WorldWideScience

Sample records for cervical spinal arthrosis

  1. Self-healing photo-neuropathy and cervical spinal arthrosis in four sisters with brachioradial pruritus

    Directory of Open Access Journals (Sweden)

    Wallengren Joanna

    2009-11-01

    Full Text Available Abstract The cause of brachioradial pruritus (a localized itching on the arms or shoulders is controversial. The role of sun and cervical spine disease has been discussed. This is a report on four sisters suffering from brachioradial pruritus recurring every summer. The sisters spent much time outdoors and exposed themselves extensively to the sun. They also had occupations requiring heavy lifting. Cervical radiographs indicated arthrosis. The density of sensory nerve fibers in the skin biopsies from the itchy skin of the arms, visualized by antibodies against a pan-neuronal marker, protein gene product 9.5, was reduced compared with biopsies from the same skin region during the symptom-free period in the winter. This data exemplifies that brachioradial pruritus is a self healing photoneuropathy occurring in middle aged adults predisposed by cervical arthrosis.

  2. THE ROLE OF ELECTROTHERAPY AND PHYSICAL THERAPY IN THE RECOVERY OF CERVICAL ARTHROSIS

    Directory of Open Access Journals (Sweden)

    Ochiana Gabriela

    2014-07-01

    Full Text Available The purpose of this study concerning the role of electrotherapy and of physical therapy in the recovery of cervical arthrosis is to maintain a high quality family, social and professional activity, by eliminating the pain and the muscle contractures. The hypothesis that was the starting point of this paper was that: if we associate electrotherapy techniques and cervical spine alignment techniques to the recovery programme, the pain and the paresthesias will diminish until they fade away for good. The study was conducted on a number of 24 subjects with the diagnosis of cervical arthrosis, over a period of 6 months. The subjects in the experimental group were 12 and they benefited from electrotherapy and physical therapy, while those in the control group had only medication. The methods, procedures and the techniques used in the recovery for the subjects included in the experimental group were: TENS currents, ultrasounds, tractions on an axis, facilitation techniques and the adjustment of the cervical spine. The results materialized in: the disappearance of pain, of paresthesias and of muscle contractions obtain in a relatively short period of time, allows us to notice the benefit of associating electrotherapy and physical therapy to the recovery of cervical arthroses. The conclusions underline the importance of the position adopted during all the activities that require head flexion in order to prevent the rectitude of the cervical spine and implicitly the pain, the paresthesias and the contractures.

  3. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    Directory of Open Access Journals (Sweden)

    ZHANG Ling

    2012-04-01

    Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

  4. Cervical perineural cyst masquerading as a cervical spinal tumor.

    Science.gov (United States)

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor.

  5. Cervical spinal canal narrowing and cervical neurological injuries

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ling; CHEN Hai-bin; WANG Yi; ZHANG Li-ying; LIU Jing-cheng; WANG Zheng-guo

    2012-01-01

    Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms including neck pain,headache,weakness and parasthesisas.According to previous and recent clinical researches,we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio.The mean sagittal diameter of cervical spinal canal at C1 to C7 ranges from 15.33 mm to 20.46 mm,the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96.With respect to narrow cervical spinal canal,the following charaterstics are found:firstly,extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly,females sustain cervical spinal canal narrowing more easily than males;finally,the consistent narrowest cervical canal level is at C4 for all ethnicity,but there is a slight variation in the sagittal diameter of cervical spinal stenosis(≤ 14 mm in Whites,≤12 mm in Japanese,≤ 13.7 mm in Chinese).Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic,degenerative and inflammatory conditions and is related with extension of cervical spine,gender,as well as ethnicity.It is hoped that this review will be helpful in diagnosing spinal cord and neurological injuries with the geometric parameters of cervical spine in the future.

  6. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

    2004-12-15

    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

  7. Surgical Strategies for Cervical Spinal Neurinomas.

    Science.gov (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Miyaoka, Yoshinari; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro

    2015-01-01

    Cervical spinal neurinomas are benign tumors that arise from nerve roots. Based on their location, these tumors can also take the form of a dumbbell-shaped mass. Treatment strategies for these tumors have raised several controversial issues such as appropriate surgical indications and selection of surgical approaches for cervical dumbbell-shaped spinal neurinomas. In this report, we review previous literature and retrospectively analyze cervical spinal neurinoma cases that have been treated at our hospital. Surgical indications and approaches based on tumor location and severity are discussed in detail. Thus, with advances in neuroimaging and neurophysiological monitoring, we conclude that appropriate surgical approaches and intraoperative surgical manipulations should be chosen on a case-by-case basis.

  8. [Physiokinetic therapy in the prevention of cervical disk arthrosis in helicopter personnel].

    Science.gov (United States)

    Lanciani, P; La Verde, R; Losani, F; Guicciardi, M

    1983-08-25

    Helicopter pilots subjected to "chronic microtraumatism" related to the constant vibration present in this type of aircraft are considered. The most suitable physiokinetic treatment in the prevention of cervical spondylodiscarthrosis is discussed. Spondylodiscarthrosis is the most common and debilitating problem affecting helicopter personnel.

  9. Cervical spinal canal narrowing in idiopathic syringomyelia

    Energy Technology Data Exchange (ETDEWEB)

    Struck, Aaron F. [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States); Carr, Carrie M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shah, Vinil [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Hesselink, John R. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Haughton, Victor M. [University of Wisconsin, Department of Radiology, Madison, WI (United States)

    2016-08-15

    The cervical spine in Chiari I patient with syringomyelia has significantly different anteroposterior diameters than it does in Chiari I patients without syringomyelia. We tested the hypothesis that patients with idiopathic syringomyelia (IS) also have abnormal cervical spinal canal diameters. The finding in both groups may relate to the pathogenesis of syringomyelia. Local institutional review boards approved this retrospective study. Patients with IS were compared to age-matched controls with normal sagittal spine MR. All subjects had T1-weighted spin-echo (500/20) and T2-weighted fast spin-echo (2000/90) sagittal cervical spine images at 1.5 T. Readers blinded to demographic data and study hypothesis measured anteroposterior diameters at each cervical level. The spinal canal diameters were compared with a Mann-Whitney U test. The overall difference was assessed with a Friedman test. Seventeen subjects were read by two reviewers to assess inter-rater reliability. Fifty IS patients with 50 age-matched controls were studied. IS subjects had one or more syrinxes varying from 1 to 19 spinal segments. Spinal canal diameters narrowed from C1 to C3 and then enlarged from C5 to C7 in both groups. Diameters from C2 to C4 were narrower in the IS group (p < 0.005) than in controls. The ratio of the C3 to the C7 diameters was also smaller (p = 0.004) in IS than controls. Collectively, the spinal canal diameters in the IS were significantly different from controls (Friedman test p < 0.0001). Patients with IS have abnormally narrow upper and mid cervical spinal canal diameters and greater positive tapering between C3 and C7. (orig.)

  10. Severe Facet Joint Arthrosis Caused C7/T1 Myelopathy: A Case Report

    Directory of Open Access Journals (Sweden)

    Toshimi Aizawa

    2009-01-01

    Full Text Available Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a “clay-shoveler's” fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.

  11. Transient oedema of the cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Sartoretti-Schefer, S.; Kollias, S.; Valavanis, A. [Institute of Neuroradiology, University Hospital of Zuerich (Switzerland)

    2000-04-01

    Transient but very intense oedema of the cervical spinal cord was observed in two patients with obstruction of the cerebrospinal fluid (CSF) pathways. Both presented with hydrocephalus, one due to an infratentorial obstructing mass and the other due to postmeningitic adhesive obstruction of the outlet foramina of the fourth ventricle. In animal experiments with obstruction of CSF pathways (due to outlet foramina obstruction or to downward tentorial herniation) flattening and stretching of the ependymal cells along the central canal is observed, followed by disruption and splitting of the ependymal lining and then by extracellular oedema of the subependymal tissue. Without treatment, frank cavity formation develops in a fourth stage. In our two patients, however, most probably because of appropriate decompressive therapy, the oedema disappeared completely without a residual spinal cord lesion. (orig.)

  12. Acute cervical spinal subdural hematoma not related to head injury.

    Science.gov (United States)

    Kim, Hee Yul; Ju, Chang Il; Kim, Seok Won

    2010-06-01

    We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/mm(3). She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.

  13. The Prediction of Mobility Gains in Cervical Spinal Cord Injuries

    Science.gov (United States)

    1976-01-01

    U.S. DEPARTMENT OF COMMERCE National Technical Information Service AD-A027 771 THE PREDICTION OF MOBILITY GAINS IN CERVICAL SPINAL CORD INJURIES ...The treatment of spinal cord injuries is a controversial subject among physicians 8,10 The choice of a particular procedure depends ~on the...location and severity of the injury as well as ffhe physical condition of the patient. The effectiveness of the treatment is usually rrasured in terms of

  14. Measurement of normal cervical spinal cord in metrizamide CT myelography

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Fumio; Koyama, Tsunemaro; Aii, Heihachirou

    1985-04-01

    The shape of the spinal cord is the most important factor in diagnosis of spinal disorders by metrizamide CT myelography (met. CT). Even in cases where the spinal cord looks normal in shape its size might be abnormal, for example in cases with spinal cord atrophy, syringomyelia, intramedullary tumor and several other conditions. In detecting the slightest abnormality in such cases, it is absolutely necessary to have in hand the knowledge of the nomal size of the spinal cord at each level. We measured, therefore, the sagittal and transverse diameters of the cervical spinal cord in 55 patients with no known lesions on met. CT. Comparing our results with those by others, we found some differences as to the size of the spinal cord. We assume that these differences are due to the differences in resolution of the CT scanners used. The size of the spinal cord tends to measure larger with a CT scanner with high resolution than with others. Previous authors reported that the size of the spinal cord would vary by window center settings. Our experimental results indicate, however, that window center settings do not significantly affect the measurements. It is concluded that the normal values of the spinal cord dimensions at each level somewhat differ by CT equipments used. One should have normal values with one's own equipment in hand in order to take full advantage of this sophisticated diagnostic technique. (author).

  15. Comparative evaluation of surgical alternatives in the treatment of acute cervical myelopathy and in the decompression of cervical spinal canal

    OpenAIRE

    Gábor Czigléczki; Zoltán Papp; Csaba Padányi; Péter Banczerowski

    2014-01-01

    Symptoms of cervical myelopathy are caused by the compression of the cervical spinal cord in the narrowed spinal canal. Several techniques including less invasive and minimally invasive methods have been developed with the aim of decompressing the cervical spinal canal, preserving posterior motion segments and paraspinal muscles as much as possible, reducing iatrogenic consequences and promoting faster recoveries of patients. The purpose of this article is to summarize these procedures and ev...

  16. Cervical spinal cord injury without radiological abnormality in adults.

    Directory of Open Access Journals (Sweden)

    Bhatoe H

    2000-07-01

    Full Text Available Spinal cord injury occurring without concomitant radiologically demonstrable trauma to the skeletal elements of the spinal canal rim, or compromise of the spinal canal rim without fracture, is a rare event. Though documented in children, the injury is not very well reported in adults. We present seventeen adult patients with spinal cord injury without accompanying fracture of the spinal canal rim, or vertebral dislocation, seen over seven years. None had preexisting spinal canal stenosis or cervical spondylosis. Following trauma, these patients had weakness of all four limbs. They were evaluated by MRI (CT scan in one patient, which showed hypo / isointense lesion in the cord on T1 weighted images, and hyperintensity on T2 weighted images, suggesting cord contusion or oedema. MRI was normal in two patients. With conservative management, fifteen patients showed neurological improvement, one remained quadriplegic and one died. With increasing use of MRI in the evaluation of traumatic myelopathy, such injuries will be diagnosed more often. The mechanism of injury is probably acute stretching of the cord as in flexion and torsional strain. Management is essentially conservative and prognosis is better than that seen in patients with fracture or dislocation of cervical spine.

  17. Upper cervical spinal cord compression due to bony stenosis of the spinal canal.

    Science.gov (United States)

    Benitah, S; Raftopoulos, C; Balériaux, D; Levivier, M; Dedeire, S

    1994-04-01

    Compression of the upper cervical spinal cord due to stenosis of the bony spinal canal is infrequent. In the first case reported here, stenosis was due to acquired extensive, unilateral osteophytes centered on the left apophyseal joints of C1-C2 in an elderly professional violinist. In the second case, stenosis was secondary to isolated congenital hypertrophy of the laminae of C1 and C2.

  18. Mechanisms of Spinal Micro-adjustment Manipulations in Treating Cervical Spondylotic Radiculopathy

    Institute of Scientific and Technical Information of China (English)

    ZHU Guo-miao; SUN Wu-quan; SHEN Guo-quan; FANG Min; XIAO Yuan-chun

    2007-01-01

    On the basis of the investigation of the pathogenesis of cervical spondylotic radiculopathy, this paper studies the mechanisms of spinal micro-adjustment manipulations in recovering and improving cervical dynamic and stationary balance from the perspective of biomechanics.

  19. Differential diagnosis of cervical spinal cord demyelinating diseases and cervical intramedullary gliomas

    Directory of Open Access Journals (Sweden)

    Gui-nü HE

    2014-09-01

    Full Text Available Objective To analyze the imaging characteristics of cervical spinal cord demyelinating diseases and cervical intramedullary gliomas, so as to improve the differential diagnosis between them.  Methods A retrospective analysis was conducted using clinical and MRI data from 22 cases of cervical spinal cord demyelinating diseases and 16 cases of cervical intramedullary gliomas.  Results Clinical features in both groups included paresthesia [77.27% (17/22, 12/16], weakness of limbs [72.73% (16/22, 10/16], and dysfunction of autonomic nerve [45.45% (10/22, 4/16]. In cervical MRI, the lesions involving more than 3 vertebras were 63.64% (14/22 in demyelinating group and 15/16 in glioma group, and the average lengths of lesions were (3.41 ± 1.74 and (3.59 ± 1.28 vertebras in 2 groups. The lesions showed long T1 signal [68.18% (15/22, 7/16], equisignal T1 [31.82% (7/22, 6/16] and long T2 signal [100% (22/22, 8/15] in 2 groups. Mixed T1 and T2 signals (3/16, 6/15 could be seen in glioma group. Demyelinating lesions had unclear boundary [90.91% (20/22] with patchy and ribbon-like enhancement (13/16. Limited enlargement of spinal cord (15/16 and thickening spinal meninges (14/16 were more common in glioma group, usually with block and circular enhancement (12/16. Spinal cord involvement around central canal could be seen (14/15, and the cysts or central canal enlargement, hemorrhage and "cap sign" were showed frequently (7/16, 5/16 and 4/16.  Conclusions Although none of one single clinical or MRI feature was sufficient enough to identify cervical spinal demyelinating diseases from cervical glioma, the comprehensive analysis of multiple features could help to make differential diagnosis of these diseases. doi: 10.3969/j.issn.1672-6731.2014.09.008

  20. Rehabilitation outcome of upper extremity skilled performance in persons with cervical spinal cord injuries

    NARCIS (Netherlands)

    Spooren, Annemie I.F.; Janssen-Potten, Yvonne J.M.; Snoek, Govert J.; IJzerman, Maarten J.; Kerckhofs, Eric; Seelen, Henk A.M.

    2010-01-01

    Objective: To investigate changes in arm hand skilled performance during and after active rehabilitation in (sub)groups of subjects with cervical spinal cord injuries. Design: Longitudinal multi-centre cohort study. Patients: Persons with cervical spinal cord injuries during (n?=?57) and after (n?=

  1. Rugby union injuries to the cervical spine and spinal cord.

    Science.gov (United States)

    Quarrie, Kenneth L; Cantu, Robert C; Chalmers, David J

    2002-01-01

    Injuries to the cervical spine are among the most serious injuries occurring as a result of participation in rugby. Outcomes of such injuries range from complete recovery to death, depending on the degree of spinal cord damage sustained. Much information has been gained regarding the mechanisms and frequency of such injuries, from case reports and case series studies. The most commonly reported mechanism of injury has been hyperflexion of the cervical spine, resulting in fracture dislocation of C4-C5 or C5-C6. Tracking both the trends of incidence of spinal injuries, and the effectiveness of injury prevention initiatives has proved difficult because of a lack of properly conducted epidemiological studies. Within the constraints of the research published to date, it appears that hookers and props have been at disproportionate risk of cervical spine injury, predominantly because of injuries sustained during scrummaging. While the scrum was the phase of play most commonly associated with spinal injuries throughout the 1980s in most rugby playing countries, there has been a trend through the 1990s of an increasing proportion of spinal injuries occurring in the tackle situation. The majority of injuries have occurred early in the season, when grounds tend to be harder, and players are lacking both practice and physical conditioning for the physical contact phases of the sport. A number of injury prevention measures have been launched, including changes to the laws of the game regarding scrummaging, and education programmes aimed at enforcing safe techniques and eliminating illegal play. Calls for case-registers and effective epidemiological studies have been made by researchers and physicians in most countries where rugby is widespread, but it appears to be only recently that definite steps have been made towards this goal. Well-designed epidemiological studies will be able to provide more accurate information about potential risk factors for injury such as age, grade

  2. Imaging diagnosis of cervical spine and spinal cord injuries in children

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To provide the experience in imaging diagnosis of cervical spine and spinal cord injuries in children.Methods: Imaging data of cervical spine and spinal cord injuries in 62 children were retrospectively reviewed.The routine radiography including the lateral,anteroposterior and open-mouth odontoid views were performed in all the patients. Tomography was available for 25 patients, and flexion-extension lateral views for 28patients, CT scanning for 21 patients, MRI for 26 patients.Results: Of these patients, 46 patients were identified with injuries of upper cervical spine (9 with atlantal arch fracture, seven with axial fracture, 21 with odontoid fracture, 1 with atlantal arch fracture combining with odontoid fracture, and 1 with atlantal transverse ligament disruption); 7 patients sustained injuries of lower cervical spine (3 fractures of vertebral body, 2 dislocations and 6fracture-dislocations ); 2 patients had multiple noncontiguous cervical injuries; and 3 had cervical spinal cord injury without radiographic abnormalities (SCIWORA).Conclusions: Imaging assessment is of great importance in the diagnosis of cervical spine and spinal cord injuries in children. Whenever cervical spine and spinal cord injuries are suspected for children patients, and the three-views should be routinely indicated. MRI should be routinely performed in all children with cervical SCIWORA.

  3. HOMICIDE BY CERVICAL SPINAL CORD GUNSHOT INJURY WITH SHOTGUN FIRE PELLETS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dana Turliuc, Serban Turliuc, Iustin Mihailov, Andrei Cucu, Gabriel Dumitrescu,Claudia Costea

    2015-10-01

    Full Text Available This case present a rare forensic case of cervical spinal gunshot injury of a female by her husband, a professional hunter, during a family fight with a shotgun fire pellets. The gunshot destroyed completely the cervical spinal cord, without injury to the neck vessels and organs and with the patient survival for seven days. We discuss notions of judicial ballistics, assessment of the patient with spinal cord gunshot injury and therapeutic strategies. Even if cervical spine gunshot injuries are most of the times lethal for majority of patients, the surviving patients need the coordination of a multidisciplinary surgical team to ensure the optimal functional prognostic.

  4. Strategies for autonomy used by people with cervical spinal cord injury : A qualitative study

    NARCIS (Netherlands)

    Van De Ven, Leontine; Post, Marcel; De Witte, Luc; Van Den Heuvel, Wim

    2008-01-01

    Purpose. To identify strategies used by people with high cervical spinal cord injury (SCI) to function autonomously. A multidimensional concept of autonomy was used, with four dimensions: independence, self-determination, participation and identification. Methods. Qualitative methods were used, invo

  5. Trigemino-cervical reflex in spinal cord injury.

    Science.gov (United States)

    Gündüz, Ayşegül; Uzun, Nurten; Örnek, Nurettin İrem; Ünalan, Halil; Karamehmetoğlu, Şafak Sahir; Kızıltan, Meral E

    2014-09-19

    Abnormal enhancement of polysynaptic brainstem reflexes has been previously reported in patients with spinal cord injury (SCI). We aimed to investigate trigemino-cervical reflex (TCR) in SCI since it may reflect alterations in the connections of trigeminal proprioceptive system and cervical motoneurons. Consecutive 14 patients with SCI and 16 healthy subjects were included in this study. All patients were in the chronic phase. TCR was recorded over sternocleidomastoid (SCM) and splenius capitis (SC) muscles by stimulation of infraorbital nerve. We measured onset latency, amplitudes and durations of responses and compared between groups. We obtained stable responses over both muscles after one sided stimulation in healthy volunteers whereas probability of TCR was decreased in patients over both SCM (78.6% vs. 100%, p=0.050) and SC (71.4% vs. 100%, p=0.022). The absence of TCR was related to use of oral baclofen (≥50mg/day). However, when present, responses of SCI group had higher amplitudes and were more persistent. We demonstrated that TCR probability was similar to healthy subjects in SCI patients who used no or low dose oral baclofen. But it had higher amplitudes and longer durations. It was not obtained in only two patients who used oral baclofen more than 50mg/day.

  6. Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

    OpenAIRE

    2016-01-01

    Background Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression. Methods Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepr...

  7. 'Crashing' the rugby scrum -- an avoidable cause of cervical spinal injury. Case reports.

    Science.gov (United States)

    Scher, A T

    1982-06-12

    Deliberate crashing of the opposing packs prior to a rugby scrum is an illegal but commonly practised manoeuvre which can lead to abnormal flexion forces being applied to players in the front row, with resultant cervical spine and spinal cord injury. Two cases of cervical spinal cord injury sustained in this manner are presented. The mechanism of injury, the forces involved and preventive measures are discussed.

  8. Comparative evaluation of surgical alternatives in the treatment of acute cervical myelopathy and in the decompression of cervical spinal canal

    Directory of Open Access Journals (Sweden)

    Gábor Czigléczki

    2014-01-01

    Full Text Available Symptoms of cervical myelopathy are caused by the compression of the cervical spinal cord in the narrowed spinal canal. Several techniques including less invasive and minimally invasive methods have been developed with the aim of decompressing the cervical spinal canal, preserving posterior motion segments and paraspinal muscles as much as possible, reducing iatrogenic consequences and promoting faster recoveries of patients. The purpose of this article is to summarize these procedures and evaluate their efficacy with comparing them to each other. The applicable methods are presented shortly but the differences between them are discussed in details. Comprehensive examination did not reveal the proven superiority of any techniques and in most cases the less invasive or minimally invasive treatment choices should be individually determined, considering the location and extension of pathology and the familiarity of surgeon with techniques.

  9. Comparative evaluation of surgical alternatives in the treatment of acute cervical myelopathy and in the decompression of cervical spinal canal

    Institute of Scientific and Technical Information of China (English)

    Gbor Cziglczki; Zoltn Papp; Csaba Padnyi; Pter Banczerowski

    2014-01-01

    Symptoms of cervical myelopathy are caused by the compression of the cervical spinal cord in the narrowed spinal canal.Several techniques including less invasive and minimally invasive methods have been developed with the aim of decompressing the cervical spinal canal, preserving posterior motion segments and paraspinal muscles as much as possible, reducing iatrogenic consequences and promoting faster recoveries of patients.The purpose of this article is to summarize these procedures and evaluate their efficacy with comparing them to each other. The applicable methods are presented shortly but the differences between them are discussed in details.Comprehensive examination did not reveal the proven superiority of any techniques and in most cases the less invasive or minimally invasive treatment choices should be individually determined, considering the location and extension of pathology and the familiarity of surgeon with techniques.

  10. +Gz associated stenosis of the cervical spinal canal in fighter pilots.

    Science.gov (United States)

    Hämäläinen, O; Toivakka-Hämäläinen, S K; Kuronen, P

    1999-04-01

    Previous magnetic resonance imaging (MRI) studies have shown that repeated exposure to +Gz forces can cause premature degenerative changes of the cervical spine (i.e. a work-related disease). This paper reports on two clinical cases of +Gz-associated degenerative cervical spinal stenosis caused by dorsal osteophytes in fighter pilots. Conventional x-rays and MRI were used to demonstrate narrowing of the cervical spinal canal. The first case was complicated by a C6-7 intervertebral disk prolapse and a congenitally narrow spinal canal. The second case involved progressive degenerative spinal stenosis in the C5-6 disk space which required surgery. The findings in this case were confirmed by surgery which showed posterior osteophytes and thickened ligaments compressing the cervical medulla. These two cases suggest that +Gz forces can cause degenerative spinal stenosis of the cervical spine. Flight safety may be jeopardized if symptoms and signs of medullar compression occur during high +Gz stress. It is recommended that student fighter pilots undergo conventional x-rays and MRI studies in order to screen out and reject candidates with a congenitally narrow spinal canal. These examination methods might be useful in fighter pilots' periodic medical check-ups in order to reveal acquired degenerative spinal stenosis.

  11. Phrenic nerve afferents elicited cord dorsum potential in the cat cervical spinal cord

    Directory of Open Access Journals (Sweden)

    Davenport Paul W

    2005-05-01

    Full Text Available Abstract Background The diaphragm has sensory innervation from mechanoreceptors with myelinated axons entering the spinal cord via the phrenic nerve that project to the thalamus and somatosensory cortex. It was hypothesized that phrenic nerve afferent (PnA projection to the central nervous system is via the spinal dorsal column pathway. Results A single N1 peak of the CDP was found in the C4 and C7 spinal segments. Three peaks (N1, N2, and N3 were found in the C5 and C6 segments. No CDP was recorded at C8 dorsal spinal cord surface in cats. Conclusion These results demonstrate PnA activation of neurons in the cervical spinal cord. Three populations of myelinated PnA (Group I, Group II, and Group III enter the cat's cervical spinal segments that supply the phrenic nerve

  12. Follow-up CT myelography of severe cervical spinal cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Keiichi; Onoda, Kimio; Kawashima, Yasuhiro; Muto, Atsushi; Kobayashi, Yoichi

    1987-11-01

    There are many reports describing gross anatomical and microscopical findings of severely injured cervical cords in autopsy of the acute and chronic state, but no morphological findings of a severe cervical spinal cord injury in a chronic state by follow-up CT myelography have been found in the literature so far. The sagittal and transverse diameters of the cervical spinal cord and subarachnoid space of 9 out of 14 severe cervical spinal cord injury patients were measured with CT myelography within 7.5 years after the tranuma and their size compared with a control group which was made up of 29 patients with slight radiculopathy due to cervical spondylosis and whiplash injuries. Injured cord levels were C4 4 cases, C5 4 cases and C6 1 case. Remarkable spinal cord atrophy was recogniged in the sagittal diameter from C1 to C7 and in the transverse diameter below C4 and narrowing of the cervical subarachnoid space in the sagittal diameter from C2 to C5. The significance level was set at 1 - 5 %. From these fingings, we have concluded that atrophy appeared not only in the injured segment but also the whole cervical cord after the trauma. There was less cord atrophy in a good functional prognosis than in a poor prognosis.

  13. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  14. Unusual magnetic resonance characteristics of a cerebellopontine angle epidermoid cyst with upper cervical spinal canal extension.

    Science.gov (United States)

    Teo, Beng-Tiong; Lin, Chao-chun; Chiou, Tsung-Lang; Chen, Shang-Chi; Yen, Pao-Sheng

    2006-08-01

    We present a 27-year-old woman with an epidermoid cyst at the cerebellopontine (CP) angle with caudal extension into the upper cervical spinal canal. The lesion showed unusual hyperintensity on T1-weighted images, and hypointensity on T2-weighted images. We used microneurosurgical techniques for tumour dissection and excision. To our knowledge, this is the fifth example in Index Medicus/MEDLINE of histopathologically proven CP angle epidermoid with cervical spine extension.

  15. Minimally Invasive Drainage of a Post-Laminectomy Subfascial Seroma with Cervical Spinal Cord Compression.

    Science.gov (United States)

    Kitshoff, Adriaan Mynhardt; Van Goethem, Bart; Cornelis, Ine; Combes, Anais; Dvm, Ingeborgh Polis; Gielen, Ingrid; Vandekerckhove, Peter; de Rooster, Hilde

    2016-01-01

    A 14 mo old female neutered Doberman pinscher was evaluated for difficulty in rising, a wide based stance, pelvic limb gait abnormalities, and cervical pain of 2 mo duration. Neurologic examination revealed pelvic limb ataxia and cervical spinal hyperesthesia. Spinal reflexes and cranial nerve examination were normal. The pathology was localized to the C1-C5 or C6-T2 spinal cord segments. Computed tomography (CT) findings indicated bony proliferation of the caudal articular processes of C6 and the cranial articular processes of C7, resulting in bilateral dorsolateral spinal cord compression that was more pronounced on the left side. A limited dorsal laminectomy was performed at C6-C7. Due to progressive neurological deterioration, follow-up CT examination was performed 4 days postoperatively. At the level of the laminectomy defect, a subfacial seroma had developed, entering the spinal canal and causing significant spinal cord compression. Under ultrasonographic guidance a closed-suction wound catheter was placed. Drainage of the seroma successfully relieved its compressive effects on the spinal cord and the patient's neurological status improved. CT was a valuable tool in assessing spinal cord compression as a result of a postoperative subfascial seroma. Minimally invasive application of a wound catheter can be successfully used to manage this condition.

  16. Anatomical study of blood supply to the cervical spinal cord in the guinea pig.

    Science.gov (United States)

    Mazensky, David; Danko, Jan; Petrovova, Eva; Flesarova, Slavka; Supuka, Peter; Supukova, Anna; Luptakova, Lenka; Purzyc, Halina

    2015-06-01

    The aim of this study was to describe the arterial arrangement of the cervical spinal cord in the guinea pig. The study was carried out on 20 adult English self guinea pigs using corrosion and dissection technique. Batson's corrosion casting kit no. 17(©) was used as a casting medium. The origin of the ventral spinal artery from the left vertebral artery was found on average in 35% of the cases and from the right vertebral artery on average in 40% of the cases. The ventral spinal artery with origin from the anastomosis of two medial branches was found on average in 25% of the cases. The presence of ventral radicular branches of rami spinales entering the ventral spinal artery in the cervical region was observed in 42% of the cases on the right side and in 58% of the cases on the left side. The presence of dorsal radicular branches of rami spinales that reached the spinal cord was observed in 63% of the cases on the left side and in 37% of the cases on the right side. The number of radicular branches supplying the spinal cord is greater in guinea pig than in humans.

  17. Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Paavel G. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Centre de Psychiatrie et Neurosciences, Inserm U894, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Sanchez, Katherine; Rannou, Francois; Poiraudeau, Serge [Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Service de Medecine Physique et de Readaptation, APHP, CHU Cochin, Paris (France); INSERM U1153 Epidemiologie Clinique des Maladies Osteo-Articulaires, Paris (France); Ozcan, Fidan [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Feydy, Antoine [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Maier, Marc A. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Diderot, Sorbonne Paris Cite, Paris (France)

    2016-03-15

    The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. (orig.)

  18. The Outcomes of Anterior Spinal Fusion for Cervical Compressive Myelopathy—A Retrospective Review

    Directory of Open Access Journals (Sweden)

    Tsz-King Suen

    2011-12-01

    Conclusion: Anterior cervical decompression with bone fusion is a viable surgical option for patients with one level of anterior cervical cord compression, especially for patients with kyphosis or straight canal spine. For patients with two- to three-level involvement, anterior cervical decompression with bone fusion provides good functional result in proper selection of cases. We also identified some prognostic factors (male sex, symptoms less than 1 year, and age less than 70 years in predicting a favourable outcome of anterior spinal fusion for CCM.

  19. Cervical spinal cord injury:tailoring clinical trial endpoints to relfect meaningful functional improvements

    Institute of Scientific and Technical Information of China (English)

    Lisa M Bond; Lisa McKerracher

    2014-01-01

    Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extrem-ities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in cervical subjects, raising the possibility of false positive outcomes in trials for cervical SCI. Endpoints focused on the recovery of hand and arm control (e.g., upper extremity motor score, motor level change) show the most potential for use as primary outcomes in upcoming trials of cervical SCI. As the field moves forward, the most reliable way to ensure meaningful clinical testing in cervical subjects may be the development of a composite primary endpoint that measures both neurological recovery and functional improvement.

  20. Spinal cord injury of cervical vertibrae and early diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    陈扬; 李振宇; 等

    1999-01-01

    Objective:To sum up clinical data and CT and MRI examination in 22 patients with spinal cord injury of cervical vertebrae.Methods:CT and MRI examination of the 22 patients with spinal cord injury of cervical vertebrae revealed that 16 patients had spinal comprssion caused by fracture dislocation and protrusion of intervertebral disc,5 suffered from intramedullary hemorrhage and 1 had complete spinal cord injury.A combined modality therapy of intramedullary and extramedullary decompression for spinal cord,skull traction and avoiding reinjury to spinal cord were used. Results:According to Frankel Classification,before operation 3 cases were classified as A degree,2 as B degree,5as C degree,8 as D degree and 4 as Edegree;after operation 2 were classified as A degree,1 as B degree,6 as C degree,6 as D degree and 7 as E degree.Conclusions:Early diagnosis and timely treatmetn,clear mechanism and degree of injury and early selection of effective treatment are very important in raising the rate of curing spinal cord injury.

  1. In Vivo Measurement of Cervical Spinal Cord Deformation During Traumatic Spinal Cord Injury in a Rodent Model.

    Science.gov (United States)

    Bhatnagar, Tim; Liu, Jie; Yung, Andrew; Cripton, Peter A; Kozlowski, Piotr; Oxland, Thomas

    2016-04-01

    The spinal cord undergoes physical deformation during traumatic spinal cord injury (TSCI), which results in biological damage. This study demonstrates a novel approach, using magnetic resonance imaging and image registration techniques, to quantify the three-dimensional deformation of the cervical spinal cord in an in vivo rat model. Twenty-four male rats were subjected to one of two clinically relevant mechanisms of TSCI (i.e. contusion and dislocation) inside of a MR scanner using a novel apparatus, enabling imaging of the deformed spinal cords. The displacement fields demonstrated qualitative differences between injury mechanisms. Three-dimensional Lagrangian strain fields were calculated, and the results from the contusion injury mechanism were deemed most reliable. Strain field error was assessed using a Monte Carlo approach, which showed that simulated normal strain error experienced a bias, whereas shear strain error did not. In contusion injury, a large region of dorso-ventral compressive strain was observed under the impactor which extended into the ventral region of the spinal cord. High tensile lateral strains under the impactor and compressive lateral strains in the lateral white matter were also observed in contusion. The ability to directly observe and quantify in vivo spinal cord deformation informs our knowledge of the mechanics of TSCI.

  2. Functional evaluation using several evoked spinal cord potentials in elderly patients with cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Zhenglin Li

    2006-01-01

    BACKGROUND: The recordings of evoked spinal cord potentials following epidural spinal cord stimulation are thought to be generated by volleys traversing the dorsal column pathway, and it may not directly reflect conduction defects in corticospinal tracts of cervical spinal cord. To our knowledge there has been few report using several evoked spinal cord potentials in function evaluation of the cervical spinal cord in elderly patients with cervical spondylotic myelopathy (CSM).OBJECTIVE: To investigate the function states of the cervical spinal cord in elderly patients with CSM and explore its pathophysiologic mechanism.DESIGN: Case observation.SETTING: Department of Qrthopedics for the aged, Shenzhen Pingle Hospital of Orthopedics. Department of Orthopedic Surgery, Yamaguchi University School of Medicine.PARTICIPANTS: A total of 23 elderly patients with CSM who received treatment in the Department of Orthopedic Surgery, Yamaguchi University School of Medicine of Japan from January 2003 to February 2004 were enrolled in this study. Inclusive criteria: ① Multiple intervertebral levels of cervical spinal cord compression confirmed by MRI, e.g. 3 or more than 3 levels of compressin. ② Age >70 years old. ③ Numbness and sensory disturbance in the upper limbs and showed hyperreflexia in the lower limbs. Exclusive criteria: Patients with abnormal motor and sensory nerve conduction velocities in both upper and lower limbs were excluded.METHODS: Evoked spinal cord potentials (ESCPs) following transcranial electric stimulation (TCE-ESCPs),epidural spinal cord stimulation (Spinal-ESCPs) and median nerve stimulation (MN-ESCPs) were recorded in 23 patients from posterior epidural space intraoperatively. The abnormalities of TCE-ESCPs were defined as attenuation of amplitude of the D wave. The most cranial intervertebral level showing abnormal TCE-ESCPs with a marked reduction in size of the negative peak (reduction of over 50%) was considered as the upper level of the

  3. EVALUATION OF THE RESULTS OF CERVICAL SPINE & SPINAL CORD TRAUMA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    G.R. Bahadorkhan

    2009-04-01

    Full Text Available ObjectivesMajor differences exist in the anatomy and biomechanics of the growing spine that causes failure patterns different from those in adults. Spinal injury in the pediatric patient is a main concern because timely diagnosis and appropriate treatment can prevent further neurologic damage and deformity and potentiate recovery. We conducted a retrospective clinical study of 137 cases (93 boys, 44 girls of pediatric cervical spine injuries, managed over fifteen years, to present data from a large series of pediatric patients with cervical spine injuries from a single regional trauma center. The aim was to assess and analyze complications, etiology, pathogenesis, site of injuries and age difference of cervical spine and spinal cord injury in a pediatric age group and compare the findings with current literature.Materials & MethodsOne hundred and thirty seven children with cervical spine injuries, seen over twelve years, were divided into two age groups: 54 patients were in group one (0-9 years and 83 patients were in group two (10 - 17 years . We managed them according to status at presentation and type of injury. Forty seven patients were managed surgically and ninety nonsurgically (52 wore a halo brace and 38 wore different hard collars and braces. T-test and Chi squares were used to analyze differences between groupsResultsThe most common cause of injury was motor vehicle accidents(MVA. Our younger patients (Group 1 had sustained more neurological injuries than the older ones (Group 2, 77% vs.48%.; upper cervical spine was the most common site involved in 76%, while 43% suffered head injuries. In group two, 88% of children two sustained fractures or fracture/ subluxations; also in this group, subluxation, and fracture/ subluxation was present in 10 and 25% of children respectively. The most common radiological findings were vertebral fractures (38%. Solid fusions were demonstrated in all patients at late follow-up review (mean 6 years. None

  4. Risks associated with magnetic resonance imaging and cervical collar in comatose, blunt trauma patients with negative comprehensive cervical spine computed tomography and no apparent spinal deficit

    OpenAIRE

    Dunham, C Michael; Brocker, Brian P; Collier, B David; Gemmel, David J

    2008-01-01

    Introduction In blunt trauma, comatose patients (Glasgow Coma Scale score 3 to 8) with a negative comprehensive cervical spine (CS) computed tomography assessment and no apparent spinal deficit, CS clearance strategies (magnetic resonance imaging [MRI] and prolonged cervical collar use) are controversial. Methods We conducted a literature review to delineate risks for coma, CS instability, prolonged cervical collar use, and CS MRI. Results Based on our search of the literature, the numbers of...

  5. Cervical spondylosis with spinal cord encroachment: should preventive surgery be recommended?

    Directory of Open Access Journals (Sweden)

    Murphy Donald R

    2009-08-01

    Full Text Available Abstract Background It has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma. Preventive decompression surgery has been recommended for these individuals. The purpose of this paper is to provide the non-surgical spine specialist with information upon which to base advice to patients. The evidence behind claims of increased risk is investigated as well as the evidence regarding the risk of decompression surgery. Methods A literature search was conducted on the risk of spinal cord injury in individuals with asymptomatic cord encroachment and the risk and benefit of preventive decompression surgery. Results Three studies on the risk of spinal cord injury in this population met the inclusion criteria. All reported increased risk. However, none were prospective cohort studies or case-control studies, so the designs did not allow firm conclusions to be drawn. A number of studies and reviews of the risks and benefits of decompression surgery in patients with cervical myelopathy were found, but no studies were found that addressed surgery in asymptomatic individuals thought to be at risk. The complications of decompression surgery range from transient hoarseness to spinal cord injury, with rates ranging from 0.3% to 60%. Conclusion There is insufficient evidence that individuals with spondylotic spinal cord encroachment are at increased risk of spinal cord injury from minor trauma. Prospective cohort or case-control studies are needed to assess this risk. There is no evidence that prophylactic decompression surgery is helpful in this patient population. Decompression surgery appears to be helpful in patients with cervical myelopathy, but the significant risks may outweigh the unknown benefit in asymptomatic individuals. Thus, broad recommendations for decompression surgery in suspected at-risk individuals cannot be made

  6. Myelin water fraction in human cervical spinal cord in vivo.

    Science.gov (United States)

    Wu, Yijing; Alexander, Andrew L; Fleming, John O; Duncan, Ian D; Field, Aaron S

    2006-01-01

    The noninvasive discrimination of myelin disease from axonal loss and other pathologic confounds remains an unsolved problem in multiple sclerosis but may be possible through magnetic resonance quantitation of the intramyelinic water compartment. Technical challenges have limited the study of this approach in the spinal cord, a common site of involvement in multiple sclerosis. This technical note reports the test-retest reproducibility of a short T2-based estimate of myelin content in human spinal cord in vivo.

  7. Damage control of multiple injuries headed by cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    LIU Si-hai; WANG Ai-min; DU Quan-yin; ZHAO Yu-feng; WANG Zi-ming; GUO Qing-shan; SHEN Yue

    2008-01-01

    Objective: To explore the strategy of damage control in clinical treatment of multiple injuries headed by cervical spinal cord injury.Methods: A retrospective analysis was performed in 32 patients. Cervical fractures associated with tetraplegia occurred in 18 patients, traumatic intervertebral disk hernia associated with tetraplegia in 2 patients, and cervical fractures and dislocation associated with tetraplegia in 12 patients. Seventeen cases were combined with craniocerebral injury, 7 combined with pulmonary contusion, multi-fractures of rib or hemopneumothorax, 2 combined with pelvic fracture and other 8 combined with fracture of limbs. The neural function was assessed by the American Spinal Injury Association (ASIA) scale.Results:Thirty-one patients were followed up for an average of 14 months. Of them, 10 got complete recovery, 13 obtained improvement of more than one ASIA grade, 8 did not improve, and 1 died.Conclusions: For the emergency treatment of multiple injuries headed by cervical spinal cord injury, the damage control strategy is the principle to follow. The final operations are preferably performed within 5 to 10 days after injury so as to raise the successful rate of remedy.

  8. Microsurgical resection of tumors lateroventral and ventral to the high cervical spinal cord

    Institute of Scientific and Technical Information of China (English)

    LEI Peng; WU Yi; LI Zhi-yun; WANG Yu

    2005-01-01

    Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management. Methods Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm×2.5 cm×2.0 cm to 12 cm×3.0 cm×2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium. Results The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients. Conclusion Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.

  9. The influence of changes in cervical lordosis on bulging disk and spinal stenosis: functional MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Joon; Eun, Choong Ki [Pusan Paik Hospital, Inje Univ. College of Medicine, Pusan (Korea, Republic of)

    2001-05-01

    To assess the effect of lordotic curve change of the cervical spine on disk bulging and spinal stenosis by means of functional cervical MR imaging at the flexion and extension position. Using a 1.5T imager, kinematic MR examinations of 25 patients with degenerative spondylosis (average age, 41 years) were performed at the neutral, flexed and extended position of the cervical spine. Sagittal T2-weighted turbo spin-echo images were obtained during each of the three phases. Lordotic angle, bulging thickness of the disk, AP diameter of the spinal canal, and distance between the disk and spinal cord were measured on the workstation at each disk level. After qualitative independent observation of disk bulging, one of four grades(0, normal; 1, mild; 2, moderate; 3, marked) was assigned at each phase, and after further comparative observation, one of five scores (-2, prominent decrease; -1, mild decrease; 0, no change; 1, notable increase; 2 prominent increase) was also assigned. In addition, bulging thickness of the disk was measured and compared at the neutral, flexed, and extended positions. Average angles of the cervical spine were 160.5{+-}5.9 deg (neutral position, lordotic angle); 185.4{+-}8.5 deg (flexion, kyphotic angle); and 143.7{+-}6.7 deg (extension, lordotic angle). Average grades of disk bulging were 0.55 at the neutral position. 0.16 at flexion, and 0.7 at extension. Comparative observation showed that average scores of disk bulging were -0.39 at flexion and 0.31 at extension. The bulging thickness of the disk decreased by 24.2% at flexion and increased by 30.3% at extension, while the diameter of the spinal canal increased by 4.5% at flexion and decreased by 3.6% at extension. The distance from the posterior margin of the disk to the anterior margin of the spinal cord decreased at both flexion(6.6%) and extension(19.1%). Functional MRI showed that compared with the neutral position, disk bulging and spinal stenosis are less prominent at flexion and

  10. MR imaging in neuroborreliosis of the cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Hattingen, Elke; Weidauer, Stefan; Zanella, Friedhelm E. [University of Frankfurt, Institute of Neuroradiology, Frankfurt (Germany); Kieslich, Matthias; Boda, Volker [University of Frankfurt, Department of Pediatric Neurology, Frankfurt (Germany)

    2004-11-01

    The central nervous system is involved in 10-20% of cases in Lyme disease. The neurological symptoms, time course of the disease and imaging findings are multifaceted. We report two patients with cervical radiculitis. Magnetic resonance imaging revealed strong enhancement of the cervical nerve roots on contrast-enhanced T1-weighted images. These imaging patterns of borrelia-associated radiculitis have not been reported before. Knowledge of these imaging features may help to diagnose neuroborreliosis, which presents with non-specific symptoms. (orig.)

  11. Coupling between the spinal cord and cervical vertebral column under tensile loading.

    Science.gov (United States)

    Kroeker, Shannon G; Ching, Randal P

    2013-02-22

    Current neck injury criteria are based on structural failure of the spinal (vertebral) column without consideration of injury to the spinal cord. Since one of the primary functions of the vertebral column is to protect the cord, it stands to reason that a more refined measure of neck injury threshold would be the onset of spinal cord injury (SCI). This study investigated the relationship between axial strains in the cervical vertebral column and the spinal cord using an in vitro primate model (n=10) under continuous tensile loading. Mean failure loads occurred at 1951.5±396N with failure strains in the vertebral column of 16±5% at the level of failure. Average tensile strains in the spinal cord at failure were 11±5% resulting in a mean coupling ratio of 0.54±0.17 between C1 and C7. The level of peak strain measured in the spinal cord did not always occur at the location of vertebral column failure. Spinal cord strains were less than spine strains and coupling ratios were not significantly different along the length of the spine. The largest coupling ratio was measured in the atlanto-occipital joint whereas the smallest coupling ratio occurred at the adjacent C1-C2 joint.

  12. Notalgia paresthetica associated with cervical spinal stenosis and cervicothoracic disk disease at C4 through C7.

    Science.gov (United States)

    Alai, Nili N; Skinner, Harry B; Nabili, Siamak T; Jeffes, Edward; Shahrokni, Seyed; Saemi, Arash M

    2010-02-01

    Notalgia paresthetica (NP) is a common refractory, sensory, neuropathic syndrome with the hallmark symptom of localized pruritus of the unilateral infrascapular back. It generally is a chronic noncurable condition with periodic remissions and exacerbations. While the dermatologic syndrome may be multifactorial in etiology, a possible association with underlying cervical spine disease should be evaluated for proper treatment. Collaborative multispecialty evaluation by dermatology, radiology, orthopedic surgery, and neurology may be indicated for primary management of this condition. First-line therapy for NP with associated cervical disease may include nondermatologic noninvasive treatments such as spinal manipulation, physical therapy, massage, cervical traction, cervical muscle strengthening, and oral nonsteroidal anti-inflammatory drugs and muscle relaxants. Notalgia paresthetica may in fact be a cutaneous sign of an underlying degenerative cervical spine disease. We report a case of a patient with cervical spinal stenosis that corresponded directly with the clinical findings of NP.

  13. Trapeziometacarpal arthrosis: Presentation, psychosocial aspects, and management

    NARCIS (Netherlands)

    Becker, S.J.E.

    2015-01-01

    Idiopathic TMC arthrosis is a part of normal human aging. There is substantial variability in pain intensity and limitations related to trapeziometacarpal arthrosis. Common sense suggests and our study results confirm that a substantial portion of people never seek care for their trapeziometacarpal

  14. Radiographic arthrosis after elbow trauma: interobserver reliability.

    NARCIS (Netherlands)

    Lindenhovius, A.; Karanicolas, P.J.; Bhandari, M.; Ring, D.; Kampen, A. van

    2012-01-01

    PURPOSE: This study measured observer variation in radiographic rating of elbow arthrosis. METHODS: Thirty-seven independent orthopedic surgeons graded the extent of elbow arthrosis in 20 consecutive sets of plain radiographs, according to the Broberg and Morrey rating system (grade 0, normal joint;

  15. Increased intracranial pressure in a case of spinal cervical glioblastoma multiforme: analysis of these two rare conditions

    Directory of Open Access Journals (Sweden)

    C.M. de Castro-Costa

    1994-03-01

    Full Text Available The authors describe a rare case of increased intracranial hypertension consequent to a spinal cervical glioblastoma multiforme in a young patient. They analyse the physiopathology of intracranial hypertension in spinal tumors and the rarity of such kind of tumor in this location, and its clinico-pathological aspects.

  16. Diagnosis of anterior cervical spinal epidural abscess by US and MRI in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Gudinchet, F.; Chapuis, L. (University Hospital, Lausanne (Switzerland). Dept. of Radiology); Berger, D. (University Hospital, Lausanne (Switzerland). Dept. of Pediatric Surgery)

    1991-11-01

    A 10-day-old girl who initially presented with fever developed over five days a complete paresis of both upper arms and swallowing difficulty. After emergency drainage of a retropharyngeal abscess, cervical US demonstrated a cervical anterior epidural mass compressing the cord. MRI confirmed the diagnosis of spinal epidural abscess secondary to C4-C5 spondylodiscitis. Surgical removal of the abscess was followed by complete disappearance of the neurologic symptoms after six months of follow-up. This is the first case of spinal epidural abscess in a newborn to be diagnosed by US and MRI preoperatively. The advantages of these non-invasive imaging modalities are discussed, and compared to myelography. (orig.).

  17. Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis

    OpenAIRE

    2011-01-01

    The aim of this study is to quantify the changes in the sagittal alignment of the cervical spine in patients with adolescent idiopathic scoliosis following posterior spinal fusion. Patients eligible for study inclusion included those with a diagnosis of mainly thoracic adolescent idiopathic scoliosis treated by means of posterior multisegmented hook and screw instrumentation. Pre and post-operative anterior–posterior and lateral radiographs of the entire spine were reviewed to assess the chan...

  18. Specialisation of spinal services: consequences for cervical trauma management in the district hospital

    Directory of Open Access Journals (Sweden)

    Cordell-Smith James

    2007-11-01

    Full Text Available Abstract Background Specialisation in spinal services has lead to a low threshold for referral of cervical spine injuries from district general hospitals. We aim to assess the capability of a district general hospital in providing the halo vest device and the expertise available in applying the device for unstable cervical spine injuries prior to transfer to a referral centre. Methods The study was a postal questionnaire survey of trauma consultants at district general hospitals without on-site spinal units in the United Kingdom. Seventy institutions were selected randomly from an electronic NHS directory. We posed seven questions on the local availability, expertise and training with halo vest application, and transferral policies in patients with spinal trauma. Results The response rate was 51/70 (73%. Nineteen of the hospitals (37% did not stock the halo vest device. Also, one third of the participants (18/51, 35%, 95% confidence interval 22 – 50% were not confident in application of the halo vest device and resorted to transfer of patients to referral centres without halo immobilization. Conclusion The lack of equipment and expertise to apply the halo vest device for unstable cervical spine injuries is highlighted in this study. Training of all trauma surgeons in the application of the halo device would overcome this deficiency.

  19. Cervical Spinal Meningeal Melanocytoma Presenting as Intracranial Superficial Siderosis

    Directory of Open Access Journals (Sweden)

    Savitha Srirama Jayamma

    2015-01-01

    Full Text Available Meningeal melanocytoma is a rare pigmented tumor of the leptomeningeal melanocytes. This rare entity results in diagnostic difficulty in imaging unless clinical and histopathology correlation is performed. In this case report, we describe a case of meningeal melanocytoma of the cervical region presenting with superficial siderosis. Extensive neuroradiological examination is necessary to locate the source of the bleeding in such patients. Usually, the patient will be cured by the complete surgical excision of the lesion.

  20. EVALUATION OF THE RESULTS OF CERVICAL SPINE & SPINAL CORD TRAUMA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    G.R. Bahadorkhan

    2009-01-01

    Full Text Available Objectives Major differences exist in the anatomy and biomechanics of the growing spine that causes failure patterns different from those in adults. Spinal injury in the pediatric patient is a main concern because timely diagnosis and appropriate treatment can prevent further neurologic damage and deformity and potentiate recovery. We conducted a retrospective clinical study of 137 cases (93 boys, 44 girls of pediatric cervical spine injuries, managed over fifteen years, to present data from a large series of pediatric patients with cervical spine injuries from a single regional trauma center. The aim was to assess and analyze complications, etiology, pathogenesis, site of injuries and age difference of cervical spine and spinal cord injury in a pediatric age group and compare the findings with current literature.Materials & Methods One hundred and thirty seven children with cervical spine injuries, seen over twelve years, were divided into two age groups: 54 patients were in group one (0-9 years and 83 patients were in group two (10 – 17 years . We managed them according to status at presentation and type of injury. Forty seven patients were managed surgically and ninety nonsurgically (52 wore a halo brace and 38 wore different hard collars and braces. T-test and Chi squares were used to analyze differences between groups ResultsThe most common cause of injury was motor vehicle accidents(MVA. Our younger patients (Group 1 had sustained more neurological injuries than the older ones (Group 2, 77% vs.48%.; upper cervical spine was the most common site involved in 76%, while 43% suffered head injuries. In group two, 88% of children two sustained fractures or fracture/ subluxations; also in this group, subluxation, and fracture/subluxation was present in 10 and 25% of children respectively. The most common radiological findings were vertebral fractures (38%. Solid fusions were demonstrated in all patients at late follow–up review (mean 6 years

  1. Fast diffusion tensor imaging and tractography of the whole cervical spinal cord using point spread function corrected echo planar imaging

    DEFF Research Database (Denmark)

    Lundell, Hans Magnus Henrik; Barthelemy, Dorothy; Biering-Sørensen, Fin

    2013-01-01

    spread function of the voxel intensity in a reference scan. In this study, the point spread function was mapped for an echo-planar imaging sequence in the human cervical spinal cord with isotropic resolution and large field of view. Correction with the point spread function map improved anatomical...... consistency, and full cervical tractography was thereby possible from a C1 seed region in healthy controls and one individual with spinal cord injury. It is suggested that point spread function mapping of the spinal cord can be used in combination with sequence-based methods for reduction of susceptibility...

  2. The importance of severity of arthrosis for the reliability of bone mineral density measurement in women.

    Science.gov (United States)

    Hayirlioglu, Alper; Gokaslan, Husnu; Cimsit, Canan; Baysal, Begumhan

    2009-02-01

    The objective of this study is to investigate the effect of the severity of degenerative changes on measurements of A-P lumbar spines BMD values and to determine the reliability of DEXA measurements associated with severity of the disease on A-P lumbar spines BMD values using DEXA. The measurements using DEXA were taken from L2-L4 spines and femoral neck of total 271 female cases. One hundred and ten of them had mild arthrosis (Group 0), and 69 had severe arthrosis (Group 1). Ninety-two cases without arthrosis were chosen as control group (Group 2). The cases with arthrosic changes were grouped according to their degree of severity of arthrosis. The groups were compared two by two and Tukey multiple comparison test was used for the analysis of the difference of the means of the groups. The mean age of cases was 61.79, 61.84, and 60.47, respectively. The average height was 157.26, 155.93, and 15.92 cm while the average weight was 69.21, 70.78, and 71.45 kg, respectively. The mean body mass index (BMI) was 0.00283, 0.00291, and 0.00293, respectively. L2-L4 A-P spinal BMD values were 0.9870, 0.9848, and 1.0836 g/cm(2) while the femoral neck BMD values were 0.7964, 0.8056, and 0.8223 g/cm(2), respectively. There was no statistical significance between study and control groups in terms of age, weight, height, BMI, and BMD values obtained from femoral neck. However, lumbar region BMD values of the cases with severe arthrosis were statistically significantly high when compared with other two groups. The femoral neck measurement is the prominent alternative method in severe arthrosis while taking measurements from lumbar region is still the most appropriate method in cases with mild arthrosis without having giant osteophytes.

  3. Rugby injuries to the cervical spine and spinal cord: a 10-year review.

    Science.gov (United States)

    Scher, A T

    1998-01-01

    A 10-year review (1987-1996) of injuries sustained to the spine and spinal cord in rugby players with resultant paralysis has been undertaken. This article reviews that the incidence of serious rugby spine and spinal cord injuries in South Africa has increased over the 10-year period reviewed, despite stringent new rules instituted in an attempt to decrease the incidence of these injuries. The mechanisms of injury, as previously reported, remain the same as well as the phases of game responsible for injury of the tight scrum, tackle, rucks, and mauls. Two new observations are reported: the first is related to the occurrence of spinal cord concussion with transient paralysis, and the second is related to the increased incidence of osteoarthritis of the cervical spine in rugby players.

  4. Somatostatinergic nerves in the cervical spinal cord of the monkey.

    Science.gov (United States)

    Burnweit, C; Forssmann, W G

    1979-08-03

    Somatostatinergic nerves in the spinal cord of the monkey were investigated utilizing immunohistochemistry with various antibodies against synthetic somatostatin. In contrast to earlier investigations, it is shown that somatostatinergic nerve endings occur in most of the areas of the grey matter of the spinal cord. The somatostatinergic axons are, however, characteristically distributed in three main regions: (1) Densely-packed endings are seen in lamina II of the substantia gelatinosa, forming a crescent-shaped pattern in the columna dorsalis. Somatostatin immunoreactivity is also seen in lamina I and in the Lissauer tract. (2) A fine network of fibers is observed around the central canal; the endings are concentrated on special cell bodies. Some single perikarya are also stained in this region. (3) A loose network of single fibers is found ending on perikarya of the columna lateralis or ventralis. The perikarya of the nerve axons, with the exception of those terminating in the columna dorsalis, have as yet not been identified. In order to better understand the somatostatinergic system of the spinal cord, these newly-detected somatostatinergic nerves must be studied and their exact pathways analyzed.

  5. Klippel-Feil syndrome – the risk of cervical spinal cord injury: A case report

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2002-04-01

    Full Text Available Abstract Background Klippel-Feil syndrome is defined as congenital fusion of two or more cervical vertebrae and is believed to result from faulty segmentation along the embryo's developing axis during weeks 3–8 of gestation. Persons with Klippel-Feil syndrome and cervical stenosis may be at increased risk for spinal cord injury after minor trauma as a result of hypermobility of the various cervical segments. Persons with Klippel-Feil Syndrome often have congenital anomalies of the urinary tract as well. Case presentation A 51-year male developed incomplete tetraplegia in 1997 when he slipped and fell backwards hitting his head on the floor. X-rays of cervical spine showed fusion at two levels: C2 and C3 vertebrae, and C4 and C5 vertebrae. Intravenous urography (IVU revealed no kidneys in the renal fossa on both sides, but the presence of crossed, fused renal ectopia in the left ilio-lumbar region. This patient had a similar cervical spinal cord injury about 15 years ago, when he developed transient numbness and paresis of the lower limbs following a fall. Discussion and Conclusion 1 Persons with Klippel-Feil syndrome should be made aware of the increased risk of sustaining transient neurologic deterioration after minor trauma if there is associated radiographic evidence of spinal stenosis. 2 Patients with Klippel-Feil syndrome often have congenital anomalies of the urinary tract. Our patient had crossed, fused, ectopia of kidney. 3 When patients with Klippel-Feil syndrome sustain tetraplegia they have increased chances of developing urinary tract calculi. Treatment of kidney stones may pose a challenge because of associated renal anomalies. 4 Health professionals caring for cervical spinal cord injury patients with Klippel-Feil syndrome and renal anomalies should place emphasis on prevention of kidney stones. A large fluid intake is recommended for these patients, as a high intake of fluids is still the most powerful and certainly the most

  6. Interneuronal systems of the cervical spinal cord assessed with BOLD imaging at 1.5 T

    Energy Technology Data Exchange (ETDEWEB)

    Stracke, C.P.; Schoth, F.; Moeller-Hartmann, W.; Krings, T. [University Hospital of the University of Technology, Departments of Neuroradiology and Diagnostic Radiology, Aachen (Germany); Pettersson, L.G. [University of Goeteborg, Department of Physiology, Goeteborg (Sweden)

    2005-02-01

    The purpose of this study was to investigate if functional activity with spinal cord somatosensory stimulation can be visualized using BOLD fMRI. We investigated nine healthy volunteers using a somatosensory stimulus generator. The stimuli were applied in three different runs at the first, third, and fifth finger tip of the right hand, respectively, corresponding to dermatomes c6, c7, and c8. The stimuli gave an increase of BOLD signal (activation) in three different locations of the spinal cord and brain stem. First, activations could be seen in the spinal segment corresponding to the stimulated dermatome in seven out of nine volunteers for c6 stimulation, two out of eight for c7, and three out of eight for c8. These activations were located close to the posterior margin of the spinal cord, presumably reflecting synaptic transmission to dorsal horn interneurons. Second, activation in the medulla oblongata was evident in four subjects, most likely corresponding to the location of the nucleus cuneatus. The third location of activation, which was the strongest and most reliable observed was inside the spinal cord in the c3 and c4 segments. Activation at these spinal levels was almost invariably observed independently of the dermatome stimulated (9/9 for c6, 8/8 for c7, and 7/8 for c8 stimulation). These activations may pertain to an interneuronal system at this spinal level. The results are discussed in relation to neurophysiological studies on cervical spinal interneuronal pathways in animals and humans. (orig.)

  7. Extensive Spinal Decussation and Bilateral Termination of Cervical Corticospinal Projections in Rhesus Monkeys

    Science.gov (United States)

    Rosenzweig, Ephron S.; Brock, John H.; Culbertson, Maya D.; Lu, Paul; Moseanko, Rod; Edgerton, V. Reggie; Havton, Leif A.; Tuszynski, Mark H.

    2009-01-01

    To examine neuroanatomical mechanisms underlying fine motor control of the primate hand, adult Rhesus monkeys underwent injections of biotinylated dextran amine (BDA) into the right motor cortex. Spinal axonal anatomy was examined using detailed serial-section reconstruction and modified stereological quantification. 87% of corticospinal tract (CST) axons decussated in the medullary pyramids and descended through the contralateral dorsolateral tract of the spinal cord. 11% of CST axons projected through the dorsolateral CST ipsilateral to the hemisphere of origin, and 2% of axons projected through the ipsilateral ventromedial CST. Notably, corticospinal axons decussated extensively across the spinal cord midline. Remarkably, nearly two-fold more CST axons decussated across the cervical spinal cord midline (~12,000 axons) than were labeled in all descending components of the CST (~6,700 axons). These findings suggest that CST axons extend multiple segmental collaterals. Furthermore, serial-section reconstructions revealed that individual axons descending in either the ipsilateral or contralateral dorsolateral CST can: 1) terminate in the gray matter ipsilateral to the hemisphere of origin; 2) terminate in the gray matter contralateral to the hemisphere of origin; or 3) branch in the spinal cord and terminate on both sides of the spinal cord. These results reveal a previously unappreciated degree of bilaterality and complexity of corticospinal projections in the primate spinal cord. This bilaterality is more extensive than that of the rat CST, and may resemble human CST organization. Thus, augmentation of sprouting of these extensive bilateral CST projections may provide a novel target for enhancing recovery after spinal cord injury. PMID:19125408

  8. Head Position and Football Equipment Influence Cervical Spinal-Cord Space During Immobilization

    Science.gov (United States)

    Tierney, Ryan T.; Mattacola, Carl G.; Sitler, Michael R.; Maldjian, Catherine

    2002-01-01

    Objective: To assess the effect of head position and football equipment (ie, helmet and shoulder pads) on cervical spinal cord space in individuals lying supine on a spine board. Design and Setting: The independent variables were head position (0-cm, 2-cm, and 4-cm occiput elevation with no helmet and shoulder pads and with helmet and shoulder pads) and cervical spine level (C3, C4, C5, C6, and C7). The 3 dependent variables were sagittal space available for the cord (SAC) (mm), sagittal spinal-cord diameter (mm), and cervical-thoracic angle (°), determined via magnetic resonance imaging. Subjects: Twelve men (age = 24.3 ± 2.1 years; height = 181.1 ± 5.7 cm; weight = 93.9 ± 3.6 kg). Measurements: Sagittal space available for the cord was determined by subtracting the sagittal spinal-cord diameter from the corresponding sagittal spinal-canal diameter. The spinal-canal diameter was measured as the shortest distance from the vertebral body to the spinolaminar line at each of the spinal levels. Each measurement was taken 3 times, and the 3 measurements were averaged. Results: Sagittal space available for the cord was significantly greater (P < .01) for 0-cm (mean = 5.50 mm) than for 2-cm (mean = 4.86 mm) and 4-cm (mean = 5.07 mm) occiput elevation. SAC was also significantly greater (P < .01) for the equipment condition (mean = 5.34 mm) than for the 2-cm and 4-cm elevation levels. No significant difference (P = .093) in SAC existed between 0-cm elevation and the equipment condition. Conclusions: The helmet and shoulder pads should be left on during spine-board immobilization of the injured football player. Similarly, during spine-board immobilization of an individual without football helmet and shoulder pads, the head should be maintained at 0 cm of occiput elevation. Sagittal spinal-cord space is optimized in both of these conditions. PMID:12937433

  9. Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Canavese, Federico; Turcot, Katia; De Rosa, Vincenzo; de Coulon, Geraldo; Kaelin, André

    2011-07-01

    The aim of this study is to quantify the changes in the sagittal alignment of the cervical spine in patients with adolescent idiopathic scoliosis following posterior spinal fusion. Patients eligible for study inclusion included those with a diagnosis of mainly thoracic adolescent idiopathic scoliosis treated by means of posterior multisegmented hook and screw instrumentation. Pre and post-operative anterior-posterior and lateral radiographs of the entire spine were reviewed to assess the changes of cervical sagittal alignment. Thirty-two patients (3 boys, 29 girls) met the inclusion criteria for the study. The average pre-operative cervical sagittal alignment (CSA) was 4.0° ± 12.3° (range -30° to 40°) of lordosis. Postoperatively, the average CSA was 1.7° ± 11.4° (range -24° to 30°). After surgery, it was less than 20° in 27 patients (84.4%) and between 20° and 40° in 5 patients (15.6%). The results of the present study suggest that even if rod precontouring is performed and postoperative thoracic sagittal alignment is restored, improved or remains unchanged after significant correction of the deformity on the frontal plane, the inherent rigidity of the cervical spine limits changes in the CSA as the cervical spine becomes rigid over time.

  10. Magnetic Resonance Imaging of the Cervical, Thoracic, and Lumbar Spine in Children: Spinal Incidental Findings in Pediatric Patients

    Science.gov (United States)

    Ramadorai, Uma E.; Hire, Justin M.; DeVine, John G.

    2014-01-01

    Study Design Retrospective case series. Objective To determine the rate of spinal incidental findings on magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine in the pediatric population. Methods We reviewed MRI imaging of the neuraxial spine in patients less than 18 years of age and documented abnormal spinal findings. We then reviewed the charts of these patients to determine the reason for ordering the study. Those who presented with pain were considered symptomatic. Those who had no presenting complaint were considered asymptomatic. The data were analyzed to break down the rate of spinal incidental findings in the cervical, thoracic, and lumbar spine, respectively. Results Thirty-one of the 99 MRIs had positive findings, with the most common being disk protrusion (51.6%). Spinal incidental findings were most common in the lumbar spine (9.4%) versus the cervical spine (8%) or thoracic spine (4.7%). In this group, Schmorl nodes and disk protrusion were the two most common findings (37.5% each). Other spinal incidental findings included a vertebral hemangioma and a Tarlov cyst. In the thoracic spine, the only spinal incidental finding was a central disk protrusion without spinal cord or nerve root compression. Conclusion MRI is a useful modality in the pediatric patient with scoliosis or complaints of pain, but the provider should remain cognizant of the potential for spinal incidental findings. PMID:25396102

  11. X-ray signs of traumas of the cervical region of the spinal cord in the acute period

    Energy Technology Data Exchange (ETDEWEB)

    Brodskaya, Z.L. (Inst. Usovershenstvovaniya Vrachej, Novokuznetsk (USSR))

    The results are analyzed of an X-ray examination of 208 patients with traumas of the cervical region of the spinal column and spinal cord in the acute period of trauma. The authors proposed a scheme that included telespondylography in standard and oblique projections, flebospondylography, discography and pneumomyelography in the Schantz collar with a patient lying on the back. Four types of the spinal cord traumas were diagnosed: compression with osseous elements (76.92%), with sharp discs and strained epidural hematomas (3.85%), isolated contusion of the spinal cord (10.1%) and disorder of the spinal circulation (9.13%). Special emphasis was laid on clinicospondylographic correlations, a critical distance, congenital narrowing of the vertebral canal. The concept of traumatic decompression of the spinal cord was stressed. Symptoms of its contusion and trauma of the spinal circulation were indicated.

  12. Diagnosis and management of traumatic cervical central spinal cord injury: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Full Text Available Background: The classical clinical presentation, neuroradiographic features, and conservative vs. surgical management of traumatic cervical central spinal cord (CSS injury remain controversial. Methods: CSS injuries, occurring in approximately 9.2% of all cord injuries, are usually attributed to significant hyperextension trauma combined with congenital/acquired cervical stenosis/spondylosis. Patients typically present with greater motor deficits in the upper vs. lower extremities accompanied by patchy sensory loss. T2-weighted magnetic resonance (MR scans usually show hyperintense T2 intramedullary signals reflecting acute edema along with ligamentous injury, while noncontrast computed tomography (CT studies typically show no attendant bony pathology (e.g. no fracture, dislocation. Results: CSS constitute only a small percentage of all traumatic spinal cord injuries. Aarabi et al. found CSS patients averaged 58.3 years of age, 83% were male and 52.4% involved accidents/falls in patients with narrowed spinal canals (average 5.6 mm; their average American Spinal Injury Association (ASIA motor score was 63.8, and most pathology was at the C3-C4 and C4-C5 levels (71%. Surgery was performed within 24 h (9 patients, 24-48 h (10 patients, or after 48 h (23 patients. In the Brodell et al. study of 16,134 patients with CSS, 39.7% had surgery. In the Gu et al. series, those with CSS and stenosis/ossification of the posterior longitudinal ligament (OPLL exhibited better outcomes following laminoplasty. Conclusions: Recognizing the unique features of CSS is critical, as the clinical, neuroradiological, and management strategies (e.g. conservative vs. surgical management: early vs. late differ from those utilized for other spinal cord trauma. Increased T2-weighted MR images best document CSS, while CT studies confirm the absence of fracture/dislocation.

  13. First aid and treatment for cervical spinal cord injury with fracture and dislocation

    Directory of Open Access Journals (Sweden)

    Yisheng W

    2007-01-01

    Full Text Available Background: Traumatic cervical spinal cord injury with subaxial fracture and dislocation not only indicates a highly unstable spine but can also induce life-threatening complications. This makes first aid critically important before any definitive operative procedure is undertaken. The present study analyzes the various first aid measures and operative procedures for such injury. Materials and Methods: Two hundred and ninety-five patients suffered from cervical spinal cord injury with fracture and dislocation. The average period between injury and admission was 4.5 days (range 5 h-12 weeks. The injury includes burst fractures ( n = 90, compression fractures with herniated discs ( n = 50, fractures and dislocation ( n = 88 and pure dislocation ( n = 36. Other injuries including developmental spinal canal stenosis and/or multi-segment spinal cord compression associated with trauma ( n = 12, lamina fractures compressing the spinal cord ( n = 6, ligament injuries ( n = 7 and hematoma ( n = 6 were observed in the present study. The injury level was C4 ( n = 17, C5 ( n = 29, C6 ( n = 39, C7 ( n = 35, C4-5 ( n = 38, C5-6 ( n = 58, C6-7 ( n = 49, C4-6 ( n = 16 and C5-7 ( n = 14. According to the Frankel grading system, grade A was observed in 20 cases, grade B in 91, grade C in 124 and grade D in 60. One hundred and eighteen (40% patients had a high fever and difficulty in breathing on presentation. First aid measures included early reduction and immobilization of the injured cervical spine, controlling the temperature, breathing support,and administration of high-dose methylprednisolone within eight hours of the injury ( n = 12 and administration of dehydration and neurotrophy medicine. Oxygen support was given and tracheotomy was performed for patients with serious difficulty in breathing. Measures were taken to prevent bedsores and infections of the respiratory and urological systems. Two hundred and thirty six patients were treated with anterior

  14. Serotonin(2) receptors mediate respiratory recovery after cervical spinal cord hemisection in adult rats.

    Science.gov (United States)

    Zhou, S Y; Basura, G J; Goshgarian, H G

    2001-12-01

    The aim of the present study was to specifically investigate the involvement of serotonin [5-hydroxytryptamine (5-HT(2))] receptors in 5-HT-mediated respiratory recovery after cervical hemisection. Experiments were conducted on C(2) spinal cord-hemisected, anesthetized (chloral hydrate, 400 mg/kg ip), vagotomized, pancuronium- paralyzed, and artificially ventilated female Sprague-Dawley rats in which CO(2) levels were monitored and maintained. Twenty-four hours after spinal hemisection, the ipsilateral phrenic nerve displayed no respiratory-related activity indicative of a functionally complete hemisection. Intravenous administration of the 5-HT(2A/2C)-receptor agonist (+/-)-2,5-dimethoxy-4-iodoamphetamine hydrochloride (DOI) induced respiratory-related activity in the phrenic nerve ipsilateral to hemisection under conditions in which CO(2) was maintained at constant levels and augmented the activity induced under conditions of hypercapnia. The effects of DOI were found to be dose dependent, and the recovery of activity could be maintained for up to 2 h after a single injection. DOI-induced recovery was attenuated by the 5-HT(2)-receptor antagonist ketanserin but not with the 5-HT(2C)-receptor antagonist RS-102221, suggesting that 5-HT(2A) and not necessarily 5-HT(2C) receptors may be involved in the induction of respiratory recovery after cervical spinal cord injury.

  15. 颈椎管容积和脊髓体积的MRI测量及其动态变化%Dynamic measurement of cervical spinal canal and cervical spinal cord volume

    Institute of Scientific and Technical Information of China (English)

    钱军; 申才良; 荆珏华; 田大胜

    2009-01-01

    目的 利用核磁共振测量正常人的颈椎管容积及脊髓的体积,并探讨其动态变化趋势.方法 选取正常人20名,排除退变、畸形和对扫描发生恐惧者4名,利用MRI无间隔梯度扰像回波序列方式分别扫描并测量过屈、中立、过伸位下各颈椎椎管容积和脊髓的体积,并进行统计学分析.结果 过屈、中立、过伸三种体位下正常人的颈椎管容积改变趋势为V过屈V中立V过伸,且三个体位下的容积差异有显著性(P0.05);过屈、中立和过伸位下脊髓的体积差异均无统计学意义(P>0.05),颈段脊髓的体积约10.69±0.56cm3.结论 颈椎由过屈向过伸动态变化过程中,颈椎管的容积是逐渐减小的,且颈椎管容积的改变主要发生在颈3~颈7节段;但颈段脊髓的体积是固定不变的,脊髓的形态和在椎管内的位置是变化的.%Objectives To measure the cervical spinal canal and cervical spinal cord volume of healthy people during MRI,and also to evaluate the dynamic changes of the cervical spinal canal and cervical spinal cord volume with the angle change of the cervical vertebrae. Methods Twenty healthy people are chosen to experiment,and four individuals of all are excluded because of degeneration,deformity or in fear of the scan. The remaining 16 individuals are conducted MRI scan. Last,we analyze the conclusions and evaluate their dynamic changes. Results The volume of the cervical spinal canal reduced gradually. The volume was larger in flexion position than in the central position,and the volume was larger in central position than in the extension position,and al-so they had a significant difference (P0.05),the mean volume of cer-vical spinal cord were about 10.69±0.56cm3. Conclusion The volume of the cervical spinal canal decreases gradually with increasing extension angle,but the volume of the spinal cord is always the same size with changing the angle of cervical vertebrae,and the shape and location of the spinal

  16. Anterior Cervical Discectomy and Fusion: Practice Patterns Among Greek Spinal Surgeons

    Science.gov (United States)

    Spanos, Savvas L.; Siasios, Ioannis D.; Dimopoulos, Vassilios G.; Fountas, Kostas N.

    2016-01-01

    Background A web-based survey was conducted among Greek spinal surgeons to outline the current practice trends in regard to the surgical management of patients undergoing anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine pathology. Various practice patterns exist in the surgical management of patients undergoing anterior cervical discectomy for degenerative pathology. No consensus exists regarding the type of the employed graft, the necessity of implanting a plate, the prescription of an external orthotic device, and the length of the leave of absence in these patients. Methods A specially designed questionnaire was used for evaluating the criteria for surgical intervention, the frequency of fusion employment, the type of the graft, the frequency of plate implantation, the employment of an external spinal orthosis (ESO), the length of the leave of absence, and the prescription of postoperative physical therapy. Physicians’ demographic factors were assessed including residency and spinal fellowship training, as well as type and length in practice. Results Eighty responses were received. Neurosurgeons represented 70%, and orthopedic surgeons represented 30%. The majority of the participants (91.3%) considered fusion necessary. Allograft was the preferred type of graft. Neurosurgeons used a plate in 42.9% of cases, whereas orthopedic surgeons in 100%. An ESO was recommended for 87.5% of patients without plates, and in 83.3% of patients with plates. The average duration of ESO usage was 4 weeks. Physical therapy was routinely prescribed postoperatively by 75% of the neurosurgeons, and by 83.3% of the orthopedic surgeons. The majority of the participants recommended 4 weeks leave of absence. Conclusions The vast majority of participants considered ACDF a better treatment option than an ACD, and preferred an allograft. The majority of them employed a plate, prescribed an ESO postoperatively, and recommended physical therapy to their

  17. Functional recovery after cervical spinal cord injury: Role of neurotrophin and glutamatergic signaling in phrenic motoneurons.

    Science.gov (United States)

    Gill, Luther C; Gransee, Heather M; Sieck, Gary C; Mantilla, Carlos B

    2016-06-01

    Cervical spinal cord injury (SCI) interrupts descending neural drive to phrenic motoneurons causing diaphragm muscle (DIAm) paralysis. Recent studies using a well-established model of SCI, unilateral spinal hemisection of the C2 segment of the cervical spinal cord (SH), provide novel information regarding the molecular and cellular mechanisms of functional recovery after SCI. Over time post-SH, gradual recovery of rhythmic ipsilateral DIAm activity occurs. Recovery of ipsilateral DIAm electromyogram (EMG) activity following SH is enhanced by increasing brain-derived neurotrophic factor (BDNF) in the region of the phrenic motoneuron pool. Delivery of exogenous BDNF either via intrathecal infusion or via mesenchymal stem cells engineered to release BDNF similarly enhance recovery. Conversely, recovery after SH is blunted by quenching endogenous BDNF with the fusion-protein TrkB-Fc in the region of the phrenic motoneuron pool or by selective inhibition of TrkB kinase activity using a chemical-genetic approach in TrkB(F616A) mice. Furthermore, the importance of BDNF signaling via TrkB receptors at phrenic motoneurons is highlighted by the blunting of recovery by siRNA-mediated downregulation of TrkB receptor expression in phrenic motoneurons and by the enhancement of recovery evident following virally-induced increases in TrkB expression specifically in phrenic motoneurons. BDNF/TrkB signaling regulates synaptic plasticity in various neuronal systems, including glutamatergic pathways. Glutamatergic neurotransmission constitutes the main inspiratory-related, excitatory drive to motoneurons, and following SH, spontaneous neuroplasticity is associated with increased expression of ionotropic N-methyl-d-aspartate (NMDA) receptors in phrenic motoneurons. Evidence for the role of BDNF/TrkB and glutamatergic signaling in recovery of DIAm activity following cervical SCI is reviewed.

  18. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

    Directory of Open Access Journals (Sweden)

    Pampati Vidyasagar

    2004-05-01

    Full Text Available Abstract Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine, in accordance with the criteria established by the International Association for the Study of Pain (IASP. The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%, with thoracic spine pain was 42% (95% CI, 30% – 53%, and in with lumbar spine pain was 31% (95% CI, 27% – 36%. The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72% in the cervical spine, 55% (95% CI, 39% – 78% in the thoracic spine, and 27% (95% CI, 22% – 32% in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.

  19. Pathogenesis of spinal cord involvement induced by lower cervical instability in rheumatoid spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Hironobu; Kuwabara, Shigeru; Fukuda, Kenji; Kuroki, Tatsuji; Tajima, Naoya (Miyazaki Medical Coll., Kiyotake (Japan))

    1994-07-01

    To examine prognostic factors in rheumatoid arthritis (RA), plain radiography findings and magnetic resonance imaging (MRI) findings were compared with histopathological findings in 129 RA patients who had local or neurologic symptoms due to the cervical spine. All patients underwent plain radiography, and subdislocation more than 2 mm towards the anterior and posterior directions on plain radiographs was defined as instability. In predicting induction of instability of the inferior cervical spine and risk for spinal compression, erosion of the vertebral rim, as seen on plain X-rays, and irregular findings of the end-plate of the vertebral body and Gd-enhanced nodules around the intervertebral disk, as seen on MRI, seemed to be important. (N.K.).

  20. Topiramate treatment is neuroprotective and reduces oligodendrocyte loss after cervical spinal cord injury.

    Directory of Open Access Journals (Sweden)

    John C Gensel

    Full Text Available Excess glutamate release and associated neurotoxicity contributes to cell death after spinal cord injury (SCI. Indeed, delayed administration of glutamate receptor antagonists after SCI in rodents improves tissue sparing and functional recovery. Despite their therapeutic potential, most glutamate receptor antagonists have detrimental side effects and have largely failed clinical trials. Topiramate is an AMPA-specific, glutamate receptor antagonists that is FDA-approved to treat CNS disorders. In the current study we tested whether topiramate treatment is neuroprotective after cervical contusion injury in rats. We report that topiramate, delivered 15-minutes after SCI, increases tissue sparing and preserves oligodendrocytes and neurons when compared to vehicle treatment. In addition, topiramate is more effective than the AMPA-receptor antagonist, NBQX. To the best of our knowledge, this is the first report documenting a neuroprotective effect of topiramate treatment after spinal cord injury.

  1. Investigation of the Differential Contributions of Superficial and Deep Muscles on Cervical Spinal Loads with Changing Head Postures.

    Science.gov (United States)

    Cheng, Chih-Hsiu; Chien, Andy; Hsu, Wei-Li; Chen, Carl Pai-Chu; Cheng, Hsin-Yi Kathy

    2016-01-01

    Cervical spinal loads are predominately influenced by activities of cervical muscles. However, the coordination between deep and superficial muscles and their influence on the spinal loads is not well understood. This study aims to document the changes of cervical spinal loads and the differential contributions of superficial and deep muscles with varying head postures. Electromyography (EMG) of cervical muscles from seventeen healthy adults were measured during maximal isometric exertions for lateral flexion (at 10°, 20° and terminal position) as well as flexion/extension (at 10°, 20°, 30°, and terminal position) neck postures. An EMG-assisted optimization approach was used to estimate the muscle forces and subsequent spinal loads. The results showed that compressive and anterior-posterior shear loads increased significantly with neck flexion. In particular, deep muscle forces increased significantly with increasing flexion. It was also determined that in all different static head postures, the deep muscle forces were greater than those of the superficial muscle forces, however, such pattern was reversed during peak efforts where greater superficial muscle forces were identified with increasing angle of inclination. In summary, the identification of significantly increased spinal loads associated with increased deep muscle activation during flexion postures, implies higher risks in predisposing the neck to occupationally related disorders. The results also explicitly supported that deep muscles play a greater role in maintaining stable head postures where superficial muscles are responsible for peak exertions and reinforcing the spinal stability at terminal head postures. This study provided quantitative data of normal cervical spinal loads and revealed motor control strategies in coordinating the superficial and deep muscles during physical tasks.

  2. Investigation of the Differential Contributions of Superficial and Deep Muscles on Cervical Spinal Loads with Changing Head Postures.

    Directory of Open Access Journals (Sweden)

    Chih-Hsiu Cheng

    Full Text Available Cervical spinal loads are predominately influenced by activities of cervical muscles. However, the coordination between deep and superficial muscles and their influence on the spinal loads is not well understood. This study aims to document the changes of cervical spinal loads and the differential contributions of superficial and deep muscles with varying head postures. Electromyography (EMG of cervical muscles from seventeen healthy adults were measured during maximal isometric exertions for lateral flexion (at 10°, 20° and terminal position as well as flexion/extension (at 10°, 20°, 30°, and terminal position neck postures. An EMG-assisted optimization approach was used to estimate the muscle forces and subsequent spinal loads. The results showed that compressive and anterior-posterior shear loads increased significantly with neck flexion. In particular, deep muscle forces increased significantly with increasing flexion. It was also determined that in all different static head postures, the deep muscle forces were greater than those of the superficial muscle forces, however, such pattern was reversed during peak efforts where greater superficial muscle forces were identified with increasing angle of inclination. In summary, the identification of significantly increased spinal loads associated with increased deep muscle activation during flexion postures, implies higher risks in predisposing the neck to occupationally related disorders. The results also explicitly supported that deep muscles play a greater role in maintaining stable head postures where superficial muscles are responsible for peak exertions and reinforcing the spinal stability at terminal head postures. This study provided quantitative data of normal cervical spinal loads and revealed motor control strategies in coordinating the superficial and deep muscles during physical tasks.

  3. Surgical management of cervical spinal epidural abscess caused by Brucella melitensis : report of two cases and review of the literature.

    Science.gov (United States)

    Ekici, Mehmet Ali; Ozbek, Zühtü; Gökoğlu, Abdülkerim; Menkü, Ahmet

    2012-06-01

    Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

  4. Investigation of human cervical and upper thoracic spinal cord motion: implications for imaging spinal cord structure and function.

    Science.gov (United States)

    Figley, C R; Stroman, P W

    2007-07-01

    Spinal cord (SC) motion is thought to be the dominant source of error in current diffusion and spinal functional MRI (fMRI) methods. However, until now, such motion has not been well characterized in three dimensions. While previous studies have predominantly examined motion in the superior/inferior (S/I) direction, the foci of the present study were the anterior/posterior (A/P) and right/left (R/L) components of human cervical and upper thoracic SC motion. Cardiac-gated, turbofast low-angle shot (turbo-FLASH) cinematic MRI was employed at 3T to acquire images of the cord at 24 phases throughout the cardiac cycle. Time-dependent signal fluctuations within voxels adjacent to the cord/cerebrospinal fluid (CSF) interface were then used to measure SC motion, which was found to occur predictably as a function of cardiac activity. Cord movement was largest in the A/P direction, for which principal components of motion were calculated, thereby indicating consistent patterns of SC oscillation that can potentially be used to improve SC imaging.

  5. Lumbar spinal anesthesia with cervical nociceptive blockade. Critical review of a series of 1,330 procedures

    Directory of Open Access Journals (Sweden)

    Percio Ramón Becker Benitez

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: The manufacture of minimally traumatic needles and synthesis of pharmacological adjuncts with safe and effective action on inhibitory and neuromodulatory synapses distributed along the nociceptive pathways were crucial for a new expansion phase of spinal anesthesia. The objectives of this paper are present our clinical experience with 1330 lumbar spinal anesthesia performed with purposeful nociceptive blockade of the thoracic and cervical spinal nerves corresponding to dermatomes C4 or C3; warn about the method pathophysiological risks, and emphasize preventive standards for the safe application of the technique. CONTENT: Review of the historical background and anatomical spinal anesthesia with cervical levels of analgesia. Description of the technique used in our institution; population anesthetized; and surgery performed with the described method. Critical exposition of the physiological, pathophysiological, and clinical effects occurred and registered during anesthesia-surgery and postoperative period. CONCLUSION: Spinal anesthesia with nociceptive blockade to dermatome C4, or C3, is an effective option for surgery on somatic structures distal to the metamer of the third cervical spinal nerve, lasting no more than four or five hours. The method safety depends on the unrestricted respect for the essential rules of proper anesthesia.

  6. MR diagnosis of temporomandibular arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Suenaga, Shigeaki [Kagoshima Univ. (Japan). Faculty of Dentistry

    1996-09-01

    This review described lesions of articular disk and its surrounding tissues revealed by MR examination in temporomandibular arthrosis, and problems and limits of the examination. Apparatus and imaging methods: Spin echo method was generally used and gradient echo method was alternatively used. Author`s apparatus was 1.5 tesla Signa, Advantage type, equipped with surface coil for temporomandibular joint. Imaging conditions were T1-weighted spin echo method, T2-weighted fast spin echo method, spoiled GRASS (gradient recalled acquisition in the steady state) method and GRASS method. MR findings of articular disk: MR images of normal and abnormal temporomandibular joint were presented together with computed radiographic findings. The role of dynamic imaging was described for evaluation and analysis of the joint functioning. MR findings of surrounding tissues of the disk: Dynamic MRI of the tissues was found useful to see whether the cause of pain was present inside or outside of the articular capsule. Joint effusion could not be fully imaged in T2-weighted conditions. (K.H.)

  7. A novel myoelectric pattern recognition strategy for hand function restoration after incomplete cervical spinal cord injury.

    Science.gov (United States)

    Liu, Jie; Zhou, Ping

    2013-01-01

    This study presents a novel myoelectric pattern recognition strategy towards restoration of hand function after incomplete cervical spinal cord Injury (SCI). High density surface electromyogram (EMG) signals comprised of 57 channels were recorded from the forearm of nine subjects with incomplete cervical SCI while they tried to perform six different hand grasp patterns. A series of pattern recognition algorithms with different EMG feature sets and classifiers were implemented to identify the intended tasks of each SCI subject. High average overall accuracies (> 97%) were achieved in classification of seven different classes (six intended hand grasp patterns plus a hand rest pattern), indicating that substantial motor control information can be extracted from partially paralyzed muscles of SCI subjects. Such information can potentially enable volitional control of assistive devices, thereby facilitating restoration of hand function. Furthermore, it was possible to maintain high levels of classification accuracy with a very limited number of electrodes selected from the high density surface EMG recordings. This demonstrates clinical feasibility and robustness in the concept of using myoelectric pattern recognition techniques toward improved function restoration for individuals with spinal injury.

  8. Evaluation of Facet Joint Arthrosis in Stenotic and Normal Lumbar Spines with MRI

    Directory of Open Access Journals (Sweden)

    Ebru Ozan

    2013-10-01

    Full Text Available Aim: To reveal the prevalence of lumbar facet joint arthrosis in normal and stenotic lumbar spines with magnetic resonance imaging. Material and Method: Study group consisted of 30 patients with complaints and findings of lower back pain, neurologic claudicatio and lumbar spinal stenosis detected at L3-4, L4-5 and/or L5-S1 with magnetic resonance imaging (cross section area of the dural sac

  9. High-resolution multi-parametric quantitative magnetic resonance imaging of the human cervical spinal cord at 7T.

    Science.gov (United States)

    Massire, Aurélien; Taso, Manuel; Besson, Pierre; Guye, Maxime; Ranjeva, Jean-Philippe; Callot, Virginie

    2016-12-01

    Quantitative MRI techniques have the potential to characterize spinal cord tissue impairments occurring in various pathologies, from both microstructural and functional perspectives. By enabling very high image resolution and enhanced tissue contrast, ultra-high field imaging may offer further opportunities for such characterization. In this study, a multi-parametric high-resolution quantitative MRI protocol is proposed to characterize in vivo the human cervical spinal cord at 7T. Multi-parametric quantitative MRI acquizitions including T1, T2(*) relaxometry mapping and axial diffusion MRI were performed on ten healthy volunteers with a whole-body 7T system using a commercial prototype coil-array dedicated to cervical spinal cord imaging. Automatic cord segmentation and multi-parametric data registration to spinal cord templates enabled robust regional studies within atlas-based WM tracts and GM horns at the C3 cervical level. T1 value, cross-sectional area and GM/WM ratio evolutions along the cervical cord were also reported. An original correction method for B1(+)-biased T1 mapping sequence was additionally proposed and validated on phantom. As a result, relaxometry and diffusion parameters derived from high-resolution quantitative MRI acquizitions were reported at 7T for the first time. Obtained images, with unmatched resolutions compared to lower field investigations, provided exquisite anatomical details and clear delineation of the spinal cord substructures within an acquisition time of 30min, compatible with clinical investigations. Regional statistically significant differences were highlighted between WM and GM based on T1 and T2* maps (p<10(-3)), as well as between sensory and motor tracts based on diffusion tensor imaging maps (p<0.05). The proposed protocol demonstrates that ultra-high field spinal cord high-resolution quantitative MRI is feasible and lays the groundwork for future clinical investigations of degenerative spinal cord pathologies.

  10. Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

    Science.gov (United States)

    Matsuda, Yasufumi; Kubo, Tatsuhiko; Fujino, Yoshihisa; Matsuda, Shinya; Wada, Futoshi; Sugita, Atsuko

    2016-01-01

    Background Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression. Methods Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state. Results There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09–4.38) and artificial respiration (OR 2.28; 95% CI, 1.32–3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44–0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state. Conclusions These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression. PMID:26567604

  11. Evaluation of Melatonin for Prevention of Radiation Myelopathy in Irradiated Cervical Spinal Cord

    Directory of Open Access Journals (Sweden)

    Alireza Shirazi

    2009-01-01

    Full Text Available Objective: Radiation myelopathy (RM is known as a serious complication of head andneck radiation therapy. Furthermore, the radioprotective roles of melatonin have beeninvestigated on different tissues. The aim of this study was to assess the radio protectiveeffects of melatonin on biochemical, histopathological and clinical manifestations of RMin the rat cervical spinal cord.Materials and Methods: Four groups of rats were investigated as follows: The controlgroup was treated with vehicle. The second group (melatonin only was intraperitoneallyinjected with 100 mg/kg melatonin. The third group's (radiation cervical spinal cord areawas irradiated with 22 Gy cobalt-60 gamma-rays. The fourth group (melatonin plus irradiationreceived 100 mg/kg melatonin intraperitoneally, and after 30 minutes their spinalcord area was irradiated with 22 Gy gamma radiation. Five animals from each group wererandomly selected. 72 hours, 8 and 22 weeks after irradiation for analysis of malondialdehyde(MDA and glutathione (GSH levels, and underwent histopathological studies.Results: The MDA levels in the irradiation group were significantly higher than in the controlgroup (p<0.001. Furthermore, the GSH levels in this group were significantly lowerthan that of those in the control group (p<0.001. Administration of melatonin markedlyreduced MDA (p<0.001 and increased GSH (p<0.05 levels in this group. Demyelinationand clinical signs of myelopathy were decreased in the melatonin plus irradiation group incomparison to the irradiated group.Conclusion: Our study confirms the radioprotective effects of melatonin at early stagesof biochemical, as well as late histological and clinical changes in the spinal cord.

  12. Changes in Strenght, Sensation, and Prehension in Acute Cervical Spinal Cord Injury: European Multicenter Responsiveness Study of the GRASSP

    NARCIS (Netherlands)

    Velstra, I.; Curt, A.; Frotzler, A.; Abel, R.; Kalsi-Ryan, S.; Rietman, J.S.; Bolliger, M.

    2015-01-01

    Objective: To investigate the internal and external responsiveness and recovery profiles of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) instrument in revealing changes in upper limb function within the first year following cervical spinal cord injury (SCI). Met

  13. Cervical dorsal rhizotomy increases brain-derived neurotrophic factor and neurotrophin-3 expression in the ventral spinal cord.

    Science.gov (United States)

    Johnson, R A; Okragly, A J; Haak-Frendscho, M; Mitchell, G S

    2000-05-15

    Although neurotrophic factors have been implicated in several forms of neuroplasticity, little is known concerning their potential role in spinal plasticity. Cervical dorsal rhizotomy (CDR) enhances serotonin terminal density near (spinal) phrenic motoneurons and serotonin-dependent long-term facilitation of phrenic motor output (Kinkead et al., 1998). We tested the hypothesis that selected neurotrophic factors change in a manner consistent with an involvement in this model of spinal plasticity. Brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), glial cell line-derived neurotrophic factor (GDNF), and transforming growth factor-beta(1) (TGF-beta(1)) concentrations were measured (ELISA) in three regions of interest to respiratory control: (1) ventral cervical spinal segments associated with the phrenic motor nucleus (C3-C6), (2) ventral thoracic spinal segments associated with inspiratory intercostal motor output (T3-T6) and (3) the diaphragm. Tissues were harvested from rats 7 d after bilateral CDR and compared with sham-operated and unoperated control rats. CDR increased BDNF (110%; p = 0.002) and NT-3 (100%; p = 0.002) in the cervical and NT-3 in the thoracic spinal cord (98%; p = 0.009). GDNF and TGF-beta(1) were not altered by CDR in any tissue. Immunohistochemistry localized BDNF and NT-3 to motoneurons and interneurons of the ventral spinal cord. These studies provide novel, suggestive evidence that BDNF and NT-3, possibly through their trophic effects on serotonergic neurons and/or motoneurons, may underlie serotonin-dependent plasticity in (spinal) respiratory motor control after CDR.

  14. Multimodal decoding and congruent sensory information enhance reaching performance in subjects with cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Elaine Anna Corbett

    2014-05-01

    Full Text Available Cervical spinal cord injury (SCI paralyzes muscles of the hand and arm, making it difficult to perform activities of daily living. Restoring the ability to reach can dramatically improve quality of life for people with cervical SCI. Any reaching system requires a user interface to decode parameters of an intended reach, such as trajectory and target. A challenge in developing such decoders is that often few physiological signals related to the intended reach remain under voluntary control, especially in patients with high cervical injuries. Furthermore, the decoding problem changes when the user is controlling the motion of their limb, as opposed to an external device. The purpose of this study was to investigate the benefits of combining disparate signal sources to control reach in people with a range of impairments, and to consider the effect of two feedback approaches. Subjects with cervical SCI performed robot-assisted reaching, controlling trajectories with either shoulder electromyograms (EMGs or EMGs combined with gaze. We then evaluated how reaching performance was influenced by task-related sensory feedback, testing the EMG-only decoder in two conditions. The first involved moving the arm with the robot, providing congruent sensory feedback through their remaining sense of proprioception. In the second, the subjects moved the robot without the arm attached, as in applications that control external devices. We found that the multimodal decoding algorithm worked well for all subjects, enabling them to perform straight, accurate reaches. The inclusion of gaze information, used to estimate target location, was especially important for the most impaired subjects. In the absence of gaze information, congruent sensory feedback improved performance. These results highlight the importance of proprioceptive feedback, and suggest that multi-modal decoders are likely to be most beneficial for highly impaired subjects and in tasks where such

  15. Cervical Spine Injuries: A Whole-Body Musculoskeletal Model for the Analysis of Spinal Loading

    Science.gov (United States)

    Holsgrove, Timothy P.; Preatoni, Ezio; Gill, Harinderjit S.; Trewartha, Grant

    2017-01-01

    Cervical spine trauma from sport or traffic collisions can have devastating consequences for individuals and a high societal cost. The precise mechanisms of such injuries are still unknown as investigation is hampered by the difficulty in experimentally replicating the conditions under which these injuries occur. We harness the benefits of computer simulation to report on the creation and validation of i) a generic musculoskeletal model (MASI) for the analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby activities. The musculoskeletal models were created in OpenSim, and validated against in vivo data of a healthy subject and a rugby player performing neck and upper limb movements. The novel aspects of the Rugby Model comprise i) population-specific inertial properties and muscle parameters representing rugby forward players, and ii) a custom scapula-clavicular joint that allows the application of multiple external loads. We confirm the utility of the developed generic and population-specific models via verification steps and validation of kinematics, joint moments and neuromuscular activations during rugby scrummaging and neck functional movements, which achieve results comparable with in vivo and in vitro data. The Rugby Model was validated and used for the first time to provide insight into anatomical loading and cervical spine injury mechanisms related to rugby, whilst the MASI introduces a new computational tool to allow investigation of spinal injuries arising from other sporting activities, transport, and ergonomic applications. The models used in this study are freely available at simtk.org and allow to integrate in silico analyses with experimental approaches in injury prevention. PMID:28052130

  16. MRI morphometric characterisation of the paediatric cervical spine and spinal cord in children with MPS IVA (Morquio-Brailsford syndrome).

    Science.gov (United States)

    Solanki, Guirish A; Lo, William B; Hendriksz, Christian J

    2013-03-01

    Nearly all children with MPS IVA develop skeletal deformities affecting the spine. At the atlanto-axial spine, odontoid hypoplasia occurs. GAG deposition around the dens, leads to peri-odontoid infiltration. Transverse/alar ligament incompetence causes instability. Atlanto-axial instability is associated with cord compression and myelopathy, leading to major morbidity and mortality. Intervention is often required. Does the presence of widened bullet shaped vertebra in platyspondily encroach on the spinal canal and cause spinal stenosis in MPS IVA? So far, there have been no standardised morphometric measurements of the paediatric MPS IVA cervical spine to evaluate whether there is pre-existing spinal stenosis predisposing to compressive myelopathy or whether this is purely an acquired process secondary to instability and compression. This study provides the first radiological quantitative analysis of the cervical spine and spinal cord in a series of affected children. MRI morphometry indicates that the MPS IVA spine is narrower at C1-2 level giving an inverted funnel shape. There is no evidence of a reduction in the Torg ratio (canal-body ratio) in the cervical spine. The spinal canal does not exceed 11 mm at any level, significantly smaller than normal historical cohorts (14 mm). The sagittal diameter and axial surface area of both spinal canal and cord are reduced. C1-2 level cord compression was evident in the canal-cord ratio but the Torg ratio was not predictive of cord compression. In MPS IVA the reduction in the space available for the cord (SAC) is multifactorial rather than due to congenital spinal stenosis.

  17. Radiographic study on temporomandibular joint Arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University , Seoul (Korea, Republic of)

    1980-11-15

    The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological changes of condylar head, articular eminence, and articular fossa were analyzed and discussed from radiographic view point. The positional change of condylar head and articular fossa relation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthritic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 105 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrome and osteoarthrosis of TMJ.

  18. Functional electrical stimulation therapy improves grasping in chronic cervical spinal cord injury: Two case studies

    Directory of Open Access Journals (Sweden)

    Miller Rosalynn C.

    2008-01-01

    Full Text Available OBJECTIVE AND IMPORTANCE: To present case studies of two individuals with chronic cervical spinal cord injury (SCI who participated in functional electrical stimulation (FES therapy with the objective to restore voluntary grasp function. CLINICAL PRESENTATION: Both individuals (right hand dominant males, age 24 and 31 had a sustained a cervical SCI (C6 and C4-5, respectively at least 8 years prior to participation in this study. INTERVENTION: Both individuals participated in an individualized FES therapy program for 6 weeks. FES therapy was administered through a regimen of three, one-hour sessions, per week for three months. A single arm of each participant (n = 2 was treated. FES therapy is an integrative intervention strategy combining muscle strengthening, functional movement training and stretching. The participant's hand movement abilities were assessed pre and post FES therapy using the Manual Muscle Test (MMT, a modified Sollerman Hand Function Test (mSHFT, and the Reach, Grasp, Transport and Release Task (RGTR. DISCUSSION: As the injuries of participants in the current study were chronic and thus neurologically stable, no spontaneous improvements/recovery in hand function was expected. However, FES as part of an integrated therapeutic approach affected restoration and improvement of hand function in both participants. CONCLUSION: The concurrent improvement in strength, integrated motor function and object contact following FES therapy, demonstrated that there is potential for affecting change in hand function of individuals with chronic SCI.

  19. Epicritic sensation in cervical spinal cord injury: diagnostic gains beyond testing light touch.

    Science.gov (United States)

    Velstra, Inge-Marie; Bolliger, Marc; Baumberger, Michael; Rietman, Johan Swanik; Curt, Armin

    2013-08-01

    Abstract Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pathway conveys several large diameter afferent modalities (e.g., sensation of touch, two-point discrimination, and proprioception). Therefore, the objective of this study was to compare the epicritic sensation assessed by LT, Semmes-Weinstein monofilament (SWM), and electrical perception threshold (EPT) across cervical dermatomes (C3-C8) in individuals with cervical SCI. A multicenter cross-sectional study was performed at 6 months after cervical SCI, applying combined measures of LT, SWM, and EPT, bilaterally over predefined key sensory points (C3-C8). A total of 300 left- and right-sided dermatomes were tested for each outcome measure in 25 participants. The percentage agreement between classifications according to LT and SWM/EPT testing for all dermatomes between C3 and C8 ranged from 95.5% to 36.2%. The degree of agreement showed considerably variable κ coefficients (-0.1≥kw≤0.7) for each dermatome between C3 and C8. The additional measurements of epicritic sensation by SWM and EPT increased sensitivity by detecting and quantifying differences in sensory thresholds above, at, and below the LT level of injury. This is relevant for early clinical trials (phase 1/2), in which disclosing any biological activity of an intervention may be revealed by subtle sensory changes that might gain a clinical relevance.

  20. Characterization of DTI Indices in the Cervical, Thoracic, and Lumbar Spinal Cord in Healthy Humans

    Directory of Open Access Journals (Sweden)

    Rachael L. Bosma

    2012-01-01

    Full Text Available The aim of this study was to characterize in vivo measurements of diffusion along the length of the entire healthy spinal cord and to compare DTI indices, including fractional anisotropy (FA and mean diffusivity (MD, between cord regions. The objective is to determine whether or not there are significant differences in DTI indices along the cord that must be considered for future applications of characterizing the effects of injury or disease. A cardiac gated, single-shot EPI sequence was used to acquire diffusion-weighted images of the cervical, thoracic, and lumbar regions of the spinal cord in nine neurologically intact subjects (19 to 22 years. For each cord section, FA versus MD values were plotted, and a k-means clustering method was applied to partition the data according to tissue properties. FA and MD values from both white matter (average FA=0.69, average MD=0.93 × 10−3 mm2/s and grey matter (average FA=0.44, average MD=1.8 × 10−3 mm2/s were relatively consistent along the length of the cord.

  1. Forced exercise as a rehabilitation strategy after unilateral cervical spinal cord contusion injury.

    Science.gov (United States)

    Sandrow-Feinberg, Harra R; Izzi, Jessica; Shumsky, Jed S; Zhukareva, Victoria; Houle, John D

    2009-05-01

    Evaluation of locomotor training after spinal cord injury (SCI) has primarily focused on hind limb recovery, with evidence of functional and molecular changes in response to exercise. Since trauma at a cervical (C) level is common in human SCI, we used a unilateral C4 contusion injury model in rats to determine whether forced exercise (Ex) would affect spinal cord biochemistry, anatomy, and recovery of fore and hind limb function. SCI was created with the Infinite Horizon spinal cord impactor device at C4 with a force of 200 Kdyne and a mean displacement of 1600-1800 microm in adult female Sprague-Dawley rats that had been acclimated to a motorized exercise wheel apparatus. Five days post-operatively, the treated group began Ex on the wheel for 20 min per day, 5 days per week for 8 weeks. Wheel speed was increased daily according to the abilities of each animal up to 14 m/min. Control rats were handled daily but were not exposed to Ex. In one set of animals experiencing 5 days of Ex, there was a moderate increase in brain-derived neurotrophic factor (BDNF) and heat shock protein-27 (HSP-27) levels in the lesion epicenter and surrounding tissue. Long-term (8 weeks) survival groups were exposed to weekly behavioral tests to assess qualitative aspects of fore limb and hind limb locomotion (fore limb scale, FLS and BBB [Basso, Beattie, and Bresnahan locomotor rating scale]), as well as sensorimotor (grid) and motor (grip) skills. Biweekly assessment of performance during wheel walking examined gross and fine motor skills. The FLS indicated a significant benefit of Ex during weeks 2-4. The BBB test showed no change with Ex at the end of the 8-week period, however hind limb grid performance was improved during weeks 2-4. Lesion size was not affected by Ex, but the presence of phagocytic and reactive glial cells was reduced with Ex as an intervention. These results suggest that Ex alone can influence the evolution of the injury and transiently improve fore and hind limb

  2. Distribution of collateral fibers in the monkey cervical spinal cord detected with diffusion-weighted magnetic resonance imaging

    DEFF Research Database (Denmark)

    Lundell, Henrik; Nielsen, Jens Bo; Ptito, Maurice

    2011-01-01

    Diffusion anisotropy monitored with diffusion-weighted magnetic resonance imaging (DWMRI) is a sensitive marker to monitor developmental or pathological microstructural changes in spinal cord. The white matter is often treated as a unidirectional axonal bundle but collateral fibers branching off...... techniques. We calculate the diffusion tensor and the persistent angular structure (PAS), a multi-fiber reconstruction technique, from high quality post mortem data of a perfusion-fixed vervet monkey cervical spinal cord sample and simulated crossing fiber data. Our results show that (i) cylindrical geometry...

  3. Five-level noncontiguous spinal injuries of cervical region:report of a case and literature review

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-gang; MA Xin-long; LI Feng-tan; FENG Shi-qing

    2012-01-01

    The incidence of multiple noncontiguous spinal injuries (MNSI) in the cervical spine is rare but has catastrophic consequences.The patient in this report was a 34-year-old woman with five-level cervical MNSI.CT and MRI showed that injuries included atlantoaxial instability,burst fracture of C6,dislocation of G6/7,rupture of the intervertebal disc or ligamentous complex,and irreversible cord damage.The mechanism for this case was a combined pattern of hyperflexion,compression,and hyperextension injuries.A review of the literature revealed that this case is the first report in the literature of a vehicle related accident causing five-level noncontiguous injuries of the cervical spine.

  4. One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    WANG Chang-sheng; LIU Mou-jun; LIN Jian-hua; XU Wei-hong; LUO Hong-bin

    2011-01-01

    Objectives: To explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.Methods: From March 2004 to September 2009, 16cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10to 16 one year postoperatively, 13.95±2.06 on average (improvement rate= 70.10% ). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants' position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal

  5. Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index.

    Science.gov (United States)

    Rodine, Robert J; Vernon, Howard

    2012-03-01

    Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

  6. Identifying Homogeneous Subgroups in Neurological Disorders: Unbiased Recursive Partitioning in Cervical Complete Spinal Cord Injury.

    Science.gov (United States)

    Tanadini, Lorenzo G; Steeves, John D; Hothorn, Torsten; Abel, Rainer; Maier, Doris; Schubert, Martin; Weidner, Norbert; Rupp, Rüdiger; Curt, Armin

    2014-07-01

    Background The reliable stratification of homogeneous subgroups and the prediction of future clinical outcomes within heterogeneous neurological disorders is a particularly challenging task. Nonetheless, it is essential for the implementation of targeted care and effective therapeutic interventions. Objective This study was designed to assess the value of a recently developed regression tool from the family of unbiased recursive partitioning methods in comparison to established statistical approaches (eg, linear and logistic regression) for predicting clinical endpoints and for prospective patients' stratification for clinical trials. Methods A retrospective, longitudinal analysis of prospectively collected neurological data from the European Multicenter study about Spinal Cord Injury (EMSCI) network was undertaken on C4-C6 cervical sensorimotor complete subjects. Predictors were based on a broad set of early (homogeneous subgroups. The partitioning is carried out in a data-driven manner, independently from a priori decisions or predefined thresholds. Conclusion Unbiased recursive partitioning techniques may improve prediction of future clinical endpoints and the planning of future SCI clinical trials by providing easily implementable, data-driven rationales for early patient stratification based on simple decision rules and clinical read-outs.

  7. Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Sébastien eMateo

    2015-09-01

    Full Text Available Individuals with cervical spinal cord injury (SCI that causes tetraplegia are challenged with dramatic sensorimotor deficits. However, certain rehabilitation techniques may significantly enhance their autonomy by restoring reach-to-grasp movements. Among others, evidence of motor imagery (MI benefits for neurological rehabilitation of upper limb movements is growing. This literature review addresses motor imagery (MI effectiveness during reach-to-grasp rehabilitation after tetraplegia. Among articles from MEDLINE published between 1966 and 2015, we selected ten studies including 34 participants with C4 to C7 tetraplegia and 22 healthy controls published during the last fifteen years. We found that MI of possible non-paralyzed movements improved reach-to-grasp performance by i increasing both tenodesis grasp capabilities and muscle strength, ii decreasing movement time, and trajectory variability, and, iii reducing the abnormally increased brain activity. MI can also strengthen motor commands by potentiating recruitment and synchronization of motoneurons, which leads to improved recovery. These improvements reflect brain adaptations induced by MI. Furthermore, MI can be used to control brain computer interfaces (BCI that successfully restore grasp capabilities. These results highlight the growing interest for MI and its potential to recover functional grasping in individuals with tetraplegia, and motivate the need for further studies to substantiate it.

  8. Accuracy of diffusion tensor imaging for diagnosing cervical spondylotic myelopathy in patients showing spinal cord compression

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Bo; Chung Tae Sub; Kim, Sung Jun; Yoo, Yeon Hwa; Yoon, Choon Sik; Park, Jung Hyun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Han [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Jeong, Eun Kee [Dept. of Radiology, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake (United States); Kim, In Seong [Siemens Healthcare, Seoul (Korea, Republic of)

    2015-12-15

    To assess the performance of diffusion tensor imaging (DTI) for the diagnosis of cervical spondylotic myelopathy (CSM) in patients with deformed spinal cord but otherwise unremarkable conventional magnetic resonance imaging (MRI) findings. A total of 33 patients who underwent MRI of the cervical spine including DTI using two-dimensional single-shot interleaved multi-section inner volume diffusion-weighted echo-planar imaging and whose spinal cords were deformed but showed no signal changes on conventional MRI were the subjects of this study. Mean diffusivity (MD), longitudinal diffusivity (LD), radial diffusivity (RD), and fractional anisotropy (FA) were measured at the most stenotic level. The calculated performance of MD, FA, MD∩FA (considered positive when both the MD and FA results were positive), LD∩FA (considered positive when both the LD and FA results were positive), and RD∩FA (considered positive when both the RD and FA results were positive) in diagnosing CSM were compared with each other based on the estimated cut-off values of MD, LD, RD, and FA from receiver operating characteristic curve analysis with the clinical diagnosis of CSM from medical records as the reference standard. The MD, LD, and RD cut-off values were 1.079 × 10'-{sup 3}, 1.719 × 10{sup -3}, and 0.749 × 10{sup -3} mm{sup 2}/sec, respectively, and that of FA was 0.475. Sensitivity, specificity, positive predictive value and negative predictive value were: 100 (4/4), 44.8 (13/29), 20 (4/20), and 100 (13/13) for MD; 100 (4/4), 27.6 (8/29), 16 (4/25), and 100 (8/8) for FA; 100 (4/4), 58.6 (17/29), 25 (4/16), and 100 (17/17) for MD∩FA; 100 (4/4), 68.9 (20/29), 30.8 (4/13), and 100 (20/20) for LD∩FA; and 75 (3/4), 68.9 (20/29), 25 (3/12), and 95.2 (20/21) for RD∩FA in percentage value. Diagnostic performance comparisons revealed significant differences only in specificity between FA and MD∩FA (p = 0.003), FA and LD∩FA (p < 0.001), FA and RD∩FA (p < 0.001), MD and LD

  9. The effects of cervical transcutaneous spinal direct current stimulation on motor pathways supplying the upper limb in humans.

    Science.gov (United States)

    Dongés, Siobhan C; D'Amico, Jessica M; Butler, Jane E; Taylor, Janet L

    2017-01-01

    Non-invasive, weak direct current stimulation can induce changes in excitability of underlying neural tissue. Many studies have used transcranial direct current stimulation to induce changes in the brain, however more recently a number of studies have used transcutaneous spinal direct current stimulation to induce changes in the spinal cord. This study further characterises the effects following cervical transcutaneous spinal direct current stimulation on motor pathways supplying the upper limb. In Study 1, on two separate days, participants (n = 12, 5 F) received 20 minutes of either real or sham direct current stimulation at 3 mA through electrodes placed in an anterior-posterior configuration over the neck (anode anterior). Biceps brachii, flexor carpi radialis and first dorsal interosseous responses to transcranial magnetic stimulation (motor evoked potentials) and cervicomedullary stimulation (cervicomedullary motor evoked potentials) were measured before and after real or sham stimulation. In Study 2, on two separate days, participants (n = 12, 7 F) received either real or sham direct current stimulation in the same way as for Study 1. Before and after real or sham stimulation, median nerve stimulation elicited M waves and H reflexes in the flexor carpi radialis. H-reflex recruitment curves and homosynaptic depression of the H reflex were assessed. Results show that the effects of real and sham direct current stimulation did not differ for motor evoked potentials or cervicomedullary motor evoked potentials for any muscle, nor for H-reflex recruitment curve parameters or homosynaptic depression. Cervical transcutaneous spinal direct current stimulation with the parameters described here does not modify motor responses to corticospinal stimulation nor does it modify H reflexes of the upper limb. These results are important for the emerging field of transcutaneous spinal direct current stimulation.

  10. The possible meaning of fractional anisotropy measurement of the cervical spinal cord in correct diagnosis of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Budrewicz, Slawomir; Szewczyk, Pawel; Bladowska, Joanna; Podemski, Ryszard; Koziorowska-Gawron, Ewa; Ejma, Maria; Słotwiński, Krzysztof; Koszewicz, Magdalena

    2016-03-01

    Diagnosis of amyotrophic lateral sclerosis (ALS) is based on clinical criteria and electrophysiological tests (electromyography, and transcranial magnetic stimulation). In the search for ALS biomarkers, the role of imaging procedures is currently emphasized, especially modern MR techniques. MR procedures were performed on 15 ALS patients and a sex- and age-matched control group. The MR examinations were performed with a 1.5-T MR unit, and the protocol consisted of sagittal T1-weighed images, sagittal and axial T2-weighed images, and sagittal T2-weighed FAT SAT images followed by an axial diffusion tensor imaging (DTI) sequence of the cervical spinal cord. FA values in individual segments of the cervical spinal cord were decreased in the ALS group in comparison with the control group. After comparing FA values for anterior, posterior, and lateral corticospinal columns, the greatest difference was observed between the C2 and C5 segments. Spinal cord assessment with the use of FA measurements allows for confirmation of the motor pathways lesion in ALS patients. The method, together with clinical criteria, could be helpful in ALS diagnosis, assessment of clinical course, or even the effects of new drugs. The results also confirmed the theory of the generalized character of ALS.

  11. Mechanism of Forelimb Motor Function Restoration after Cervical Spinal Cord Hemisection in Rats: A Comparison of Juveniles and Adults

    Directory of Open Access Journals (Sweden)

    Atsushi Hasegawa

    2016-01-01

    Full Text Available The aim of this study was to investigate forelimb motor function after cervical spinal cord injury in juvenile and adult rats. Both rats received a left segmental hemisection of the spinal cord after C3-C4 laminectomy. Behavioral evaluation of motor function was monitored and assessed using the New Rating Scale (NRS and Forelimb Locomotor Scale (FLS and by measuring the range of motion (ROM of both the elbow and wrist. Complete left forelimb motor paralysis was observed in both rats. The NRS showed motor function recovery restored to 50.2±24.7% in juvenile rats and 34.0±19.8% in adult rats. FLS was 60.4±26.8% in juvenile rats and 46.5±26.9% in adult rats. ROM of the elbow and wrist were 88.9±20.6% and 44.4±24.1% in juvenile rats and 70.0±29.2% and 40.0±21.1% in adult rats. Thus, the NRS and ROM of the elbow showed a significant difference between age groups. These results indicate that left hemisection of the cervical spinal cord was not related to right-sided motor functions. Moreover, while motor paralysis of the left forelimb gradually recovered in both groups, the improvement was greater in juvenile rats.

  12. [Combined spinal and epidural anesthesia for cesarean delivery in a patient with a cervical fracture at C2].

    Science.gov (United States)

    Mochidome, Mariko; Sakamoto, Akiyuki; Tanaka, Hidenori; Sugiyama, Daisuke; Kawamata, Mikito

    2013-04-01

    There are only a few reports on cesarean section in a patient with cervical fracture without spinal cord injury (SCI). Such patients have high risks for deterioration of SCI following general or regional anesthesia. Here, we present a patient with a fracture of C2 vertebra who underwent cesarean section safely under combined spinal and epidural anesthesia(CSEA). A 30-year-old woman had a fracture of the C2 cervical vertebra (Hangman's fracture) due to a traffic accident at 34 weeks of gestation. Conservative immobilization of the head and neck was done with a neck collar (Philadelphia brace) in order to prevent subsequent SCI after the spine injury. Pre-viability amniorrhexis was seen at 37 weeks' gestation, and an emergency cesarean section was scheduled under combined epidural and spinal anesthesia (CSEA). Her neck and head were carefully fixed before, during and after surgery in order to prevent subsequent SCI. As a result, cesarean section under CSEA was successfully performed in the patient without any deterioration of the spine and/or SCI.

  13. Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, W.G. Jr.; Waluch, V.; Yadley, R.A.; Wycoff, R.R.

    1984-09-01

    Magnetic resonance imaging (MR) (0.35T) and computed tomography (CT) were compared in 400 consecutive patients with suspected disease of the brain and cervical spinal cord. Of 325 positive diagnoses, MR detected abnormality while CT was normal in 93; MR was more specific in 68; MR and CT gave equivalent information in 129; CT was more specific in 32; and CT was positive while MR was normal in 3. MR was superior to CT in detection of multiple sclerosis, subcortical arteriosclerotic encephalopathy, posterior fossa infarcts and tumors, small extra-axial fluid collections, and cervical syringomyelia. CT was preferable in evaluation of meningiomas and separation of tumor from edema. CT takes less time and may be preferable in patients with acute trauma as well as very young or elderly individuals. Thus the two studies should be considered complementary.

  14. Early Versus Late Tracheostomy for Patients with High and Low Cervical Spinal Cord Injuries

    Science.gov (United States)

    Guirgis, Akram H.; Menon, Venugopal K.; Suri, Neelam; Chatterjee, Nilay; Attallah, Emil; Saad, Maged Y.; Elshaer, Shereen

    2016-01-01

    Objectives This study aimed to evaluate the effects of early versus late tracheostomies among patients with cervical spinal cord injuries (CSCIs). Methods This retrospective study included 69 adult CSCI patients who underwent bedside percutaneous tracheostomies at the Intensive Care Unit of Khoula Hospital, Muscat, Oman, between January 2011 and October 2015. The tracheostomy was considered early if the procedure took place within one week of the CSCI. The impact of an early tracheostomy on patient outcomes was analysed in terms of duration of mechanical ventilation and intensive care unit (ICU) stay among patients with high (C1–C2 vertebrae) and low (C3–C7 vertebrae) CSCIs. Ventilator dependence, bradycardia episodes and surgical intervention outcomes were also examined. Results Patients with a high CSCI who underwent an early tracheostomy spent significantly fewer days on mechanical ventilation compared to those who underwent a late tracheostomy (9.3 ± 7.2 days versus 13.7 ± 3.2 days; P = 0.041). Low CSCI patients who received an early tracheostomy also experienced significantly fewer days on mechanical ventilation compared to those undergoing a late tracheostomy (12.1 ± 10.4 days versus 25.2 ± 17.7 days; P = 0.035). Moreover, ICU mortality was significantly lower for high CSCI patients who underwent an early tracheostomy (P = 0.015). However, there was no association between length of ICU stay and either type of CSCI or timing of the tracheostomy procedure. Conclusion An early tracheostomy is beneficial in reducing the duration of mechanical ventilation among patients with CSCIs, irrespective of the level of injury. PMID:28003892

  15. Early Versus Late Tracheostomy for Patients with High and Low Cervical Spinal Cord Injuries

    Directory of Open Access Journals (Sweden)

    Akram H. Guirgis

    2016-11-01

    Full Text Available Objectives: This study aimed to evaluate the effects of early versus late tracheostomies among patients with cervical spinal cord injuries (CSCIs. Methods: This retrospective study included 69 adult CSCI patients who underwent bedside percutaneous tracheostomies at the Intensive Care Unit of Khoula Hospital, Muscat, Oman, between January 2011 and October 2015. The tracheostomy was considered early if the procedure took place within one week of the CSCI. The impact of an early tracheostomy on patient outcomes was analysed in terms of duration of mechanical ventilation and intensive care unit (ICU stay among patients with high (C1–C2 vertebrae and low (C3–C7 vertebrae CSCIs. Ventilator dependence, bradycardia episodes and surgical intervention outcomes were also examined. Results: Patients with a high CSCI who underwent an early tracheostomy spent significantly fewer days on mechanical ventilation compared to those who underwent a late tracheostomy (9.3 ± 7.2 days versus 13.7 ± 3.2 days; P = 0.041. Low CSCI patients who received an early tracheostomy also experienced significantly fewer days on mechanical ventilation compared to those undergoing a late tracheostomy (12.1 ± 10.4 days versus 25.2 ± 17.7 days; P = 0.035. Moreover, ICU mortality was significantly lower for high CSCI patients who underwent an early tracheostomy (P = 0.015. However, there was no association between length of ICU stay and either type of CSCI or timing of the tracheostomy procedure. Conclusion: An early tracheostomy is beneficial in reducing the duration of mechanical ventilation among patients with CSCIs, irrespective of the level of injury.

  16. The cervical spinal cord in neuromyelitis optica patients: A comparative study with multiple sclerosis using diffusion tensor imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pessôa, Fernanda Miraldi Clemente, E-mail: fernandamiraldi@hotmail.com [Federal University of Rio de Janeiro, Medical Student, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Lopes, Fernanda Cristina Rueda, E-mail: frueda81@hotmail.com [Department of Radiology, Federal University of Rio de Janeiro, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); Costa, João Victor Altamiro, E-mail: victoraltamiro@gmail.com [Department of Radiology, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Leon, Soniza Vieira Alves, E-mail: sonizavleon@globo.com [Department of Neurology, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Domingues, Romeu Côrtes, E-mail: romeu@CDPi.com.br [CDPI – Clínica de Diagnóstico Por Imagem, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); Gasparetto, Emerson Leandro, E-mail: egasparetto@gmail.com [Department of Radiology, Federal University of Rio de Janeiro, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); CDPI – Clínica de Diagnóstico Por Imagem, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil)

    2012-10-15

    Introduction: This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord in patients with neuromyelitis optica (NMO), using diffusion tensor MR imaging, comparing to controls and patients with multiple sclerosis (MS). Materials and methods: We studied 8 patients with NMO and 17 without any neurologic disorder. Also, 32 MS patients were selected. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results: At C2, the FA value was decreased in NMO patients compared to MS and controls in the anterior column. Also in this column, RD value showed increase in NMO compared to MS and to controls. The FA value of the posterior column was decreased in NMO in comparison to controls. At C7, AD value was higher in NMO than in MS in the right column. At the same column, MD values were increased in NMO compared to MS and to controls. Conclusions: There is extensive NASC damage in NMO patients, including peripheral areas of the cervical spinal cord, affecting the white matter, mainly caused by demyelination. This suggests a new spinal cord lesion pattern in NMO in comparison to MS.

  17. Trauma related changes in cervical spine and spinal cord in myelography and MRI; Zmiany pourazowe kregoslupa i rdzenia w odcinku szyjnym, w mielografii i w obrazie NMR

    Energy Technology Data Exchange (ETDEWEB)

    Wozniak, E.; Bronarski, J.; Kiwerski, J.; Krasuski, M. [Akademia Medyczna, Warsaw (Poland)]|[Stoleczny Zespol Rehabilitacji, Konstancin (Poland)

    1993-12-31

    Myelographic and MRI results in 14 patients treated in 1992 because of cervical spine injury with neurological complications have been presented. Myelography proves to be useful in posttraumatic spine diagnostics but in some cases does not render sufficient information, especially if the trauma superimposes previously existing pathological changes. MRI is exceptionally valuable diagnostic modality in cervical spine injuries offering an advantage of both early and late evaluation of the post-traumatic spinal cord changes. (author). 12 refs, 6 figs, 2 tabs.

  18. A rare cause of spinal cord compression: imaging appearances of gout of the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Dharmadhikari, R.; Hide, I.G. [Freeman Hospital, Department of Radiology, High Heaton, Newcastle-upon-Tyne (United Kingdom); Dildey, P. [Freeman Hospital, Department of Pathology, High Heaton, Newcastle-upon-Tyne (United Kingdom)

    2006-12-15

    Gout is a metabolic disorder typically affecting the peripheral joints, more commonly in males. Spinal involvement is uncommon and is usually associated with hyperuricemia. We present the imaging findings of a case of spinal gout in a female patient with no previous history of hyperuricaemia, involving multiple spinal segments. (orig.)

  19. The characteristics of the mechanoreceptors of the hip with arthrosis

    Directory of Open Access Journals (Sweden)

    Moraes Miguel RB

    2011-11-01

    Full Text Available Abstract Mechanoreceptors have been extensively studied in different joints and distinct signals that convey proprioceptive information to the cortex. Several clinical reports have established a link between the number of mechanoreceptors and a deficient proprioceptive system; however, little or no literature suggest concentration of mechanoreceptors might be affected by hip arthrosis. The purpose of this study is first to determine the existence of mechanoreceptors and free nerve endings in the hip joint and to distinguish between their conditions: those with arthrosis and without arthrosis. Samples of 45 male hips were analyzed: 30 taken from patients with arthrosis that were submitted to total arthroplasty and 15 taken from male cadavers without arthrosis. The patients' ages ranged from 38 to75 years (average 56.5 and the cadavers' ages ranged from 21 to 50 years (average 35.5. The capsule, labrum, and femoral head ligament tissues were obtained during the arthroplasty procedure from 30 patients with arthrosis and from 15 male cadavers. The tissue was cut into fragments of around 3 mm. Each fragment was then immediately stained with gold chloride 1% solution and divided into sections of 6 μm thickness. The Mann-Whitney test was used for two groups and the ANOVA, Friedman and Kruskal-Wallis tests for more than two groups. Results show the mechanoreceptors (Pacini, Ruffini and Golgi corpuscles and free nerve endings are present in the capsule, femoral head ligament, and labrum of the hip joint. When all the densities of the nerve endings were examined with regard to those with arthrosis and those without arthrosis, the mechanoreceptors of cadavers without arthrosis were found to be more pronounced and an increase in free nerve endings could be observed (p = 0.0082. Further studies, especially electrophysiological studies, need to be carried out to clarify the functions of the mechanoreceptors in the joints.

  20. The characteristics of the mechanoreceptors of the hip with arthrosis.

    Science.gov (United States)

    Moraes, Miguel R B; Cavalcante, Maria L C; Leite, José A D; Macedo, José N; Sampaio, Marianna L B; Jamacaru, Vagnaldo F; Santana, Mariana G

    2011-11-16

    Mechanoreceptors have been extensively studied in different joints and distinct signals that convey proprioceptive information to the cortex. Several clinical reports have established a link between the number of mechanoreceptors and a deficient proprioceptive system; however, little or no literature suggest concentration of mechanoreceptors might be affected by hip arthrosis. The purpose of this study is first to determine the existence of mechanoreceptors and free nerve endings in the hip joint and to distinguish between their conditions: those with arthrosis and without arthrosis. Samples of 45 male hips were analyzed: 30 taken from patients with arthrosis that were submitted to total arthroplasty and 15 taken from male cadavers without arthrosis. The patients' ages ranged from 38 to75 years (average 56.5) and the cadavers' ages ranged from 21 to 50 years (average 35.5). The capsule, labrum, and femoral head ligament tissues were obtained during the arthroplasty procedure from 30 patients with arthrosis and from 15 male cadavers. The tissue was cut into fragments of around 3 mm. Each fragment was then immediately stained with gold chloride 1% solution and divided into sections of 6 μm thickness. The Mann-Whitney test was used for two groups and the ANOVA, Friedman and Kruskal-Wallis tests for more than two groups. Results show the mechanoreceptors (Pacini, Ruffini and Golgi corpuscles) and free nerve endings are present in the capsule, femoral head ligament, and labrum of the hip joint. When all the densities of the nerve endings were examined with regard to those with arthrosis and those without arthrosis, the mechanoreceptors of cadavers without arthrosis were found to be more pronounced and an increase in free nerve endings could be observed (p = 0.0082). Further studies, especially electrophysiological studies, need to be carried out to clarify the functions of the mechanoreceptors in the joints.

  1. Distribution of serotonin 2A and 2C receptor mRNA expression in the cervical ventral horn and phrenic motoneurons following spinal cord hemisection.

    Science.gov (United States)

    Basura, G J; Zhou, S Y; Walker, P D; Goshgarian, H G

    2001-06-01

    Cervical spinal cord injury leads to a disruption of bulbospinal innervation from medullary respiratory centers to phrenic motoneurons. Animal models utilizing cervical hemisection result in inhibition of ipsilateral phrenic nerve activity, leading to paralysis of the hemidiaphragm. We have previously demonstrated a role for serotonin (5-HT) as one potential modulator of respiratory recovery following cervical hemisection, a mechanism that likely occurs via 5-HT2A and/or 5-HT2C receptors. The present study was designed to specifically examine if 5-HT2A and/or 5-HT2C receptors are colocalized with phrenic motoneurons in both intact and spinal-hemisected rats. Adult female rats (250-350 g; n = 6 per group) received a left cervical (C2) hemisection and were injected with the fluorescent retrograde neuronal tracer Fluorogold into the left hemidiaphragm. Twenty-four hours later, animals were killed and spinal cords processed for in situ hybridization and immunohistochemistry. Using (35)S-labeled cRNA probes, cervical spinal cords were probed for 5-HT2A and 5-HT2C receptor mRNA expression and double-labeled using an antibody to Fluorogold to detect phrenic motoneurons. Expression of both 5-HT2A and 5-HT2C receptor mRNA was detected in motoneurons of the cervical ventral horn. Despite positive expression of both 5-HT2A and 5-HT2C receptor mRNA-hybridization signal over phrenic motoneurons, only 5-HT2A silver grains achieved a signal-to-noise ratio representative of colocalization. 5-HT2A mRNA levels in identified phrenic motoneurons were not significantly altered following cervical hemisection compared to sham-operated controls. Selective colocalization of 5-HT2A receptor mRNA with phrenic motoneurons may have implications for recently observed 5-HT2A receptor-mediated regulation of respiratory activity and/or recovery in both intact and injury-compromised states.

  2. Systemic bisperoxovanadium activates Akt/mTOR, reduces autophagy, and enhances recovery following cervical spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Chandler L Walker

    Full Text Available Secondary damage following primary spinal cord injury extends pathology beyond the site of initial trauma, and effective management is imperative for maximizing anatomical and functional recovery. Bisperoxovanadium compounds have proven neuroprotective effects in several central nervous system injury/disease models, however, no mechanism has been linked to such neuroprotection from bisperoxovanadium treatment following spinal trauma. The goal of this study was to assess acute bisperoxovanadium treatment effects on neuroprotection and functional recovery following cervical unilateral contusive spinal cord injury, and investigate a potential mechanism of the compound's action. Two experimental groups of rats were established to 1 assess twice-daily 7 day treatment of the compound, potassium bisperoxo (picolinato vanadium, on long-term recovery of skilled forelimb activity using a novel food manipulation test, and neuroprotection 6 weeks following injury and 2 elucidate an acute mechanistic link for the action of the drug post-injury. Immunofluorescence and Western blotting were performed to assess cellular signaling 1 day following SCI, and histochemistry and forelimb functional analysis were utilized to assess neuroprotection and recovery 6 weeks after injury. Bisperoxovanadium promoted significant neuroprotection through reduced motorneuron death, increased tissue sparing, and minimized cavity formation in rats. Enhanced forelimb functional ability during a treat-eating assessment was also observed. Additionally, bisperoxovanadium significantly enhanced downstream Akt and mammalian target of rapamycin signaling and reduced autophagic activity, suggesting inhibition of the phosphatase and tensin homologue deleted on chromosome ten as a potential mechanism of bisperoxovanadium action following traumatic spinal cord injury. Overall, this study demonstrates the efficacy of a clinically applicable pharmacological therapy for rapid initiation of

  3. Early arthrosis of the digital joints

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.

    1984-05-01

    Arthrosis of the digital joints begins predominantly on the volar joint surface and the volar-proximal margin of the head. Because of this localisation, and in order to obtain adequate contrast and definition, these early changes are best shown by means of low R.V. radiographs in three views. The early changes consist of the following local processes: intrachondral sclerosis, exomarginal and endomarginal subchondral sclerosis, discreet increase in the spongiosa; this leads to disrounding and hooklike form of the head; thickening or disappearance of the sub-marginal spongiosa and marginal defects. Artifacts produced by the projections or local bone variants must be recognised, as well as diffuse idiopathic skeletal hyperostosis. 21 figs.

  4. Pediatric Cervical Spine and Spinal Cord Injuries%小儿颈椎及颈脊髓损伤

    Institute of Scientific and Technical Information of China (English)

    戴力扬; 倪斌; 袁文; 贾连顺

    1999-01-01

    Objective This study is designed to provide the experience in diagnosis and treatment of cervical spine and spinal cord injuries in children.Methods Forty seven children with cervical spine and spinal cord injuries were retrospectively reviewed.There were 31 males and 16 females,with their age ranging 6 to 14 years(mean,11.6 years).Nineteen children had fresh injuries,whereas the remaining 28 sustained old iniuries.Of these patients,thirty one patients were identified with injuries of upper cervical spine.10 were with injuries of lower cervical spine,1 was with multiple noncontiguous injuries of cervical spine,and 3 were with spinal cord injuries without radiographic abnormalities.All these patients underwent nonoperative(27 cases)or operative(19 cases)treatment except one who refuse treatment.Results A follow-up for 1 to 12 years showed that 34 patients had complete or significant improvement,six had moderate improvement and 5 remained unchanged.Conclusions Imaging assessment is of great importance to diagnosis and treatment of cervical spine and spinal cord injuries in children.Most injuries do not require surgical intervention,but decompression and/or fusion should be indicated in those patients with unstable injuries that cannot he reduced and stablilized by conservative therapy or progressive neurological deficit.%目的 总结小儿颈椎及颈脊髓损伤的诊断治疗经验.方法 回顾分析47例小儿颈椎及颈脊髓损伤,男31例,女16例,年龄6~14岁,平均11.6岁.新鲜损伤19例,陈旧性损伤28例.其中上颈椎损伤33例,下颈椎损伤10例,多节段间隔性颈椎损伤1例,无X线异常的脊髓损伤3例.非手术治疗27例,手术治疗19例,未治1例.结果 早期死亡1例.45例获1~12年随访,恢复正常或接近正常者34例,明显改善者6例,5例无改善.结论 影像学检查对于小儿颈椎及颈脊髓损伤的诊断具有重要价值,小儿颈椎损伤多数不需手术治疗,不稳定性损伤非手术治疗无

  5. Age-related changes of the diffusion tensor imaging parameters of the normal cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Kun, E-mail: medsciwangkun@126.com [Orthopedics Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai (China); Song, Qingxin; Zhang, Fan; Chen, Zhi; Hou, Canglong; Tang, Yixing [Orthopedics Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai (China); Chen, Shiyue [Radiology Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai (China); Hao, Qiang, E-mail: haoqiang@189.cn [Radiology Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai (China); Shen, Hongxing, E-mail: shenhxgk@126.com [Orthopedics Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai (China)

    2014-12-15

    Highlights: • It is essential to determine the DTI parameters in the whole CSC. • To analyze DTI parameters in all intervertebral space levels of the CSC. • To study the impact of age on these parameters in healthy Chinese subjects. • Provide better insights in factors that could bias the diagnosis of CSC pathologies. - Abstract: Background: The diffusion tensor imaging (DTI) parameters of the cervical spinal cord (CSC) changes with age. However, previous studies only examined specific CSC areas. Objectives: To analyze the DTI parameters in all intervertebral space levels of the whole normal CSC and to study the impact of age on these parameters in a Chinese population. Methods: Thirty-six healthy subjects aged 20–77 years were recruited. DTI parameters were calculated for gray matter (GM) and white matter (WM) funiculi in all the CSC intervertebral spaces (C1/2-C6/7). Age-related changes of DTI parameters were analyzed for the GM and WM funiculi. Results: Fractional anisotropy (FA) and mean diffusivity (MD) were lower in GM than in WM. MD and FA values were lower in the WM in the lower CSC compared with the upper CSC (all P < 0.05), but no difference was observed in GM. In ventral funiculi, MD increased with age, while FA decreased (all P < 0.001). In lateral and dorsal funiculi, MD and FA decreased with age (all P < 0.001). In GM, MD and FA decreased with age (all P < 0.001). Significant age-related changes were observed in FA and MD from GM and WM funiculi. FA was correlated with age in all funiculi (ventral: r = −0.733; lateral: r = −0.468; dorsal: r = −0.607; GM: r = −0.724; all P < 0.01). Conclusion: Important changes in MD and FA were observed with advancing age at all levels of CSC in Chinese patients. DTI parameters may be useful to assess CSC pathology, but the influence of age and segments need to be taken into account in diagnosis.

  6. Theophylline-induced respiratory recovery following cervical spinal cord hemisection is augmented by serotonin 2 receptor stimulation.

    Science.gov (United States)

    Basura, Gregory J; Nantwi, Kwaku D; Goshgarian, Harry G

    2002-11-22

    Cervical spinal cord hemisection leads to a disruption of bulbospinal innervation of phrenic motoneurons resulting in paralysis of the ipsilateral hemidiaphragm. We have previously demonstrated separate therapeutic roles for theophylline, and more recently serotonin (5-HT) as modulators to phrenic nerve motor recovery; mechanisms that likely occur via adenosine A1 and 5-HT2 receptors, respectively. The present study was designed to specifically determine if concurrent stimulation of 5-HT2 receptors may enhance motor recovery induced by theophylline alone. Adult female rats (250-350 g; n=7 per group) received a left cervical (C2) hemisection that resulted in paralysis of the ipsilateral hemidiaphragm. Twenty-four hours later rats were given systemic theophylline (15 mg/kg, i.v.), resulting in burst recovery in the ipsilateral phrenic nerve. Theophylline-induced recovery was enhanced with the 5-HT2A/2C receptor agonist, (+/-)-2,5-dimethoxy-4-iodoamphetamine hydrochloride (DOI; 1.0 mg/kg). DOI-evoked augmentation of theophylline-induced recovery was attenuated following subsequent injection of the 5-HT2 receptor antagonist, ketanserin (2.0 mg/kg). In a separate group, rats were pretreated with ketanserin, which did not prevent subsequent theophylline-induced respiratory recovery. However, pretreatment with ketanserin did prevent DOI-induced augmentation of the theophylline-evoked phrenic nerve burst recovery. Lastly, using immunocytochemistry and in situ hybridization, we showed for the first time a positive co-localization of adenosine A1 receptor mRNA and immunoreactivity with phrenic motoneurons of the cervical ventral horns. Taken together, the results of the present study suggest that theophylline may induce motor recovery likely at adenosine A1 receptors located at the level of the spinal cord, and the concurrent stimulation of converging 5-HT2 receptors may augment the response.

  7. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Łukasz Wiktor

    2015-01-01

    Full Text Available The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of “halo-vest” traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department.

  8. Long-term viral brain-derived neurotrophic factor delivery promotes spasticity in rats with a cervical spinal cord hemisection

    Directory of Open Access Journals (Sweden)

    Karim eFouad

    2013-11-01

    Full Text Available We have recently reported that rats with spinal cord injury (SCI that received a combinatorial treatment, including viral BDNF delivery in the spinal cord, did not only show enhanced axonal regeneration, but also deterioration of hindlimb motor function. By demonstrating that BDNF over-expression can trigger spasticity-like symptoms in another rat model of spinal cord injury (SCI, we proposed a causal relationship between the observed spasticity-like symptoms (i.e., resistance to passive range of motion and the over-expression of BDNF. The current study was originally designed to evaluate a comparable combined treatment to rats with cervical SCI to improve motor recovery. Once again we found similar signs of spasticity, involving clenching of the paws and wrist flexion. Using electromyographic measurements changed the focus of the study and explored whether this spasticity like symptom is directly related to the over-expression of BDNF by administering a BDNF antagonist. In an acute experiment this treatment gradually diminished the resistance to overcome forelimb flexion. Thus, we conclude that neuro-excitatory effects of chronic BDNF delivery together with diminished descending control after SCI can result in adverse effects.

  9. Altered spinal kinematics and muscle recruitment pattern of the cervical and thoracic spine in people with chronic neck pain during functional task.

    Science.gov (United States)

    Tsang, Sharon M H; Szeto, Grace P Y; Lee, Raymond Y W

    2014-02-01

    Knowledge on the spinal kinematics and muscle activation of the cervical and thoracic spine during functional task would add to our understanding of the performance and interplay of these spinal regions during dynamic condition. The purpose of this study was to examine the influence of chronic neck pain on the three-dimensional kinematics and muscle recruitment pattern of the cervical and thoracic spine during an overhead reaching task involving a light weight transfer by the upper limb. Synchronized measurements of the three-dimensional spinal kinematics and electromyographic activities of cervical and thoracic spine were acquired in thirty individuals with chronic neck pain and thirty age- and gender-matched asymptomatic controls. Neck pain group showed a significantly decreased cervical velocity and acceleration while performing the task. They also displayed with a predominantly prolonged coactivation of cervical and thoracic muscles throughout the task cycle. The current findings highlighted the importance to examine differential kinematic variables of the spine which are associated with changes in the muscle recruitment in people with chronic neck pain. The results also provide an insight to the appropriate clinical intervention to promote the recovery of the functional disability commonly reported in patients with neck pain disorders.

  10. Hydrocephalus following bilateral dumbbell-shaped c2 spinal neurofibromas resection and postoperative cervical pseudomeningocele in a patient with neurofibromatosis type 1: a case report.

    Science.gov (United States)

    Montemurro, Nicola; Cocciaro, Ardico; Meola, Antonio; Lutzemberger, Ludovico; Vannozzi, Riccardo

    2014-10-01

    Study Design Case report. Objective To present a rare case of hydrocephalus following bilateral dumbbell-shaped C2 spinal neurofibromas resection and postoperative cervical pseudomeningocele in a patient with neurofibromatosis type 1 (NF1). Methods The patient's clinical course is retrospectively reviewed. A 37-year-old man affected by NF1 referred to our department for progressive weakness of both lower extremities and gait disturbance. Radiological imaging showed bilateral dumbbell-shaped C2 spinal neurofibromas. After its resection, at the 1-month follow-up evaluation, the patient reported headache and nausea. A CT brain scan showed a postoperative cervical pseudomeningocele and an increase in the ventricular sizes, resulting in hydrocephalus. Results A ventriculoperitoneal shunting was performed using a programmable valve opening pressure set to 120 mmH20. After surgery, the patient's neurological status markedly improved. Conclusion Hydrocephalus must be considered a possible complication of cervical spine tumor resection.

  11. Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature.

    Science.gov (United States)

    Vallejo, Ricardo; Kramer, Jeffery; Benyamin, Ramsin

    2007-03-01

    Electrical spinal neuromodulation in the form of spinal cord stimulation is currently used for treating chronic painful conditions such as complex regional pain syndrome, diabetic neuropathy, postherpetic neuralgia, peripheral ischemia, low back pain, and other conditions refractory to more conservative treatments. To date, there are very few published reports documenting the use of spinal cord stimulation in the treatment of head/neck and upper limb pain. This paper reports a case series of 5 consecutive patients outlining the use of spinal cord stimulation to treat upper extremity pain. All subjects had previously undergone cervical fusion surgery to treat chronic neck and upper limb pain. Patients were referred following failure of the surgery to manage their painful conditions. Spinal cord stimulators were placed in the cervical epidural space through a thoracic needle placement. Stimulation parameters were adjusted to capture as much of the painful area(s) as possible. In total, 4 out of 5 patients moved to implantation. In all cases, patients reported significant (70-90%) reductions in pain, including axial neck pain and upper extremity pain. Interestingly, 2 patients with associated headache and lower extremity pain obtained relief after paresthesia-steering reportedly covered those areas. Moreover, 2 patients reported that cervical spinal cord stimulation significantly improved axial low back pain. Patients continue to report excellent pain relief up to 9 months following implantation. This case series documents the successful treatment of neck and upper extremity pain following unsuccessful cervical spine fusion surgery. Given this initial success, prospective, controlled studies are warranted to more adequately assess the long term utility and cost effectiveness of electrical neuromodulation treatment of chronic neck and upper extremity pain.

  12. Alterations in Cortical Sensorimotor Connectivity following Complete Cervical Spinal Cord Injury: A Prospective Resting-State fMRI Study.

    Directory of Open Access Journals (Sweden)

    Akinwunmi Oni-Orisan

    Full Text Available Functional magnetic resonance imaging (fMRI studies have demonstrated alterations during task-induced brain activation in spinal cord injury (SCI patients. The interruption to structural integrity of the spinal cord and the resultant disrupted flow of bidirectional communication between the brain and the spinal cord might contribute to the observed dynamic reorganization (neural plasticity. However, the effect of SCI on brain resting-state connectivity patterns remains unclear. We undertook a prospective resting-state fMRI (rs-fMRI study to explore changes to cortical activation patterns following SCI. With institutional review board approval, rs-fMRI data was obtained in eleven patients with complete cervical SCI (>2 years post injury and nine age-matched controls. The data was processed using the Analysis of Functional Neuroimages software. Region of interest (ROI based analysis was performed to study changes in the sensorimotor network using pre- and post-central gyri as seed regions. Two-sampled t-test was carried out to check for significant differences between the two groups. SCI patients showed decreased functional connectivity in motor and sensory cortical regions when compared to controls. The decrease was noted in ipsilateral, contralateral, and interhemispheric regions for left and right precentral ROIs. Additionally, the left postcentral ROI demonstrated increased connectivity with the thalamus bilaterally in SCI patients. Our results suggest that cortical activation patterns in the sensorimotor network undergo dynamic reorganization following SCI. The presence of these changes in chronic spinal cord injury patients is suggestive of the inherent neural plasticity within the central nervous system.

  13. Cervicitis

    Science.gov (United States)

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  14. Radiographic analysis of temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1984-11-15

    The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36..90% (217 cases), sclerosis 34.18% (201 cases), erosive change 25.58% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent (36.90%), of which frequency was significantly higher than forward positioning (11.22%) and backward positioning (4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restrict ed movement of condylar head within articular fossa was most frequent (35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erosive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33 .33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of norma l positioning, forward positioning and

  15. 颈前路减压植骨治疗脊髓型颈椎病%Treatment of Anterior Cervical Decompression and Fusion with Cervical Spinal Cord

    Institute of Scientific and Technical Information of China (English)

    余润泽; 喻德富; 章杰斌; 陶学顺; 王家顺; 吕建军

    2011-01-01

    Objective To observe the cervical spinal column fusion anterior cervical decompression and clinical efficacy. Methods 21 cases of single or double in patients with cervical myclopathy were selected,Central Bank of antcrior cervical discectomy and decompression saws,implantation of autologous iliac bone fusion columnar neck immobilization were performed.The patients were followed up by cervical spine X-ray observations,fell,clinical functional evaluation of nerve function recovery.Results 21 patients were followed up for 12 to 24 months( mean 16 months ). Recovery after surgery,bone fusion,the basic life of patients were satisfactory, Some patients returned to work.Neurological function according to the Japanese Orthopacdic Association(JOA) evaluation system,excellent in 16 cases,good in 2 cases,in 2 cases,1 patient;JOA score improved from(9.3±2.1) points up to postoperative(15.4±1.6) points.Conclusion Anterior decompression and fusion was a single,double cervical myclopathy effective treatment,with complete decompression,shorter operation time,trauma,neurological recovery was good,and with low cost advantage.%目的 观察脊髓型颈稚病颈前路减压柱状植骨融合的临床疗效.方法 21例单或双节段脊髓型颈椎病患者,行颈前路环锯椎间盘切除减压,自体柱状髂骨植入融合,颈托外固定.术后随访观察颈椎X线片、自我感觉、临床功能评价、神经功能恢复情况.结果 21例患者全部获得随访,随访时间12~24个月(平均16个月).术后恢复满意,植骨全部融合,患者生活基本可自理,部分患者重返工作.神经功能改善依据日本矫形外科学会(JOA)评定标准,优16例,良2例,中2例,无效1例;JOA评分由术前(9.3±2.1)分上升至术后的(15.4±1.6)分.结论 前路减压植骨是单、双节段脊髓型颈椎病的有效治疗方法,具有减压彻底,手术时间短,创伤小,神经恢复好,费用低等优点;术后需较长期外固定.

  16. Extensive Spinal Decussation and Bilateral Termination of Cervical Corticospinal Projections in Rhesus Monkeys

    OpenAIRE

    2009-01-01

    To examine neuroanatomical mechanisms underlying fine motor control of the primate hand, adult Rhesus monkeys underwent injections of biotinylated dextran amine (BDA) into the right motor cortex. Spinal axonal anatomy was examined using detailed serial-section reconstruction and modified stereological quantification. 87% of corticospinal tract (CST) axons decussated in the medullary pyramids and descended through the contralateral dorsolateral tract of the spinal cord. 11% of CST axons projec...

  17. Posterior arthrodesis of C1-C3 for the stabilization of multiple unstable upper cervical fractures with spinal cord compromise

    Science.gov (United States)

    Xue, Deting; Chen, Qixin; Chen, Gang; Zhuo, Wenhai; Li, Fangcai

    2017-01-01

    Abstract Background: Multiple fractures of the atlas and axis are rare. The management of multiple fragment axis fractures and unstable atlas fractures is still challenging for the spinal surgeon. There are no published reports of similar fractures with 3-part fracture of axis associated with an unstable atlas fracture. Case summary: We present a patient with concurrent axis and atlas fractures, which have not been reported. The patient suffered hyperextension injury with neck pain and numbness of the bilateral upper extremity associated with weakness after a 2-m fall. The axis fractures included an odontoid type IIA fracture and traumatic spondylolisthesis of C2-C3. The atlas fracture was unstable. The neurological examination manifested as central canal syndrome, which was due to the hyperextension injury of cervical spine and spondylolisthesis of C2-C3. The patient was diagnosed as multiple unstable upper cervical fractures with spinal cord compromise. We performed posterior arthrodesis of C1-C3. Postoperatively, the patient showed neurological improvement, and C1-C3 had fused at the 3-month follow-up. Conclusion: Posterior arthrodesis of C1-C3 could provide a stable fixation for the 3 parts of axis (an odontoid type IIA fracture and traumatic spondylolisthesis of C2-C3) combined an unstable atlas fracture. Both the patient and the doctor were satisfied with the results of the treatment. So posterior arthrodesis of C1-C3 is a suitable treatment option for the treatment of a concurrent unstable atlas fracture and multiple fractures of the axis. PMID:28072744

  18. Diffusion-weighted MRI of the cervical spinal cord using a single-shot fast spin-echo technique: findings in normal subjects and in myelomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, K.; Katase, S.; Fujikawa, A.; Hachiya, J. [Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Tokyo (Japan); Kanazawa, H. [Toshiba Corporation, 1-1-1 Shibaura, Minato-ku, 105-8001, Tokyo (Japan); Yodo, K. [Toshiba Medical Systems, 3-26-5 Hongo, Bunkyo-ku, 113-8456, Tokyo (Japan)

    2003-02-01

    We have implemented a new diffusion-weighted MRI (DWI) sequence based on the single-shot fast spin-echo technique. We hypothesised that this would add information to conventional MRI for diagnosis of lesions of the cervical spinal cord. DWI was performed using a technique in which echo collection after the application of motion-probing gradients was done in the same manner as in the single-shot fast spin-echo technique. We first imaged six healthy volunteers to demonstrate the cervical spinal cord using the sequence. Then we applied the sequence to 12 patients with cervical myelomalacia due to chronic cord compression. The spinal cord was well seen in all subjects without the distortion associated with echo-planar DWI. In the patients, lesions appeared as areas of low- or isointense signal on DWI. Calculated apparent diffusion coefficients of the lesions (3.30{+-}0.38 x 10{sup -3} mm{sup 2}/s) were significantly higher than those of normal volunteers (2.26{+-}0.08 x 10{sup -3} mm{sup 2}/s). Increased diffusion in areas of cervical myelomalacia, suggesting irreversible damage, can be detected using this technique. (orig.)

  19. Comparison of the occurrence rates of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus%颈神经在椎间孔与脊神经沟处受嵌压的出现率比较

    Institute of Scientific and Technical Information of China (English)

    李英平; 郭瑞芳; 温海青

    2005-01-01

    背景:椎间盘髓核向侧后方脱出以及神经根管内的软组织炎性肿胀可直接或间接压迫神经根,但颈神经在椎间孔及脊神经沟处的嵌压因素与严重性待进一步研究.目的:探讨颈神经在椎间孔及脊神经沟处受嵌压的出现率与颈椎病严重程度关系.设计:单一样本研究.单位:承德医学院解剖教研室、附属医院老年病科、教务处.对象:实验选用承德医学院解剖教研室提供的经甲醛固定成尸60具,男28,女32;共120侧.方法:取60具成尸,测量颈椎间孔及其脊神经根的外径以及对脊神经沟外口宽度及其沟内段脊神经前支横径,数据进行统计学处理.主要观察指标:颈神经前支横径/脊神经沟宽度和颈神经根外径/椎间孔大小的均值,比值≥1的出现率.结果:颈神经根与椎间孔之比值明显大于脊神经与脊神经沟之比值(t=2.66,P<0.01);颈神经在椎间孔处受压的出现率(24.6%)明显高于脊神经沟处(6.3%),二者比较差异有非常显著性意义(x2=6.95,P<0.01).结论:颈神经在颈椎间孔和脊神经沟处均可受累,颈神经在椎间孔处受累的严重性明显大于在脊神经沟处.临床诊治颈椎病在充分考虑椎间孔处神经受累的同时,也不可忽视颈椎脊神经沟处神经受累的可能性.%BACKGROUND: Nerve root could be directly or indirectly entrapped due to lateral backward prolapse of nucleus pulposus of intervertebral disc, as well as parenchymal inflammatory tumefaction of the soft tissues in nerve root tube. But the factors and their severity related to cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus still need further studies.OBJECTIVE: To investigate the relationship between the occurrence rate of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus and the severity of cervical syndrome.DESIGN: A single sample study.SETTING: Department of Anatomy, Department of

  20. Morphology of Donor and Recipient Nerves Utilised in Nerve Transfers to Restore Upper Limb Function in Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Aurora Messina

    2016-09-01

    Full Text Available Loss of hand function after cervical spinal cord injury (SCI impacts heavily on independence. Multiple nerve transfer surgery has been applied successfully after cervical SCI to restore critical arm and hand functions, and the outcome depends on nerve integrity. Nerve integrity is assessed indirectly using muscle strength testing and intramuscular electromyography, but these measures cannot show the manifestation that SCI has on the peripheral nerves. We directly assessed the morphology of nerves biopsied at the time of surgery, from three patients within 18 months post injury. Our objective was to document their morphologic features. Donor nerves included teres minor, posterior axillary, brachialis, extensor carpi radialis brevis and supinator. Recipient nerves included triceps, posterior interosseus (PIN and anterior interosseus nerves (AIN. They were fixed in glutaraldehyde, processed and embedded in Araldite Epon for light microscopy. Eighty percent of nerves showed abnormalities. Most common were myelin thickening and folding, demyelination, inflammation and a reduction of large myelinated axon density. Others were a thickened perineurium, oedematous endoneurium and Renaut bodies. Significantly, very thinly myelinated axons and groups of unmyelinated axons were observed indicating regenerative efforts. Abnormalities exist in both donor and recipient nerves and they differ in appearance and aetiology. The abnormalities observed may be preventable or reversible.

  1. Task-dependent modulation of primary afferent depolarization in cervical spinal cord of monkeys performing an instructed delay task.

    Science.gov (United States)

    Seki, Kazuhiko; Perlmutter, Steve I; Fetz, Eberhard E

    2009-07-01

    Task-dependent modulation of primary afferent depolarization (PAD) was studied in the cervical spinal cord of two monkeys performing a wrist flexion and extension task with an instructed delay period. We implanted two nerve cuff electrodes on proximal and distal parts of the superficial radial nerve (SR) and a recording chamber over a hemi-laminectomy in the lower cervical vertebrae. Antidromic volleys (ADVs) in the SR were evoked by intraspinal microstimuli (ISMS, 3-10 Hz, 3-30 microA) applied through a tungsten microelectrode, and the area of each ADV was measured. In total, 434 ADVs were evoked by ISMS in two monkeys, with onset latency consistently shorter in the proximal than distal cuffs. Estimated conduction velocity suggest that most ADVs were caused by action potentials in cutaneous fibers originating from low-threshold tactile receptors. Modulation of the size of ADVs as a function of the task was examined in 281 ADVs induced by ISMS applied at 78 different intraspinal sites. The ADVs were significantly facilitated during active movement in both flexion and extension (Pmodulation of PAD. This facilitation started 400-900 ms before the onset of EMG activity. Such pre-EMG modulation is hard to explain by movement-induced reafference and probably is associated with descending motor commands.

  2. Chronological observation in early radiation myelopathy of the cervical spinal cord; Gadolinium-enhanced MRI findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Hirota, Saeko; Yoshida, Shoji; Soejima, Toshinori (Hyogo Medical Center for Adults, Akashi (Japan)) (and others)

    Gd-enhanced MR images of two patients with clinically and histopathologically diagnosed chronic progressive radiation myelitis (CPRM) were observed chronologically. One of them had had nasopharyngeal cancer and received radiotherapy at a dose of 100 Gy to the C1-2 level of the spinal cord. She developed CPRM 25 months after the termination of radiotherapy. The other had had malignant lymphoma originating from the tonsil and received chemoradiotherapy. The dose delivered to her cervical spinal cord was 40 Gy, and she developed CPRM 30 months later. Gd-enhanced MRI in the early phase revealed a small crescent-shaped nidus with or without a very small central nonenhanced area in both cases. Enhancement was not great. At that time, patients noticed only the inability to perceive pain and temperature or paresthesia in the opposite side. In a few months, MRI revealed a much more strongly enhanced and larger nidus with enlargement of a central nonenhanced area accompanied by long segmental cord enlargement. The patients' neurological symptoms had also progressed, with hemiparesis developing, for example. (author).

  3. Mechanical Design and Analysis of a Unilateral Cervical Spinal Cord Contusion Injury Model in Non-Human Primates.

    Science.gov (United States)

    Sparrey, Carolyn J; Salegio, Ernesto A; Camisa, William; Tam, Horace; Beattie, Michael S; Bresnahan, Jacqueline C

    2016-06-15

    Non-human primate (NHP) models of spinal cord injury better reflect human injury and provide a better foundation to evaluate potential treatments and functional outcomes. We combined finite element (FE) and surrogate models with impact data derived from in vivo experiments to define the impact mechanics needed to generate a moderate severity unilateral cervical contusion injury in NHPs (Macaca mulatta). Three independent variables (impactor displacement, alignment, and pre-load) were examined to determine their effects on tissue level stresses and strains. Mechanical measures of peak force, peak displacement, peak energy, and tissue stiffness were analyzed as potential determinants of injury severity. Data generated from FE simulations predicted a lateral shift of the spinal cord at high levels of compression (>64%) during impact. Submillimeter changes in mediolateral impactor position over the midline increased peak impact forces (>50%). Surrogate cords established a 0.5 N pre-load protocol for positioning the impactor tip onto the dural surface to define a consistent dorsoventral baseline position before impact, which corresponded with cerebrospinal fluid displacement and entrapment of the spinal cord against the vertebral canal. Based on our simulations, impactor alignment and pre-load were strong contributors to the variable mechanical and functional outcomes observed in in vivo experiments. Peak displacement of 4 mm after a 0.5N pre-load aligned 0.5-1.0 mm over the midline should result in a moderate severity injury; however, the observed peak force and calculated peak energy and tissue stiffness are required to properly characterize the severity and variability of in vivo NHP contusion injuries.

  4. Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report

    OpenAIRE

    Kim, Taikwan; Jwa, Cheol Su

    2015-01-01

    We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock last...

  5. A PET/CT-based Morphometric Study of Spinal Canal in Korean Young Adults: Anteroposterior Diameter from Cervical Vertebra to Sacrum

    OpenAIRE

    Kang, Moo Sung; Park, Jeong Yoon; Chin, Dong Kyu; Kim, Kyung Hyun; Kuh, Sung Uk; Kim, Keun Su; Cho, Yong Eun

    2012-01-01

    Objective To establish normative data for spinal canal AP diameter from cervical vertebra to sacrum in the Korean young and to assess the exposed spinal canal after laminectomy which was related with restenosis by post-laminectomy membrane formation. Methods From PET/CT, axial bone-window CT of 83 young adults (20-29 years) were obtained, and we measured AP diameters of C3, C5, C7, T1, T4, T8, T12, L1, L3, L5 and S1. We also measured exposed AP diameter of C3, C5, C7, T1 and T2 above imaginar...

  6. Long descending cervical propriospinal neurons differ from thoracic propriospinal neurons in response to low thoracic spinal injury

    Directory of Open Access Journals (Sweden)

    Stelzner Dennis J

    2010-11-01

    Full Text Available Abstract Background Propriospinal neurons, with axonal projections intrinsic to the spinal cord, have shown a greater regenerative response than supraspinal neurons after axotomy due to spinal cord injury (SCI. Our previous work focused on the response of axotomized short thoracic propriospinal (TPS neurons following a low thoracic SCI (T9 spinal transection or moderate spinal contusion injury in the rat. The present investigation analyzes the intrinsic response of cervical propriospinal neurons having long descending axons which project into the lumbosacral enlargement, long descending propriospinal tract (LDPT axons. These neurons also were axotomized by T9 spinal injury in the same animals used in our previous study. Results Utilizing laser microdissection (LMD, qRT-PCR, and immunohistochemistry, we studied LDPT neurons (located in the C5-C6 spinal segments between 3-days, and 1-month following a low thoracic (T9 spinal cord injury. We examined the response of 89 genes related to growth factors, cell surface receptors, apoptosis, axonal regeneration, and neuroprotection/cell survival. We found a strong and significant down-regulation of ~25% of the genes analyzed early after injury (3-days post-injury with a sustained down-regulation in most instances. In the few genes that were up-regulated (Actb, Atf3, Frs2, Hspb1, Nrap, Stat1 post-axotomy, the expression for all but one was down-regulated by 2-weeks post-injury. We also compared the uninjured TPS control neurons to the uninjured LDPT neurons used in this experiment for phenotypic differences between these two subpopulations of propriospinal neurons. We found significant differences in expression in 37 of the 84 genes examined between these two subpopulations of propriospinal neurons with LDPT neurons exhibiting a significantly higher base line expression for all but 3 of these genes compared to TPS neurons. Conclusions Taken collectively these data indicate a broad overall down

  7. Cervical Spinal Cord Atrophy Profile in Adult SMN1-Linked SMA.

    Directory of Open Access Journals (Sweden)

    Mohamed-Mounir El Mendili

    Full Text Available The mechanisms underlying the topography of motor deficits in spinal muscular atrophy (SMA remain unknown. We investigated the profile of spinal cord atrophy (SCA in SMN1-linked SMA, and its correlation with the topography of muscle weakness.Eighteen SMN1-linked SMA patients type III/V and 18 age/gender-matched healthy volunteers were included. Patients were scored on manual muscle testing and functional scales. Spinal cord was imaged using 3T MRI system. Radial distance (RD and cord cross-sectional area (CSA measurements in SMA patients were compared to those in controls and correlated with strength and disability scores.CSA measurements revealed a significant cord atrophy gradient mainly located between C3 and C6 vertebral levels with a SCA rate ranging from 5.4% to 23% in SMA patients compared to controls. RD was significantly lower in SMA patients compared to controls in the anterior-posterior direction with a maximum along C4 and C5 vertebral levels (p-values < 10-5. There were no correlations between atrophy measurements, strength and disability scores.Spinal cord atrophy in adult SMN1-linked SMA predominates in the segments innervating the proximal muscles. Additional factors such as neuromuscular junction or intrinsic skeletal muscle defects may play a role in more complex mechanisms underlying weakness in these patients.

  8. Epicritic Sensation in Cervical Spinal Cord Injury: Diagnostic Gains Beyond Testing Light Touch

    NARCIS (Netherlands)

    Velstra, Inge-Marie; Bolliger, Marc; Baumberger, Michael; Rietman, Johan Swanik; Curt, Armin

    2013-01-01

    Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pat

  9. Scaphoid pseudo-arthrosis: Frequency, pathogenesis and course

    Energy Technology Data Exchange (ETDEWEB)

    Schunk, K.; Teifke, A.; Benning, R.; Dahm, M.; Thelen, R.; Schild, H.

    1989-06-01

    Eighty-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixtyseven were present at the first examination and 16 pseudo-arthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion. (orig.).

  10. One-stage microsurgical excision for intra- and extra-spinal dumbbell-shaped tumors in cervical spine: a report of 11 cases

    Directory of Open Access Journals (Sweden)

    GAO Fang-you

    2013-07-01

    Full Text Available Objective To investigate the clinical characteristics and surgical treatment strategy of intra- and extra-spinal dumbbell-shaped tumors in cervical spine. Methods Clinical data of 11 patients with intra- and extra-spinal dumbbell-shaped tumors in cervical spine were retrospectively studied. Male was in 7 cases, female in 4 cases. The tumors were in stageⅠin 4 cases, Ⅱ in 2 cases, Ⅲ in 4 cases and Ⅳ in one case. The tumors were resected via posterior midline approach alone in 9 cases, among whom unilateral hemilaminectomy was performed in 4 cases (screw fixation via posterior approach was performed for fusion of lesion segments after tumor resection in 2 cases, one was stage Ⅳ tumor, another one was stage Ⅲ tumor in cervicothoracic junction, total laminotomy and reduction by titanium miniplates and screws in 2 cases, and via interlaminar approach in 3 cases. Posterior midline approach combined with anterior lateral approach was performed in the rest 2 cases. Results Tumors were one-stage totally resected in all of the cases. Histological types of the tumors included schwannoma in 10 cases, and ganglioneuroma in one case. The numbness area was enlarged in one case, and the motor function improved in other cases. All of the patients were followed-up from 8 months to 3.50 years with an average of 21 months. No tumor relapse and spinal deformity were found. Conclusion Most cases of intra- and extra-spinal dumbbell-shaped tumors can be treated with one-stage microsurgery. The surgical treatment strategy can be reached according to the location and surgical staging of tumors. Unilateral hemilaminectomy technique is useful to maintain the stability of the cervical spine for most of tumors. Combined approach is needed in some of the tumors and fixation should be implemented in the case of stability of cervical spine damaged after tumor resection.

  11. The proposed use of cervical spinal cord stimulation for the treatment and prevention of cognitive decline in dementias and neurodegenerative disorders.

    Science.gov (United States)

    Tomycz, Nestor D

    2016-11-01

    Cervical spinal cord stimulation is a well-established treatment for intractable neuropathic upper extremity pain. More than 20years ago it was demonstrated that cervical spinal cord stimulation could engender an increase in cerebral blood flow. Cerebral blood flow has been shown to be decreased in many patients with dementia and in various neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Furthermore, there is evidence that reduced cerebral blood flow worsens neurodegenerative disease and may also predict which patients progress from mild cognitive impairment to full blown Alzheimer's disease. Thus, the identification of decreased cerebral blood flow in patients with early cognitive problems may offer clinicians a window of opportunity to intervene and prevent further brain damage. Further evidence that supports augmenting cerebral blood flow as an effective strategy for preventing and treating cognitive brain dysfunction comes from experimental studies with omental transposition. The author proposes cervical spinal cord stimulation as a titratable, programmable extracranial neuromodulation technique to increase cerebral blood flow for the purposes of improving cognitive function and preventing cognitive deterioration in patients with dementias and neurodegenerative disorders.

  12. Craniofacial and Cervical Morphology Related to Sagittal Spinal Posture in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Emil Segatto

    2014-01-01

    Full Text Available Studies on the relationship between body posture and craniofacial parameters often focus on the cervical spine. Thus, less attention has been paid to the morphology of the vertebra C2 that serves as both a structural and functional link between the craniofacial area and the other part of the spine. The objective of this study was to assess the relation of craniofacial features to certain morphological and positional characteristics of the cervical vertebrae and the spine during growth. We determined body posture indices for 69 children and adolescents by means of a radiation-free method (rasterstereography. The morphological and positional analysis of the craniofacial area and the cervical vertebrae was based on standardized lateral X-ray cephalograms. Medium to strong correlations were found between body posture, C2 morphology, and craniofacial parameters. We found significant correlations between the C2 dens axis height and maxillary indices as well as between the C2 dens axis inclination and cephalometrical values of the mandibular area. Similarly the correlation between the C2 dens axis inclination and the postural index flèche cervicale was highly significant (P<0.05, r=0.333. These results suggest that morphological features of the odontoid process may serve as valuable predictive markers in interdisciplinary orthopedic-orthodontic diagnostics.

  13. Craniofacial and cervical morphology related to sagittal spinal posture in children and adolescents.

    Science.gov (United States)

    Segatto, Emil; Segatto, Angyalka; Braunitzer, Gábor; Kirschneck, Christian; Fanghänel, Jochen; Danesh, Gholamreza; Lippold, Carsten

    2014-01-01

    Studies on the relationship between body posture and craniofacial parameters often focus on the cervical spine. Thus, less attention has been paid to the morphology of the vertebra C2 that serves as both a structural and functional link between the craniofacial area and the other part of the spine. The objective of this study was to assess the relation of craniofacial features to certain morphological and positional characteristics of the cervical vertebrae and the spine during growth. We determined body posture indices for 69 children and adolescents by means of a radiation-free method (rasterstereography). The morphological and positional analysis of the craniofacial area and the cervical vertebrae was based on standardized lateral X-ray cephalograms. Medium to strong correlations were found between body posture, C2 morphology, and craniofacial parameters. We found significant correlations between the C2 dens axis height and maxillary indices as well as between the C2 dens axis inclination and cephalometrical values of the mandibular area. Similarly the correlation between the C2 dens axis inclination and the postural index flèche cervicale was highly significant (P orthodontic diagnostics.

  14. Effect of Fujian tablet on the expression of Nogo-A mRNA in the cervical spinal cord of middle cerebral artery occlusion model rats

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Inhibiting the expression of Nogo-A in cervical spinal cord by use of interaction of antigen and antibody can help the remodeling of corticospinal projection of focal cerebral ischemia model rats to facilitate neurological recovery, which provides a new possible mechanism for drugs to promote neurological recovery. However, the effects of drugs on the expression of Nogo-A in cervical spinal cord are still unclear.OBJECTIVE: To observe the effect of Fujian tablet on the expression of Nogo-A mRNA in cervical spinal cords of middle cerebral artery occlusion (MCAO) rats, and to investigate the possible regulatory effect of Fujian tablet on the regenerated microenvironment of spinal conduction bundle.DESIGN: A randomized and controlled trial taking Wistar rats as experimental animals.SETTING: Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine.MATERIALS: This experiment was carried out in the laboratory of Shandong Academy of Medical Science between June 2005 and July 2006. A total of 40 healthy male Wistar rats, aged 12 weeks, weighing 250 -300 g, were provided by the Experimental Animal Center of Shandong University. Fujian tablets (main components: Heshouwu, Yinyanghuo, etc) were provided by office of Pharmaceutics of Shandong University of traditional Chinese medicine. Nogo-A detection kit was provided by Wuhan Boster Biotechnology Co.,Ltd.,and batch number was 040309009. This experiment was approved by Local Animal Ethics Committee.METHODS: Forty male rats were randomly divided into 4 groups, with 10 in each: normal group,sham-operation group, model group and administration group. Rats in the administration group and model group were subjected to MCAO. Rats in the sham-operation group underwent the same craniotomy, and their middle cerebral arteries (MCA) were not occluded. Rats in the normal group were untouched. Rats in administration group were intragastrically administrated with the solution of Fujian

  15. Fluoxetine treatment promotes functional recovery in a rat model of cervical spinal cord injury

    Science.gov (United States)

    Scali, Manuela; Begenisic, Tatjana; Mainardi, Marco; Milanese, Marco; Bonifacino, Tiziana; Bonanno, Giambattista; Sale, Alessandro; Maffei, Lamberto

    2013-01-01

    Spinal cord injury (SCI) is a severe condition leading to enduring motor deficits. When lesions are incomplete, promoting spinal cord plasticity might be a useful strategy to elicit functional recovery. Here we investigated whether long-term fluoxetine administration in the drinking water, a treatment recently demonstrated to optimize brain plasticity in several pathological conditions, promotes motor recovery in rats that received a C4 dorsal funiculus crush. We show that fluoxetine administration markedly improved motor functions compared to controls in several behavioral paradigms. The improved functional effects correlated positively with significant sprouting of intact corticospinal fibers and a modulation of the excitation/inhibition balance. Our results suggest a potential application of fluoxetine treatment as a non invasive therapeutic strategy for SCI-associated neuropathologies. PMID:23860568

  16. Correlation between magnetic resonance T2 image signal intensity ratio and cell apoptosis in a rabbit spinal cord cervical myelopathy model

    Institute of Scientific and Technical Information of China (English)

    Ma Lei; Zhang Di; Chen Wei; Shen Yong; Zhang Yingze; Ding Wenyuan; Zhang Wei

    2014-01-01

    Background Cervical spondylotic myelopathy (CSM) is a common cause of disability in elderly patients.Previous studies have shown that spinal cord cell apoptosis due to spinal cord compression plays an important role in the pathology of myelopathy.Although changes in magnetic resonance imaging (MRI) T2 signal intensity ratio (SIR) are considered to be an indicator of CSM,little information is published supporting the correlation between changes in MRI signal and pathological changes.This study aims to testify the correlation between MRI T2 SIR changes and cell apoptosis using a CSM animal model.Methods Forty-eight rabbits were randomly assigned to four groups:one control group and three experimental chronic compression groups,with each group containing 12 animals.Chronic compression of the cervical spinal cord was implemented in the experimental groups by implanting a screw in the C3 vertebra.The control group underwent sham surgery.Experimental groups were observed for 3,6,or 9 months after surgery.MRI T2-weighted SIR Tarlov motor scores and cortical somatosensory-evoked potentials (CSEPs) were periodically monitored.At each time point,rabbits from one group were sacrificed to determine the level of apoptosis by histology (n=6) and Western blotting (n=6).Results Tarlov motor scores in the compression groups were lower at all time points than the control group scores,with the lowest score at 9 months (P <0.001).Electrophysiological testing showed a significantly prolonged latency in CSEP in the compression groups compared with the control group.All rabbits in the compression groups showed higher MRI T2 SIR in the injury epicenter compared with controls,and higher SIR was also found at 9 months compared with 3 or 6 months.Histological analysis showed significant apoptosis in the spinal cord tissue in the compression groups,but not in the control group.There were significant differences in apoptosis degree over time (P <0.001),with the 9-month group displaying the

  17. The impact of spinal cord nerve roots and denticulate ligaments on cerebrospinal fluid dynamics in the cervical spine.

    Directory of Open Access Journals (Sweden)

    Soroush Heidari Pahlavian

    Full Text Available Cerebrospinal fluid (CSF dynamics in the spinal subarachnoid space (SSS have been thought to play an important pathophysiological role in syringomyelia, Chiari I malformation (CM, and a role in intrathecal drug delivery. Yet, the impact that fine anatomical structures, including nerve roots and denticulate ligaments (NRDL, have on SSS CSF dynamics is not clear. In the present study we assessed the impact of NRDL on CSF dynamics in the cervical SSS. The 3D geometry of the cervical SSS was reconstructed based on manual segmentation of MRI images of a healthy volunteer and a patient with CM. Idealized NRDL were designed and added to each of the geometries based on in vivo measurments in the literature and confirmation by a neuroanatomist. CFD simulations were performed for the healthy and patient case with and without NRDL included. Our results showed that the NRDL had an important impact on CSF dynamics in terms of velocity field and flow patterns. However, pressure distribution was not altered greatly although the NRDL cases required a larger pressure gradient to maintain the same flow. Also, the NRDL did not alter CSF dynamics to a great degree in the SSS from the foramen magnum to the C1 level for the healthy subject and CM patient with mild tonsillar herniation (∼ 6 mm. Overall, the NRDL increased fluid mixing phenomena and resulted in a more complex flow field. Comparison of the streamlines of CSF flow revealed that the presence of NRDL lead to the formation of vortical structures and remarkably increased the local mixing of the CSF throughout the SSS.

  18. The Impact of Spinal Cord Nerve Roots and Denticulate Ligaments on Cerebrospinal Fluid Dynamics in the Cervical Spine

    Science.gov (United States)

    Heidari Pahlavian, Soroush; Yiallourou, Theresia; Tubbs, R. Shane; Bunck, Alexander C.; Loth, Francis; Goodin, Mark; Raisee, Mehrdad; Martin, Bryn A.

    2014-01-01

    Cerebrospinal fluid (CSF) dynamics in the spinal subarachnoid space (SSS) have been thought to play an important pathophysiological role in syringomyelia, Chiari I malformation (CM), and a role in intrathecal drug delivery. Yet, the impact that fine anatomical structures, including nerve roots and denticulate ligaments (NRDL), have on SSS CSF dynamics is not clear. In the present study we assessed the impact of NRDL on CSF dynamics in the cervical SSS. The 3D geometry of the cervical SSS was reconstructed based on manual segmentation of MRI images of a healthy volunteer and a patient with CM. Idealized NRDL were designed and added to each of the geometries based on in vivo measurments in the literature and confirmation by a neuroanatomist. CFD simulations were performed for the healthy and patient case with and without NRDL included. Our results showed that the NRDL had an important impact on CSF dynamics in terms of velocity field and flow patterns. However, pressure distribution was not altered greatly although the NRDL cases required a larger pressure gradient to maintain the same flow. Also, the NRDL did not alter CSF dynamics to a great degree in the SSS from the foramen magnum to the C1 level for the healthy subject and CM patient with mild tonsillar herniation (∼6 mm). Overall, the NRDL increased fluid mixing phenomena and resulted in a more complex flow field. Comparison of the streamlines of CSF flow revealed that the presence of NRDL lead to the formation of vortical structures and remarkably increased the local mixing of the CSF throughout the SSS. PMID:24710111

  19. The impact of spinal cord nerve roots and denticulate ligaments on cerebrospinal fluid dynamics in the cervical spine.

    Science.gov (United States)

    Heidari Pahlavian, Soroush; Yiallourou, Theresia; Tubbs, R Shane; Bunck, Alexander C; Loth, Francis; Goodin, Mark; Raisee, Mehrdad; Martin, Bryn A

    2014-01-01

    Cerebrospinal fluid (CSF) dynamics in the spinal subarachnoid space (SSS) have been thought to play an important pathophysiological role in syringomyelia, Chiari I malformation (CM), and a role in intrathecal drug delivery. Yet, the impact that fine anatomical structures, including nerve roots and denticulate ligaments (NRDL), have on SSS CSF dynamics is not clear. In the present study we assessed the impact of NRDL on CSF dynamics in the cervical SSS. The 3D geometry of the cervical SSS was reconstructed based on manual segmentation of MRI images of a healthy volunteer and a patient with CM. Idealized NRDL were designed and added to each of the geometries based on in vivo measurments in the literature and confirmation by a neuroanatomist. CFD simulations were performed for the healthy and patient case with and without NRDL included. Our results showed that the NRDL had an important impact on CSF dynamics in terms of velocity field and flow patterns. However, pressure distribution was not altered greatly although the NRDL cases required a larger pressure gradient to maintain the same flow. Also, the NRDL did not alter CSF dynamics to a great degree in the SSS from the foramen magnum to the C1 level for the healthy subject and CM patient with mild tonsillar herniation (∼ 6 mm). Overall, the NRDL increased fluid mixing phenomena and resulted in a more complex flow field. Comparison of the streamlines of CSF flow revealed that the presence of NRDL lead to the formation of vortical structures and remarkably increased the local mixing of the CSF throughout the SSS.

  20. Diffusion tensor magnetic resonance imaging may show abnormalities in the normal-appearing cervical spinal cord from patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Fernanda Miraldi

    2013-09-01

    Full Text Available Objective This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord (NASC in patients with multiple sclerosis (MS compared to controls, using diffusion tensor MR imaging. Methods We studied 32 patients with MS and 17 without any neurologic disorder. Fractional anisotropy (FA, axial diffusivity (AD, radial diffusivity (RD and mean diffusivity (MD were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results At C2, FA value was decreased in MS patients. Besides, RD value was higher in MS than in controls. At C7, MD values were increased in MS. Conclusion The NASC in the right column of the cervical spinal cord showed abnormal FA, RD and MD values, which is possibly related to demyelination, since the FA abnormality was related to the RD and not to the AD.

  1. MR imaging of compressive cervical myelopathy after surgery; High signal intensity of the spinal cord on T2 weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Mimura, Fumitoshi; Fujiwara, Kazuhisa; Otake, Shoichiro (Tenri Hospital, Nara (Japan)) (and others)

    1990-06-01

    We reviewed the MR images of 32 patients with cervical myelopathy, showing lesions of high signal intensity in the spinal cord on the sagittal T2 weighted images (T2WI) after surgery: 16 with ossification of posterior longitudinal ligament (OPLL); 9 with spondylosis; 4 with disc herniation and 3 with trauma. All images were obtained on a superconducting 1.5 Tesla system. The lesions were classified into five groups, according to the shape and grade of signal intensity on the sagittal T2WI: (I) oval-shaped lesion of signal intensity less brighter than CSF with blurred margin, (II) longitudinal linear-shaped lesion of signal intensity similar to CSF, (III) spindle-shaped lesion of signal intensity similar to CSF, (IV) round-shaped lesion of signal intensity similar to CSF, and (V) mixed-types lesions which consisted of group I and II. The present study was summarized as follows: Oval-shaped lesions were seen in the cases of disc herniation and spondylosis with relatively short duration of the symptom, presumptively with relatively short duration of the symptom, presumptively indicative of edema. Most cases of OPLL and spondylosis showed linear-shaped lesions, suggesting necrosis and/or cavitations of the central gray matter. One case of spondylosis developed a spindle-shaped lesion, implicating syringomyelia. Round-shaped lesions were seen in the cases of spinal trauma, suggesting postraumatic cyst. In a case of mixed-typed lesion examined pre- and postoperatively, only an oval-shaped lesion decreased in size after surgery. (author).

  2. Reliable volumetry of the cervical spinal cord in MS patient follow-up data with cord image analyzer (Cordial).

    Science.gov (United States)

    Amann, Michael; Pezold, Simon; Naegelin, Yvonne; Fundana, Ketut; Andělová, Michaela; Weier, Katrin; Stippich, Christoph; Kappos, Ludwig; Radue, Ernst-Wilhelm; Cattin, Philippe; Sprenger, Till

    2016-07-01

    Spinal cord (SC) atrophy is an important contributor to the development of disability in many neurological disorders including multiple sclerosis (MS). To assess the spinal cord atrophy in clinical trials and clinical practice, largely automated methods are needed due to the sheer amount of data. Moreover, using these methods in longitudinal trials requires them to deliver highly reliable measurements, enabling comparisons of multiple data sets of the same subject over time. We present a method for SC volumetry using 3D MRI data providing volume measurements for SC sections of fixed length and location. The segmentation combines a continuous max flow approach with SC surface reconstruction that locates the SC boundary based on image voxel intensities. Two cutting planes perpendicular to the SC centerline are determined based on predefined distances to an anatomical landmark, and the cervical SC volume (CSCV) is then calculated in-between these boundaries. The development of the method focused on its application in MRI follow-up studies; the method provides a high scan-rescan reliability, which was tested on healthy subject data. Scan-rescan reliability coefficients of variation (COV) were below 1 %, intra- and interrater COV were even lower (0.1-0.2 %). To show the applicability in longitudinal trials, 3-year follow-up data of 48 patients with a progressive course of MS were assessed. In this cohort, CSCV loss was the only significant predictor of disability progression (p = 0.02). We are, therefore, confident that our method provides a reliable tool for SC volumetry in longitudinal clinical trials.

  3. A rare cause of cervical spinal stenosis: posterior arch hypoplasia in a bipartite atlas

    Energy Technology Data Exchange (ETDEWEB)

    Atasoy, C. [Emek, Kirim Caddesi, Ankara (Turkey); Department of Radiology, Ankara University School of Medicine (Turkey); Fitoz, S.; Karan, B.; Erden, I.; Akyar, S. [Department of Radiology, Ankara University School of Medicine (Turkey)

    2002-03-01

    We describe CT and MRI of a previously unreported combination of atlantoaxial anomalies consisting of posterior arch hypoplasia in a bipartite atlas with an os odontoideum, in a 30-year-old woman presenting with neck and left arm pain. MRI showed the os odontoideum, marked stenosis of the spinal canal at the level of the atlas, with cord compression and evidence of myelopathy. CT revealed a bipartite atlas with midline clefts in anterior and posterior arches, thickening in the anterior arch and hypoplasia of the posterior arch with incurving of both hemiarches. Flexion and extension radiographs demonstrated atlantoaxial instability. (orig.)

  4. Single pellet grasping following cervical spinal cord injury in adult rat using an automated full-time training robot.

    Science.gov (United States)

    Fenrich, Keith K; May, Zacincte; Torres-Espín, Abel; Forero, Juan; Bennett, David J; Fouad, Karim

    2016-02-15

    Task specific motor training is a common form of rehabilitation therapy in individuals with spinal cord injury (SCI). The single pellet grasping (SPG) task is a skilled forelimb motor task used to evaluate recovery of forelimb function in rodent models of SCI. The task requires animals to obtain food pellets located on a shelf beyond a slit at the front of an enclosure. Manually training and testing rats in the SPG task requires extensive time and often yields results with high outcome variability and small therapeutic windows (i.e., the difference between pre- and post-SCI success rates). Recent advances in automated SPG training using automated pellet presentation (APP) systems allow rats to train ad libitum 24h a day, 7 days a week. APP trained rats have improved success rates, require less researcher time, and have lower outcome variability compared to manually trained rats. However, it is unclear whether APP trained rats can perform the SPG task using the APP system after SCI. Here we show that rats with cervical SCI can successfully perform the SPG task using the APP system. We found that SCI rats with APP training performed significantly more attempts, had slightly lower and less variable final score success rates, and larger therapeutic windows than SCI rats with manual training. These results demonstrate that APP training has clear advantages over manual training for evaluating reaching performance of SCI rats and represents a new tool for investigating rehabilitative motor training following CNS injury.

  5. Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient.

    Science.gov (United States)

    Bodman, Alexa; Riordan, Margaret; Chin, Lawrence S

    2016-05-23

    Spinal epidural abscesses are an uncommon cause of spinal cord injury but, depending on the size and presence of neurological deficits, urgent neurosurgical intervention may be required. We present a unique case of a patient presenting with a spinal epidural collection several days after a fall. While a spinal epidural hematoma was suspected based on the patient's history and MRI findings, a spinal epidural abscess was found during surgery. The patient underwent laminectomy and instrumented fusion with successful treatment of her infection.

  6. Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison

    Directory of Open Access Journals (Sweden)

    Savni R Satoskar

    2014-01-01

    Full Text Available Objective : The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ′Goel facet spacer′ in the treatment of degenerative spinal canal stenosis. Materials and Methods : Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results : The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions : Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis.

  7. Persistent at-level thermal hyperalgesia and tactile allodynia accompany chronic neuronal and astrocyte activation in superficial dorsal horn following mouse cervical contusion spinal cord injury.

    Science.gov (United States)

    Watson, Jaime L; Hala, Tamara J; Putatunda, Rajarshi; Sannie, Daniel; Lepore, Angelo C

    2014-01-01

    In humans, sensory abnormalities, including neuropathic pain, often result from traumatic spinal cord injury (SCI). SCI can induce cellular changes in the CNS, termed central sensitization, that alter excitability of spinal cord neurons, including those in the dorsal horn involved in pain transmission. Persistently elevated levels of neuronal activity, glial activation, and glutamatergic transmission are thought to contribute to the hyperexcitability of these dorsal horn neurons, which can lead to maladaptive circuitry, aberrant pain processing and, ultimately, chronic neuropathic pain. Here we present a mouse model of SCI-induced neuropathic pain that exhibits a persistent pain phenotype accompanied by chronic neuronal hyperexcitability and glial activation in the spinal cord dorsal horn. We generated a unilateral cervical contusion injury at the C5 or C6 level of the adult mouse spinal cord. Following injury, an increase in the number of neurons expressing ΔFosB (a marker of chronic neuronal activation), persistent astrocyte activation and proliferation (as measured by GFAP and Ki67 expression), and a decrease in the expression of the astrocyte glutamate transporter GLT1 are observed in the ipsilateral superficial dorsal horn of cervical spinal cord. These changes have previously been associated with neuronal hyperexcitability and may contribute to altered pain transmission and chronic neuropathic pain. In our model, they are accompanied by robust at-level hyperaglesia in the ipsilateral forepaw and allodynia in both forepaws that are evident within two weeks following injury and persist for at least six weeks. Furthermore, the pain phenotype occurs in the absence of alterations in forelimb grip strength, suggesting that it represents sensory and not motor abnormalities. Given the importance of transgenic mouse technology, this clinically-relevant model provides a resource that can be used to study the molecular mechanisms contributing to neuropathic pain

  8. Cervical Fracture Dislocation with Spinal Cord Injury Preoperative Observation and Nursing%颈椎骨折脱位合并颈髓损伤的术前观察和护理

    Institute of Scientific and Technical Information of China (English)

    赵勤娟; 蔡梅芬

    2014-01-01

    Objective To study the cervical spine fracture with cervical spinal injury patients combined observation and ef ective nursing methods, improve the cervical spine fracture with cervical spinal injury patients combined nursing level. Methods Analyzed and 1 case of cervical fracture with cervical spinal injury patients combined care, including observation patient's condition carefully, lie the hard bed, prevent infection, the nursing measures such as nutrition support. When merging spinal cord injury, notify the doctor according to the fracture type and line pressure parts needed surgery. Results The patients were cured by surgical treatment. Conclusion The observation patient's condition careful y, positive and appropriate nursing measures are effective treatment for cervical spine fracture dislocation with cervical spinal injury patients and improve the level of care.%目的探讨颈椎骨折脱位合并颈髓损伤患者的观察和有效护理方法,提高颈椎骨折脱位合并颈髓损伤患者的护理水平。方法分析探讨1例颈椎骨折脱位合并颈髓损伤患者的护理,包括严密观察病情变化,卧硬板床,防止感染,营养支持等护理措施。合并脊髓损伤时,通知医生根据骨折类型和受压部位行必要手术治疗。结果本例患者经手术治疗治愈出院。结论严密观察病情变化,采取积极适当的护理措施是有效治疗颈椎骨折脱位合并颈髓损伤患者及提高护理水平的重点。

  9. Clinical Trial of Human Fetal Brain-Derived Neural Stem/Progenitor Cell Transplantation in Patients with Traumatic Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Ji Cheol Shin

    2015-01-01

    Full Text Available In a phase I/IIa open-label and nonrandomized controlled clinical trial, we sought to assess the safety and neurological effects of human neural stem/progenitor cells (hNSPCs transplanted into the injured cord after traumatic cervical spinal cord injury (SCI. Of 19 treated subjects, 17 were sensorimotor complete and 2 were motor complete and sensory incomplete. hNSPCs derived from the fetal telencephalon were grown as neurospheres and transplanted into the cord. In the control group, who did not receive cell implantation but were otherwise closely matched with the transplantation group, 15 patients with traumatic cervical SCI were included. At 1 year after cell transplantation, there was no evidence of cord damage, syrinx or tumor formation, neurological deterioration, and exacerbating neuropathic pain or spasticity. The American Spinal Injury Association Impairment Scale (AIS grade improved in 5 of 19 transplanted patients, 2 (A → C, 1 (A → B, and 2 (B → D, whereas only one patient in the control group showed improvement (A → B. Improvements included increased motor scores, recovery of motor levels, and responses to electrophysiological studies in the transplantation group. Therefore, the transplantation of hNSPCs into cervical SCI is safe and well-tolerated and is of modest neurological benefit up to 1 year after transplants. This trial is registered with Clinical Research Information Service (CRIS, Registration Number: KCT0000879.

  10. Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report.

    Science.gov (United States)

    Kim, Taikwan; Jwa, Cheol Su

    2015-10-01

    We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex. Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.

  11. Cine phase-contrast MRI measurement of CSF flow in the cervical spine: a pilot study in patients with spinal cord injury

    Science.gov (United States)

    Negahdar, MJ; Shakeri, M.; McDowell, E.; Wells, J.; Vitaz, T.; Harkema, S.; Amini, A.

    2011-03-01

    MRI velocimetry (also known as phase-contrast MRI) is a powerful tool for quantification of cerebrospinal fluid (CSF) flow in various regions of the brain and craniospinal junction and has been accepted as a diagnostic tool to assist with the diagnosis of certain conditions such as hydrocephalus and chiari malformations. Cerebrospinal fluid is continually produced in the ventricles of the brain, flows through the ventricular system and then out and around the brain and spinal cord and is reabsorbed over the convexity of the brain. Any disease process which either impedes the normal pattern of flow or restricts the area where flow occurs can change the pattern of these waveforms with the direction and velocity of flow being determined by the pressure transmitted from the pulsation of the heart and circulation of blood within the central nervous system. Therefore, we hypothesized that phase-contrast MRI could eventually be used as a diagnostic aid in determining the degree of spinal cord compression following injury to the cervical or thoracic spine. In this study, we examined CSF flow in 3 normal subjects and 2 subjects with non-acute injuries in the cervical spine using Cine phasecontrast MRI. CSF flow analysis was performed using an in-house developed software. The flow waveform was calculated in both normal subjects (n=3) as well as subjects with spinal cord injury in the cervical spine (n=2). The bulk flow at C2 was measured to be 0.30 +/- 0.05 cc, at 5 cm distal to C2, it was 0.19+/- 0.07 cc, and at 10 cm distal to C2, it was 0.17+/- 0.05 cc. These results were in good agreement with previously published results. In patients with spinal cord injury, at the site of injury in the cervical spine, bulk flow was found to be 0.08 +/- 0.12 cc, at 5 cm proximal to the site of injury it was found to be 0.18 +/- 0.07 cc, and at 5 cm distal to the site of injury, it was found to be 0.12 +/- 0.01 cc.

  12. Gênese da dor na artrose Genesis of pain in arthrosis

    Directory of Open Access Journals (Sweden)

    Gilberto Luis Camanho

    2011-01-01

    , when the pain becomes refractory, peripheral and central sensitization mechanisms contribute towards maintaining and amplifying the painful conditions, regardless of the peripheral process that originated the pain. At this stage, even removal of the etiological agent may no longer be enough to relieve the painful symptoms. It then becomes necessary to envisage that other factors, distant from the affected joint, may be responsible for the disabling painful condition in such patients. At present, osteoarthrosis does not have any known cure, and the aim of treatment is to lessen the pain while improving function and health -related quality of life, and whenever possible, to minimize the toxicity of the therapy. In the light of emerging evidence suggesting that the central nervous system has a role in the physiopathology of pain in patients with knee arthrosis, the central nervous system should be taken into consideration as a therapeutic target, instead of only administering local treatment using ordinary analgesics, antiinflammatory drugs and non-pharmacological measures. Thus, methods that modulate the spinal cord and cerebral cortex, including the use of antidepressants, may have a role in managing these patients.

  13. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture

    OpenAIRE

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functional result following minimally invasive pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture. There are no previous reports of similar pseudo-arthrosis repairs, and other aut...

  14. Chronobiological aspects of changes in straight electro stimulation of spinal cord for treatment of neurological complications of cervical vertebrae osteochondro-sis

    Directory of Open Access Journals (Sweden)

    Chekhonatsky V.A.

    2012-06-01

    Full Text Available

    Research Goal was to study infuence of treatment seance time, disease duration, and age on effcacy of straight electrostimulation of spinal cord. Materials. Biorhythmological characteristics of optimal time choice for electrostimula-tion séance were studied based on the sample of 32 patients with cervical osteochondrosis, who were subjected to paracentetic electrodes placement on posterior part of spinal cord. Results. Group of patients used morning séance, demonstrated change of clinical manifestations severity in accordance to JOA scale from 8,4±0,2 to 12,8±0,3 points that formed 46,6 %. Séance during daylight hours helped to decrease clinical manifestations severity by 25,1 %; evening séance promoted reduction by 22,1 %. In patients under 40 the average percentage of decrease of posttreatment neurological symptomatology consisted 83,6±3,6 %, in patients aged 60 and upwards this index was 74,6±3,2 %. Decrease of myelopathy severity was marked in the following way: 1 – 4 years of disease duration — by 73,6±4,8 %, more than 10 years — 63,7±2,1 %; estimation was carried out using JOA scale. Conclusion. Maximum effect of straight elec-trostimulation of spinal cord was observed in the morning hours. Clinical effect of isolated use of straight electrostimula-tion of spinal cord in the complex of treating neurological symptoms of cervical vertebrae osteochondrosis decreases while disease duration extends. Effect of electrostimulation reduces in accordance with patients’ age; maximum positive results of this method can be achieved in 1 – 4 years of disease duration.

  15. Surgical Treatment for No Fracture Dislocation Cervical Spinal Cord Injury%无骨折脱位型颈脊髓损伤的手术治疗

    Institute of Scientific and Technical Information of China (English)

    项惠灿; 叶君健; 欧国潮; 卢生香; 赵庆淞

    2011-01-01

    目的 探讨无骨折脱位型颈脊髓损伤的手术治疗方法 与效果.方法 我科自2000年10月至2007年10月手术治疗无骨折脱位型颈脊髓损伤21 例,其中单节段椎间盘突出4 例,双节段椎间盘突出10 例,三节段及多节段突出7 例,合并椎体后缘骨赘6 例,黄韧带肥厚5 例,先天性椎体融合2 例.合并先天性和发育性颈椎管狭窄9 例.致压物主要来源于脊髓前方的单节段、二节段压迫脊髓,采用颈前路椎体次全切除减压自体髂骨植骨融合、带锁钛板内固定术14 例.三节段及以上多节段压迫脊髓,采用颈后路单开门或双开门颈椎管扩大椎板成型术7 例.结果 21 例经平均30个月随访,2 例完全性颈脊髓损伤术后难以忍受胸腹部束带感缓解,但四肢肌力、大小便功能无恢复.19 例按JOA评分,术前平均5.58分,术后提高到11.46分.结论 无骨折脱位型颈脊髓损伤,根据脊髓致压部位节段争取早期手术治疗,选择适当的手术方法,可较好地改善脊髓功能,提高病人的生活质量.%Objective To investigate the method and effect of surgical treatment for non fracture-dislocation of cervical spinal cord injury. Methods 21 patients with no fracture dislocation cervical spinal cord injury were underwent surgical treatment,among them four cases were single segment discintervertebral disk hernia, 10 cases were two disc segment intervertebral disk hernia, 7 cases were three paragraphs and mutti-segmentintervertebral disk hernia, 6 cases of combined posterior marginal osteophytes, 5 cases of hypertrophy ligamentum flavum,congenital vertebral fusion in 2 cases. And development and congenital neck Spinal stenosis in 9 cases. Compression was mainly caused by objects in front of the spinal cord,a single segment or two segments of spinal cord compression. Using ante-cervical approach sub-total removal of cervical vertebrae for decompression and fusion with autologous iliac bone graft ,locking by

  16. Dwarf with dual spinal kyphotic deformity at the cervical and dorsal spine unassociated with odontoid hypoplasia: Surgical management

    Directory of Open Access Journals (Sweden)

    Guru Dutta Satyarthee

    2016-01-01

    Full Text Available Morquio's syndrome is associated with systemic skeletal hypoplasia leading to generalized skeletal deformation. The hypoplasia of odontoid process is frequent association, which is responsible for atlantoaxial dislocation causing compressive myelopathy. However, development of sub-axial cervical kyphotic deformity unassociated with odontoid hypoplasia is extremely rare, and coexistence of dorsal kyphotic deformity is not reported in the western literature till date and represents first case. Current case is 16-year-old boy, who presented with severe kyphotic deformity of cervical spine with spastic quadriparesis. Interestingly, he also had additional asymptomatic kyphotic deformity of dorsal spine; however, odontoid proves hypoplasia was not observed. He was only symptomatic for cervical compression, accordingly surgery was planned. The patient was planned for correction of cervical kyphotic deformity under general anesthesia, underwent fourth cervical corpectomy with resection of posterior longitudinal ligament and fusion with autologous bone graft derived from right fibula, which was refashioned approximating to the width of the corpectomy size after harvesting and fixed between C3 and C5 vertebral bodies and further secured with anterior cervical plating. He tolerated surgical procedure well with improvement in power with significant reduction in spasticity. Postoperative X-ray, cervical spine revealed complete correction of kyphotic deformity cervical spine. At follow-up 6 months following surgery, he is doing well. Successful surgical correction of symptomatic cervical kyphotic deformity can be achieved utilizing anterior cervical corpectomy, autologous fibular bone graft, and anterior cervical plating.

  17. Radiographic study of bone changes on TMJ arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1982-11-15

    The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

  18. Quantitative assessment of physiological cerebrospinal fluid flow in the cervical spinal canal with 3.0T phase-contrast cine MRI

    Institute of Scientific and Technical Information of China (English)

    Hua Shang; Huaijun Liu; Leka Yan; Jianming Lei; Caixia Cui; Hui Li

    2012-01-01

    A total of 50 healthy volunteers aged between 18 and 54 years underwent phase-contrast cine MRI to assess cerebrospinal fluid flow characteristics in different regions of the vertebral canal. The results revealed that the cerebrospinal fluid peak flow velocity and peak flow rate in the systolic phase were significantly greater than those in the diastolic phase at the same level in the subarachnoid space of the cervical spinal canal. The ventral peak flow velocity and peak flow rate were significantly greater than the post-lateral peak flow velocity and flow rate, while there were no differences between left and right post-lateral subarachnoid peak velocity and flow rate. Moreover, there were no significant differences in peak flow velocity and peak flow rate between the systolic and diastolic phases, ventral, right post-lateral or left post-lateral peak flow velocity and peak flow rate at the same level in the subarachnoid space of the cervical spinal canal among different age groups (18-24, 25-34, 35-44, ≥ 45 years).

  19. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Czajka-Pepl, Agnieszka [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Ponocny-Seliger, Elisabeth [Department of Psychology, Sigmund Freud Private University Vienna, Vienna (Austria); Scharbert, Gisela; Wetzel, Léonore [Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Sturdza, Alina [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Dimopoulos, Johannes C. [Metropolitan Hospital, Athens (Greece); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

    2014-06-01

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  20. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture.

    NARCIS (Netherlands)

    Hoogervorst, P.; Gardeniers, J.W.M.; Moret-Wever, S.; Kampen, A. van

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functi

  1. Incidence and risk factors for the development of radiographic arthrosis after traumatic elbow injuries

    NARCIS (Netherlands)

    T.G. Guitton; D. Zurakowski; N.C. van Dijk; D. Ring

    2010-01-01

    Radiographic arthrosis is a common sequela of elbow trauma. Few studies have addressed risk factors for radiographic arthrosis after elbow injury, especially in the long term. Data from multiple long-term follow-up studies of patients with surgically treated elbow fractures provided us with an oppor

  2. Isolated subacute tuberculous spinal epidural abscess of the cervical spine: a brief report of a special case.

    Science.gov (United States)

    Alg, Varinder S; Demetriades, Andreas K; Naik, Sunil; Gunasekera, Lal

    2009-06-01

    A tuberculous spinal epidural abscess is seen rarely as a late complication of Pott's disease or in immunocompromised patients. Such abscesses in isolation are rare indeed and very uncommon in the developed and developing world. We report a patient with an isolated subacute tuberculous spinal epidural abscess without disc or vertebral involvement and no primary focus or risk factors associated with the development of spinal tuberculosis.

  3. Changes of gene expression profiles in the cervical spinal cord by acupuncture in an MPTP-intoxicated mouse model: microarray analysis.

    Science.gov (United States)

    Choi, Yeong-Gon; Yeo, Sujung; Hong, Yeon-Mi; Kim, Sung-Hoon; Lim, Sabina

    2011-07-15

    It has been shown that acupuncture at acupoints GB34 and LR3 inhibits the degeneration of nigrostriatal neurons in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of Parkinson's disease. The degeneration of spinal cord was reported to be induced in the MPTP-treated pre-symptomatic mouse. In this study, the gene expression profile changes following acupuncture at the acupoints were investigated in the cervical spinal cord of an MPTP-induced parkinsonism model using a whole transcript array (Affymetrix GeneChip mouse gene 1.0 ST array). It was shown that 8 of the probes up-regulated in MPTP, as compared to the control, were down-regulated after acupuncture at the acupoints. Of these 8 probes, 6 probes (4 annotated genes in 6 probes: Ctla2a, EG383229, Ppbp and Ube2l6) were exclusively down-regulated by acupuncture at the specific acupoints except for 2 probes as these 2 probes were commonly down-regulated by acupuncture at both the acupoints and the non-acupoints. In addition, 11 of the probes down-regulated in MPTP, as compared to the control, were up-regulated by acupuncture at the acupoints. Of these 11 probes, 10 probes (5 annotated genes in 10 probes: EG665033, ENSMUSG00000055323, Obox6, Pbp2 and Tmem150) were exclusively up-regulated by acupuncture at the specific acupoints except for the Fut11 because the Fut11 was commonly up-regulated by acupuncture at both the acupoints and the non-acupoints. The expression levels of the representative genes in the microarray were validated by real-time RT-PCR. These data suggest that the expression of these exclusively regulated 16 probes (9 genes) may be, at least in part, affected by acupuncture at the acupoints in the cervical spinal cord which can be damaged by MPTP intoxication.

  4. Ⅰ期前后联合入路手术治疗颈椎骨折合并颈髓损伤%Microneurosurgery through anterio-posterior approach for cervical spine fracture and cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    耿凤阳; 张学广; 杜池刚; 侯磊; 张志逖; 李忠民

    2016-01-01

    目的:比较Ⅰ期手术与分期手术治疗颈椎骨折合并颈髓损伤的疗效差异。方法2010年6月至2014年10月收治颈椎骨折合并颈髓损伤26例,其中16例采用Ⅰ期前后联合入路手术,10例采用分期手术(Ⅰ期后路减压+内固定手术、Ⅱ期前路椎间盘摘除+椎体固定术),以Frankel分级和日本骨科协会(JOA)评分评估脊髓功能,并计算改善率=(术后JOA评分-术前JOA评分)/(17-术前JOA评分)×100%。结果两组手术前后Frankel分级均无统计学差异(P>0.05)。两组术前JOA评分无统计学差异(P>0.05),两组术后2 d、3个月、6个月JOA评分较术前均明显增高(P<0.05),Ⅰ期手术组增高更明显(P<0.05);术后3、6个月,Ⅰ期手术组改善率均明显高于分期手术组(P<0.05)。结论Ⅰ期前后联合入路手术治疗颈椎骨折合并颈髓损伤,能及时、彻底地解除对脊髓压迫,恢复颈椎稳定性,缩短疗程,近期、远期疗效明显,是安全有效的手术方式。%Objective To compare clinical effects of one-stage microneurosurgery through anterio-posterior approach on cervical spine fracture and cervical spinal cord injury (SCI) with those of two-stage operations, of which, stageⅠoperation included posterior decompression and internal fixation and stageⅡdid intervertebral disk removal and vertebral body fixation. Methods The clinical data of 26 patients with cervical spine fracture and cervical spinal cord injury, of whom, 16 (group A) were treated by the above-mentioned one-stage microsurgery, and 10 (group B) were treated by the above-mentioned two-stage operations, were analyzed retrospectively. The spinal cord functions were assessed by Japanese Orthopedics Association (JOA) scores before and after the surgery. Results There was no significant difference in the preoperative JOA scores between groups A and B. JOA scores and spinal cord function improvement rates were (9.94

  5. Subdural fluid collection and hydrocephalus following cervical schwannoma resection: hydrocephalus resolution after spinal pseudomeningocele repair: case report.

    Science.gov (United States)

    Benedetto, Nicola; Cagnazzo, Federico; Gambacciani, Carlo; Perrini, Paolo

    2016-12-01

    The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus associated with cervical pseudomeningocele. The clinical symptoms, subdural fluid collections, and ventricular dilation resolved after surgical correction of the pseudomeningocele. This report emphasizes that hydrocephalus may be related to disorders of cerebrospinal fluid flow dynamics induced by cervical pseudomeningocele. In these rare cases, both the hydrocephalus and the symptoms are resolved by the simple correction of the pseudomeningocele.

  6. 半椎板-小关节突切除术后颈椎稳定性的研究%Postoperative change of spinal stability after hemi -laminectomy and facetectomy approach for resection of dumbbell shaped cervical spinal cord tumor

    Institute of Scientific and Technical Information of China (English)

    谢京城; 王振宇; 马长城; 刘彬; 陈晓东

    2011-01-01

    Objective To evaluate the postoperative changes of spinal stability and relevant factors followed posterior approach via hemilaminectomy and facetectomy for removal of dumbbell shaped cervical spinal cord tumor. Method The authors retrospectively analyzed a series of 25 patients with dumbbell intra -extra spinal tumors surgically treated through hemilaminectomy and facetectomy from 1999 to 2009. 30 patients with intra - spinal tumor removed through hemilaminectomy approach during the same period were chosen as comparative group. The clinical and radiographic data were reviewed. The short and long - term follow - up was performed to evaluate the clinical outcome and biomechanical change of the spine. Results 25 operations had been performed with gross total of tumor resection in all cases with histological of neurolemomas in 19 cases, neurofibroma in 1 case, ganglioneuroma in 5 cases. As comparative group, 30 tumors which had been removed successfully including neurolemomas in 24, meningiomas in 6 cases were analyzed. The short - term clinical outcome was satisfactory in the two groups ( P > 0. 05 ). The period of follow - up was ranged from 7 months to 10 years with average of 4. 28 years. There was no change in terms of range of motion of cervical spine in both groups The incidence of worsen of cervical curvature was found to be 8% in research group, 10% in comparative group ( P > 0. 05 ). The incidence of cervical spinal instability during the follow - up period was 4% in research group, and 3% in comparative group ( P >0. 05). During the follow- up, no significant different was found between the two groups in terms of long - term clinical outcome ( P > 0. 05 ). Conclusions Benign dumbbell shaped spinal cord tumor of cervical spine are well exposed and totally removed with satisfactory outcome via hemilaminectomy and facetectomy approach. Compared with hemilaminectomy, hemilaminectomy and facetectomy equally pose little impact of cervical

  7. 颈椎前路减压植骨钛板内固定治疗颈脊髓损伤%Treatment of Cervical Spinal Cord Injury by Anterior Decompression, Bone Graft and Titanium Plate Internal Fixation

    Institute of Scientific and Technical Information of China (English)

    沈宁江; 王先安; 林庆彪; 林明侠; 陈建

    2013-01-01

    Objective To evaluate the clinical efficacy of anterior decompression, bone graft and internal fixation for cervical spine fracture with cervical spinal cord injury. Methods 215 cases of cervical spine fracture with cervical spinal cord injury had been treated by the method of anterior decompression,iliac bone graft and cervical locking titanium plate fixation. X-rays were taken regularly after surgery and recovery of spinal cord function were recorded. Results 184 cases were followed for an average time of 3. 5 years. Bone graft union was achieved 3 months after surgery. The cervical intervertebral height and the physiological curvature maintained satisfactory without implant complications. Nerve function of 172 patients improved 1 to 2 degree. Only 12 cases with stage A nerve function obtained no recovery. Conclusion Patients of cervical fracture with cervical spinal cord injury should undergo surgery of anterior decompression,bone graft and plate fixation as soon as possible. It is good to spinal cord function recovery. The injured segments can obtain instant and firm stability, which makes care and functional exercises easier.%目的 评价颈椎前路减压植骨内固定治疗颈椎骨折合并颈脊髓损伤的临床疗效.方法 对215例颈椎骨折合并颈脊髓损伤的患者施行颈椎前路减压、自体髂骨植骨和颈椎带锁钛板内固定术.术后定期复查X线片,判定脊髓功能恢复情况.结果 随访184例患者,平均随访时间3.5年.术后3个月植骨块获得骨性愈合,颈椎椎间高度和生理曲度维持满意,无内置物并发症,172例患者神经功能提高1~2级,仅12例A级患者神经功能无恢复.结论 颈椎骨折合并颈脊髓损伤应尽早行前路减压、植骨、钛板内固定术,有利于脊髓功能恢复,能使损伤节段获得即刻、坚强的稳定,方便护理和功能锻炼.

  8. Spinal curves (image)

    Science.gov (United States)

    There are four natural curves in the spinal column. The cervical, thoracic, lumbar, and sacral curvature. The curves, along with the intervertebral disks, help to absorb and distribute stresses that occur from everyday activities such as walking or from ...

  9. 探讨颈椎骨折伴脊髓损伤护理%To Explore the Nursing of Cervical Fracture Combined With Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    韩旭

    2015-01-01

    目的:探讨颈椎骨折伴脊髓损伤护理。方法选取我院2014年1~12月间收治的颈椎骨折患者10例进行分析。结果经临床治疗及精心的规范化的康复护理,10例患者均达到了预期治疗效果,患者及家属满意。结论护理工作的开展有利于患者康复,提高了医疗满意度。%Objective To investigate the cervical spine fracture with spinal cord injury care.Methods Patients with cervical spine fracture between January 2014 to December 10 cases admitted to our hospital for analysis. ResultsThe clinical treatment and rehabilitation care carefully standardized, 10 patients have reached the desired therapeutic effect, patient and family satisfaction.ConclusionThe work carried out in favor of patient care and rehabilitation, to improve the health care satisfaction.

  10. Analysis of motor fibers in the communicating branch between the cervical nerves and the spinal accessory nerve to innervate trapezius in the rat.

    Science.gov (United States)

    Yan, Jun; Hitomi, Jiro

    2006-11-01

    The communicating branch between the ventral rami of cervical nerves and the spinal accessory nerve (SAN) has been reported to also send motor fibers to supply the trapezius. However, the motor fiber type of the communicating branch and its peripheral distribution are still unclear. To determine the fiber elements within the branch and its peripheral distribution of the motor fibers in the trapezius, the anterograde tracing method was used in this study. The results show that a few a motor end plates from the communicating branch were observed on the extrafusal fibers, while in the muscle spindle the motor elements from the communicating branch were distributed to the polar portions of the intrafusal fibers. These results indicated that the motor fibers passing through the communicating branch to supply the trapezius are mainly y motor fibers, with some a motor fibers. Moreover, the a and y motor fibers from the communicating branch were observed in the clavotrapezius, acromiotrapezius and the rostral part of spinotrapezius. These findings also correlate with the clinical observation indicating that even when the spinal accessory nerve is injured, the trapezius is still capable of slight movement.

  11. Relationship between bulbocavernosus reflex, patellar reflex and rehabilitation during acute stage of cervical spinal injury%颈髓损伤急性期球海绵体反射、膝反射与康复的关系

    Institute of Scientific and Technical Information of China (English)

    杨茂伟; 朱悦; 吕刚; 范广宇; 薛明

    2003-01-01

    AIM: To investigate the relationship between bulbocavemous refiex(BTR),patallar reflex(PTR) and rehabilitation during acute stage of cervical spinalinjury. METHODS: 73 cases of a class frankel cervical spinal injury patientswere examined with BTR and PTR and recorded the time of the two reflexes,then follow-up after 6 months to monitor recovery situation. RESUULTS: Therewere 28 cases of positive BCR within the first 72 h (38%), 7 cases of improvedcondifions(25% ); there were 13 cases of PTR positive (17%), 13 cases ofimproved status(100% ). CONCLUSION: BCR and PTR are the sign of ima-proved status and better rehabilitation during the acute stage.

  12. 慢性颈脊髓压迫的磁共振质谱成像%Magnetic resonance spectroscopy study of the chronic compression of cervical spinal cord.

    Institute of Scientific and Technical Information of China (English)

    张琥; 杜炎鑫; 林定坤; 陈博来; 田铁桥; 陈树良; 陈加良; 蔡懿

    2011-01-01

    Objective To evaluate the clinical application of magnetic resonance spectroscopy ( MRS ) in chronic compression of cervical spinal cord, and to study the risk factors of symptomatic rnyelopathy. Methods Tirty - four patients with MRI -proved compressed cervical spinal cord, were divided into two groups according to JOA scores: symptomatic group ( Group Ⅰ , n = 15 ) and presymptomatic group ( Group Ⅱ, n = 19 ). Fifteen aged - matched healthy volunteers were enrolled in control group ( Group Ⅲ ). Preoperative neurological examination, functional assessment, and cervicai spine MR spectroscopy were carried out in patients preoperatively. Voxels were placed at the adjacent level to the maxis compressive level. The main metabolite concentration ratios, including N -acetylaspartate/creatine ( NAA/Cr ),choline/creatine ( Cho/Cr ), myoinositol/creatine ( mI/Cr ), lactate/creatine( Lac/Ct ) and glutamate/creatine ( Glx/Cr), were obtained. Results Total 49 cases succeeded to have MR spectroscopy. Epidural compression, spinal cord compression and abnormal signal were observed in 4, 30 and 17 cases, respectively. When comparing with those in Group Ⅲ, significant reduction of NAA/Cr and Glx/Cr were revealed in Group Ⅰ ( P <0. 01 ); so was significant reduction of Glx/Cr in Group Ⅱ ( P <0. 05 ). Glx/Cr was proved as a protective factor for cervical spondylotic myelopathy ( Wald x2=3. 951, P <0. 05, OR =0. 23 ), while altered MRI signal was a risk factor ( Wald x2 = 13. 561, P < 0. 001, OR =35. 991 ). Conclusion MRS provides useful semi - quantitative estimates of the cellular biochemistry of the spinal cord in patients with chronic compression. Reduced ratios of NAA/Cr and Glx/Cr in patients with CSM indicates the axonal and neuronal loss in cervical spinal cord. Seventy percent of the patients with spondylotic cervical cord compression had significant Lac peaks, which further supports the role of ischemia in the pathophysiology of chronic compression. The

  13. Evaluation of the anatomical and functional consequences of repetitive mild cervical contusion using a model of spinal concussion.

    Science.gov (United States)

    Jin, Ying; Bouyer, Julien; Haas, Christopher; Fischer, Itzhak

    2015-09-01

    Spinal cord concussion is characterized by a transient loss of motor and sensory function that generally resolves without permanent deficits. Spinal cord concussions usually occur during vehicular accidents, falls, and sport activity, but unlike brain concussions, have received much less attention despite the potential for repeated injury leading to permanent neurological sequelae. Consequently, there is no consensus regarding decisions related to return to play following an episode of spinal concussion, nor an understanding of the short- and long-term consequences of repeated injury. Importantly, there are no models of spinal concussion to study the anatomical and functional sequelae of single or repeated injury. We have developed a new model of spinal cord concussion focusing on the anatomical and behavioral outcomes of single and repeated injury. Rats received a very mild (50 kdyn, IH impactor) spinal contusion at C5 and were separated into two groups three weeks after the initial injury--C1, which received a second, sham surgery, and C2, which received a second contusion at the same site. To track motor function and recovery, animals received weekly behavioral tests--BBB, CatWalk™, cylinder, and Von Frey. Analysis of locomotor activity by BBB demonstrated that rats rapidly recovered, regaining near-normal function by one week after the first and second injury, which was confirmed using the more detailed CatWalk™ analysis. The cylinder test showed that a single contusion did not induce significant deficits of the affected limb, but that repeated injury resulted in significant alteration in paw preference, with animals favoring the unaffected limb. Intriguingly, Von Frey analysis demonstrated an increased sensitivity in the contralateral hindlimb in the C2 group vs. the C1 group. Anatomical analyses revealed that while the lesion volume of both groups was minimal, the area of spared white matter in the C2 group was significantly reduced 1 and 2mm rostral to

  14. The cause and prevention of sacroiliac arthrosis in the Standardbred horse: a theoretical study.

    Science.gov (United States)

    Rooney, J R

    1981-11-01

    Sacroiliac arthrosis is a major cause of "hiking" lameness (often, so-called "stifle lameness") in Standardbred horses. The cause of this arthrosis is found in the moment forces generated as horses negotiate unbanked and underbanked turns and in the forces generated on cambered racing surfaces. The prediction is that such lameness could be virtually eliminated if racetrack and training track turns were properly banked and camber held to a minimum.

  15. 颈神经在颈椎间孔及脊神经沟处受嵌压的解剖学因素%Anatomical factors of wedge pressure on cervical nerves in cervical intervertebral foramen of cervical nerve and sulcus of spinal nerve

    Institute of Scientific and Technical Information of China (English)

    李英平; 郭瑞芳

    2005-01-01

    nerve root.OBJECTIVE: To probe into the anatomical factors of cervical spondylosis of nerve root type with occurrence rate of involved cervical nerve in cervical intervertebral foramen and sulcus of spinal nerve.DESIGN: Single sample observation was designed.SETTING: Department of Anatomy of Chengde Medical College.PARTICIPANTS: Totally 120 sides of 60 adult corpses were employed with formaldehyde fixation (28 cases of male and 32 cases of female).METHODS: Sixty adult corpses were measured with the vernier of 0.02 mm spinal nerve and the transverse diameter of anterior branch (A-diameter) of superoinferior diameter (S - I diameter) of cervical intervertebral foramen and its spinal nerve root. The ratios were calculated between A-diameter cervical nerve and E-diameter of the corresponding sulcus of spinal nerve and between A - P diameter and S - I diameter of spinal nerve root and those of corresponding intervertebral foramen respectively. The rates of occurrence were concluded for those cervical nerves whose A-diameter larger than or equal to E-diameter of sulcus of spinal nerves and for those spinal nerve roots whose rations larger than or equal to those of corresponding intervertebral foramens.cervical nerve in C3-6 larger than or equal to E-diameter of sulcus of spinal nerve roots in C3-6 larger than or equal to those of corresponding intervertebral foramens.RESULTS: Totally 120 sides of 60 corpses were measured (56 cases of male wedge pressure in intervertebral foramen of cervical nerve root for both male and female, of which, that of female was remarkably superior to the male was 6. 3% for wedge pressure of anterior branch of cervical spinal nerve in sulcus in spinal nerve for both male and female, of which, that of male was remarkably superior to the female(8.9%, 3.9%, χ2 = 6.65, P < 0. 01 ).CONCLUSION: The involvement of cervical nerve is related not only to the stenosis of bone canal but also to the injury of peripheral soft tissues. By the ratios between E

  16. Acupoints for cervical spondylosis

    OpenAIRE

    Zhu, Jihe; Arsovska, Blagica; Vasileva, Dance; Petkovska, Sofija; Kozovska, Kristina

    2015-01-01

    Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck, as well as the contents of the spinal canal. This is one of the most common degenerative disorders of the spine. The disease can be symptomatic and asymptomatic. Symptoms that are distinctive for cervical spondylosis are: tingling, numbness and weakness in the limbs, lack of coordination, stiff neck, shoulder pain, occipital pain, vertigo, poor...

  17. [The scaphoid-trapezium-trapezoid arthrosis. A clinical study 1982-1985].

    Science.gov (United States)

    Wilhelm, K; Rolle, A; Hild, A

    1989-02-01

    The present study deals with patients in whom the diagnostic procedures applied in rhizoid arthrosis were considered to reveal scaphoid-trapezium-trapezoid (STT) arthrosis. Between 1982 and 1985, 21 of 396 rhizoid arthrosis patients developed symptoms of STT arthosis. Examination of the case histories showed that in 20 STT patients the pathogenesis included trauma. In addition, the majority of these 396 patients (71.5%) had to be retreated because of new traumata and the resultant problems. The time lapse between the first trauma considered sufficiently severe to have caused STT arthrosis and its diagnosis was up to 7.1 years. Our improved facilities for diagnosis of pathologic conditions of the wrist enabled us to distinguish four types of STT arthrosis. Persistent complex instability of the capsular ligament appears to be the major cause of post-traumatic STT arthrosis. Extended diagnostic techniques based on standardized radiograms allow the development of a design for treatment aimed at preventing posttraumatic STT of the hand as far as possible.

  18. Influence of adjacent low-dose fields on tolerance to high doses of protons in rat cervical spinal cord

    NARCIS (Netherlands)

    Bijl, HP; van Luijk, P; Coppes, RP; Schippers, JM; Konings, AWT; van der Kogel, AJ

    2006-01-01

    Purpose: The dose-response relationship for a relatively short length (4 mm) of rat spinal cord has been shown to be significantly modified by adjacent low-dose fields. In an additional series of experiments, we have now established the dose-volume dependence of this effect. Methods and Materials: W

  19. Ascending and descending axon-collaterals from cervical spinal neurons : a retrograde fluorescent double-labeling study in the rat.

    NARCIS (Netherlands)

    C.A. Verburgh

    1990-01-01

    textabstractIn order to gain insight into the function of the central nervous system it is of importance to know the lay-out of fiber connections between its constituent cells and cell-groups. Much is already known of the anatomy of the spinal cord and its afferent and efferent fibers; this will be

  20. The Epidemiological Study on Cervical Spinal Canal Ratio of Xinjiang Uighur%新疆维吾尔族人正常颈椎管率的流行病学研究

    Institute of Scientific and Technical Information of China (English)

    张鹰; 杨宇; 凯赛尔江·艾合买提; 徐子昂; 倪鹏辉

    2016-01-01

    目的:研究新疆维吾尔族正常颈椎管率的流行病学特点。方法应用随机、整群、分层抽样法,抽取新疆5个市(喀什、和田、吐鲁番、哈密、伊宁)健康成年人群脊柱样本,收集维吾尔民族不同性别、不同年龄组人群的正常颈椎侧位 X 线片,测量并统计颈椎 C2~7各节段椎管矢状径(a)及与其对应的椎体矢状径(b),并换算成颈椎管率(a/ b)。结果新疆维吾尔族的平均颈椎 C2~7节段(除 C4稍低于 C5节段外)椎管率呈现从高到低的趋势;不同性别间的椎管率在颈椎C2~7节段男性明显小于女性( P ﹤0.05),不同性别间的椎体矢状径在颈椎C2~7节段男性大于女性( P ﹤0.05),不同性别间的椎管矢状径在颈椎 C2~7节段女性与男性接近,差异无统计学意义(P ﹥0.05)。维吾尔族不同年龄组的颈椎管率在 C2、C3、C4、C6、C7节段的差异有统计学意义(P ﹤0.05),但不同年龄组颈椎管率在颈椎 C5节段的差异无统计学意义(P ﹥0.05),不同年龄组的椎管及椎体矢状径在颈椎 C2~7节段女性与男性接近,差异均无统计学意义(P ﹥0.05)。结论颈椎管率的相关测量结果揭示了新疆维吾尔族正常颈椎管率的流行病学特点,为临床应用及进一步基因学研究新疆维吾尔族颈椎管率的解剖学和遗传学的特点提供统计学依据。%Objective To study the epidemiological characteristics of the rate of cervical spinal canal of Xinjiang uygur. Methods We selected five cities(kashi,hotan,turpan,hami,yining)of Xinjiang and examed the adults of healthy spine as samples by random layer sampling method. Lateral X-ray of cervical vertebral of different genders groups and different age groups of Xinjiang uygur were collected. We measured sagittal diameter of vertebral canal(a)and the sagittal diameter of ver-tebral body(b)of each of cervical vertebra C2 ~ 7 and converted to

  1. Study of position control to cervical spinal cord injury of hemiplegic patients during functional activities%颈髓挫伤致偏瘫患者功能锻炼中抗肌痉挛体位的研究

    Institute of Scientific and Technical Information of China (English)

    何瑞琼

    2009-01-01

    目的 抗痉挛体位对颈髓挫伤致瘫痪患者功能锻炼中降低肌痉挛的效果.方法 观察82例颈髓挫伤致偏瘫患者功能锻炼时肌痉挛情况及抗痉挛降低肌痉挛的情况.结果 颈髓挫伤致瘫痪患者,体位转换、移动活动、平衡活动及一些力量性训练过程中发生患侧上肢屈肌痉挛(不自主屈肘或握拳)和下肢伸肌痉挛(不自主膝过伸或踝趾屈)的阳性率,以及采取对抗痉挛体位1个月后,患者肌痉挛被抑制.结论 颈髓挫伤致瘫痪患者早期一些功能活动可以诱发肌肉痉挛产生,抗痉挛抑制体位对此有控制效果.%Objective To study position control to cervical spinal cord injury of hemiplegic patients during functional activities. Methods 82 cases of cervical spinal cord injury of hemiplegic patients functional activities and position control was observated. Results The cervical spinal cord injury of hemiplegic patients while body transfer, balance and strengthening, functional activities easily induced muscles spasticity, against muscles spasticity can in-crease the muscles spasticity. Conclusion The inhibition of muscles spasticity can increased the muscles spasticity the patients of cervical spinal cord injury of hemiplegic.

  2. Spinal actinomycosis: A rare disease

    Directory of Open Access Journals (Sweden)

    Dua Rakesh

    2010-01-01

    Full Text Available Actinomycosis is an indolent, slowly progressive infection caused by Actinomyces species. Of human actinomycosis, the spinal form is rare and actinomycosis-related spinal neurological deficit is uncommon. We report two cases with cervical and dorsal actinomycosis and one of them with spinal neurological deficit.

  3. SATISFACTION OF PATIENTS WITH ARTHROSIS FROM MULTIDISCIPLINARY COOPERATION

    Directory of Open Access Journals (Sweden)

    Gergana Nenova

    2016-10-01

    Full Text Available INTRODUCTION: The research of patient satisfaction with arthrosis from multidisciplinary cooperation is related to clarifying the position and the role of the physiotherapist in public health and in the development of integrated care. AIM OF THE STUDY: To investigate the satisfaction of patients with arthrosis from multidisciplinary cooperation. MATERIAL AND METHODS: In this research study participated 30 patients of the Department of Orthopedics and Traumatology of University Hospital "St. Marina" EAD - Varna for the period 2012-2016 of which 13 were men and 17 women. A feedback from these patients was sought based on the 5-point Likert scale regarding their satisfaction after the completion of the work of the multidisciplinary task team that provides integrated care at home. The questionnaire includes 12 questions, grouped in the following areas: awareness, attitude / communication, time, physical activity, professionalism and benefit / effectiveness. The data were compared with the results from a study of the satisfaction of a control group of 30 patients who were treated in the same ward, but chose to continue their rehabilitation with NHIF. RESULTS: The respondents from the test group are highly satisfied in the "awareness" area (respectively 4.80 and 4.90. They say that they have more freedom in daily activities after the procedure conducted by physiotherapist (4.93 and would seek the same physiotherapist if they need rehabilitation in the future. Patients appreciate the quality behavior/approach and communication skills displayed by the physiotherapist during the rehabilitation process (5.00, which enables them to better understand their illness (4.93. The respondents from the test group felt much better after each procedure performed by the physiotherapist (5.00 and would recommend him/her to other patients who have the same need (5.00. The satisfaction from the work of the physiotherapist is appreciated by patients extremely high, but

  4. 类固醇激素治疗急性颈髓损伤的临床观察%The clinical study of steroid hormone on the treatment in acute cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    张建宏; 范建中; 杨哲

    2002-01-01

    Objective To observe the therapeutic effect of methylprednisolone and dexamethasone on acute cervical spinal cord injury, and to explore the function and mechanism of steroid. Methods 59 patients with cervical spinal cord injury and post operation were divided into the methylprednisolone group (19 cases), the dexamethasone group (25 cases) and routine treatment group (15 cases). Based on the neural and functional grade standard of spinal cord injury, the degree of damage were assessed and the clinical data and complications were recorded. Results The function of sensory and motor in the three groups were all improved remarkably (P< 0.05). The sensory improvement of the methylprednisolone group was better than the other two groups and the motor improvement of the methylprednisolone group was better than routine treatment group. There was no difference in the treatment effect between the dexamethasone group and routine treatment group. There was no different in the complications among the three groups. Conclusion The steroid hormone can improve the function of sensory and motor in the patients with acute spinal cord injury. The theraputic effect of the methylprednisolone was better than that of the dexamethasone.

  5. Perfusion CT measurements in healthy cervical spinal cord: feasibility and repeatability of the study as well as interchangeability of the perfusion estimates using two commercially available software packages

    Energy Technology Data Exchange (ETDEWEB)

    Bisdas, Sotirios [Johann Wolfgang University Hospital, Department of Radiology, Frankfurt (Germany); Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Johann Wolfgang Goethe University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Rumboldt, Zoran; Deveikis, John; Spampinato, Maria Vittoria [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Surlan, Katarina [Clinical Centre Ljubljana, Department of Clinical Radiology, Ljubljana (Slovenia); Koh, Tong San [Nanyang Technological University, School of Electrical and Electronic Engineering, Singapore (Singapore)

    2008-10-15

    Our purpose was to examine the feasibility and reproducibility of perfusion CT studies in the cervical spinal cord and the interchangeability of the values obtained by two post-processing methods. The perfusion CT studies of 40 patients with neck tumours were post-processed using two software packages (Software-1: deconvolution-based analysis with adiabatic tissue homogeneity approach and Software-2: maximum-slope-model with Patlak analysis). Eight patients were examined twice for assessing the reproducibility of the technique. Two neuroradiologists separately post-processed the images with two arterial input functions (AIFs): (1) the internal carotid artery (ICA) and (2) the vertebral artery (VA). Maps of blood flow (F) in ml/min/100 g, blood volume (V) in ml/100 g, mean transit time (MTT) in seconds (s) and permeability (PS) in ml/min/100 g were generated. The mean F, V, MTT and PS (Software-1) with VA-AIF and ICA-AIF were 8.93, 1.12, 16.3, 1.88 and 8.57, 1.19, 16.85 and 1.94, respectively. The reproducibility of the techniques was satisfactory, while the V and MTT values (in Software-1) and the F and V values (in Software-2) were dependent on the site of the AIF (p{>=}0.03 and p=0.02, respectively). The interobserver agreement was very good. The significant differences in measurements for a single patient (%) using Software-1/Software-2 were {+-}120%/110%, 90%/80%, 180% and 250%/130% for F, V, MTT and PS, respectively. Only F and PS values in the healthy tissue seemed to be interchangeable. Our results were in essential agreement with those derived by invasive measurements in animals. The cervical spine perfusion CT studies are feasible and reproducible. The present knowledge has to be validated with studies in spinal cord tumours in order to decide the usefulness of the perfusion CT in this field. (orig.)

  6. Position of increased signal intensity in the spinal cord on MR images: does it predict the outcome of cervical spondylotic myelopathy?

    Institute of Scientific and Technical Information of China (English)

    SHEN Hong-xing; LI Ling; YANG Zhi-gao; HOU Tie-sheng

    2009-01-01

    Background Increased signal intensity (ISI) in the spinal cord on T2-weighted MR images has been reported in some previous researches, however no study focused on the position of the ISI in the spinal cord and its potential value. The aim of this study was to investigate the correlation between ISI position and the outcome of surgical treatment for cervical spondylotic myelopathy (CSM) patients.Methods A retrospective study was conducted. Pre- and post-operative clinical status was evaluated by modified Japanese Orthopaedic Association (JOA) score. ISI was evaluated according to the T2-weighted sequences. The JOA score and the recovery ratios among patients with ISI in gray matter (group A), in both gray and white matter (group B), and ISI-negative group were compared.Results Totally 64 patients were enrolled in this retrospective study. Preoperative JOA score of ISI positive and negative group had significant difference, but the recovery ratios had no significant difference (the recovery ratios of the two groups in week 1, week 26, and week 104 were (21.54±14.65)%, (50.56±14.76)%, (59.23±13.08)% and (20.25±14.32)%, (54.46±23.16)% and (61.26±29.4)%, respectively; P>0.05). The recovery ratios of negative group and group A in week 104 were superior to group B (the recovery ratios of negative group, group A, and group B in week 104 were (61.26±E29.49)%, (65.35±11.36)%, and (50.33±10.20)%, respectively; P <0.05). Conclusions Patients with ISI in the gray matter alone on T2-weighted MR images did not have significantly different surgical outcomes compared with those without ISI. Patients with ISI in both gray and white matter had surgical outcomes that were worse than those without ISI.

  7. Perspective: Does Laboratory-Based Maximal Incremental Exercise Testing Elicit Maximum Physiological Responses in Highly-Trained Athletes with Cervical Spinal Cord Injury?

    Science.gov (United States)

    West, Christopher R; Leicht, Christof A; Goosey-Tolfrey, Victoria L; Romer, Lee M

    2015-01-01

    The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate) responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push). In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardized exercise intensities.

  8. Perspective: Does laboratory-based maximal incremental exercise testing elicit maximum physiological responses in highly-trained athletes with cervical spinal cord injury?

    Directory of Open Access Journals (Sweden)

    Christopher R West

    2016-01-01

    Full Text Available The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push. In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardised exercise intensities.

  9. Semi-automatic segmentation and modeling of the cervical spinal cord for volume quantification in multiple sclerosis patients from magnetic resonance images

    Science.gov (United States)

    Sonkova, Pavlina; Evangelou, Iordanis E.; Gallo, Antonio; Cantor, Fredric K.; Ohayon, Joan; McFarland, Henry F.; Bagnato, Francesca

    2008-03-01

    Spinal cord (SC) tissue loss is known to occur in some patients with multiple sclerosis (MS), resulting in SC atrophy. Currently, no measurement tools exist to determine the magnitude of SC atrophy from Magnetic Resonance Images (MRI). We have developed and implemented a novel semi-automatic method for quantifying the cervical SC volume (CSCV) from Magnetic Resonance Images (MRI) based on level sets. The image dataset consisted of SC MRI exams obtained at 1.5 Tesla from 12 MS patients (10 relapsing-remitting and 2 secondary progressive) and 12 age- and gender-matched healthy volunteers (HVs). 3D high resolution image data were acquired using an IR-FSPGR sequence acquired in the sagittal plane. The mid-sagittal slice (MSS) was automatically located based on the entropy calculation for each of the consecutive sagittal slices. The image data were then pre-processed by 3D anisotropic diffusion filtering for noise reduction and edge enhancement before segmentation with a level set formulation which did not require re-initialization. The developed method was tested against manual segmentation (considered ground truth) and intra-observer and inter-observer variability were evaluated.

  10. Developmental localization of calcitonin gene-related peptide in dorsal sensory axons and ventral motor neurons of mouse cervical spinal cord.

    Science.gov (United States)

    Kim, Jeongtae; Sunagawa, Masanobu; Kobayashi, Shiori; Shin, Taekyun; Takayama, Chitoshi

    2016-04-01

    Calcitonin gene-related peptide (CGRP) is a 37-amino-acid neuropeptide, synthesized by alternative splicing of calcitonin gene mRNA. CGRP is characteristically distributed in the nervous system, and its function varies depending on where it is expressed. To reveal developmental formation of the CGRP network and its function in neuronal maturation, we examined the immunohistochemical localization of CGRP in the developing mouse cervical spinal cord and dorsal root ganglion. CGRP immunolabeling (IL) was first detected in motor neurons on E13, and in ascending axons of the posterior funiculus and DRG neurons on E14. CGRP-positive sensory axon fibers entered Laminae I and II on E16, and Laminae I through IV on E18. The intensity of the CGRP-IL gradually increased in both ventral and dorsal horns during embryonic development, but markedly decreased in the ventral horn after birth. These results suggest that CGRP is expressed several days after neuronal settling and entry of sensory fibers, and that the CGRP network is formed in chronological and sequential order. Furthermore, because CGRP is markedly expressed in motor neurons when axons are vastly extending and innervating targets, CGRP may also be involved in axonal elongation and synapse formation during normal development.

  11. Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: an explorative study.

    Science.gov (United States)

    Kloosterman, Marieke G M; Snoek, Govert J; Kouwenhoven, Mirjam; Nene, Anand V; Jannink, Michiel J A

    2010-01-01

    Many interventions in upper-limb rehabilitation after cervical spinal cord injury (CSCI) use arm support (gravity compensation); however, its specific effects on kinematics and muscle activation characteristics in subjects with a CSCI are largely unknown. We conducted a cross-sectional explorative study to study these effects. Nine subjects with a CSCI performed two goal-directed arm movements (maximal reach, reach and retrieval) with and without gravity compensation. Angles at elbow and shoulder joints and muscle activation were measured and compared. Seven subjects reduced elbow extension (range 1.8°-4.5°) during the maximal reaching task with gravity compensation. In the reach and retrieval task with gravity compensation, all subjects decreased elbow extension (range 0.1°-11.0°). Eight subjects executed movement closer to the body. Regarding muscle activation, gravity compensation did not influence timing; however, the amplitude of activation decreased, especially in antigravity muscles, namely mean change +/- standard deviation of descending part of trapezius (18.2% +/- 37.5%), anterior part of deltoid (37.7% +/- 16.7%), posterior part of deltoid (32.0% +/- 13.9%), and long head biceps (49.6% +/- 20.0%). Clinical implications for the use of gravity compensation in rehabilitation (during activities of daily living or exercise therapy) should be further investigated with a larger population.

  12. The relationship between the imaging features and prognosis in the patients with cervical spinal stenosis and cervical spondylotic myelopathy%先天性颈椎管狭窄与脊髓型颈椎病影像学表现以及预后的关系

    Institute of Scientific and Technical Information of China (English)

    丁文元; 曹来震; 申勇; 张为; 王林峰; 张英泽

    2011-01-01

    目的 探讨脊髓型颈椎病(cervical spondylotic myelopathy,CSM)患者先天性颈椎管狭窄(cervical spinal stenosis,CSS)与颈椎MRI改变及预后的关系.方法 回顾性分析自2006年11月至2009年11月,采用前路、后路或前后路联合手术治疗的286例CSM患者的病例资料,根据患者是否存在CSS将患者分为两组,在MRI T2加权像上评价脊髓高信号的等级以及脊髓受压程度.记录患者日本骨科学会评分标准(Japanese Orthopaedic Associatio,JOA)评分、病程和体征,包括感觉减退或者消失、Hoffman征、Babinski征、腱反射.结果 在CSM患者中CSS的发生率为33.6%,先天性CSS组的年龄、JOA评分、病程均大于无CSS组,术后临床改善率小于无CSS组.两组之间性别的差异无统计学意义(x2=0.006,P=1.00),两组之间的颈椎MRI T2加权像脊髓高信号发生率的差异有统计学意义(x2=-62.396,P<0.001),CSS组脊髓高信号的发生率为70.8%,无CSS组脊髓高信号的发生率为22.6%.先天性CSS组脊髓受压程度相对于无CSS组严重,且先天性CSS组患者体征的数目相对较多.应用多元线性回归分析法得出术后改善率与CSS、病程、临床体征的数目和年龄有关(R2=0.565).结论 先天性CSS患者出现CSM时往往脊髓受压程度较重、MRI T2加权像脊髓内高信号出现的概率大,病程长且预后较差.%Objective To investigate the relationship between the cervical MR images and pathological changes, prognosis in patients with cervical spinal stenosis and cervical spondylotic myelopathy. Methods From Nov. 2006 to Nov. 2009, 286 patients with cervical spondylotic myelopathy were included through retrospective analysis. All patients were divided into two groups according to whether there was cervical stenosis, the grade of increased signal intensity (ISI) in spinal cord and the degree of spinal cord compression was evaluate in T2-weighted MR images of midian sagittal slices. JOA scale, duration of disease

  13. 颈脊髓损伤血液动力学变化%Changes of hemodynamic parameters in acute cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    赵昌松; 张强; 蔡娟; 袁征; 高峥嵘; 权学民; 陈小龙

    2012-01-01

    [Objective]To evaluate the relationship between the severity of cervical spinal cord injury ( SCI) and hemodynamic parameters changes. [Method]Blood pressure(BP)and heart rate(HR)were taken once daily during the first 7 days in hospital persist warding the electrocardiogram. The mean value of the hemodynamic parameters were choosen as statistic data. The neurologic clinical status of patients was assessed according to the American Spinal Injury Association ( ASIA) impairment scale. Severe complete SCI( Frankel grade A) was determined in 31 patients of these patients,frankel B in 19 patients,Frankel C/D in 28 patients. The mean patient age w4s 36. 5 years( range of 16 - 78 ) . [ Result] The occurrence of hypotension and brad-ycardia revealed a statistically significant difference among Frankel A,Frankel B and C/D(P<0.05). [Conclusion] Dysfunction of cardiovascular system usually develops in patients with cervical SCI, the main clinical presentations are hypotension and bradycardia. Detailed evaluation of autonomic dysfunctions following SCI cardiovascular instability can improve our understanding of the complicated of clinical presentations and possible neurological impairment.%[目的]探讨颈脊髓损伤的严重性(Franke1分级)与患者血液动力学变化的关系.[方法]颈脊髓损伤患者入院后进行连续7d心电监护测量血压、心率取平均值,并作为统计参数.患者神经功能根据美国脊髓损伤协会(American Spinal Injury Association,ASIA)损伤系统分级法,其中Franke1 A 31例,Franke1 B 19例,Franke1 C/D 28例.患者平均年龄36.5岁(16 ~ 78岁),平均随访时间30个月(12~ 60个月).[结果]Franke1 A组出现低血压和心动过缓病例和Franke1 B,Franke1 C/D组比较,有显著差异性(P<0.05).[结论]颈脊髓损伤后可引起植物神经系统功能障碍,常发生心血管功能紊乱,临床表现为低血压、心动过缓.详细评价颈脊髓损伤后自主神经功能紊乱所致的心血管功能

  14. 急性颈髓损伤并发低钠血症的临床分析及治疗%Clinical Analysis and Treatment of Acute Cervical Spinal Cord Injury With Hyponatremia

    Institute of Scientific and Technical Information of China (English)

    王永亮; 刘学静; 孙晓林; 王大伟; 廉克强

    2015-01-01

    目的:探讨急性颈髓损伤并发低钠血症患者的临床特点及治疗效果。方法选取我院2012年5月~2014年12月急性颈髓损伤并发低钠血症患者136例,将其随机分成两组。结果不同颈髓损伤平面损伤程度及是否合并感染各项比较,各组别之间低钠血症发生率比较,P<0.05,差异具有统计学意义。34例低钠血症患者经限制水摄入量和适量的补钠治疗,低钠症状1~2 W内改善。结论急性颈髓损伤并发低钠血症患者的并发因素,多与受损颈髓部位的平面损伤程度及合并感染相关限制水摄入量有关,适当补钠是安全有效的治疗方法。%Objective To investigate the clinical characteristics and treatment effect of acute cervical spinal cord injury complicated with hyponatremia.Methods Selected 136 cases of acute cervical spinal cord injury complicated with hyponatremia from May 2012 to December 2014 in our hospital were randomly divided into two groups. ResultsThere were differences in the level of injury of different cervical cord injury and the incidence of low sodium,P<0.05, had difference statistically signiifcance. 34 patients with hyponatremia were treated with restriction of water intake and appropriate amount of sodium, and the symptoms of low sodium were improved by 1 to 2 weeks.Conclusion Acute cervical spinal cord injury complicated with hyponatremia in patients with the extent of damage to the extent of the damage to the cervical spinal cord injury and combined with infection associated with restricted water intake, appropriate sodium is a safe and effective treatment method.

  15. Differences in Left Ventricular Global Function and Mechanics in Paralympic Athletes with Cervical and Thoracic Spinal Cord Injuries

    Science.gov (United States)

    Currie, Katharine D.; West, Christopher R.; Krassioukov, Andrei V.

    2016-01-01

    Following a spinal cord injury, there are changes in resting stroke volume (SV) and its response to exercise. The purpose of the following study was to characterize resting left ventricular structure, function, and mechanics in Paralympic athletes with tetraplegia (TETRA) and paraplegia (PARA) in an attempt to understand whether the alterations in SV are attributable to inherent dysfunction in the left ventricle. This retrospective study compared Paralympic athletes with a traumatic, chronic (>1 year post-injury), motor-complete spinal cord injury (American Spinal Injury Association Impairment Scale A-B). Eight male TETRA wheelchair rugby players (34 ± 5 years, C5-C7) and eight male PARA alpine skiers (35 ± 5 years, T4-L3) were included in the study. Echocardiography was performed in the left lateral decubitus position and indices of left ventricular structure, global diastolic and systolic function, and mechanics were derived from the average across three cardiac cycles. Blood pressure was measured in the supine and seated positions. All results are presented as TETRA vs. PARA. There was no difference in left ventricular dimensions between TETRA and PARA. Additionally, indices of global diastolic function were similar between groups including isovolumetric relaxation time, early (E) and late (A) transmitral filling velocities and their ratio (E/A). While ejection fraction was similar between TETRA and PARA (59 ± 4 % vs. 61 ± 7 %, p = 0.394), there was evidence of reduced global systolic function in TETRA including lower SV (62 ± 9 ml vs. 71 ± 6 ml, p = 0.016) and cardiac output (3.5 ± 0.6 L/min vs. 5.0 ± 0.9 L/min, p = 0.002). Despite this observation, several indices of systolic and diastolic mechanics were maintained in TETRA but attenuted in PARA including circumferential strain at the level of the papillary muscle (−23 ± 4% vs. −15 ± 6%, p = 0.010) and apex (−36 ± 10% vs. −23 ± 5%, p = 0.010) and their corresponding diastolic strain rates

  16. Dysphagia produced by cervical spine osteophyte. A case report

    Directory of Open Access Journals (Sweden)

    Claudio Silveri

    2014-01-01

    Full Text Available We present a case of a 73-year-old male patient with progressive dysphagia, and hoarseness (irritability in the throat. He was studied with the appropriate imaging techniques, and esophagoscopy led to a diagnosis of extrinsic esophageal dysphagia for osteophyte obstruction of the cervical spine due to the arthrosis. A surgical resection was performed, without complications. Some considerations are given on this theme.

  17. Radiological study of the condylar heads in temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1985-11-15

    The author obtained the oblique lateral transcranial radiograms from 376 patients (114 of male, and 262 of female) with temporomandibular joint arthrosis. After tracing each film, the author analyzed the dimensional changes of the condylar heads with pain, clicking, mouth opening limitation, and masticatory difficulty respectively, which were the chief complaints of the TMJ arthrosis and compared these data with control group. The results were as follows; 1. There was a great predilection for occurrence of the TMJ arthrosis in female (262 cases) over male (114 cases). But there was no significant difference in ratio between the sexes on each symptom. In male, 60 patients (52.6%) had pain, 28 patients (24.6%) had clicking, 21 patients (18.4%) had mouth opening limitation, and 5 patients (4.4%) had masticatory difficulty. In female, 148 patients (56.5%) had pain, 57 patients (21.8%) had clicking, 47 patients (17.9%) had mouth opening limitation, and 10 patients (3.8%) had masticatory difficulty. 2. Examined controlled group, the author analyzed the dimension of W-W', 0-H, 0-A, 0-B on the right side first, and left side second. In male, the dimension of W-W' was 14.52 mm, 14.13 mm; 0-H was 13.92 mm, 13.71 mm; 0-A was 8.91 mm, 9.03 mm and 0-B was 8.67 mm, 8.78 mm. In female, W-W' was 13.77 mm, 13.51 mm; 0-H was 13.42 mm, 13.35 mm; 0-A was 8.92 mm, 9.01 mm and 0-B was 8.59 mm, 8.80 mm. 3. W-W' and 0-H of the experimental group were distinctly lesser than the controlled group. Male with mouth opening limitation show the least (12.70 mm, 13.00 mm) on W-W', but both sexes with pain show the least on 0-H. There was no significant difference between experimental group with clicking and controlled group on 0-H, 0-A, and 0- B. And also there was no difference on 0-B in patients with every symptom except masticatory difficulty. The dimensional changes of the condylar heads with those symptoms were as follows; a) In male patients, complaining of pain, W

  18. Cytokeratin-positive meningeal peripheral PNET/Ewing's sarcoma of the cervical spinal cord: diagnostic value of genetic analysis.

    Science.gov (United States)

    Woestenborghs, Heidi; Debiec-Rychter, Maria; Renard, Marleen; Demaerel, Philippe; Van Calenbergh, Frank; Van Gool, Stefaan; Sciot, Raf

    2005-01-01

    Peripheral primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES) of the central nervous system is extremely rare and should be differentiated from central PNET and other small blue round cell tumors. We describe a case of a meningeal peripheral PNET/ES of the spinal cord in an 11-year-old boy. Immunohistochemically, the small blue round cell tumor showed expression of epithelial markers and of CD99, thus posing an important differential diagnostic problem with a poorly differentiated synovial sarcoma. Fluorescence in situ hybridization revealed rearrangement of the EWS gene, as seen in peripheral PNET/ES. Peripheral PNET/ES does occur in the central nervous system, but its diagnosis can be extremely difficult on morphologic and immunohistochemical grounds alone. Genetic analysis plays a key role in its distinction from other small blue round cell tumors.

  19. Osteoclastic finger arthrosis - a subtype of polyarthrosis of the hand; Osteoklastische Fingerarthrose - Subtyp der Handpolyarthrose

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W. [Radiologische Praxis, Hamburg-Barmbek (Germany); Dihlmann, A. [Berufsgenossenschaftliches Unfallkrankenhaus Hamburg (Germany)

    1998-02-01

    Aim: Description of a subtype of arthrosis deformans of the hand which is characterised as osteoclastic arthrosis. Patients and methods: Retrospective analysis of radiographs of the hands of 150 women and 100 men with radiological findings of arthrosis deformans. Results: 5% of women and 2% of men showed at least one digital joint with subchondral osteolysis of one or both articulating bones involving at least a third of the phalanx. This subchondral osteolysis far exceeds the cysts which are situated in the epiphyseal part of the articular region. It may develop within a year. Conclusion: Osteoclastic arthrosis of the finger is a subtype of polyarthrosis of the hand. Serial observations suggest that an osteoclast stimulating substance is produced by the cysts or arises directly from the synovial fluid; this enters the subchondral part of the bone through clefts which may or may not be visible radiologically and that this produces osteoclastic activity. The most important differential diagnoses are chronic tophacious gout and a benign tumor. (orig.) [Deutsch] Ziel: Beschreibung eines Subtyps der Arthrosis deformans an der Hand, der als osteoklastische Arthrose bezeichnet wird. Patienten und Methode: Retrospektive Analyse der Handroentgenaufnahmen von 150 Frauen und 100 Maennern mit Roentgenbefunden der Arthrosis deformans. Ergebnisse: 5% der Frauen und 2% der maennlichen Patienten des durchgesehenen Krankenguts zeigten an mindestens einem Fingergelenk eine Arthrose mit subchondralen Osteolysen an einem oder beiden artikulierenden Knochen, die mindestens ein Drittel der Phalanxlaenge erfasst hatten. Diese subchondralen Osteolysen gehen ueber die Groesse und Form der arthrotischen Geroellzysten, die lediglich im knoechernen (epiphysaeren) Gelenksockel sitzen, weit hinaus. Sie koennen innerhalb eines Jahres entstehen. Schlussfolgerung: Die osteoklastische Arthrose der Finger ist ein Subtyp der Handpolyarthrose. Nach Verlaufsbeobachtungen wird vermutet, dass eine

  20. Biochemical T2* MR quantification of ankle arthrosis in pes cavovarus.

    Science.gov (United States)

    Krause, Fabian G; Klammer, Georg; Benneker, Lorin M; Werlen, Stefan; Mamisch, Tallal C; Weber, Martin

    2010-12-01

    Pes cavovarus affects the ankle biomechanics and may lead to ankle arthrosis. Quantitative T2 STAR (T2*) magnetic resonance (MR) mapping allows high resolution of thin cartilage layers and quantitative grading of cartilage degeneration. Detection of ankle arthrosis using T2* mapping in cavovarus feet was evaluated. Eleven cavovarus patients with symptomatic ankle arthrosis (13 feet, mean age 55.6 years, group 1), 10 cavovarus patients with no or asymptomatic, mild ankle arthrosis (12 feet, mean age 41.8 years, group 2), and 11 controls without foot deformity (18 feet, mean age 29.8 years, group 3) had quantitative T2* MR mapping. Additional assessment included plain radiographs and the American Orthopaedic Foot and Ankle Society (AOFAS) score (groups 1 and 2 only). Mean global T2* relaxation time was significantly different between groups 1 and 2 (p = 0.001) and groups 1 and 3 (p = 0.017), but there was no significance for decreased global T2* values in group 2 compared to group 3 (p = 0.345). Compared to the medial compartment T2* values of the lateral compartment were significantly (p = 0.025) higher within group 1. T2* values in the medial ankle joint compartment of group 2 were significantly lower than those of group 1 (p = 0.019). Ankle arthrosis on plain radiographs and the AOFAS score correlated significantly with T2* values in the medial compartment of group 1 (p = 0.04 and 0.039, respectively). Biochemical, quantitative T2* MR mapping is likely effective to evaluate ankle arthrosis in cavovarus feet but further studies are required.

  1. 严重颈髓损伤早期救治措施探讨%Early treatment of severe injury of cervical spinal cord

    Institute of Scientific and Technical Information of China (English)

    邵将; 贾连顺; 朱巍; 陈雄生; 宋滇文; 严望军; 周许辉

    2008-01-01

    Objective To investigate the effects of current major management strategies on early survival of patients with severe injury of cervical spinal cord. Methods A retrospective analysis was done on 532 patients with severe injury of cervical spinal cord (American Spinal Injury Association Grades A and B). The correlations of the early survival and major treatment measures, post-injury temporary immobilization of neck, operation, tracheotomy, systemic nutritional support, administration of glucocorticoid, were analyzed by Binary Logistic Regression. The problems related to the major treatment measures were also analyzed.Results 438 cases survived within 1 month. There was a positive correlation between the early survival and operation and nutritional support. There was a negative correlation between the early survival and tracheotomy.There was not any significant correlation between the early survival and the other 2 measures. The early sur-vival rate for patients of operation was 93.5%, for those without operation was 32. 7%, for those of goodnutrition was 97.8%, for those without good nutrition was 66. 7%, for those of tracheotomy was 58.1%, and for those without tracheotomy was 87.5%. Conclusions For patients with severe injury of cervical spinal cord, active operation and fine systemic nutritional support may increase early survival rate, undue tra-cheotomy may increase the risk of early death, and glucocorticoid may not have an effect on improvement of early survival rate.%目的 探讨目前主要治疗措施对严重颈髓损伤患者早期生存(外伤后1个月)的作用. 方法 对532例严重颈髓损伤患者(脊髓损伤ASIA分级中的A级和B级)的临床资料进行详尽的收集整理,通过Logistic回归确定主要救治措施:伤后颈椎临时稳定、手术、气管切开、全身营养支持、糖皮质激素与患者早期生存的相关性;然后将Logistic回归确定的相关治疗措施与患者早期生存率之间的关系情况列表;

  2. Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

    Directory of Open Access Journals (Sweden)

    Jun Dong

    2015-07-01

    Full Text Available OBJECTIVE: To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group. METHODS: Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group. RESULTS: In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM of C3-7 in all directions in the non-fusion group compared with the intact group (p>0.05, but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05. The ROM of adjacent segments (C3-4, C6-7 of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05. Significant differences in the C4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C4-6 ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01. The stability index ROM (SI-ROM of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C4-6 segment of the non-fusion group compared with the fusion group. CONCLUSION: An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be

  3. An analysis of plasticity in the rat respiratory system following cervical spinal cord injury and the application of nanotechnology to induce or enhance recovery of diaphragm function

    Science.gov (United States)

    Walker, Janelle

    Second cervical segment spinal cord hemisection (C2Hx) results in ipsilateral hemidiaphragm paralysis. However, the intact latent crossed phrenic pathway can restore function spontaneously over time or immediately following drug administration. WGA bound fluorochromes were administered to identify nuclei associated with diaphragm function in both the acute and chronic C2Hx models. WGA is unique in that it undergoes receptor mediated endocytosis and is transsynaptically transported across select physiologically active synapses. Comparison of labeling in the acutely injured to the chronically injured rat provided an anatomical map of spinal and supraspinal injury induced synaptic plasticity. The plasticity occurs over time in the chronic C2Hx model in an effort to adapt to the loss of hemidiaphragm function. Utilizing the selectivity of WGA, a nanoconjugate was developed to target drug delivery to nuclei involved in diaphragm function post C2Hx in an effort to restore lost function. Theophylline was selected due to its established history as a respiratory stimulant. Theophylline was attached to gold nanoparticles by a transient bond designed to degrade intracellularly. The gold nanoparticles were then permanently attached to WGA-HRP. Following intradiaphragmatic injection, the WGA portion was identified in the ipsilateral phrenic nuclei and bilaterally in the rVRGs. The location of WGA should reflect the location of the AuNP since the peptide bond between them is permanent. The effectiveness of the nanoconjugate was verified with EMG analysis of the diaphragm and recordings from the phrenic nerves. All doses administered in the acute C2Hx model resulted in resorted hemidiaphragm and phrenic nerve activity. A dose of 0.14mg/kg had a significantly higher percent recovery on day 3, whereas 0.03mg/kg was significantly higher on day 14. The change in most effective dose over time is likely due to the availability or concentration of the drug and location of drug release

  4. Prognostic analysis of cervical spinal cord injury without fracture or dislocation%无骨折脱位型颈脊髓损伤的预后分析

    Institute of Scientific and Technical Information of China (English)

    尹飞; 朱灏宇; 朱庆三; 赵昆池; 李然; 赵东旭; 孟春阳

    2014-01-01

    Objective To compare the effect of conservative and operative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD)and to detect mechanism of injury as well as its relationship to outcome.Methods A retrospective review was conducted on 688 patients with CSCIWFD treated from August 1994 to March 2013.There were 155 patients managed conservatively (conservation group) and 533 surgically (operation group).Neurological function improvement was compared between two groups to detect the correlation of patents' age and treatment methods with outcome.Results The patients were followed up for mean 17.9 months (range,3-36 months).Neurological function was estimated using Japanese Orthopedic Association (JOA) score:(1) the recovery rate of patients aged over 40 years in operation group was better than that in conservation group (P <0.05) ; (2) the recovery rate in patients aged under 39 years was unsatisfactory in both groups,with insignificant difference between the two groups (P > 0.05).Conclusions Different age of patients with CSCIWFD has different injury mechanism,injury severity and outcome.Surgery provides better results than conservative treatment for patients aged over 40 years,but both results are poor for patients aged under 39 vears.%目的 比较无骨折脱位型颈髓损伤(cervical spinal cord injury without fracture or dislocation,CSCIWFD)非手术治疗和手术治疗的疗效,分析其发生机制及其与预后的关系. 方法 回顾性分析1994年8月-2013年3月收治的CSCIWFD患者688例,对不同年龄段患者采用非手术治疗(非手术组,155例)和手术治疗(手术组,533例)后神经功能的恢复结果进行比较,分析不同年龄组患者、不同治疗方法与预后的相关性. 结果 随访3 ~ 36个月,平均17.9个月.两组患者神经功能改善程度按日本骨科学会(Japanese Orthopedic Association,JOA)评分:(1)40岁以上各年龄段患者神经功能改善率手

  5. Acupotome and spinal balancing in the treatment of cervical spondylotic arteriopathy%针刀松解术结合脊柱调衡治疗椎动脉型颈椎病

    Institute of Scientific and Technical Information of China (English)

    罗青锋; 李敏

    2015-01-01

    目的:观察针刀松解术结合脊柱调衡治疗椎动脉型颈椎病的临床疗效。方法将40例椎动脉型颈椎病患者随机等分为治疗组与对照组。针刀松解术结合脊柱调衡为治疗组,常规电针联合推拿为对照组;观察2组治疗后的临床疗效。结果治疗组治愈率和总有效率为70%、95%,对照组为40%、80%;2组疗效比较差异有统计学意义( P<0.05)。结论针刀松解术结合脊柱调衡通过恢复颈椎内外生物力学平衡治疗椎动脉型颈椎病。%Objective To observe the efficacy of the combined therapy of acupotome andSpinal balancing .Methods The 40 patients with cervical spondylosis of vertebral artery type were randomly divided into two groups .The treatment group were treated with acupotome and spinal balancing ,and those in control group with electro-acupuncture and massage therapy . Then observe the clinical efficacy of the two groups after treatment .Results In treatment group ,the curative rate was 70%and the total effective rate was 95% .In control group ,the curative was 40% and the total effective rate was 80% .There was a significant difference between twogroups ( P<0 .05 ) .Conclusion The combined treatment of acupotome and spinal bal-ancing could treat cervical spondylotic arteriopathy by restoring the cervical biomechanical balance inside and outside .

  6. PEGylated interferon-beta modulates the acute inflammatory response and recovery when combined with forced exercise following cervical spinal contusion injury.

    Science.gov (United States)

    Sandrow-Feinberg, Harra R; Zhukareva, Victoria; Santi, Lauren; Miller, Kassi; Shumsky, Jed S; Baker, Darren P; Houle, John D

    2010-06-01

    Secondary degeneration leads to an expansion of the initial tissue damage sustained during a spinal cord injury (SCI). Dampening the cellular inflammatory response that contributes to this progressive tissue damage is one possible strategy for neuroprotection after acute SCI. We initially examined whether treatment with a PEGylated form of rat interferon-beta (IFN-beta) would modulate the expression of several markers of inflammation and neuroprotection at the site of a unilateral cervical level 5 contusion injury. Adult female Sprague-Dawley rats were injured using the Infinite Horizon Impactor at a force of 200 kdyn (equivalent to a severe injury) and a mean displacement of 1600-1800 mum. A single dose (5x10(6) units) of PEGylated IFN-beta or vehicle was administered 30 min following SCI. Here we demonstrate temporal changes in pro- and anti-inflammatory cytokine levels and the expression of heat shock proteins and iNOS (involved in neuroprotection) at the lesion epicenter and one segment caudally after SCI and PEG IFN-beta treatment. The results suggested a potential therapeutic treatment strategy for modulation of secondary damage after acute SCI. Therefore, we examined whether acute treatment with PEG IFN-beta would improve forelimb function alone or when combined with forced exercise (Ex). Animals began the Ex paradigm 5 days post SCI and continued for 5 days/week over 8 weeks. Locomotion (forelimb locomotor scale [FLS], hindlimb BBB, and TreadScan) and sensorimotor function (grid walking) was tested weekly. Additional outcome measures included lesion size and glial cell reactivity. Significant FLS improvements occurred at 1 week post SCI in the PEGylated IFN-beta-treated group but not at any other time point or with any other treatment approaches. These results suggest that this acute neuroprotective treatment strategy does not translate into long term behavioral recovery even when combined with forced exercise.

  7. Chronic at-level thermal hyperalgesia following rat cervical contusion spinal cord injury is accompanied by neuronal and astrocyte activation and loss of the astrocyte glutamate transporter, GLT1, in superficial dorsal horn.

    Science.gov (United States)

    Putatunda, Rajarshi; Hala, Tamara J; Chin, Jeannie; Lepore, Angelo C

    2014-09-18

    Neuropathic pain is a form of pathological nociception that occurs in a significant portion of traumatic spinal cord injury (SCI) patients, resulting in debilitating and often long-term physical and psychological burdens. While many peripheral and central mechanisms have been implicated in neuropathic pain, central sensitization of dorsal horn spinothalamic tract (STT) neurons is a major underlying substrate. Furthermore, dysregulation of extracellular glutamate homeostasis and chronic astrocyte activation play important underlying roles in persistent hyperexcitability of these superficial dorsal horn neurons. To date, central sensitization and astrocyte changes have not been characterized in cervical SCI-induced neuropathic pain models, despite the fact that a major portion of SCI patients suffer contusion trauma to cervical spinal cord. In this study, we have characterized 2 rat models of unilateral cervical contusion SCI that behaviorally result in chronic persistence of thermal hyperalgesia in the ipsilateral forepaw. In addition, we find that STT neurons are chronically activated in both models when compared to laminectomy-only uninjured rats. Finally, persistent astrocyte activation and significantly reduced expression of the major CNS glutamate transporter, GLT1, in superficial dorsal horn astrocytes are associated with both excitability changes in STT neurons and the neuropathic pain behavioral phenotype. In conclusion, we have characterized clinically-relevant rodent models of cervical contusion-induced neuropathic pain that result in chronic activation of both STT neurons and astrocytes, as well as compromise in astrocyte glutamate transporter expression. These models can be used as important tools to further study mechanisms underlying neuropathic pain post-SCI and to test potential therapeutic interventions.

  8. Dolor cervical incoercible

    Directory of Open Access Journals (Sweden)

    Adrián F Narváez-Muñoz

    2014-03-01

    Astrocytomas are relatively common glial neoplasm of the central nervous system, but only a small percentage of them are located in the spinal cord, with a predilection for the cervical and dorsal regions. In most cases, extend longitudinally, affecting several cord segments. Pain is a frequent symptom of local character bone segments involving the tumor, associated with sensory deficit and / or motor. The following is the case of a 60 year old woman with cervical cord astrocytoma extended to the brainstem.

  9. Kinematic analysis of the daily activity of drinking from a glass in a population with cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    de los Reyes-Guzmán Ana

    2010-08-01

    cervical SCI.

  10. 急性无骨折脱位型颈髓损伤的MRI诊断价值探讨%MRI Features of Acute Cervical Spinal Cord Injuries without Radiographic Abnormality

    Institute of Scientific and Technical Information of China (English)

    钟俊远; 刘晓玉; 彭吉东; 梁宗辉

    2011-01-01

    Purpose: To illustrate the MRI features of acute cervical spinal cord injuries without radiographic abnormality(SCIWORA) in order to improve the knowledge and diagnosis accuracy.Methods:Clinical proved 108 cases of acute cervical spinal cord injuries without radiographic abnormality were included in this series.All patients were examined with X - rays, CT and MRI plain scan.The image data were analyzed.Results: In 108 cases, there were 86 males and 22 females, their age ranged from 22 to 79 years with average 43.8 years.Acute cervical spinal cord injuries without radiographic abnormality may occur in every part of the cervical spine, mostly in the fourth and fifth vertebral plain (63.3%).Among all cases, 51 cases were gross edema type, 19 cases were edema with hemorrhage and 38 cases were localized.Moreover, 24 cases were found bone contusion in 38 vertebrae; 85 cases were found 183 herniated nucleus pulposus with dural sac and spine compression, mostly in C4/5 and C5/6 (85.2%); 17 cases were found thickened anterior longitudinal ligament with edema; 32 cases were found edema in nuchal region soft tissue.Conclusion: MRI could find and classify acute cervical spinal cord injuries without radiographic abnormality in time, also find the injury of ligaments and soft tissue.MRI plays a valuable role in diagnosis, treatment and prognosis in acute cervical spinal cord injuries without radiographic abnormality.%目的:探讨MRI对急性无骨折脱位型颈髓损伤的诊断价值.方法:回顾108例经X线和CT证实无骨折脱位型颈髓损伤的MRI表现,分析其影像特征.结果:无骨折脱位型颈髓损伤可累及颈髓任一平面,而以C、C椎体对应平面最多见(63.3%),其中广泛水肿型51例,出血水肿型19例,局限型38例.此外,24例共计38个椎体骨挫伤;85例183个椎间盘髓核突出,相应平面硬膜囊及脊髓受压,以C、C椎间盘突出多见(85.2%);17例可见前纵韧带增厚及水肿信号;32例可见颈后部软组织

  11. 无骨折脱位型颈脊髓损伤法医学鉴定25例分析%Forensic Identification of Cervical Spinal Cord Injury without Fracture or Dislocation in 25 Cases

    Institute of Scientific and Technical Information of China (English)

    顾晓峰

    2011-01-01

    目的 探讨无骨折脱位型颈脊髓损伤案例中外伤与损害后果因果关系法医学鉴定的要点.方法 收集25例无骨折脱位型颈脊髓损伤的法医学鉴定案例资料,总结被鉴定人的年龄、致伤方式、影像学检查结果、自身颈椎退变情况、临床表现、主要诊疗情况、预后情况等,按照损伤与损害后果相关程度分为直接原因、主要原因、同等原因、次要原因、无原因进行伤病关系分析.结果 年龄、致伤方式、颈椎退变及椎管狭窄等是伤病关系分析的重要因素,年龄≤8岁者,一般均认为外伤是损害后果的直接原因,而在其他年龄段,一般均需全面分析上述各种因素,综合评定.结论 综合被鉴定人的年龄、致伤方式、颈椎退变及椎管狭窄等因素,有助于准确分析、判定无骨折脱位型颈脊髓损伤者损伤与损害后果的因果关系.%Objective To explore forensic identification of causality between injury and the consequence in cases of cervical spinal cord injury without fracture or dislocation. Methods Twenty-five cases of cervical spinal cord injury without fracture or dislocation were collected. The age, mode of injury, imaging reports, cervical vertebral degeneration, clinical manifestations, diagnosis, treatment and injury consequences were summarized. The causality between injury and its consequence were classified as direct cause, main cause, same cause, minor cause and no cause. Results Age, mode of injury, cervical vertebral degeneration and spinal stenosis were important factors in the analysis of causality. In the injured younger than 8-year-old trauma was generally the direct cause to the damage. While in other injured, it was needed to analyze the various factors comprehensively. Conclusion Comprehensive analysis of age, mode of injury, cervical vertebral degeneration, spinal stenosis and other factors would contribute to accurate identification of the causality between the

  12. 急性颈椎脊髓损伤并发呼吸功能障碍的早期救治%Early treatment of respiratory dysfunction after acute cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    徐广辉; 满毅; 张咏; 史建刚; 贾连顺

    2013-01-01

    目的 探讨急性颈椎脊髓损伤并发呼吸功能障碍的临床特点及早期有效的治疗措施.方法 回顾性分析105例急性颈椎脊髓损伤患者的临床资料,分析患者入院时的呼吸模式、血气分析指标,判断患者脊髓损伤平面,以ASIA评分评价瘫痪程度,根据患者颈椎损伤情况及呼吸功能状况行颈部牵引制动、气管切开及呼吸机辅助呼吸、加强翻身拍背及支气管镜吸痰、抗感染、颈椎前后路减压植骨内固定手术等治疗措施.结果 出现呼吸功能障碍97例,其中严重呼吸衰竭行气管切开、呼吸机辅助呼吸34例,单纯气管切开48例,15例未气管切开、仅行吸氧及支气管镜吸痰治疗.2例死亡,其中l例肺部严重感染,1例颅脑外伤合并纵隔血肿等多发伤.气管切开、呼吸机辅助呼吸患者全部脱机封管成功.结论 急性颈椎脊髓损伤患者应早期进行呼吸功能评估,采用气管切开等进行有效的呼吸道管理,调整患者营养状态并加强抗感染,必要时行颈椎手术等综合治疗.%Objective To explore the clinical characteristics and early effective treatment for respiratory dysfunction after acute cervical spinal cord injury.Methods Retrospectively 105 patients with acute cervical spinal cord injury were analyzed.When the patients were in hospital,respiratory mode and blood gas analysis were recorded and the ASIA score was used to evaluate the degree of paralysis and spinal cord injury level.According to the respiratory condition and cervical injury,cervical traction and other immobilization were finished.Some patients were operated for incision of trachea and the breath was supported by ventilator.All the patients were turned over and slapped the back in order to excrete phlegm on time.Sometimes bronchial lavage was used to excrete phlegm.Anti-infection was emphasized.Anterior cervical discectomy and fusion or posterior decompression and fusion operation were finished once the

  13. Evaluation of the results from non-arthroplastic treatment (arthroscopy for shoulder arthrosis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol. METHODS: Between 1998 and 2011, 31 patients (32 shoulders with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. RESULTS: There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation ( p< 0.001 and there was a tendency ( p= 0.057 toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. CONCLUSION: Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor

  14. Chronic inflammatory demyelinating polyradiculoneuropathy: two cases with cervical spinal cord compression Polirradiculoneuropatia desmielinizante inflamatória crônica: dois casos com síndrome de compressão medular

    Directory of Open Access Journals (Sweden)

    Marcos R.G. de Freitas

    2005-09-01

    Full Text Available Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP is a peripheral nerve disorder probably due to an immunological disturb. It evolves either in a steadily progressive or in a relapsing and fluctuating course. Weakness is mainly in the lower limbs proximally and distally. The electromyography is demyelinating. The cerebral spinal fluid protein is most of times elevated. Sometimes enlarged nerves are found. There are few cases described with spinal cord compression due to hypertrophic spinal nerve roots. Two patients (females, 66 and 67 years old with diagnosis of a long standing CIDP are described. In the first one, the evolution was characterized by remission and relapsing course. The second patient had a chronic and progressive course. These patients presented after a long evolution a cervical spinal cord compression syndrome due to hypertrophic cervical roots. Neurologists must be aware of the possibility of development of spinal cord compression by enlarged spinal roots in patients with a long standing CIDP.A polirradiculoneuropatia desmielinizante inflamatória crônica (PDIC é uma afecção dos nervos periféricos de natureza autoimune, com evolução por surtos de exacerbação e remissão ou de evolver progressivo. O acometimento motor é predominante, com fraqueza proximal e distal nos membros inferiores. A eletroneuromiografia é do tipo desmielinizante com bloqueio de condução nervosa em dois ou mais nervos. Há aumento de proteínas do líquor. Com a evolução da doença pode haver espessamento dos nervos distal e/ou proximalmente. Excepcionalmente ocorre compressão da medula espinhal em qualquer segmento por raízes próximas hipertrofiadas. Foram estudadas duas mulheres de 66 e 67 anos respectivamente com quadro de PDIC de longa evolução. A primeira tinha evolução por surtos e na segunda o evolver era progressivo. Nos dois casos o espessamento proximal dos nervos provocou síndrome de compressão medular alta

  15. [Information analysis of spinal ganglia].

    Science.gov (United States)

    Lobko, P I; Kovaleva, D V; Kovalchuk, I E; Pivchenko, P G; Rudenok, V V; Davydova, L A

    2000-01-01

    Information parameters (entropia and redundancy) of cervical and thoracic spinal ganglia of albino rat foetuses, mature animals (cat and dog) and human subjects were analysed. Information characteristics of spinal ganglia were shown to be level-specified and to depend on their functional peculiarities. Information parameters of thoracic spinal ganglia of man and different animals are specie specified and may be used in assessment of morphological structures as information systems.

  16. 无骨折脱位型颈髓损伤的治疗%Treatment of cervical spinal cord injury without fracture or dislocation

    Institute of Scientific and Technical Information of China (English)

    潘海涛; 郑启新; 杨述华

    2011-01-01

    Objective: To explore the treatment strategies and clinical outcomes of cervical spinal cord injury without fracture or dislocation (CSC1WFD). Method:Fifty-one cases of CSCIWFD patients treated in our hospital from Aug 2005 to Dec 2010 were retrospectively analyzed. Their short and middle-term clinical outcomes were assessed according to JOA scale system. Result: All cases were followed up for 6 to 60 months (mean 24 months). Forty-three cases were surgically treated and their average recovery rate of JOA scale was (46. 5±5. 8) % ,and the percentage of receiving "excellent" or "good" ratings was 48. 8%. The other 8 cases were conservatively treated and the same indexes were (25. 6±3. 1)% and 25. 0% respectively, which were significantly lower than those from the surgical group (P0. 05). Conclusion; Appropriate choices of operative method and time according to the radiographic results of the CSCIWFD patients will improve their spinal cord function and achieve relatively satisfactory clinical outcomes.%目的:探讨无骨折脱位型颈髓损伤(CSCIWFD)的治疗策略及临床疗效.方法:回顾性分析我科自2005年8月-2010年12月收治的51例CSCIWFD患者,根据日本骨科学会评分系统(JOA评分)分析CSCIWFD患者治疗的短中期疗效.结果:全部患者随访6~60个月,平均24个月.43例患者采取手术治疗,JOA评分的平均改善率和优良率分别为(46.5±5.8)%和48.8%,均显著高于8例采取保守治疗患者JOA评分的平均改善率(25.6±3.1)%和优良率25.0% (P<0.01).7d内手术的35例患者JOA评分的平均改善率和优良率分别为(50.6±3.6)%和54.3%,均明显高于7d后手术的8例患者JOA评分的平均改善率(37.5土2.9)%和优良率25.0% (P<0.01).采用前路或后路手术的JOA评分平均改善率和优良率差异无统计学意义(P>0.05).结论:根据CSCIWFD患者的影像学结果,选择合适的术式,尽早手术,可较好地改善颈脊髓功能,获得较满意的临床疗效.

  17. Surgical Treatment Experience of Cervical Spine Fracture Complicated With Spinal Cord Injury%颈椎骨折伴脊髓损伤的手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    赵光远

    2015-01-01

    目的:对颈椎骨折伴脊髓损伤的手术治疗效果进行分析,并将手术治疗体会进行总结。方法对于2013年9月~2014年6月期间在我院接受手术治疗的35例颈椎骨折脱位伴脊髓损伤患者的手术资料进行回顾性分析,并对手术治疗方法、临床效果以及治疗体会进行分析总结。结果23例患者行颈前路椎间盘及部分椎体切除脊髓减压术,8例患者行后路双开门椎管扩大减压手术,4例患者行一期后、前路手术;本次治疗的总有效率为91.4%,半年后患者的脊髓功能优良率为94.3%。结论对颈椎骨折脱位伴脊髓损伤患者有针对性的选择适宜的手术方式治疗能够取得显著的治疗效果,有利于患者感觉功能、脊髓功能的恢复。%Objective To analyze surgical effect in treatment of cervical spine fracture complicated with spinal cord injury and then summarizes its surgical treatment experience. Methods Selected from 35 patients of cervical spine fracture complicated with spinal cord injury who were treated with surgical treatment in hospital from September 2013 to June 2014 and then summarized surgical treatment approach,its clinical effect and treatment experience. Results There are 23 cases of patients operated with treatment of anterior cervical disc combined with partial corpectomy decompression of spinal cord,and 8 cases of patients treated with posterior double-door vertebra expanded decompression surgery,and 4 cases of patients underwent anterior operation of 1st stage,treatment efficiency rate was up to 91.4% in current,and patients’spinal function excel ence rate was 94.3% after half a year treatment. Conclusion Adopting proper surgical treatment to cure patients of cervical spine fracture complicated with spinal cord injury is conducive to patients’ sense recovery as wel as spinal function recovery.

  18. Fresh frozen plasma transfusion for the treatment of hyponatremia after cervical spinal cord injury%输入新鲜冰冻血浆治疗颈脊髓损伤后低钠血症★

    Institute of Scientific and Technical Information of China (English)

    张圣飞; 王永祥; 冯新民; 陶玉平

    2013-01-01

      背景:课题组考虑到新鲜冰冻血浆在临床上有综合治疗的价值,如抗休克、免疫、止血和解毒等,并能纠正胶体渗透压。如果在限水、补钠的同时补充新鲜冰冻血浆能提高脊髓损伤患者血钠水平,将为临床治疗脊髓损伤后低钠血症找到一个新的突破点。  目的:建立家兔颈脊髓损伤并发低钠血症动物模型,观察输入新鲜冰冻血浆治疗颈脊髓损伤并发低钠血症的疗效。  方法:健康成年家兔60只,采用改良ALLen氏打击法制作家兔颈脊髓损伤模型,将幸存且合并低钠血症的40只家兔随机分为2组,对照组20只,实验组20只,再按取标本时间不同依次分为1,3,6,10,15 d组,共10组,每组4只。实验组家兔出现低钠血症后每24 h静脉输入20 mL新鲜冰冻血浆(即1 d组输入1次,3 d组输入3次,6 d组输入6次,10 d组输入10次,15 d组输入15次)。对照组家兔每24 h静脉输入20 mL生理盐水。各组动物分别于术前及输入血浆后24 h采取标本分别进行血清钠离子及脊髓组织钠离子测定。  结果与结论:①术后3 d和术后6 d时实验组及对照组家兔的平均血钠浓度较术前明显降低(P OBJECTIVE:To establish a rabbit model of cervical spinal cord injury combined with hyponatremia, and to observe the effectiveness of fresh frozen plasma transfusion for hyponatremia after cervical spinal cord injury. METHODS:Sixty healthy adult rabbits subjected a Al en’s punch method to establish rabbit models of cervical spinal cord injury. Forty survived and hyponatremia rabbits were randomly divided into two groups:control group and experimental group, 20 rabbits in each group, and then each group was divided into 1, 3, 6, 10 and 15 days group according to time for taking the specimens, a total of 10 sub-groups and 4 rabbits in each sub-group. The rabbits in the experimental group were injected with 20 mL fresh

  19. The risk factors inducing spinal cord injury in cervical myelopathy patients with mild to moderate cervical cord compression%轻中度颈脊髓压迫患者产生脊髓损害症状与体征的危险因素

    Institute of Scientific and Technical Information of China (English)

    张静涛; 申勇; 张英泽; 刘法敬; 杨大龙; 曹俊明

    2013-01-01

    目的:探讨轻中度颈脊髓压迫患者产生脊髓损害症状与体征的危险因素.方法:回顾性分析我院脊柱外科2008年11月~2011年11月门诊诊治的68例轻、中度颈脊髓压迫患者的病例资料.男37例,女31例.单节段32例,两节段22例,三节段14例.患者均有颈椎正侧位和过伸过屈位X线平片和颈椎CT及MRI检查图片.根据有无脊髓损害症状与体征,将其分为两组,无脊髓损害症状与体征的30例患者为A组,有脊髓损害症状与体征的38例患者为B组,比较两组患者年龄、性别、病程、病变节段数目,以及最大受压节段颈椎管比率、整体活动范围、节段不稳发生率、C2~C7 Cobb角、脊髓受压方向及脊髓高信号发生率.结果:两组患者年龄、性别、病程、病变节段数目差异均无统计学意义;平均最大受压节段颈椎管比率,A组为90.3%,B组为83.6%(P<0.05);平均颈椎整体活动范围A组为47 5°,B组为44.1°(P>0.05);颈椎节段不稳发生率,A组为23.3%,B组为65.8%(P<0.05);平均C2~C7 Cobb角A组为14.1°,B组为14.1°(P>0.05);脊髓受压方向,A组中央型19例,旁中央型11例,B组中央型17例,旁中央型21例(P>0.05);颈椎MRI T2加权像高信号发生率,A组为13.3%,B组为86.9%(P<0.05).结论:对于轻、中度颈脊髓压迫患者,颈椎节段不稳和脊髓高信号是导致出现脊髓损害症状与体征的危险因素,而颈椎管比率较大是一种保护因素,尚不能认为脊髓受压方向、颈椎整体曲度和活动范围对出现脊髓损害症状与体征产生影响.%Objectives: To investigate the risk factors inducing spinal cord injury in cervical myelopalhy patients with mild to moderate cervical cord compression. Methods: From November 2008 to November 2011, 68 patients (male:female=37:31) with mild to moderate cervical cord compression were included in this retrospective analysis. There were 32 single-segment cases, 22 double

  20. Cervical spondylosis anatomy: pathophysiology and biomechanics.

    Science.gov (United States)

    Shedid, Daniel; Benzel, Edward C

    2007-01-01

    Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

  1. Respiratory Plasticity Following Spinal Injury: Role of Chloride-Dependent Inhibitory Neurotransmission

    Science.gov (United States)

    2014-10-27

    injuries . In the last year, we performed experiments to test the specific hypothesis that cervical spinal contusion injuries (CSC) and repetitive...blot analyses, prepare a manuscript for publication and begin work on Specific Aims 1c, 1d, 2c. 15. SUBJECT TERMS Spinal Injury , Treatment ...functional recovery from chronic cervical spinal injuries . In this project period, we will test the specific hypothesis that cervical spinal contusion

  2. The natural history and clinical syndromes of degenerative cervical spondylosis.

    LENUS (Irish Health Repository)

    Kelly, John C

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

  3. [The causes of arthrosis of the hip-joint. A radiologic study (author's transl)].

    Science.gov (United States)

    Mutter, K; Schlegel, K F

    1975-06-01

    It is often possible to establish the origin of an arthosis of the hip joint radiologically. Only in 17 out of 445 patients were we unable to arrive at a classification because the arthrosis was already too advanced. Data relating to the history are of limited value -- only 21% of our patients knew of earlier disorders of the joint --, so definition of causes an radiographs is important. The high percentage of arthroses the origin of which is known, makes it likely that the concept of "primary arthrosis" is unnecessary, since behind it there hide those cases of apparently ill-defined arhtroses which -- as shown in our results -- can be further differentiated. This radiologically based classification will serve to increase the possibilities of progressing from symptomatic to prophylactic treatment.

  4. The results of ankle arthrodesis with screws for end stage ankle arthrosis.

    Science.gov (United States)

    Torudom, Yingyong

    2010-02-01

    Aim of this study was to evaluate the results of ankle arthrodesis with screws in patients with ankle arthrosis. The author studied 19 patients (20 feet) who had been treated by ankle arthrodesis with screws from 2003 to 2008. Ten patients were men (11 feet) and nine (9 feet) were women. Their mean age was 56 years (30 to 65), and the average duration of follow-up was four years (2 to 6). Two compression screws were used in all feet. Union was achieved in 19 of the 20 feet (95%). Average scores for pain and clinical condition are increase after operation. One re-operation was performed for nonunion. Author conclude that ankle arthrodesis with screws was effective treatment for ankle arthrosis.

  5. Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yanagi, Yoshinobu; Asaumi, Jun-ichi E-mail: asaumi@md.okayama-u.ac.jp; Maki, Yuu; Murakami, Jun; Hisatomi, Miki; Matsuzaki, Hidenobu; Konouchi, Hironobu; Honda, Yosutoshi; Kishi, Kanji

    2003-07-01

    We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.

  6. Non-surgical spinal decompression traction treatment of nerve root type cervical spondylosis%非手术脊柱减压牵引治疗神经根型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄莉华; 白跃宏

    2013-01-01

    Objective To observe the SDS9900 cervical spinal decompression system of curative effect in patients with cervical spondylosis of nerve root type. Methods 60 patients with cervical spondylosis of nerve root type were randomly divided into treatment group and control group. Treat-ment group using SDS 9900 cervical spinal decompression treatment traction system,the control group with conventional traction,two groups give the dynamic interference electric traction or after treatment. Before treatment and 4 weeks after treatment using the method of visual analog score (VAS) and quality of life scale for SF-36 pairs of two groups of patients with curative effect e-valuation. Results Two groups of patients after treatment for 4 weeks respectively,found that the VAS score and the result of SF-36 scale was better,the margin of improvement and the above in-dexes in the treatment group is significant,and the differences between the control group with sta-tistical significance (P<0.05);Conclusion SDS 9900 cervical spinal decompression system can re-duce the pain of nerve root type of cervical spondylosis patients, and significantly improve the pa-tients quality of life.%目的:观察SDS9900颈椎脊柱减压系统对神经根型颈椎病患者的临床疗效。方法将60例神经根型颈椎病患者随机分为治疗组及对照组,治疗组采用SDS 9900颈椎脊柱减压牵引系统治疗,对照组用常规颈椎牵引;两组牵引后均给予动态干扰电治疗。治疗前、治疗4周后采用目测类比评分法(VAS)及生存质量量表SF-36对两组患者进行疗效评定。结果两组患者分别经4周治疗后,VAS评分及SF-36评分结果均较治疗前好转,治疗组的改善幅度较显著,与对照组间差异具有统计学意义(P<0.05);结论 SDS 9900颈椎脊柱上述指标均以减压系统能缓解神经根型颈椎病患者的疼痛,并显著提高患者生活质量。

  7. 生物活性颈椎椎间融合器在颈椎融合术中不同固定方式的生物力学研究%Biomechanical study of bioactive cervical fusion cage with different types of fixation in cervical spinal fusion

    Institute of Scientific and Technical Information of China (English)

    胡孔和; 吴强; 段扬; 包拥政; 靳安民; 赵卫东

    2012-01-01

    目的 探讨由羟基磷灰石和左旋聚乳酸复合研制的新型生物活性颈椎椎间融合器在颈椎融合术中不同固定方式的生物力学特性.方法 制备新鲜人颈椎标本6个(尸体均为合法捐赠,由南方医科大学解剖学教研室提供),模拟临床术式行前路C5~6减压椎间分别植入髂骨、生物活性颈椎椎间融合器和生物活性颈椎椎间融合器加钢板内固定,通过脊柱三维运动实验机测量C5~6节段的运动范围.结果 生物活性颈椎椎间融合器加钢板固定后稳定性增加,在各个状态的运动范围均明显小于其他各组(P <0.005).单纯生物活性颈椎椎间融合器组在后伸状态下运动范围(6.25±0.29)度较正常组(5.76±0.40)度增大,稳定性下降,但差异无统计学意义(P>0.05);在除后伸外的其他各种状态下的运动范围均小于髂骨组,较髂骨组稳定,差异有统计学意义(P<0.005).结论 新型生物活性颈椎椎间融合器具有良好的生物力学性能,加钢板内固定后各个方向稳定性好,能重建颈椎稳定性.%Objective To investigate the biomechanical characteristics of different types of fixation with bioactive cervical fusion cage made of hydroxyapatite and poly L-lactic acid in cervical spinal fusion.Methods Iliac crest bone,bioactive cervical fusion cage and bioactive cervical fusion cage with plate fixation were used for anterior interbody implants after anterior discectomy across C5-6 in six fresh human cervical spine specimens respectively,and the range of motion of the cervical vertebrae interbody fusion were measured through the motional stability test.Results After discectomy,Bioactive Cervical Fusion Cage with plate fixation exhibited a significant increase in stability and a decrease of range of motion in angular motion than others in all motional directions ( P < 0.005 ). Bioactive cervical fusion cage exhibited a decrease in stability and an increase of range of motion (6.25

  8. The Postoperative Application of Percutanous Dilatational Tracheostomy for Patients with Serious Cervical Spinal Cord Injury Undergoing Anterior or Combined Anterior-posterior Cervical Spine Fixation%经皮扩张气管切开术在重度颈髓损伤颈椎前路或前后路联合手术后人工气道中的应用

    Institute of Scientific and Technical Information of China (English)

    李强; 安卫红; 白宇; 刘飞; 么改琦; 朱曦

    2013-01-01

    Objective To investigate the feasibility of percutanous dilatational tracheostomy on patients undergoing anterior and anterior-posterior cervical spine fixation.Methods A retrospective analysis was done on 17 patients with cervical spinal cord injury who were admitted to ICU of Peking University Third Hospital from January 2012 to March 2013,including 12 cases of anterior and 5 cases of combined anterior-posterior cervical spine fixation.All patients received percutanous dilatational tracheostomy after anterior or anterior-posterior cervical spine fixation.The duration between the percutanous dilatational tracheostomy and the anterior/anterior-posterior cervical spine fixation were 5 to 11 days.Results The procedure of percutanous dilatational tracheostomy was smooth in all 17 cases,with no intraoperative impairment to the vital organs,no postoperative heavy blood loss and no fistula infection.No concurrent anterior and anterior-posterior cervical incision infection occurred.Conclusions Percutanous dilatational tracheostomy is a safe and efficient way of building the artificial airway 5 days after the anterior and anterior-posterior cervical spine fixation.%目的 探讨颈椎前路和颈椎前后路联合颈椎切开复位内固定手术后行经皮扩张气管切开术的安全性. 方法 回顾性分析2012年1月~2013年3月颈脊髓损伤17例,行颈前路(12例)或颈前后路(5例)切开复位内固定手术,术后5 ~11d行经皮扩张气管切开术. 结果 17例经皮扩张气管切开术均过程顺利,无颈前部重要器官损伤、术后局部大量出血、造瘘区域感染、颈前路手术切口及切口深层感染. 结论 颈前路手术5日后行经皮扩张气管切开术是安全高效的建立人工气道的方法.

  9. Study Effect of Different Endotracheal Intubation General Anesthesia in High Cervical Spine Fracture With Cervical Spinal Cord Injury%不同气管插管全麻方式应用于高位颈椎骨折伴颈髓损伤的效果研究

    Institute of Scientific and Technical Information of China (English)

    刘卫忠

    2015-01-01

    Objective To investigate the effect of different endotracheal intubation and general anesthesia in high cervical spine fracture with cervical spinal cord injury.Methods 75 patients were randomly divided into three groups, and compared the cervical lfexion degree change, intubation time, the time of the exposure and the success rate of one intubation. Results The three groups of intubation time and glottic exposure time,t he laryngeal mask group intubation time and glottis exposure for the longest time, shikani laryngoscope group was the shortest,P0.05, had no difference statistically significance.Conclusion Shikani laryngoscope in high cervical spine fracture with cervical spinal cord injury of tracheal intubation with intubation laryngeal mask and direct laryngoscope has more advantages.%目的 探讨不同气管插管全麻方式应用于高位颈椎骨折伴颈髓损伤的效果.方法 将75例患者随机分为3组,并比较颈椎屈曲度变化、插管时间、声门显露时间和一次插管成功率.结果 3组插管时间和声门暴露时间比较,插管型喉罩组插管时间和声门暴露时间最长,视可尼喉镜组最短,P<0.05,差异具有统计学意义;在暴露声门时,视可尼喉镜组和插管型喉罩组颈椎屈曲度变化低于直接喉镜组,P<0.05,差异具有统计学意义,气管插入后,视可尼喉镜组颈椎屈曲度变化低于直接喉镜组,P < 0.05,差异具有统计学意义.三种方式在一次插管成功率方面对比,P > 0.05,差异不具有统计学意义.结论 视可尼喉镜在高位颈椎骨折伴颈髓损伤气管插管中较插管性喉罩和直接喉镜有更优势.

  10. 多爪钳夹式颈椎固定器的生物力学测试及临床应用%Biomechanical Study and Clinical Application of Multiclaw Cliplike Cervical Spinal Fixator

    Institute of Scientific and Technical Information of China (English)

    黄令坚; 王以进; 等

    2001-01-01

    Objective To improve the results of treatment for cervical spine injury with a new device. Methods A new device, multiclaw cliplike spinal fixator (MSCF) was designed by authors. The experiments were performed on 10 cadaveric cervical spines to compare the biomechanical characteristic of MCSF, articular process plate and the intact Spines. Fifteen cases of lower cervical spine injury were treated with MCSF. Results MCSF had advantage over the articular process plate and the intact spines in anti-axial compression, antibending and antirotation. In the 15 cases. the cervical spine normal carvature and the height of the vertebra injuried had been restored after operation. The follow-up of 24.3 months showed there were no loosening of the device, recurence of deformation and so on. Conclusiou MCSF posseses adequate strength and good stability and the technique is simple and safe. The authors consider this device is one of ideal fixators for cervical spine and is worthy recommending.%目的 提高颈椎内固定的效果。方法自行设计一种新型的脊柱固定器(MCSF)。经临床治疗下颈椎损伤15例,并用10具新鲜尸体脊柱标本(C1~T1)进行力学测定,比较MCSF、关节突钢板及正常脊柱的生物力学特性。结果在抗轴向压缩、弯曲及旋转应力方面,MCSF明显优于关节突钢板及正常脊柱。而临床应用显示术后颈椎的生理曲线和伤椎高度完全得到恢复,平均随访时间24.3个月,未见固定器松脱及畸形矫正度丢失现象。结论MCSF符合生物力学原理,有良好的固定作用,手术操作安全简便,是颈椎后路理想的固定器之一,值得推广应用。

  11. Cervical spine in Treacher Collins syndrome.

    Science.gov (United States)

    Pun, Amy Hoi-Ying; Clark, Bruce Eric; David, David John; Anderson, Peter John

    2012-05-01

    Treacher Collins syndrome is a congenital syndrome with characteristic craniofacial malformations, which are well described in the literature. However, the presence of cervical spine dysmorphology in this syndrome has been minimally described. This study reviews cervical spine radiographs of 40 patients with Treacher Collins syndrome. In this sample, 7 of 40 patients displayed cervical spine anomalies, with 3 of these patients displaying multiple cervical spine anomalies. The patterns of spinal anomalies were variable, suggesting that the underlying genetic mutation has variable expressivity in cervical spine development as it does elsewhere in the craniofacial skeleton.

  12. Comparison of T{sub 2}-weighted turbo-spin echo sequence and ultra-fast HASTE sequence in the diagnosis of cervical myelopathies and spinal stenoses against static and kinematic MRT of the cervical spine; Vergleich von T{sub 2}-gewichteter Turbo-Spin-Echo- und ultraschneller, HASTE-Sequenz in der Diagnostik von zervikalen Myelopathien und Spinalstenosen mit der statischen und kinematischen MRT der Halswirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C.; Metzner, J.; Brinkmann, G.; Kuehn, B.; Bischoff, L.; Hutzelmann, A.; Wesner, F.; Heller, M. [Klinik fuer Radiologische Diagnostik, Christian-Albrechts-Universitaet zu Kiel (Germany)

    1997-11-01

    Purpose: The purpose of this study was to compare HASTE-sequence with T{sub 2}-weighted TSE-sequence in the detection of cervical myelopathy and cervical spinal stenosis in kinematic MRI. Methods: 24 patients with degenerative disease of the cervical spine were studied. Images were evaluated according to the following criteria: Artifacts, delineation of the vertebra, disks and degenerative changes, grade of spinal stenosis (grade 0-3) and evaluation of the cervical spinal cord. Results: Due to image blurring and artifacts, evaluation and delineation of the cervical spine was possible in all cases in the T{sub 2}-weighted TSE-sequence, but only in 23 of 24 patients using HASTE-sequence. Differentiation between osteophytes and disks was obtained in most cases (23/24) in the T{sub 2}-weighted TSE-sequence but none in the HASTE-sequence. Cervical myelopathy was observed in 4 patients in T{sub 2}-weighted TSE images but only in two cases using HASTE-sequence. Compared to T{sub 2}-weighted TSE-sequence spinal canal stenosis was underestimated using HASTE-sequence. (orig./AJ) [Deutsch] Ziel: Beurteilung von zervikalen Myelopathien und Spinalstenosen im Vergleich von ultraschneller HASTE-Sequenz sowie T{sub 2}-TSE-Sequenz. Methode: 24 Patienten mit degenerativen Halswirbelsaeulenveraenderungen wurden untersucht. Die Aufnahmen wurden hinsichtlich der Artefaktanfaelligkeit, der Darstellung von Halswirbelkoerper, Bandscheiben und degenerativen Veraenderungen, dem Grad einer Spinalstenose (Stadium 0-3) sowie der Beurteilung des Zervikalmarks ausgewertet. Ergebnisse; Aufgrund von ausgepraegten Artefakten konnten nur 23 von 24 Untersuchungen mit der HASTE-Sequenz, hingegen alle Untersuchungen mit der T{sub 2}-TSE-Sequenz ausgewertet werden. Eine Differenzierung von osteophytaeren Randanbauten von Bandscheiben und Wirbelkoerpern war in der HASTE-Sequenz gegenueber der T{sub 2}-TSE-Sequenz nur eingeschraenkt moeglich. Eine in 4 Faellen in der T{sub 2}-TSE-Sequenz diagnostizierte

  13. 颈椎病与腰椎管狭窄症术后感染的危险因素分析%Related risk factors for postoperative infections in patients with cervical spondylosis or lumbar spinal stenosis

    Institute of Scientific and Technical Information of China (English)

    朱修桥; 郭景东; 吕慧; 邵士元

    2014-01-01

    目的:探讨颈椎病与腰椎管狭窄症术后感染的防护措施与相关危险因素,为临床治疗提供依据。方法选取2008-2013年210例颈椎病与200例腰椎管狭窄症患者,全部患者均行手术治疗,回顾性分析导致患者术后感染的相关危险因素及相应的防护措施。结果颈椎病患者术后感染率为5.24%,导致颈椎术后感染的危险因素为手术时间与合并症,手术时间为术后感染的独立危险因素(OR=2.164,P<0.05);腰椎管狭窄症患者术后感染率为4.00%,导致腰椎术后感染的危险因素有手术时间、体质量指数及合并症,其中手术时间与合并症为术后感染的独立危险因素(OR=2.024、2.097,P<0.05);颈椎与腰椎术后感染在感染类型与感染原因之间差异有统计学意义(P<0.05)。结论颈腰椎术后感染的原因与类型虽有显著性差异,但颈腰椎术后感染均与手术时间与合并症密切相关,对颈腰椎等脊柱疾病进行积极的防护有助于改善神经功能,促进康复。%OBJECTIVE To explore the related risk factors for postoperative infections in the patients with cervical spondylosis or lumbar spinal stenosis and put forward the prevention measures so as to provide guidance for the clinical treatment .METHODS From 2008 to through 2013 ,totally 210 patients with cervical spondylosis and 200 patients with lumbar spinal stenosis were recruited in the study ,all the patients received the surgical procedures , then the related risk factors for the postoperative infections were retrospectively analyzed ,and the corresponding prevention measures were put forward .RESULTS The incidence of postoperative infections was 5 .24% in the pa-tients with cervical spondylosis ,the risk factors for the postoperative infections included the operation duration and complications ,and the operation duration was the independent risk factor (OR=2 .164 ,P<0 .05

  14. New approaches to early diagnosis of arthrosis and prospects for its pathogenetic therapy

    Directory of Open Access Journals (Sweden)

    Lilia Vladimirovna Luchikhina

    2014-12-01

    Full Text Available Objective: to study the possible chondroprotective effect of the viscoelastic agent synvisc, by applying the developed methodological and classification approaches to evaluating the intraarticular cartilage by arthroscopy and magnetic resonance imaging (MRI.Subjects and methods. Eighty six patients with knee arthrosis were examined and divided into 2 groups: a study group of 64 patents and a control one of 22 patients. Synvisc was injected into the affected joint in the study group; methylprednisolone acetate in the control group. Arthroscopic and MRI criteria were used to evaluate the articular cartilage. Arthroscopy and MRI were performed before and 6 and 12 months after treatment.Results. The developed methodological approaches are distinguished for their high sensitivity (89.7% and specificity (95.2%, which could estimate changes in arthrosis just at the stage of hyperhydration and dechondral changes and monitor long the chondroprotective effect of synvisc. The agent was noted to have a positive effect at the stage of hyperhydration and dechondral changes and in grade I–II intrachondral changes and to be able to prevent or stop the progression of OA in later (II–III X-ray stages. The effect of synvisc did not depend on disease duration and patient age, but it decreased in the presence of marked articular anatomic and morphological changes. The administration of the agent could reduce or preclude the use of nonsteroidal anti-inflammatory drugs or intraarticular glucocorticoids n 96% of cases.Conclusion. Arthroscopy and MRI make possible to recognize arthrosis in its earliest stage and to monitor the effect of drugs on the cartilage. The use of synvisc in early-stage gonarthrosis allows a long-term symptomatic effect and some structure-modifying activity.

  15. New approaches to early diagnosis of arthrosis and prospects for its pathogenetic therapy

    Directory of Open Access Journals (Sweden)

    Lilia Vladimirovna Luchikhina

    2014-01-01

    Full Text Available Objective: to study the possible chondroprotective effect of the viscoelastic agent synvisc, by applying the developed methodological and classification approaches to evaluating the intraarticular cartilage by arthroscopy and magnetic resonance imaging (MRI.Subjects and methods. Eighty six patients with knee arthrosis were examined and divided into 2 groups: a study group of 64 patents and a control one of 22 patients. Synvisc was injected into the affected joint in the study group; methylprednisolone acetate in the control group. Arthroscopic and MRI criteria were used to evaluate the articular cartilage. Arthroscopy and MRI were performed before and 6 and 12 months after treatment.Results. The developed methodological approaches are distinguished for their high sensitivity (89.7% and specificity (95.2%, which could estimate changes in arthrosis just at the stage of hyperhydration and dechondral changes and monitor long the chondroprotective effect of synvisc. The agent was noted to have a positive effect at the stage of hyperhydration and dechondral changes and in grade I–II intrachondral changes and to be able to prevent or stop the progression of OA in later (II–III X-ray stages. The effect of synvisc did not depend on disease duration and patient age, but it decreased in the presence of marked articular anatomic and morphological changes. The administration of the agent could reduce or preclude the use of nonsteroidal anti-inflammatory drugs or intraarticular glucocorticoids n 96% of cases.Conclusion. Arthroscopy and MRI make possible to recognize arthrosis in its earliest stage and to monitor the effect of drugs on the cartilage. The use of synvisc in early-stage gonarthrosis allows a long-term symptomatic effect and some structure-modifying activity.

  16. Efficiency of combined treatment and conventional physical treatment in bilateral knee arthrosis

    Directory of Open Access Journals (Sweden)

    Samir Bojičić

    2013-04-01

    Full Text Available Introduction: Degenerative joint disease, which is standardized in Europe by the name of arthrosis or osteoarthrosis, while in the Anglo-Saxon literature is in use for a long time by the name of osteoarthritis (OA although this is not a classical inflammation,is the most common joint disease in general and the most common cause of functional damage of the musculoskeletal system. Recently, the term osteoarthritisappears more frequently in domestic literature. Arthroses are degenerative joint diseases with progressive character, also one of the most frequent diseases in orthopedics. The disease fi rst affects the articular cartilage, then the bony edges of the articular surfaces, and then the articular lining.Methods: Retrospective analysis and evaluation of data of treated patients, with the "Praxis" physical treatment during the period of time from 2000 to the end of 2010 on a sample of 79 patients,valorized the efficacy of Praxis treatment. The  correlation of these results, with valorisation of the efficacy of standard physical treatment in clinics D.Z. " Novi Grad " on a sample of 81 patients, during the period of time from 2000 to the end of 2010, a statistical analysis was performed for comparing the effi cacy of the two methods.Results: There is a functional difference after therapy of bilateral gonarthrosis in clinics D.Z. "Novi Grad" and "Praxis" with statistical reliability.Conclusion: A combined approach in the treatment of knee arthrosis has a wider range of treatment procedures, comprehensively approaches to the problem and gives better results, so we can say that this method has priority compared to the standard approach to the knee arthrosis treatment.

  17. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  18. 以颈部肿块为主要临床表现的颈段椎管内外交通性神经鞘瘤的诊断与治疗%Dumbbell-shaped cervical spinal neurilemmoma presenting as neck mass: diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    李超; 石芳琼; 伍军; 翦新春; 蒋灿华

    2011-01-01

    PURPOSE: Cervical neurilemmoma originating from cervical spine could extend through foramen intervertebrale and displayed a radiographic features as a cervical intra- and extra-spinal dumbbell-shaped mass.Because of its early compressive spine cord, patients usually visited neurosurgery at first.In this paper, two patients of cervical intra- and extra-spinal dumbbell-shaped neurilemmoma visiting oral and maxillofacial surgery complained of upper cervical mass were reported, aiming to improve the diagnostic and therapeutic skill for oral and maxillofacial surgeons.METHODS: Two case of cervical dumbbell tumors who complained of a neck mass underwent surgery and were followed up by oral and maxillofacial surgeons.The pathogenesis,operative approach and prognosis were discussed by reviewing relevant literatures retrospectively.RESULTS: Both of the two patients' presenting symptoms were upper-cervical masses.Preoperative imaging suggested trans-cervical vertebra dumbbell masses.The tumors were removed through combining the posterior midline and lateral cervical approach, and a gross total resection was achieved.No evidence of recurrence was noted after one-year of follow-up.CONCLUSIONS: The initial symptom of cervical intra- and extra-spinal dumbbellshaped neurilemmoma may be a cervical mass and inconspicuous compressive spine cord.Analysis is essentially devoted to the radicality of tumor resection, nerve root preservation, relation to the vertebral artery, and compromise of spinal stability.The surgical resection of dumbbell-shaped cervical spinal neurilemmoma can pose a formidable challenge.%目的:发生于颈段椎管的神经鞘瘤可沿椎间孔向外生长,表现为颈椎内外交通性肿块,但多因早期出现脊髓压迫症状而就诊于神经外科.本文报告2例以颈部肿块为主要临床表现而就诊于口腔颌面外科的颈椎内外交通性神经鞘瘤,旨在提高临床医师对本病的诊断与治疗水平.方法:对中南大学湘雅医

  19. Inter-examiner reliability of the diagnosis of cervical pillar hyperplasia (CPH and the correlation between CPH and spinal degenerative joint disease (DJD

    Directory of Open Access Journals (Sweden)

    Mauron Damien

    2003-12-01

    Full Text Available Abstract Background Cervical pillar hyperplasia (CPH is a recently described phenomenon of unknown aetiology. Its clinical importance is poorly understood at the present time; therefore, the objective of this study was to determine (1 the inter-examiner reliability of detecting CPH and (2 if there is a clinically important correlation (r > 0.4 between the number of cervical spine levels showing signs of degenerative joint disease (DJD and CPH. Methods The sample consisted of 320 radiographs of human male and female subjects who ranged from 40 to 79 years of age. The inter-examiner reliability of assessing the presence/absence of pillar hyperplasia was evaluated on 50 neutral lateral radiographs by two examiners using line drawings and it was quantified using the kappa coefficient of concordance. To determine the presence/absence of hyperplastic pillars as well as the presence/absence of DJD at each intervertebral disc and zygapophysial joint, 320 AP open mouth, AP lower cervical and neutral lateral radiographs were then examined. The unpaired t-test at the 5% level of significance was performed to test for a statistically significant difference between the number of levels affected by DJD in patients with and without hyperplasia. The Spearman's rho at the 5% level of significance was performed to quantify the correlation between DJD and age. Results The inter-examiner reliability of detecting cervical pillar hyperplasia was moderate with a kappa coefficient of 0.51. The unpaired t-test indicated that there was no statistically significant difference (p > 0.05 between the presence/absence of cervical pillar hyperplasia and the number of levels affected by DJD in an age-matched population, regardless of whether all elements were considered together, or the discs and facets were analyzed separately. A Spearman correlation rank of 0.67 (p Conclusion Cervical pillar hyperplasia is a reasonable concept that requires further research. Its evaluation is

  20. Cervical diplomyelia revealed by computed tomography (CT)

    Energy Technology Data Exchange (ETDEWEB)

    Giordano, G.B.; Davidovits, P.; Cerisoli, M.; Giulioni, M.

    1982-05-01

    An unusual case of cervical diplomyelia diagnosed by Computed Tomography (CT) is reported. The usefulness of CT examination in the evaluation of spinal dysraphic defects is emphasized, though performed without CSF enhancement. Visualisation of spinal cord splitting in the absence of bony spicula allows the authors to differentiate between diplomyelia and diastematomyelia which have been often described by using both terms interchangeably.

  1. Observation of tenderness parts of cervical spondylotic radiculopathy and analysis relevant tenderness parts and spinal nerve%神经根型颈椎病压痛部位分布及其与神经节段的关系

    Institute of Scientific and Technical Information of China (English)

    于杰; 王乾; 魏戌; 甄朋超; 朱立国; 房敏; 林定坤; 李俊杰; 洪毅; 王平; 高景华; 王尚全

    2011-01-01

    Objective To ohserve tenderness parts of cervical spondylotic radiculopathy and analysis relevant tenderness parts and spinal nerve. Methods Tenderness parts of neck and shoulder of the 480 patients ( 3 patients removed) with cervical spondylotic radiculopathy were check with thumb and recoved reference to the main tenderness parts of neck and shoulder. Results Nerve root type cervical spondylosis The main spine nerve root of cervical spondylotic radiculopathy were C6 ( 53. 04% ) . C5 ( 24. 53% ) C7 ( 18. 87% ). The common tenderness points were located at the side of processus spinosus.medial angle of scapula、neck and shoulder transmigration of cowl-muscle、margo medialis scapulae. Conclusion The examination and analysis of tenderness points is important to the diagnosis and treatment ofcervical spondylotic radiculopathy.%目的 观察神经根型颈椎病压痛部位分布特征及其与神经节段的关系.方法 本组神经根型颈椎病患者480例(剔除3例),研究者以拇指逐次按压患者颈肩部进行压痛的体格检查,并参照主要颈肩压痛点记录压痛点.采用关联规则的研究方法作神经根节段与压痛部位作相关性分析.结果 神经根型颈椎病患者主要发病的神经根为C6(53.04%)、C5(24.53%)、C7(18.87%).神经根节段与压痛部位的关联分析显示压痛部位集中于受累神经根节段棘突旁、斜方肌颈肩移行部即肩井穴、斜方肌颈肩移行部即肩井穴)、肩胛骨上角即肩胛提肌止点等部位.结论 压痛点的检查与分析对于神经根型颈椎病的诊断和治疗具有重要意义.

  2. Mechanism and correlation factor of hyponatremia in patients with acute cervical spinal cord trauma%急性颈髓损伤后低钠血症发生机制及相关因素

    Institute of Scientific and Technical Information of China (English)

    赵磊; 王帅; 宋朝晖; 吴春生; 彭阿钦

    2013-01-01

    [ Objective ] To investigate the mechanism and correlation factors of hyponatremia in patients with acute cervical spinal cord trauma and principle of clinical diagnosis and treatment. [ Method ] Fasting blood electrolyte values in 52 patients were tested in 10 days after the cervical spinal trauma. The data of blood pressure and intake and output volumes were recorded. According to the Frankel criteria,using statistic methods,some factors affecting hyponatremia including injury level and severity were compared, the change rules of mean arterial pressure and the intake and output volumes of 24 hours and the relativity with hyponatremia were analyzed. [ Result] Fasting blood sodium value was ( 134. 7 ± 5. 13) mmol/L,blood pressure value was (101.4 ±5. 21/78. 6 ±4. 81) mmHg.the intake volumes of 24 hours was (5810±493. 18) ml and the output volumes of 24 hours was (5450 ±497. 21) ml in 38 patients with actue spinal cord injury. Fasting blood sodium value was ( 139. 8 ±2. 18) mmol/L,blood pressure value was (127.2 ±2.81/84.6 ± 3.42) mmHg and the intake volumes of 24 hours was (2890 ± 255. 82) ml and the output volumes of 24 hours was (2580 ±214. 99) ml in 14 patients without actue spinal cord injury. The occurrence time of post - traumatic hyponatremia was 5. 2 - 8. 3 days. [ Conclusion ] The severity of hyponatremia is related to the severity of spinal cord injury,is not related to level of cervical spinal injury. The more severe spinal cord injury is,the more severe hypotension and hyponatremiais is. The intake and output volumes of 24 hours increases obviously in patients with actue spinal cord injury.%[目的]探讨急性颈髓损伤后低钠血症的发生机制、相关因素及临床诊治原则.[方法]检测52例急性颈椎损伤后连续10 d的空腹电解质、血压、出入量的情况,根据Frankel评分标准,利用统计学方法,比较分析损伤平面、损伤程度等因素对低钠血症的影响,分析平均动脉压及24 h出入量

  3. Cervical spine alignment, sagittal deformity, and clinical implications: a review.

    Science.gov (United States)

    Scheer, Justin K; Tang, Jessica A; Smith, Justin S; Acosta, Frank L; Protopsaltis, Themistocles S; Blondel, Benjamin; Bess, Shay; Shaffrey, Christopher I; Deviren, Vedat; Lafage, Virginie; Schwab, Frank; Ames, Christopher P

    2013-08-01

    This paper is a narrative review of normal cervical alignment, methods for quantifying alignment, and how alignment is associated with cervical deformity, myelopathy, and adjacent-segment disease (ASD), with discussions of health-related quality of life (HRQOL). Popular methods currently used to quantify cervical alignment are discussed including cervical lordosis, sagittal vertical axis, and horizontal gaze with the chin-brow to vertical angle. Cervical deformity is examined in detail as deformities localized to the cervical spine affect, and are affected by, other parameters of the spine in preserving global sagittal alignment. An evolving trend is defining cervical sagittal alignment. Evidence from a few recent studies suggests correlations between radiographic parameters in the cervical spine and HRQOL. Analysis of the cervical regional alignment with respect to overall spinal pelvic alignment is critical. The article details mechanisms by which cervical kyphotic deformity potentially leads to ASD and discusses previous studies that suggest how postoperative sagittal malalignment may promote ASD. Further clinical studies are needed to explore the relationship of cervical malalignment and the development of ASD. Sagittal alignment of the cervical spine may play a substantial role in the development of cervical myelopathy as cervical deformity can lead to spinal cord compression and cord tension. Surgical correction of cervical myelopathy should always take into consideration cervical sagittal alignment, as decompression alone may not decrease cord tension induced by kyphosis. Awareness of the development of postlaminectomy kyphosis is critical as it relates to cervical myelopathy. The future direction of cervical deformity correction should include a comprehensive approach in assessing global cervicalpelvic relationships. Just as understanding pelvic incidence as it relates to lumbar lordosis was crucial in building our knowledge of thoracolumbar deformities, T

  4. Imaging in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  5. 颈髓电刺激治疗“植物人”疗效观察(附10例病例报告)%Observating the effect of cervical spinal cord stimulation in the treatment of the vegetables(report of 10 cases)

    Institute of Scientific and Technical Information of China (English)

    刘坤; 刘华; 黄红星; 邹叔骋; 徐龙彪; 刘博; 罗宗晚; 李创华; 李凌; 张卫民

    2014-01-01

    目的:观察颈髓电刺激治疗“植物人”的临床效果。方法:对10例“植物人”采用常规治疗,包括脑室分流术、颅骨修补术、药物、高压氧等治疗,并加用颈脊电刺激治疗。按持续植物状态量表评分、脑电图、诱发电位及 TCD、临床疗效标准评定疗效。结果:10例患者,通过颈髓电刺激,8例(80%)明显好转,其中3例(30%)有效,2例(20%)效果不明显。结论:颈髓电刺激对“植物人”促醒有一定疗效。%Objective:To observe the ef ect of cervical spinal cordstimulation in the treatment of the vegetables.Methods 10 patiends were treated by conventional.Methods:Including ventricular shunt,cra-nioplasty,drug,hyperbaric oxygen therapy,combined with cervical spinal stimulation.According to the persistent vegetative state scale,EEG,evoked potentials and TCD,clinical ef icacy was evaluated.Re-sult:10 patients were being operated by the cervical spinal cord stimulation,8 patients (80%)were improved,3 patients(30%)were ef ective,2 patients (20%)had no obvious ef ect.Conclusion:Cervical spinal cord stimulation to cure the vegetatives is one of the certain ef ective metheods.

  6. 颈椎过伸性脊髓损伤节段的相关性因素研究%Research on correlative factor of spinal segment distribution in cervical hyperextension injury

    Institute of Scientific and Technical Information of China (English)

    张永进; 何海潮; 吕晓强; 刘志英; 徐杰; 杜英勋; 贾连顺

    2010-01-01

    目的 探讨颈椎过伸性损伤的退变性因素、损伤节段的分布及其原因.方法 温州医学院附属东阳医院89例颈椎过伸性损伤患者进行回顾性分析,统计颈椎退行性病变、T2WI相脊髓高信号的位置及颜面部外伤的位置.结果 间盘突出58例,居首位;其后依次为后纵韧带骨化(8例)、发育性椎管狭窄(7例)及椎间盘突出+黄韧带肥厚(6例).单节段T2WI相脊髓高信号在椎间盘水平:C2~3者4例,额部外伤1例;C3~4者12例,额部外伤10例,颧部外伤1例;CA~5者12例,额部外伤5例,额部+颧部外伤1例,额部+下颌部外伤1例;C5~6者11例,额部外伤3例,颧部外伤3例,下颌部外伤2例.单节段脊髓高信号位置不在椎间盘水平4例,脊髓高信号在两个不连续节段10例,脊髓高信号超过2个节段2例,脊髓高信号超过3个节段6例.结论 椎间盘突出是颈椎过伸性损伤患者最多见的退变性因素,T2WI相脊髓高信号的水平与额面部撞击的部位相关,拐点的剪切力(inflection point shear force)合并(或)颈椎过伸的前后挤压力是颈椎过伸性损伤的机制.%Objective To discuss the degenerative factors, the spinal segment distribution, and the mechanism in hyperextension injury of cervical spine. Method Eighty-nine patients with hyperextension injury of cervical spine were retrospectively analyzed by observing the degenerativelesion, the spinal cord segment with high signal in T2WI, and the location of facial trauma. Results Fifty-eight cases showed the disc hemiation which was the most common lesion, followed by 8 cases showing the calcification of the posterior longitudinal ligament. Besides, 7 cases presented the developmental stenosis of spinal canal, and also, 6 cases showed disc hemiation combined with the yellow ligament hypertrophy. The intervertebral level of the spinal cord with high signal in T2WI were distributed as follows:4 cases were at C2/3, of which onesuffered the forehead trauma

  7. Radiographic study on the interrelation between bone deformans and condylar head position in the TMJ arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1981-11-15

    The author analysed the interrelation between the morphologic changes of bone structures and the position of condylar head from the routine radiographs of 134 cases of the temporomandibular joint arthrosis. The frequencies of coincidence between the site of bone deformity and condylar head positional change were examined. Also, the positional changes of condylar head and the direction of condylar movement in relation to the kind of bone deformities were observed. The results obtained were as follows; 1. In 52.65 per cent of total cases, the site of positional change of condylar head was coincided with the site of bone deformans. The frequencies of the coincidence between these in the five items among seven items examined were above 53 per cent. From the results, it seems that the positional changes of condylar head were related with the morphological change of bone structure. 2. Eburnation and erosion revealed frequently positional changes in the opening and closing position of the mouth, although in the early stages of the TMJ arthrosis. 3. In the bone deformans, during open position of the mouth 44.81 per cent of total cases revealed backward movement and 37.74 per cent showed forward movement. In closed position of the mouth, downward movement was revealed in 35.23 percent of total cases and upward movement 28.41 percent of total cases.

  8. Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1983-11-15

    The author analyzed the morphologic changes of bone structure from 848 radiographics (424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and ortho pantomography. The interrelation of the bone changes and condylar head positions the results were as follows: 1. In the 212 patients with TMJ arthrosis, 210 patients (99.05%) show the condylar positional changes. Among them, 187 patients (89.05%) show the bone changes. 2. In TMJ arthrosis patients with bone changes, 108 patients (57.75%) show both the condylar positional changes and bone changes. 66 patients show the condylar positional changes bilaterally and bone changes unilaterally. On the other hand, 11 patients (5.88%) show the condylar positional changes unilaterally and bone change bilaterally. 3. The bone changes in the TMJ arthrosis patients with the condylar positional changes were as follows: There were the flattening of articular surface in 103 cases (26.55%) the erosion in 99 cases (25.52%), and the erosion in 88 cases (22.68%). There were not much differences among the three types of bone changes. And the deformity in 70 cases (18.04%), the sclerosis in 22 cases (5.67%), the marginal proliferation in 6 cases (1.55%) were seen. 4. The regions of bone changes in TMJ arthrosis patients with condylar positional changes were as follows: They occurred at the condyle head (51.04%), the articular eminence (39.20%) and the articular fossa (9.60%) in that order. The condylar positional changes and bone changes according to the regions were as follows: a) In the bone changes at the condylar head, the flattening (34.63%) was a most frequent finding and the deformity (27.63%) the erosion (34.63%) in the order. In the condylar positional changes, the downward positioning of condyle (41.44%) was a most frequent finding in the mouth closed state and the restricted movement within the articular fossa (35.46%) in the mouth open state. b) In

  9. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  10. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: a case report.

    Science.gov (United States)

    Mimata, Yoshikuni; Murakami, Hideki; Sato, Kotaro; Suzuki, Yoshiaki

    2014-01-01

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important.

  11. Acute cervical spinal cord injury complicated with hyponatremia analysis of 16 cases%急性颈髓损伤并发低钠血症临床分析

    Institute of Scientific and Technical Information of China (English)

    刘云龙; 汪勇

    2012-01-01

    Objective To investigate the clinical characteristics, pathogenesis, and treatment of acute cervical spinal cord injury complicated with hyponatremia. Methods The clinical data of 16 patients of acute cervical spinal cord injury complicated with hyponatremia, 15 males and 1 female, aged 35.6 (17 ~ 46), 4 with the injury at C4 and above, and 12 with the injuries below C4, were retrospectively analyzed. Results With a duration of (18.9+5.1) days, hyponatremia occurred (5.3 + 1.6) days after the injury on average, and the peak time of occurrence of hyponatremia was (7.9 ±2.1) days following the injury. The lowest serum sodium level was (112.7 ±3.8) mmol/L. Central venous pressure was monitored in all patients by cannulation of the deep vein. After appropriate salt supplement and restriction of water intake, hyponatremia were improved in 14 patients and 2 patients were discharged against medical advise. Conclusion hyponatremia is one of the common severe complications of cervical spinal cord injury. Close monitoring and maintenance of sodiu m metabolism help correct this disorder.%目的 探讨急性颈髓损伤后低钠血症的临床特点和有效的治疗方法.方法 回顾性分析急性颈髓损伤后低钠血症患者16例,男15例,女1例,年龄35.6(17~46)岁,高位颈髓(C4及C4以上)损伤4例,低位颈髓(C4以下)损伤12例,的临床资料.结果 平均出现低钠血症时间为伤后(5.3±1.6)d,出现低钠高峰时间为伤后(7.9±2.1)d,低钠持续时间(18.7±5.1)d,最低血清钠浓度为(112.7±3.8)mmol/L.所有患者均给予深静脉插管以补液及行中心静脉压监测,经限水、补钠等治疗后14例患者低钠血症纠正,2例患者自动出院.结论 低钠血症原因是颈髓损伤发常见的严重并发症.通过严密监测患者血钠并维持钠代谢正平衡可纠正患者的低钠血症.

  12. A critical evaluation of subtalar joint arthrosis associated with middle facet talocalcaneal coalition in 21 surgically managed patients: a retrospective computed tomography review. Investigations involving middle facet coalitions-part III.

    Science.gov (United States)

    Kernbach, Klaus J; Barkan, Howard; Blitz, Neal M

    2010-01-01

    Symptomatic middle facet talocalcaneal coalition is frequently associated with rearfoot arthrosis that is often managed surgically with rearfoot fusion. However, no objective method for classifying the extent of subtalar joint arthrosis exists. No study has clearly identified the extent of posterior facet arthrosis present in a large cohort treated surgically for talocalcaneal coalition through preoperative computerized axial tomography. The authors conducted a retrospective review of 21 patients (35 feet) with coalition who were surgically treated over a 12-year period for coalition on at least 1 foot. Using a predefined original staging system, the extent of the arthrosis was categorized into normal or mild (Stage I), moderate (Stage II), and severe (Stage III) arthrosis. The association of stage and age is statistically significant. All of the feet with Stage III arthrosis had fibrous coalitions. No foot with osseous coalition had Stage III arthrosis. The distribution of arthrosis staging differs between fibrous and osseous coalitions. Only fibrous coalitions had the most advanced arthrosis (Stage III), whereas osseous coalitions did not. This suggests that osseous coalitions may have a protective effect in the prevention of severe degeneration of the subtalar joint. Concomitant subtalar joint arthrosis severity progresses with age; surgeons may want to consider earlier surgical intervention to prevent arthrosis progression in patients with symptomatic middle facet talocalcaneal coalition.

  13. Delayed onset of a spinal epidural hematoma after facet joint injection

    Directory of Open Access Journals (Sweden)

    Mirko Velickovic

    2016-10-01

    Full Text Available The treatment of chronic back pain is a challenging problem. Facet joint infiltration is an established treatment for chronic low back pain caused by arthrosis of the lumbar facet joints. Due to the increasing number of patients with chronic low back pain, this therapy has become more frequent. We treated a 51-year-old male patient, who developed an epidural hematoma 2 months after infiltration therapy. Our case shows that even a delayed onset of spinal epidural hematoma is possible and should be kept in mind as a possible cause of acute myelopathy after spinal intervention.

  14. 早期颈前路手术治疗多节段急性颈椎间盘突出并脊髓损伤的研究%Early anterior approach operation with internal fixation in treatment of acute multilevel cervical disc herniation patients with cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李晓彬; 刘涛; 程应全; 王伟

    2012-01-01

    Objective To evaluate the clinical effect of early anterior approach operation with internal fixation in treating traumatic cervical disc herniation patients with cervical spinal cord injury.Methods Twenty-three patients with spinal cord injury caused by acute cervical disc herniation,admitted to our hospital from January 2010 to January 2011,were chosen in our study; all patients underwent anterior cervical surgery with the application of titanium mesh plate and cage to perform decompression and reconstruction; 14 patients received surgery within 72 h of injury and other 9 adopted surgery after 72 h of injury.The clinical data and postoperative recovery degree of the spinal cord injury were retrospectively analyzed.Results All patients were followed up for 6 to 13 months (averaged 11 months).X-ray examination showed bony fusion in the fusion segments without loosening/breakage of internal fixation or interbody fusion sinking.Except for 1 patient having grade A according to American Spinal Injury Association (ASIA) criteria enjoyed no recovery after the operation,the remaining patients enjoyed good improvement.The postoperative average Japanese Orthopedic Association (JOA) scale scores were significantly higher than those before surgery; the postoperative average JOA scale scores and recovery ratio of JOA in patients received surgery within 72 h of injury were obviously higher than those in patients received surgery over 72 h of injury (P<0.05).Conclusion Early anterior titanium mesh combined with cage and locking plate operation can make acute cervical disc herniation patients with spinal cord injury get rapid improvement and restoration; the earlier the operation time,the better the recovery degree; surgery can make cervical operation section obtain immediate stability,fusion and clinical effects are satisfied.%目的 探讨早期颈前路手术治疗多节段急性颈椎间盘突出引起的颈脊髓损伤的临床疗效. 方法 河南省人民

  15. Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis%单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效

    Institute of Scientific and Technical Information of China (English)

    汪雷; 李涛; 宋跃明; 刘浩; 裴福兴; 刘立岷; 龚全; 孔清泉; 曾建成

    2011-01-01

    目的:探讨单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效.方法:2009年8月~2010年6月采用后路C3~C7单开门椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症患者30例,其中男性23例,女性7例,年龄42~81岁,平均65.2岁.MRI显示3个节段狭窄9例,4个节段狭窄15例,5个节段狭窄6例.以JOA评分(17分法)及其改善率评价术后神经功能改善情况;术后复查颈椎X线、CT及MRI,在术前及术后3d、6个月的颈椎侧位X线片上测量C5节段椎管矢状径,计算椎管扩大率[(术后椎管矢状径-术前椎管矢状径)/(术前椎管矢状径)x 100%],评价椎管扩大和维持情况及门轴侧骨融合情况结果:手术时间为145±20min,术中出血量为215±75ml,术中未出现相关并发症.1例术后第2天出现C5神经根症状,经2周保守治疗疼痛明显缓解,术后2个月时症状完全消失.随访9~20个月,平均14.6个月,术前JOA评分为8.7±0.8分,术后6个月为15.2±1.1分,改善率为(75±18) %.影像学复查示术后3d、6个月时颈椎管扩大满意,脊髓受压完全解除,C5节段椎管矢状径术前为9.2±0.8mm,术后3d,6个月均为15.9±1.2mm,椎管扩大率为(71.8±11.0)%.术后6个月时门轴侧均达骨性愈合,无1例出现关门及神经损害症状加重的情况结论:单开门颈椎管扩大成形Centerpiece钛板内固定术是治疗颈椎管狭窄症的一种简便、安全的方法,早期疗效较满意.%Objective:To evaluate the early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis. Method : From August 2009 to June 2010,30 cases suffering from cervical spinal stenosis underwent unilateral open-door expansive laminoplasty plus centerpiece fixation,of these,there were 23 males and 7 females,with a mean age of 65.2 years (range, 42-81 years ) .Preoperative MRI showed stenosis at three

  16. Halo-vest辅助下前路手术治疗严重颈椎结核伴后凸畸形%Halo-vest Assisted Anterior Approach for the Treatment of Cervical Spinal Tuberculosis Complicated with Kyphosis

    Institute of Scientific and Technical Information of China (English)

    杨成伟; 屈涛; 王世勇; 张军华

    2013-01-01

    Objective: The purpose of this study is to explore the surgical method and clinical effects of Halo-vest assisted anterior approach operation for the treatment of cervical spine tuberculosis complicated with kyphosis. Methods: 12 patients suffered from cervical spine tuberculosis complicated with kyphosis were managed in our department from October 2004 to September 2010. The preoperative Cobb angle was 34° (range from 20°to 42°). Before operation, all patients accepted anti-tuberculosis chemotherapy for 2-4 weeks. The patients with cervical kyphosis were treated by Halo-vest and the spinal deformity was corrected before operation. All patients were treated by anterior debridement and fusion with internal fixation. Anti-tuberculosis chemotherapy was performed for 12 to 24 months. Results: The average duration of follow-up was 26 months (range from 12 to 48 months). All the patients stood surgery well. The kyphosis deformity was corrected and the normal cervical lordosis was maintained without associated complication. The neural symptoms were improved. All cases had bony fusion in 3-6 months. There were no plates and screws complications and Halo-vest associated complications. No recurrence of tuberculosis was noted at final follow-up. Conclusion: Application of Halo-vest can correct the cervical kyphosis and maintain normal cervical lordosis. When kyphosis was corrected, the risk of spinal cord injury in the operation can be reduced. Anterior debridement and internal fixation assisted with Halo-vest is a safe and effective method for treatment of the cervical tuberculosis complicated with kyphosis.%目的:探讨使用halo-vest支具牵引复位并通过前路手术治疗严重颈椎结核并后凸畸形的方法和疗效.方法:通过对2004年10月至2010年9月在我科住院治疗的14例严重颈椎结核并后凸畸形的患者进行回顾性研究.本组患者中男8例,女6例,术前颈椎后凸Cobb角24-42°,平均34°.术前使

  17. Drug distribution in spinal cord during administration with spinal loop dialysis probes in anaesthetized rats

    DEFF Research Database (Denmark)

    Uustalu, Maria; Abelson, Klas S P

    2007-01-01

    ]Epibatidine in concentrations of 1, 10 and 100 nM was dissolved in Ringer's solution and administered through the dialysis membrane into the dorsal region of the cervical spinal cord. First, the outflow of [(3)H]epibatidine from the probe into the spinal cord was examined with respect to different concentrations and changes...

  18. Challenges in Diagnosis and Treatment of a Cervical Spinal Cord Injury Patient with Melanoma, Adenocarcinoma, and Hepatic and Osteolytic Metastases: Need to Implement Strategies for Prevention and Early Detection of Cancer in Spinal Cord Injury Patients

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2012-01-01

    Full Text Available A male tetraplegic patient with, who had been taking warfarin, developed haematuria. Ultrasound scan revealed no masses, stones, or hydronephrosis. Urinary bladder had normal configuration with no evidence of masses or organised haematoma. Urine cytology revealed no malignant cells. Four months later, CT urography revealed an irregular mass at the base of urinary bladder. Cystoscopic biopsy revealed moderately differentiated adenocarcinoma, which contained goblet cells and pools of mucin showing strongly positive immunostaining for prostatic acid hosphatase and patchy staining for prostate specific antigen. Computed Tomography revealed multiple hypodense hepatic lesions and several osteolytic areas in femoral heads and iliac bone. With a presumptive diagnosis of prostatic carcinoma, leuprorelin acetate 3.75 mg was prescribed. This patient expired a month later. Conclusion. (i Spinal cord injury patient, who passed blood in urine while taking warfarin, requires repeated investigations to look for urinary tract neoplasm. (ii Anti-androgen therapy should be prescribed for 2 weeks prior to administration of gonadorelin analogue to prevent tumour flare causing bone pain, bladder outlet obstruction, uraemia, and cardiovascular risk due to hypercoagulability associated with a rapid increase in tumour burden. (iii Spinal cord physicians should adopt a caring and compassionate approach while managing tetraplegic patients with several co-morbidities, as aggressive diagnostic tests and therapeutic procedures may lead to deterioration in the quality of life.

  19. Challenges in Diagnosis and Treatment of a Cervical Spinal Cord Injury Patient with Melanoma, Adenocarcinoma, and Hepatic and Osteolytic Metastases: Need to Implement Strategies for Prevention and Early Detection of Cancer in Spinal Cord Injury Patients

    Science.gov (United States)

    Vaidyanathan, Subramanian; Mansour, Paul; Hughes, Peter L.; Selmi, Fahed; Singh, Gurpreet; Pulya, Kamesh; Soni, Bakul M.

    2012-01-01

    A male tetraplegic patient with, who had been taking warfarin, developed haematuria. Ultrasound scan revealed no masses, stones, or hydronephrosis. Urinary bladder had normal configuration with no evidence of masses or organised haematoma. Urine cytology revealed no malignant cells. Four months later, CT urography revealed an irregular mass at the base of urinary bladder. Cystoscopic biopsy revealed moderately differentiated adenocarcinoma, which contained goblet cells and pools of mucin showing strongly positive immunostaining for prostatic acid hosphatase and patchy staining for prostate specific antigen. Computed Tomography revealed multiple hypodense hepatic lesions and several osteolytic areas in femoral heads and iliac bone. With a presumptive diagnosis of prostatic carcinoma, leuprorelin acetate 3.75 mg was prescribed. This patient expired a month later. Conclusion. (i) Spinal cord injury patient, who passed blood in urine while taking warfarin, requires repeated investigations to look for urinary tract neoplasm. (ii) Anti-androgen therapy should be prescribed for 2 weeks prior to administration of gonadorelin analogue to prevent tumour flare causing bone pain, bladder outlet obstruction, uraemia, and cardiovascular risk due to hypercoagulability associated with a rapid increase in tumour burden. (iii) Spinal cord physicians should adopt a caring and compassionate approach while managing tetraplegic patients with several co-morbidities, as aggressive diagnostic tests and therapeutic procedures may lead to deterioration in the quality of life. PMID:23227385

  20. 颈椎损伤的影像学诊断:回顾与展望%Image diagnosis of cervical spinal injury

    Institute of Scientific and Technical Information of China (English)

    陈誉; 李明

    2012-01-01

    With the rapid development of modern imaging technology, the imaging technology plays more and more important role in the diagnosis of cervical spine injuries(CSI ). This article attempts to summarize the strengths and weaknesses of each technology, identify its indication, and especially discuss the diseases which should be performed image technology. The purpose of this article is to supply a new idea to the diagnosis and treatment of cervical spine injuries(CSI).%现代影像学技术发展日新月异,在颈椎损伤(CSI)的诊断中扮演着越来越重要的角色.本文旨在对目前常用的影像学技术进行综述,明确其各自的优缺点及适应证,尤其对哪些人需要进行哪种影像学检查做了详尽的讨论,以期为临床诊治颈椎损伤提供新的思路.

  1. Bone mineral density in patients with destructive arthrosis of the hip joint.

    Science.gov (United States)

    Okano, Kunihiko; Aoyagi, Kiyoshi; Enomoto, Hiroshi; Osaki, Makoto; Chiba, Ko; Yamaguchi, Kazumasa

    2014-05-01

    Recent reports have shown the existence of subchondral insufficiency fracture in rapidly destructive arthrosis of the hip joint (RDA), and the findings suggest that osteopenia is related to the pathogenesis of the rapid progression of this disease. Therefore, we measured bone mineral density (BMD) in RDA patients. We measured BMD of the lumbar spine, radius, and calcaneus using dual-energy X-ray absorptiometry in 19 patients with RDA and 75 with osteoarthritis of the hip (OA) and compared BMD at different skeletal sites between RDA and OA patients. No significant differences were observed in BMD of the lumbar spine, ultradistal radius, mid-radius, and calcaneous between the RDA and OA groups. Our data suggest that RDA is not accompanied by generalized osteoporosis. Factors other than generalized bone status, for example, BMD around the affected hip joint before destruction, need to be analyzed to elucidate the pathophysiological mechanism of RDA.

  2. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  3. Neuroimaging for spine and spinal cord surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koyanagi, Izumi [Hokkaido Neurosurgical Memorial Hospital (Japan); Iwasaki, Yoshinobu; Hida, Kazutoshi

    2001-01-01

    Recent advances in neuroimaging of the spine and spinal cord are described based upon our clinical experiences with spinal disorders. Preoperative neuroradiological examinations, including magnetic resonance (MR) imaging and computerized tomography (CT) with three-dimensional reconstruction (3D-CT), were retrospectively analyzed in patients with cervical spondylosis or ossification of the posterior longitudinal ligament (130 cases), spinal trauma (43 cases) and intramedullary spinal cord tumors (92 cases). CT scan and 3D-CT were useful in elucidating the spine pathology associated with degenerative and traumatic spine diseases. Visualization of the deformity of the spine or fracture-dislocation of the spinal column with 3D-CT helped to determine the correct surgical treatment. MR imaging was most important in the diagnosis of both spine and spinal cord abnormalities. The axial MR images of the spinal cord were essential in understanding the laterality of the spinal cord compression in spinal column disorders and in determining surgical approaches to the intramedullary lesions. Although non-invasive diagnostic modalities such as MR imaging and CT scans are adequate for deciding which surgical treatment to use in the majority of spine and spinal cord disorders, conventional myelography is still needed in the diagnosis of nerve root compression in some cases of cervical spondylosis. (author)

  4. 显微手术治疗颈胸腰段椎管内硬膜外蛛网膜囊肿%Microsurgical treatment for cervical, thoracic and lumbar spinal extradural arachnoid cysts

    Institute of Scientific and Technical Information of China (English)

    高海浩; 尚爱加; 程诚; 张远征; 乔广宇; 佟怀宇

    2014-01-01

    目的 探讨颈胸腰段椎管内硬膜外蛛网膜囊肿的临床特点和治疗方法.方法 回顾性分析2011年1月至2013年11月收治的有明确症状的15例颈胸腰椎管内硬膜外蛛网膜囊肿患者.其中,1例发生于颈段,12例发生于胸腰段,2例发生于腰段.症状以腰腿疼痛为主,部分患者存在间歇性跛行和感觉功能障碍.结果 15例均行显微手术切除囊肿,术中探查并找到囊肿和硬脊膜囊交通孔予以封闭.术后早期患者症状改善明显.随访1 ~32个月,平均19个月,均未见囊肿复发.其中,11例症状消失,4例症状缓解,不影响正常生活.结论 对有明确症状的椎管内硬膜外蛛网膜囊肿患者,应首选显微手术治疗.手术方法采用囊肿切除、交通孔封闭、椎板复位,临床疗效良好.%Objective To explore the clinical features and surgical treatment of cervical,thoracic and lumbar spinal extradural arachnoid cysts.Methods The clinical data of 15 patients with cervical,thoracic and lumbarspinal extradural arachnoid cysts in our department from Jan 2011 to Nov 2013 were analyzed respectively.Of 15 patients,1 case occurred in cervical segment,12 in thoracolumbar segment,and 2 in lumbar segment.The symptom was given priority to the pain of lumbosacral region,followed by intermittent claudication and sensory dysfunction.Results 15 patients were treated by microsurgical operation to remove the cysts,explore and close the access hole between the cyst and dural sac.In early postoperative period,the symptoms were relieved significantly.15 patients were followed-up from 1 to 32 months (mean duration:19 months) and there was no cyst recurrence.The symptoms of 11 patients were disappeared,and 4 with relief of symptoms and without influence on their daily life.Conclusions Microsurgery was recommended for the patients with spinal extradural arachnoid cysts who suffered from significant symptoms,which included the cyst resection,access hole closure and lamina

  5. End-stage hindfoot arthrosis: outcomes of tibiocalcaneal fusion using internal and Ilizarov fixation.

    Science.gov (United States)

    Crawford, Brooke; Watson, J Tracy; Jackman, James; Fissel, Brian; Karges, David E

    2014-01-01

    End-stage post-traumatic pantalar arthrosis from ankle, pilon, and talus fractures has often been complicated by infection, bone loss, and a soft tissue deficit. Patients can present with neuropathy, diabetes, tobacco use, and previously failed arthrodesis. Fusion in this population has been challenging, with nonunion rates up to 30%, often leading to amputation. We reviewed the results of a standardized protocol that combined simultaneous internal fixation with the Ilizarov technique to achieve fusion in high-risk patients. With institutional review board approval, a retrospective review of the patients treated with simultaneous internal fixation and an Ilizarov frame was undertaken. The records and radiographs allowed identification of the comorbidities and the presence or absence of successful fusion. Complications were acknowledged and treated. Fifteen patients had undergone the procedure. The mean follow-up period was 27.9 (range 9 to 67) months. Thirteen patients (86.67%) had had previous fusion failure. Twelve patients (80%) had developed post-traumatic arthrosis, 5 (33.33%) of whom had open injuries. All patients had 1 comorbidity, and 10 (66.67%) had multiple, including rheumatoid arthritis, diabetes (types 1 and 2), and smoking. Four patients (26.67%) presented with deep infection and bone loss. Union was achieved in 11 (73.33%), with 12 (80%) patients experiencing profound pain relief. Seven patients (46.67%) required symptomatic hardware removal. Three patients (20%) eventually underwent below-the-knee amputation for recalcitrant nonunion. Statistically significant correlations were found between smoking and wound infection and revision and between nonunion and amputation. Our results have indicated that combined internal fixation with Ilizarov application can provide a strong surgical option for the management of end-stage, pantalar arthritis. More studies are needed to compare the cohort outcomes and gait analysis in these patients with those who have

  6. 高位颈段椎管内神经鞘瘤显微手术治疗59例%Microsurgical treatment of neurilemmoma in upper cervical spinal canal: 59 cases report

    Institute of Scientific and Technical Information of China (English)

    王林; 傅先明; 牛朝诗; 钱若兵; 凌士营; 计颖; 汪业汉

    2011-01-01

    目的 探讨高位颈段神经鞘瘤显微手术技巧和疗效.方法从2004年1月至2007年12月,对59例均采用后正中入路显微手术治疗,采用德国产Laika显微镜下切除肿瘤,较大肿瘤不能完整切除时,用分块切除或囊内切除,术后常规颈托限制颈部活动,55例术后随访6个月~2年.结果 痊愈54例,症状改善5例,无死亡.55例随访6个月~2年,4例失访.35例术后3~12个月MR检查未见肿瘤残存或复发,42例术后6个月颈椎正侧位及张口位片检查未见脊柱骨性结构变形,脊柱稳定性好.结论 高位颈段神经鞘瘤一旦确诊,就应该及早显微手术治疗.手术安全、效果良好.%Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years (6.5 ± 1.5 months). MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal

  7. MRI Findings in Spinal Canal Stenosis

    Directory of Open Access Journals (Sweden)

    Maryam Barzin

    2010-05-01

    Full Text Available Spinal canal stenosis results from progressive narrowing of the central spinal canal and the lateral recesses. Primary (congenital lumbar spinal stenosis is associated with achondroplastic dwarfism. The spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposus posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the facet joints, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins and uncovertebral joint hypertrophy in the neck. The central canal and the neurorecess may be compromised by tumor infiltration, such as metastatic disease, or by infectious spondylitis."nAP diameter of the normal adult cervical canal has a mean value of 17-18 mm at vertebral levels C3-5. The lower cervical canal measures 12-14 mm. Cervical stenosis is associated with an AP diameter of less than 10 mm. The thoracic spinal canal varies from 12 to 14 mm in diameter in the adult. The diameter of the normal lumbar spinal canal varies from 15 to 27 mm. Lumbar stenosis results from a spinal canal diameter of less than 12 mm in some patients; a diameter of 10 mm is definitely stenotic."nSpinal MRI is the most suitable technique for the diagnosis of spinal stenosis. The examination should be performed using thin sections (3 mm and high resolution, including the axial and sagittal planes using T1-weighted, proton-density, and T2-weighted techniques. The bony and osteophytic components are seen best using a T2-weighted gradient-echo technique."nOn MRI, findings of spinal stenosis have a variable presentation depending on the specific disease. The goal of spinal imaging is to localize the site and level of disease and to help differentiate between conditions in which patients require surgery or conservative treatment."nIn this presentation, different kinds of spinal canal stenosis and their MRI findings would be discussed.

  8. Nuclear magnetic resonance tomography of the cervical canal

    Energy Technology Data Exchange (ETDEWEB)

    Terwey, B.; Koschorek, F.; Jensen, H.P.

    1985-12-01

    170 patients with suspected lesions of the cervical part of the medulla were examined using nuclear magnetic resonance (NMR) tomography. 27 cases revealed no pathological changes in the regions of the cervical medulla, the cervical canal and of the cervical spine. 143 cases produced pathological findings whose diagnoses determined therapeutical approach. Verified pathological changes comprised anomalies of the cranio-cervical junction like basilar impression and Arnold-Chiari malformation, various types of cavity formation in the cervical medulla (syringomyelia, hydromyelia), demyelinization processes, intramedullary and extramedullary tumours, intervertebral disk degeneration processes, dislocation of intervertebral disks and spondylophytes with spinal stenoses. Sagittal sections in different functional positions allowed to demonstrate the biomechanical effects of extramedullary masses on the cervical medulla. However, proven tumours could not be differentiated successfully using histological methods. Nevertheless, NMR tomography will replace invasive methods like conventional cervical myelography and CT myelography in diagnostic clarification of diseases of the cervical medulla.

  9. Hemangiopericytoma of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raghvendra V Ramdasi

    2014-01-01

    Full Text Available A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC. The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented.

  10. Professor Fan Binghua's Experience in Treating Thoracic Spinal Little Joints Disorder by Manipulation of Embracing Cervical and Extract-ing Chest%范炳华教授抱颈提胸法治疗胸椎小关节紊乱症经验

    Institute of Scientific and Technical Information of China (English)

    曲建鹏; 邓文章; 范炳华

    2014-01-01

    [Objective] To summarize the clinical experience on treating thoracic spinal little joints disorder by manipulation of embracing cervical and extracting chest. [Method] To col ect and analyze the theory and methodology of Pro.Fan's clinical treatment on thoracic spinal little joints disorder. [Result]Professor Fan has rich clinical experience for many years in the study and treatment of spinal diseases. He puts forward theories of“close relationship between symptoms with etiology”and“correct spinal little joints disorder”, that is to say, considering symptoms to detect it's etiology, thinking etiology to find out it's dislocation, the method of treatment is removing pathogeny, etiology is removed, symptoms are removed. Based on the theory, Pro.Fan invents the manipulation of “embracing cervical and extracting chest”to treat thoracic spinal little joints disorder.And this manipulation has significant effect on clinic. [Conclusion] Pro.Fan has great innovation on treatment of thoracic spinal little joints disorder and the manipulation of“embracing cervical and extracting chest”has significant effect on clinic.%[目的]探究范炳华教授抱颈提胸法治疗胸椎小关节紊乱症的临床经验。[方法]对范炳华教授临床治疗胸椎小关节紊乱症的理论及方法进行整理与分析。[结果]范炳华教授对诊疗脊柱相关疾病提出“症因相关”和“有错必纠”理论,基于此理论首创了“抱颈提胸法治疗胸椎小关节紊乱症诊疗技术”,这项技术在临床上取得了比较好的效果。[结论]范炳华教授治疗胸椎小关节紊乱症的理论有较大创新,其抱颈提胸法治疗胸椎小关节紊乱症效果显著,临床上值得推广。

  11. Concentration of nitric oxide (NO in spinal fluid of chronic spinal disease.

    Directory of Open Access Journals (Sweden)

    Yumite Y

    2001-08-01

    Full Text Available We studied total nitric oxide (nitrite + nitrate (NO levels in cerebrospinal fluid (CSF of chronic spinal diseases in nonsmokers (133 patients: 76 men and 57 women; mean age, 63 years; range, 15-92 years by the Griess method to clarify the role of NO in different spinal diseases. The extent of compression in terms of numbers of disc level at the compressed spinal nerve and neurological evaluation were also assessed according to the Japanese Orthopaedic Association scores. The spinal diseases included cervical myelopathy and radiculopathy (cervical disease group, ossification of yellow ligament (thoracic disease group, and lumbar disc herniation, lumbar canal stenosis and lumbar spondylolisthesis (lumbar disease group. NO levels in the spinal disease groups (4.98+/-2.28 micromol/l: mean +/- SD were significantly higher than that in the control group (2.53+/-0.94 micromol/l. An inverse correlation was detected between the elevated levels of NO and the grade of clinical symptoms in the cervical disorders. The number of disc level at the compressed spinal nerve was positively correlated with elevated NO levels in CSF in the cervical and lumbar disorder groups. These results indicate that nerve compression may elevate NO levels in CSF, and that NO concentration in the CSF might be a useful marker of damage to nervous system in spinal disorders.

  12. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  13. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  14. Imaging and differential diagnosis of pediatric spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-ying Xing

    2015-03-01

    Conclusion: Pediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.

  15. Hyperoxaluria, Hypocitraturia, Hypomagnesiuria, and Lack of Intestinal Colonization by Oxalobacter formigenes in a Cervical Spinal Cord Injury Patient with Suprapubic Cystostomy, Short Bowel, and Nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available Although urolithiasis is common in spinal cord injury patients, it is presumed that the predisposing factors for urinary stones in spinal cord injury patients are immobilization-induced hypercalciuria in the initial period after spinal injury and, in later stages, urine infection by urease-producing micro-organisms, e.g., Proteus sp., which cause struvite stones. We describe a patient who sustained C-7 complete tetraplegia in a road traffic accident in 1970, when he was 16 years old. Left ureterolithotomy was performed in 1971 followed by left nephrectomy in 1972. Probably due to adhesions, this patient developed volvulus of the intestine in 1974. As he had complete tetraplegia, he did not feel pain in the abdomen and there was a delay in the diagnosis of volvulus, which led to ischemia of a large segment of the small bowel. All but 1 ft of jejunum and 1 ft of ileum were resected leaving the large bowel intact. In 1998, suprapubic cystostomy was performed. In 2004, this patient developed calculus in the solitary right kidney. Complete stone clearance was achieved by extracorporeal shock wave lithotripsy. Stone analysis: calcium oxalate 60% and calcium phosphate 40%. Metabolic evaluation revealed hyperoxaluria, hypocitraturia, and hypomagnesiuria. Since this patient had hyperoxaluria, the stool was tested for Oxalobacter formigenes, a specific oxalate-degrading, anerobic bacterium inhabiting the gastrointestinal tracts of humans; absence of this bacterium appears to be a risk factor for development of hyperoxaluria and, subsequently, calcium oxalate kidney stone disease. DNA from the stool was extracted using the QIAamp DNA stool Mini Kit (Qiagen, Chatsworth, CA. The genomic DNA was amplified by polymerase chain reaction using specific primers for oxc gene (developed by Sidhu and associates. The stool sample tested negative for O. formigenes. The patient was prescribed potassium citrate mixture; he was advised to avoid oxalate-rich food, maintain

  16. Fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raphael Martus Marcon

    2013-11-01

    Full Text Available OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2 and the lower cervical spine (C3-C7, according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification, which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

  17. Tuina treatment in cervical spondylosis

    Directory of Open Access Journals (Sweden)

    Florin Mihai Hinoveanu

    2010-12-01

    Full Text Available Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the principles of Traditional Chinese Medicine (TCM, especially suitable for use on the elderly population and on infants. While performing Tuina, the therapist concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. For a better result is recommended to try to combine acupuncture with tuina treatment. Tuina can help relieve the pain associated with spondylosis. After this kind of treatment, the symptomes produced by irritated nerves and sore muscles can find some relief. Tuina helps patients with cervical spondylosis regain muscle control, nerve function and flexibility, all through the restoration of the life force flow.

  18. Spinal Column

    Science.gov (United States)

    ... head which is approximately 10-12 pounds. The cervical spine has the greatest range of motion, in part because of two specialized vertebra that move with the skull. Cervical vertebrae are the smallest of the vertebrae. The ...

  19. Risk factors of perioperative severe hyponatremia after cervical spinal cord injury: A case-control study%颈髓损伤患者围术期重度低钠血症相关因素的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    唐绍辉; 潘志国

    2012-01-01

    Objective To evaluate the risk factors of perioperative severe hyponatremia after cervical spinal cord injury. Methods Patients hospitalized from 2007 to 2011 for cervical spinal cord injury with ( n =31 ) or without ( control, n =31 ) severe hyponatremia were analyzed. A matched case - control study was conducted. T test, chi - square test and Logistic regression analysis were used for statistics. Results For uni-variate analysis, the factors associated with severe hyponatremia after cervical spinal cord injury were Frankle grade, cervical spine injury, mechanical ventilation, hypoproteinemia, the duration of intubation, the duration of operation, tracheotomy, body mass index < 18.5 and pulmonary infection. Multivariate Logistic regression analysis identified four independent risk factors associated with severe hyponatremia after cervical spinal cord injury: Frankle grade, cervical spine injury, hypoproteinemia, and pulmonary infection. Conclusion Frankle grade, cervical spine injury, hypoproteinemia and pulmonary infection are important influence factor of hyponatremia after cervical cord injury.%目的 探讨颈髓损伤患者围术期重度低钠血症的相关因素.方法 采用病例对照研究方法,病例组收集2007年10月至2011年10月住院的31例颈髓损伤合并重度低钠血症的患者,并随机选择同时期颈髓损伤不合并重度低钠血症病例31例作为对照组;单因素分析采用t检验或χ2检验,多因素分析采用Logistic回归分析.结果 单因素分析发现脊髓损伤程度(Frankle分级)、上颈椎(C1~2)损伤、机械通气、低蛋白血症(血清白蛋白<35 g/L)、气管导管留置时间、手术时间、气管切开、术前低体重指数(Body mass index<18.5)及合并有肺部感染与颈髓损伤患者重度低钠血症相关;Logistic多因素回归分析发现只有脊髓损伤程度(Frankle分级)、上颈椎(C1~2)损伤、低蛋白血症(血清白蛋白<35 g/L)及合并有肺部感染

  20. Bryan人工颈椎间盘对颈椎整体及置换节段曲度影响的中期观察%The mid-term effects of Bryan cervical disc prosthesis on sagital alignment of overall cervical spine and the functional spinal unit

    Institute of Scientific and Technical Information of China (English)

    姜宇; 田野; 王以朋; 邱贵兴; 翁习生; 冯宾

    2012-01-01

    Objective To investigate the mid-term radiological outcome of sagital alignment of overall cervical spine and the functional spinal unit after replacement surgery with Bryan cervical disc prosthesis.Methods Eighteen patients with cervical disc disorder were performed cervical disc replacement with 20 Bryan discs from November 2005 to May 2010,including single-level 16 cases and bi-level 2 cases.The patient consisted of 13 males and 5 females with age ranging from 38 to 59 years (average,(47 ± 6) years). Fourteen cases with overall cervical lordotic alignment and segmental lordotic alignment peroperatively ( group 1 ) and 4 others with segmental kyphotic alignment and overall cervical kyphotic alignment per-operatively (group 2 ).The overall sagital alignment (C2-7 ) and segmental sagital alignment were measured pre-operatively,post-operatively aud at final follow-up to evaluate the outcome. Results All cases obtained the follow-up with an average of ( 24 5 ) months ( range 12 to 53 months ).To the mean overall cervical alignment,there were 9.9° ± 1.9° per-operatively,12.8° ± 2.1° post-operatively and 11.6° ± 1.8° at final follow-up in group 1 and - 1.8° ±0.8° per-operatively,7.3° ± 1.3° post-operatively and 5.0° ± 2.1°at final follow-up in group 2.There were statistical significance between per-operatively and post-operatively(t =- 2.987 and - 5.058,P < 0.05 ) and no statistical significance between postoperatively and final follow-up ( P > 0.05 ) in both groups. To the mean segmental alignment there were 2.6° ±0.8° per-operatively,5.4° ± 1.0°post-operatively and 4.3° ±0.9°at final follow-up in group 1 and -3.0° ±0.8° per-operatively,3.8° ± 1.3° post-operatively and 0.3° ± 2.8° at final follow-up in group 2.There were statistical significance between per-operatively and post-operatively in both groups (t =-3.829 and - 4.086,P < 0.05 ) and between post-operatively and final follow-up in group 1 ( t =2.630,P <0.05 ) but

  1. 综合护理对颈椎骨折伴颈髓损伤病人呼吸系统的影响%Study the Effects of the Comprehensive Nursing care of Reparatory System of the Patients with Cervical Spine Fracture Combined with Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    常波; 郑桂周; 余国勇; 李学东

    2014-01-01

    目的:探讨颈椎骨折伴颈髓损伤患者呼吸系统的主要护理方法,制定较完善的临床护理方案。方法:回顾分析我院2008~2013收入院的25例颈椎骨折伴颈髓损伤的病人接受综合护理的疗效。结果:我院25例患者,其中19例康复好转,气管切开8例,发生并发症14例,其中肺部感染7例,发生急性呼吸衰竭2例,死亡3例。结论:制定系统的呼吸系统的护理方案、规范化的护理可减少颈椎骨折伴颈髓损伤病人因急性呼吸衰竭和肺部感染而致的死亡,提高病人的康复机会。%Objective:To investigate the major methods of nursing care of repiratory system in cervical Spine fracture combined with spinal cord injury patients ,then formulate more perfect clinical nursing protocols .Methods:A retrospective analysis of the clinical data of 25 cases with cervical fracture combined with spinal cord injury admitted in our hospital from 2011 to 2013 years , all the patients were given comprehensive nursing care .Results: Of 25 cases of patients , 19 patients recovered , 8 patients were operated with incision of trache, 14 cases of complications ,including 7 cases of pulmonary infection ,2 cases of acute respiratory failure .3 patients died .Conclu-sion:The prevention and therapy of respiratory complications is the key to the nursing care of the patients with cervical Spine fracture com -bined with spinal cord injury .Systematic respiratory nursing protocals and normalization of nursing can reduce the occurrence of death caused by the acute respiratory failure and pulmonary infection in the patients with cervical spine fracture combined with spinal cord inju -ry, and it also improve the patients'rehabilitation.

  2. Surgical management of cervical spondylotic myelopathy

    Directory of Open Access Journals (Sweden)

    N Muthukumar

    2012-01-01

    Full Text Available Cervical spondylotic myelopathy (CSM is emerging as the most common cause of spinal cord dysfunction in the elderly worldwide. In the past decade, our understanding of the biomechanics of the spine has improved along with advances in spinal instrumentation and this has led to significant changes in the surgical management of CSM. This review will discuss the indications, advantages and limitations of different operative approaches as well as the complications and prognosis of surgery for cervical spondylotic myelopathy. Choice of surgical approach for CSM should be based on the clinical and radiological characteristics of the individual patient and not on the preferences of the surgeon.

  3. Spontaneous rupture of an infected renal cyst and external drainage through a lumbar surgical scar in a male patient with cervical spinal cord injury: a case report

    Directory of Open Access Journals (Sweden)

    Vaidyanathan Subramanian

    2008-05-01

    Full Text Available Abstract Introduction The spontaneous rupture of an infected renal cyst is a rare event. Spontaneous rupture with drainage to the exterior through a surgical scar has not been reported previously. Case presentation A 49-year-old male with tetraplegia had undergone extended right pyelolithotomy in 1999. Deroofing and marsupialisation of a cyst in the upper pole of the right kidney was performed in 2003. Subsequently there was recurrence of a thick-walled cystic space-occupying lesion in the upper pole of the right kidney. Thick pus was aspirated from the renal cyst on six occasions between September 2003 and November 2004. In March 2006, ultrasound examination revealed a cyst measuring 6.2 cm in diameter in the upper pole of the right kidney. Aspiration was planned when the renal cyst reached 7.5 cm in diameter. However, 11 months later, the cyst ruptured spontaneously and drained through the previous surgical scar in the flank, while the patient was recovering from a severe chest infection in the spinal unit. Ultrasound examination showed a fistulous tract running between the renal cyst and the abdominal wall. Repeated minor trauma sustained during turning, hoisting and chest physiotherapy all may have contributed to the rupture of the infected renal cyst and drainage through a weak spot in the abdominal wall. Conclusion In hindsight, we might have prevented rupture of the renal cyst had we considered aspiration of the renal cyst before it reached 7.5 cm in diameter, although this 7.5 cm diameter, as the threshold for percutaneous aspiration, is an arbitrary setting. This patient could have been advised to wear an abdominal corset to protect the right flank from pressure applied unintentionally during turning, hoisting or assisted coughing.

  4. In-vivo spinal cord deformation in flexion

    Science.gov (United States)

    Yuan, Qing; Dougherty, Lawrence; Margulies, Susan S.

    1997-05-01

    Traumatic mechanical loading of the head-neck complex results cervical spinal cord injury when the distortion of the cord is sufficient to produce functional or structural failure of the cord's neural and/or vascular components. Characterizing cervical spinal cord deformation during physiological loading conditions is an important step to defining a comprehensive injury threshold associated with acute spinal cord injury. In this study, in vivo quasi- static deformation of the cervical spinal cord during flexion of the neck in human volunteers was measured using magnetic resonance (MR) imaging of motion with spatial modulation of magnetization (SPAMM). A custom-designed device was built to guide the motion of the neck and enhance more reproducibility. the SPAMM pulse sequence labeled the tissue with a series of parallel tagging lines. A single- shot gradient-recalled-echo sequence was used to acquire the mid-sagittal image of the cervical spine. A comparison of the tagged line pattern in each MR reference and deformed image pair revealed the distortion of the spinal cord. The results showed the cervical spinal cord elongates during head flexion. The elongation experienced by the spinal cord varies linearly with head flexion, with the posterior surface of the cord stretching more than the anterior surface. The maximal elongation of the cord is about 12 percent of its original length.

  5. Anterior cervical interbody Cage placement for treatment of multilevel cervical spondylotic myelopathy: Reconstruction of spinal function%椎前路Cage植入技术治疗多节段脊髓型颈椎病重建脊柱功能的效应

    Institute of Scientific and Technical Information of China (English)

    李建光; 苗军; 夏群

    2007-01-01

    then spinal cord in patients with multilevel cervical spondylotic myelopathy. Complete decompression is very important for such patients. This study is to investigate the effect of this technique on reconstruction of spinal function.METHODS:①Thirty-eight inpatients with multilevel cervical spondylotic myelopathy admitted to Department of Spine Surgery, Tianjin Hospital between April 2003 and February 2006 were involved in this study. The involved patients, 35 male and 3 female, were aged 43-72 years, with disease course of 0.5 to 5 years. Informed consents of therapeutic regimen were obtained from all the patients.②All the patients underwent anterior cervical discectomy and cage placement operation. The patients with destabilized combination underwent titanium-plate fixation, and those with stabilized combination underwent cage implantation alone. The cage used in the experiment was made of tetragonal polyether ether ketone (Intromed Company), and titatium-plate was Zephir plate (sofarmor Danek Company). The elastic modulus of tetragonal polyether ether ketone Cage was similar to bone tissue and could allow X-ray pass through, which was easy for postoperative fusion of implanted bone. The outer design of Cage bone graft with certain angle could allow cervical physiological antecurvature well recover; Surface radian was the same as end plate, and good fitness contributed to the good fusion rate of bone graft; The sawtooth antiskid design on the surface provided good stability immediately after implantation; Elastic modulus was between os integumentale and cancellous bone that made stress-shielding and subsidence of fusion cage reduced, and had good anticausticity and biocompatibility. ③ The clinical results were evaluated with Japanese Orthopaedic. Association (JOA) scoring system before, 2,8 and 24 weeks after operation: upper limb motor function (4 points), lower limb motor function (4 points), sensation (6 points) and bladder function (3 points). Higher scores

  6. Diagnostic radiology for functional analysis of the cervical vertebral column. Roentgenfunktionsdiagnostik der Halswirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Kamieth, H.

    1986-01-01

    The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs..

  7. Gold Bead Implantation in Acupoints for Coxofemoral Arthrosis in Dogs: Method Description and Adverse Effects

    Directory of Open Access Journals (Sweden)

    Lars Moe

    2012-09-01

    Full Text Available Gold bead implantation has been used for years as an alternative method to improve function in chronic joint disease both in humans and dogs. The aims of the present study were to describe the technique of implanting 24-karat gold beads around the hip joints of dogs with chronic hip dysplasia, and to record any side effects or complications of such treatment. A prospective placebo-controlled double-blinded clinical trial was performed. Eighty dogs were randomly allocated to treatment or placebo, with 38 in the gold implantation group and 42 in the placebo group, and followed intensely for six months. The implantation technique was simple to perform, using fluoroscopy and with the dogs under inhalation anesthesia for about 30 minutes. Adverse effects, measured as pain or discomfort, were seen for a period of up to four weeks in 15 of the dogs in the gold implantation group, compared to six dogs in the placebo group. During implantation, a technical difficulty occurred as 82% of the dogs showed leakage of blood and/or synovia from the needles. The dogs in the gold implantation group were radiographed 18 months later. Of the 30 dogs that were radiographed at both inclusion and 24 months, 80% (24 dogs showed a deterioration of the coxofemoral arthrosis, the other six had stable disease evaluated by radiography. Migration of gold beads was only observed in one dog.

  8. Bilateral rapidly destructive arthrosis of the hip joint resulting from subchondral fracture with superimposed secondary osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan); Schneider, Robert [Hospital for Special Surgery, Department of Radiology, New York (United States); Bullough, Peter G. [Hospital for Special Surgery, Department of Laboratory Medicine, New York, NY (United States)

    2010-02-15

    A 57-year-old woman suffered rapid destruction of both hip joints over a 10 months period. At the first visit, her radiographs demonstrated slight joint space narrowing and acetabular cyst formation in both hips. Five months later, joint space narrowing had further progressed, and intra-articular injection of steroid was given in both hips. However, the hip pain gradually became worse. Five months later, both joint spaces had totally disappeared and both femoral heads had undergone massive collapse. At gross examination, both resected femoral heads showed extensive opaque yellow areas consistent with osteonecrosis. Microscopic examination of these areas revealed evidence of both extensive fracture and callus formation, as well as necrosis throughout, indicating that the osteonecrosis observed in this case was a secondary phenomenon superimposed on pre-existing osteoarthritis and subchondral fracture. There were many pseudogranulomatous lesions in the marrow space and necrotic area, where tiny fragments of bone and articular cartilage, surrounded by histiocytes and giant cells, were embedded, such as are typically seen in rapidly destructive arthrosis. No radiologic or morphologic evidence of primary osteonecrosis was noted. This case indicates that at least some cases of rapidly destructive arthritis are the result of subchondral fracture with superimposed secondary osteonecrosis. (orig.)

  9. The correlation analysis of the cervical spine alignment, flexion ROM of adjacent segments with the spinal cord atrophy in Hirayama disease%平山病患者颈椎曲度和相邻节段椎体屈曲度与脊髓萎缩的相关性

    Institute of Scientific and Technical Information of China (English)

    刘鑫; 孙宇

    2013-01-01

    curvature,flexion ROM of adjacent segment with spinal cord atrophy of Hirayama disease,and to provide rationale for its surgical management.Methods:36 consecutive patients underwent flexion X-ray and neutral position cervical MRI.The radiological mcasurement included the cervical spine alignment from C2 to C7 and the arc chord distance (ACD) by the Borden's method,flexion ROM of adjacent segments by calculating the difference between neutral and flexion position of Cobb angle defined as the tangent of the posterior body line of every two adjacent segments from C3-C7,observing spinal cord atrophy on sagittal position MRI and measuring the cross-sectional area of spinal from C3-C7 on neutral position cervical MRI.According to the ACD of cervical curvature,all patients were divided into 4 groups:7mm≤ACD≤17mm,normal cervical spine alignment; 1mm<ACD<7mm,straight or mild kyphosis;-4mm<ACD≤1mm,moderate kyphosis; ACD≤-4mm,severe kyphosis.The correlation analysis was performed between the adjacent vertebral flexion ROM and the cross-sectional area of corresponding cervical spinal cord on neutral position MRI.Results:In the 36 patients,normal cervical alignment accounted for 8 cases,straight or mild kyphosis for 13 cases; moderatc or severe kyphosis for 15 cases,of these 15 patients,14 had apex of kyphosis on C5 and 1 on C44.14 patients showed lower spinal cord atrophy on neutral MRI.13/28 cases with cervical straight or ankylosis presented with spinal cord compression was much higher than 1/8 of cases with normal cervical alignment (P<0.05).There were significant differences among flexion ROM of adjacent segments from C3 to C7 (P<0.05),with a higher flexion ROM of C5-C6 & C6-C7.Significant differences also existed between the cross-sectional area of spinal cord form C3 to C7 (P<0.05),with the lowest value at C5-C6 & C6-C7.Flexion ROM of adjacent segments was negatively correlated with the corresponding cross-sectional area of spinal cord in neutral MRI(r=-0

  10. Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U.; Winkler, U.

    1983-09-01

    Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

  11. Spinal myoclonus following a peripheral nerve injury: a case report

    Directory of Open Access Journals (Sweden)

    Erkol Gokhan

    2008-08-01

    Full Text Available Abstract Spinal myoclonus is a rare disorder characterized by myoclonic movements in muscles that originate from several segments of the spinal cord and usually associated with laminectomy, spinal cord injury, post-operative, lumbosacral radiculopathy, spinal extradural block, myelopathy due to demyelination, cervical spondylosis and many other diseases. On rare occasions, it can originate from the peripheral nerve lesions and be mistaken for peripheral myoclonus. Careful history taking and electrophysiological evaluation is important in differential diagnosis. The aim of this report is to evaluate the clinical and electrophysiological characteristics and treatment results of a case with spinal myoclonus following a peripheral nerve injury without any structural lesion.

  12. Acute spinal cord injury | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available s of SUN13837 Injection in Adult Subjects with Acute Spinal Cord Injury A.3.1Titl...under investigation E.1.1Medical condition(s) being investigated Acute spinal cord injury E.1.1.1Medical con...ub-study No E.3Principal inclusion criteria 1. Acute traumatic injury to the cervical neurological spinal co

  13. Cervical Angina

    Science.gov (United States)

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  14. Effects of long-term theophylline exposure on recovery of respiratory function and expression of adenosine A1 mRNA in cervical spinal cord hemisected adult rats.

    Science.gov (United States)

    Nantwi, Kwaku D; Basura, Gregory J; Goshgarian, Harry G

    2003-07-01

    Our lab has previously shown that when administered acutely, the methylxanthine theophylline can activate a latent respiratory motor pathway to restore function to the hemidiaphragm paralyzed by an ipsilateral C2 spinal cord hemisection. The recovery is mediated by the antagonism of CNS adenosine A1 receptors. The objective of the present study was to assess quantitatively recovery after chronic theophylline administration, the effects of weaning from the drug, and the effects of the drug on adenosine A1 receptor mRNA expression in adult rats subjected to a C2 hemisection. Rats subjected to a left C2 hemisection received theophylline orally for 3, 7, 12, or 30 days and were classified as 3D, 7D, 12D, or 30D respectively. Separate groups of 3D animals were weaned from drug administration for 7, 12, and 30 days before assessment of respiratory recovery. Additional groups of 7D and 12D animals were also weaned from drug administration for 7 and 12 days prior to assessment. Sham-operated controls received theophylline vehicle for similar periods. Quantitative assessment of recovered respiratory activity was conducted under standardized electrophysiologic recording conditions approximately 18 h after each drug application period. Serum theophylline analysis was conducted at the end of electrophysiologic recordings. Adenosine A1 receptor mRNA expression in the phrenic nucleus was assessed with in situ hybridization and immunohistochemistry. Chronic theophylline induced a dose-dependent effect on respiratory recovery over a serum theophylline range of 1.2-1.9 microg/ml. Recovery was characterized as respiratory-related activity in the left phrenic nerve and expressed as a percentage of activity in the homolateral nerve in noninjured animals under similar recording conditions. Recovered activity was 34.13 +/- 2.07, 55.89 +/- 2.96, 74.78 +/- 1.93, and 79.12 +/- 1.75% respectively in the 3D, 7D, 12D, and 30D groups. Theophylline-induced recovered activity persisted for as

  15. Effects of spinal manipulation in patients with mechanical neck pain

    Directory of Open Access Journals (Sweden)

    Diana Gregoletto

    2014-12-01

    Full Text Available Objective: To analyse changes in the range of motion (ROM and pain after spinal manipulation of the cervical spine and thoracic spine in subjects with mechanical neck pain. Methods : Spinal manipulations were performed in the cervical and thoracic spine with the Gonstead and Diversified DTV techniques. To assess cervical ROM an inclinometer was used. Cervical pain was assessed by Visual Analogue Scale (VAS. The participation of 73 patients was obtained. Ages ranged from 18 to 63 years, with an average of 42.27 years. The subjects of this study were characterized by having mechanical neck pain and restricted cervical ROM. Results: We observed a reduction in the intensity of pain perceived by patients and increased cervical ROM. There were significant differences between pre-treatment values (first visit and the fifth and tenth visits (p<0.01, and between the fifth and tenth visits (p<0.01 in all parameters except in the cervical extension of 70º. Conclusions: The results of this study suggest that spinal manipulation of the cervical and thoracic regions with the Gonstead and Diversified DTV techniques could subjectively reduce pain and produce considerable increase in cervical ROM in adults with mechanical neck pain.

  16. Application of magnetic resonance imaging in cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Chuan; Zhang; Sushant; K; Das; Dong-Jun; Yang; Han-Feng; Yang

    2014-01-01

    Cervical spondylotic myelopathy(CSM) is the most common cause of spinal cord dysfunction and is caused by static or dynamic repeated compression of the spinal cord resulting from degenerative arthritis of the cervical spine and some biological injuries to the cervical spine. The T2 signal change on conventional magnetic resonance imaging(MRI) is most commonly associated with neurological deficits. Diffusion tensor imaging and MR spectroscopy show altered microstructure and biochemistry that reflect patient-specific pathogenesis and can be used to predict neurological outcome and response to intervention. Functional MRI can help to assess the neurological functional recovery after decompression surgery for CSM.

  17. 护患沟通在颈椎骨折脱位不伴脊髓损伤患者中的应用%The application in the communication between the nurse and patient who have cervical vertebra fracture dislocation without spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李婷

    2012-01-01

    目的:探讨护患沟通在颈椎骨折脱位不伴脊髓损伤患者护理中的应用.方法:对17例颈椎骨折脱位不伴脊髓损伤患者,给予人文关怀、专业知识宣教、围手术期心理辅导及术后康复指导.结果:17例患者均能接受医疗护理措施,提高配合度,未出现任何并发症,好转出院.结论:加强颈椎骨折脱位不伴脊髓损伤患者护患沟通是保证获得和维持良好治疗效果的有利措施和重要因素.%Objective:To discuss the application of nurse - patient communication during the caring for patients who have cervical vertebra fracture dislocation without spinal cord injury. Methods:Provide guidance on 17 people in the follow aspects:humanistic care, professional knowledge,periopeiative psychological counselling, Postoperative rehabilitation guidance. Results: 17 patients can accept medical miring measures .improve coordination degree, did not appear any complications. Conclution: Strengthen the nurse - patient communication is a favorable measure and important factor for the patients who have cervical vertebra fracture dislocation without Spinal cord injury acquire and maintain a better therapeutic effect.

  18. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  19. Value of MRI Examination of Supine Sagittal Flexion,Hyperextension in Diagnosis of Cervical Spinal Stenosis%仰卧矢状过屈、过伸位磁共振成像对颈椎椎管狭窄诊断的价值

    Institute of Scientific and Technical Information of China (English)

    梁继军; 袁文昭; 邓德茂; 陈文福

    2013-01-01

    目的:探讨仰卧矢状过屈、过伸位磁共振成像( MRI)在颈椎椎管狭窄诊断中的价值。方法对30例颈椎椎管狭窄患者行颈椎仰卧静息状矢状位、过屈位及过伸位MRI检查,比较不同体位下颈椎管矢状径的变化。结果怀疑颈椎管狭窄者在静息仰卧矢状位MRI检查无明显变化时,颈椎过屈或过伸位MRI检查椎管狭窄可以较明显地显示;静息仰卧矢状位MRI检查有明显变化时,颈椎过屈或过伸位MRI检查椎管狭窄程度表现更明显。仰卧矢状过屈位、过伸位MRI检查显示颈椎椎管狭窄程度比较,差异有统计学意义(P<0.05),过伸位MRI检查显示颈椎椎管狭窄程度加重的比例明显高于过屈位( P<0.05)。结论仰卧矢状过屈、过伸位MRI检查在颈椎椎管狭窄诊断中有重要临床应用价值。%Objective To investigate the value of MRI examination of supine sagittal flexion ,hyperextension in the diagnosis of cervical spinal stenosis .Methods MRI scans were performed in 30 spinal stenosis patients with supine sagittal in resting,flexion,hyperextension positions,and the changes of sagittal diameter among patients in 3 different positions were statistically compared .Results MRI scans showed no obvious changes of sagittal diameter among patients with suspected cervical stenosis in supine sagittal resting position ,but the changes were observed clearly in flexion or hyperextension position .MRI scans showed obvious changes of sagittal diameter among patients in supine sagittal resting position,while the degree of cervical spinal stenosis could be observed more clearly in flexion or hyperextension position.There was significant difference in the degree of cervical spinal stenosis between hyperextension and flexion positions (P<0.05),and the degree of the former one was significantly higher than that of the latter one(P<0.05).Conclusion MRI using supine sagittal flexion ,hyperextension position

  20. 一期前路病灶清除钛笼植骨内固定术治疗下颈椎结核%One-stage anterior debridement, titanium cage fusion with autograft and instrumentation for lower cervical spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    沈生军; 官众; 任磊; 赵宇; 杨杰山

    2012-01-01

    Objectives: To evaluate the clinical efficacy of one-stage anterior debridement, titanium cage fusion with autograft and instrumentation for lower cervical spinal tuberculosis (TB). Methods: From December 2006 to July 2010, 10 patients suffering from lower cervical TB(6 males and 4 females, aged 42-71 years, mean age 52.1 years) underwent one-stage anterior debridement, titanium cage fusion with autograft and instrumentation. The defect sites were C3-C4 in 1 case, C4-C5 in 1 case, C5-C6 in 3 cases, C6-C7 in 2 cases, CS-C7 vertebrae in 3 cases. All patients had neck pain, fever, night sweats, 6 cases han limb sensory-motor dysfunction, the preoperative Frankel grade: 1 Frankel B, 2 Frankel C, 3 Frankel D, 4 Frankel E. 5 of them with cold abscess had no perforation to the posterior longitudinal ligament. The mean preoperative kyphosis angle was 19.1°±5.1 °(ranged from 10° to 30°). Preoperative anti-TB treatment was given for at least 2 weeks, then the treatment lasted for 6-12 months postoperatively. Improvement of clinical symptoms and bone fusion were followed up. Results: The operations were successfully completed without injury of blood vessels, spinal cord, esophagus and trachea. The incision healed with no complications such as sinus formation and wound infection. The mean follow-up was 14.5 months ranged from 10 to 24 months. The patients' clinical symptoms and the neurological dysfunction had different degrees of improvement, 5 cases combined with neurological deficits improved to Frankel E, 1 case improved from Frankel B to Frankel D. The kyphosis was corrected well. The average kyphosis angle of cervical spine was 2.9° ±1.6° after 1 week of operation,which was significantly lower than preoperative one(P0.05). After 3-6 months postoperatively, all cases were showed signs of bone fusion. All cases were observed fully integrated titanium cage bone graft between the upper and lower vertebrae at the final follow-up, and no recurrence or instrument

  1. Clincal research of hyponatremia and early death in cervical spinal cord injury%颈脊髓损伤后低钠血症与早期死亡的临床分析

    Institute of Scientific and Technical Information of China (English)

    尚明富; 赵廷宝; 孟庆溪

    2011-01-01

    目的 分析研究颈脊髓损伤(CSCI)低钠血症的相关因冈素、发病机制及对早期死亡的影响.方法 收集整理2005~2010年入院的131例CSCI患者的临床资料(早期死亡11例),分析CSCI后低钠血症与CSCI节段、损伤程度的关系及对早期死亡的影响.结果 颈脊髓不同损伤程度、不同损伤节段低钠血症发病率的统计分析,相互之间差异有统计学意义(X2值分别为为10.036,19.885,P<0.001);是否存在低钠血症的CSCI患者早期死亡率经统计学分析,差异有统计学意义(X2值为8.285,P<0.001).结论 CSCI程度越重、损伤节段越高,低钠血症的发病率越高,低钠血症是CSCI早期死亡的危险因素.%Objective The research had been launched to analyze the correlated factors mechanism and the influence to the early death of the hyponatremia in cervical spinal cord injury (CSCI).Methods There were totally 131 CSCI cases which had been collected from May 2005 to 2010 (early death 11 cases).The relationship among the hyponatremia and location of spine injury degree of the injury and the influence to the early death was analysed.Result The difference about the frequency of hyponatremia with distinct injury degree and location were statiscally significant (X2 is 15.933,23.443 separately,P<0.001)meanwhile it was statistically significant about early death rate in CSCI with hyponatremia or not (X2 is 8.285,P<0.001).Conclusions The frenquence of hyponatremia increase with the more serious injury and higher location,hyponatremia play a very important role in early death in CSCI.

  2. 手术治疗延颈交界区病变30例分析%Neurosurgery for intramedullary cord tumors involved in medulla oblongata and cervical spinal cord (report of 30 cases)

    Institute of Scientific and Technical Information of China (English)

    许晖; 王业忠; 赵冬; 董江涛; 代林志

    2013-01-01

    Objective To discuss the clinical and imaging features of the intramedullary tumors involved in the medulla oblongata and cervical spinal cord (ITIMOCSC) and the opportunity and skills of neurosurgery for them. Methods The clinical data of 30 patients with ITIMOCSC. who underwent neurosurgery through the posterior midline approach, were analyzed retrospectively, including the clinical manifestations, imaging examinations, the extent of tumor resection, therapeutic outcomes and pathological findings. Results Of 30 patients with ITIMOCS, 29 received the total removal of the tumors and 1, who had the metastasis from melanoma, subtotal. No patients die of the surgery. The clinical manifestations were improved in all the patients and no lesions recurred 6 months after the surgery. Conclusions ITIMOCS may be definitely diagnosed by MRI, and most of them may be totally resected by micosurgery. The postoperative radiotherapy should be performed in the patients with malignant ITIMOCS.%目的 探讨各种不同延颈交界区病变的临床特征、影像学诊断及手术时机和技巧.方法 回顾性分析2002年6月至2012年6月经手术治疗的30例延颈交界区病变患者的临床资料,包括病理类型、临床表现、辅助检查、手术切除程度及疗效.结果 30例延颈交界区病变中全切除29例(96.7%),1例黑色素瘤脑内转移近全切除,无手术死亡病例.术后6个月随访,所有患者临床症状改善,未见病变复发.结论 延颈交界区病变可通过MRI作出正确诊断,对绝大多数肿瘤可用显微外科手术切除,对恶性肿瘤术后应辅以放射治疗.

  3. Combined SCI and TBI: recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement.

    Science.gov (United States)

    Inoue, Tomoo; Lin, Amity; Ma, Xiaokui; McKenna, Stephen L; Creasey, Graham H; Manley, Geoffrey T; Ferguson, Adam R; Bresnahan, Jacqueline C; Beattie, Michael S

    2013-10-01

    A significant proportion (estimates range from 16 to 74%) of patients with spinal cord injury (SCI) have concomitant traumatic brain injury (TBI), and the combination often produces difficulties in planning and implementing rehabilitation strategies and drug therapies. For example, many of the drugs used to treat SCI may interfere with cognitive rehabilitation, and conversely drugs that are used to control seizures in TBI patients may undermine locomotor recovery after SCI. The current paper presents an experimental animal model for combined SCI and TBI to help drive mechanistic studies of dual diagnosis. Rats received a unilateral SCI (75 kdyn) at C5 vertebral level, a unilateral TBI (2.0 mm depth, 4.0 m/s velocity impact on the forelimb sensori-motor cortex), or both SCI+TBI. TBI was placed either contralateral or ipsilateral to the SCI. Behavioral recovery was examined using paw placement in a cylinder, grooming, open field locomotion, and the IBB cereal eating test. Over 6weeks, in the paw placement test, SCI+contralateral TBI produced a profound deficit that failed to recover, but SCI+ipsilateral TBI increased the relative use of the paw on the SCI side. In the grooming test, SCI+contralateral TBI produced worse recovery than either lesion alone even though contralateral TBI alone produced no observable deficit. In the IBB forelimb test, SCI+contralateral TBI revealed a severe deficit that recovered in 3 weeks. For open field locomotion, SCI alone or in combination with TBI resulted in an initial deficit that recovered in 2 weeks. Thus, TBI and SCI affected forelimb function differently depending upon the test, reflecting different neural substrates underlying, for example, exploratory paw placement and stereotyped grooming. Concurrent SCI and TBI had significantly different effects on outcomes and recovery, depending upon laterality of the two lesions. Recovery of function after cervical SCI was retarded by the addition of a moderate TBI in the contralateral

  4. Dynamic MR imaging of the temporomandibular joint arthrosis using spoiled GRASS sequence

    Energy Technology Data Exchange (ETDEWEB)

    Suenaga, Shigeaki; Hamamoto, Sadatoshi; Kawano, Kazunori (Kagoshima Univ. (Japan). Dental School) (and others)

    1994-07-01

    The purpose of this study was to quantitatively evaluate contrast enhancement effects of the posterior disk attachment in the temporomandibular joint arthrosis using dynamic MRI with bilateral surface coils. One hundred twenty-four temporomandibular joints in 96 symptomatic patients and 27 control subjects were examined with a spoiled GRASS pulse sequence (TR: 35 ms, TE: 8 ms, flip angle: 60deg). One sagittal scan was performed prior to injection, then 0.1 mmol/kg of Gd-DTPA was given as a rapid bolus injection, immediately after which scans were performed at 30 seconds intervals for a period of 5 minutes. Signal intensity (SI) was measured from the ROI of the posterior disk attachment region. The contrast enhancement effects may be calculated by SI ratio (SIR) = ( SI[sup post]-SI[sup pre])/SI[sup pre], where SI[sup post] and SI[sup pre] were the signal intensities after and before administration of contrast medium. The time intensity curve of SIR versus time after injection was obtained on each symptoms. Join pain group (85 joints) tended to show a rapid enhancement pattern, while control group (54 joints), joint sound or opening limitation group (39 joints), and asymptomatic group (68 joints) showed a relatively gradual enhancement pattern. The drop of SIR in four groups were hardly observed during examination. Mean peak SIR of control group, joint pain group, joint sound or opening limitation group, and asymptomatic group was 0.62[+-]0.24 (SD), 1.53[+-]0.69, 0.73[+-]0.38 and 0.78[+-]0.44 respectively. The mean SIR of pain group was significantly (P<0.001, t-test) higher than that of other groups. These results suggested that dynamic MRI of the temporomandibular joint may effectively depict the inflammatory changes of the posterior disk attachment. (author).

  5. Neuron counting and the changes of section size after chronic pressure on cervical spinal cord in rabbit%兔颈脊髓慢性受压后神经元计数及截面积的变化

    Institute of Scientific and Technical Information of China (English)

    陈锋; 黄有荣; 韦贵康; 李寿斌

    2005-01-01

    neurocyte and neurocyte damage. DESIGN: A randomized controlled observational study using experimental animals as study subjects.MATERIALS: The study was conducted in the Central Laboratory of Ruikang Hospital affiliated to Guangxi Traditional Chinese Medical University from December 2002 to August 2003.SUBJECTS: Fourty-eight male New Zealand rabbits with a bodymass of (2.45 ± 0. 28) kg were randomly divided into control group, mild pressure group and severe pressure group with 16 rabbits in each group.METHODS: Animal models with mild and severe cervical spinal cord chronic pressure were established in rabbits. Control group was pseudo-operation group. Spinal cord observation under optical microscope and electron microscope, neurocyte apoptosis analysis (TUNEL method), neuron counting, and the section size of the neuron were analyzed respectively.MAIN OUTCOME MEASURES: Main results: observational results under optical microscope of each group. Subordinate results: ① observational results under electron microscope of each group; ② neurocyte apoptosis analysis RESULTS: After chronic pressure in the spinal cord of rabbits, phenomena like neuron atrophy,loss,reduced section size,and neuron and neurocyte apoptosis appeared. The morphology of neurons in control group was normal and the quantity was quite a lot, which was (40 ± 2), and the neuron section size was(41.24 ± 15.61) μm2.The number of neuron of mild pressurc group was(27 ± 2), and the neuron section size was(20. 82 ± 6.57) μm2. The number of neurons of severe pressure group was (22± 2), and the neuron section size was( 17. 96 ± 9.03 ) μm2. The difference between mild, severe pressure group and control group was significant( P < 0.01),while the difference between mild and severe pressure groups was insignificant(P > 0. 05 ). The ultrastructural changes of neurons after chronic pressure were reduced volume of soma, unclear nucleolus and reduced rough endoplasmic reticulum. The lamellar structure of

  6. Surgery in cervical disc herniation: anterior cervical discectomy without fusion or with fusion

    Directory of Open Access Journals (Sweden)

    Iencean Andrei Stefan

    2017-03-01

    Full Text Available The study included a group of anterior cervical microdiscectomy without fusion performed at one level (either C5-C6 level or at the C6-C7 level and a second group of patients with same single-level of anterior cervical discectomy with fusion. The kinematic analysis included the range of motion, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level the range of motion and the translation were minimal in the anterior cervical discectomy without fusion group, both for the C5-C6 and C6-C7 levels, and absent in the cervical discectomy with fusion group. The superior adjacent levels translations were greater in the ACDF group compared with the ACD group. The clinical results of both types of cervical discectomy were comparable. In cervical microdiscectomy without fusion the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. No need for anterior cervical discectomy with fusion to trait a single level cervical disc herniation than in selected cases.

  7. Spinal infections.

    Science.gov (United States)

    Tay, Bobby K-B; Deckey, Jeffrey; Hu, Serena S

    2002-01-01

    Spinal infections can occur in a variety of clinical situations. Their presentation ranges from the infant with diskitis who is unwilling to crawl or walk to the adult who develops an infection after a spinal procedure. The most common types of spinal infections are hematogenous bacterial or fungal infections, pediatric diskitis, epidural abscess, and postoperative infections. Prompt and accurate diagnosis of spinal infections, the cornerstone of treatment, requires a high index of suspicion in at-risk patients and the appropriate evaluation to identify the organism and determine the extent of infection. Neurologic function and spinal stability also should be carefully evaluated. The goals of therapy should include eradicating the infection, relieving pain, preserving or restoring neurologic function, improving nutrition, and maintaining spinal stability.

  8. Spinal brucellosis.

    Science.gov (United States)

    Tali, E Turgut; Koc, A Murat; Oner, A Yusuf

    2015-05-01

    Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. Recognition of spinal brucellosis is challenging. Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.

  9. Spinal cord ischemia secondary to hypovolemic shock.

    Science.gov (United States)

    Oh, Jacob Yl; Kapoor, Siddhant; Koh, Roy Km; Yang, Eugene Wr; Hee, Hwan-Tak

    2014-12-01

    A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable.

  10. Congenital segmental spinal muscular atrophy: a case report.

    Science.gov (United States)

    Savaş, Tülin; Erol, Ilknur; Özkale, Yasemin; Saygi, Semra

    2015-03-01

    Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al (J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient's situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs.

  11. Spinal Stenosis

    Science.gov (United States)

    ... Pharyngitis, Adenitis Syndrome (Juvenile) Polymyalgia Rheumatica Psoriatic Arthritis Raynaud's Phenomenon Reactive Arthritis Rheumatoid Arthritis Scleroderma Sjogren's Syndrome Spinal Stenosis Spondyloarthritis Systemic Lupus Erythematosus (Juvenile) Takayasu's ...

  12. Operative Outcomes for Cervical Myelopathy and Radiculopathy

    Directory of Open Access Journals (Sweden)

    J. G. Galbraith

    2012-01-01

    Full Text Available Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

  13. Cervical dysplasia - series (image)

    Science.gov (United States)

    ... to detect cervical cancer. Limited or early cervical cancer (carcinoma in situ, or cervical intraepithelial neoplasia, or dysplasia) requires treatment with ablation therapy, usually in the form of ...

  14. Syringomyelia associated with cervical spondylosis: A rare condition.

    Science.gov (United States)

    Landi, Alessandro; Nigro, Lorenzo; Marotta, Nicola; Mancarella, Cristina; Donnarumma, Pasquale; Delfini, Roberto

    2013-06-16

    Spinal spondylosis is an extremely common condition that has only rarely been described as a cause of syringomyelia. We describe a case of syringomyelia associated with cervical spondylosis admitted at our division and treated by our institute. It is the case of a 66-year-old woman. At our observation she was affected by moderate-severe spastic tetraparesis. T2-weighted magnetic resonance imaging (MRI) showed an hyperintense signal within spinal cord from C3 to T1 with a more sharply defined process in the inferior cervical spinal cord. At the same level bulging discs, facets and ligamenta flava hypertrophy determined a compression towards subarachnoid space and spinal cord. Spinal cord compression was more evident in hyperextension rather than flexion. A 4-level laminectomy and subsequent posterior stabilization with intra-articular screws was executed. At 3-mo follow up there was a regression of tetraparesis but motor deficits of the lower limbs residuated. At the same follow up postoperative MRI was executed. It suggested enlargement of the syrinx. Perhaps hyperintensity within spinal cord appeared "bounded" from C3 to C7 with clearer margins. At the level of surgical decompression, subarachnoid space and spinal cord enlargement were also evident. A review of the literature was executed using PubMed database. The objective of the research was to find an etiopathological theory able to relate syringomyelia with cervical spondylosis. Only 6 articles have been found. At the origin of syringomyelia the mechanisms of compression and instability are proposed. Perhaps other studies assert the importance of subarachnoid space regard cerebrospinal fluid (CSF) dynamic. We postulate that cervical spine instability may be the cause of multiple microtrauma towards spinal cord and consequently may damage spinal cord parenchyma generating myelomalacia and consequently syrinx. Otherwise the hemorrhage within spinal cord central canal can cause an obstruction of CSF outflow

  15. Magnetic resonance imaging of traumatic cervical injury

    Energy Technology Data Exchange (ETDEWEB)

    Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J. [Wonkwang University School of Medicine, Iri (Korea, Republic of)

    1994-04-15

    To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine.

  16. A case of primary spinal myoclonus: clinical presentation and possible mechanisms involved

    OpenAIRE

    Campos Cynthia Resende; Limongi João Carlos Papaterra; Machado Flávia Costa Nunes; Brotto Mário Wilson Iervolino

    2003-01-01

    Spinal myoclonus is a rare movement disorder characterized by myoclonic involvement of a group of muscles supplied by a few contiguous segments of the spinal cord. Structural lesions are usually the cause, but in primary spinal myoclonus the etiology remains unknown. We present the case of a 26-year-old woman with cervical spinal myoclonus in which both clinical and electromyographic findings pointed to the segment C1-C3 as the origin of the myoclonus. Laboratorial examinations were normal an...

  17. Course prognosis of cervical osteochondrosis

    Directory of Open Access Journals (Sweden)

    Kolesov V.N.

    2012-06-01

    Full Text Available

    Today we can state that in spite of a considerable number of cervical osteochondrosis studies, there is a lack of research devoted to analysis of its course. There is no correlation between initial expert evaluations of cervical osteo-chondrosis cases and further course of pathological process. Goal of the research is to develop system of course prognosis of cervical osteochondrosis taking into account environmental infuence, heredity, living conditions, psychological profle of patient’s personality. Materials and methods. Dynamics of degenerative-dystrophic changes progressing of cervical vertebrae in 236 patients was analyzed. Results. Received data demonstrated that probability of stage I changing to stage II, III and IV depended on patients’ sex, age and type of labour activity, frequent supercooling and stress. Probability of fast progression of cervical osteochondrosis (5-year cycle of stage I changing to stage III and IV was to a great extent associated with heredity, urban living, presence of endocrine system diseases, syndrome of nonspecifc dysplasia of connective tissue and low indices of quality of life. Conclusion. Proposed system allows making prognosis of morphologic changes in spinal cord, and is based on radiation methods of verifcation without taking into consideration dynamics of neurological symptomatology.

  18. Primary multifocal gliosarcoma of the spinal cord

    Directory of Open Access Journals (Sweden)

    Ramesh M. Kumar

    2016-03-01

    Full Text Available Gliosarcoma (GS is a rare and exceedingly malignant neoplasm of the central nervous system. It displays clinical features similar to glioblastoma, yet is histologically unique as it harbors both gliomatous and sarcomatous cellular components. Involvement of the neuroaxis is predominantly limited to the cerebral parenchyma and meninges. Primary GS of the spinal cord is rarely encountered. We report a case of a 54 year old male who presented with 2 months of progressive, bilateral lower extremity sensory deficits. Magnetic resonance imaging of the neuro-axis revealed multiple intradural lesions involving the cervical and thoracic spinal cord without evidence of intracranial involvement. Surgical resection of a dural based, extramedullary cervical lesion and two exophytic, intramedullary thoracic lesions revealed gliosarcoma, WHO grade IV. The patient died approximately 11 months after presentation. This report confirms that GS is not limited to supratentorial involvement and can primarily affect the spinal cord.

  19. SURGICAL TREATMENT OF SEVERE (2-3 DEGREE DEFORMING ARTHROSIS OF FIRST METATARSOPHALANGEAL JOINT OF FOOT: TASKS, APPROACHES, TECHNIQUE

    Directory of Open Access Journals (Sweden)

    A. V. Mazalov

    2011-01-01

    Full Text Available Based on the experience of treating 67 patients (98 feet with deforming arthrosis of first metatarsophalangeal joint is shown that the treatment of this disease the distal decompressing osteotomy in combination with maximally radical the separation of the unions and cheilectomy possesses the significant health-improvement potential, which makes it possible to be turned to arthrodesis or arthroplasty only in the limiting cases of that the heavy cases of hallux rigidus. L-osteotomy 1-st metatarsus gives more than possibilities for the correction with the heavy deformations and the degenerate changes, the basic criterion of sufficiency of which is the volume of the intra-operating straightening of 1-st fingers reached. Optimum is reaching the straightening 1-st toes to 65° even above. An indispensable stage of complex operation is maximally radical of cheilectomy. During the formation of arthrodesis 1-st metatarsophalangeal joint in the horizontal plane the axis of 1 finger should be oriented in parallel to axis second metatarsal bones. The sagittal angle of the formation of arthrodesis depends on the manifestation of valgus of rear division. Active postoperative conducting essentially improves the distant results of the surgical treatment of deforming arthrosis of first metatarsophalangeal joint.

  20. 经纤维支气管镜沐舒坦肺泡灌洗在颈脊髓损伤并发呼吸功能衰竭患者中的应用%Fiberoptic bronchoscopy aspirating sputum and mucovent lavage in the treatment of cervical spinal cord injury with respiratory insufficiency patients

    Institute of Scientific and Technical Information of China (English)

    路闯; 袁宏伟; 刘俊杰; 代振动; 王灿亚; 田俊华; 贾会光; 赵惠强

    2011-01-01

    目的 探讨颈脊髓损伤并发呼吸功能衰竭患者经纤维支气管镜沐舒坦肺泡灌洗的疗效.方法 选择38例经常规吸氧、抗感染、解痉平喘、化痰止咳或人工通气治疗效果不佳,并具有痰液堵塞的颈脊髓损伤并发呼吸衰竭患者进行经纤支镜沐舒坦支气管肺泡灌洗治疗.结果 显效26例(68.4%),有效9例(23.7%),总有效率为92.1%,无效3例(7.9%).结论 对于分泌物较多难以排出气道的颈脊髓损伤并发呼吸衰竭患者,及时给予经纤支镜沐舒坦肺泡灌洗,有利于迅速解除气道阻塞,改善血气交换.支气管吸引灌洗技术是一种安全有效、简便经济、易被患者接受的治疗方法,应用沐舒坦肺泡灌洗治疗颈脊髓损伤并发呼吸衰竭能改善病情.%[Objective]To investigate the clinical values of aspirating sputum by bronchofibroscopy and bronchoalveolar mucovent lavage in cervical fracture with spinal cord injury patients respiratory insufficiency.[Methods]Bronchoscope was inserted into 38 patients cervical spinal cord injury with respiratory insufficiency through nose or tracheal catheter to clear the secretion, phlegm.[Results]35 lives were saved and the mission successful rate was 92.1%.[Conclusions]The clinical values of bedside fiberoptic bronchoscopy for cervical fracture with spinal cord injury patients respiratory insufficiency are grateful.

  1. 呼吸训练器用于颈髓损伤患者呼吸道护理的效果观察%The effects of respiratory trainer in the care of the respiratory tracts of the patients with cervical spinal cord injuries

    Institute of Scientific and Technical Information of China (English)

    包芸; 苏建华

    2011-01-01

    Objectives To study the effects of respiratory trainer in the respiratory care of patients with cervical spinal cord injuries. Methods select 34 patients with cervical spinal injuries in our department from January, 2010 until January, 2011 for controlled trial. The control group received traditional nursing care for respiratory tract. The study group received respiratory training with respiratory trainer in the early stage based on the traditional care for the control group, to compare the incidence of pulmonary infection in two groups 30 days later. Results the incidence of pulmonary infection is 44. 4% in the study group, the incidence of pulmonary infection is 87. 5% in the control group,the incidence of pulmonary infection is lower in the study group than the control one(X2 = 6. 88,P<0. 01). Conclusion giving the patients with cervical spinal injuries the respiratory training with the respiratory trainer could obviously reduce the incidence of pulmonary infection.%目的 探讨呼吸训练器用于颈髓损伤患者护理道护理的效果.方法 选择在我科治疗的颈髓损伤患者34例分组进行对照研究,对照组16例使用传统的呼吸道护理方法,观察组18例在传统护理方法的基础上,再早期加用呼吸训练器进行呼吸训练,比较30天后两组患者肺部感染的发生率.结果 观察组肺部感染发生率为44.4%,对照组肺部感染发生率为87.5%,观察组明显低于对照组(x2=6.88,P<0.01).结论 颈髓损伤患者应用呼吸训练器进行呼吸训练,可显著降低肺部感染的发生率,具有临床应用价值.

  2. 经络脊柱推拿疗法对椎动脉型颈椎病的临床价值分析%Clinical Value Analysis in Spinal Massage Therapy of Main and Collateral Channels for Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    涂小刚

    2013-01-01

    Objective:To investigate the clinical value of spinal massage therapy with main and collateral channels for cervical spondylosis of verte-bral artery type. Methods:104 patients with cervical spondylosis of vertebral artery type were randomly divided into treatment group and control group, control group was treated with infusion of conventional western medicine, treatment group with spinal massage therapy of main and collateral channels, to observe the clinical efficacy of two groups. Results:The excellent and good rate and total effective rate of treatment group were 67.3%and 94.2%, higher than that of the control group by 32.7%and 59.6%(P<0.05). Conclusion:There is significant efficacy in spinal massage therapy of main and collateral channels treating cervical spondylosis of vertebral artery type, being worth the clinical promotion with higher clinical value.%  目的:探讨经络脊柱推拿疗法治疗椎动脉型颈椎病的临床价值。方法:将104例椎动脉型颈椎病患者随机分成治疗组和对照组,对照组采用常规西药滴注治疗,治疗组采用经络脊柱推拿治疗,观察两组临床疗效。结果:治疗组优良率及总有效率分别为67.3%、94.2%,高于对照组的32.7%、59.6%(P<0.05)。结论:经络脊柱推拿疗法治疗椎动脉型颈椎病疗效显著,具有较高的临床治疗价值,值得临床推广。

  3. Cervical Laminoplasty

    Science.gov (United States)

    ... spine showing extension of the spine following a cervical laminoplasty. B) Post-operative lateral x-rays of the same patient showing flexion. Note that the range of motion is maintained after the laminoplasty and that no ...

  4. Cervical spondylosis

    Science.gov (United States)

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... therapist). Sometimes, a few visits will help with neck pain. Cold packs and heat therapy may help your ...

  5. Spondilitis Tuberkulosa Cervical

    Directory of Open Access Journals (Sweden)

    Roni Eka Saputra

    2015-05-01

    -3% kasus spondilitistuberkulosa. Keterlibatan spinal biasanya merupakan akibat dari penyebaran hemaKata kunci: spondilitis TB, cervical, pembedahan Abstract Cervical tuberculous spondylitis is a fairly rare disease, only about 2-3% of all cases of tuberculousspondylitis. The clinical features vary widely, ranging from mild and non-specific symptoms until the fatal neurologicalcomplications. A 29-year-old woman came with a complaint weakness of the four limbs become heavy in the last 10days, were preceded by neck pain that radiates to the shoulders and arms since 6 months earlier. Pain was initiallyperceived as a limitation of neck movement when turned to the left and right side, and bowed his head. Perceived painexacerbated by movement and reduced if the rest. Patients lost weight since the last 2 months. Found no history ofcough or chest pain. Neurologic examination showed weakness in four extremities. Laboratory results found increasedErythrocyte Sedimentation Rate (ESR. X-ray radiographic normal. Cervical x-ray photograph shows destruction ashigh as C5. MRI shows destruction in the corpus C5-6 with narrowing at C5-6 intervertebre disc  accompanied byparavertebral abscess with emphasis to the posterior. Found destruction corpus verebre T 4.5 with intervertebral discnarrowing. Suggestive of a tuberculous spondylitis. At 5.6 C spondylitis vertebre anterior corpectomi following surgery,microsurgery with iliac graft, and insertion one level anterior plate. Anatomical Pathology examination showedcaseating tuberculosis spodilitis. At T 4.5 vertebre spondylitis done laminectomi, costotrasversektomi debridement, andstabilization with pedicle screw T2, T3, and T5. Patients also treated with anti-tuberculosis drugs. Present status,patient is able to perform daily activity with sensoric and motoric good. Tuberculous Spondylitis is the most common form of tuberculosis that affect the bone. Cervical Tuberculous spondylitis ranges from 2-3% of cases of tuberculousspondylitis. Spinal

  6. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  7. 急性重度外伤性颈脊髓损伤患者早期死亡的危险因素分析%Analysis of the risk factors for early death in acute severe traumatic cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    冷玉鑫; 聂春艳; 姚智渊; 朱曦

    2013-01-01

    目的 寻找急性重度外伤性颈脊髓损伤患者早期死亡的危险因素.方法 回顾性分析1994年1月1日至2012年10月1日本院收治的急性重度外伤性颈脊髓损伤患者的临床资料,按30 d内是否死亡分为死亡组和存活组.通过单因素分析和logistic回归分析来寻找影响患者早期死亡的危险因素.结果 1093例急性外伤性颈脊髓损伤患者中有352例重度患者纳入本研究,早期病死率为14.49%(51/352);致伤原因以车祸伤(153例)和摔伤(117例)为主;死亡原因以呼吸衰竭(16例)、多器官功能衰竭(14例)、消化道出血(11例)居多.综合单因素分析和logistic回归分析发现:高急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分[>15分,优势比(OR=11.595,P=0.000]、高损伤节段(OR=3.519,P=0.032)、低钠血症(OR =6.316,P=0.000)、神经源性休克(OR=6.209,P=0.000)、肺部感染(OR=14.627,P=0.000)、气管切开(OR=8.983,P=0.000)等因素为重度损伤患者早期死亡的危险因素;而性别,年龄,是否手术,是否存在骨折或脱位、中枢性高热,是否使用糖皮质激素等因素对急性重度颈脊髓损伤患者是否早期死亡无确切影响.结论 反映急性重度外伤性颈脊髓损伤患者病情严重程度和并发症的相关指标对预测患者是否早期死亡的意义更大;而年龄、手术等相关因素的影响被削弱.%Objective To survey the risk factors for early death of patients with acute severe traumatic cervical spinal cord injury.Methods A retrospective analysis of data of consecutive patients with acute severe traumatic cervical spinal cord injury admitted from January 1st 1994 to October 1st 2012 were made.The patients died within 30 days or not were allocated for death group or survival group.The risk factors for early death were analyzed through univariate analysis and logistic analysis.Results Among 1093 patients with acute traumatic cervical spinal cord injury,352 patients

  8. Effect of MOTOmed movement training on enhancing the balance of patients with cervical spinal cord injury%MOTOmed运动训练对颈髓损伤患者平衡功能的影响

    Institute of Scientific and Technical Information of China (English)

    金玉光; 王丽华; 柳尧花

    2014-01-01

    Objective To investigate the impact of MOTOmed movement training on the balance of patients with cervical spinal cord injury (CSCI).Methods 205 cases were included and divided into two groups randomly.The observation group had 99 cases and the control group had 106 cases.The observation group combined the conventional rehabilitation training and MOTOmed 713.4 /W41a type bed training, and then used the MOTOmed viva2 onset of type training when they can sit .The Berg balance scale (BBS) of the two groups after rehabilitation training were compared .Results The BBS and QIF score had no statistical significant before training (P>0.05).The BBS score after 4 courses and 8 courses rehabilitation training were (12.2 ±2.8) and (17.6 ±2.8) in the observation group, respectively, which were significantly higher than those in the control group (t=2.117,2.651, respectively; P<0.05).The QIF score after 4 courses and 8 courses rehabilitation training of the observation group were significantly different from the control group ( P<0.05) .Conclusions The MOTOmed training can improve the balance control ability of patients with CSCI .%目的:探讨MOTOmed运动训练对颈髓损伤患者平衡的影响。方法将入选的205例患者,随机分为观察组99例,对照组106例,观察组卧床期,在常规康复训练的基础上加 MOTOmed 713.4/W41a型进行床边训练,能达坐位平衡后采用MOTOmed viva2上下肢型进行训练。经过康复训练后分别对两组进行Berg平衡量表( BBS )评定,日常生活活动能力采用四肢瘫功能指数( QIF )评定表。结果康复训练前两组患者BBS评分、QIF总分比较差异均无统计学意义(P>0.05);康复训练4,8个疗程后观察组患者BBS评分分别为(12.2±2.8),(17.6±2.8)分,均高于对照组,两组比较差异有统计学意义(t值分别为2.117,2.651;P<0.05);康复训练4,8个疗程后两组患者QIF总分及各项评

  9. Prof.Luo Zhiqiang's Experience in Treating Cervical Vertigo

    Institute of Scientific and Technical Information of China (English)

    金明华

    2004-01-01

    @@ The common symptoms of cervical spondylopathy include dizziness and vertigo, headache, neck rigidity and numbness, or pain in the shoulders, arms, and fingers. Modem medicine has divided cervical spondylopathy into 6 types, namely, the cervical,radicular, spinal, vertebroarterial, sympathetic, and the mixed types. In TCM, according to the main symptoms of dizziness and vertigo, cervical spondylopathy is traditionally called ‘cervical vertigo'. Having been engaged in TCM for more than 40 years, Prof. Luo Zhiqiang (罗致强) has acquired a profound and unique knowledge about this disorder and obtained quite good therapeutic results. The following is a brief introduction of his experience in the TCM treatment of cervical vertigo.

  10. Spinal Stenosis

    Science.gov (United States)

    ... lower part of the body. It resembles a “horse’s tail” ( cauda equina in Latin). What Causes Spinal ... of the spine fails, it usually places increased stress on other parts of the spine. For example, ...

  11. Spinal Hemangiomas

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2010-06-01

    Full Text Available The given article considers the modern view on etiology, pathogenesis, classifications, clinical picture, diagnosis and treatment of spinal hemangiomas. Advantages of vertebroplasty over the other techniques of treatment of studied pathology are presented

  12. Spinal Hemangiomas

    OpenAIRE

    I.A. Norkin; S.V. Likhachev; A.Yu. Chomartov; A.I. Norkin; D.M. Puchinian

    2010-01-01

    The given article considers the modern view on etiology, pathogenesis, classifications, clinical picture, diagnosis and treatment of spinal hemangiomas. Advantages of vertebroplasty over the other techniques of treatment of studied pathology are presented

  13. Spinal Infections

    Science.gov (United States)

    ... infections may occur following surgery or spontaneously in patients with certain risk factors. Risk factors for spinal infections include poor nutrition, immune suppression, human immunodeficiency virus (HIV) infection, cancer, diabetes and obesity. Surgical risk factors ...

  14. Spinal Stenosis

    Science.gov (United States)

    ... risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include Pain in your neck or back Numbness, weakness, cramping, or pain in ...

  15. Impact of intravenous acetaminophen therapy on the necessity of cervical spine imaging in patients with cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Ahmadi Koorosh

    2014-07-01

    Full Text Available 【Abstract】Objective: We evaluated a new hypothesis of acetaminophen therapy to reduce the necessity of imaging in patients with probable traumatic cervical spine injury. Methods:Patients with acute blunt trauma to the neck and just posterior midline cervical tenderness received acetaminophen (15 mg/kg intravenously after cervical spine immobilization. Then, all the patients underwent plain radiography and computerized tomography of the cervical spine. The outcome measure was the presence of traumatic cervical spine injury. Sixty minutes after acetaminophen infusion, posterior midline cervical tenderness was reassessed. Results:Of 1 309 patients, 41 had traumatic cervical spine injuries based on imaging. Sixty minutes after infusion, posterior midline cervical tenderness was eliminated in 1 041 patients, none of whom had abnormal imaging. Conclusion: Patients with cervical spine trauma do not need imaging if posterior midline cervical tenderness is eliminated after acetaminophen infusion. This analgesia could be considered as a diagnostic and therapeutic intervention. Key words: Acetaminophen; Diagnosis; Spinal Injuries; Cervical vertebrae; Radiography

  16. Spinal angiography. Anatomy, technique and indications; Spinale Angiographie. Anatomie, Technik und Indikation

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Simgen, A.; Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal angiography is a diagnostic modality requiring detailed knowledge of spinal vascular anatomy. The cervical spinal cord is supplied by the vertebral arteries while segmental arteries which are preserved from fetal anatomy, supply the thoracic and lumbar regions. As spinal angiography carries the risk of paraplegia the indications have to be considered very carefully. Nevertheless, spinal angiography should be performed if there is reason to suspect a spinal vascular malformation from magnetic resonance imaging (MRI). (orig.) [German] Indikationsstellung, Technik und Durchfuehrung der spinalen Angiographie erfordern detaillierte Kenntnisse der Gefaessversorgung des Spinalkanals und des Rueckenmarks. Die Gefaessversorgung des Rueckenmarks erfolgt im Bereich des Halsmarks aus den beiden Aa. vertebrales. Eine zusaetzliche arterielle Versorgung der Wirbelsaeule einschliesslich des Rueckenmarks wird ueber segmentale Arterien hergestellt, die im Bereich der Thorakal- und Lumbalregion aus der Embryonalphase als segmentale, interkostale und Lumbalarterien erhalten geblieben sind. Da die spinale Angiographie die Gefahr der Querschnittslaehmung birgt, ist eine strenge Indikation notwendig. Eine ueber laengere Zeit bestehende unklare klinische Symptomatik kann auch durch eine spinale Gefaessmalformation hervorgerufen werden. Ist durch die MRT-Bildgebung der Verdacht auf eine spinale Gefaessfehlbildung gegeben, sollte eine Angiographie durchgefuehrt werden, da diese Fehlbildungen oft kurabel sind. (orig.)

  17. Post laminoplasty cervical kyphosis—Case report

    Science.gov (United States)

    Dugoni, D.E.; Mancarella, C.; Landi, A.; Tarantino, R.; Ruggeri, A.G.; Delfini, R.

    2014-01-01

    INTRODUCTION Cervical kyphosis is a progressive cervical sagittal plane deformity that may cause a reduction in the ability to look horizontally, breathing and swallowing difficulties, sense of thoracic oppression and social isolation. Moreover, cervical kyphosis can cause myelopathy due to a direct compression by osteo-articular structures on the spinal cord or to a transitory ischaemic injury. The treatment of choice is surgery. The goals of surgery are: nervous structures decompression, cervical and global sagittal balance correction and vertebral stabilization and fusion. PRESENTATION OF CASE In October 2008 a 35 years old woman underwent surgical removal of a cervical-bulbar ependymoma with C1–C5 laminectomy and a C2–C5 laminoplasty. Five months after surgery, the patient developed a kyphotic posture, with intense neck and scapular girdle pain. The patients had a flexible cervical kyphosis. Therefore, we decided to perform an anterior surgical approach. We performed a corpectomy C4–C5 in order to achieve the anterior decompression; we placed a titanium expansion mesh. DISCUSSION Cervical kyphosis can be flexible or fixed. Some authors have reported the use of anterior surgery only for flexible cervical kyphosis as discectomy and corpectomy. This approach is useful for anterior column load sharing however it is not required for deformity correction. CONCLUSION The anterior approach is a good surgical option in flexible cervical kyphosis. It is of primary importance the sagittal alignment of the cervical spine in order to decompress the nervous structures and to guarantee a long-term stability. PMID:25462050

  18. Addressing Stretch Myelopathy in Multilevel Cervical Kyphosis with Posterior Surgery Using Cervical Pedicle Screws

    Science.gov (United States)

    Mahesh, Bijjawara; Vijay, Shekarappa; Arun, Kumar; Srinivasa, Reddy

    2016-01-01

    Study Design Technique description and retrospective data analysis. Purpose To describe the technique of cervical kyphosis correction with partial facetectomies and evaluate the outcome of single-stage posterior decompression and kyphosis correction in multilevel cervical myelopathy. Overview of Literature Kyphosis correction in multilevel cervical myelopathy involves anterior and posterior surgery. With the advent of cervical pedicle screw-rod instrumentation, single-stage posterior kyphosis correction is feasible and can address stretch myelopathy by posterior shortening. Methods Nine patients underwent single-stage posterior decompression and kyphosis correction for multilevel cervical myelopathy using cervical pedicle screw instrumentation from March 2011 to February 2014 and were evaluated preoperatively and postoperatively with modified Japanese Orthopaedic Association (mJOA) scoring and computed tomography scans for radiological measurements. Kyphosis assessment was made with Ishihara curvature index and C2–C7 Cobb's angle. The linear length of the spinal canal and the actual spinal canal length were also evaluated. The average follow-up was 40.56 months (range, 20 to 53 months). Results The average preoperative C2–7 Cobb's angle of 6.3° (1° to 12°) improved to 2° (10° to −9°). Ishihara index improved from −15.8% (−30.5% to −4.7%) to −3.66% (−14.5% to +12.6%). The actual spinal canal length decreased from 83.64 mm (range, 76.8 to 91.82 mm) to 82.68 mm (range, 75.85 to 90.78 mm). The preoperative mJOA score of 7.8 (range, 3 to 11) improved to 15.0 (range, 13 to 17). Conclusions Single-stage posterior decompression and kyphosis correction using cervical pedicle screws for multilevel cervical myelopathy may address stretch myelopathy, in addition to decompression in the transverse plane. However, cervical lordosis was not achieved with this method as predictably as by the anterior approach. The present study shows evidence of mild

  19. Gemistocytic astrocytoma in the spinal cord in a dog: a case report

    Directory of Open Access Journals (Sweden)

    R.O. Chaves

    2016-08-01

    Full Text Available ABSTRACT This paper reports a case of a rare variant of the cervical spinal cord astrocytoma diagnosed in a dog with progressive neurological signs, initially asymmetrical, not ambulatory tetraparesis, segmental reflexes and normal muscle tone in all four limbs and absence of pain upon palpation of the cervical spine. Myelography revealed attenuation of the ventral and dorsal contrast line in the third region of the fifth cervical vertebra. At necropsy intramedullary cylindrical mass that stretched from the third to the sixth cervical vertebra, which replaced all the gray matter of the spinal cord was observed. In the histological study, there was the replacement of the substance by neoplastic cells mantle arranged loosely. The cells were large and slightly rounded. The eosinophilic cytoplasm was well defined, sometimes forming processes interconnecting cells. The nucleus was eccentric, round, oval or kidney-shaped, and the nucleolus was evident. Thus, the microscopic changes observed in the cervical spinal cord were consistent with gemistocytic astrocytoma.

  20. 3例颈髓损伤死亡案例的法医学讨论分析%Analysis and Discussion of Forensic Identification in 3 Case of Death After Cervical Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    陈亮; 袁启勇

    2016-01-01

    After completed a large number of to forensic identification, the author found cervical cord injury and deaths caused by the external force on the neck or trunk is common. Because of lack of knowledge or inadequate experience, cervical spine examination is often ignored in routine anatomical examination, which cause the cause of death is diffcult to determine or inaccurate. So the author believes medical expert must examine cervical vertebra and cervical cord in case of possible injuries to the cervical cord the routine.%在笔者的法医实际检案工作中,发现外力作用于颈部或躯干致颈椎、颈髓损伤致死案例并不鲜见。由于认识不足或经验欠缺,常规解剖检验中颈椎检查常常被忽略,造成死因难以确定或不准确。故笔者认为在可能伤及颈髓的案件中,尸体检验常规行颈椎检查。

  1. Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management

    Directory of Open Access Journals (Sweden)

    M. Zafrullah Arifin

    2012-06-01

    Full Text Available Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management. Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008, sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated inNeurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute /chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chi-square test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+ 1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury.

  2. 术前颈椎曲度与椎管扩大成形术后脊髓后移程度及疗效的相关性%Correlation between cervical curvature and spinal cord shift, surgical outcome after expansive open-door laminoplasty

    Institute of Scientific and Technical Information of China (English)

    朱继超; 刘晓光; 刘忠军; 姜亮; 韦峰; 于淼; 吴奉梁

    2013-01-01

    cervical curvature after expansive open-door laminoplasty for cervical myelopathy,and to investigate the relationship between cervical curvature and spinal cord shift.Methods:63 cases of cervical myelopathy undergoing traditional expansive open-door laminoplasty between January 2005 and December 2011 were reviewed retrospectively,the pathogenesis included cervical spondylotic myelopathy(26 cases),ossification of posterior longitudinal ligament(OPLL,20 cases) and developmental cervical spinal stenosis(17 cases).Traditional expansive open-door laminoplasty was performed because of multisegmental disc disease,multilevel OPLL or developmental cervical stenosis.All cases were divided into three groups according to the cervical curvature:the kyphosis group(n=16),the straight group(n=18) and the normal alignment group(n=29).The posterior shift of center of spinal cord(PCS) at each level of laminoplasty(C3-C7) was measured and calculated through the midsagittal images of MRI T2-weighted before and after surgery.Statistic analysis was performed to analyze the difference of PCS at each level (C3-C7) among three groups.The neurofunction for each patient was estimated by using the Japanese Orthopedic Association(JOA) score before surgery and at final follow-up,and the JOA recovery rate was calculated.Statistic analysis was performed to analyze the difference of the JOA recovery rate at final follow-up among three groups.Results:There was no statistical difference in the age,sex ratio,duration of symptoms,entity,follow-up time or the preoperative JOA score(P>0.05).Posterior migration of spinal cord was observed in all three groups,and there was no significant difference with respect to the mean PCS at C3-C7 level among three groups(P>0.05).The mean follow-up was 47±24(range 15-90) months,and the mean JOA recovery rate at final follow-up of each group was 59.81%,69.25% and 54.44% respectively,which showed no statistical difference(P>0.05).No linear correlation was found

  3. Interest of the SPECT-CT merging to detect pseudo-arthrosis after lumbar arthrodesis: preliminary results; Interet de la fusion TEMP-TDM pour la detection des pseudarthroses apres arthrodese lombaire: resultats preliminaires

    Energy Technology Data Exchange (ETDEWEB)

    Rager, O.; Ratib, O.; Tessitore, E. [Hopitaux universitaire de Geneve (Switzerland)

    2010-07-01

    Pseudo arthrosis is a potential complication after a lumbar arthrodesis. The symptoms are nonspecific and revision surgery is not always an effective treatment. Scintigraphy SPECT / CT with {sup 99m}Tc and CT were studied separately for the diagnosis of pseudo arthrosis before the widespread use of software fusion. It is well established that the diagnosis based on CT led to a number of false positive (10%). The purpose of this study is to evaluate the usefulness of SPECT-CT fusion imaging in the diagnosis of pseudo arthrosis. Conclusions: SPECT / CT fusion imaging may increase the specificity for the diagnosis of pseudo arthrosis at the level of inter body cages and increase sensitivity for the detection of degenerative diseases on the back joints. (N.C.)

  4. Emergency department evaluation and treatment of cervical spine injuries.

    Science.gov (United States)

    Kanwar, Rajdeep; Delasobera, Bronson E; Hudson, Korin; Frohna, William

    2015-05-01

    Most spinal cord injuries involve the cervical spine, highlighting the importance of recognition and proper management by emergency physicians. Initial cervical spine injury management should follow the ABCDE (airway, breathing, circulation, disability, exposure) procedure detailed by Advanced Trauma Life Support. NEXUS (National Emergency X-Radiography Utilization Study) criteria and Canadian C-spine Rule are clinical decision-making tools providing guidelines of when to obtain imaging. Computed tomography scans are the preferred initial imaging modality. Consider administering intravenous methylprednisolone after discussion with the neurosurgical consultant in patients who present with spinal cord injuries within 8 hours.

  5. Analysis of functional CT scan in cervical vertebral disease

    Energy Technology Data Exchange (ETDEWEB)

    Hirofuji, Eiichi; Tanaka, Seisuke; Tomihara, Mitsuo; Kita, Hiroshi; Yamasaki, Hiroyuki

    1982-12-01

    The atlantoaxial joint showed displacement in various directions in rheumatoid arthritis and cervical spondylosis. The displacements were promoted by anterior flexion and rotatory movements, exerting great influences on the spnial cord. The intervertebral space between the 5th and 6th vertebra showed narrowing of the vertebral canal in cervical spondylosis and was promoted by posterior flexion to affect the spinal cord to a great extent. Functional CT scan was useful for observation of pathologic conditions of vertebral diseases.

  6. Delayed post-traumatic spinal cord infarction in an adult after minor head and neck trauma: a case report

    Directory of Open Access Journals (Sweden)

    Bartanusz Viktor

    2012-09-01

    Full Text Available Abstract Introduction Delayed post-traumatic spinal cord infarction is a devastating complication described in children. In adults, spinal cord ischemia after cardiovascular interventions, scoliosis correction, or profound hypotension has been reported in the literature. However, delayed spinal cord infarction after minor head trauma has not been described yet. Case presentation We report the case of a 45-year-old Hispanic man who had a minor head trauma. He was admitted to our hospital because of paresthesias in his hands and neck pain. A radiological workup showed cervical spinal canal stenosis and chronic cervical spondylotic myelopathy. Twelve hours after admission, our patient became unresponsive and, despite full resuscitation efforts, died. The autopsy revealed spinal cord necrosis involving the entire cervical spinal cord and upper thoracic region. Conclusions This case illustrates the extreme fragility of spinal cord hemodynamics in patients with chronic cervical spinal canal stenosis, in which any further perturbations, such as cervical hyperflexion related to a minor head injury, can have catastrophic consequences. Furthermore, the delayed onset of spinal cord infarction in this case shows that meticulous maintenance of blood pressure in the acute post-traumatic period is of paramount importance, even in patients with minimal post-traumatic symptoms.

  7. Cervical spine injuries in American football.

    Science.gov (United States)

    Rihn, Jeffrey A; Anderson, David T; Lamb, Kathleen; Deluca, Peter F; Bata, Ahmed; Marchetto, Paul A; Neves, Nuno; Vaccaro, Alexander R

    2009-01-01

    American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of

  8. Spinal manipulation or mobilization for radiculopathy: a systematic review.

    Science.gov (United States)

    Leininger, Brent; Bronfort, Gert; Evans, Roni; Reiter, Todd

    2011-02-01

    In this systematic review, we present a comprehensive and up-to-date systematic review of the literature as it relates to the efficacy and effectiveness of spinal manipulation or mobilization in the management of cervical, thoracic, and lumbar-related extremity pain. There is moderate quality evidence that spinal manipulation is effective for the treatment of acute lumbar radiculopathy. The quality of evidence for chronic lumbar spine-related extremity symptoms and cervical spine-related extremity symptoms of any duration is low or very low. At present, no evidence exists for the treatment of thoracic radiculopathy. Future high-quality studies should address these conditions.

  9. EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE

    NARCIS (Netherlands)

    Veraa, Stefanie; Bergmann, Wilhelmina; van den Belt, Antoon Jan; Wijnberg, Inge; Back, Willem

    2016-01-01

    Diagnostic imaging is one of the pillars in the clinical workup of horses with clinical signs of cervical spinal disease. An improved awareness of morphologic variations in equine cervical vertebrae would be helpful for interpreting findings. The aim of this anatomic study was to describe CT variati

  10. Common surgical complications in degenerative spinal surgery.

    Science.gov (United States)

    Papadakis, Michael; Aggeliki, Lianou; Papadopoulos, Elias C; Girardi, Federico P

    2013-04-18

    The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.

  11. Degenerative spinal disease in large felids.

    Science.gov (United States)

    Kolmstetter, C; Munson, L; Ramsay, E C

    2000-03-01

    Degenerative spinal disorders, including intervertebral disc disease and spondylosis, seldom occur in domestic cats. In contrast, a retrospective study of 13 lions (Panthera leo), 16 tigers (Panthera tigris), 4 leopards (Panthera pardis), 1 snow leopard (Panthera uncia), and 3 jaguars (Panthera onca) from the Knoxville Zoo that died or were euthanatized from 1976 to 1996 indicated that degenerative spinal disease is an important problem in large nondomestic felids. The medical record, radiographic data, and the necropsy report of each animal were examined for evidence of intervertebral disc disease or spondylosis. Eight (three lions, four tigers, and one leopard) animals were diagnosed with degenerative spinal disease. Clinical signs included progressively decreased activity, moderate to severe rear limb muscle atrophy, chronic intermittent rear limb paresis, and ataxia. The age at onset of clinical signs was 10-19 yr (median = 18 yr). Radiographic evaluation of the spinal column was useful in assessing the severity of spinal lesions, and results were correlated with necropsy findings. Lesions were frequently multifocal, included intervertebral disc mineralization or herniation with collapsed intervertebral disc spaces, and were most common in the lumbar area but also involved cervical and thoracic vertebrae. Marked spondylosis was present in the cats with intervertebral disc disease, presumably subsequent to vertebral instability. Six of the animals' spinal cords were examined histologically, and five had acute or chronic damage to the spinal cord secondary to disc protrusion. Spinal disease should be suspected in geriatric large felids with decreased appetite or activity. Radiographic evaluation of the spinal column is the most useful method to assess the type and severity of spinal lesions.

  12. MRI study on spinal canal content in Western Maharashtrian population

    Directory of Open Access Journals (Sweden)

    Khanapurkar SV, Kulkarni DO, Bahetee BH, Vahane MI

    2014-07-01

    Full Text Available The morphology of the spinal canal content has been studied since the invention of myelography. However, most studies have measured the diameters of the spinal cord only, not the size of the subarachnoid space. The present study complements the current data on the morphology of the spinal contents, and in particular, the spinal subarachnoid space, by analyzing MRI images. Objective: To study morphology of the dural sac, spinal cord & subarachnoid space using MRI. To define the inner geometrical dimensions of spinal canal content that confine the maneuver of an endoscope inserted in cervical spine. 3. To have comprehensive knowledge of the anatomy of cervical spinal canal. Method: Based on MRI images of the spine from 60 normal patients of age between 25-60 years, the dimensions of spinal cord, dural sac & subarachnoid space were measured at mid-vertebral & intervertebral level from C1-C7 vertebrae. The parameters measured were transverse, sagittal diameter of spinal cord & dural sac. The subarachnoid space was measured as anterior, posterior, right, left distance between spinal cord and dura mater. Results: It was found that at each selected transverse level, the subarachnoid space tends to be symmetrical on the right and left sides of the cord, and measures 3.38 mm on an average. However, the anterior and posterior segment, measured on the mid-sagittal plane are generally asymmetric & varies greatly in size ranging 1mm to 6mm with mean 2.57 of anterior & 2.59 of posterior. These measurements match those found in previous studies. The coefficient of variance for the dimensions of the subarachnoid space is as high as 36.16%, while that for the dimensions of the spinal cord (transverse & sagittal are11.08%&13.28%respectively. Conclusion: The findings presented here, expand our knowledge of morphology of spinal canal and show that a thecaloscope must be smaller than 3.38 mm in diameter.

  13. Spinal dural ossification causing neurological signs in a cat.

    Science.gov (United States)

    Antila, Johanna M; Jeserevics, Janis; Rakauskas, Mindaugas; Anttila, Marjukka; Cizinauskas, Sigitas

    2013-06-19

    A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat's locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats.

  14. Cervical Ligamentum Flavum Hematoma: A Case Report.

    Science.gov (United States)

    Haghnegahdar, Ali; Sedighi, Mahsa; Rahmanian, Abdolkarim; Baghban, Fahim

    2016-02-01

    Study Design Case report. Objective To report the first case of ligamentum flavum hematoma after cervical spine instrumentation 11 years after the index surgery. Methods After performing bilateral C3 and C4 laminectomy, we observed a dark greenish discoloration over the ligamentum flavum, which was opened. We evacuated 15 mL of subacute hematoma. Results The first ligamentum flavum hematoma of the cervical spine that occurred after spinal instrumentation with sublaminar hooks. Conclusion Ligamentum flavum hematoma might happen even after a long delay (in our case, 11 years) from spinal instrumentation (sublaminar hooks). In symptomatic patients, evacuation is the treatment of choice. In cases of instrument adhesion to the surrounding intracanal tissues, removal should be done meticulously after performing a complete release.

  15. The fluid management for mild and moderate hyponatremia after acute cervical spinal cord iniurv%急性颈脊髓损伤后轻中度低钠血症的液体管理

    Institute of Scientific and Technical Information of China (English)

    张仲汇; 韩岳; 颜柳子

    2011-01-01

    目的:探讨急性颈脊髓损伤(ACSCI)后出现轻中度低钠血症时采用不同液体管理策略对疗效的影响.方法:采用前瞻性随机对照研究.选取外伤致ACSCI并发轻中度低钠血症者48例,随机分为A、B两组,每组24人,在同样基础治疗的前提下,A组进行限制性液体管理,B组实行开放性液体管理策略,分别记录两组自开始补钠治疗后24h和72 h血钠、平均动脉压(MAP)、中心静脉压(CVP)、24 h尿量、24 h尿钠、尿渗透压/血渗透压.结果:治疗24 h后A组血钠、MAP、CVP、24 h尿量、24 h尿钠、尿渗透压/血渗透压与B组比较无统计学意义.治疗72 h后A组血钠[(128.98±4.32)mmol/L]、MAP[( 64.32±3.25 )mmHg]、CVP[(5.14±0.68)cmH2O]低于B组血钠[(138.64±5.78 )mmol/L]、MAP[(74.89±5.21 )mmHg]、CVP[( 7.93±0.81 )cmH2O] (P<0.05);A组24 h尿量[(2 100.32±32.21 )mL]、24 h尿钠[(189.25±11.21) mmol/L],尿渗透压/血渗透压(2.78±0.79)高于B组尿量[(1915.54±27.65 )mL]、24h尿钠[(34.67±8.12)mmol/L],尿渗透压/血渗透压(1.64±0.31)(P<0.01).结论:对于大部分ACSCI后并发轻中度低钠血症的患者,开放性液体管理策略较之限制性液体管理策略能更快地纠正低钠血症及其相关并发症.%Objective: To explore the influence of different fluid management on mild and moderate hyponatremia after acute cervical spinal cord injury (ACSCI). Methods: Prospective randomized control trial was carried out in Intensive Care Unit. 48 adult patients suf fered mild and moderate hyponatremia after ACSCI were chosen and randomly divided into two groups (n=24 each): conservative fluid management (group A) and liberal fluid management group (group B ) . The parameters of serum sodium, mean arterial pressure (MAP), central venous pressure (CVP), urine volume of 24 h, urine sodium of 24 h, urine osmoticpressure/sodium osmoticpressure at 24 h,72 h after treatment were recorded and analysed. Results: Comparing with the parameters of

  16. Cervical intraspinal microstimulation evokes robust forelimb movements before and after injury

    Science.gov (United States)

    Sunshine, Michael D.; Cho, Frances S.; Lockwood, Danielle R.; Fechko, Amber S.; Kasten, Michael R.; Moritz, Chet T.

    2013-06-01

    Objective. Intraspinal microstimulation (ISMS) is a promising method for reanimating paralyzed limbs following neurological injury. ISMS within the cervical and lumbar spinal cord is capable of evoking a variety of highly-functional movements prior to injury, but the ability of ISMS to evoke forelimb movements after cervical spinal cord injury is unknown. Here we examine the forelimb movements and muscles activated by cervical ISMS both before and after contusion injury. Approach. We documented the forelimb muscles activated and movements evoked via systematic stimulation of the rodent cervical spinal cord both before injury and three, six and nine weeks following a moderate C4/C5 lateralized contusion injury. Animals were anesthetized with isoflurane to permit construction of somatotopic maps of evoked movements and quantify evoked muscle synergies between cervical segments C3 and T1. Main results. When ISMS was delivered to the cervical spinal cord, a variety of responses were observed at 68% of locations tested, with a spatial distribution that generally corresponded to the location of motor neuron pools. Stimulus currents required to achieve movement and the number of sites where movements could be evoked were unchanged by spinal cord injury. A transient shift toward extension-dominated movements and restricted muscle synergies were observed at three and six weeks following injury, respectively. By nine weeks after injury, however, ISMS-evoked patterns were similar to spinally-intact animals. Significance. The results demonstrate the potential for cervical ISMS to reanimate hand and arm function following spinal cord injury. Robust forelimb movements can be evoked both before and during the chronic stages of recovery from a clinically relevant and sustained cervical contusion injury.

  17. Computed tomography in the foramen magnum and high cervical cord lesion

    Energy Technology Data Exchange (ETDEWEB)

    Isu, T.; Ito, T.; Iwasaki, Y.; Tsuru, M. (Hokkaido Univ., Sapporo (Japan). School of Medicine); Kitaoka, K.

    1981-10-01

    The value of computed tomography in the spine and spinal cord disease recently has been well documented. However, little attention is made to the role of computed tomography in foramen magnum and high cervical cord lesion. We report 16 cases of the foramen magnum and high cervical cord lesion. Method: Either EMI Head Scanner, CT 1010 (slice thickness 10 mm) or EMI Whole Body Scanner, CT 5005 (slice thickness 13 mm) was used. In 9 cases enhanced CT with intravenous injection of contrast medium was performed. Eleven cases received intrathecal injection of metrizamide. Materials: 1) control group without cervical pathology 70 cases, 2) spinal cord tumor 6 cases, 3) atlanto-axial dislocation 6 cases, 4) Chiari malformation (type 1) 3 cases, 5) spinal foreign body (acupuncture needle) 1 case. Results: 1. plain CT. 1) In control group without cervical pathology the cervical cord at C/sub 1/ level was seen as area surrounded by ring of subarachnoid space. 2) In 14 cases except for 1 case of atlanto-axial dislocation and 1 case of spinal foreign body identification of the cervical cord at C/sub 1/ level was impossible. 3) CT was of diagnostic value in detecting altanto-axial dislocation and spinal foreign body. 2. enhanded CT. Meningioma and neurinoma showed positive contrast enhancement. However, astrocytoma and herniated cerebellar tonsils were not detectable. 3. CT metrizamide myelography visualized the subarachnoid space and made it possible to localize the lesion in the spinal canal in relation to the spinal cord. Conclusion: Attention should be given to plain CT finding at C/sub 1/ level in diagnosis of foramen magnum and high cervical cord lesion. If identification of cervical cord at C/sub 1/ level is impossible, it is suspected that subarachnoid space is blocked by the lesion, and enhanced CT and CT metrizamide myelography must be performed.

  18. Drop metastases to the spinal cord from infratentorial glioblastoma multiforme in post-temozolomide era

    Directory of Open Access Journals (Sweden)

    Shripad Brahmanand Pande

    2015-01-01

    Full Text Available Drop metastases from glioblastoma multiforme (GBM to the spinal cord are extremely rare in clinical practice. We report herewith multiple drop metastases to the cervical and thoracic spinal cord presenting as paraplegia in a patient treated initially with tumor resection followed by chemoradiation and later with temozolomide-.based adjuvant chemotherapy.

  19. Morphological studies at subchondral bone structures in human early arthrosis. Final report; Morphologische Studien an subchondralen Knochenstrukturen bei humanen Frueharthrosen. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1992-12-31

    Quantitative histomorphometric studies using an image analysis system were performed simultaneously on hyaline cartilage, calcified cartilage and subchondral cancellous bone of human tibial heads for detailed information about the pathogenesis of arthrosis. Joint structures need to be fully detected in three dimensions since measurement values are more affected by topographical aspects than by either age, or sex, or arthrosin stage. Mechanical factors were found to affect essentially the initiation and progression of arthrosis. Results are demonstrated in detail. (orig.) [Deutsch] Um detaillierte Aussagen ueber die Pathogenese der Arthrose machen zu koennen, wurden hyaliner Knorpel, Kalkknorpel und subchondrale Spongiosa menschlicher Tibiakoepfe gleichzeitig mit Hilfe eines Bildanalysesystems quantitativ histomorphometrisch untersucht. Eine umfangreiche dreidimensionale Erfassung der Gelenkstrukturen ist erforderlich, da sich topographische Aspekte wesentlich staerker auf die Messwerte auswirken als Alter, Geschlecht oder Arthrosestadium. Insgesamt zeigt sich ein wesentlicher Einfluss mechanischer Faktoren auf die Arthroseinitiierung und -progredienz. Die Ergebnisse werden detailliert dargestellt. (orig.)

  20. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : Small: 756x576 ... Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing and inset ...

  1. Magnetic resonance imaging of spinal cord injury in chronic stage

    Energy Technology Data Exchange (ETDEWEB)

    Tobimatsu, Haruki; Nihei, Ryuichi; Kimura, Tetsuhiko; Yano, Hideo; Touyama, Tetsuo; Tobimatsu, Yoshiko; Suyama, Naoto; Yoshino, Yasumasa (National Rehabilitation Center for the Disabled, Tokorozawa, Saitama (Japan))

    1991-10-01

    Magnetic resonance (MR) images of a total of 195 patients with cervical (125) or thoracic (70) spinal cord injury were reviewed. The imaging studies of the spinal cord lesions were correlated with clinical manifestations. Sequential MR imaging revealed hypointensity on T1-weighted images (T1WI) and hyperintensity on T2-weighted images (T2WI) in all patients, except for five patients showing no signal changes and two showing isointensity, suggesting gliosis, myelomalacia, and syringomyelia. Spinal cord lesions were classified into four types: small lesions, large lesions, complete transverse, and longitudinal rupture. These lesions were well correlated with the severity of injury and paralysis. Complete paralysis was frequently associated with enlarged, complete transverse for cervical spinal cord injury, and longitudinal ruptured or thinned complete transverse for thoracic spinal cord injury. The height of paralysis was well in agreement with that of lesions. For incomplete paralysis, localized lesions were seen within the spinal cord, coinciding with the paralysis or severity. Traumatic syringomyelia was seen in 17 patients (8.7%)-- for the cervical site (10 patients, 8%) and the thoracic site (7 patients, 10%). When homogeneous and marginally clear hypointensity is shown on T1-weighted images and vacuolated hyperintensity is shown on T2-weighted images, in addition to lesions spreading two or more cords or 1.5 or more cords above the nervous root level of paralysis, traumatic syringomyelia is strongly suspected, requiring the follow up observation. (N.K.).

  2. Classification and Management of Pediatric Subaxial Cervical Spine Injuries.

    Science.gov (United States)

    Madura, Casey J; Johnston, James M

    2017-01-01

    Appropriate management of subaxial spine injury in children requires an appreciation for the differences in anatomy, biomechanics, injury patterns, and treatment options compared with adult patients. Increased flexibility, weak neck muscles, and cranial disproportion predispose younger children to upper cervical injuries and spinal cord injury without radiographic abnormality. A majority of subaxial cervical spine injuries can be treated nonoperatively. Surgical instrumentation options for children have significantly increased in recent years. Future studies of outcomes for children with subaxial cervical spine injury should focus on injury classification and standardized outcome measures to ensure continued improvement in quality of care for this patient population.

  3. Functional cervical myelography with iohexol

    Energy Technology Data Exchange (ETDEWEB)

    Nakstad, P.; Aaserud, O.; Nyberg-Hansen, R.; Ganes, T.

    1985-05-01

    Thirty patients underwent functional cervical myelography, i.e. radiographs in the lateral view were obtained in extension as well as in flexion of the neck. Sagittal tomography was performed in both positions. Narrowing of the subarachnoid space and increased sagittal diameter of the spinal cord due to shortening were demonstrated in the lateral view in extension. In flexion a widening of the subarachnoid space was seen in almost all. In some cases with advanced narrowing or spinal block in extension, such widening in flexion resulted in better diagnostic images by providing passage of the contrast medium caudally. Although iohexol (Omnipaque, Nyegaard and Co., Oslo) was regularly forced into the posterior cranial fossa by the movements, the frequency of side effects was approximately the same as in our former trials with iohexol in conventional cervical myelography. EEG changes occurred in two patients (7%). A sitting position for 3-4 min after the examination followed by an elevated head end of the bed was probably important for preventing side effects from the contrast medium. Specific questioning revealed twice as many subjective side effects as reported after general questions alone.

  4. Presentation and outcome of traumatic spinal fractures

    Directory of Open Access Journals (Sweden)

    Ahmed El-Faramawy

    2012-01-01

    Full Text Available Background: Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability. Aim: To define the incidence, causes, and outcome of spinal fractures. Materials and Methods: Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009. Results: Among 3712 patients who were admitted to the section of trauma surgery, 442 (12% injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5% and falls from height (19.3% were the leading causes of cervical injury (P = 0.001. The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04. Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001. Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001. The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%. Conclusions: Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws.

  5. Spinal Cord Ischemia Secondary to Hypovolemic Shock

    OpenAIRE

    Oh, Jacob YL; Kapoor, Siddhant; Koh, Roy KM; Yang, Eugene WR; Hee, Hwan-Tak

    2014-01-01

    A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressi...

  6. Spinal cord injury following chiropractic manipulation to the neck.

    Science.gov (United States)

    Chakraverty, Julian; Curtis, Olivia; Hughes, Tom; Hourihan, Margaret

    2011-12-01

    Spinal cord injury is a rare complication of chiropractic treatment. This case report describes a 50-year-old man who developed neurological symptoms a few hours after manipulation (high velocity low amplitude [HVLA] technique) of the cervical spine. Magnetic resonance (MR) imaging of the cervical spine revealed intramedullary high signal at the C2/3 level of the right side of the cervical cord on the T2-weighted images. The potential mechanism of injury and causes of the radiological appearance are discussed.

  7. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.

    Science.gov (United States)

    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

    2008-12-01

    postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery.

  8. Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine.

    Science.gov (United States)

    Egerter, Alexander C; Kim, Eric S; Lee, Darrin J; Liu, Jonathan J; Cadena, Gilbert; Panchal, Ripul R; Kim, Kee D

    2015-10-01

    Study Design Retrospective case series. Objective Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease involves hyperostosis of the spinal column. Hyperostosis involving the anterior margin of the cervical vertebrae can cause dysphonia, dyspnea, and/or dysphagia. However, the natural history pertaining to the risk factors remain unknown. We present the surgical management of two cases of dysphagia secondary to cervical hyperostosis and discuss the etiology and management of DISH based on the literature review. Methods This is a retrospective review of two patients with DISH and anterior cervical osteophytes. We reviewed the preoperative and postoperative images and clinical history. Results Two patients underwent anterior cervical osteophytectomies due to severe dysphagia. At more than a year follow-up, both patients noted improvement in swallowing as well as their associated pain. Conclusion The surgical removal of cervical osteophytes can be highly successful in treating dysphagia if refractory to prolonged conservative therapy.

  9. 高压氧综合治疗对不完全颈髓损伤术后恢复的影响%Effects of comprehensive hyperbaric oxygen therapy on the recovery of patients following surgery of incomplete cervical spinal injury

    Institute of Scientific and Technical Information of China (English)

    李倩; 张志武; 董平; 余芳; 许文根; 卢一生; 李玢

    2014-01-01

    Objective To investigate the effects of comprehensive hyperbaric oxygen (HBO) therapy on the recovery of patients following surgery of incomplete cervical spinal injury.Methods A retrospective analysis was made on the clinical data of 78 cases of incomplete cervical spinal injury by trauma collected from the medical file of our hospital from June 2010 to June 2012.All the patients had complete follow-up medical data,and no statistical significance could be noted in age,gender,injury sites,seriousness of injury etc.In addition,all the patients underwent nerve decompression and internal fixation within 2 weeks after injury.With the knowledge and consent of the patients and following approval by the Hospital Ethics Committee,the patients were divided into the HBO group (40 cases) and non-HBO(NHBO)group (38 cases).Following surgery,the patients in the NHBO group were treated with only routine treatment,while the patients in the HBO group received HBO therapy in addition to routine treatment.American Spinal Cord Injury Association (ASIA) Scores and Barthel's Index (BI) were respectively used to evaluate the spinal cord function and their daily life activity,before treatment,1 month and 3 months after treatment,6 months and 1 year after surgery.Results Total effective rates for the HBO group and the NHBO group were 90.0% and 78.9%,with statistical significance,when comparisons were made between the 2 groups (P < 0.05).Following 1 month and 3 months of treatment,and after 6 months and l year of surgery,statistical significance could be noted in the scores of ASIA and BI between the 2 groups (P < 0.05),with the therapeutic effect of the HBO group being superior to that of the NHBO group.Recovery was most obvious in the first month after surgery.One month after surgery,ASIA scores,motor function scores and Barthel scores for both the HBO group and the NHBO group were all significantly higher,as compared with those before treatment,with the scores of the HBO group

  10. Developmental biomechanics of the human cervical spine.

    Science.gov (United States)

    Nuckley, David J; Linders, David R; Ching, Randal P

    2013-04-05

    Head and neck injuries, the leading cause of death for children in the U.S., are difficult to diagnose, treat, and prevent because of a critical void in our understanding of the biomechanical response of the immature cervical spine. The objective of this study was to investigate the functional and failure biomechanics of the cervical spine across multiple axes of loading throughout maturation. A correlational study design was used to examine the relationships governing spinal maturation and biomechanical flexibility curves and tolerance data using a cadaver human in vitro model. Eleven human cadaver cervical spines from across the developmental spectrum (2-28 years) were dissected into segments (C1-C2, C3-C5, and C6-C7) for biomechanical testing. Non-destructive flexibility tests were performed in tension, compression, flexion, extension, lateral bending, and axial rotation. After measuring their intact biomechanical responses, each segment group was failed in different modes to measure the tissue tolerance in tension (C1-C2), compression (C3-C5), and extension (C5-C6). Classical injury patterns were observed in all of the specimens tested. Both the functional (pcervical spine throughout maturation and elucidated age, spinal level, and mode of loading specificity. These data support our understanding of the child cervical spine from a developmental perspective and facilitate the generation of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.

  11. Isolated in vitro brainstem-spinal cord preparations remain important tools in respiratory neurobiology.

    Science.gov (United States)

    Johnson, Stephen M; Turner, Sara M; Huxtable, Adrianne G; Ben-Mabrouk, Faiza

    2012-01-15

    Isolated in vitro brainstem-spinal cord preparations are used extensively in respiratory neurobiology because the respiratory network in the pons and medulla is intact, monosynaptic descending inputs to spinal motoneurons can be activated, brainstem and spinal cord tissue can be bathed with different solutions, and the responses of cervical, thoracic, and lumbar spinal motoneurons to experimental perturbations can be compared. The caveats and limitations of in vitro brainstem-spinal cord preparations are well-documented. However, isolated brainstem-spinal cords are still valuable experimental preparations that can be used to study neuronal connectivity within the brainstem, development of motor networks with lethal genetic mutations, deleterious effects of pathological drugs and conditions, respiratory spinal motor plasticity, and interactions with other motor behaviors. Our goal is to show how isolated brainstem-spinal cord preparations still have a lot to offer scientifically and experimentally to address questions within and outside the field of respiratory neurobiology.

  12. Spinal fractures resulting from traumatic injuries

    Institute of Scientific and Technical Information of China (English)

    Heidari Pedram; Zarei Mohammad Reza; Rasouli Mohammad Reza; Alexander R Vaccaro; Rahimi-Movaghar Vafa

    2010-01-01

    Objective:To illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran.Methods:Data regarding spinal injuries including demographics,mechanism and level of spinal injury,abbreviated injury score,associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004.Results:A total of 619 patients with traumatic spine fractures were identified,of whom 68.5% were males.The peak frequency of these injuries occurred in the 21-40 year age-group.Accidental falls and road traffic crashes(RTCs)were the most common mechanisms of spinal fractures(47.2% and 44.1%,respectively).RTCs tended to occur in younger patients compared with accidental falls.The most common spinal region for spinal fracture was the lumbar spine(53.63%).Cervical spine fractures were significantly more common in RTCs,while lumbar spine fractures were more common in accidental falls(P<0.001).A total of 171(27.6%)patients had associated non-spinal injuries,of whom 127 had associated extremity injuries,and 55 had head injuries.Thirty-six(5.6%)patients had spinal cord injury(SCI).The injury severity score of the RTC group was significantly higher than that of accidental falls(P=0.002).Fifteen(4%)patients died of traumatic injuries.The rate of death was significantly higher in RTCs compared with accidental falls(5.1% vs 2.1%,P=0.039).Conclusions:The patterns of spinal fractures are similar to those reported from developed countries.RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls.Therefore preventive strategies should be based on reduction of the number and severity of RTCs.

  13. The effects of repetitive transcranial magnetic stimulation combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury%重复功能性磁刺激联合腹直肌电刺激对颈髓损伤患者肺通气功能的影响

    Institute of Scientific and Technical Information of China (English)

    李宁; 袁华; 牟翔; 杜起; 毛利; 惠楠

    2013-01-01

    Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury.Methods Twenty-five patients with cervical spinal cord injury were randomized into an experimental group (n =13) and a control group (n =12).The control group was given comprehensive rehabilitation treatment,including upper limb movements,standing training and training of respiratory function,while the experimental group was given repetitive transcranial magnetic stimulation and abdominal muscle electrical stimulation in addition to the comprehensive rehabilitation treatment.The patients' maximum lung capacity (VC),forced expiratory volume for 1 second (FEV1),peak expiratory flow rate (PEF) and tidal volume (VT) were measured at the outset and after 3 months of treatment.Results The lung function indexes increased in both groups after treatment,but each index improved significantly more in the experimental group,on average,than in the control group.Conclusion As a supplement to routine respiratory function training,repetitive transcranial magnetic stimulation combined with abdominal intermediate frequency electrical stimulation can improve the pulmonary ventilation function of patients with middle and lower cervical spinal cord injury.%目的 观察重复功能性磁刺激(rFMS)联合腹直肌电刺激对中、低位颈髓损伤(CSCI)患者肺通气功能的影响.方法 共选取25例中、低位CSCI患者,采用随机数字表法将其分为治疗组及对照组.对照组给予上肢主动运动、站立训练、呼吸功能训练等综合康复治疗,治疗组在此基础上辅以rFMS及腹直肌中频电刺激.分别于治疗前、治疗3个月后对2组患者肺功能[包括最大肺活量(VC)、1秒钟用力呼气量(FEV1)、呼气峰值流速(PEF)及潮气量(VT)等指标]进行评定.结果 2组患者分别经3个

  14. Hospital acquired pneumonia and pathogen analysis in patients with cervical spinal cord injury%颈脊髓损伤患者医院获得性肺炎及其病原菌分析

    Institute of Scientific and Technical Information of China (English)

    古正涛; 邓小玲; 郑国栋; 张亮达; 戴建强; 尹庆水

    2011-01-01

    目的:了解颈脊髓损伤(CSCI)患者医院获得性肺炎(HAP)的发生情况及病原菌的分布特点和耐药情况.方法:2008年10月~2010年8月我院骨科监护病区(OICU)共收治CSCI患者123例,其中完全性损伤32例,不完全性损伤91例,C1-C4损伤51例,C5~C7损伤72例.回顾性分析本组患者HAP发生情况及其病原菌分布特点与耐药情况,并采用X2检验比较CSCI平面、程度与HAP发生、再次感染及耐药菌感染的关系.结果:共33例(26.8%)患者出现51例次HAP,其中C1~C4 CSCI者的HAP发生率、再次感染率及多重耐药菌感染率分别为39.2%(20/51)、13.7%(7/51)、58.8%(30/51,按例次计算),C5~C7损伤患者分别为18.1%(13,72)、6.9%(5/72)、20.8%(15,72),C1~C4损伤者与C5~C7损伤者比较差异有统计学意义(P<0.05);完全性CSCI患者的HAP发生率、再次感染率及多重耐药菌感染率分别为56.3%(18/32)、28.1%(9/32)、68.8%(22/32,按例次计算),不完全性CSCI者分别为16.5%(15/91)、3.3%(3/91)、20.9%(19/91),两者比较差异有统计学意义(P<0.05).33例(51例次)HAP患者痰标本中共分离出93株病原菌,其中革兰氏阴性(G-)杆菌占63.4%,主要为肺炎克雷伯菌(17.20%)、铜绿假单胞菌(15.05%)、大肠埃希菌(13.98%)、鲍曼不动杆菌(10.75%);革兰氏阳性(G+)球菌主要为金黄色葡萄球菌(8.60%);真菌主要为热带假丝酵母菌(8.60%).G-杆菌和G+球菌普遍呈现多药耐药性,G-杆菌以碳青霉烯类敏感率最高,G+球菌对万古霉素均敏感.结论:CSCI患者HAP发生率较高,其发生率与CSCI平面及程度明显相关;病原菌以G-杆菌为主,常呈多药耐药.%Objective:To study the characteristics of hospital acquired pneumonia(HAP) in patients with cervical spinal cord injury(CSCI) as well as its pathogen distribution and drug susceptibility of bacteria. Method: 123 patients with CSCI who were admitted into the OICU in our hospital between October 2008 and August 2010 were reviewed

  15. Spinal cord ischemia: aetiology, clinical syndromes and imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Weidauer, Stefan [Frankfurt Univ., Sankt Katharinen Hospital Teaching Hospital, Frankfurt am Main (Germany). Dept. of Neurology; Hattingen, Elke; Berkefeld, Joachim [Frankfurt Univ., Frankfurt am Main (Germany). Inst. of Neuroradiology; Nichtweiss, Michael

    2015-03-01

    The purpose of this study was to analyse MR imaging features and lesion patterns as defined by compromised vascular territories, correlating them to different clinical syndromes and aetiological aspects. In a 19.8-year period, clinical records and magnetic resonance imaging (MRI) features of 55 consecutive patients suffering from spinal cord ischemia were evaluated. Aetiologies of infarcts were arteriosclerosis of the aorta and vertebral arteries (23.6 %), aortic surgery or interventional aneurysm repair (11 %) and aortic and vertebral artery dissection (11 %), and in 23.6 %, aetiology remained unclear. Infarcts occurred in 38.2 % at the cervical and thoracic level, respectively, and 49 % of patients suffered from centromedullar syndrome caused by anterior spinal artery ischemia. MRI disclosed hyperintense pencil-like lesion pattern on T2WI in 98.2 %, cord swelling in 40 %, enhancement on post-contrast T1WI in 42.9 % and always hyperintense signal on diffusion-weighted imaging (DWI) when acquired. The most common clinical feature in spinal cord ischemia is a centromedullar syndrome, and in contrast to anterior spinal artery ischemia, infarcts in the posterior spinal artery territory are rare. The exclusively cervical location of the spinal sulcal artery syndrome seems to be a likely consequence of anterior spinal artery duplication which is observed preferentially here. (orig.)

  16. Spinal cord projections to the cerebellum in the mouse.

    Science.gov (United States)

    Sengul, Gulgun; Fu, YuHong; Yu, You; Paxinos, George

    2015-09-01

    The projections from the spinal cord to the cerebellar cortex were studied using retrograde neuronal tracers. Thus far, no study has shown the detailed topographic mapping of the projections from the spinal neuron clusters to the cerebellar cortex regions for experimental animals, and there are no studies for the mouse. Tracers Fluoro-Gold and cholera toxin B were injected into circumscribed regions of the cerebellar cortex, and retrogradely labeled spinal cord neurons were mapped throughout the spinal cord. Spinal projections to the cerebellar cortex were mainly from five neuronal columns--central cervical nucleus, dorsal nucleus, lumbar and sacral precerebellar nuclei, and lumbar border precerebellar cells--and from scattered neurons located in the deep dorsal horn and laminae 6-8. The spinocerebellar projections to the cortex were mainly to the vermis. All five precerebellar cell columns projected to both anterior and posterior parts of the cerebellar cortex. Results of this study provide an amendment to the known rostral and caudal boundaries of the precerebellar cell columns in the mouse. Scattered precerebellar neurons in the most caudal deep dorsal horn and laminae 6-8 projected exclusively to the anterior part of the cerebellar cortex. In this study, no labeled spinal neurons were found to project to the lobules 6 and 7 of the cerebellar vermis, the flocculus, and the paraflocculus. Spinocerebellar neurons were located bilaterally, but the majority of the projections were contralateral for the central cervical nucleus, and ipsilateral for the remaining spinal precerebellar neuronal clusters.

  17. Spinal cord injury without radiographic abnormality

    Directory of Open Access Journals (Sweden)

    Singh Anil

    2006-01-01

    Full Text Available Spinal cord injury without radiological abnormality is rare in adults. Below we present a case report of 20 yrs old male with isolated cervical cord injury, without accompanying vertebral dislocation or fracture involving the spinal canal rim. He fell down on plain and smooth ground while carrying 40 kg weight overhead and developed quadriparesis with difficulty in respiration. Plain radiographs of the neck revealed no fractures or dislocations. MRI showed bulky spinal cord and an abnormal hyper intense signal on the T2W image from C2 vertebral body level to C3/4 intervertebral disc level predominantly in the anterior aspect of the cord The patient was managed conservatively with head halter traction and invasive ventilatory support for the initial 7 days period in the ICU. In our patient recovery was good and most of the neurological deficit improved over 4 weeks with conservative management.

  18. Airway management in a patient of ankylosing spondylitis with traumatic cervical spine injury

    Directory of Open Access Journals (Sweden)

    Nilesh Kumar

    2015-01-01

    Full Text Available Traumatic cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Preexisting ankylosing spondylitis with spinal column involvement renders the spinal column more rigid and introduces difficulty in airway management of the patient with traumatic cervical spinal cord. To improve ease and success, and reduce cervical spine movement, awake fibreoptic intubation (FOI is considered the gold standard technique for airway management in such cases. Attaining appropriate position for intubation was challenge in this case due to rigid curvature of the ankylosed spinal column. To prevent neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and attaining appropriate position was of prime concern. Optimal sedation with self-positioning by the patient in a comfortable posture is quite imperative and assures both airway as well as neurological protection in such expected difficult situations. We report the use of dexmedetomidine for self-positioning and awake FOI in a patient with ankylosing spondylitis having traumatic cervical spine who was otherwise neither able to co-operative nor able to give appropriate position for FOI.

  19. [Application of finite element analysis in Chinese cervical manipulation biomechanics].

    Science.gov (United States)

    Wang, Huihao; Chen, Bo; Zhan, Hongsheng; Wang, Huihao; Chen, Bo; Zhan, Hongsheng

    2013-10-01

    Clinical advantages of Chinese spinal manipulation therapy (CSMT) were recognized for spinal chronic lesions of soft tissues and bones, such as cervical spondylosis, etc. However, the security of CSMT and the hypotheses of practice mechanisms were questioned for lacking of the relevant basic researches. Researches have proved that these methods could be used to observe the dynamic effects of spine with application of finite element analysis (FEA) computer technology. Combining with other biomechanical experimental methods and applying advanced FEA technology for mechanical problems of CSMT, we may not only find the mechanisms of action and provide theoretical supports for the traditional Chinese therapy, but also standardize the key techniques and optimize the treatment options improving clinical outcomes, and even promote spreading of CSMT. Computer models are ideally suited for studying phenomena that cannot be satisfactorily investigated with other models. However, computer models of CSMT practice remain to be further refined. The results which had been acquired so far not only verified some of the traditional points of view, but also revised and specified some perspectives of the past. This paper intends to review FEA studies with Chinese cervical manipulation therapy (CCMT) for cervical spinal chronic lesions of soft tissues and bones, involving different effects for cervical spine joints (pulling/traction and thrusting) with practice techniques and cervical spine soft tissues (including vessels and its hemodynamics, muscles and fasciae, etc).

  20. The biomechanical behavior on the interface of tumor arthrosis/allograft prosthetic composite by finite element analysis

    Science.gov (United States)

    Chen, H. Z.; Jiang, W.; Zou, W.; Luo, J. M.; Chen, J. Y.; Tu, C. Q.; Xing, B. B.; Gu, Z. W.; Zhang, X. D.

    2008-11-01

    The biomechanical behavior of the uniting interface between the allograft bone and the autogenetic bone plays an important role in the treatment of the proximal femur massive defects with artificial tumor arthrosis/allograft prosthetic composite (TAAPC). According to the CT data of a patient, a 3D medical treatment model of TAAPC was established. Under the loads of 1.5 and 2.5 times standard body weight (70 kg), the mechanical behavior of the treatment model was analyzed by finite element analysis (FEA) for three typical healing periods. The results show that there are significant differences in the stress values and distribution in different healing periods. With healing of osteotomy, the hardness of the tissue of the uniting interface increases, the stress in uniting area was increased greatly and the stress concentration decreased. After cured the stress almost reached the level of normal bone. In the initial stage of healing, the healing training is not encouraged because there is an obvious risk of fracture of prosthesis and bone cement. In addition, porous hydroxyapatite (HA) ceramic used as bone tissue scaffold for this case, not only facilitates the generation of new bone, but also can avoid this risk caused by the non-uniting interface.

  1. Is End-Stage Ankle Arthrosis Best Managed with Total Ankle Replacement or Arthrodesis? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Robert W. Jordan

    2014-01-01

    Full Text Available Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA has been the surgical intervention of choice but the emergence of total ankle replacement (TAR has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure. Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn. Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial.

  2. Is End-Stage Ankle Arthrosis Best Managed with Total Ankle Replacement or Arthrodesis? A Systematic Review

    Science.gov (United States)

    Jordan, Robert W.; Chahal, Gurdip S.; Chapman, Anna

    2014-01-01

    Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure. Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn. Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial. PMID:25215242

  3. Clinical effect of posterior pedicle screw fixation combined with total laminectomy decompression on cervical spinal fracture and dislocation%后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位的临床效果

    Institute of Scientific and Technical Information of China (English)

    吕乔; 刘卫华; 杨会武; 程微; 杨子斌

    2016-01-01

    目的 探讨后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位的临床效果.方法 选择2010年1月至2014年7月云南省大理白族自治州人民医院收治的颈椎骨折脱位患者87例,术前美国脊髓损伤学会(ASIA)神经病损分级:A级18例,B级34例,C级21例,D级10例,E级4例.所有患者均采用单纯后路椎弓根内固定联合全椎板减压治疗,记录手术时间、术中出血量、术后引流量、并发症发生情况、置钉情况和随访情况,采用ASIA分级评定术后脊髓神经功能恢复情况.结果 87例患者均顺利完成手术,置钉成功率92.5%(285/308),手术时间40 ~ 96 min,平均(63±15)min;术中出血量100~400 ml,平均(260 ±44) ml;术后引流量230 ~3000ml,平均(320 ±46) ml.术后发生脑脊液漏6例,切口表层感染2例,肺不张3例,下肢静脉血栓形成3例,肺栓塞1例,顽固性低钠低氯血症2例,酸中毒、高钾血症1例,经对症治疗后均好转或痊愈术后13例(ASIA分级A级6例、B级7例)死亡,19例(ASIA分级B级12例、C级5例、D级2例)失访,余55例患者中完全解剖复位38例(69.1%),基本复位17例(30.9%),末次随访时无再脱位及断钉、断棒情况;末次随访时ASIA分级:A级12例,均无脊髓神经功能恢复;B级15例,1例恢复至C-级,6例恢复至B+级,8例无恢复;C级16例,8例恢复至D级,5例恢复至E-级,3例无恢复;D级8例,7例恢复至E级,1例无恢复.结论 后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位安全、有效.%Objective To evaluate the clinical effect of posterior pedicle screw fixation combined with total laminectomy decompression on cervical spinal fracture and dislocation.Methods Totally 87 patients with cervical spinal fracture and dislocation from January 2010 to July 2014 in Dali Bai Autonomous Prefecture People's Hospital were enrolled;preoperative American Spinal Injury Association(ASIS) grades were as follows:18 cases of grade A,34 cases of grade B

  4. Peripheral nervous system involvement in chronic spinal cord injury

    DEFF Research Database (Denmark)

    Tankisi, Hatice; Pugdahl, Kirsten; Rasmussen, Mikkel Mylius

    2015-01-01

    Introduction: Upper motor neuron disorders are believed to leave the peripheral nervous system (PNS) intact. In this study we examined whether there is evidence of PNS involvement in spinal cord injury (SCI). Methods: Twelve subjects with chronic low cervical or thoracic SCI were included...

  5. Learning about Spinal Muscular Atrophy

    Science.gov (United States)

    ... News Release Fischbeck Group Learning About Spinal Muscular Atrophy What is spinal muscular atrophy? What are the ... for Spinal Muscular Atrophy What is spinal muscular atrophy? Spinal muscular atrophy is a group of inherited ...

  6. Dynamics of the spinal cord: An analysis of functional myelography by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Y.; Suzuki, K.; Ohmori, K.

    1988-12-01

    The antero-posterior movement of the spinal cord with flexion and extension of the neck was analyzed in order to clarify the mechanism of spinal cord compression in cases with postoperative spinal deformity, and to contribute to the improvement of the surgical methods of conventional laminectomy. The control subjects were 47 cases without cervico-thoracic neurological symptoms, who underwent CT myelography in flexion and extension of the neck; the cervical spinal cord was examined in 27 of these cases and the thoracic cord in the other 20. CT myelography was also carried out in 16 patients with cervical myelopathy and in 5 patients after posterior decompression surgery (suspension laminotomy). CT sections in flexion and extension of the neck were analyzed for (1) change of configuration of the dura mater and the spinal cord, and (2) antero-posterior shift of the spinal cord in the subarachnoid space. In the control subjects, the configuration of the dura mater was slightly flattened at C5/6, C6 and C6/7 in extension of the neck. The cervical spinal cord shifted anteriorly in flexion and posteriorly in extension of the neck, and was flattened at the midcervical level in flexion in the control subjects. There was a statistically significant correlation between the location of the spinal cord and the adjacent intervertebral angles at the levels of C4, C5 and C6. These results were compared with the results from the 16 patients with cervical myelopathy and 5 patients after suspension laminotomy. The thoracic spinal cord shifted anteriorly in neck flexion and posteriorly in extension, especially at upper thoracic level. In order to avoid spinal cord compression due to anterior shift of the spinal cord caused by postoperative kyphosis, it is necessary to employ the surgical method which can prevent postoperative kyphotic deformity.

  7. Spinal Cord Contusion

    Institute of Scientific and Technical Information of China (English)

    Gong Ju; Jian Wang; Yazhou Wang; Xianghui Zhao

    2014-01-01

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and lim-ited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  8. Acquired lumbar spinal stenosis.

    Science.gov (United States)

    Deasy, JoAnn

    2015-04-01

    Lumbar spinal stenosis is the most frequent reason for spinal surgery in patients over age 65 years. In this condition, narrowing of the lumbar spinal canal and nerve root canals leads to painful, debilitating compression of spinal nerves and blood vessels. As the population ages, an increasing number of patients will be diagnosed and treated for lumbar spinal stenosis by primary care providers. This article reviews the pathophysiology, diagnosis, and management of lumbar spinal stenosis in adults over age 50 years.

  9. Syringomyelia secondary to cervical spondylosis: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Savitr Sastri Bhagavathula Venkata

    2014-01-01

    Full Text Available Syringomyelia secondary to cervical spondylosis is a rare entity to encounter in clinical practice. We discuss the case of a 53-year-old lady who presented with a syringomyelic syndrome and was found to have cervical spondylosis on imaging. Cine-MRI revealed an obstruction of cerebrospinal fluid (CSF flow in the cervical spinal subarachnoid space. Decompression of the same led to clinical and radiological improvement. There is a potential causal association between cervical spondylosis and syringomyelia. MRI CSF flow studies may help in deciding the course of treatment in such cases. A subset of patients with cervical spondylosis and concurrent spinal cord signal intensity changes may show reversal of the same following intervention.

  10. Paralysis following stereotactic spinal irradiation in pigs suggests a tolerance constraint for single-session irradiation of the spinal nerve

    NARCIS (Netherlands)

    Medin, P.M.; Foster, R.D.; Kogel, A.J. van der; Meyer, J.; Sayre, J.W.; Huang, H.; Oz, O.K.

    2013-01-01

    BACKGROUND AND PURPOSE: Paralysis observed during a study of vertebral bone tolerance to single-session irradiation led to further study of the dose-related incidence of motor peripheral neuropathy. MATERIALS AND METHODS: During a bone tolerance study, cervical spinal nerves of 15 minipigs received

  11. Could spinal canal compression be a cause of polyneuropathy?

    Directory of Open Access Journals (Sweden)

    Richard Bostelmann

    2016-04-01

    Full Text Available Causality between spinal cord compression and polyneuropathy is difficult to define, especially under the circumstances that polyneuropathy can have many causes. Seven patients with spinal cord compression and electrophysiological signs of polyneuropathy were treated surgically on decompression of their spinal canal stenosis in the time from April 2010 to January 2013. Median follow up time was 9 months (2-23 months. Causes of polyneuropathy were: 1 patient with methotrexate-induced polyneuropathy, 1 endocrine-dysfunction-induced, 2 with diabetic- polyneuropathy, and 3 patients had unknown reasons. The localization of the spinal canal stenosis was also varying: 2 patients suffered of cervical spinal canal stenosis and 5 of lumbar. Decompressive surgery led to pain relieve in all patients initially. Surprisingly, also symptoms of polyneuropathy seemed to regress in all 7 patients for the first 5 months after surgery, and in 5 patients for the time of 9 months after surgery. There are two points we would like to emphasize in this short report. Since 5/7 patients with polyneuropathy and spinal canal stenosis improved clinically after surgery, surgery has a place in the treatment of such a combined pathology. Since it seems to be a possible causality between polyneuropathy of unknown origin and spinal cord stenosis, decompression of the spinal canal could also be a therapeutic step in a specific kind of polyneuropathy. Which patients could possibly have a spinal canal stenosis induced polyneuropathy remains a subject of further studies.

  12. MRI findings of spinal visceral larva migrans of Toxocara canis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Ho, E-mail: leeinho1974@hanmail.ne [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Department of Radiology, Chungnam National University Hospital, 33 Munhwa-ro, Jung-gu, Daejeon 301-721 (Korea, Republic of); Kim, Sung Tae, E-mail: st7.kim@hotmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Oh, Dae Kun, E-mail: odk6464@nate.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Hyung-Jin, E-mail: hyungkim@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Keon Ha, E-mail: somatom@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Jeon, Pyoung, E-mail: drpjeon@gmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Byun, Hong Sik, E-mail: byun5474@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of)

    2010-08-15

    Purpose: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord. Materials and methods: We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response. Results: Total 8 patients (M = 8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients. Conclusion: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.

  13. Epidemiologic evidence of spinal cord injury in Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Neelamegan Sridharan

    2015-01-01

    Full Text Available Background: Spinal cord injury is a fearsome disability leading to increased rate of morbidity and mortality. Information about the incidence of spinal cord injury may provide support for the healthcare advancements. The aim of the present study is to investigate the epidemiology of spinal cord injury. Methods: The present study was carried out in Rajiv Gandhi government general hospital, Chennai, India. The study design was approved by the institutional human ethical committee. Questionnaire was used to collect the information from the patients in a prospective manner. The American Spinal Injury Association (ASIA scoring systems was used to evaluate the severity of spinal cord injury. Results: A total of 245 cases of spinal injury were studied. Among them, 88 % (n=216 were male and 12% (n=29 were female. Spinal cord injuries of falls from height were prominent over the road traffic accident. Cervical level injuries are widespread in males and dorsal level Injuries are common in females. Conclusion: Hence awareness of the spinal cord injury and availability of healthcare facilities may minimise the consequences of spinal cord injury. [Int J Res Med Sci 2015; 3(1.000: 220-223

  14. Developmental biomechanics of the cervical spine: Tension and compression.

    Science.gov (United States)

    Nuckley, David J; Ching, Randal P

    2006-01-01

    Epidemiological data and clinical indicia reveal devastating consequences associated with pediatric neck injuries. Unfortunately, neither injury prevention nor clinical management strategies will be able to effectively reduce these injuries or their effects on children, without an understanding of the cervical spine developmental biomechanics. Thus, we investigated the relationship between spinal development and the functional (stiffness) and failure biomechanical characteristics of the cervical spine in a baboon model. A correlation study design was used to define the relationships between spinal tissue maturation and spinal biomechanics in both tension and compression. Eighteen baboon cervical spine specimens distributed across the developmental spectrum (1-26 human equivalent years) were dissected into osteoligamentous functional spinal units. Using a servo-hydraulic MTS, these specimens (Oc-C2, C3-C4, C5-C6, C7-T1) were non-destructively tested in tension and compression and then displaced to failure in tension while measuring the six-axes of loads and displacements. The functions describing the developmental biomechanical response of the cervical spine for stiffness and normalized stiffness exhibited a significant direct relationship in both tension and compression loading. Similarly, the tensile failure load and normalized failure load demonstrated significant maturational increases. Further, differences in biomechanical response were observed between the spinal levels examined and all levels exhibited clinically relevant failure patterns. These data support our understanding of the child cervical spine from a developmental biomechanics perspective and facilitate the development of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.

  15. Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.

    Science.gov (United States)

    Franz, Steffen; Ciatipis, Mareva; Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

    2014-01-01

    After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis) in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC) or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn) of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU) to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord) and unaltered in neurogenic regions (dentate gyrus and SVZ) of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement.

  16. Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.

    Directory of Open Access Journals (Sweden)

    Steffen Franz

    Full Text Available After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord and unaltered in neurogenic regions (dentate gyrus and SVZ of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement.

  17. First description of cervical intradural thymoma metastasis.

    Science.gov (United States)

    Marotta, Nicola; Mancarella, Cristina; Colistra, Davide; Landi, Alessandro; Dugoni, Demo Eugenio; Delfini, Roberto

    2015-11-16

    Thymoma and thymic carcinoma are rare epithelial tumors, which originate from the thymus gland. According to the World Health Organization there are "organotypic" (types A, AB, B1, B2, and B3) and "non-organotypic" (thymic carcinomas) thymomas. Type B3 thymomas are aggressive tumors, which can metastasize. Due to the rarity of these lesions, only 7 cases of extradural metastasis are described in the literature. We report the first and unique case of a man with cervical intradural B3 thymoma metastasis. A 46-year-old man underwent thymoma surgical removal. The year after the procedure he was treated for a parietal pleura metastasis. In 2006 he underwent cervical-dorsal extradural metastasis removal and C5-Th1 stabilization. Seven years after he came to our observation complaining left cervicobrachialgia and a reduction of strength of the left arm. He underwent a cervical spine magnetic resonance imaging, which showed a new lesion at the C5-C7 level. The patient underwent a surgery for the intradural B3 thymoma metastasis. Neurological symptoms improved although the removal was subtotal. He went through postoperative radiation therapy with further mass reduction. Spinal metastases are extremely rare. To date, only 7 cases of spinal extradural metastasis have been described in the literature. This is the first case of spinal intradural metastasis. Early individuation of these tumors and surgical treatment improve neurological outcome in patients with spinal cord compression. A multimodal treatment including neoadjuvant chemotherapy, surgery and postoperative radiation therapy seems to improve survival in patients with metastatic thymoma.

  18. Severe, Protracted Spasm of Urinary Bladder and Autonomic Dysreflexia Caused by Changing the Suprapubic Catheter in a Cervical Spinal Cord Injury Patient: Treatment by a Bolus Dose and Increased Total Daily Dose of Intrathecal Baclofen

    Science.gov (United States)

    Vaidyanathan, Subramanian; Oo, Tun; Soni, Bakul M.; Hughes, Peter L.; Singh, Gurpreet

    2016-01-01

    BACKGROUND Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported. CASE REPORT A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump. CONCLUSION Severe, protracted bladder spasms, abdominal muscles spasms, and autonomic dysreflexia, induced by change of suprapubic catheter in a spinal cord injury patient, were treated successfully by a bolus dose and increased total daily dose of intrathecal baclofen. PMID:28008298

  19. 颈段椎管内外“哑铃”形肿瘤的Ⅰ期显微手术疗效初步探讨%One-stage microsurgical excision for intra-and extra-spinal dumbbell-shaped tumors in cervical spine: a report of 11 cases

    Institute of Scientific and Technical Information of China (English)

    高方友; 王曲; 刘窗溪; 韩国强; 熊云彪; 尹浩; 王超; 杨承勇; 马骏

    2013-01-01

    目的 探讨颈段椎管内外“哑铃”形肿瘤的临床特点及手术方法.方法 回顾分析11例经手术治疗的颈段椎管内外“哑铃”形肿瘤患者临床资料,男性7例,女性4例.经颈椎后路行肿瘤显微切除者9例,其中行半椎板切除4例(包括1例颈胸交界区Ⅲ期肿瘤和1例Ⅳ期肿瘤,均行颈椎后路钉棒系统内固定术),全椎板切开肿瘤切除后微钛片、钛钉椎板复位2例,经椎板间入路切除3例;其余2例经颈椎后路半椎板切除联合前外侧入路手术切除肿瘤.结果 所有患者均经Ⅰ期显微手术全切除肿瘤(神经鞘瘤10例、节细胞神经瘤l例).术后除l例感觉麻木面积略增大外,其余患者临床症状与体征明显改善,神经根性疼痛明显减轻或完全消失,肢体运动障碍改善.术后平均随访21个月,无一例肿瘤残留或复发,亦无脊柱畸形.结论 颈段椎管内外“哑铃”形肿瘤术前可根据肿瘤外科分期和部位制定详细的手术方案,通过Ⅰ期显微手术切除.以半椎板入路为主,必要时可采取颈椎前后联合入路手术,影响颈椎稳定性者需同时行辅助内固定.%Objective To investigate the clinical characteristics and surgical treatment strategy ot intra-and extra-spinal dumbbell-shaped tumors in cervical spine.Methods Clinical data of 11 patients with intra-and extra-spinal dumbbell-shaped tumors in cervical spine were retrospectively studied.Male was in 7 cases,female in 4 cases.The tumors were in stage Ⅰ in 4 cases,Ⅱ in 2 cases,Ⅲ in 4 cases and Ⅳ in one case.The tumors were resected via posterior midline approach alone in 9 cases,among whom unilateral hemilaminectomy was performed in 4 cases (screw fixation via posterior approach was performed for fusion of lesion segments after tumor resection in 2 cases,one was stage Ⅳ tumor,another one was stage Ⅲ tumor in cervicothoracic junction),total laminotomy and reduction by titanium miniplates and screws in 2 cases

  20. Coexistence of a single cerebral arteriovenous malformation and spinal arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Wang Yabing

    2009-01-01

    Full Text Available The coexistence of a cerebral and a spinal arteriovenous malformation (AVM together is extremely rare. We present a 31-year-old woman, who suffered from severe root pains in the left upper extremity. Magnetic resonance imaging (MRI revealed the abnormal vessels in the left occipital lobe and upper cervical segment of spinal cord. Cerebral angiography and spinal angiogram revealed two AVMs: One was in the right occipital lobe and the other was located in the C1-C2 segments of cervical cord. She had no other vascular lesions, and nor did her other family members. As the primary problem in her was left upper extremity root pains, which we considered was related to the spinal AVM, the first therapeutic treatment was focused on spinal AVM. The cerebral AVM of the right occipital lobe was surgically resected after part embolization.

  1. Herniation of the cervical disk in plastic surgeons.

    Science.gov (United States)

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Chen, Tim-Mo

    2012-12-01

    Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease.

  2. Cervical biomechanics and neck pain of "head-spinning" breakdancers.

    Science.gov (United States)

    Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

    2014-05-01

    The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (pcervical torque in all planes (p<0.001). The CROM showed a negative moderate to strong correlation with NDI, pain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers.

  3. Distribution of Neuron Cell Bodies in the Intraspinal Portion of the Spinal Accessory Nerve in Humans.

    Science.gov (United States)

    Boehm, Karl E; Kondrashov, Peter

    2016-01-01

    The spinal accessory nerve is often identified as a purely motor nerve innervating the trapezius and sternocleidomastoid muscles. Although it may contain proprioceptive neurons found in cervical spinal levels C2-C4, limited research has focused on the histology of the spinal accessory nerve. The objective of the present study was to examine the spinal accessory nerve to determine if there are neuronal cell bodies within the spinal accessory nerve in humans. Cervical spinal cords were dissected from eight cadavers that had previously been used for dissection in other body regions. The segmental rootlets were removed to quantify the neuron cell bodies present at each spinal level. Samples were embedded in paraffin; sectioned; stained with hematoxylin and eosin; and examined using a microscope at 4×, 10×, and 40× magnification. Digital photography was used to image the samples. Neuronal cell bodies were found in 100% of the specimens examined, with non-grossly visible ganglia found at spinal levels C1-C4. The C1 spinal level of the spinal accessory nerve had the highest number of neuron cell bodies.

  4. Poro-elastic modeling of Syringomyelia - a systematic study of the effects of pia mater, central canal, median fissure, white and gray matter on pressure wave propagation and fluid movement within the cervical spinal cord.

    Science.gov (United States)

    Støverud, Karen H; Alnæs, Martin; Langtangen, Hans Petter; Haughton, Victor; Mardal, Kent-André

    2016-01-01

    Syringomyelia, fluid-filled cavities within the spinal cord, occurs frequently in association with a Chiari I malformation and produces some of its most severe neurological symptoms. The exact mechanism causing syringomyelia remains unknown. Since syringomyelia occurs frequently in association with obstructed cerebrospinal fluid (CSF) flow, it has been hypothesized that syrinx formation is mechanically driven. In this study we model the spinal cord tissue either as a poro-elastic medium or as a solid linear elastic medium, and simulate the propagation of pressure waves through an anatomically plausible 3D geometry, with boundary conditions based on in vivo CSF pressure measurements. Then various anatomic and tissue properties are modified, resulting in a total of 11 variations of the model that are compared. The results show that an open segment of the central canal and a stiff pia (relative to the cord) both increase the radial pressure gradients and enhance interstitial fluid flow in the central canal. The anterior median fissure, anisotropic permeability of the white matter, and Poisson ratio play minor roles.

  5. Nestin-positive cells in the spinal cord: a potential source of neural stem cells.

    Science.gov (United States)

    Xu, Renshi; Wu, Chengsi; Tao, Yuhui; Yi, Juan; Yang, Yunzhu; Zhang, Xiong; Liu, Rugao

    2008-11-01

    Some literatures have reported neural precursor cells (NPCs) exist in spinal cord of adult mammal, however, the NPCs distribution feature in spinal cord of adult mice so far is not described in detail. In order to observe and compare the distribution feature of NPCs in various spinal cord regions of adult mice, to research a potential source of neural stem cells (NSCs), we obtained NPCs distribution feature by analyzing the distribution of the nestin-containing cells (NCCs) in spinal cord of adult nestin second-intron enhancer controlled LacZ reporter transgenic mice (pNes-Tg) with LacZ staining and positive cell quantification. The results showed that: NCCs were observed in various regions of spinal cord of adult mice, but amount of NCCs was different in distinct region, the rank order of NCCs amount in various spinal cord regions was dorsal horn region greater than central canal greater than the ventral and lateral horn. NCCs in dorsal horn region mainly distributed in substantia gelatinosa, NCCs in central canal mainly distributed in ependymal zone, on the contrary, NCCs in ventral, lateral horn, medullae, nucleus regions of spinal cord were comparatively less. The rank order of NCCs amount in various spinal cord segments was cervical segment greater than lumbar sacral segment greater than thoracic segment. There was no significantly difference between NCCs amount in the left and right sides, and within cervical 1-7, thoracic 1-12, lumbar 1-5, sacral segment of spinal cord in adult mice. These data collectively indicate that NPCs extensively distribute in various regions of spinal cord of adult mice, especially in substantia gelatinosa and ependymal zone. NPCs in cervical segment are abundant, NPCs in thoracic segment are the least while compared the different spinal cord segment, the NPCs in various regions of spinal cord of adult mice are a potential source of NSCs.

  6. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics

    2006-07-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  7. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  8. Dynamic function MR of the cervical vertebral column. Dynamische Funktions-MRT der Halswirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Naegele, M.; Woell, B.; Reiser, M. (Radiologische Universitaetsklinik, Bonn (Germany)); Koch, W. (Orthopaedische Universitaetsklinik, Bonn (Germany)); Kaden, B. (Neurochirurgische Universitaetsklinik, Bonn (Germany))

    1992-09-01

    To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T[sub 1] and T[sub 2][sup *] weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations. (orig.).

  9. Fixation of total hip components in rheumatoid arthritis and arthrosis. A radiographic, roentgen stereophotogrammetric, densitometric and histomorphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Oensten, I.

    1994-10-14

    The radiographic survival of the Charnley prosthesis was studied in two retrospective, matched-pair cohorts of rheumatoid arthritis (RA) and arthrosis (OA) patients. In RA, the 7-year radiographic socket survival improved from 87% to 96% after the introduction of flanged sockets, bone transplants in cases of acetabular protrusion and the rejection of the pilot hole technique. In OA the 10-year radiographic socket survival was 95%. In both groups the 7-year radiographic stem survival improved from 80% to 96% following the introduction of the new cementing technique. Migration of the Charnley prosthesis in the first two years was evaluated by roentgen stereophotogrammetric analysis (RSA) in RA and OA patients, and related to the histomorphometric characteristics of trabecular bone in the acetabulum and the femur. In RA, sockets migrated six times more in the proximal direction as compared with OA; there was no difference in migration in other directions. Stem fixation was equally secure in RA and OA. RA cases had more osteoid in both the femur and the acetabulum, but the amount of osteoid was not correlated with the degree of migration. The bone mineral content (BMC) of RA and OA hips was assessed by dual photone roentgen absorptiometry prior to hip replacement. Patients with RA had 20% less BMC than those with OA but there were no signs of a relative peri-acetabular deficit. In two randomized trials of 81 OA patients, migration of the uncemented, Harris-Galante type I socket was evaluated by RSA and compared with Charnley sockets. After a minimum follow-up of 2 years, no difference in migration between the two socket designs was found. 98 refs, 18 figs, 2 tabs.

  10. Blast overpressure induced axonal injury changes in rat brainstem and spinal cord

    Directory of Open Access Journals (Sweden)

    Srinivasu Kallakuri

    2015-01-01

    Full Text Available Introduction: Blast induced neurotrauma has been the signature wound in returning soldiers from the ongoing wars in Iraq and Afghanistan. Of importance is understanding the pathomechansim(s of blast overpressure (OP induced axonal injury. Although several recent animal models of blast injury indicate the neuronal and axonal injury in various brain regions, animal studies related to axonal injury in the white matter (WM tracts of cervical spinal cord are limited. Objective: The purpose of this study was to assess the extent of axonal injury in WM tracts of cervical spinal cord in male Sprague Dawley rats subjected to a single insult of blast OP. Materials and Methods: Sagittal brainstem sections and horizontal cervical spinal cord sections from blast and sham animals were stained by neurofilament light (NF-L chain and beta amyloid precursor protein immunocytochemistry and observed for axonal injury changes. Results: Observations from this preliminary study demonstrate axonal injury changes in the form of prominent swellings, retraction bulbs, and putative signs of membrane disruptions in the brainstem and cervical spinal cord WM tracts of rats subjected to blast OP. Conclusions: Prominent axonal injury changes following the blast OP exposure in brainstem and cervical spinal WM tracts underscores the need for careful evaluation of blast induced injury changes and associated symptoms. NF-L immunocytochemistry can be considered as an additional tool to assess the blast OP induced axonal injury.

  11. Reduced field-of-view DTI segmentation of cervical spine tissue.

    Science.gov (United States)

    Tang, Lihua; Wen, Ying; Zhou, Zhenyu; von Deneen, Karen M; Huang, Dehui; Ma, Lin

    2013-11-01

    The number of diffusion tensor imaging (DTI) studies regarding the human spine has considerably increased and it is challenging because of the spine's small size and artifacts associated with the most commonly used clinical imaging method. A novel segmentation method based on the reduced field-of-view (rFOV) DTI dataset is presented in cervical spinal canal cerebrospinal fluid, spinal cord grey matter and white matter classification in both healthy volunteers and patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). Due to each channel based on high resolution rFOV DTI images providing complementary information on spinal tissue segmentation, we want to choose a different contribution map from multiple channel images. Via principal component analysis (PCA) and a hybrid diffusion filter with a continuous switch applied on fourteen channel features, eigen maps can be obtained and used for tissue segmentation based on the Bayesian discrimination method. Relative to segmentation by a pair of expert readers, all of the automated segmentation results in the experiment fall in the good segmentation area and performed well, giving an average segmentation accuracy of about 0.852 for cervical spinal cord grey matter in terms of volume overlap. Furthermore, this has important applications in defining more accurate human spinal cord tissue maps when fusing structural data with diffusion data. rFOV DTI and the proposed automatic segmentation outperform traditional manual segmentation methods in classifying MR cervical spinal images and might be potentially helpful for detecting cervical spine diseases in NMO and MS.

  12. Combined total ankle replacement and modified bridle tendon transfer for end-stage ankle joint arthrosis with paralytic dropfoot: report of an unusual case.

    Science.gov (United States)

    Bibbo, Christopher; Baronofsky, Hyim J; Jaffe, Leland

    2011-01-01

    In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.

  13. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: roberto1766@interfree.it [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: t.popolizio1@gmail.com [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: paoladaprile@yahoo.it [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)

    2015-05-15

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  14. Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    YANG Da-long; DING Wen-yuan; ZHANG Ying-ze; ZHANG Wei; XU Jia-xin; SHEN Yong

    2013-01-01

    Background Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments.The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated.However,no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty.This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.Methods We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty.Sixty patients who underwent Bryan cervical disc arthroplasty were included.The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group).All of the patients were followed up for more than 18 months.Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle,range of movement (ROM),and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).Results Clinical outcomes in the investigational group were significantly superior to those in the control group.There were no significant differences in the FSU angle and ROM (P=-0.41 and 0.16,respectively) between the two groups.However,the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).Conclusions Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty.This procedure does not have a large effect on imbalance and motion of the cervical spine.

  15. LECTURE ON ACUPUNCTURE PartⅠ Clinical Acupuncture Lecture Thirty-fiveCervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    罗汀; 王卫; 徐力

    2004-01-01

    @@ Cervical spondylopathy, also known as cervical syndrome, is a commonly encountered disease in the middle-aged and elderly people. This disease mostly results from the retrograde affection of the cervical intervertebral disc and hyperosteogeny of the cervical vertebrae. This hyperplastic substance may stimulate and give rise to oppression to the surrounding spinal cord, nerve roots, blood vessels and sympathetic nerves, resulting in a series of symptoms as numbness, pain, etc. in the neck, shoulder and the upper limbs. The cervical vertebra of the human spine is smallest in the size, weakest in the strength, higher in the motor range and frequency, and bigger in the bearing of per unit area. Along with the increasing of people's age and the accumulated aftereffect of chronic and acute injury, the pulpiform nucleus of the cervical intervertebral disc presents retrograde affection, dehydration, bulge and rupture of the fibrous ring, narrowing of the intervertebral space, and reduction in the stability of cervical vertebrae due to injury and slackening of intervertebral ligaments to stretch and to induce compression upon periosteum. All these changes may lead to break of blood vessels to cause bleeding and hematoma. With the organization of hematoma and calcium salt deposit, osteophyte is formed at last. When the protruded intervertebral disc and hyperplastic osteophyte stimulate and oppress the surrounding spinal nerve root, vertebral artery or spinal cord, the resultant injury, aseptic inflammation, reactions after renovation, etc. will generate a series of clinical symptoms of cervical spondylopathy. In Western medicine, there are five types of cervical spondylopathy including stiff-neck type, nerve root type, spinal cord type, vertebral artery type and sympathetic nerve type. The stiff-neck type, nerve root type and vertebral artery type will be introduced in this article.

  16. 髓内外减压在有脊髓信号改变的颈椎后纵韧带骨化症中的疗效分析%Efficacy of intramedullary and extramedullary decompression on cervical ossification of the posterior longitudinal ligament with spinal cord signal change

    Institute of Scientific and Technical Information of China (English)

    焦根龙; 李志忠; 潘永勤; 周志刚; 孙国栋; 卲建立; 周霖

    2013-01-01

    Objective To evaluate the clinical effect of different surgical approaches for treating cervical ossification of the posterior longitudinal ligament (OPLL) with spinal cord signal change. Methods Thirty-eight patients with OPLL with spinal cord signal change were treated from January 2005 to January 2011. Surgical removal via an anterior approach or partial decompression was performed in 10 cases (group A), posterior approach open-door laminoplasty with decompression, bone grafting and internal fixation was performed in 12 cases (group B), and opening the cervical spinal meninges to relieve the pressure was performed in 16 cases (group C) on the basis of the procedures in group B. All the patients were followed up and the pre- and postoperative JOA scores, improvement ratio and inter-body implant fusion were evaluated. Imaging examinations including X-rays, CT and MRI were also performed pre- and postoperatively, and the surgical complications were recorded. Results At 12 months postoperatively, the mean improvement rates in groups A, B, and C were 52.39%, 55.15%, and 60.32%, respectively, with the mean JOA scores of 13.54 ± 0.56, 13.56 ± 1.26, and 14.70 ± 1.41, respectively. The JOA scores and improvement rates significantly increased after the surgeries. One patient in group A became paraplegic after the operation with cerebrospinal fluid leakage, and one patient in group B and one in group C reported numbness of the upper limb. Group C showed a shorter postoperative recovery time without severe complications. Conclusion Posterior open-door laminoplasty, decompression, bone grafting and internal fixation can be an effective approach for treatment of cervical OPLL with spinal cord signal change and requires shorter rehabilitation time after the operation.%目的观察不同手术方式在治疗有脊髓信号改变的颈椎后纵韧带骨化症(OPLL)的疗效,为临床选择手术方式提供依据。方法随访自2005年1月~2011年1月治疗

  17. Spinal infections

    Energy Technology Data Exchange (ETDEWEB)

    Tali, E. Turgut E-mail: turguttali@gazi.edu.tr

    2004-05-01

    Spinal infections can be thought of as a spectrum of disease comprising spondylitis, discitis, spondylodiscitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy and myelitis. Radiological evaluations have gained importance in the diagnosis, treatment planning, treatment and treatment monitoring of the spinal infections. Conventional radiographs are usually the initial imaging study. The sensitivity and specificity of the plain radiographs are very low. The sensitivity of CT is higher while it lacks of specificity. Conventional CT has played minor role for the diagnosis of early spondylitis and disc space infection and for follow-up, researches are going on the value of MDCT. MRI is as sensitive, specific and accurate as combined nuclear medicine studies and the method of choice for the spondylitis. Low signal areas of the vertebral body, loss of definition of the end plates and interruption of the cortical continuity, destruction of the cortical margins are typical on T1WI whereas high signal of affected areas of the vertebral body and disc is typical on T2WI. Contrast is mandatory and increases conspicuity, specificity, and observer confidence in the diagnosis and facilitates the treatment planning. Contrast enhancement is the earliest sign and pathognomonic in the acute inflammatory episode and even in the subtle infection then persists to a varying degree for several weeks or months. The outcome of the treatment is influenced by the type of infection and by the degree of neurologic compromise before treatment. There is an increasing move away from surgical intervention towards conservative therapy, percutaneous drainage of abscess or both. It is therefore critical to monitor treatment response, particularly in the immuno-deficient population.

  18. Preliminary observation of effects of extrace from inflammatory cutaneous tissues of the rabbit inoculated with vaccina virus in the treatment of hyperextension injuries of cervical spinal cord%牛痘疫苗接种家兔炎症皮肤提取物早期治疗颈髓过伸伤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    接健; 陈福扬; 冯玉旭; 徐国浩; 王梅生

    2014-01-01

    Objective To explore the preliminary clinical effects of extrace from inlfammatory cutaneous tissues of the rabbit inoculated with vaccina virus, also called Neurotropin ( NTP ) in the treatment of hyperextension injuries of cervical spinal cord. Methods From January 2010 to January 2014, 20 patients with hyperextension injuries of cervical spinal cord were adopted, who were randomly divided into the NTP group and the control group. Traction was performed on the patients in the NTP group for 3 weeks and then plaster ifxation for 3 months, besides the NTP treatment. Occipital-jaw-traction was performed on the patients in the control group for 3 weeks and then plaster fixation for 3 months. The Visual Analogue Scale ( VAS ) was used to assess pain, limb numbness and electrified sensation in both groups, and the scores before the treatment and at the end of traction and treatment were recorded and compared. Results The VAS scores of pain, limb numbness and electriifed sensation in the NTP group were ( 6.2±1.81 ) points, ( 5.3±1.15 ) points and ( 5.4±0.84 ) points before the treatment, which were obviously reduced to ( 1.2±0.78 ) points, ( 1.6±0.84 ) points and ( 0.6±0.51 ) points at the end of traction. The differences between them were statistically signiifcant ( P0.05 ). The VAS scores of pain, limb numbness and electriifed sensation in the NTP group were ( 1.3±0.98 ) points, ( 1.8±0.86 ) points and ( 0.5±0.49 ) points at the end of treatment, which were respectively lower than ( 2.6±0.49 ) points, ( 2.9±1.26 ) points and ( 1.8±0.76 ) points in the control group. The differences between them were statistically signiifcant ( P<0.05 ). Cervical spine alignment was restored in all the patients when the plaster was removed, and the cervical spine was stable. No cervical unstability, pneumonia or bedsore occurred. According to the Frankel grading system, 2 of the 3 patients rated as grade A underwent NTP treatment, and the last one did not. The improvement in

  19. Thyroid cancer after x-ray treatment of benign disorders of the cervical spine in adults

    Energy Technology Data Exchange (ETDEWEB)

    Damber, Lena; Johansson, Lennart; Johansson, Robert; Larsson, Lars-Gunnar [Univ. Hospital, Umeaa (Sweden). Oncology Centre

    2002-02-01

    While there is very good epidemiological evidence for induction of thyroid cancer by radiation exposure in children, the risk for adults after exposure is still uncertain, especially when concerning relatively small radiation doses. A cohort of 27415 persons which in 1950 through 1964 had received x-ray treatment for various benign disorders in the locomotor system (such as painful arthrosis and spondylosis) was selected from three hospitals in Northern Sweden. A proportion of this cohort, consisting of 8144 persons (4075 men and 4069 women), had received treatment to the cervical spine and thereby received an estimated average dose in the thyroid gland of about 1 Gy. Standard incidence rates (SIR) were calculated by using the Swedish Cancer Register. In the cervical spine cohort, 22 thyroid cancers were found versus 13.77 expected (SIR 1.60; CI 1.00-2.42). The corresponding figures for women were 16 observed cases versus 9.60 expected cases (SIR 1.67; CI 0.75-2.71). Most thyroid cancers (15 out of 22) were diagnosed >15 years after the exposure. In the remaining part of the total cohort, i.e. those without cervical spine exposure, no increased risk of thyroid cancer was found (SIR 0.98; CI 0.64-1.38). The study strongly suggests that external radiation exposure of adults at relatively small doses increases the risk of thyroid cancer but also that this increase is very much lower than that reported after exposure in children.

  20. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  1. Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  2. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

  3. Comparison of Naloxone and Thyrotropin-Releasing Hormone in the Treatment of Experimental Spinal Injury: Endogenous Opioids and Experimental Spinal Injury.

    Science.gov (United States)

    1983-09-30

    For these reasons we evaluated TRH treatment in a feline model of cervical spinal cord injury (8). Animals treated with -1...photomicrograph of lung illustrates severe pulmonary edema. Alveoli are filled with an eosinophilic , proteinaceous fluid. Scattered macrophages are...compression trauma to the feline spinal cord. J Neurosurg 55:200-208, 1981 26. Meyer GA, Berman IR, Dote DB, et al: Hemodynamic responses to acute

  4. Measuring methods and classification in the muscoskeletal radiology; Messverfahren und Klassifikationen in der muskuloskelettalen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, Simone; Eiber, Matthias; Woertler, Klaus [Klinikum rechts der Isar der Technischen Univ. Muenchen (TUM), Muenchen (Germany). Inst. fuer Radiologie

    2011-07-01

    The book on measuring methods and classification in the musculoskeletal radiology covers the following topics: legs; hip joint; knee joint; foot; shoulder joint; elbow joint; wrist joint; spinal column; craniocervical transition region and cervical spine; muscular-skeletal carcinomas; osteoporosis; arthrosis; articular cartilage; hemophilia; rheumatic arthritis; muscular injuries; skeleton age.

  5. Intramedullary spinal cord primitive neuroectodermal tumor presenting with hydrocephalus.

    Science.gov (United States)

    Alexiou, George A; Siozos, George; Stefanaki, Kalliopi; Moschovi, Maria; Prodromou, Neofytos

    2013-02-01

    Spinal primitive neuroectodermal tumors are exceedingly rare. Herewith, we present the first case of an intramedullary spinal cord tumor associated with hydrocephalus in a 2-month-old boy that presented with left hemiparesis. The patient had been diagnosed on prenatal ultrasound with enlarged ventricular system. At his current admission, a brain magnetic resonance imaging (MRI) revealed hydrocephalus and an intramedullary lesion extending from the second cervical to the first thoracic vertebrae. Dissemination of the tumor was revealed intracranially and in the spinal canal. After a ventriculoperitoneal shunt placement a radical resection of the tumor was performed, however some small tumor remnants could not be safely removed. Postoperative there was no neurologic deterioration. The tumor was diagnosed as a central nervous system primitive neuroectodermal tumor (World Health Organization grade IV). Spinal intramedullary primitive neuroectodermal tumors are extremely rare. In such rare tumors, multiinstitutional studies are needed for treatment guidelines to be established.

  6. Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse.

    Science.gov (United States)

    Johnson, Jeremiah; Patel, Shnehal; Saraf-Lavi, Efrat; Aziz-Sultan, Mohammad Ali; Yavagal, Dileep R

    2015-07-01

    Posterior spinal artery (PSA) aneurysms are a rare cause of subarachnoid hemorrhage (SAH). The commonly abused street drug 3,4-methylenedioxymethamphetamine (MDMA) or 'Ecstasy' has been linked to both systemic and neurological complications. A teenager presented with neck stiffness, headaches and nausea after ingesting 'Ecstasy'. A brain CT was negative for SAH but a CT angiogram suggested cerebral vasculitis. A lumbar puncture showed SAH but a cerebral angiogram was negative. After a spinal MR angiogram identified abnormalities on the dorsal surface of the cervical spinal cord, a spinal angiogram demonstrated a left PSA 2 mm fusiform aneurysm. The patient underwent surgery and the aneurysmal portion of the PSA was excised without postoperative neurological sequelae. 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, SAH and potentially even de novo aneurysm formation and subsequent rupture. PSA aneurysms may be treated by endovascular proximal vessel occlusion or open surgical excision.

  7. MRI findings in the upper cervical spine of rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kawaida, Hidefumi; Sakou, Takashi; Morizono, Yoshiyuki; Yoshikuni, Nagatoshi; Taketomi, Eiji; Hashiguchi, Masanao

    1989-04-01

    In 55 patients with rheumatoid arthritis associated with upper cervical spine abnormality, the presence or absence of medullary and upper cervical pressures was examined on sagittal MRI scans. Atlanto-dental anterior incomplete dislocation and horizontal dislocation were imaged concurrently with X-rays. For horizontal dislocation, an abnormal Redlund-Johnell value and a Ranawat value of 7 mm or less were always associated with medullary pressure as seen on MRI. For anterior incomplete dislocation, upper cervical pressure was always associated when a space available for the spinal cord was 13 mm or less or frequently associated when the atlanto-dental interval was 8 mm or more. Many of the patients with the upper cervical abnormalities complained of occipital or cervical pain. The pain was always encountered in patients with an abnormal Redlund-Johnell value. Roentgenography of the cervical spine confirmed MRI-proven medullary or upper cervical pressure, suggesting the potential of MRI in the treatment of rheumatoid arthritis. (Namekawa, K).

  8. Adjacent-level arthroplasty following cervical fusion.

    Science.gov (United States)

    Rajakumar, Deshpande V; Hari, Akshay; Krishna, Murali; Konar, Subhas; Sharma, Ankit

    2017-02-01

    OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1-3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2-7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow

  9. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  10. Spinal cord injury in Parkour sport (free running: a rare case report

    Directory of Open Access Journals (Sweden)

    Derakhshan Nima

    2014-06-01

    Full Text Available A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient’s muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome. Key words: Spinal cord injuries; Cervical vertebrae; Athletic injuries

  11. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  12. MRI of acute cervical injury: correlation with neurologic deficit

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Chang Dong; Kwon, Soon Tae; Lim, Seung Chul; Shin, Myung Jin; Han, Boo Kyung; Kim, Sang Joon; Park, Man Soo; Yoon, Hyun Ki; Suh, Dae Chul [Asan Medical Center University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1Wl (TR/TE: 500/20), gradient-echo (TR/TE: 300/14), sagittal T1Wl (TR/TE: 500/20), proton (TR/TE: 2000. 20 msec), T2Wl (TR/TE: 2000/80) were performed. In 11 patients, post-enhancement T1Wl was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. 15 patients had flexion injury, seven had extension injury and three had injury of unknown mechanism. Twelve patients showed iso-signal intensity on T2Wl and high signal intensity on T2Wl. Three patients showed low signal intensity on T1Wl and high signal intensity on T2Wl. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16 (64%), 17 (68%), 15 (60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6 (eight patients) and C5 (five patients). MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent.

  13. Spinal osteoblastoma: relationship between paravertebral muscle abnormalities and scoliosis

    Energy Technology Data Exchange