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Compressive Cervical Myelopathy

Wei Lin, Yuan Xue, Ying Zhao, Yaqi Zong, Chao Sun, Bo Pei, Pei Wang
PURPOSE: The generation and tissue origination of disc-associated axial pain is still under exploration. This study was performed to evaluate disc-associated axial pain and to explore whether it originates in the disc or its surrounding components. METHODS: A 6-year series of 88 single-level Smith-Robinson disc and posterior longitudinal ligament (PLL) resections performed to treat single-level cervical spondylotic myelopathy was retrospectively examined. All single-level anterior disc decompressions were performed under local infiltration anesthesia; the PLL was not anesthetized to avoid cervical cord block...
October 6, 2016: European Spine Journal
Tae Hyun Kim, Yoon Ha, Jun Jae Shin, Yong Eun Cho, Ji Hae Lee, Woo Ho Cho
Patients with intramedullary signal intensity (SI) changes have a poor prognosis after surgical decompression in cervical compressive myelopathy (CCM); however, some patients show no clear relationship between the SI and postsurgical prognosis. This discrepancy may be because no comprehensive and proper quantitative evaluation exists to assess SI on magnetic resonance imaging (MRI). The purpose of this study was prospectively to evaluate the correlation between the clinical features, neurological outcome of patients with CCM, and the quantitative assessment of SI changes preoperatively and postoperatively, and the correlation with SI severity...
September 2016: Medicine (Baltimore)
Xiaoxiao Zhou, Pan Cai, Yuwei Li, Haijiao Wang, Shengli Xia, Xiuhui Wang
STUDY DESIGN: A single-center, retrospective, longitudinal matched cohort clinical study of prospectively collected outcomes. OBJECTIVE: To compare retrospectively the clinical outcomes and complications of the posterior approach laminoplasty and single-stage anterior approach laminoplasty combined with anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion for treating patients with cervical spondylotic myelopathy coincident multilevel anterior and posterior compression, known as complex cervical spondylotic myelopathy (cCSM) here...
September 27, 2016: Clinical Spine Surgery
Nam Lee, Do Heum Yoon, Keung Nyun Kim, Hyun Chul Shin, Dong Ah Shin, Yoon Ha
OBJECTIVES: The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. METHODS: Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group...
September 2016: Journal of Korean Neurosurgical Society
Roberta Reichert, Lillian Gonçalves Campos, Filippo Vairo, Carolina Fischinger Moura de Souza, Juliano Adams Pérez, Juliana Ávila Duarte, Fernando Araujo Leiria, Maurício Anés, Leonardo Modesti Vedolin
Mucopolysaccharidosis (MPS) is an inherited metabolic disease and a member of the group of lysosomal storage disorders. Its hallmark is a deficiency of lysosomal enzymes involved in the degradation of mucopolysaccharides, also known as glycosaminoglycans (GAGs). The products of GAG degradation accumulate within lysosomes and in the extracellular space, thereby interfering with the degradation of other macromolecules. This process leads to chronic degeneration of cells, which in turn affects multiple organs and systems...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Kiran Talekar, Michael Poplawski, Rahul Hegde, Mougnyan Cox, Adam Flanders
We review the pathophysiology and imaging findings of acute traumatic spinal cord injury (SCI), cervical spondylotic myelopathy, and briefly review the much less common cord herniation as a unique cause of myelopathy. Acute traumatic SCI is devastating to the patient and the costs to society are staggering. There are currently no "cures" for SCI and the only accepted pharmacologic treatment regimen for traumatic SCI is currently being questioned. Evaluation and prognostication of SCI is a demanding area with significant deficiencies, including lack of biomarkers...
October 2016: Seminars in Ultrasound, CT, and MR
Masayuki Nakahara, Kenki Nishida, Shinji Kumamoto, Yasukazu Hijikata, Kei Harada
PURPOSE: To describe the surgical experience of spondylectomy and spinal reconstruction for aggressive vertebral hemangioma (VH) induced at the C4 vertebra. No reports have described surgical strategy in cases covering an entire cervical vertebra presenting with progressive myelopathy. METHODS: A 28-year-old man presented with rapidly progressing skilled motor dysfunction and gait disorder. The Japanese Orthopedic Association (JOA) score was 6. Radiography showed a honeycomb appearance for the entire circumference of the C4 vertebra...
September 9, 2016: European Spine Journal
Satoshi Maki, Masao Koda, Junya Saito, Sho Takahashi, Taigo Inada, Koshiro Kamiya, Mitsutoshi Ota, Yasushi Iijima, Yoshitada Masuda, Koji Matsumoto, Masatoshi Kojima, Kazuhisa Takahashi, Takayuki Obata, Masashi Yamazaki, Takeo Furuya
BACKBROUND: Patients with cervical compression myelopathy (CCM) generally present bilateral neurological symptoms in their extremities. However, a substantial portion of patients with CCM exhibit laterality of neurological symptoms. The aim of this study was to assess the correlation between intrinsic structural damage and laterality of symptoms using spinal cord diffusion tensor imaging (DTI) of the corticospinal tract. METHODS: We enrolled 10 healthy volunteers and 40 patients with CCM in this study...
September 5, 2016: World Neurosurgery
Aria Nouri, Lindsay Tetreault, Kristian Dalzell, Juan J Zamorano, Michael G Fehlings
BACKGROUND: Degenerative cervical myelopathy encompasses a group of conditions resulting in progressive spinal cord injury through static and dynamic compression. Although a constellation of changes can present on magnetic resonance imaging (MRI), the clinical significance of these findings remains a subject of controversy and discussion. OBJECTIVE: To investigate the relationship between clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathy...
September 5, 2016: Neurosurgery
Choi Byung-Wan
AIM: We analyzed the demographics, clinical and radiological characteristics of non-myelopathic cervical OPLL patients, which could serve as a basis for further studies on natural history of OPLL. MATERIAL AND METHODS: This study included 115 patients with cervical OPLL without myelopathy. Clinically, visual analog scale (VAS) scores for the neck and arm, and Japanese Orthopaedic Association (JOA) scores were evaluated. Radiologically, the number of involved segments, type of OPLL, and the maximal compression ratio were analyzed using a CT scan...
December 7, 2015: Turkish Neurosurgery
Toshinari Kawasaki, Hitoshi Fukuda, Yoshitaka Kurosaki, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: The patient with SAH by hemorrhagic AVFs usually presents with meningeal signs including headache and nausea, and focal neurological deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CLINICAL DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head CT showed subarachnoid hemorrhage (SAH) exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH...
August 24, 2016: World Neurosurgery
Yasutaka Murahashi, Tsuneo Takebayashi, Yoshinori Terashima, Hajime Tsuda, Mitsunori Yoshimoto, Toshihiko Yamashita
STUDY DESIGN: Single-center retrospective study. PURPOSE: To clarify the clinical features of cervical myelopathy at the C1-2 level. OVERVIEW OF LITERATURE: Methods for distinguishing the affected level based on myelomere symptoms or dysfunction of the conducting pathway were established. However, no symptoms have been identified as being specific to the C1-2 level segment. METHODS: We evaluated 24 patients with cervical myelopathy due to spinal cord compression at the C1-2 level...
August 2016: Asian Spine Journal
Jae Hwan Cho, Kyung-Soo Suk, Jong-Beom Park, Jung-Ki Ha, Chang Ju Hwang, Choon Sung Lee, Dong-Ho Lee
STUDY DESIGN: Survey based study. PURPOSE: To assess the degree of agreement in level selection of laminoplasty (LP) for the selected cervical myeloradiculopathy cases between experienced spine surgeons. OVERVIEW OF LITERATURE: Although, cervical LP is a widely used surgical technique for multi-level spinal cord compression, until now there is no consensus about how many segments or which segments should be opened to achieve a satisfactory decompression...
August 2016: Asian Spine Journal
Rana S Dhillon, John Parker, Yasir A Syed, Steve Edgley, Adam Young, James W Fawcett, Nick D Jeffery, Robin J M Franklin, Mark R N Kotter
Cervical spondylotic myelopathy (CSM) is the most common spinal cord disorder and a major cause of disability in adults. Improvements following surgical decompression are limited and patients often remain severely disabled. Post mortem studies indicate that CSM is associated with profound axonal loss. However, our understanding of the pathophysiology of CSM remains limited.To investigate the hypothesis that axonal plasticity plays a role in the recovery following surgical decompression, we adopted a novel preclinical model of mild to moderate CSM...
2016: Acta Neuropathologica Communications
Weihe Zhang, Yujuan Jiao, Lei Cui, Lei Liu, Linwei Zhang, Jinsong Jiao
Longitudinally extensive myelopathy (LEM) is a rare spinal syndrome, and was mostly assessed in western populations. In order to investigate the etiological, clinical, and radiological features of LEM in Chinese patients, we retrospectively analyzed eighty-nine (40 men and 49 women, median age 45.9±15.7years) patients with LEM hospitalized in China-Japan Friendship Hospital. LEM comprised autoimmune inflammatory myelitis (n=53), metabolic and compressive disorders (n=13), vascular diseases (n=10), neoplastic diseases (n=7), infectious diseases (n=4), and syringomyelia (n=2)...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yoshiki Terashima, Takashi Yurube, Hiroaki Hirata, Daisuke Sugiyama, Masatoshi Sumi
STUDY DESIGN: A prospective multicenter >10-year cohort study of outpatients with rheumatoid arthritis (RA). OBJECTIVE: To identify predictive risk factors of cervical spine instabilities which may induce compression myelopathy in RA patients. SUMMARY OF BACKGROUND DATA: Many reports described the natural course of cervical spine involvement in RA. However, only a few studies conducted comprehensive evaluation of its prognostic factors...
August 12, 2016: Spine
Ivana Kovalova, Milos Kerkovsky, Zdenek Kadanka, Zdenek Kadanka, Martin Nemec, Barbora Jurova, Ladislav Dusek, Jiri Jarkovsky, Josef Bednarik
STUDY DESIGN: Cross-sectional population-based observational study. OBJECTIVE: To estimate the prevalence of non-myelopathic spondylotic cervical cord compression (NMSCCC) and cervical spondylotic myelopathy (CSM) in a population above the age of forty and to evaluate the magnetic resonance imaging (MRI) characteristics of these conditions. SUMMARY OF BACKGROUND DATA: The prevalence of neither NMSCCC nor CSM is known and there exists no commonly accepted quantitative MRI definition of cervical cord compression...
August 9, 2016: Spine
Yoshiharu Kawaguchi, Masato Nakano, Taketoshi Yasuda, Shoji Seki, Takeshi Hori, Kayo Suzuki, Hiroto Makino, Masahiko Kanamori, Tomoatsu Kimura
STUDY DESIGN: Case series. OBJECTIVE: To clarify the following questions 1) How long after cervical laminoplasty did the patients die? 2) What were the causes of the death? 3) Was the severity of the neurological dysfunction related to early death? SUMMARY OF BACKGROUND DATA: Life expectancy in patients with cervical myelopathy is unclear. Cervical laminoplasty was performed in 216 patients between 1981 and 1994. It was possible to follow 148 patients for more than 20 years...
August 5, 2016: Spine
Tadao Morino, Tadanori Ogata, Hideki Horiuchi, Shintaro Yamaoka, Mitsumasa Fukuda, Hiromasa Miura
BACKGROUND: We report 8 years of follow-up after decompression to treat cervical myelopathy in a patient with Coffin-Lowry syndrome (CLS). CLS is a rare X-linked semidominant syndrome associated with growth and psychomotor retardation, general hypotonia, and skeletal abnormalities. In this patient, the spinal cord was compressed by calcium pyrophosphate crystal deposition in the cervical yellow ligament (YL). To date, only 1 report has described clinical features after surgery for calcified cervical YL in CLS...
August 2016: Medicine (Baltimore)
S Le Pape, R Gauthé, C Latrobe, J Leroux, X Roussignol, M Ould-Slimane
An episode of acute decompensation of cervical myelopathy occurred after an injury without fracture of an os odontoideum associated with a compressive retro-odontoid cyst. The 51-year-old female patient presented Fränkel C, Nurick grade 4 neurological status and pyramid syndrome. The initial MRI demonstrated an intramedullary T2 hyperintense signal in the context of spinal cord narrowing. The retro-odontoid cyst demonstrates atlantoaxial instability related to the os odontoideum. Harms C1-C2 arthrodesis without laminectomy was performed and the cyst disappeared completely...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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