence of C5 palsy in patients with LF has been poorly understood...
February 20, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28207658/association-between-paraspinal-muscle-morphology-clinical-symptoms-and-functional-status-in-patients-with-degenerative-cervical-myelopathy
#10
Maryse Fortin, Octavian Dobrescu, Matthew Courtemanche, Carolyn J Sparrey, Carlo Santaguida, Michael G Fehlings, Michael H Weber
STUDY DESIGN: A cross-sectional study. OBJECTIVE: The aim of this study was to assess fatty infiltration and asymmetry of the multifidus (MF), semispinalis cervicis (SCer), semispinalis capitis (SCap), and splenius capitis (SPL) muscles in patients with degenerative cervical myelopathy (DCM), and evaluate their correlations with clinical symptoms and functional scores. SUMMARY OF BACKGROUND DATA: Cervical muscle alterations have been reported in patients with chronic neck pain, but the assessment of cervical muscle morphology has been overlooked in patients with DCM...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28185847/an-unusual-case-of-rapidly-progressed-cervical-compression-myelopathy-caused-by-overnight-inappropriate-usage-of-smartphone-device
#11
Chen-Ya Yang, Jia-Chi Wang
A 38-year-old man was healthy before presenting to our clinic with pain and marked weakness in the right upper extremity. He stated that the symptoms developed the day after he accidentally fell asleep while playing with his Smartphone half-lying on his back with two thick pillows supporting his upper back. Physical examination revealed significant increase in deep tendon reflexes in the lower extremities and clonus. Hoffman's sign was positive in the left upper extremity. Magnetic resonance image showed high signal change on T2-weighted images of the left spinal cord at the C4-5 level, which was indicative of compression myelopathy...
February 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28151906/mini-plate-fixation-versus-suture-suspensory-fixation-in-cervical-laminoplasty-a-meta-analysis
#12
COMPARATIVE STUDY
Feng-Yu Liu, Lei Ma, Li-Shuang Huo, Yan-Xiang Cao, Da-Long Yang, Hui Wang, Si-Dong Yang, Wen-Yuan Ding
BACKGROUND: Both the mini-plate fixation and suture suspensory fixation techniques are extensively applied in cervical laminoplasty, but which technique is superior has not been ascertained. The purpose of this meta-analysis is to compare the results between mini-plate fixation and suture suspensory fixation in cervical laminoplasty for the patients with multilevel cervical compressive myelopathy. METHODS: PubMed, Embase, the Cochrane library, CNKI, and WANFANG were searched for studies that compared mini-plate fixation and suture suspensory fixation in cervical laminoplasty up to November 1, 2016...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151550/canine-acute-cervical-myelopathy-hydrated-nucleus-pulposus-extrusion-or-intraspinal-discal-cysts
#13
Cristian Falzone
OBJECTIVE: To differentiate between hydrated nucleus pulposus extrusion and ventral intraspinal discal cysts in dogs. STUDY DESIGN: Prospective case series. ANIMALS: Twenty dogs with acute onset of cervical myelopathy due to hydrated nucleus pulposus extrusion or ventral intraspinal discal cysts. METHODS: Clinical and magnetic resonance (MR) imaging findings, outcome after surgical treatment, cytologic and histologic findings of compressive material were taken into account...
February 2, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28130805/topologically-preserving-straightening-of-spinal-cord-mri
#14
Benjamin De Leener, Gabriel Mangeat, Sara Dupont, Allan R Martin, Virginie Callot, Nikola Stikov, Michael G Fehlings, Julien Cohen-Adad
PURPOSE: To propose a robust and accurate method for straightening magnetic resonance (MR) images of the spinal cord, based on spinal cord segmentation, that preserves spinal cord topology and that works for any MRI contrast, in a context of spinal cord template-based analysis. MATERIALS AND METHODS: The spinal cord curvature was computed using an iterative Non-Uniform Rational B-Spline (NURBS) approximation. Forward and inverse deformation fields for straightening were computed by solving analytically the straightening equations for each image voxel...
January 27, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28130167/congenital-cervical-fusion-as-a-risk-factor-for-development-of-degenerative-cervical-myelopathy
#15
Aria Nouri, Allan R Martin, Stefan F Lange, Mark Kotter, David J Mikulis, Michael G Fehlings
BACKGROUND: Congenital fusion of cervical vertebrae, including Klippel-Feil Syndrome (KFS), is a suspected risk factor for development of degenerative cervical myelopathy (DCM). We aimed to establish prevalence and degenerative patterns of congenital cervical fusion (CCF) among a global cohort of patients with DCM. METHODS: Data from three prospective DCM studies were merged, including clinical data for 813 patients and imaging for 592 patients. CCF was diagnosed by presence of fused cervical vertebrae without signs of degenerative fusion...
January 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28130164/does-dynamic-supine-magnetic-resonance-imaging-improve-the-diagnostic-accuracy-of-cervical-spondylotic-myelopathy-a-review-of-the-current-evidence
#16
REVIEW
Nanfang Xu, Shaobo Wang, Huishu Yuan, Xiaoguang Liu, Zhongjun Liu
PURPOSE: We aimed to critically analyze the current evidence regarding the role of dynamic supine MRI (dsMRI) in the evaluation of cervical spondylotic myelopathy (CSM). METHODS: 13 studies were identified through a comprehensive literature search performed in the PubMed, EMBASE, and ISI databases as fulfilling the inclusion criteria and were reviewed for subject characteristics, radiographical parameters, and salient findings. RESULTS: Studies herein reviewed suggested that dsMRI was able to detect new appearance or increased grade of medullary compression in at least 20% of patients and to demonstrate an average narrowing of the cervical canal by 20% (in comparison to the neutral position)...
January 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28127374/the-change-of-range-of-motion-at-anterior-compression-of-the-cervical-cord-after-laminoplasty-in-patients-with-cervical-spondylotic-myelopathy
#17
Yongjae Cho
OBJECTIVE: Degenerative diseases of the spine, such as cervical spondylotic myelopathy (CSM), are increasing among the old age population, and surgical treatment of CSM is becoming more and more common. The aim of this study was to investigate how functional recovery can be influenced by anterior compression of the spinal cord (ACS) after laminoplasty for treatment of patients with CSM. METHODS: We retrospectively analyzed 32 patients admitted to Ewha Womans Mok-Dong Hospital with CSM who underwent open-door laminoplasty from January 2012 to December 2014...
December 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/28125929/trans-synaptic-degeneration-of-motoneurons-distal-to-chronic-cervical-spinal-cord-compression-in-cervical-spondylotic-myelopathy
#18
Chaojun Zheng, Yu Zhu, Feizhou Lu, Xiaosheng Ma, Dong Tian, Jianyuan Jiang
OBJECTIVE: To assess the effect of chronic cervical spinal cord compression upon remote motor unit function in patients with cervical spondylotic myelopathy (CSM). METHODS: Fifty-three CSM patients and 47 healthy subjects were included. Bilateral motor unit number estimations (MUNEs) were recorded from both abductor digiti minimi and abductor pollicis brevis, and bilateral flexor carpi radialis (FCR) H-reflexes were examined in all subjects along with the nine-hole peg test (NHPT)...
January 26, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28104259/utility-of-extension-views-in-spondylotic-myelopathy-mimicking-transverse-myelitis
#19
Brittani L Conway, Michelle J Clarke, Timothy J Kaufmann, Eoin P Flanagan
Cervical spondylotic myelopathy is a common cause of myelopathy and may mimic transverse myelitis. We report a 55 year-old lady with subacute myelopathy initially treated with glatiramer acetate for suspected clinically isolated syndrome. MRI head and spine revealed a single short cervical cord T2-hyperintense lesion with enhancement just below a region of moderate stenosis. Cerebrospinal fluid revealed elevated oligoclonal bands. Repeat MRI 7 months later showed persistent enhancement. Dynamic MRI revealed cord compression during extension...
January 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28099187/a-comparative-study-of-anterior-decompression-with-fusion-and-posterior-decompression-with-laminoplasty-for-the-treatment-of-cervical-spondylotic-myelopathy-patients-with-large-anterior-compression-of-the-spinal-cord
#20
Takashi Hirai, Toshitaka Yoshii, Yoshiyasu Arai, Kenichiro Sakai, Ichiro Torigoe, Hidetsugu Maehara, Masaki Tomori, Takashi Taniyama, Hirokazu Sato, Atsushi Okawa
STUDY DESIGN: This is a retrospective observational single-center study. OBJECTIVES: To compare anterior decompression and fusion (ADF) and laminoplasty (LAMP) for the treatment of cervical spondylotic myelopathy (CSM) patients with large anterior compression in terms of clinical and radiologic outcomes. SUMMARY OF BACKGROUND DATA: We have reported that insufficient posterior decompression could be often seen after laminoplasty for CSM patients with preoperative anterior clearance of the spinal cord, defined as an interval <4 mm between the preoperative the modified K-line and anterior structure of the spinal canal at most compressive segment on sagittal T1-weighted magnetic resonance imaging...
January 17, 2017: Clinical Spine Surgery
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