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Sample records for cervical spinal interneurons

  1. Spinal surgery -- cervical - series (image)

    Science.gov (United States)

    ... on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine problems include: pain that interferes with daily ...

  2. Primitive roles for inhibitory interneurons in developing frog spinal cord

    OpenAIRE

    Li, W-C; Higashijima, S-I; Parry, DM; Roberts, A.; Soffe, SR

    2004-01-01

    Understanding the neuronal networks in the mammal spinal cord is hampered by the diversity of neurons and their connections. The simpler networks in developing lower vertebrates may offer insights into basic organization. To investigate the function of spinal inhibitory interneurons in Xenopus tadpoles, paired whole-cell recordings were used.We show directly that one class of interneuron, with distinctive anatomy, produces lycinergic, negative feedback inhibition that can limit firing in moto...

  3. Spinal Inhibitory Interneuron Diversity Delineates Variant Motor Microcircuits.

    Science.gov (United States)

    Bikoff, Jay B; Gabitto, Mariano I; Rivard, Andre F; Drobac, Estelle; Machado, Timothy A; Miri, Andrew; Brenner-Morton, Susan; Famojure, Erica; Diaz, Carolyn; Alvarez, Francisco J; Mentis, George Z; Jessell, Thomas M

    2016-03-24

    Animals generate movement by engaging spinal circuits that direct precise sequences of muscle contraction, but the identity and organizational logic of local interneurons that lie at the core of these circuits remain unresolved. Here, we show that V1 interneurons, a major inhibitory population that controls motor output, fractionate into highly diverse subsets on the basis of the expression of 19 transcription factors. Transcriptionally defined V1 subsets exhibit distinct physiological signatures and highly structured spatial distributions with mediolateral and dorsoventral positional biases. These positional distinctions constrain patterns of input from sensory and motor neurons and, as such, suggest that interneuron position is a determinant of microcircuit organization. Moreover, V1 diversity indicates that different inhibitory microcircuits exist for motor pools controlling hip, ankle, and foot muscles, revealing a variable circuit architecture for interneurons that control limb movement. PMID:26949184

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

    OpenAIRE

    Zhang, Ling; Chen, Hai-Bin; Wang, Yi; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【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, ...

  5. Non-Contiguous Spinal Injury in Cervical Spinal Trauma: Evaluation with Cervical Spine MRI

    OpenAIRE

    Choi, Soo-Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang-Jin

    2004-01-01

    Objective 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. Materials and Methods 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, hyp...

  6. Preferred locomotor phase of activity of lumbar interneurons during air-stepping in subchronic spinal cats

    OpenAIRE

    AuYong, Nicholas; Ollivier-Lanvin, Karen; Lemay, Michel A.

    2010-01-01

    Spinal locomotor circuits are intrinsically capable of driving a variety of behaviors such as stepping, scratching, and swimming. Based on an observed rostrocaudal wave of activity in the motoneuronal firing during locomotor tasks, the traveling-wave hypothesis proposes that spinal interneuronal firing follows a similar rostrocaudal pattern of activation, suggesting the presence of spatially organized interneuronal modules within the spinal motor system. In this study, we examined if the spat...

  7. Synaptic and functional linkages between spinal premotor interneurons and hand-muscle activity during precision grip

    Directory of Open Access Journals (Sweden)

    Tomohiko Takei

    2013-04-01

    Full Text Available Grasping is a highly complex movement that requires the coordination of a number of hand joints and muscles. Previous studies showed that spinal premotor interneurons (PreM-INs in the primate cervical spinal cord have divergent synaptic effects on hand motoneurons and that they might contribute to hand-muscle synergies. However, the extent to which these PreM-IN synaptic connections functionally contribute to modulating hand-muscle activity is not clear. In this paper, we explored the contribution of spinal PreM-INs to hand-muscle activation by quantifying the synaptic linkage (SL and functional linkage (FL of the PreM-INs with hand-muscle activities. The activity of 23 PreM-INs was recorded from the cervical spinal cord (C6–T1, with EMG signals measured simultaneously from hand and arm muscles in two macaque monkeys performing a precision grip task. Spike-triggered averages (STAs of rectified EMGs were compiled for 456 neuron–muscle pairs; 63 pairs showed significant post-spike effects (i.e., SL. Conversely, 231 of 456 pairs showed significant cross-correlations between the IN firing rate and rectified EMG (i.e., FL. Importantly, a greater proportion of the neuron–muscle pairs with SL showed FL (43/63 pairs, 68% compared with the pairs without SL (203/393, 52%, and the presence of SL was significantly associated with that of FL. However, a significant number of pairs had SL without FL (SL∩!FL, n = 20 or FL without SL (!SL∩FL, n = 203, and the proportions of these incongruities exceeded the number expected by chance. These results suggested that spinal PreM-INs function to significantly modulate hand-muscle activity during precision grip, but the contribution of other neural structures is also needed to recruit an adequate combination of hand-muscle motoneurons.

  8. Acute Hydrocephalus Following Cervical Spinal Cord Injury

    OpenAIRE

    Son, Seong; Lee, Sang Gu; Park, Chan Woo; Kim, Woo Kyung

    2013-01-01

    We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drow...

  9. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  10. 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.

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

    International Nuclear Information System (INIS)

    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 (ρ > 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

  12. Preferred locomotor phase of activity of lumbar interneurons during air-stepping in subchronic spinal cats.

    Science.gov (United States)

    AuYong, Nicholas; Ollivier-Lanvin, Karen; Lemay, Michel A

    2011-03-01

    Spinal locomotor circuits are intrinsically capable of driving a variety of behaviors such as stepping, scratching, and swimming. Based on an observed rostrocaudal wave of activity in the motoneuronal firing during locomotor tasks, the traveling-wave hypothesis proposes that spinal interneuronal firing follows a similar rostrocaudal pattern of activation, suggesting the presence of spatially organized interneuronal modules within the spinal motor system. In this study, we examined if the spatial organization of the lumbar interneuronal activity patterns during locomotor activity in the adult mammalian spinal cord was consistent with a traveling-wave organizational scheme. The activity of spinal interneurons within the lumbar intermediate zone was examined during air-stepping in subchronic spinal cats. The preferred phase of interneuronal activity during a step cycle was determined using circular statistics. We found that the preferred phases of lumbar interneurons from both sides of the cord were evenly distributed over the entire step cycle with no indication of functional groupings. However, when units were subcategorized according to spinal hemicords, the preferred phases of units on each side largely fell around the period of extensor muscle activity on each side. In addition, there was no correlation between the preferred phases of units and their rostrocaudal locations along the spinal cord with preferred phases corresponding to both flexion and extension phases of the step cycle found at every rostrocaudal level of the cord. These results are consistent with the hypothesis that interneurons operate as part of a longitudinally distributed network rather than a rostrocaudally organized traveling-wave network. PMID:21084683

  13. Adenosine-mediated modulation of ventral horn interneurons and spinal motoneurons in neonatal mice.

    Science.gov (United States)

    Witts, Emily C; Nascimento, Filipe; Miles, Gareth B

    2015-10-01

    Neuromodulation allows neural networks to adapt to varying environmental and biomechanical demands. Purinergic signaling is known to be an important modulatory system in many parts of the CNS, including motor control circuitry. We have recently shown that adenosine modulates the output of mammalian spinal locomotor control circuitry (Witts EC, Panetta KM, Miles GB. J Neurophysiol 107: 1925-1934, 2012). Here we investigated the cellular mechanisms underlying this adenosine-mediated modulation. Whole cell patch-clamp recordings were performed on ventral horn interneurons and motoneurons within in vitro mouse spinal cord slice preparations. We found that adenosine hyperpolarized interneurons and reduced the frequency and amplitude of synaptic inputs to interneurons. Both effects were blocked by the A1-type adenosine receptor antagonist DPCPX. Analysis of miniature postsynaptic currents recorded from interneurons revealed that adenosine reduced their frequency but not amplitude, suggesting that adenosine acts on presynaptic receptors to modulate synaptic transmission. In contrast to interneurons, recordings from motoneurons revealed an adenosine-mediated depolarization. The frequency and amplitude of synaptic inputs to motoneurons were again reduced by adenosine, but we saw no effect on miniature postsynaptic currents. Again these effects on motoneurons were blocked by DPCPX. Taken together, these results demonstrate differential effects of adenosine, acting via A1 receptors, in the mouse spinal cord. Adenosine has a general inhibitory action on ventral horn interneurons while potentially maintaining motoneuron excitability. This may allow for adaptation of the locomotor pattern generated by interneuronal networks while helping to ensure the maintenance of overall motor output. PMID:26311185

  14. Traumatic neuropathy of second cervical spinal nerves.

    OpenAIRE

    Behrman, S

    1983-01-01

    The second cervical spinal nerves are unduly vulnerable to forcible approximation of the arches of the atlas and axis and to excessive rotation of the atlas on the axis. Sequelae of such injury include sensory aberrations ranging from loss of feeling to severe neuralgia and disorders of balance. Diagnosis of second cervical neuropathy may be difficult when there are multiple injuries to the cervical spine, but most cases clear up spontaneously within one to three years.

  15. Radiological evaluation of the cervical spinal trauma

    International Nuclear Information System (INIS)

    Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal

  16. Organization of projection-specific interneurons in the spinal cord of the red-eared turtle

    DEFF Research Database (Denmark)

    Nissen, Ulla Vig; Moldovan, Mihai; Hounsgaard, Jørn;

    2008-01-01

    Using differential retrograde axonal tracing, we identified motoneurons (MNs) and projection-specific interneuron (IN) classes in lumbar segment D9 of the adult red-eared turtle spinal cord. We characterized the distribution of these neurons in the transverse plane, and estimated their numbers and...

  17. Cryptic organisation within an apparently irregular rostrocaudal distribution of interneurons in the embryonic zebrafish spinal cord

    International Nuclear Information System (INIS)

    The molecules and mechanisms involved in patterning the dorsoventral axis of the developing vertebrate spinal cord have been investigated extensively and many are well known. Conversely, knowledge of mechanisms patterning cellular distributions along the rostrocaudal axis is relatively more restricted. Much is known about the rostrocaudal distribution of motoneurons and spinal cord cells derived from neural crest but there is little known about the rostrocaudal patterning of most of the other spinal cord neurons. Here we report data from our analyses of the distribution of dorsal longitudinal ascending (DoLA) interneurons in the developing zebrafish spinal cord. We show that, although apparently distributed irregularly, these cells have cryptic organisation. We present a novel cell-labelling technique that reveals that DoLA interneurons migrate rostrally along the dorsal longitudinal fasciculus of the spinal cord during development. This cell-labelling strategy may be useful for in vivo analysis of factors controlling neuron migration in the central nervous system. Additionally, we show that DoLA interneurons persist in the developing spinal cord for longer than previously reported. These findings illustrate the need to investigate factors and mechanisms that determine 'irregular' patterns of cell distribution, particularly in the central nervous system but also in other tissues of developing embryos.

  18. Cryptic organisation within an apparently irregular rostrocaudal distribution of interneurons in the embryonic zebrafish spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Wells, Simon, E-mail: simon.wells@adelaide.edu.au [Discipline of Genetics, School of Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia 5005 (Australia); The Special Research Centre for the Molecular Genetics of Development, University of Adelaide, Adelaide, South Australia 5005 (Australia); Conran, John G., E-mail: john.conran@adelaide.edu.au [Ecology and Evolutionary Biology, School of Earth and Environmental Sciences, University of Adelaide, Adelaide, South Australia 5005 (Australia); Tamme, Richard, E-mail: rtamme@ttu.ee [Discipline of Genetics, School of Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia 5005 (Australia); Gaudin, Arnaud, E-mail: a.gaudin@uq.edu.au [School of Biomedical Sciences, University of Queensland, Brisbane, Queensland 4072 (Australia); Webb, Jonathan, E-mail: jonathan.webb@worc.ox.ac.uk [Discipline of Genetics, School of Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia 5005 (Australia); Lardelli, Michael, E-mail: michael.lardelli@adelaide.edu.au [Discipline of Genetics, School of Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia 5005 (Australia); The Special Research Centre for the Molecular Genetics of Development, University of Adelaide, Adelaide, South Australia 5005 (Australia)

    2010-11-15

    The molecules and mechanisms involved in patterning the dorsoventral axis of the developing vertebrate spinal cord have been investigated extensively and many are well known. Conversely, knowledge of mechanisms patterning cellular distributions along the rostrocaudal axis is relatively more restricted. Much is known about the rostrocaudal distribution of motoneurons and spinal cord cells derived from neural crest but there is little known about the rostrocaudal patterning of most of the other spinal cord neurons. Here we report data from our analyses of the distribution of dorsal longitudinal ascending (DoLA) interneurons in the developing zebrafish spinal cord. We show that, although apparently distributed irregularly, these cells have cryptic organisation. We present a novel cell-labelling technique that reveals that DoLA interneurons migrate rostrally along the dorsal longitudinal fasciculus of the spinal cord during development. This cell-labelling strategy may be useful for in vivo analysis of factors controlling neuron migration in the central nervous system. Additionally, we show that DoLA interneurons persist in the developing spinal cord for longer than previously reported. These findings illustrate the need to investigate factors and mechanisms that determine 'irregular' patterns of cell distribution, particularly in the central nervous system but also in other tissues of developing embryos.

  19. Identification of Multiple Subsets of Ventral Interneurons and Differential Distribution along the Rostrocaudal Axis of the Developing Spinal Cord

    NARCIS (Netherlands)

    C. Francius (Cédric); A Harris (Anna); V. Rucchin (Vincent); T.J. Hendricks (Timothy); F.J. Stam (Floor); M. Barber (Melissa); D. Kurek (Dorota); F.G. Grosveld (Frank); A. Pierani (Alessandra); J. Goulding (John); F. Clotman (Frédéric)

    2013-01-01

    textabstractThe spinal cord contains neuronal circuits termed Central Pattern Generators (CPGs) that coordinate rhythmic motor activities. CPG circuits consist of motor neurons and multiple interneuron cell types, many of which are derived from four distinct cardinal classes of ventral interneurons,

  20. Morphometric analysis of the cervical spinal canal on MRI.

    Science.gov (United States)

    Matveeva, Niki; Janevski, Petar; Nakeva, Natasha; Zhivadinovik, Julija; Dodevski, Ace

    2013-01-01

    Two useful numerical values, called the Torg ratio and the spinal canal diameter (SC diameter) are widely accepted as reliable morphometric determinants of spinal stenosis. The aims of the study were to examine morphometric determinants of the cervical spinal canal on MRI in both sexes and analyse them as reliable indicators of spinal stenosis. Measurements were made on 50 MR images (sagittal T2 weighted images from C3 to C7) of the cervical spine of patients from the Emergency Centre who had undertaken MRI of the cervical spine in addition to CT for various diagnostic indications. Torg ratio, used in evaluation of the spinal canal stenosis on plain x-ray radiographs, cannot be used as a spinal canal stenosis indicator due to the gender differences in the vertebral bodies' width. Sagittal canal diameters were more spread out in males than in females. MRI enables the value of the space available for the spinal cord, (SAC) to be determined, by subtracting the sagittal diameter of the spinal cord from the sagittal diameter of the spinal canal. Not gender, but individual and level differences in the SAC values were evident (cervical cord enlargement). SAC values relied more on the spinal canal than on the spinal cord, so that the differences in the dimensions of the spinal cord accounted for less variability in the SAC values. MR imaging of the cervical spine provides more accurate cervical canal and spinal cord measurements that could serve as morphometric determinants of the cervical canal stenosis. PMID:24280784

  1. Interactions between pathways controlling posture and gait at the level of spinal interneurones in the cat.

    Science.gov (United States)

    Jankowska, E; Edgley, S

    1993-01-01

    The properties of three interneuronal populations controlling posture and locomotion are briefly reviewed. These are interneurones mediating reciprocal inhibition of antagonistic muscles and interneurones in pathways from secondary muscle spindle afferents to ipsilateral and contralateral motoneurones, respectively. It will be shown that these interneurones subserve a variety of movements, with functionally specialized subpopulations being selected under different conditions. Mechanisms for gating the activity of these neurones appear to be specific for each of them but to act in concert. Interneurones which are active during locomotion and postural reactions are distributed over many segments of the spinal cord and over several of Rexed's laminae, both in the intermediate zone and in the ventral horn (Berkinblit et al., 1978; Bayev et al., 1979; Schor et al., 1986; Yates et al., 1989). The location of neurones discharging during neck and labyrinthine reflexes is illustrated in Fig. 1A and B but indications that neurones with an even wider distribution contribute to locomotion, scratching and the related postural reactions have been provided by neuronal markers which preferentially label active neurones (WGA-HRP; see Noga et al., 1987) or neurones with active genetic transcription (c-fos; I. Barajon, personal communication; Dai et al., 1991). Such a wide distribution indicates a high degree of non-homogeneity, since neurones of different functional types are usually located in different laminae. It has been demonstrated that some of these neurones may be particularly important for setting up the rhythm of muscle contractions specific for different gaits or scratching, as part of their "pattern generators" (see, e.g., Grillner, 1981). Other neurones may be primarily involved in initiation of these movements or in postural adjustments combined with them. A considerable proportion of neurones mediating these movements are nevertheless likely to be used not in one

  2. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    Directory of Open Access Journals (Sweden)

    Jung-Ju Huang

    2004-07-01

    Full Text Available Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical spondylosiswho were operated on via an anterior route were enrolled to evaluate thecomplexity, safety, and clinical results. The collected parameters were operationtime, blood loss, hospital days, and early and late complications forevaluating the operative complexity, radiographic follow-up for evaluatingfusion, graft problems, implants problems, and the recovery rate using theJapanese Orthopaedic Association score (JOA score for evaluating the operativeresults.Results: The mean operation time was 363.4 min, and blood loss was 431.4 ml. Anearly complication was noted in 1 patient with combined deep vein thrombosisand a pulmonary embolism. Late complications were screw breakage in1 patient and screw loosening in 5 patients. The mean duration of follow-upwas 21.9 months. The mean recovery rate of the JOA score was 38.8% postoperativelyand 51.9% at the final follow-up. The fusion rate was 100% inthis series.Conclusions: Anterior cervical decompression and fusion for multilevel stenosis requires alonger operation time than posterior procedures; however, the clinical resultsare satisfactory.

  3. Cervical spinal cord compression after thyroidectomy under general anesthesia.

    Science.gov (United States)

    Yao, Wenlong; Qiu, Jin; Zhou, Zhiqiang; Zhang, Lin; Zhang, Chuanhan

    2014-02-01

    Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery. PMID:23828450

  4. 360-degree cervical spinal arthrodesis for treatment of pediatric cervical spinal tuberculosis with kyphosis

    OpenAIRE

    Zeng, Hao; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Zhang, Yupeng; Liu, Zheng; Wang, Xiyang; Cao, Yong

    2016-01-01

    Background There is limited evidence to guide treatment for pediatric cervical spinal tuberculosis with kyphosis (PCSTK). This study retrospectively evaluates the safety, feasibility and efficacy of 360-degree arthrodesis combined with anterior debridement and decompression for treating PCSTK, while simultaneously emphasizing the role of posterior fixation for the correction and maintenance of the kyphosis angle. Methods From May 2006 to December 2012, a total of 12 children with PCSTK underw...

  5. Repeated early thrombolysis in cervical spinal cord ischemia.

    Science.gov (United States)

    Etgen, Thorleif; Höcherl, Constanze

    2016-07-01

    Specific therapy of acute spinal ischemia is not established. We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery. Three days later she developed again a severe right-sided sensorimotor hemiparesis and a second off-label intravenous thrombolysis was repeated. Magnetic resonance imaging revealed a right-sided posterior-lateral cervical spinal ischemia. Spinal ischemia may clinically present with a cerebral-stroke-like picture challenging diagnostic and therapeutic procedure. Systemic thrombolysis might be a treatment option in acute spinal ischemia. In addition, early repeated systemic thrombolysis may be considered in selected strokes. PMID:26762860

  6. Spinal CT scan, 1. Cervical and thoracic spines

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    Nakagawa, Hiroshi (Aichi Medical Univ. (Japan))

    1982-01-01

    Methods of CT of the cervical and thoracic spines were explained, and normal CT pictures of them were described. Spinal CT was evaluated in comparison with other methods in various spinal diseases. Plain CT revealed stenosis due to spondylosis or ossification of posterior longitudinal ligament and hernia of intervertebral disc. CT took an important role in the diagnosis of spinal cord tumors with calcification and destruction of the bone. CT scan in combination with other methods was also useful for the diagnosis of spinal injuries, congenital anomalies and infections.

  7. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs

    International Nuclear Information System (INIS)

    Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space

  8. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  9. MRI of anterior spinal artery syndrome of the cervical spinal cord

    International Nuclear Information System (INIS)

    Cervical spinal cord lesions in the anterior spinal artery syndrome were delineated on magnetic resonance images (MRI) in four patients. The lesion was always seen anteriorly in the cervical cord. On T2-weighted images, the lesions appeared hyperintense relative to the normal spinal cord, while on T1-weighted images, two chronic lesions appeared hypointense, with local atrophy of the cord. In one case, repeated T1-weighted images showed no signal abnormality 4 days after the ictus, but the lesion became hypointense 18 days later, when contrast enhancement was also recognized after injection of Gd-DTPA; this sequence of intensity changes was similar to that of cerebral infarction. The extent of the lesion seen MRI correlated closely with neurological findings in all cases. Although the findings may not be specific, MRI is now the modality of choice for confirming the diagnosis in patients suspected of having an anterior spinal artery syndrome. (orig.)

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

    OpenAIRE

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

    2015-01-01

    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 ar...

  11. Radiation tolerance of the cervical spinal cord

    International Nuclear Information System (INIS)

    A total of 109 patients were studied after receiving radiation therapy that included a dose to the spinal cord. In addition to irradiation of the primary site, 59 patients received radiation to the lower neck. Transverse myelopathy developed in three patients; all three had been treated with fields to the lower neck. The dose to the spinal cord at the site of junctional fields was thought to be considerably higher because of the beam divergence from multiple fields employed. The authors stress that prolonged fractionation of treatment, fixation of the head during treatment, precise dosimetry, and close surveillance of the patient are important factors in avoiding radiation myelitis. The authors also stress the importance of controlling divergence of multiple beams by employing appropriate shields

  12. Radiation tolerance of the cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y.H.; Fayos, J.V.

    1981-05-01

    A total of 109 patients were studied after receiving radiation therapy that included a dose to the spinal cord. In addition to irradiation of the primary site, 59 patients received radiation to the lower neck. Transverse myelopathy developed in three patients; all three had been treated with fields to the lower neck. The dose to the spinal cord at the site of junctional fields was thought to be considerably higher because of the beam divergence from multiple fields employed. The authors stress that prolonged fractionation of treatment, fixation of the head during treatment, precise dosimetry, and close surveillance of the patient are important factors in avoiding radiation myelitis. The authors also stress the importance of controlling divergence of multiple beams by employing appropriate shields.

  13. Intramedullary sarcoidosis of the cervical spinal cord.

    OpenAIRE

    Vighetto, A; Fischer, G.; Collet, P.; Bady, B; Trillet, M

    1985-01-01

    A 26-year-old male with a history of pulmonary sarcoidosis showed clinical, myelographic and intra-operative evidence of a C5-C6 spinal cord tumour, which was diagnosed by biopsy as a pure intramedullary granuloma. Among the 29 published cases of histologically proven cord sarcoidosis, only five presented with pure parenchymatous infiltration without meningeal involvement. Corticosteroids are the most useful therapy, and surgery is indicated only for minimal biopsy when the parenchyma is inva...

  14. The effects of anodal transcranial direct current stimulation and patterned electrical stimulation on spinal inhibitory interneurons and motor function in patients with spinal cord injury.

    Science.gov (United States)

    Yamaguchi, Tomofumi; Fujiwara, Toshiyuki; Tsai, Yun-An; Tang, Shuen-Chang; Kawakami, Michiyuki; Mizuno, Katsuhiro; Kodama, Mitsuhiko; Masakado, Yoshihisa; Liu, Meigen

    2016-06-01

    Supraspinal excitability and sensory input may play an important role for the modulation of spinal inhibitory interneurons and functional recovery among patients with incomplete spinal cord injury (SCI). Here, we investigated the effects of anodal transcranial direct current stimulation (tDCS) combined with patterned electrical stimulation (PES) on spinal inhibitory interneurons in patients with chronic incomplete SCI and in healthy individuals. Eleven patients with incomplete SCI and ten healthy adults participated in a single-masked, sham-controlled crossover study. PES involved stimulating the common peroneal nerve with a train of ten 100 Hz pulses every 2 s for 20 min. Anodal tDCS (1 mA) was simultaneously applied to the primary motor cortex that controls the tibialis anterior muscle. We measured reciprocal inhibition and presynaptic inhibition of a soleus H-reflex by stimulating the common peroneal nerve prior to tibial nerve stimulation, which elicits the H-reflex. The inhibition was assessed before, immediately after, 10 min after and 20 min after the stimulation. Compared with baseline, simultaneous application of anodal tDCS with PES significantly increased changes in disynaptic reciprocal inhibition and long-latency presynaptic inhibition in both healthy and SCI groups for at least 20 min after the stimulation (all, p < 0.001). In patients with incomplete SCI, anodal tDCS with PES significantly increased the number of ankle movements in 10 s at 20 min after the stimulation (p = 0.004). In conclusion, anodal tDCS combined with PES could induce spinal plasticity and improve ankle movement in patients with incomplete SCI. PMID:26790423

  15. Ca2+ -Mediated Plateau Potentials in a Subpopulation of Interneurons in the Ventral Horn of the Turtle Spinal Cord

    DEFF Research Database (Denmark)

    Hounsgaard, J.; Kjaerulff, O.

    1992-01-01

    The response properties of interneurons in the ventral horn were studied in transverse slices of segments D8 to S2 from the turtle spinal cord, using the current clamp technique. In about half of the neurons the response properties were dominated by their ability to generate plateau potentials. In...

  16. Sparing of descending axons rescues interneuron plasticity in the lumbar cord to allow adaptive learning after thoracic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Christopher Nelson Hansen

    2016-03-01

    Full Text Available This study evaluated the role of spared axons on structural and behavioral neuroplasticity in the lumbar enlargement after a thoracic spinal cord injury (SCI. Previous work has demonstrated that recovery in the presence of spared axons after an incomplete lesion increases behavioral output after a subsequent complete spinal cord transection (TX. This suggests that spared axons direct adaptive changes in below-level neuronal networks of the lumbar cord. In response to spared fibers, we postulate that lumbar neuron networks support behavioral gains by preventing aberrant plasticity. As such, the present study measured histological and functional changes in the isolated lumbar cord after complete TX or incomplete contusion (SCI. To measure functional plasticity in the lumbar cord, we used an established instrumental learning paradigm. In this paradigm, neural circuits within isolated lumbar segments demonstrate learning by an increase in flexion duration that reduces exposure to a noxious leg shock. We employed this model using a proof-of-principle design to evaluate the role of sparing on lumbar learning and plasticity early (7 days or late (42 days after midthoracic SCI in a rodent model. Early after SCI or TX at 7d, spinal learning was unattainable regardless of whether the animal recovered with or without axonal substrate. Failed learning occurred alongside measures of cell soma atrophy and aberrant dendritic spine expression within interneuron populations responsible for sensorimotor integration and learning. Alternatively, exposure of the lumbar cord to a small amount of spared axons for 6 weeks produced near-normal learning late after SCI. This coincided with greater cell soma volume and fewer aberrant dendritic spines on interneurons. Thus, an opportunity to influence activity-based learning in locomotor networks depends on spared axons limiting maladaptive plasticity. Together, this work identifies a time dependent interaction between

  17. Induced Pluripotent Stem Cell Therapies for Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Vanessa M. Doulames

    2016-04-01

    Full Text Available Cervical-level injuries account for the majority of presented spinal cord injuries (SCIs to date. Despite the increase in survival rates due to emergency medicine improvements, overall quality of life remains poor, with patients facing variable deficits in respiratory and motor function. Therapies aiming to ameliorate symptoms and restore function, even partially, are urgently needed. Current therapeutic avenues in SCI seek to increase regenerative capacities through trophic and immunomodulatory factors, provide scaffolding to bridge the lesion site and promote regeneration of native axons, and to replace SCI-lost neurons and glia via intraspinal transplantation. Induced pluripotent stem cells (iPSCs are a clinically viable means to accomplish this; they have no major ethical barriers, sources can be patient-matched and collected using non-invasive methods. In addition, the patient’s own cells can be used to establish a starter population capable of producing multiple cell types. To date, there is only a limited pool of research examining iPSC-derived transplants in SCI—even less research that is specific to cervical injury. The purpose of the review herein is to explore both preclinical and clinical recent advances in iPSC therapies with a detailed focus on cervical spinal cord injury.

  18. Induced Pluripotent Stem Cell Therapies for Cervical Spinal Cord Injury.

    Science.gov (United States)

    Doulames, Vanessa M; Plant, Giles W

    2016-01-01

    Cervical-level injuries account for the majority of presented spinal cord injuries (SCIs) to date. Despite the increase in survival rates due to emergency medicine improvements, overall quality of life remains poor, with patients facing variable deficits in respiratory and motor function. Therapies aiming to ameliorate symptoms and restore function, even partially, are urgently needed. Current therapeutic avenues in SCI seek to increase regenerative capacities through trophic and immunomodulatory factors, provide scaffolding to bridge the lesion site and promote regeneration of native axons, and to replace SCI-lost neurons and glia via intraspinal transplantation. Induced pluripotent stem cells (iPSCs) are a clinically viable means to accomplish this; they have no major ethical barriers, sources can be patient-matched and collected using non-invasive methods. In addition, the patient's own cells can be used to establish a starter population capable of producing multiple cell types. To date, there is only a limited pool of research examining iPSC-derived transplants in SCI-even less research that is specific to cervical injury. The purpose of the review herein is to explore both preclinical and clinical recent advances in iPSC therapies with a detailed focus on cervical spinal cord injury. PMID:27070598

  19. Neural Precursor Cell Transplantation Enhances Functional Recovery and Reduces Astrogliosis in Bilateral Compressive/Contusive Cervical Spinal Cord Injury

    OpenAIRE

    Wilcox, Jared T.; Satkunendrarajah, Kajana; Zuccato, Jeffrey A.; Nassiri, Farshad; Fehlings, Michael G.

    2014-01-01

    This study examined the effects of neural precursor cell (NPC) transplants in a rodent model of bilateral cervical contusion-compression spinal cord injury. Transplantation of NPCs in the bilaterally injured cervical spinal cord resulted in significantly improved spinal cord tissue composition and forelimb function and warrants study in preclinical cervical models to improve this treatment paradigm for clinical translation.

  20. Magnetic resonance imaging in cervical spinal cord compression

    Directory of Open Access Journals (Sweden)

    Giovanni Giammona

    1993-09-01

    Full Text Available In patients with cervical spondylotic myelopathy MRI sometimes shows increased signal intensity zones on the T2-weighted images. It has been suggested that these findings carry prognostic significance. We studied 56 subjects with cervical spinal cord compression. Twelve patients showed an increased signal intensity (21.4% and a prevalence of narrowing of the AP-diameter (62% vs 24%. Furthemore, in this group, there was evidence of a longer mean duration of the symptoms and, in most of the patients, of more serious clinical conditions. The importance of these predisposing factors remains, however, to be clarified since they are also present in some patients without the increased signal intensity.

  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. Use of quadrupedal step training to re-engage spinal interneuronal networks and improve locomotor function after spinal cord injury

    OpenAIRE

    Shah, Prithvi K.; Garcia-Alias, Guillermo; Choe, Jaehoon; Gad, Parag; Gerasimenko, Yury; Tillakaratne, Niranjala; Zhong, Hui; Roy, Roland R.; Edgerton, V. Reggie

    2013-01-01

    Can lower limb motor function be improved after a spinal cord lesion by re-engaging functional activity of the upper limbs? We addressed this issue by training the forelimbs in conjunction with the hindlimbs after a thoracic spinal cord hemisection in adult rats. The spinal circuitries were more excitable, and behavioural and electrophysiological analyses showed improved hindlimb function when the forelimbs were engaged simultaneously with the hindlimbs during treadmill step-training as oppos...

  3. 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.

  4. Technique and results of the spinal computed tomography in the diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    We give a description of a technique of the patient's positioning with traction of the arms during the cervical spinal computed tomography which allows to draw the shoulders downwards by about one to three cervical segments. By this method the quality of the images can be improved in 96% in the cervical segment 6/7 and in 81% in the cervical/thoracal segment 7/1 to such a degree that a reliable judgement of the soft parts in the spinal canal becomes possible. The diagnostic reliability of the computed tomography of the cervical disc herniation is thus improved so that the necessity of a myelography is decreasing. The results of 396 cervical spinal computed tomographies are presented. (orig.)

  5. Pure traumatic upper cervical disc herniation causing spinal cord injury: a case report and review of literature

    OpenAIRE

    Sharifi, Guive; Mosavi, Seyed Ali; Shafieezad, Misagh; Asgari Nosari, Massoud

    2012-01-01

    Abstract: One third of all spinal injuries involve cervical vertebrae, and the impact of injury to the cervical spinal cord is profound and requires systemic treatment. The role and timing of surgical decompression after an acute spinal cord injury (SCI) remains one of the most controversial topics pertaining to spinal surgery. Lack of controlled, prospective, multicenter clinical studies has contributed to confusion in optimal treatment methods for patients with injuries of the cervical spin...

  6. 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.

  7. Electrophysiological and morphological characterization of propriospinal interneurons in the thoracic spinal cord

    DEFF Research Database (Denmark)

    Saywell, S A; Ford, T W; Meehan, Claire Francesca;

    2011-01-01

    neuromuscular blockade and with the respiratory drive stimulated by inhaled CO(2). The majority of the interneurons were shown by antidromic activation to have axons descending for at least two to four segments, mostly contralateral to the soma. In all, 81% of the neurons showed postsynaptic potentials (PSPs......) to stimulation of intercostal or dorsal ramus nerves of the same segment for low-threshold (= 5T) afferents. A monosynaptic component was present for the majority of the peripherally evoked excitatory PSPs. A central respiratory drive potential was present in most of the recordings, usually of small...

  8. The diameters of the cervical spinal cord shown by Amipaque-myelography

    International Nuclear Information System (INIS)

    The sagittal and cross diameters of the cervical spinal cord were measured in 53 patients with cervical nerve root compression and with no evidence of spinal cord involvement, as well as in 45 patients with spastic tetraparesis and no localised space occupying lesion, and 29 patients with myelographically proven cervical myelography. The true diameters were calculated by the known magnification factor (1:1,4). Patients with spastic tetraparesis showed diameters in normal ranges, as well as widened or diminished sizes of the cord. Some of the patients with cervical myelopathy showed diminished diameters in the caudal parts. This may be a hint for a poor outcome after decompression operation. (orig.)

  9. MR spectroscopy of cervical spinal cord in patients with multiple sclerosis

    International Nuclear Information System (INIS)

    MR spectroscopy (MRS) of the brain in patients with multiple sclerosis has been well studied. However, in vivo MRS of the spinal cord in patients with MR spectroscopy has not been reported to our knowledge. We performed MRS of normal-appearing cervical spinal cords in multiple sclerosis patients and in healthy controls. N-acetyl aspartate was shown to be reduced within the cervical spinal cord of multiple sclerosis patients when compared with healthy controls. This finding supports axonal loss and damage within even normal-appearing spinal cords of multiple sclerosis patients. (orig.)

  10. Interneurons and proprioneurons in the adult human spinal grey matter and in the general somatic and visceral afferent cranial nerve nuclei.

    OpenAIRE

    Abdel-Maguid, T E; Bowsher, D

    1984-01-01

    Using the classification of Abdel-Maguid & Bowsher (1984), interneurons of the dorsal horn of the grey matter of the human spinal cord and medulla oblongata were found to belong to only three 'families' of neurons, out of a possible thirteen. This is in itself one of the justifications for the method of classification. Functional identification of these human neurons has been made on the basis of topological, morphological and projectional comparison with known cells in other mammalian specie...

  11. Motoneuron BDNF/TrkB Signaling Enhances Functional Recovery after Cervical Spinal Cord Injury

    OpenAIRE

    Mantilla, Carlos B.; Gransee, Heather M.; Zhan, Wen-Zhi; Sieck, Gary C.

    2013-01-01

    A C2 cervical spinal cord hemisection (SH) interrupts descending inspiratory-related drive to phrenic motoneurons located between C3 and C5 in rats, paralyzing the ipsilateral hemidiaphragm muscle. There is gradual recovery of rhythmic diaphragm muscle activity ipsilateral to cervical spinal cord injury over time, consistent with neuroplasticity and strengthening of spared, contralateral descending premotor input to phrenic motoneurons. Brainderived neurotrophic factor (BDNF) signaling throug...

  12. '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. PMID:7089756

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

    OpenAIRE

    Yisheng W; Fuying Z; Limin W; Junwei Li; Guofu P; Weidong W

    2007-01-01

    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 frac...

  14. Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury

    OpenAIRE

    West, CR; Goosey-Tolfrey, VL; Campbell, IG; Romer, LM

    2014-01-01

    West CR, Goosey-Tolfrey VL, Campbell IG, Romer LM. Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury. J Appl Physiol 117: 36–45, 2014. First published May 22, 2014; doi:10.1152/japplphysiol.00218.2014.—We asked whether elastic binding of the abdomen influences respiratory mechanics during wheelchair propulsion in athletes with cervical spinal cord injury (SCI). Eight Paralympic wheelchair rugby players with m...

  15. EFFECTS OF CHANGES IN HIP POSITION ON ACTIONS OF SPINAL INHIBITORY INTERNEURONS IN HUMANS

    OpenAIRE

    Knikou, Maria

    2006-01-01

    The aim of the present study was to establish whether in healthy human subjects the actions of group I muscle afferents arising from the same spinal segments as the soleus innervation (e.g., common peroneal nerve; CPN) or from more proximal spinal segments (femoral nerve; FN) on the soleus H-reflex are modified by changes in hip position. Control and conditioned soleus H-reflexes were elicited and recorded via conventional methods. In seated subjects, CPN and FN stimulation resulted in simila...

  16. ARE SUBJECTS WITH SPONDYLOTIC CERVICAL CORD ENCROACHMENT AT INCREASED RISK OF CERVICAL SPINAL CORD INJURY AFTER MINOR TRAUMA?

    OpenAIRE

    Bednarik, Josef; Kadanka, Zdenek; Sladkova, Dagmar; Dusek, Ladislav; Kerkovsky, Milos; Vohanka, Stanislav; Urbanek, Igor; Nemec, Martin; Novotny, Oldrich

    2010-01-01

    Abstract The aim of the study was to analyse the risk of symptomatic myelopathy after minor trauma in patients with asymptomatic spondylotic cervical spinal cord encroachment (ASCCE). In a cohort of 199 patients with ASCCE, previously followed prospectively in a study investigating progression into symptomatic myelopathy, we now looked retrospectively for traumatic episodes that may have involved injury to the cervical spine. A questionnaire and data file analysis were employed to ...

  17. The 'double tackle'--another cause of serious cervical spinal injury in rugby players. Case reports.

    Science.gov (United States)

    Scher, A T

    1983-10-01

    The rugby player who is simultaneously tackled by 2 opponents is more susceptible to cervical spinal and spinal cord injury than the player tackled by a single opponent. The reasons for this increased susceptibility are described. Two illustrative case reports are presented. PMID:6623252

  18. Diffusion Tensor Imaging of Mouse Brain Stem and Cervical Spinal Cord

    OpenAIRE

    Kim, Joong Hee; Haldar, Justin; Liang, Zhi-Pei; Song, Sheng-Kwei

    2008-01-01

    In vivo diffusion tensor imaging measurements of the mouse brain stem and cervical spinal cord are presented. Utilizing actively decoupled transmit/receive coils, high resolution diffusion images (117 × 59 × 500 μm3) were acquired at 4.7 T within an hour. Both brain stem and cervical spine displayed clear gray-white matter contrast. The cervical spinal cord white matter showed similar tissue characteristics as seen in the thoracic cord. The coherent fiber orientation in the white matter was o...

  19. Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

    OpenAIRE

    Shilton, Michael; Branney, Jonathan; de Vries, Bas Penning; Breen, Alan C

    2015-01-01

    Background The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Methods Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy vo...

  20. Lhermitte's sign: Incidence and treatment variables influencing risk after irradiation of the cervical spinal cord

    International Nuclear Information System (INIS)

    Lhermitte's sign is a relatively infrequent sequela of irradiation of the cervical spinal cord. In this study, the authors sought to determine whether various treatment parameters influenced the likelihood of developing Lhermitte's sign. Between October 1964 and December 1987, 2901 patients with malignancies of the upper respiratory tract were treated at the University of Florida. The dose of radiation to the cervical spinal cord was calculated for those patients who had a minimum 1-year follow-up. A total of 1112 patients who received a minimum of 3000 cGy to at least 2 cm of cervical spinal cord were included in this analysis. Forty patients (3.6%) developed Lhermitte's sign. The mean time to development of Lhermitte's sign after irradiation was 3 months, and the mean duration of symptoms was 6 months. No patient with Lhermitte's sign developed transverse myelitis. Several variables were examined in a univariate analysis, including total dose to the cervical spinal cord, length of cervical spinal cord irradiated, dose per fraction, continuous-course compared with split-course radiotherapy, and once-daily compared with twice-daily irradiation. Only two variables proved to be significant. Six (8%) of 75 patients who received > 5000 cGy to the cervical spinal cord developed Lhermitte's sign compared with 34 (3.3%) of 1037 patients who received < 5000 cGy (p = .04). For patients treated with once-daily fractionation, 28 (3.4%) of 821 patients who received < 200 cGy per fraction developed Lhermitte's sign compared with 6 (10%) of 58 patients who received ≥ 200 cGy (p = .02). An increased risk of developing Lhermitte's sign was demonstrated for patients who received either ≥ 200 cGy per fraction (one fraction per day) or ≥ 5000 cGy total dose to the cervical spinal cord. 29 refs., 1 fig., 5 tabs

  1. Are subjects with spondylotic cervical cord encroachment at increased risk of cervical spinal cord injury after minor trauma?

    Science.gov (United States)

    Bednařík, Josef; Sládková, Dagmar; Kadaňka, Zdeněk; Dušek, Ladislav; Keřkovský, Miloš; Voháňka, Stanislav; Novotný, Oldřich; Urbánek, Igor; Němec, Martin

    2011-07-01

    The aim of the study was to analyse the risk of symptomatic myelopathy after minor trauma in patients with asymptomatic spondylotic cervical spinal cord encroachment (ASCCE). In a cohort of 199 patients with ASCCE, previously followed prospectively in a study investigating progression into symptomatic myelopathy, the authors looked retrospectively for traumatic episodes that may have involved injury to the cervical spine. A questionnaire and data file analysis were employed to highlight whatever hypothetical relationship might emerge with the development of symptomatic myelopathy. Fourteen traumatic episodes in the course of a follow-up of 44 months (median) were recorded in our group (who had been instructed to avoid risky activities), with no significant association with the development of symptomatic myelopathy (found in 45 cases). Only three minor traumatic events without fracture of the cervical spine were found among the symptomatic myelopathy cases, with no chronological relationship between trauma and myelopathy. Furthermore, 56 traumatic spinal cord events were found before the diagnosis of cervical cord encroachment was established, with no correlation to either type of compression (discogenic vs osteophytic). In conclusion, the risk of spinal cord injury after minor trauma of the cervical spine in patients with ASCCE appeared to be low in our cohort provided risky activities in these individuals are restricted. Implementation of preventive surgical decompression surgery into clinical practice in these individuals should be postponed until better-designed studies provide proof enough for it to take precedence over a conservative approach. PMID:20587498

  2. Coexpression of auxiliary subunits KChIP and DPPL in potassium channel Kv4-positive nociceptors and pain-modulating spinal interneurons.

    Science.gov (United States)

    Cheng, Chau-Fu; Wang, Wan-Chen; Huang, Chia-Yi; Du, Po-Hau; Yang, Jung-Hui; Tsaur, Meei-Ling

    2016-03-01

    Subthreshold A-type K(+) currents (ISA s) have been recorded from the somata of nociceptors and spinal lamina II excitatory interneurons, which sense and modulate pain, respectively. Kv4 channels are responsible for the somatodendritic ISA s. Accumulative evidence suggests that neuronal Kv4 channels are ternary complexes including pore-forming Kv4 subunits and two types of auxiliary subunits: K(+) channel-interacting proteins (KChIPs) and dipeptidyl peptidase-like proteins (DPPLs). Previous reports have shown Kv4.3 in a subset of nonpeptidergic nociceptors and Kv4.2/Kv4.3 in certain spinal lamina II excitatory interneurons. However, whether and which KChIP and DPPL are coexpressed with Kv4 in these ISA -expressing pain-related neurons is unknown. In this study we mapped the protein distribution of KChIP1, KChIP2, KChIP3, DPP6, and DPP10 in adult rat dorsal root ganglion (DRG) and spinal cord by immunohistochemistry. In the DRG, we found colocalization of KChIP1, KChIP2, and DPP10 in the somatic surface and cytoplasm of Kv4.3(+) nociceptors. KChIP3 appears in most Aβ and Aδ sensory neurons as well as a small population of peptidergic nociceptors, whereas DPP6 is absent in sensory neurons. In the spinal cord, KChIP1 is coexpressed with Kv4.3 in the cell bodies of a subset of lamina II excitatory interneurons, while KChIP1, KChIP2, and DPP6 are colocalized with Kv4.2 and Kv4.3 in their dendrites. Within the dorsal horn, besides KChIP3 in the inner lamina II and lamina III, we detected DPP10 in most projection neurons, which transmit pain signal to brain. The results suggest the existence of Kv4/KChIP/DPPL ternary complexes in ISA -expressing nociceptors and pain-modulating spinal interneurons. PMID:26239200

  3. Enhanced cervical MRI in identifying intracranial dural arteriovenous fistulae with spinal perimedullary venous drainage

    International Nuclear Information System (INIS)

    Diagnosis of an intracranial dural arteriovenous fistula (DAVF) with spinal perimedullary venous drainage is challenging because the presenting symptoms are usually related to dysfunction of the spine, not of the brain. Repeated spinal angiograms are usually performed before the diagnosis is finally made by cerebral angiography. We report two cases of intracranial DAVFs with spinal perimedullary venous drainage. In both cases contrast-enhanced cervical MRI demonstrated dilated lower brainstem and upper spinal veins, which, we believe, is a good indicator of the existence of such drainage. We suggest that, in cases with perimedullary serpentine enhancement on thoracic or lumbar MR images, additional Gd-enhanced cervical spinal MR imaging should be performed. The simple process of tracing the veins upwards may avoid a lot of unnecessary examinations and delay in the diagnosis. (orig.)

  4. Numerical model of the human cervical spinal cord--the development and validation.

    Science.gov (United States)

    Czyż, Marcin; Scigała, Krzysztof; Jarmundowicz, Włodzimierz; Będziński, Romuald

    2011-01-01

    The influence of mechanical load on the extent of nervous tissue damage in the spinal cord at the time of trauma is presently incontestable. Although numerical modelling cannot fully replace physical testing, it seems to be the perfect complement to experiments in terms of the analysis of such a complex phenomenon as traumatic spinal cord injury. Previous numerical models of the human cervical spinal cord have been limited by several factors: two-dimensional modelling, spinal cord geometry simplification and incomplete reflection of specific anatomical and biomechanical relations of the objects being modelled. The objective of this study was to develop and validate an accurate and universal numerical Finite Element Method (FEM) model of the human cervical spinal cord. Our survey focuses mainly on geometric, constraint and material aspects. Experimental validation was carried out based on a controlled compression of the porcine spinal cord specimens. Each stage of compression was simulated using the FEM model of the compressed segment. Our 3D numerical simulation results compared with experimental results show a good agreement. It is possible to use the developed numerical model of the human cervical spinal cord in the biomechanical analysis of the spinal cord injury phenomenon. However, further clinical evaluation is clearly justified. PMID:22339282

  5. Magnetic resonance imaging of the cervical and thoracic spine and the spinal cord

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MR), using a 0.3 T resistive scanner with an iron core and a vertical magnetic field, was evaluated in patients with different diseases affecting the cervical and thoracic spine and the spinal cord. The results indicate that MR is well suited as the procedure of choice for emergency examination of patients with spinal cord symptoms, for examination of patients with suspected spinal multiple sclerosis and for pre-operative evaluation of patients with rheumatoid arthritis with neurological symptoms emanating from the cranio-cervical junction. In patients with cervical radiculapathy and/or myelopathy, caused by spondylosis or disk herniation, MR was found to be equivalent with myelography and CT myelography but MR has several practical advantages. MR at 0.3 T using a vertical magnetic field provided information comparable to that reported from examinations performed with superconducting MR scanners. In order to optimize the MR examinations of the spine, the signal characteristics of different coils available when using a vertical magnetic field were determined by phantom studies. Recommendations for optimal coil selection for different levels of the cervical and thoracic spine are given. In addition, the paramagnetic contrast medium gadolinium-DTPA was administered intravenously to patients with suspected spinal multiple sclerosis. Enhancement of clinically active lesions in the cervical spinal cord was observed. Serial MR examinations with gadolinium-DTPA showed that a decrease in enhancement could be correlated with decrease in clinical symptoms and signs. (author)

  6. 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.

  7. SURGICAL ANATOMY OF DORSAL ROOT ENTRY ZONE OF CERVICAL SPINAL NERVES : CADAVERIC STUDY

    OpenAIRE

    A Arun Kumar; Sudha Seshayyan; V.Tamilalagan; Sindou, M

    2014-01-01

    Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five...

  8. SSFSE sequence functional MRI of the human cervical spinal cord with complex finger tapping

    International Nuclear Information System (INIS)

    Purpose: Functional MR imaging of the human cervical spinal cord was carried out on volunteers during alternated rest and a complex finger tapping task, in order to detect image intensity changes arising from neuronal activity. Methods: Functional MR imaging data using single-shot fast spin-echo sequence (SSFSE) with echo time 42.4 ms on a 1.5 T GE Clinical System were acquired in eight subjects performing a complex finger tapping task. Cervical spinal cord activation was measured both in the sagittal and transverse imaging planes. Postprocessing was performed by AFNI (Analysis of Functional Neuroimages) software system. Results: Intensity changes (5.5-7.6%) were correlated with the time course of stimulation and were consistently detected in both sagittal and transverse imaging planes of the cervical spinal cord. The activated regions localized to the ipsilateral side of the spinal cord in agreement with the neural anatomy. Conclusion: Functional MR imaging signals can be reliably detected with finger tapping activity in the human cervical spinal cord using a SSFSE sequence with 42.4 ms echo time. The anatomic location of neural activity correlates with the muscles used in the finger tapping task.

  9. An Incidental Finding of a Radiopaque Pill following Cervical Spinal Surgery in a Parkinson's Disease Patient.

    Science.gov (United States)

    Gu, Bon Sub; Choi, Soo-Jung; Yoo, Byoungwoo; Han, Koon Hee; Park, Jong Kyu; Lee, Young-Seok; Park, Jin Hoon

    2015-09-01

    There are previous reports of the identification of radiopaque medications on abdominal X-rays or computed tomography (CT). We describe an interesting case of the incidental identification of a radiopaque medication on cervical spinal CT following cervical spinal surgery. A sixty seven-year-old male patient with Parkinson's disease (PD) visited our emergency center with a C5-6 dislocation and fracture. Surgery was performed with open reduction and pedicle screw fixation through the posterior approach. No abnormal events occurred during the perioperative period. However, a radiopaque incidental foreign body in front of the C6 vertebrae was found on a cervical spinal CT and X-rays that were performed as routine examinations on postoperative day 3. After 6 hours, we performed gastrofibroscopy (GFS) but were unable to find anything. Therefore, we checked all of his medications related to the neck and check X-ray again. One enteric-coated pill he had taken exhibited strong radiodensity. Although our patient underwent an unnecessary GFS, every spinal surgeon should keep in mind that radiopaque pills can appear similar to spinal instruments on X-ray and CT. In addition, we should also know the associated dysphagia is a possible cause of the delayed passage of medicine in PD with or without cervical osteophytes. PMID:26512272

  10. 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. PMID:27008321

  11. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  13. Bilateral Contusion-Compression Model of Incomplete Traumatic Cervical Spinal Cord Injury

    OpenAIRE

    Forgione, Nicole; Karadimas, Spyridon K.; Foltz, Warren D; Satkunendrarajah, Kajana; Lip, Alyssa; Fehlings, Michael G.

    2014-01-01

    Despite the increasing incidence and prevalence of cervical spinal cord injury (cSCI), we lack clinically relevant animal models that can be used to study the pathomechanisms of this injury and test new therapies. Here, we characterize a moderate cervical contusion-compression model in rats that is similar to incomplete traumatic cSCI in humans. We characterized the effects of 18-g clip-compression injury at cervical level C6 over an 8-week recovery period. Using Luxol fast blue/hematoxylin-e...

  14. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    International Nuclear Information System (INIS)

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO2 measurements (pO2 histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO2 values were pooled, and overall median pO2 values and fractions of hypoxic pO2 values ≤ 5 mm Hg were calculated. Overall median pO2 values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO2 values, median intratumoral pO2 values, and the fractions of hypoxic pO2 values ≤ 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO2 values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO2 measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O2-related efficacy of high-dose-rate brachytherapy. (orig.)

  15. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weitmann, H.D.; Knocke, T.H.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, Univ. of Vienna, General Hospital of Vienna (Austria); Gustorff, B. [Dept. of Anesthesia and General Intensive Care B, Univ. of Vienna, General Hospital of Vienna (Austria); Vaupel, P. [Inst. of Physiology and Pathophysiology, Univ. of Mainz (Germany)

    2003-09-01

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO{sub 2} measurements (pO{sub 2} histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO{sub 2} values were pooled, and overall median pO{sub 2} values and fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg were calculated. Overall median pO{sub 2} values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO{sub 2} values, median intratumoral pO{sub 2} values, and the fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO{sub 2} values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO{sub 2} measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O{sub 2}-related efficacy of high-dose-rate brachytherapy. (orig.)

  16. Role Of Cervical Paraspinal Electromyography In Cervical Spinal Root Avulsions And Its Correlations With Intra Operative Findings

    OpenAIRE

    Arulmozhi T; Dhanaraj M; Jayavelu A

    2004-01-01

    The diagnosis of cervical spinal root avulsion in patients with brachial plexus injuries is major challenge of the present day with the available investigatory procedures. To validate the use of the paraspinal electromyography was done in20 successive patients who all had sustained injuries to their upper limb nerves following road traffic accidents. Electromyographic abnormalities indicative of root avulsion were identified. All of them underwent explorative surgery. The results of the par...

  17. 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.

  18. 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.

  19. Clinical application of a high-resolution positron emission tomography for cervical spinal cord lesions

    International Nuclear Information System (INIS)

    A high-resolution 18F-2-fluoro-deoxyglucose (FDG)-PET is possible in order for qualitative and quantitative estimation of impaired glucose metabolic activity of cervical spinal cord lesions. The imaging may be expected to offer some information on disturbed neuronal function in addition to the conventional MR imaging. (author)

  20. Stenosis of the cervical spinal canal in view of the cerebrispinal fluid dynamics

    Czech Academy of Sciences Publication Activity Database

    Kaczmarská, A.; Štěpáník, Z.; Vaněk, P.; Převorovská, Světlana; Maršík, František; Otáhal, J.

    Soul: Organizing Comitee of ISPRM 2007, 2007 - (Rah, W.), s. 299-300 [World Congress of International Society of Physical and Rehabilitation Medicine /4./. Soul (KR), 10.06.2007-14.06.2007] Institutional research plan: CEZ:AV0Z20760514 Keywords : cerebrospinal fluid dynamic * cervical spinal canal * stenosis Subject RIV: BK - Fluid Dynamics www.isprm2007.org

  1. Unexpected changes of rat cervical spinal cord tolerance caused by inhomogeneous dose distributions

    NARCIS (Netherlands)

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

    2003-01-01

    Purpose: The effects of dose distribution on dose-effect relationships have been evaluated and, from this, iso-effective doses (ED(50)) established. Methods and Materials: Wistar rats were irradiated on the cervical spinal cord with single doses of unmodulated protons (150MeV) to obtain sharp latera

  2. Unexpected changes of rat cervical spinal cord tolerance caused by inhomogeneous dose distributions.

    NARCIS (Netherlands)

    Bijl, H.P.; Luijk, P. van; Coppes, R.P.; Schippers, J.M.; Konings, A.W.T.; Kogel, A.J. van der

    2003-01-01

    PURPOSE: The effects of dose distribution on dose-effect relationships have been evaluated and, from this, iso-effective doses (ED(50)) established. METHODS AND MATERIALS: Wistar rats were irradiated on the cervical spinal cord with single doses of unmodulated protons (150 MeV) to obtain sharp later

  3. Congenital spondylolysis of the cervical spine with spinal cord compression: MR and CT studies

    International Nuclear Information System (INIS)

    Spondylolysis of the cervical spine is a rare disorder that is characterized by a defect in the articular mass between the superior and inferior facets of a cervical vertebra. It is considered to be congenital because it is usually associated with dysplastic changes, especially involving the posterior arch of the vertebra, which differentiates it from its traumatic equivalent. We present two cases of spondylolysis of the cervical spine without spondylolisthesis, which were studied by means of magnetic resonance (MR) and computerized tomography (CT). One patient showed contralateral involvement at two levels and the other had a single lesion presenting canal stenosis with chronic spinal cord compression, an unusual association in previously reported series. the combination of MR and CT makes it possible to limit the spectrum of bone changes and their impact on the spinal cord in these patients. (Author) 12 refs

  4. High resolution CT of the cervical spinal cord

    International Nuclear Information System (INIS)

    High resolution CT demonstrates the anatomy of the spine, spinal canal and spinal cord. In many cases, the non-contrast HRCT images provide enough information to guide patient management. Where necessary, intravenously-enhanced HRCT and metrizamide HRCT may be employed to gain additional data. Other studies may be obviated in many cases. (orig.)

  5. Suspected cervical spinal cord vascular anomaly in an African warthog (Phacochoerus africanus).

    Science.gov (United States)

    Whiteside, Douglas P; Shury, Todd K; Black, Sandra R; Raverty, Stephen

    2006-09-01

    Vascular myelopathies of the spinal cord have not been described in Suidae, and are a rare finding in companion animals. An 8.5-yr female African warthog (Phacochoerus africanus) presented with an acute onset of tetraparesis. Based on neurologic findings, a cervical spinal cord lesion between C7-T2 was suspected. Magnetic resonance imaging revealed severe intramedullary hemorrhage with suspected abnormal vessels in the spinal cord at the level of the seventh cervical vertebrae. The acute onset of clinical signs and rapid deterioration of neurological status precluded surgical managements. A vascular anomaly was suspected on gross pathology and histology. Immunohistochemistry identified the lesion as a spontaneous intramedullary hematoma. Spontaneous intramedullary hematomyelia should be considered as a differential for acute onset of paresis in suid species. PMID:17319141

  6. A rare, high cervical traumatic spinal subdural hematoma.

    Science.gov (United States)

    Berhouma, Moncef; Al Dahak, Nouman; Messerer, Rostom; Al Rammah, Mohamed; Vallee, Bernard

    2011-04-01

    Spinal subdural hematomas (SSDH) are rare lesions occurring in association with a wide variety of conditions, including anticoagulation, coagulation disorders, spinal anesthesia, lumbar puncture, spinal tumors and vascular malformations. SSDH resulting from trauma are the exception. We present a 62-year-old woman with a rare post-traumatic focal SSDH at C1 with bulbomedullary compression, treated successfully with surgery. A review of the literature revealed 26 patients with traumatic SSDH. The aim of this report is to describe the clinical presentation, imaging characteristics and management of traumatic SSDH. The controversial pathogenesis is also discussed. PMID:21277780

  7. 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

  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

    2002-06-01

    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 ( degrees ), 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 SAC was also significantly greater (P 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. The high rugby tackle--an avoidable cause of cervical spinal injury?

    Science.gov (United States)

    Scher, A T

    1978-06-17

    The type and circumstances of injury to 14 rugby players with cervical spinal cord damage sustained during a tackle have been analysed. Two specific mechanisms of injury were evident. Four players were injured when their heads collided with fixed objects while they were attempting to tackle an opponent. Ten players were injured while being tackled and 5 of them were tackled around the neck. The risk of trauma to the cervical spine caused by the force applied to the neck in a high tackle is discussed. The susceptibility of the ligaments of the cervical spine to the rotational force exerted during a high tackle is stressed. An amendment to the rules of rugby, which would reduce cervical trauma, is suggested. PMID:694671

  10. Targeted, activity-dependent spinal stimulation produces long-lasting motor recovery in chronic cervical spinal cord injury.

    Science.gov (United States)

    McPherson, Jacob G; Miller, Robert R; Perlmutter, Steve I

    2015-09-29

    Use-dependent movement therapies can lead to partial recovery of motor function after neurological injury. We attempted to improve recovery by developing a neuroprosthetic intervention that enhances movement therapy by directing spike timing-dependent plasticity in spared motor pathways. Using a recurrent neural-computer interface in rats with a cervical contusion of the spinal cord, we synchronized intraspinal microstimulation below the injury with the arrival of functionally related volitional motor commands signaled by muscle activity in the impaired forelimb. Stimulation was delivered during physical retraining of a forelimb behavior and throughout the day for 3 mo. Rats receiving this targeted, activity-dependent spinal stimulation (TADSS) exhibited markedly enhanced recovery compared with animals receiving targeted but open-loop spinal stimulation and rats receiving physical retraining alone. On a forelimb reach and grasp task, TADSS animals recovered 63% of their preinjury ability, more than two times the performance level achieved by the other therapy groups. Therapeutic gains were maintained for 3 additional wk without stimulation. The results suggest that activity-dependent spinal stimulation can induce neural plasticity that improves behavioral recovery after spinal cord injury. PMID:26371306

  11. Role Of Cervical Paraspinal Electromyography In Cervical Spinal Root Avulsions And Its Correlations With Intra Operative Findings

    Directory of Open Access Journals (Sweden)

    Arulmozhi T

    2004-01-01

    Full Text Available The diagnosis of cervical spinal root avulsion in patients with brachial plexus injuries is major challenge of the present day with the available investigatory procedures. To validate the use of the paraspinal electromyography was done in20 successive patients who all had sustained injuries to their upper limb nerves following road traffic accidents. Electromyographic abnormalities indicative of root avulsion were identified. All of them underwent explorative surgery. The results of the paraspinal electromyography were correlated with the intra-operative findings. Paraspinal electromyography was abnormal in six and normal in 14. All the six patients with abnormal results had evidence of multiple spinal root avulsion. Among those with normal paraspinal electromyography, two showed single spinal root avulsion and in the remaining 12 they were intact. The sensitivity of this test was 75% specificity 100% positive predictive value 100% and negative predictive value 85%. Paraspinal electromyography is an useful test in identifying cervical root avulsions because of its high positive predictive value. However with single root avulsion the sensitivity of the test falls. Somato sensory evoked potential and magnetic resonance imaging studies may be valuable adjuncts in diagnosing such cases.

  12. Comparison of Modic Changes in the Lumbar and Cervical Spine, in 3167 Patients with and without Spinal Pain

    OpenAIRE

    Sheng-yun, Li; Letu, Suyou; JIAN, CHEN; Mamuti, Maiwulanjiang; Jun-Hui, Liu; Zhi, Shan; Chong-yan, Wang; Shunwu, Fan; Zhao, Fengdong

    2014-01-01

    Background Context There are few comparisons of Modic changes (MCs) in the lumbar and cervical spine. Purpose Compare the prevalence of MCs in the lumbar and cervical spine, and determine how MC prevalence depends on spinal pain, age, disc degeneration, spinal level, and the presence or absence of kyphosis. Study Design Retrospective clinical survey. Materials and Methods Magnetic resonance images (MRIs) were compared from five patient groups: 1. 1223 patients with low-back pain/radiculopathy...

  13. 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

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

    International Nuclear Information System (INIS)

    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 accentuated

  15. MR imaging in neuroborreliosis of the cervical spinal cord

    International Nuclear Information System (INIS)

    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.)

  16. 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.)

  17. 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. PMID:20349681

  18. 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

    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...... mainly located laterally and increase towards the cervical enlargement....

  19. Data from subjects receiving intrathecal laronidase for cervical spinal stenosis due to mucopolysaccharidosis type I

    Directory of Open Access Journals (Sweden)

    P.I. Dickson

    2015-12-01

    Full Text Available Five subjects with mucopolysaccharidosis type I and symptomatic cervical spinal stenosis received intrathecal laronidase in a 4-month pilot study and/or a 12-month extension study [1]. Clinical descriptions of study subjects, nonserious adverse events, individual data tables, and scoring system methods are provided. There were ten nonserious adverse events that occurred in more than one study subject. Somatosensory evoked potentials were absent in two subjects and normal in two subjects, limiting their utility as an endpoint. There were no significant changes in magnetic resonance imaging of cervical spinal cord or brain, pulmonary function tests, or cerebrospinal fluid opening pressure. These data are presented along with the scoring methods used in evaluation of the study subjects.

  20. Data from subjects receiving intrathecal laronidase for cervical spinal stenosis due to mucopolysaccharidosis type I.

    Science.gov (United States)

    Dickson, P I; Kaitila, I; Harmatz, P; Mlikotic, A; Chen, A H; Victoroff, A; Passage, M B; Madden, J; Le, S Q; Naylor, D E

    2015-12-01

    Five subjects with mucopolysaccharidosis type I and symptomatic cervical spinal stenosis received intrathecal laronidase in a 4-month pilot study and/or a 12-month extension study [1]. Clinical descriptions of study subjects, nonserious adverse events, individual data tables, and scoring system methods are provided. There were ten nonserious adverse events that occurred in more than one study subject. Somatosensory evoked potentials were absent in two subjects and normal in two subjects, limiting their utility as an endpoint. There were no significant changes in magnetic resonance imaging of cervical spinal cord or brain, pulmonary function tests, or cerebrospinal fluid opening pressure. These data are presented along with the scoring methods used in evaluation of the study subjects. PMID:26484358

  1. Lumbar Epidural Steroid Injection for Painful Spasticity in Cervical Spinal Cord Injury: A Case Report

    OpenAIRE

    Bang, Hyun; Chun, Seong Min; Park, Hee Won; Bang, Moon Suk; Kim, Keewon

    2015-01-01

    We report a case of a 53-year-old male with traumatic cervical spinal cord injury (SCI). He could not maintain a standing position because of painful spasticity in his lower limbs. A magnetic resonance imaging and electromyography indicated chronic lumbosacral radiculopathy, explaining his chronic low back pain before the injury. For diagnostic as well as therapeutic purposes, transforaminal epidural steroid injection (ESI) to the right L5 root was performed. After the intervention, the spast...

  2. Alteration of Forebrain Neurogenesis after Cervical Spinal Cord Injury in the Adult Rat

    OpenAIRE

    ValeryAMatarazzo; PatrickGauthier

    2012-01-01

    Spinal cord injury (SCI) triggers a complex cellular response at the injury site, leading to the formation of a dense scar tissue. Despite this local tissue remodeling, the consequences of SCI at the cellular level in distant rostral sites (i.e. brain), remain unknown. In this study, we asked whether cervical SCI could alter cell dynamics in neurogenic areas of the adult rat forebrain. To this aim, we quantified BrdU incorporation and determined the phenotypes of newly generated cells (neuron...

  3. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury

    OpenAIRE

    Li, Le; LI, XIAOYAN; Liu, Jie; Zhou, Ping

    2015-01-01

    The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX) technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI). The MD-MUNIX was estimated from the compound muscle action potential (CMAP) and different levels of surface interference pattern electromyogram (EMG) at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI), thenar and hypothe...

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

    OpenAIRE

    Percio Ramón Becker Benitez; Celso Schmalfuss Nogueira; Ana Cristina Carvalho de Holanda; José Caio Santos

    2016-01-01

    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 correspondin...

  5. SURGICAL ANATOMY OF DORSAL ROOT ENTRY ZONE OF CERVICAL SPINAL NERVES : CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    A.Arun Kumar

    2014-06-01

    Full Text Available Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five adult formalin fixed cadavers are taken for this study. Conventional Spinal cord dissection is followed as per Cunningham’s Dissection Mannual. Findings: The parameters included are Number of dorsal rootlets, Longitudinal Length of DREZ, Distance between two successive DREZ, Length of dorsal rootlets, Distance between right and left DREZ, Distance between DREZ and Ligamentum denticulatum, Cranial angles of Superior & inferior rootlets. Results: Results were noted for all the parameters and are compared with the previous studies. The significant observations are obtained. Conclusion: Surgical anatomy of Dorsal Root Entry Zone (DREZ of cervical spinal nerves will be useful for the neurosurgeons doing Drezotomy procedure, in which the nociceptive fibres alone are specifically severed with preservation of other sensations

  6. Magnetisation transfer ratio measurement in the cervical spinal cord: a preliminary study in multiple sclerosis

    International Nuclear Information System (INIS)

    MRI readily detects the lesions of multiple sclerosis (MS) in the brain and spinal cord. Conventional MRI sequences do not, however, permit distinction between the various pathological characteristics (oedema, demyelination, axonal loss and gliosis) of lesions in MS. Magnetisation transfer (MT) imaging may be more specific in distinguishing the pathologies responsible for disability in MS, namely demyelination and axonal loss, and therefore may have a potential role in monitoring treatment. We have applied MT imaging to the cervical spinal cord to see if it is feasible to measure MT ratios (MTR) in this region where pathological changes may result in considerable disability. We studied 12 patients with MS and 12 age- and sex-matched normal controls using a sagittal T2-weighted fast spin-echo sequence with and without an MT pulse. The median value for cervical cord mean MTR measurement in normal controls was 19.30 % units (interquartile range 19.05-19.55), whereas values were significantly lower in MS patients (median = 17.95 % units, interquartile range 17.25-19.00, P 0.0004). There was a low intrarater variability for repeated mean MTR measurements. We conclude that it is possible to measure MTR in the cervical spinal cord, that a significant reduction occurs in patients with MS, and that there may be a role for this measure in future MS treatment trials. (orig.). With 2 figs., 1 tab

  7. 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.

  8. 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

  9. Cervical Posterior Spinal Artery Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Sakurai, Takeo; Wakida, Kenji; Nishida, Hiroshi

    2016-06-01

    We report a case of left upper cervical posterior spinal artery (PSA) syndrome caused by atherosclerosis of the left vertebral artery. A 70-year-old female experienced sudden dizziness and paralysis of the left upper and lower limbs. Diffusion-weighted magnetic resonance imaging (DWI) of the brain showed high signal intensity at the vermis and lower left hemisphere of the cerebellum, and magnetic resonance angiography showed that the entire left vertebral artery was thin. The patient was treated with an intravenous infusion of tissue plasminogen activator 2 hours after symptom onset and made a full recovery. Repeat DWI, fluid-attenuated inversion recovery images, and T2-weighted images showed high signal intensity in the left upper cervical PSA area from the lower medulla oblongata to the C2 level in addition to the cerebellum. Previously reported cases of cervical posterior artery syndrome are reviewed. PMID:27012218

  10. Safety of laronidase delivered into the spinal canal for treatment of cervical stenosis in mucopolysaccharidosis I.

    Science.gov (United States)

    Dickson, Patricia I; Kaitila, Ilkka; Harmatz, Paul; Mlikotic, Anton; Chen, Agnes H; Victoroff, Alla; Passage, Merry B; Madden, Jacqueline; Le, Steven Q; Naylor, David E

    2015-01-01

    Enzyme replacement therapy with laronidase (recombinant human alpha-l-iduronidase) is successfully used to treat patients with mucopolysaccharidosis type I (MPS I). However, the intravenously-administered enzyme is not expected to treat or prevent neurological deterioration. As MPS I patients suffer from spinal cord compression due in part to thickened spinal meninges, we undertook a phase I clinical trial of lumbar intrathecal laronidase in MPS I subjects age 8 years and older with symptomatic (primarily cervical) spinal cord compression. The study faced significant challenges, including a heterogeneous patient population, difficulty recruiting subjects despite an international collaborative effort, and an inability to include a placebo-controlled design due to ethical concerns. Nine serious adverse events occurred in the subjects. All subjects reported improvement in symptomatology and showed improved neurological examinations, but objective outcome measures did not demonstrate change. Despite limitations, we demonstrated the safety of this approach to treating neurological disease due to MPS I. PMID:26260077

  11. A SQUID biomagnetometer system for measurement of a human cervical spinal cord evoked field

    International Nuclear Information System (INIS)

    We developed a SQUID biomagnetometer system for detecting the magnetic signals evoked from the human cervix within the scope of non-invasive diagnosis of the function of the cervical spinal cord. The system has two main particular features. One is vector SQUID gradiometers and the other is a cryostat optimized for a reclining subject. The vector SQUID gradiometers can maximize the magnetic information acquired from the limited observation area around the neck and the shape of the new cryostat enables a subject to keep his/her position stably in a relaxed manner during the measurement. As a result, we successfully recorded the evoked magnetic fields corresponding to the neural signal travelling along the spinal cords from the necks of human subjects who were given electric stimuli to their thoracic spinal cords

  12. A SQUID biomagnetometer system for measurement of a human cervical spinal cord evoked field

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Y [Applied Electronics Laboratory, Kanazawa Institute of Technology, 3 Amaike, Kanazawa, Ishikawa 920-1331 (Japan); Kawai, J [Applied Electronics Laboratory, Kanazawa Institute of Technology, 3 Amaike, Kanazawa, Ishikawa 920-1331 (Japan); Uehara, G [Applied Electronics Laboratory, Kanazawa Institute of Technology, 3 Amaike, Kanazawa, Ishikawa 920-1331 (Japan); Ogata, H [Applied Electronics Laboratory, Kanazawa Institute of Technology, 3 Amaike, Kanazawa, Ishikawa 920-1331 (Japan); Miyamoto, M [Applied Electronics Laboratory, Kanazawa Institute of Technology, 3 Amaike, Kanazawa, Ishikawa 920-1331 (Japan); Kawabata, S [Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519 (Japan); Tomizawa, S [Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519 (Japan)

    2005-12-15

    We developed a SQUID biomagnetometer system for detecting the magnetic signals evoked from the human cervix within the scope of non-invasive diagnosis of the function of the cervical spinal cord. The system has two main particular features. One is vector SQUID gradiometers and the other is a cryostat optimized for a reclining subject. The vector SQUID gradiometers can maximize the magnetic information acquired from the limited observation area around the neck and the shape of the new cryostat enables a subject to keep his/her position stably in a relaxed manner during the measurement. As a result, we successfully recorded the evoked magnetic fields corresponding to the neural signal travelling along the spinal cords from the necks of human subjects who were given electric stimuli to their thoracic spinal cords.

  13. 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. PMID:9475983

  14. 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

  15. The correlation between evoked spinal cord potentials and magnetic resonance imaging before Surgery in cervical spondylotic myelopathy

    International Nuclear Information System (INIS)

    The purpose of this study is to clarify the correlation between electrophysiological examination and MRI diagnosis. Twenty-four patients with cervical spondylotic myelopathy were examined with magnetic resonance imaging and evoked spinal cord potentials (ESCPs) before surgery. In all the patients, only the intervertebral level was symptomatic, as shown by ESCPs. ESCPs following median nerve stimulation (MN-ESCPs), transcranial electric stimulation (TCE-ESCPs), and spinal cord stimulation (Spinal-ECSPs) were recorded. The patients were grouped into two groups as follows: group A, all ESCPs were abnormal; group B, normal spinal cord stimulation. Spinal cord transverse area and compression ratio (central and 1/4-lateral anteroposterior diameter divided by transverse diameter) were measured on T1-weighted axial imaging, with abnormal ESCPs as indicators of spinal cord morphology. Central and 1/4-lateral compression ratio was significantly lower in group A. Spinal cord morphology of magnetic resonance imaging is useful for functional diagnosis. (author)

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

    International Nuclear Information System (INIS)

    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

  17. 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.

  18. 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.

  19. Spontaneous Resolution of Non-traumatic Cervical Spinal Subdural Hematoma Presenting Acute Hemiparesis: A Case Report.

    Science.gov (United States)

    Park, Yong Jin; Kim, Seok Won; Ju, Chang Il; Wang, Hui Sun

    2012-09-01

    Spontaneous cervical SDH with no underlying pathology is a very unusual condition. To the best of the authors' knowledge, only two cases have been previously reported. A 48-year-old female patient was admitted to our emergency room due to severe neck pain following standing up position with rapid onset of hemiparesis. MRI revealed a dorsolateral subdural hematoma from C3-C5 with cord compression. An emergency laminectomy was planned, but motor weakness gradually improved during surgical preparation. The patient showed substantial clinical improvement and complete recovery was confirmed after 7 days of conservative management without surgical treatment. To determine a differential diagnosis distinct from other conditions such as cervical epidural hematoma, a lumbar spinal puncture was performed. Follow-up MRI performed 10 days after admission revealed complete resolution of the hematoma. We report an extremely rare case of spontaneous cervical spinal subdural hematoma (SDH), present a review of relevant literature, and discuss the etiology, pathogenesis, and prognosis of this case. PMID:25983826

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

    Science.gov (United States)

    Yisheng, W; Fuying, Z; Limin, W; Junwei, Li; Guofu, P; Weidong, W

    2007-01-01

    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 decompression, 31

  1. 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

  2. Changes in carbohydrate expression in the cervical spinal cord of rats during aging.

    Science.gov (United States)

    Lozza, Facundo A; Chinchilla, Leonardo A; Barbeito, Claudio G; Goya, Rodolfo G; Gimeno, Eduardo J; Portiansky, Enrique L

    2009-06-01

    Aging is a process where histochemical changes occur. Some of these may consist of age-dependent loss of expression of some cell markers. Conversely, cell markers not expressed in young animals may be detectable in their older counterparts. Histochemical age changes in carbohydrate profiles in the spinal cord have not been documented. In order to fill this information gap lectin histochemistry and image analysis were used to characterize the histochemical age changes occurring in the cervical segments of the rat spinal cord. From a battery of 11 lectins, the more important age changes were detected with Glicine maximus (SBA)-lectin. Thus, SBA-lectin neuronal staining which was moderately positive in the cervical segments of young animals was negative in old rats. In contrast the same lectin which did not react with the ependyma of young animals strongly bound to the ependyma of senescent rats. None of the tested lectins bound to glial cells, either in young or old animals. In no case the senile animals evidenced anatomopathological changes. We conclude that although in the aged spinal cord changes in lectin histochemical binding patterns occur, they do not reflect a pathologic situation. PMID:18992009

  3. 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. PMID:26506253

  4. Absent cervical spine pedicle and associated congenital spinal abnormalities - a diagnostic trap in a setting of acute trauma: case report

    International Nuclear Information System (INIS)

    Congenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma. This patient presented at the emergency unit of our university hospital after a motor vehicle accident and was sent to our radiology department for imaging of the cervical spine. Initial clinical examination and plain radiographs of the cervical spine were performed but not conclusive. Additional CT of the neck helped establish the right diagnosis. CT as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma

  5. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    Science.gov (United States)

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  6. Total Excision of a Giant Ventral Midline Cervical Spinal Intradural Schwannoma via Posterior Approach

    Science.gov (United States)

    Peethambaran, Anilkumar

    2016-01-01

    Schwannomas are the most common intradural extramedullary tumors of the spine. They usually occupy a posterolateral or lateral position in relation to the cord. The ventral midline is a very rare location for the origin of a spinal schwannoma. A giant one in such a location causes technical difficulties in excision. Here, we present a giant cervical spinal schwannoma, located ventral to the cord, in a 38-year-old lady who presented with features of myelopathy and bladder involvement. Magnetic resonance imaging was suggestive of an intradural extramedullary lesion extending from cervico-medullary junction to the third dorsal vertebral level with severe cord compression. The same was excised totally via a posterior approach after midline suboccipital craniectomy and C2–C6 laminoplasty. Postoperatively, she made a good recovery and was ambulant without support. Postoperative magnetic resonance imaging showed complete excision of the tumor. Histopathology was suggestive of schwannoma. PMID:26949471

  7. Comparison of MRI pulse sequences for investigation of lesions of the cervical spinal cord

    International Nuclear Information System (INIS)

    Small spinal cord lesions, even if clinically significant, can be due to the low sensitivity of some pulse sequences. We compared T2-weighted fast (FSE), and conventional (CSE) spin-echo and short-tau inversion-recovery (STIR)-FSE overlooked on MRI sequences to evaluate their sensitivity to and specificity for lesions of different types. We compared the three sequences in MRI of 57 patients with cervical spinal symptoms. The image sets were assessed by two of us individually for final diagnosis, lesion detectability and image quality. Both readers arrived at the same final diagnoses with all sequences, differentiating four groups of patients. Group 1 (30 patients, 53 %), with a final diagnosis of multiple sclerosis (MS). Demyelinating lesions were better seen on STIR-FSE images, on which the number of lesions was significantly higher than on FSE, while the FSE and CSE images showed approximately equal numbers of lesions; additional lesions were found in 9 patients. The contrast-to-noise ratio (CNR) of 17 demyelinating lesions was significantly higher on STIR-FSE images than with the other sequences. Group 2, 19 patients (33 %) with cervical pain, 15 of whom had disc protrusion or herniation: herniated discs were equally well delineated with all sequences, with better myelographic effect on FSE. In five patients with intrinsic spinal cord abnormalities, the conspicuity and demarcation of the lesions were similar with STIR-FSE and FSE. Group 3, 4 patients (7 %) with acute myelopathy of unknown aetiology. In two patients, STIR-FSE gave better demarcation of lesions and in one a questionable additional lesions. Group 4, 4 patients (7 %) with miscellaneous final diagnoses. STIR-FSE had high sensitivity to demyelinating lesions, can be considered quite specific and should be included in spinal MRI for assessment of suspected demyelinating disease. (orig.)

  8. Comparison of MRI pulse sequences for investigation of lesions of the cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Campi, A.; Pontesilli, S.; Gerevini, S.; Scotti, G. [San Raffaele Hospital, Milan (Italy). Dept. of Neuroradiology

    2000-09-01

    Small spinal cord lesions, even if clinically significant, can be due to the low sensitivity of some pulse sequences. We compared T2-weighted fast (FSE), and conventional (CSE) spin-echo and short-tau inversion-recovery (STIR)-FSE overlooked on MRI sequences to evaluate their sensitivity to and specificity for lesions of different types. We compared the three sequences in MRI of 57 patients with cervical spinal symptoms. The image sets were assessed by two of us individually for final diagnosis, lesion detectability and image quality. Both readers arrived at the same final diagnoses with all sequences, differentiating four groups of patients. Group 1 (30 patients, 53 %), with a final diagnosis of multiple sclerosis (MS). Demyelinating lesions were better seen on STIR-FSE images, on which the number of lesions was significantly higher than on FSE, while the FSE and CSE images showed approximately equal numbers of lesions; additional lesions were found in 9 patients. The contrast-to-noise ratio (CNR) of 17 demyelinating lesions was significantly higher on STIR-FSE images than with the other sequences. Group 2, 19 patients (33 %) with cervical pain, 15 of whom had disc protrusion or herniation: herniated discs were equally well delineated with all sequences, with better myelographic effect on FSE. In five patients with intrinsic spinal cord abnormalities, the conspicuity and demarcation of the lesions were similar with STIR-FSE and FSE. Group 3, 4 patients (7 %) with acute myelopathy of unknown aetiology. In two patients, STIR-FSE gave better demarcation of lesions and in one a questionable additional lesions. Group 4, 4 patients (7 %) with miscellaneous final diagnoses. STIR-FSE had high sensitivity to demyelinating lesions, can be considered quite specific and should be included in spinal MRI for assessment of suspected demyelinating disease. (orig.)

  9. Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI

    OpenAIRE

    Evans, Linton T.; S. Scott Lollis

    2015-01-01

    Introduction. Flexion-extension, or kinematic, MRI has been used to identify dynamic spondylotic spinal cord compression not seen with traditional static MRI. The use of kinematic MRI to diagnose postoperative complications, specifically dynamic compression, is not as well documented. The authors describe a case of dynamic spinal cord compression by the paraspinal muscles causing worsening myelopathy following cervical laminectomy. This was only diagnosed with flexion-extension MRI. Methods....

  10. Functional MRI of the cervical spinal cord on 1.5 T with fingertapping: to what extent is it feasible?

    International Nuclear Information System (INIS)

    Until recently, functional magnetic resonance imaging (fMRI) with blood oxygen level-dependent (BOLD) contrast, was mainly used to study brain physiology. The activation signal measured with fMRI is based upon the changes in the concentration of deoxyhaemoglobin that arise from an increase in blood flow in the vicinity of neuronal firing. Technical limitations have impeded such research in the human cervical spinal cord. The purpose of this investigation was to determine whether a reliable fMRI signal can be elicited from the cervical spinal cord during fingertapping, a complex motor activity. Furthermore, we wanted to determine whether the fMRI signal could be spatially localized to the particular neuroanatomical location specific for this task. A group of 12 right-handed healthy volunteers performed the complex motor task of fingertapping with their right hand. T2*-weighted gradient-echo echo-planar imaging on a 1.5-T clinical unit was used to image the cervical spinal cord. Motion correction was applied. Cord activation was measured in the transverse imaging plane, between the spinal cord levels C5 and T1. In all subjects spinal cord responses were found, and in most of them on the left and the right side. The distribution of the activation response showed important variations between the subjects. While regions of activation were distributed throughout the spinal cord, concentrated activity was found at the anatomical location of expected motor innervation, namely nerve root C8, in 6 of the 12 subjects. fMRI of the human cervical spinal cord on an 1.5-T unit detects neuronal activity related to a complex motor task. The location of the neuronal activation (spinal cord segment C5 through T1 with a peak on C8) corresponds to the craniocaudal anatomical location of the neurons that activate the muscles in use. (orig.)

  11. The morphometric analysis of the intervertebral foramen and the spinal nerve root in the cervical spine

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the onset of cervical myelopathy and cervical spondylotic radiculopathy as well as what influence the anatomy of the cervical spine and cervical nerves have on their onset and occurrence of various types of disease state. We conducted imaging and morphological measurements on specimens of cervical spine of Japanese people, focusing attention on the running of intervertebral foramen and dorsal nerve rootlets of the cervical spine. The subjects were cervical spine specimens from 12 cadavers (7 males and 5 females, age at the time of death ranged from 48 to 93 years with a mean of 71 years) obtained at Showa University School of Dentistry in 2005 and 2006. Specimens were prepared by removing the atlas through the 1st thoracic vertebra from the cadavers, then resecting the soft tissue such as muscles to expose the cervical spine in whole circumference. The removed cervical spine specimens, from 1st to 7th cervical spines, were imaged by volume scan of radiographic helical CT at 0.6 mm spatial resolution, and their images were stored as Digital Imaging and Communications in Medicine (DICOM) data. Image measurement on the vertebral body, vertebral foramen, and intervertebral foramen was conducted based on DICOM data. Furthermore, macroscopic observation and measurement were conducted on the dorsal nerve rootlets of cervical spine specimens. The image measurement of cervical spine specimens showed that the intervertebral foramen at C5/6 was the narrowest, followed by C3/4, C4/5, C6/7, and C2/3, respecting. With regard to angles in the frontal section and horizontal section of the groove for the spinal nerve, there was no significant difference in the angle between the right and the left. In the frontal section, the angle was about 63deg at C3, about 57deg at C4, about 52deg at C5, and about 55deg at C6, showing a significantly acute angle at C5, while in the horizontal section, it was about 54deg at C3, about 59deg at C4, about 63

  12. Effect of posterior decompression extent on biomechanical parameters of the spinal cord in cervical ossification of the posterior longitudinal ligament.

    Science.gov (United States)

    Khuyagbaatar, Batbayar; Kim, Kyungsoo; Park, Won Man; Kim, Yoon Hyuk

    2016-06-01

    Ossification of the posterior longitudinal ligament is a common cause of the cervical myelopathy due to compression of the spinal cord. Patients with ossification of the posterior longitudinal ligament usually require the decompression surgery, and there is a need to better understand the optimal surgical extent with which sufficient decompression without excessive posterior shifting can be achieved. However, few quantitative studies have clarified this optimal extent for decompression of cervical ossification of the posterior longitudinal ligament. We used finite element modeling of the cervical spine and spinal cord to investigate the effect of posterior decompression extent for continuous-type cervical ossification of the posterior longitudinal ligament on changes in stress, strain, and posterior shifting that occur with three different surgical methods (laminectomy, laminoplasty, and hemilaminectomy). As posterior decompression extended, stress and strain in the spinal cord decreased and posterior shifting of the cord increased. The location of the decompression extent also influenced shifting. Laminectomy and laminoplasty were very similar in terms of decompression results, and both were superior to hemilaminectomy in all parameters tested. Decompression to the extents of C3-C6 and C3-C7 of laminectomy and laminoplasty could be considered sufficient with respect to decompression itself. Our findings provide fundamental information regarding the treatment of cervical ossification of the posterior longitudinal ligament and can be applied to patient-specific surgical planning. PMID:26951839

  13. Lhermitte's sign: Incidence and treatment variables influencing risk after irradiation of the cervical spinal cord

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    Fein, D.A.; Marcus, R.B. Jr.; Parsons, J.T.; Mendenhall, W.M.; Million, R.R. (Univ. of Florida, Gainesville, FL (United States))

    1993-12-01

    Lhermitte's sign is a relatively infrequent sequela of irradiation of the cervical spinal cord. In this study, the authors sought to determine whether various treatment parameters influenced the likelihood of developing Lhermitte's sign. Between October 1964 and December 1987, 2901 patients with malignancies of the upper respiratory tract were treated at the University of Florida. The dose of radiation to the cervical spinal cord was calculated for those patients who had a minimum 1-year follow-up. A total of 1112 patients who received a minimum of 3000 cGy to at least 2 cm of cervical spinal cord were included in this analysis. Forty patients (3.6%) developed Lhermitte's sign. The mean time to development of Lhermitte's sign after irradiation was 3 months, and the mean duration of symptoms was 6 months. No patient with Lhermitte's sign developed transverse myelitis. Several variables were examined in a univariate analysis, including total dose to the cervical spinal cord, length of cervical spinal cord irradiated, dose per fraction, continuous-course compared with split-course radiotherapy, and once-daily compared with twice-daily irradiation. Only two variables proved to be significant. Six (8%) of 75 patients who received > 5000 cGy to the cervical spinal cord developed Lhermitte's sign compared with 34 (3.3%) of 1037 patients who received < 5000 cGy (p = .04). For patients treated with once-daily fractionation, 28 (3.4%) of 821 patients who received < 200 cGy per fraction developed Lhermitte's sign compared with 6 (10%) of 58 patients who received [ge] 200 cGy (p = .02). An increased risk of developing Lhermitte's sign was demonstrated for patients who received either [ge] 200 cGy per fraction (one fraction per day) or [ge] 5000 cGy total dose to the cervical spinal cord. 29 refs., 1 fig., 5 tabs.

  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. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels Ronald HMA; Hosman Allard JF; van de Meent Henk; Hofmeijer Jeannette; Vos Pieter E; Slooff Willem Bart; Öner F Cumhur; Coppes Maarten H; Peul Wilco C; Verbeek André LM

    2013-01-01

    Abstract Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treat...

  16. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels, R.H.M.A.; Hosman, A.J.F.; Meent, H. van de; Hofmeijer, J.; Vos, P.E.; Slooff, W.B.; Oner, F. C.; Coppes, M.H.; Peul, W.C.; Verbeek, A L M

    2013-01-01

    ABSTRACT: BACKGROUND: Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative tre...

  17. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels, R.H.M.; Hosman, A.J.F.; Meent, H. van de; Hofmeijer, J.; Vos, P.E.; Slooff, W.B.; Öner, F.C.; Coppes, M.H.; Peul, W.C.; Verbeek, A L M

    2013-01-01

    Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25 % of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was...

  18. 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. PMID:23404316

  19. Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury.

    Science.gov (United States)

    West, Christopher R; Goosey-Tolfrey, Victoria L; Campbell, Ian G; Romer, Lee M

    2014-07-01

    We asked whether elastic binding of the abdomen influences respiratory mechanics during wheelchair propulsion in athletes with cervical spinal cord injury (SCI). Eight Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) performed submaximal and maximal incremental exercise tests on a treadmill, both with and without abdominal binding. Measurements included pulmonary function, pressure-derived indices of respiratory mechanics, operating lung volumes, tidal flow-volume data, gas exchange, blood lactate, and symptoms. Residual volume and functional residual capacity were reduced with binding (77 ± 18 and 81 ± 11% of unbound, P tolerance. Changes in respiratory mechanics with binding may benefit O2 transport capacity by an improvement in central circulatory function. PMID:24855136

  20. Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI.

    Science.gov (United States)

    Evans, Linton T; Lollis, S Scott

    2015-01-01

    Introduction. Flexion-extension, or kinematic, MRI has been used to identify dynamic spondylotic spinal cord compression not seen with traditional static MRI. The use of kinematic MRI to diagnose postoperative complications, specifically dynamic compression, is not as well documented. The authors describe a case of dynamic spinal cord compression by the paraspinal muscles causing worsening myelopathy following cervical laminectomy. This was only diagnosed with flexion-extension MRI. Methods. The patient was a 90-year-old male presenting to the neurosurgery clinic with functional decline and cervical spondylotic myelopathy. Results. A multilevel laminectomy was performed. Following surgery the patient had progressive weakness and worsening myelopathy. No active cord compression was seen on multiple MRIs obtained in a neutral position, and flexion-extension X-rays did not show instability. A kinematic MRI demonstrated dynamic compression of the spinal cord only during neck extension, by the paraspinal muscles. To relieve the compression, the patient underwent an instrumented fusion, with cross-links used to buttress the paraspinal muscles away from the cord. This resulted in neurologic improvement. Conclusions. We describe a novel case of spinal cord compression by paraspinal muscles following cervical laminectomy. In individuals with persistent myelopathy or delayed neurologic decline following posterior decompression, flexion-extension MRI may prove useful in diagnosing this potential complication. PMID:25984378

  1. Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI

    Directory of Open Access Journals (Sweden)

    Linton T. Evans

    2015-01-01

    Full Text Available Introduction. Flexion-extension, or kinematic, MRI has been used to identify dynamic spondylotic spinal cord compression not seen with traditional static MRI. The use of kinematic MRI to diagnose postoperative complications, specifically dynamic compression, is not as well documented. The authors describe a case of dynamic spinal cord compression by the paraspinal muscles causing worsening myelopathy following cervical laminectomy. This was only diagnosed with flexion-extension MRI. Methods. The patient was a 90-year-old male presenting to the neurosurgery clinic with functional decline and cervical spondylotic myelopathy. Results. A multilevel laminectomy was performed. Following surgery the patient had progressive weakness and worsening myelopathy. No active cord compression was seen on multiple MRIs obtained in a neutral position, and flexion-extension X-rays did not show instability. A kinematic MRI demonstrated dynamic compression of the spinal cord only during neck extension, by the paraspinal muscles. To relieve the compression, the patient underwent an instrumented fusion, with cross-links used to buttress the paraspinal muscles away from the cord. This resulted in neurologic improvement. Conclusions. We describe a novel case of spinal cord compression by paraspinal muscles following cervical laminectomy. In individuals with persistent myelopathy or delayed neurologic decline following posterior decompression, flexion-extension MRI may prove useful in diagnosing this potential complication.

  2. Reference values for radiological evaluation of cervical vertebral body shape and spinal canal

    International Nuclear Information System (INIS)

    Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated. This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.)

  3. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury.

    Science.gov (United States)

    Li, Le; Li, Xiaoyan; Liu, Jie; Zhou, Ping

    2015-01-01

    The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX) technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI). The MD-MUNIX was estimated from the compound muscle action potential (CMAP) and different levels of surface interference pattern electromyogram (EMG) at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI), thenar and hypothenar muscles of SCI (n = 12) and healthy control (n = 12) subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX) demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration. PMID:26005410

  4. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Le eLi

    2015-05-01

    Full Text Available The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI. The MD-MUNIX was estimated from the compound muscle action potential (CMAP and different levels of surface interference pattern electromyogram (EMG at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI, thenar and hypothenar muscles of SCI (n=12 and healthy control (n=12 subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration.

  5. Bilateral contusion-compression model of incomplete traumatic cervical spinal cord injury.

    Science.gov (United States)

    Forgione, Nicole; Karadimas, Spyridon K; Foltz, Warren D; Satkunendrarajah, Kajana; Lip, Alyssa; Fehlings, Michael G

    2014-11-01

    Despite the increasing incidence and prevalence of cervical spinal cord injury (cSCI), we lack clinically relevant animal models that can be used to study the pathomechanisms of this injury and test new therapies. Here, we characterize a moderate cervical contusion-compression model in rats that is similar to incomplete traumatic cSCI in humans. We characterized the effects of 18-g clip-compression injury at cervical level C6 over an 8-week recovery period. Using Luxol fast blue/hematoxylin-eosin staining in combination with quantitative stereology, we determined that 18-g injury results in loss of gray matter (GM), white matter (WM), as well as in cavity formation. Magnetization transfer and T2-weighted magnetic resonance imaging were used to analyze lesion dynamics in vivo. This analysis demonstrated that both techniques are able to differentiate between the injury epicenter, subpial rim, and WM distal to the injury. Neurobehavioral assessment of locomotor function using Basso, Beattie, and Bresnahan (BBB) scoring and CatWalk revealed limited recovery from clip-compression injury at C6. Testing of forelimb function using grip strength demonstrated significant forelimb dysfunction, similar to the loss of upper-limb motor function observed in human cSCI. Sensory-evoked potentials recorded from the forelimb and Hoffman reflex recorded from the hindlimb confirmed the fore- and hindlimb deficits observed in our neurobehavioral analysis. Here, we have characterized a clip-compression model of incomplete cSCI that closely models this condition in humans. This work directly addresses the current lack of clinically relevant models of cSCI and will thus contribute to improved success in the translation of putative therapies into the clinic. PMID:24949719

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

    International Nuclear Information System (INIS)

    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 , average  mm2/s) and grey matter (average , average mm2/s) were relatively consistent along the length of the cord

  7. One stage anterior-posterior approach for traumatic at- lantoaxial instability combined with subaxial cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    WANG Chang-sheng

    2011-06-01

    Full Text Available 【Abstract】 Objectives: To explore the clinical fea- tures of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI, and to analyze the feasibility, indication and therapeutic effects of ante- rior-posterior approach in such cases. Methods: From March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixa- tion and bone graft fusion were conducted to manage trau- matic 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 pa- tients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA scores ranged from 10 to 16 one year postoperatively, 13.95±2.06 on average (improvement rate=70.10%. X-rays, spiral CT and MRI con- firmed normal cervical alignments, complete decompression and fine implants’ position. There was no breakage or loos- ening 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 immedi- ately restore the normal alignments and stability of the cer- vical spine and effectively

  8. Possibility of Independence in ADL (Activities of Daily Living) for Patients with Cervical Spinal Cord Injuries : An Evaluation based on the Zancolli Classification of Residual Arm Functions

    OpenAIRE

    Yoshimura, Osamu; Takayanagi, Kiyomi; Kobayashi, Ryuji; Hosoda, Masataka; Minematsu, Akira; Sasaki, Hisato; Maejima, Hiroshi; Matsuda, Yuiti; Tanaka, Satiko; Matsuo, Akihisa; Kanemura, Naohiko

    1998-01-01

    For patients with cervical spinal cord injuries to become independent in their ADL (Activities of Daily Living), residual arm function is very important. Also, age, sex, physical strength, obesity, spasticity, pain, contracture and motivation are related. We investigated the possibility of independence in ADL for patients with cervical spinal cord injuries, carrying out our evaluation based on the Zancolli Classification of Residual Arm Functions. Zancolli classification C6BII is taken as the...

  9. MR evaluation of cervical CSF flow. An examination in patients with spinal canal stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Iida, Makoto [Miyoshi General Hospital, Hiroshima (Japan); Kajima, Toshio; Miyasaka, Kenji; Nakanishi, Tadashi; Ono, Chiaki; Ito, Katsuhide

    1999-06-01

    To evaluate the flow dynamics of cerebrospinal fluid (CSF) throughout the cervical spine, 18 healthy controls and 14 patients with spinal canal stenosis were examined by phase-contrast cine MR. MR imaging was performed using a sagittal technique that is flow-sensitive in the craniocaudal direction. Flow encoding depicted craniocaudal flow as high intensity and caudocranial flow as low intensity. In this technique, either retrospective cardiac or peripheral gating was used to cover the complete cardiac cycle. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle. Using a region-of-interest cursor at each vertebral level, the graphs of flow-velocity versus time were generated. The recorded CSF at each vertebral level in the controls showed almost the same pattern in the change of flow in the craniocaudal direction, indicating that the onset of craniocaudal CSF flow was synchronous with the onset of cardiac systole in these subjects. At all vertebral levels, flow-velocity time curves showed the same variation in pattern. CSF flow was significantly lower in patients than in controls at each vertebral level (p<0.01). In addition, the flow patterns of the patients with spinal canal stenosis differed at each vertebral level. As a results, the total sum of the difference in velocity between graphs of two serial vertebrae at all sampling points (the area between the curves: ABC) per mean velocity amplitude in the patients was significantly higher than controls (p<0.05). Furthermore, the ABC per mean velocity amplitude at the stenotic level was significantly larger in the patients than that at the non-stenotic level (p<0.01). These data suggest that turbulent CSF flow occurs at the stenotic level. Thus, assessment of CSF flow dynamics is a useful adjunct to routine MRI in patients with spinal canal stenosis. (author)

  10. Muscle activity and mood state during simulated plant factory work in individuals with cervical spinal cord injury

    Science.gov (United States)

    Okahara, Satoshi; Kataoka, Masataka; Okuda, Kuniharu; Shima, Masato; Miyagaki, Keiko; Ohara, Hitoshi

    2016-01-01

    [Purpose] The present study investigated the physical and mental effects of plant factory work in individuals with cervical spinal cord injury and the use of a newly developed agricultural working environment. [Subjects] Six males with C5–C8 spinal cord injuries and 10 healthy volunteers participated. [Methods] Plant factory work involved three simulated repetitive tasks: sowing, transplantation, and harvesting. Surface electromyography was performed in the dominant upper arm, upper trapezius, anterior deltoid, and biceps brachii muscles. Subjects’ moods were monitored using the Profile of Mood States. [Results] Five males with C6–C8 injuries performed the same tasks as healthy persons; a male with a C5 injury performed fewer repetitions of tasks because it took longer. Regarding muscle activity during transplantation and harvesting, subjects with spinal cord injury had higher values for the upper trapezius and anterior deltoid muscles compared with healthy persons. The Profile of Mood States vigor scores were significantly higher after tasks in subjects with spinal cord injury. [Conclusion] Individuals with cervical spinal cord injury completed the plant factory work, though it required increased time and muscle activity. For individuals with C5–C8 injuries, it is necessary to develop an appropriate environment and assistive devices to facilitate their work. PMID:27134377

  11. Spinal cord swelling with abnormal gadolinium-enhancement mimicking intramedullary tumors in cervical spondylosis patients: Three case reports and review of the literature

    Science.gov (United States)

    Sasamori, Toru; Hida, Kazutoshi; Yano, Shunsuke; Takeshi, Aoyama; Iwasaki, Yoshinobu

    2010-01-01

    Objective: Spinal cord swelling with abnormal gadolinium (Gd) enhancement is a rare preoperative radiological finding in patients with cervical spondylosis. In the presence of progressive myelopathy, timely surgical decompression can be curative. Case presentation: We report 3 patients with cervical spondylotic myelopathy. Preoperative magnetic resonance imaging (MRI) revealed spondylotic changes and intramedullary lesions in the cervical spine. We noted cervical cord swelling with high intensity on T2-weighted MRI and abnormal Gd-DTPA enhancement. Laminoplasty resulted in marked improvement of their neurological condition and postoperative MRI revealed gradual regression of the intramedullary lesions during the first year. Conclusion: We posit that the intramedullary lesions in our patients were reflective of spinal cord edema with blood-brain-barrier disturbance in the cervical cord, possibly due to minor recurrent spinal cord injury and disturbed venous circulation. Spinal cord edema is a rare condition in patients with cervical spondylosis and an accurate diagnosis and timely surgery are necessary for cure. Therefore, this unusual condition must be considered in spondylosis patients manifesting as intramedullary lesions on MRI of the cervical spinal cord. Careful evaluation of the postoperative course can be used to confirm the diagnosis and help in selecting a subsequent therapeutic strategy. PMID:22028753

  12. Transfer of the Brachialis to the Anterior Interosseous Nerve as a Treatment Strategy for Cervical Spinal Cord Injury: Technical Note

    OpenAIRE

    Hawasli, Ammar H.; Chang, Jodie; Reynolds, Matthew R; Wilson Z. Ray

    2014-01-01

    Study Design Technical report. Objective To provide a technical description of the transfer of the brachialis to the anterior interosseous nerve (AIN) for the treatment of tetraplegia after a cervical spinal cord injury (SCI). Methods In this technical report, the authors present a case illustration of an ideal surgical candidate for a brachialis-to-AIN transfer: a 21-year-old patient with a complete C7 spinal cord injury and failure of any hand motor recovery. The authors provide detailed de...

  13. Cervical Myeloradiculopathy due to Ossification of the Posterior Longitudinal Ligament with versus without Diffuse Idiopathic Spinal Hyperostosis

    OpenAIRE

    TAUCHI, RYOJI; Lee, Sang-Hun; Peters, Colleen; Imagama, Shiro; Ishiguro, Naoki; Riew, K. Daniel

    2015-01-01

    Study Design Retrospective study. Objectives Assess demographics, ossification characteristics, surgical outcomes, and complications in patients with both diffuse idiopathic spinal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL) compared with patients who only have OPLL. Methods Clinical charts and radiographs of all patients treated surgically from February 2004 to July 2012 for cervical myeloradiculopathy due to DISH with OPLL or OPLL alone were reviewed r...

  14. Alternative technique of cervical spinal stabilization employing lateral mass plate and screw and intra-articular spacer fixation

    OpenAIRE

    Atul Goel

    2013-01-01

    Aim: The author discusses an alternative technique of segmental cervical spinal fixation. Material and Methods: The subtleties of the technique are discussed on the basis of experience with 3 cases with a follow-up of between 30 and 36 months. Technique: The technique involves debridement of facetal articular cartilage, distraction of facets, jamming of ′Goel spacer′ into the articular cavity and fortification of the fixation by lateral mass plate and screw fixation. The ′double-insurance′ me...

  15. 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

  16. [Surgical treatment after cervical spine and spinal cord injuries of the C3-C7 level].

    Science.gov (United States)

    Kopczyński, Stefan; Derenda, Marek; Kowalina, Ireneusz; Siwiecki, Tomasz

    2002-01-01

    The authors report the methods and results of the treatment of 83 patients with lower cervical spine (C3-C7) injuries, who were treated in the Neurosurgery Department in Elblag in a period of 11 years. Lesions ranged from fractures mainly of vertebral C5 and C6 bodies, and dislocations--mostly at levels C4-C5 and C5-C6. Most lesions were the consequence of a headlong jump into water (38.5%) and traffic accidents (29%). In admission sensory disturbances (38.5%) and tetraplegia or paresis of the upper limbs with paralysis of lower limbs (together 44.6%) were most frequently observed. The state of the patients was evaluated according to the ASIA-Frankel's scale. 148 surgical procedures were carried out. Decompression and autogenic and/or plate stabilization--from the anterior approach using Caspar's system and Crutchfield's traction--were the preferred methods. The post-surgical follow up extends from 9 years to 3 months. The most satisfying result was the improvement observed in the patients from groups A and B according to ASIA-Frankel's scale. Among 36 such patients, the medullary functions of 17 patients improved. 14 patients died from 5 days to 3 months after surgery. The authors also present an overview of contemporary management of lower cervical spine injuries. The emphasis is placed on the importance of factors making the treatment of spine and spinal cord injuries more difficult and delaying the beginning of early and efficient surgery. PMID:12418133

  17. The roles of mechanical compression and chemical irritation in regulating spinal neuronal signaling in painful cervical nerve root injury.

    Science.gov (United States)

    Zhang, Sijia; Nicholson, Kristen J; Smith, Jenell R; Gilliland, Taylor M; Syré, Peter P; Winkelstein, Beth A

    2013-11-01

    Both traumatic and slow-onset disc herniation can directly compress and/or chemically irritate cervical nerve roots, and both types of root injury elicit pain in animal models of radiculopathy. This study investigated the relative contributions of mechanical compression and chemical irritation of the nerve root to spinal regulation of neuronal activity using several outcomes. Modifications of two proteins known to regulate neurotransmission in the spinal cord, the neuropeptide calcitonin gene-related peptide (CGRP) and glutamate transporter 1 (GLT-1), were assessed in a rat model after painful cervical nerve root injuries using a mechanical compression, chemical irritation or their combination of injury. Only injuries with compression induced sustained behavioral hypersensitivity (p≤0.05) for two weeks and significant decreases (pspinal CGRP and GLT-1 is associated with enhanced excitatory signaling in the spinal cord, a second study evaluated the electrophysiological properties of neurons in the superficial and deeper dorsal horn at day 7 after a painful root compression. The evoked firing rate was significantly increased (p=0.045) after compression and only in the deeper lamina. The painful compression also induced a significant (p=0.002) shift in the percentage of neurons in the superficial lamina classified as low- threshold mechanoreceptive (sham 38%; compression 10%) to those classified as wide dynamic range neurons (sham 43%; compression 74%). Together, these studies highlight mechanical compression as a key modulator of spinal neuronal signaling in the context of radicular injury and pain. PMID:24435733

  18. Neurologic complications after irradiation of the cervical spinal cord for malignant tumour of the head and neck

    International Nuclear Information System (INIS)

    A total of 165 patients with tumours of the head and neck were irradiated via fields including the entire cervical portion of the spinal cord. Eight patients (4.8 per cent) developed mild reversible signs of radiation myelitis. Only one of these cases was found among the 44 patients who received a dose to the spinal cord of over 5 000 rad via fields of less than 16 cm in length; 7 cases were patients with Hodgkin's disease who were given up to 3 700 rad via mantle fields. A survey of previous reports on transverse spinal lesions provoked by irradiation revealed a possibility of overdosage in several cases, and dose tolerance limits mentioned previously should accordingly be applied with caution. (author)

  19. Alteration of forebrain neurogenesis after cervical spinal cord injury in the adult rat.

    Directory of Open Access Journals (Sweden)

    Marie-Solenne eFELIX

    2012-04-01

    Full Text Available Spinal cord injury (SCI triggers a complex cellular response at the injury site, leading to the formation of a dense scar tissue. Despite this local tissue remodeling, the consequences of SCI at the cellular level in distant rostral sites (i.e. brain, remain unknown. In this study, we asked whether cervical SCI could alter cell dynamics in neurogenic areas of the adult rat forebrain. To this aim, we quantified BrdU incorporation and determined the phenotypes of newly generated cells (neurons, astrocytes, or microglia during the subchronic and chronic phases of injury. We find that subchronic SCI leads to a reduction of BrdU incorporation and neurogenesis in the olfactory bulb and in the hippocampal dentate gyrus. By contrast, subchronic SCI triggers an increased BrdU incorporation in the dorsal vagal complex of the hindbrain, where most of the newly generated cells are identified as microglia. In chronic condition 90 days after SCI, BrdU incorporation returns to control levels in all regions examined, except in the hippocampus, where SCI produces a long-term reduction of neurogenesis, indicating that this structure is particularly sensitive to SCI. Finally, we observe that SCI triggers an acute inflammatory response in all brain regions examined, as well as a hippocampal-specific decline in BDNF levels, which could explain the SCI-mediated distant effects on forebrain neurogenesis. This study provides the first demonstration that forebrain neurogenesis is vulnerable to a distal SCI.

  20. Integration in trigeminal premotor interneurones in the cat. 3. Input characteristics and synaptic actions of neurones in subnucleus-gamma of the oral nucleus of the spinal trigeminal tract with a projection to the masseteric motoneurone subnucleus.

    Science.gov (United States)

    Westberg, K G; Sandström, G; Olsson, K A

    1995-01-01

    A population of last-order interneurones within the rostrodorsal part of the oral nucleus of the spinal trigeminal tract (NVspo-gamma) has been investigated in 21 chloralose anaesthetised cats. The neurones were identified by their antidromic (AD) response to microstimulation (median current 9 microA, range 3-39 microA) of the ipsior the contralateral masseteric subnucleus of the trigeminal motor nucleus. Fifty-one of 113 interneurones tested were discharged from the ipsilateral and eight from the contralateral motor nucleus. The average conduction time was 0.50 ms from the ipsilateral and 0.74 ms from the contralateral motoneurone pool. Conduction velocities of the axons ranged from 2.0 to 14.0 ms. The pattern of primary afferent input onto the selected neurones was analysed by graded electrical stimulation of dissected trigeminal nerves. Low-threshold afferents innervating the intraoral mucosa including the tongue and the perioral skin of the lower lip were the most effective inputs, as judged from both the frequency of occurrence and from the latencies of the evoked spike discharges. Ninety-six percent of the neurones responded to stimulation of the inferior alveolar nerve (Alv inf) and 83% responded to stimulation of the lingual nerve (Ling). The median threshold strength required to evoke the Alv inf and the Ling responses was 1.7 T (range 1.0-3.6 T) and 1.3 T (range 1.0-5.0 T), respectively. The median latency to spike discharges evoked by the Alv inf was 2.0 ms (range 1.3-4.8 ms) and to the Ling it was 2.5 ms (range 1.4-7.0 ms). Action potentials elicited by stimulation of the masseteric and digastric nerves were observed in 40% and 10% of the neurones, respectively. These responses, which had median latencies of more than 8 ms (range 4.7-16.0 ms), were only seen at stimulation intensities above 2 T (range 2.5-25 T). An input from the maxillary whisker nerve was seen in only one case. Postspike averages of the extracellular field potentials within the

  1. Awake behaving electrophysiological correlates of forelimb hyperreflexia, weakness and disrupted muscular synchronization following cervical spinal cord injury in the rat.

    Science.gov (United States)

    Ganzer, Patrick Daniel; Meyers, Eric Christopher; Sloan, Andrew Michael; Maliakkal, Reshma; Ruiz, Andrea; Kilgard, Michael Paul; Robert, LeMoine Rennaker

    2016-07-01

    Spinal cord injury usually occurs at the level of the cervical spine and results in profound impairment of forelimb function. In this study, we recorded awake behaving intramuscular electromyography (EMG) from the biceps and triceps muscles of the impaired forelimb during volitional and reflexive forelimb movements before and after unilateral cervical spinal cord injury (cSCI) in rats. C5/C6 hemicontusion reduced volitional forelimb strength by more than 50% despite weekly rehabilitation for one month post-injury. Triceps EMG during volitional strength assessment was reduced by more than 60% following injury, indicating reduced descending drive. Biceps EMG during reflexive withdrawal from a thermal stimulus was increased by 500% following injury, indicating flexor withdrawal hyperreflexia. The reduction in volitional forelimb strength was significantly correlated with volitional and reflexive biceps EMG activity. Our results support the hypothesis that biceps hyperreflexia and descending volitional drive both significantly contribute to forelimb strength deficits after cSCI and provide new insight into dynamic muscular dysfunction after cSCI. The use of multiple automated quantitative measures of forelimb dysfunction in the rodent cSCI model will likely aid the search for effective regenerative, pharmacological, and neuroprosthetic treatments for spinal cord injury. PMID:27033345

  2. 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. PMID:26590991

  3. Effects of 50 MeV/sub d→ Be/ neutron irradiation on Rhesus monkey cervical spinal cord

    International Nuclear Information System (INIS)

    The cervical spinal cords of ten Rhesus monkeys were irradiated with 50 MeV/sub d → Be/ neutrons according to one of two dosage schedules: (1) 1300 rad/ sub nγ/ in nine fractions over 29 days, and (2) 1550 rad/sub nγ/ in nine fractions over 29 days. These doses are equivalent to 4000 rad/sub eq/ and 4800 rad/sub eq/, respectively, with 60Co using an RBE of 3.1 for late effects (conventional 200 rad per day fractionation). Whereas none of five monkeys that received a spinal cord dose of 1300 rad/sub nγ/ developed signs of neurologic dysfunction, all five animals that were irradiated to a dose of 1550 rad/sub nγ/ developed significant radiation myelitis. The histopathologic changes correlated well with the clinical observations. All of the animals that received 1550 rad/sub nγ/ exhibited severe malacia and moderate to severe demyelination of the white matter of the cervical spinal cord. The histopathologic changes in the monkeys irradiated with 1300 rad/sub nγ/ were minimal by comparison

  4. Clinical analysis of spinal cord injury with or without cervical ossification of the posterior longitudinal ligament, spondylosis, and canal stenosis in elderly head injury patients

    International Nuclear Information System (INIS)

    Patients with degenerative diseases of the cervical spine, such as ossification of the posterior longitudinal ligament, spondylosis, and canal stenosis, sometimes present with acute spinal cord injury caused by minor trauma. However, the relative risk of cervical cord injury with these diseases is unknown. The clinical and radiological features of 94 elderly patients with head injury, 57 men and 37 women aged from 65 to 98 years (mean 76.6 years), were retrospectively analyzed to assess the association of spinal cord injury with degenerative cervical diseases. Degenerative cervical diseases were present in 25 patients, and spinal cord injury was more common in the patients with degenerative diseases (11/25 patients) than in the patients without such diseases (3/69 patients; relative risk=10.2). The incidence of degenerative cervical diseases seems to be increasing in Japan because life expectancy has increased and the elderly are a rapidly growing part of the population. A fall while walking or cycling is a common mechanism of head injury and/or cervical cord injury in the elderly. To decrease the occurrence of cervical myelopathy, prevention by increasing social awareness and avoiding traffic accidents and falls is important. (author)

  5. Indication for the operative methods in surgical treatment of cervical spondylotic myelopathy. Shape of the spinal cord in the CT-myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Akira; Inoue, Shunichi; Watabe, Tsuneo; Nagase, Joji; Harada, Yoshitada (Chiba Univ. (Japan). School of Medicine)

    1984-04-01

    Indication for the operative methods for cervical spondylotic myelopathy was examined in 16 patients undergoing CT-myelography before and after operation. There was a highly significant correlation between the anteroposterior (A-P) diameter of the spinal cord and clinical symptoms. Patients with shorter A-P diameter of the spinal cord tended to have severer preoperative clinical symptoms. Clinical symptoms improved as the post operative A-P diameter of the spinal cord increased. Fixation with decompression of the anterior spinal cord should be indicated when constriction of 5 mm or less of the spinal cord is seen segmentally at the level of the intervertebral disc. Dilation of the spinal cavity should be indicated when the constriction of the spinal cord is 5 mm or less at all levels of the cervical spinal cord. In performing fixation with anterior decompression, 15 mm is considered to be the most suitable width for complete and safe decompression of the flattened spinal cord with a wide transverse diameter.

  6. Atypical symptoms in patients with cervical spondylosis might be the result of stimulation on the dura mater and spinal cord.

    Science.gov (United States)

    Muheremu, Aikeremujiang; Sun, Yuqing

    2016-06-01

    Patients with cervical spondylosis often present with some atypical symptoms such as vertigo, headache, palpitation, nausea, abdominal discomfort, tinnitus and blurred vision and hypomnesia. Although there are a few hypotheses about the etiology of those symptoms, none of them have provided evidence convincing enough to explain the clinical, pathological and anatomic manifestation of those symptoms. One of the more acceptable explanations is that those symptoms are the results of stimulation of the sympathetic nerves in the posterior longitudinal ligament. The clinical fact that dissection of the posterior longitudinal ligament significantly alleviates the severity of those symptoms seems like an evidence for the validity of this hypothesis. However, recent clinical studies showed that laminoplasty, which has no effect on the posterior longitudinal ligament, can achieve the similar effect. In this paper, we hypothesize that stimulation of the dura mater and spinal cord might be the cause of atypical symptoms in patients with cervical spondylosis. PMID:27142142

  7. Alternative technique of cervical spinal stabilization employing lateral mass plate and screw and intra-articular spacer fixation

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2013-01-01

    Full Text Available Aim: The author discusses an alternative technique of segmental cervical spinal fixation. Material and Methods: The subtleties of the technique are discussed on the basis of experience with 3 cases with a follow-up of between 30 and 36 months. Technique: The technique involves debridement of facetal articular cartilage, distraction of facets, jamming of ′Goel spacer′ into the articular cavity and fortification of the fixation by lateral mass plate and screw fixation. The ′double-insurance′ method of fixation is safe for vertebral artery, nerve roots and spinal neural structures and the fixation is strong. Conclusions: The discussed technique is safe and provides a strong fixation and a ground for ultimate arthrodesis.

  8. Inflatable external leg compression prevents orthostatic hypotension in a patient with a traumatic cervical spinal cord injury.

    Science.gov (United States)

    Helmi, Mochamat; Lima, Alexandre; Gommers, Diederik; van Bommel, Jasper; Bakker, Jan

    2013-09-01

    High thoracic spine or cervical injury may cause long-term orthostatic hypotension (OH). To stabilize hemodynamics and prevent presyncope symptoms in these patients, noninvasive management is preferable. We describe a case of a 61-year-old man who experienced presyncope symptoms as a result of severe OH due to spinal cord injury, after 60° head-up tilt position. The patient was referred to the intensive care unit where he was successfully managed with an inflatable external leg compression (ELC). Accordingly, inflatable ELC succeeded not only in improving presyncope symptoms, but also in preventing orthostatic hypotension for several hours. ELC may be an alternative way to stabilize hemodynamics and prevent presyncope symptoms in patients with OH following spinal cord injury. PMID:24020666

  9. The radiation response of the cervical spinal cord of the pig: Effects of changing the irradiated volume

    International Nuclear Information System (INIS)

    An investigation of the field size effect for the cervical spinal cord of the pig after single doses of γ-rays. In this study, clinically relevant volumes of the spinal cord were irradiated. The effects of the local irradiation of different lengths of the spinal cord (2.5 cm, 5.0 cm, and 10.0 cm) have been evaluated in mature pigs (37-43 weeks). Single doses of 25-31 Gy were given using a 60Co γ-source, at a dose rate of 0.21-0.30 Gy/min. The incidence of radiation-induced paralysis was used as the endpoint. The data were analyzed using probit analysis and a normal tissue complication probability (NTCP)-model. Twenty-five animals out of a total of 53 developed paralysis, with histological evidence of parenchymal and vascular changes in their white matter. The slope of the dose-response curves decreased with the decrease in field size; however, there was no significant difference at the radiation dose associated with a 50% incidence of paralysis (ED50) irrespective of the method of analysis. The ED50 values ± standard errors (± SE) were 27.02 ± 0.36 Gy, 27.68 ± 0.57 Gy, and 28.28 ± 0.78 Gy for field lengths of 10, 5, and 2.5 cm, respectively. Analysis of the data with a normal tissue complication probability (NCTP) model gave similar results. The latent period of paralysis was 7.5-16.5 weeks with no significant differences between dose and field size. No significant field size-related differences in response were detectable in the cervical spinal cord of mature pigs after single dose irradiations, specifically at a clinically relevant level of effect (10). 21 refs., 1 fig., 1 tab

  10. Intravenous Transplantation of Mesenchymal Progenitors Distribute Solely to the Lungs and Improve Outcomes in Cervical Spinal Cord Injury.

    Science.gov (United States)

    White, Seok Voon; Czisch, Chris E; Han, May H; Plant, Christine D; Harvey, Alan R; Plant, Giles W

    2016-07-01

    Cellular transplantation strategies utilizing intraspinal injection of mesenchymal progenitor cells (MPCs) have been reported as beneficial for spinal cord injuries. However, intraspinal injection is not only technically challenging, but requires invasive surgical procedures for patients. Therefore, we investigated the feasibility and potential benefits of noninvasive intravenous injection of MPCs in two models of cervical spinal cord injury, unilateral C5 contusion and complete unilateral C5 hemisection. MPCs isolated from green fluorescence protein (GFP)-luciferase transgenic mice compact bone (1 × 10(6) cells), or vehicle Hank's Buffered Saline Solution (HBSS), were intravenously injected via the tail vein at D1, D3, D7, D10, or D14. Transplanted MPCs were tracked via bioluminescence imaging. Live in vivo imaging data showed that intravenously injected MPCs accumulate in the lungs, confirmed by postmortem bioluminescence signal-irrespective of the time of injection or injury model. The results showed a rapid, positive modulation of the inflammatory response providing protection to the injured spinal cord tissue. Histological processing of the lungs showed GFP(+) cells evenly distributed around the alveoli. We propose that injected cells can act as cellular target decoys to an immune system primed by injury, thereby lessening the inflammatory response at the injury site. We also propose that intravenous injected MPCs modulate the immune system via the lungs through secreted immune mediators or contact interaction with peripheral organs. In conclusion, the timing of intravenous injection of MPCs is key to the success for improving function and tissue preservation following cervical spinal cord injury. Stem Cells 2016;34:1812-1825. PMID:26989838

  11. 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.

  12. Do intramedullary spinal cord changes in signal intensity on MRI affect surgical opportunity and approach for cervical myelopathy due to ossification of the posterior longitudinal ligament?

    OpenAIRE

    Sun, Qizhi; Hu, Hongwei; Zhang, Ying; Li, Yang; Chen, Linwei; Chen, Huajiang; Yuan, Wen

    2011-01-01

    Some controversy still exists over the optimal treatment time and the surgical approach for cervical myelopathy due to ossification of the posterior longitudinal ligament (OPLL). The aim of the current study was first to analyze the effect of intramedullary spinal cord changes in signal intensity (hyperintensity on T2-weighted imaging and hypointensity on T1-weighted imaging) on magnetic resonance imaging (MRI) on surgical opportunity and approach for cervical myelopathy due to OPLL. This was...

  13. 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.

  14. The Prevalence and Phenotype of Activated Microglia/Macrophages within the Spinal Cord of the Hyperostotic Mouse (twy/twy) Changes in Response to Chronic Progressive Spinal Cord Compression: Implications for Human Cervical Compressive Myelopathy

    OpenAIRE

    Hirai, Takayuki; Uchida, Kenzo; Nakajima, Hideaki; Guerrero, Alexander Rodriguez; Takeura, Naoto; Watanabe, Shuji; Sugita, Daisuke; Yoshida, Ai; Johnson, William E B; Baba, Hisatoshi

    2013-01-01

    Background Cervical compressive myelopathy, e.g. due to spondylosis or ossification of the posterior longitudinal ligament is a common cause of spinal cord dysfunction. Although human pathological studies have reported neuronal loss and demyelination in the chronically compressed spinal cord, little is known about the mechanisms involved. In particular, the neuroinflammatory processes that are thought to underlie the condition are poorly understood. The present study assessed the localized pr...

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

    OpenAIRE

    Chekhonatsky V.A.; Ovsyannikov D.M.; Korshunova G.A.; Chekhonatsky A.A.

    2012-01-01

    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 cli...

  16. Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report.

    Science.gov (United States)

    Dimar, John R; Endriga, David T; Carreon, Leah Y

    2016-06-01

    Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression. This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction. A 61-year-old man who underwent prior posterior cervical implantation with an SCS followed by multiple revisions presented with progressive paresthesias, numbness, and weakness of his upper extremities 10 years later. The SCS was removed followed by decompression, and instrumented fusion of the cervical spine. Histopathologic analysis reveals foreign-body reaction to the SCS and its silicone debris. Tissue cultures were negative for bacterial, fungal, or mycobacterial infection. No malignancy was seen. The current case illustrates the inherent possibility of foreign-body granulomatous reactions with SCS and its silicone particulate matter, made unique in this instance by the associated bony destruction of the adjacent vertebrae. PMID:27247910

  17. Cervical osteochondroma as a cause of spinal cord compression in a patient with hereditary multiple exostoses: computed tomography and magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Spinal cord compression is a rare but extremely serious complication of hereditary multiple exostoses (HME). Imaging of the spine is important for surgical planning and follow up. We present CT and MR findings in a male patient with HME who developed spinal cord compression from a cervical osteochondroma, demonstrating the origin, size and extent of the lesion and its relationship with the spinal canal or neural foramina. MRI should be used in the evaluation and follow-up of the patients. Complete recovery was achieved following surgery. Copyright (2002) Blackwell Science Pty Ltd

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

    International Nuclear Information System (INIS)

    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

  19. 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.

  20. Illness experience of adults with cervical spinal cord injury in Japan: a qualitative investigation

    Directory of Open Access Journals (Sweden)

    Ide-Okochi Ayako

    2013-01-01

    Full Text Available Abstract Background There is growing recognition that healthcare policy should be guided by the illness experience from a layperson’s or insider’s perspective. One such area for exploration would include patient-centered research on traumatic Spinal Cord Injury (SCI, a condition associated with permanent physical disability requiring long-term and often complex health care. The chronicity of SCI can, in turn, affect individuals’ sense of self. Although previous research in Western countries suggests that people with SCI find a way to cope with their disability through social participation and family bonds, the process of adjustment among people with cervical SCI (CSCI living in Japan may be different because of the restrained conditions of their social participation and the excessive burden on family caregivers. The purpose of this study was to examine the impact of injury and the process of accommodation in people with CSCI in Japan. Methods Semi-structured home interviews were conducted with 29 participants who were recruited from a home-visit nursing care provider and three self-help groups. Interviews were recorded, transcribed and analyzed based on the grounded theory approach. Results Five core categories emerged from the interview data: being at a loss, discrediting self by self and others, taking time in performance, restoring competency, and transcending limitations of disability. Overall, the process by which participants adjusted to and found positive meaning in their lives involved a continuous search for comfortable relationships between self, disability and society. Conclusions The results of this study suggest that persons with CSCI do not merely have disrupted lives, but find positive meaning through meaningful interactions. Family members added to the discredit of self by making the injured person entirely dependent on them. Gaining independence from family members was the key to restoring competency in people with CSCI

  1. 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.

  2. Morphometrical study of the axial view of the cervical spinal cord with MRI. Analysis of the normal shape and relation between the shape of the spinal cord and the clinical result in compression myelopathy

    International Nuclear Information System (INIS)

    The axial view of normal cervical spinal cord was analyzed to elucidate the relationships between its shape and clinical result in compression myelopathy. Subjects were 104 cases with normal shape and 35 cases with cervical myelopathy of a single intervertebral compressive lesion. MRI was performed with General Electric 1.5 T superconducting apparatus to get T1-weighted cross image of 5 mm slice thickness. Morphometry was performed with high performance image processor (SPICCA, Nihon-Avionics) to compute the area and longitudinal and lateral lengths of spinal cord to calculate flatness. The area and longitudinal length were positively correlated with body height, and the longitudinal length and flatness, negatively with age. The reduction rate of the spinal cord area had a relation with neurological symptoms, but, together with age and duration of the disease, had no relation with the clinical results from operation. (H.O.)

  3. Morphometrical study of the axial view of the cervical spinal cord with MRI. Analysis of the normal shape and relation between the shape of the spinal cord and the clinical result in compression myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Tanida, Yasutaka [Osaka Medical Coll., Takatsuki (Japan)

    1996-01-01

    The axial view of normal cervical spinal cord was analyzed to elucidate the relationships between its shape and clinical result in compression myelopathy. Subjects were 104 cases with normal shape and 35 cases with cervical myelopathy of a single intervertebral compressive lesion. MRI was performed with General Electric 1.5 T superconducting apparatus to get T1-weighted cross image of 5 mm slice thickness. Morphometry was performed with high performance image processor (SPICCA, Nihon-Avionics) to compute the area and longitudinal and lateral lengths of spinal cord to calculate flatness. The area and longitudinal length were positively correlated with body height, and the longitudinal length and flatness, negatively with age. The reduction rate of the spinal cord area had a relation with neurological symptoms, but, together with age and duration of the disease, had no relation with the clinical results from operation. (H.O.)

  4. Cardiac arrest during spinal anesthesia for cervical conization: a case report.

    Science.gov (United States)

    Shinohara, Satoshi; Sakamoto, Ikuko; Numata, Masahiro; Ikegami, Atsushi; Teramoto, Katsuhiro; Hirata, Shuji

    2016-05-01

    Spinal anesthesia is regularly performed worldwide and is an integral part of the modern day anesthesia practice. Although unexpected cardiac arrests during this procedure are very rare, medical professionals should be aware of the potential for this complication. In making the decision to use spinal anesthesia, judicious patient selection, adequate preventive measures, and strict monitoring are important. PMID:27190608

  5. Freeze-dried fibular allograft in anterior spinal surgery: cervical and lumbar applications.

    OpenAIRE

    Wetzel, F.T.; Hoffman, M. A.; Arcieri, R. R.

    1993-01-01

    Fifty-six patients who underwent anterior fusion utilizing fibular allograft are reviewed. Thirty-two patients underwent multiple-level anterior cervical discectomy and fusion utilizing fibular strut allograft, and 24 underwent anterior lumbar discectomy and fusion using fibular strut allograft. Cervical surgery was performed via the strut technique of Whitecloud and LaRocca and lumbar surgery was performed via a transperitoneal or retroperitoneal approach. Postoperatively, patients were assi...

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

    OpenAIRE

    Wallengren Joanna

    2009-01-01

    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 biop...

  7. 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.

  8. Early Decompression following Cervical Spinal Cord Injury: Examining the Process of Care from Accident Scene to Surgery.

    Science.gov (United States)

    Battistuzzo, Camila R; Armstrong, Alex; Clark, Jillian; Worley, Laura; Sharwood, Lisa; Lin, Peny; Rooke, Gareth; Skeers, Peta; Nolan, Sherilyn; Geraghty, Timothy; Nunn, Andrew; Brown, Doug J; Hill, Steven; Alexander, Janette; Millard, Melinda; Cox, Susan F; Rao, Sudhakar; Watts, Ann; Goods, Louise; Allison, Garry T; Agostinello, Jacqui; Cameron, Peter A; Mosley, Ian; Liew, Susan M; Geddes, Tom; Middleton, James; Buchanan, John; Rosenfeld, Jeffrey V; Bernard, Stephen; Atresh, Sridhar; Patel, Alpesh; Schouten, Rowan; Freeman, Brian J C; Dunlop, Sarah A; Batchelor, Peter E

    2016-06-15

    Early decompression may improve neurological outcome after spinal cord injury (SCI), but is often difficult to achieve because of logistical issues. The aims of this study were to 1) determine the time to decompression in cases of isolated cervical SCI in Australia and New Zealand and 2) determine where substantial delays occur as patients move from the accident scene to surgery. Data were extracted from medical records of patients aged 15-70 years with C3-T1 traumatic SCI between 2010 and 2013. A total of 192 patients were included. The median time from accident scene to decompression was 21 h, with the fastest times associated with closed reduction (6 h). A significant decrease in the time to decompression occurred from 2010 (31 h) to 2013 (19 h, p = 0.008). Patients undergoing direct surgical hospital admission had a significantly lower time to decompression, compared with patients undergoing pre-surgical hospital admission (12 h vs. 26 h, p decompression (12.5 h). There was a relationship between the timing of decompression and the proportion of patients demonstrating substantial recovery (2-3 American Spinal Injury Association Impairment Scale grades). In conclusion, the time of cervical spine decompression markedly improved over the study period. Neurological recovery appeared to be promoted by rapid decompression. Direct surgical hospital admission, rapid organization of theater, and where possible, use of closed reduction, are likely to be effective strategies to reduce the time to decompression. PMID:26650510

  9. Elevated levels of plasminogen activators in the pathogenesis of delayed radiation damage in rat cervical spinal cord in vivo

    International Nuclear Information System (INIS)

    The pathophysiology of the cellular basis of radiation-induced demyelination and white-matter necrosis of the central nervous system (CNS) is poorly understood. Preliminary data suggest that tissue damage is partly mediated through changes in the proteolytic enzymes. In this study, we irradiated rat cervical spinal cords with single doses of 24 Gy of 18 MV photons or 20 MeV electrons and measured the levels of plasminogen activators at days 2, 7, 30, 60, 90, 120, 130 and 145 after irradiation, using appropriate controls at each time. Fibrin zymography revealed fibrinolytic bands representing molecular weights of 68,000 and 48,000 in controls and irradiated samples; these bands increased significantly at days 120, 130 and 145 after irradiation. Inhibition of these enzymatic bands with specific antibodies against tissue-type plasminogen activator (tPA) and amiloride, an inhibitor for urokinase plasminogen activator (uPA), confirmed that these bands were tPA and uPA. Enzymatic levels quantified by densitometry showed a twofold elevation in the levels of tPA and more than a tenfold increase in uPA after 120 days' irradiation. Activity of uPA was increased threefold by day 2 and increased steadily with time compared to nonirradiated control samples. Enzyme-linked immunosorbent assay (ELISA) also showed a threefold increase in the tPA content in the extracts of irradiated rat cervical spinal cords at days 120, 130 and 145. This study adds additional information to the proposed role of plasminogen activators in the pathogenic pathways of radiation damage in the CNS. 38 refs., 6 figs

  10. Penatalaksanaan Trauma Spinal

    OpenAIRE

    Hanafiah, Hafas

    2010-01-01

    Spinal trauma has a potential capability for catastrophic neurologic injury and physical injury. Spinal Trauma usually involved bony elements (vertebral spine), spinal cord, nerve roots, peripheral nerves and soft tissue. Early treatment should begun at the site of injury and during transportation to hospital. Protection to cervical spine and cervical spinal cord and patent respiration are the top priorities. There has been an established definitive procedures for the treatment of spinal trauma.

  11. Cervical Myeloradiculopathy due to Ossification of the Posterior Longitudinal Ligament with versus without Diffuse Idiopathic Spinal Hyperostosis.

    Science.gov (United States)

    Tauchi, Ryoji; Lee, Sang-Hun; Peters, Colleen; Imagama, Shiro; Ishiguro, Naoki; Riew, K Daniel

    2016-06-01

    Study Design Retrospective study. Objectives Assess demographics, ossification characteristics, surgical outcomes, and complications in patients with both diffuse idiopathic spinal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL) compared with patients who only have OPLL. Methods Clinical charts and radiographs of all patients treated surgically from February 2004 to July 2012 for cervical myeloradiculopathy due to DISH with OPLL or OPLL alone were reviewed retrospectively. All patients were observed for a minimum of 1 year. Pre- and postoperative Nurick grades were assessed for all patients. Results Forty-nine patients underwent surgical treatment for cervical myeloradiculopathy due to OPLL, and 8 also had DISH (average 58.9 years, range 37 to 70). The DISH with OPLL group had a significantly higher proportion of subjects with diabetes mellitus (50 versus 9.8% in the OPLL-only group). Everyone in the DISH with OPLL group had continuous or mixed-type OPLL, whereas 78% of patients in the OPLL-only group had primarily segmental type. Operative treatments for patients in the DISH with OPLL group included laminoplasty, anterior decompression and fusion, and posterior laminectomy with fusion. By Nurick grade, 5 patients improved and 3 showed no change. Conclusion Patients with both DISH and OPLL had a higher prevalence of diabetes mellitus and either continuous or mixed-type OPLL classifications. Surgical outcomes were mostly satisfactory; there was no aggravation of symptoms after surgery during the follow up period. PMID:27190737

  12. Subject-specific multi-validation of a finite element model of ovine cervical functional spinal units.

    Science.gov (United States)

    Mengoni, Marlène; Vasiljeva, Ksenija; Jones, Alison C; Tarsuslugil, Sami M; Wilcox, Ruth K

    2016-01-25

    The complex motion and geometry of the spine in the cervical region makes it difficult to determine how loads are distributed through adjacent vertebrae or between the zygapophysial (facet) joints and the intervertebral disc. Validated finite element modes can give insight on this distribution. The aim of this contribution was to produce direct validation of subject-specific finite element models of Functional Spinal Units (FSU׳s) of the cervical spine and to evaluate the importance of including fibre directionality in the mechanical description of the annulus fibrosus. Eight specimens of cervical FSU׳s were prepared from five ovine spines and mechanically tested in axial compression monitoring overall load and displacements as well as local facet joints pressure and displacement. Subject-specific finite element models were produced from microCT image data reproducing the experimental setup and measuring global axial force and displacement as well as local facet joints displacement and contact forces. Material models and parameters were taken from the literature, testing isotropic and anisotropic materials for the annulus fibrosus. The validated models showed that adding the direction of the fibres to their non-linear behaviour in the description of the annulus fibrosus improves the predictions at large strain values but not at low strain values. The load transferred through the facet joints was always accurate, irrespective of the annulus material model, while the predicted facet displacement was larger than the measured one but not significantly. This is, to the authors׳ knowledge, the first subject-specific direct validation study on a group of specimens, accounting for inter-subject variability. PMID:26708919

  13. Conditionally immortalized stem cell lines from human spinal cord retain regional identity and generate functional V2a interneurons and motorneurons

    Czech Academy of Sciences Publication Activity Database

    Cocks, G.; Romanyuk, Nataliya; Amemori, Takashi; Jendelová, Pavla; Forostyak, Oksana; Jeffries, A. R.; Perfect, L.; Thuret, S.; Dayanithi, Govindan; Syková, Eva; Price, J.

    2013-01-01

    Roč. 4, č. 3 (2013), s. 69. ISSN 1757-6512 R&D Projects: GA AV ČR IAA500390902; GA ČR GAP304/11/2373; GA ČR GA13-00939S; GA ČR(CZ) GBP304/12/G069 Institutional research plan: CEZ:AV0Z50390703 Institutional support: RVO:68378041 Keywords : neural stem cell s * spinal cord * motoneurons Subject RIV: FH - Neurology Impact factor: 4.634, year: 2013

  14. 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...

  15. 单开门颈椎椎管扩大成形术治疗颈椎椎管狭窄症的临床观察%Clinical Observation on Cervical Spinal Stenosis Treatel with Single-door Cervical Laminoplasty

    Institute of Scientific and Technical Information of China (English)

    王林伟; 董宇启

    2012-01-01

      目的:探讨对于颈椎椎管狭窄症患者应用单开门颈椎椎管扩大成形术进行治疗的效果.方法:回顾性分析我院收治的34例颈椎椎管狭窄症患者的临床资料,均行单开门椎管扩大成形术,观察疗效及JOA17分评分.结果:所有患者均有效随访,术后优11例,良17例,优良为82%.术前JOA17评分平均为5.34,术后评分平均为10.27.结论:对于颈椎椎管狭窄症的患者采用单开门椎管扩大成形术治疗疗效确切,安全性高,值得在临床上推广使用.%  Objective:To investigate the effects of any treatment for cervical spinal stenosis in patients with single-door cervical laminoplasty.Methods:A retrospective analysis of clinical data of 34 cases of patients with cervical spinal stenosis in our hospital and underwent a single-door laminoplasty effects were observed and JOA17 score.Results:All patients were effective follow-up after surgery that were excellent in 11 cases, good in 17 cases, good for 82%. The preoperative JOA17 score an average of 5.34, the average postoperative score of 10.27. Conclusion: For patients with cervical spinal stenosis, spinal canal of a single door angioplasty for treatment might be efficacy, safety, worthy of use in clinical practice.

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

    International Nuclear Information System (INIS)

    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: Wistar rats were irradiated on the cervical spinal cord with single doses of unmodulated protons (150 MeV) to obtain sharp lateral penumbras, by use of the shoot-through technique, which employs the plateau of the depth-dose profile rather than the Bragg peak. Three types of inhomogeneous dose distributions were administered: Twenty millimeters of cervical spinal cord were irradiated with variable subthreshold (= bath) doses (4 and 18 Gy). At the center of the 20-mm segment, a short segment of 2 mm or 8 mm (= shower) was irradiated with variable single doses. These inhomogeneous dose distributions are referred to as symmetrical bath-and-shower experiments. An asymmetrical dose distribution was arranged by irradiation of 12 mm (= bath) of spinal cord with a dose of 4 Gy. The caudal 2 mm (= shower) of the 12-mm bath was additionally irradiated with variable single doses. This arrangement of inhomogeneous dose distribution is referred to as asymmetrical bath-and-shower experiment. The endpoint for estimation of the dose-response relationships was paralysis of the fore limbs or hind limbs and confirmation by histology. Results: The 2-mm bath-and-shower experiments with a 4-Gy bath dose showed a large shift of the dose-response curves compared with the 2-mm single field, which give lower ED5 values of 61.2 Gy and 68.6 Gy for the symmetrical and asymmetrical arrangement, respectively, compared with an ED5 of 87.8 Gy after irradiation of a 2-mm field only. If the bath dose is increased to 18 Gy, the ED5 value is decreased further to 30.9 Gy. For an 8-mm field, addition of a 4-Gy bath dose did not modify the ED5 obtained for an 8-mm field only (23.2 and 23.1 Gy). Conclusions: The

  17. Delineation of the white and gray matter of the normal human cervical spinal cord using diffusion-weighted echo planar imaging

    International Nuclear Information System (INIS)

    To delineate the white and gray matter of the normal human cervical spinal cord, diffusion-weighted echo planar imaging (DW-EPI) was performed in 11 healthy volunteers. Three axial (X-, Y- and Z-axis) anisotrophic diffusion-weighted images were obtained on a 1.5 T superconducting clinical unit using a single-shot DW-EPI sequence. On X- and Y-axis DWIs the white and gray matter could be well differentiated: the former showed high intensity and the latter low intensity. Anterior columns were clearly visible, whereas posterior columns were not. On Z-axis DWI the white and gray matter could not be differentiated at all, because both showed low intensity. In conclusion, DW-EPI can clearly delineate the white and gray matter of the cervical spinal cord, and this technique will be useful to evaluate white matter disorders such as ischemic or demyelinating disease. (author)

  18. 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

  19. 颈脊髓损伤的康复训练和疗效评价%Rehabilitation training and effect evaluation of cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    王艳华

    2016-01-01

    Objective:To investigate the rehabilitation training method and its effect of cervical spinal cord injury.Methods:According to the actual situation of patients,17 cases of patients with cervical spinal cord injury as the research object were given comprehensive rehabilitation training,the functional improvement and daily life ability of the patients before and after the treatment were compared.Results:The cervical spinal cord injury of patients were significantly improved and the Barthel index was significantly better than before treatment(P<0.05).Conclusion:Early active rehabilitation training could improve the condition of patients with cervical spinal cord injury and improve the living ability,which could promote the rehabilitation of patients.%目的:探讨颈脊髓损伤的康复训练方法及其效果.方法:收治颈脊髓损伤患者17例作为研究对象,根据患者的实际情况给予综合性康复训练,比较治疗前后患者功能改善情况及日常生活自理能力.结果:患者颈脊髓损伤明显改善,且Barthel指数明显优于治疗前(P<0.05).结论:早期、积极的康复训练可改善颈脊髓损伤患者的病情,提高生活能力,促进患者的康复.

  20. Generation patterns of four groups of cholinergic neurons in rat cervical spinal cord: a combined tritiated thymidine autoradiographic and choline acetyltransferase immunocytochemical study

    International Nuclear Information System (INIS)

    This report examines the generation of cholinergic neurons in the spinal cord in order to determine whether the transmitter phenotype of neurons is associated with specific patterns of neurogenesis. Previous immunocytochemical studies identified four groups of choline acetyltransferase (ChAT)-positive neurons in the cervical enlargement of the rat spinal cord. These cell groups vary in both somatic size and location along the previously described ventrodorsal neurogenic gradient of the spinal cord. Thus, large (and small) motoneurons are located in the ventral horn, medium-sized partition cells are found in the intermediate gray matter, small central canal cluster cells are situated within lamina X, and small dorsal horn neurons are scattered predominantly through laminae III-V. The relationships among the birthdays of these four subsets of cholinergic neurons have been examined by combining 3H-thymidine autoradiography and ChAT immunocytochemistry. Embryonic day 11 was the earliest time that neurons were generated within the cervical enlargement. Large and small ChAT-positive motoneurons were produced on E11 and 12, with 70% of both groups being born on E11. ChAT-positive partition cells were produced between E11 and 13, with their peak generation occurring on E12. Approximately 70% of the cholinergic central canal cluster and dorsal horn cells were born on E13, and the remainder of each of these groups was generated on E14. Other investigators have shown that all neurons within the rat cervical spinal cord are produced in a ventrodorsal sequence between E11 and E16. In contrast, ChAT-positive neurons are born only from E11 to E14 and are among the earliest cells generated in the ventral, intermediate, and dorsal subdivisions of the spinal cord

  1. Spontaneous Resolution of Non-traumatic Cervical Spinal Subdural Hematoma Presenting Acute Hemiparesis: A Case Report

    OpenAIRE

    Park, Yong Jin; Kim, Seok Won; Ju, Chang Il; Wang, Hui Sun

    2012-01-01

    Spontaneous cervical SDH with no underlying pathology is a very unusual condition. To the best of the authors' knowledge, only two cases have been previously reported. A 48-year-old female patient was admitted to our emergency room due to severe neck pain following standing up position with rapid onset of hemiparesis. MRI revealed a dorsolateral subdural hematoma from C3-C5 with cord compression. An emergency laminectomy was planned, but motor weakness gradually improved during surgical prepa...

  2. Quantitative study of the cervical spinal cord damage in patients with multiple sclerosis and neuromyelitis optica using diffusion tensor imaging

    International Nuclear Information System (INIS)

    Objective: To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) using diffusion tensor imaging (DTI) and to analyze its correlations with clinical disability scores. Methods: Thirty patients with MS (MS group),28 patients with NMO (NMO group) and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner. DTI indices of cervical spinal cord from all participants were measured, including mean diffusivity (MD) and fractional anisotropy (FA), and the correlations between the DTI metrics and the expanded disability status scale (EDSS) scores were assessed. One-way ANOVA, Dunnett-t test and Spearman correlation analysis were used for statistics. Results: (1) The values of MD among three groups were different at C3 level for left lateral and dorsal columns, C4 level for the central gray substance and dorsal columns, and C5-C6 level for all structures. There were significant differences among them (F=4.006-36.814, P<0.05). The values of FA were significantly different at all levels (F=5.561-98.128, P<0.05). (2) Compared with the control group, the values of MD were increased and FA were decreased for both MS and NMO groups, there were significant differences among them (t=-0.320-3.138, P<0.05). In MS and NMO groups, there were no significant differences of MD (t=-1.183-0.069, P>0.05), while the FA at C4-C6 levels (including the central gray substance, dorsal columns,right lateral columns and left lateral columns) for NMO group were 0.57 ± 0.09, 0.56 ± 0.11, 0.54 ±0.10, 0.57±0.09, 0.55 ±0.11, 0.52 ±0.13, 0.55 ±0.11, 0.54 ±0.13, 0.54±0.10, 0.54±0.11, 0.53 ±0.13, 0.52 ±0.11; and for MS group were 0.67 ±0.10, 0.68 ±0.10, 0.68 ±0.10, 0.70 ±0.12, 0.68 ±0.11, 0.69±0.10, 0.68 ±0.11, 0.69 ±0.12, 0.67 ±0.14, 0.68 ±0.15, 0.69 ±0.14, 0.69 ±0.16, and there were significant differences between two groups (t=-0.011-0.169, P<0.05). (3) Univariate

  3. Synergistic effects of self-assembling peptide and neural stem/progenitor cells to promote tissue repair and forelimb functional recovery in cervical spinal cord injury.

    Science.gov (United States)

    Iwasaki, Motoyuki; Wilcox, Jared T; Nishimura, Yusuke; Zweckberger, Klaus; Suzuki, Hidenori; Wang, Jian; Liu, Yang; Karadimas, Spyridon K; Fehlings, Michael G

    2014-03-01

    While neural stem/progenitor cells (NPCs) show promise for traumatic spinal cord injury (SCI), their efficacy in cervical SCI remains to be established. Moreover, their application to SCI is limited by the challenges posed by the lesion including the glial scar and the post-traumatic cavitation. Given this background, we sought to examine the synergistic effect of self-assembling peptide (SAP) molecules, designed to optimize the post-traumatic CNS microenvironment, and NSCs in a clinically-relevant model of contusive/compressive cervical SCI. We injected K2(QL)6K2 (QL6) SAPs into the lesion epicenter 14 days after bilateral clip compression-induced cervical SCI in rats, combined with simultaneous transplantation of neural stem/progenitor cells (NPCs) intraspinally adjacent to the lesion epicenter. The QL6 SAPs reduced the volume of cystic cavitation in the spinal cord lesion. Simultaneously engrafted NPCs preserved motor neurons and attenuated perilesional inflammation. The combination of QL6 and NPCs promoted forelimb neurobehavioral recovery and was associated with significant improvement in forelimb print area and stride length. In summary, we report for the first time histologic and functional benefits in a clinically-relevant model of cervical SCI through the synergistic effects of combined SAP and NPCs. PMID:24406216

  4. 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

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

    OpenAIRE

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

    2013-01-01

    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 ...

  6. 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.

  7. 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.

  8. A cervical ligamentum flavum cyst in an 82-year-old woman presenting with spinal cord compression: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Brotis Alexandros G

    2012-03-01

    Full Text Available Abstract Introduction We report on a very rare case of a cervical ligamentum flavum cyst, which presented with progressive myelopathy and radiculopathy. The cyst was radically extirpated and our patient showed significant recovery. A review of the relevant literature yielded seven cases. Case presentation An 82-year-old Greek woman presented with progressive bilateral weakness of her upper extremities and causalgia, cervical pain, episodes of upper extremity numbness and significant walking difficulties. Her neurological examination showed diffusely decreased motor strength in both her upper and lower extremities. Magnetic resonance imaging of her cervical spine demonstrated a large, well-demarcated cystic lesion on the dorsal aspect of her spinal cord at the C3 to C4 level, significantly compressing the spinal cord at this level, in close proximity to the yellow ligament and the C3 left lamina. The largest diameter of this lesion was 1.4 cm, and there was no lesion enhancement after the intravenous administration of a paramagnetic contrast. The lesion was surgically removed after a bilateral C3 laminectomy. The thick cystic wall was yellow and fibro-elastic in consistency, while its content was gelatinous and yellow-brownish. A postoperative cervical-spine magnetic resonance image was obtained before her discharge, demonstrating decompression of her spinal cord and dural expansion. Her six-month follow-up evaluation revealed complete resolution of her walking difficulties, improvement in the muscle strength of her arms (4+/5 in all the affected muscle groups, no causalgia and a significant decrease in her preoperative upper extremity numbness. Conclusion Cervical ligamentum flavum cysts are rare benign lesions, which should be included in the list of differential diagnosis of spinal cystic lesions. They can be differentiated from other intracanalicular lesions by their hypointense appearance on T1-weighted and hyperintense appearance on T2

  9. 2-Octyl-cyanoacrylate for wound closure in cervical and lumbar spinal surgery

    OpenAIRE

    Wachter, Dorothee; Brückel, Anja; Stein, Marco; Oertel, Matthias; Christophis, Petros; Böker, Dieter-Karsten

    2010-01-01

    It is claimed that wound closure with 2-octyl-cyanoacrylate has the advantages that band-aids are not needed in the postoperative period, that the wound can get in contact with water and that removal of stitches is not required. This would substantially enhance patient comfort, especially in times of reduced in-hospital stays. Postoperative wound infection is a well-known complication in spinal surgery. The reported infection rates range between 0% and 12.7%. The question arises if the advant...

  10. Theophylline treatment improves mitochondrial function after upper cervical spinal cord hemisection

    OpenAIRE

    Hüttemann, Maik; Nantwi, Kwaku D; Lee, Icksoo; Liu, Jenney; Mohiuddin, Syed; Petrov, Theodor

    2010-01-01

    The importance of mitochondria in spinal cord injury has mainly been attributed to their participation in apoptosis at the site of injury. But another aspect of mitochondrial function is the generation of more than 90% of cellular energy in the form of ATP, mediated by the oxidative phosphorylation (OxPhos) process. Cytochrome c oxidase (CcO) is a central OxPhos component and changes in its activity reflect changes in energy demand. A recent study suggests that respiratory muscle function in ...

  11. 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. PMID:26611563

  12. Motor-related cortical activity after cervical spinal cord injury: multifaceted EEG analysis of isometric elbow flexion contractions.

    Science.gov (United States)

    Cremoux, Sylvain; Tallet, Jessica; Berton, Eric; Dal Maso, Fabien; Amarantini, David

    2013-10-01

    Electroencephalographic (EEG) studies have well established that motor cortex (M1) activity ~20 Hz decreases during muscular contraction and increases as soon as contraction stops, which are known as event-related desynchronization (ERD) and event-related synchronization (ERS), respectively. ERD is supposed to reflect M1 activation, sending information to recruited muscles, while the process underlying ERS is interpreted either as active cortical inhibition or as processing of sensory inputs. Investigation of the process behind ERD/ERS in people with spinal cord injury (SCI) would be particularly relevant since their M1 remains effective despite decreased sensorimotor abilities. In this study, we recorded net joint torque and EEG in 6 participants with cervical SCI and 8 healthy participants who performed isometric elbow flexion at 3 force levels. Multifaceted EEG analysis was introduced to assess ERD/ERS according to their amplitude, frequency range and duration. The results revealed that net joint torque increased with the required force level for all participants and time to contraction inhibition was longer in the SCI group. At the cortical level, ERD/ERS frequency ranges increased with the required force level in all participants, indicating that the modulation of cortical activity with force level is preserved after SCI. However, ERS amplitude decreased only in SCI participants, which may be linked to delayed contraction inhibition. All in all, cortical modulation of frequency range and amplitude could reflect two different kinds of neural communication. PMID:23939224

  13. Trendelenburg chest optimization prolongs spontaneous breathing trials in ventilator-dependent patients with low cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Charles J. Gutierrez, PhD, RRT, FAARC

    2010-05-01

    Full Text Available Chest optimization, an evidence-based protocol-guided multimodal chest physiotherapy consisting of body positioning, sputum mobilization, bronchodilation, and lung hyperinflation, may be routinely administered to ventilator-dependent patients with low cervical spinal cord injury (CSCI for improving pulmonary functional outcomes that facilitate weaning from mechanical ventilation. We undertook this study to determine whether position-specific chest optimization was associated with changes in spontaneous breathing trial (SBT duration. Cardiac output (CO, alveolar minute volume (MValv, carbon dioxide elimination (VCO2, and static chest compliance (Cst were measured during chest optimization; then MValv and rapid shallow breathing index (RSBI were measured during SBT. Study participants (N = 12 were clinically stable ventilator-dependent patients with low CSCI. Trendelenburg chest optimization (TCO was associated with significant increases in SBT (p < 0.001, CO (p < 0.001, MValv (p < 0.003, VCO2 (p < 0.001, and Cst (p < 0.002. SBT following TCO was associated with significant increases in MValv (p < 0.03 and RSBI (p < 0.002. These preliminary findings suggest the importance of proper recumbent body positioning during evidence-based, protocol-guided multimodal chest physiotherapy for ventilator-dependent patients with low CSCI.

  14. 儿童寰枢椎脱位合并颈脊髓压迫%Atlanto-axial Dislocation Associated with Compression of Cervical Spinal Cord in Children

    Institute of Scientific and Technical Information of China (English)

    刘洪奎; 贾连顺; 徐印坎

    1986-01-01

    This paper reports five children suffering from atlantoaxial dislocation due to trauma of cervical vertebrae,congenital abnormality of atlas,dysptasia or defects of os odontoideum and other diseases.As conservative therapy,traction and cervical support treatment all.failed and cervical spinal cord compression symptom gradually appeared,such as spasmotic palsy of lower limbs (2 cases),weak and unstable gait (3),so a procedure of resection of posterior arch of atlas and occipito-cervical fusion was performed.Follow-ups carried on 6 to 60 months after operation showed that satisfactory results were achieved in 4 cases,disappearance of lower limb spasm in 2 cases,4 children went back to school and only one died from other cause.The operative technique is described as well as its indications,choice of operation time and the modified occipitocervical fusion.The authors also point out that in children once atlanto-axial dislocation is found to be associated with cervical spinal cord compression,operation should be imminent and the result will be good.%@@ 寰枢椎由于先天发育不良、畸形、外伤或疾患引起不稳定者并非少见,此位置的关节不稳定比脊柱任何部位的关节不稳定更为危险,并有脊髓压迫症状时可导致四肢瘫痪或突然死亡~((1、2)),儿童期寰枢椎不稳定,保守治疗可能得到治愈,而需要行寰椎后弓切除减压及枕颈融合者极少.

  15. Morphology and measurements of the cervical spinal cord in computer-assisted myelography

    International Nuclear Information System (INIS)

    Thirty-six control subjects had Computer Assisted Myelography (CAM) using the EMI CT 5005 scanner. The normal cervical cord is elliptical, more circular at the upper and lower ends and flatter in the mid-segments. Asymptomatic cord deformities, usually mild, were present in nine subjects (25%). Four measurements, namely, sagittal diameter (APD), transverse diameter (TD), area (a) and circumference (c) were made and two more parameters calculated i.e. APD/TD ratio and circularity (=4 π a/c2). These control values from the basis of qualitative and quantitative assessment of cord deformity. When cord measurements are to be used, control values should be obtained for each scanner and procedures should be standardized. (orig.)

  16. The prevalence and phenotype of activated microglia/macrophages within the spinal cord of the hyperostotic mouse (twy/twy changes in response to chronic progressive spinal cord compression: implications for human cervical compressive myelopathy.

    Directory of Open Access Journals (Sweden)

    Takayuki Hirai

    Full Text Available BACKGROUND: Cervical compressive myelopathy, e.g. due to spondylosis or ossification of the posterior longitudinal ligament is a common cause of spinal cord dysfunction. Although human pathological studies have reported neuronal loss and demyelination in the chronically compressed spinal cord, little is known about the mechanisms involved. In particular, the neuroinflammatory processes that are thought to underlie the condition are poorly understood. The present study assessed the localized prevalence of activated M1 and M2 microglia/macrophages in twy/twy mice that develop spontaneous cervical spinal cord compression, as a model of human disease. METHODS: Inflammatory cells and cytokines were assessed in compressed lesions of the spinal cords in 12-, 18- and 24-weeks old twy/twy mice by immunohistochemical, immunoblot and flow cytometric analysis. Computed tomography and standard histology confirmed a progressive spinal cord compression through the spontaneously development of an impinging calcified mass. RESULTS: The prevalence of CD11b-positive cells, in the compressed spinal cord increased over time with a concurrent decrease in neurons. The CD11b-positive cell population was initially formed of arginase-1- and CD206-positive M2 microglia/macrophages, which later shifted towards iNOS- and CD16/32-positive M1 microglia/macrophages. There was a transient increase in levels of T helper 2 (Th2 cytokines at 18 weeks, whereas levels of Th1 cytokines as well as brain-derived neurotrophic factor (BDNF, nerve growth factor (NGF and macrophage antigen (Mac-2 progressively increased. CONCLUSIONS: Spinal cord compression was associated with a temporal M2 microglia/macrophage response, which may act as a possible repair or neuroprotective mechanism. However, the persistence of the neural insult also associated with persistent expression of Th1 cytokines and increased prevalence of activated M1 microglia/macrophages, which may lead to neuronal loss and

  17. 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。

  18. 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.

  19. Axonal regeneration and development of de novo axons from distal dendrites of adult feline commissural interneurons after a proximal axotomy

    DEFF Research Database (Denmark)

    Fenrich, Keith K; Skelton, Nicole; MacDermid, Victoria E;

    2007-01-01

    Following proximal axotomy, several types of neurons sprout de novo axons from distal dendrites. These processes may represent a means of forming new circuits following spinal cord injury. However, it is not know whether mammalian spinal interneurons, axotomized as a result of a spinal cord injur...

  20. Chemical exchange saturation transfer of the cervical spinal cord at 7 T.

    Science.gov (United States)

    Dula, Adrienne N; Pawate, Siddharama; Dethrage, Lindsey M; Conrad, Benjamin N; Dewey, Blake E; Barry, Robert L; Smith, Seth A

    2016-09-01

    High-magnetic-field (7 T) chemical exchange saturation transfer (CEST) MRI provides information on the tissue biochemical environment. Multiple sclerosis (MS) affects the entire central nervous system, including the spinal cord. Optimal CEST saturation parameters found via simulation were implemented for CEST MRI in 10 healthy controls and 10 patients with MS, and the results were examined using traditional asymmetry analysis and a Lorentzian fitting method. In addition, T1 - and T2 *-weighted images were acquired for lesion localization and the transmitted B1 (+) field was evaluated to guide imaging parameters. Distinct spectral features for all tissue types studied were found both up- and downfield from the water resonance. The z spectra in healthy subjects had the expected z spectral shape with CEST effects apparent from 2.0 to 4.5 ppm. The z spectra from patients with MS demonstrated deviations from this expected normal shape, indicating this method's sensitivity to known pathology as well as to tissues appearing normal on conventional MRI. Examination of the calculated CESTasym revealed increased asymmetry around the amide proton resonance (Δω = 3.5 ppm), but it was apparent that this measure is complicated by detail in the CEST spectrum upfield from water, which is expected to result from the nuclear Overhauser effect. The z spectra upfield (negative ppm range) were also distinct between healthy and diseased tissue, and could not be ignored, particularly when considering the conventional asymmetry analysis used to quantify the CEST effect. For all frequencies greater than +1 ppm, the Lorentzian differences (and z spectra) for lesions and normal-appearing white matter were distinct from those for healthy white matter. The increased frequency separation and signal-to-noise ratio, in concert with prolonged T1 at 7 T, resulted in signal enhancements necessary to detect subtle tissue changes not possible at lower field strengths. This study

  1. Metabotropic glutamate receptor 5 contributes to inflammatory tongue pain via extracellular signal-regulated kinase signaling in the trigeminal spinal subnucleus caudalis and upper cervical spinal cord

    Directory of Open Access Journals (Sweden)

    Liu Ming-Gang

    2012-11-01

    Full Text Available Abstract Background In the orofacial region, limited information is available concerning pathological tongue pain, such as inflammatory pain or neuropathic pain occurring in the tongue. Here, we tried for the first time to establish a novel animal model of inflammatory tongue pain in rats and to investigate the roles of metabotropic glutamate receptor 5 (mGluR5-extracellular signal-regulated kinase (ERK signaling in this process. Methods Complete Freund’s adjuvant (CFA was submucosally injected into the tongue to induce the inflammatory pain phenotype that was confirmed by behavioral testing. Expression of phosphorylated ERK (pERK and mGluR5 in the trigeminal subnucleus caudalis (Vc and upper cervical spinal cord (C1-C2 were detected with immunohistochemical staining and Western blotting. pERK inhibitor, a selective mGluR5 antagonist or agonist was continuously administered for 7 days via an intrathecal (i.t. route. Local inflammatory responses were verified by tongue histology. Results Submucosal injection of CFA into the tongue produced a long-lasting mechanical allodynia and heat hyperalgesia at the inflamed site, concomitant with an increase in the pERK immunoreactivity in the Vc and C1-C2. The distribution of pERK-IR cells was laminar specific, ipsilaterally dominant, somatotopically relevant, and rostrocaudally restricted. Western blot analysis also showed an enhanced activation of ERK in the Vc and C1-C2 following CFA injection. Continuous i.t. administration of the pERK inhibitor and a selective mGluR5 antagonist significantly depressed the mechanical allodynia and heat hyperalgesia in the CFA-injected tongue. In addition, the number of pERK-IR cells in ipsilateral Vc and C1-C2 was also decreased by both drugs. Moreover, continuous i.t. administration of a selective mGluR5 agonist induced mechanical allodynia in naive rats. Conclusions The present study constructed a new animal model of inflammatory tongue pain in rodents, and

  2. Comparison of MRI sequences for evaluation of multiple sclerosis of the cervical spinal cord at 3 T

    International Nuclear Information System (INIS)

    Purpose: Debate remains regarding the utility of the traditional STIR (short inversion time recovery) sequence in aiding MRI diagnosis of spinal cord lesions in patients with multiple sclerosis (MS) and this sequence is not included in the current imaging guidelines. A recent study proposed a T1 weighted STIR as a superior alternative to the traditional STIR and T2 fast spin echo (FSE). Thus, the aim of this study was to compare the sensitivity of T2, standard STIR and T1 weighted STIR sequences in the evaluation of MS plaques on our 3 T system. Methods and materials: A retrospective analysis of patients with multiple sclerosis who presented to our institution over a period of 5 months and who had cervical cord lesions was undertaken. Patients had been examined with our institutional protocol which included T2 FSE, STIR and the recommended T1 STIR. Quantitative analysis of the lesions versus background cord using sample T-tests was performed for each sequence, and comparative analysis of the lesion contrast:background cord ratios of the 3 sequences (using two-way ANOVA tests) was performed. Results: The T2 sequence was not as sensitive in detecting lesions versus the traditional STIR and T1 weighted STIR, with 10% of lesions not detected using statistical analysis (p < 0.05). The traditional STIR also demonstrated greater contrast ratios than the T2 sequence (p < 0.05) suggesting increased sensitivity. However, the T1 STIR demonstrated even greater contrast ratios than both the traditional STIR and T2 sequences (p < 0.05). Conclusion: This study confirms earlier findings of the traditional STIRs increased sensitivity versus the T2 sequence. However, the new “T1 weighted STIR” appears to be even more sensitive than both these sequences showing potential promise as an alternative method to monitor demyelinating plaques of MS.

  3. 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.

  4. 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

  5. Tuina treatment in cervical spondylosis

    OpenAIRE

    Florin Mihai Hinoveanu

    2010-01-01

    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 princ...

  6. Simultaneous Brain-Cervical Cord fMRI Reveals Intrinsic Spinal Cord Plasticity during Motor Sequence Learning.

    Directory of Open Access Journals (Sweden)

    Shahabeddin Vahdat

    2015-06-01

    Full Text Available The spinal cord participates in the execution of skilled movements by translating high-level cerebral motor representations into musculotopic commands. Yet, the extent to which motor skill acquisition relies on intrinsic spinal cord processes remains unknown. To date, attempts to address this question were limited by difficulties in separating spinal local effects from supraspinal influences through traditional electrophysiological and neuroimaging methods. Here, for the first time, we provide evidence for local learning-induced plasticity in intact human spinal cord through simultaneous functional magnetic resonance imaging of the brain and spinal cord during motor sequence learning. Specifically, we show learning-related modulation of activity in the C6-C8 spinal region, which is independent from that of related supraspinal sensorimotor structures. Moreover, a brain-spinal cord functional connectivity analysis demonstrates that the initial linear relationship between the spinal cord and sensorimotor cortex gradually fades away over the course of motor sequence learning, while the connectivity between spinal activity and cerebellum gains strength. These data suggest that the spinal cord not only constitutes an active functional component of the human motor learning network but also contributes distinctively from the brain to the learning process. The present findings open new avenues for rehabilitation of patients with spinal cord injuries, as they demonstrate that this part of the central nervous system is much more plastic than assumed before. Yet, the neurophysiological mechanisms underlying this intrinsic functional plasticity in the spinal cord warrant further investigations.

  7. Development of Cortical Interneurons

    OpenAIRE

    Chu, Jianhua; Anderson, Stewart A.

    2014-01-01

    Inhibitory local circuit neurons (LCNs), often called interneurons, have vital roles in the development and function of cortical networks. Their inhibitory influences regulate both the excitability of cortical projection neurons on the level of individual cells, and the synchronous activity of projection neuron ensembles that appear to be a neural basis for major aspects of cognitive processing. Dysfunction of LCNs has been associated with neurological and psychiatric diseases, such as epilep...

  8. 颈前路手术治疗脊髓型颈椎病并颈椎外伤所致急性颈髓损伤19例临床分析%Clinical analysis on 19 cases of anterior cervical surgical treatment of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma

    Institute of Scientific and Technical Information of China (English)

    张明友; 陈德元

    2014-01-01

    目的 探讨颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的疗效.方法 回顾性分析采用颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗的脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的19例患者病历资料,对患者外伤前(T1)、外伤后(T2)、术后1周内(T3)、术后10个月后(T4)四个时期的颈椎曲度及神经功能评分(JOA)变化进行分析,判断手术疗效.结果 所有患者均获得10~24个月随访,平均(15.2±6.7)个月.T1、T2、T3、T4四个时期的颈椎曲度分别为(28.621±1.850)°、(29.326±2.416)°、(38.384±2.611)°、(37.316±2.521)°.T1、T2、T3、T4四个时期的JOA脊髓型颈椎病评分分别为(12.79±1.316)、(4.00±2.082)、(9.68±3.001)、(11.68±3.334).结论 颈前路椎体次全切并后纵韧带切除减压植骨融合术可达到有效减压效果、可重建颈椎曲度,能提供脊髓型颈椎病并颈椎外伤所导致的颈髓损伤有效康复条件;术后积极康复治疗也是改善神经功能的重要方法.%Objective To explore the effect of anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic in acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma.Methods Retrospective analysis was carried out to 19 cases of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma who used anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic,and analysis of patients before trauma (T)1,post-traumatic (T2),within 1 week after operation (T3),10 months after operation (T4) these four periods about the changes of cervical curvature and neural function (JOA score) were analyzed,then evaluated the operation curative effect.Results All patients were followed

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

    Directory of Open Access Journals (Sweden)

    Campos Cynthia Resende

    2003-01-01

    Full Text Available 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 and no structural lesion was found in magnetic resonance imaging (MRI. Botulinum toxin type A was injected in infrahyoid muscles and cervical paraspinal musculature. The patient remained free of symptoms for almost five months. The pathophysiology of spinal myoclonus remains speculative, but there is evidence that various possible mechanisms can be involved: loss of inhibitory function of local dorsal horn interneurons, abnormal hyperactivity of local anterior horn neurons, aberrant local axons re-excitations and loss of inhibition from suprasegmentar descending pathways.

  10. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    Directory of Open Access Journals (Sweden)

    Bartels Ronald HMA

    2013-01-01

    Full Text Available Abstract Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was propagated with good clinical results. Proponents for early surgery as well those favoring conservative treatment are still in debate. The proposed trial will contribute to the discussion and hopefully also to a decrease in the variability of clinical practice. Methods/Design A randomized controlled trial is designed to compare the clinical outcome of early surgical strategy versus a conservative approach. The primary outcome is clinical outcome according to mJOA. This also measured by ASIA score, DASH score and SCIM III score. Other endpoints are duration of the stay at a high care department (medium care, intensive care, duration of the stay at the hospital, complication rate, mortality rate, sort of rehabilitation, and quality of life. A sample size of 36 patients per group was calculated to reach a power of 95%. The data will be analyzed as intention-to-treat at regular intervals, but the end evaluation will take place at two years post-injury. Discussion At the end of the study, clinical outcomes between treatments attitudes can be compared. Efficacy, but also efficiency can be determined. A goal of the study is to determine which treatment will result in the best quality of life for the patients. This study will certainly contribute to more uniformity of treatment offered to patients with a special sort of spinal cord injury. Trial Registration Gov: NCT01367405

  11. 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

    International Nuclear Information System (INIS)

    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

  12. 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

  13. 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. PMID:21440609

  14. Surgical treatment of cervical spinal cord injury without fracture and dislocation%无骨折脱位的颈脊髓损伤的手术治疗

    Institute of Scientific and Technical Information of China (English)

    乔宗瑞

    2014-01-01

    Objective To explore the effect of surgical treatment of cervical spinal cord injury without fracture and dislocation. Methods 45 cases of cervical spinal cord injury without fracture and dislocation were treated with early decompression surgery. The changes in JOA score before and after treatment were compared. Results The excellent rate of surgical treatment reached 82.2%. The average JOA score after surgery (9.31±1.86) was significantly higher than that before surgery (5.24±1.52), with statistical significance(P < 0.01). Conclusion Prompt and correct diagnosis, propoer grasp of the operation time and positive surgical intervention can achieve better clinical effect for spinal cord injury without fracture and dislocation.%目的:探讨无骨折脱位的颈髓损伤的手术治疗效果。方法45例无骨折脱位型颈髓损伤患者,均行早期减压手术治疗。对比治疗前后JOA评分变化。结果手术治疗优良率82.2%。术后JOA平均评分(9.31±1.86)明显高于术前(5.24±1.52),差异有统计学意义(P<0.01)。结论对无骨折脱位型脊髓损伤,及时正确的诊断,正确把握手术时机,积极外科干预可取得较好的临床效果。

  15. The psychological state of the post- hospital patients with quadriplegia caused by cervical spinal cord injury%颈髓损伤并四肢瘫痪患者出院后心理状况的调查分析

    Institute of Scientific and Technical Information of China (English)

    杨绿频; 黄楚君; 陈楚玲

    2010-01-01

    目的 调查颈髓损伤并四肢瘫痪患者出院后的心理状况,寻求相应康复对策.方法 应用症状自评量表(SCL-90)对88例出院后的颈髓损伤并四肢瘫痪患者进行调查.结果 出院后的颈髓损伤并四肢瘫痪患者的SCL各项得分均超出常模.结论 颈髓损伤并四肢瘫痪患者出院后的心理健康状况都不理想,应采取相应措施改变其心理状况.%Objective To investigate the psychological state of the post-hospital patients with quadriplegia caused by cervical spinal cord injury , so as to seek appropriate rehabilitation strategies. Methods SCL (SCL-90) was used to investigate 88 post -hospital patients with quadriplegia caused by cervical spinal cord injury. Results The every SCL score of post - hospital patients with quadriplegia caused by cervical spinal cord injury was beyond the normal. Conclusions The mental health of the post - hospital patients with quadriplegia caused by cervical spinal cord injury has not been satisfied.

  16. Clinical Observation on Surgery in the Treatment of Traumatic Cervical Spinal Column and Spinal Cord Injury%手术治疗外伤性颈段脊柱、脊髓损伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    宋善新

    2015-01-01

    目的:观察前路植骨钢板内固定法在外伤性颈椎间盘突出疾病治疗中的临床疗效。方法将31例外伤性颈椎间盘突出伴脊髓损伤的患者根据Franke功能分别分为A、B、C、D、E级,采取前路手术方法减压,观察并记录临床疗效。结果多数患者术后恢复1~2个等级,平均随访(15±0.4)个月,未出现植骨不融合或钢板松动、断裂的现象。结论治疗外伤性颈椎间盘突出伴脊髓损伤最有效的手段是前路植骨钢板内固定法,减压效果显著,术后损伤脊柱、脊髓恢复效果良好。%Objective To observe the clinical efficacy of anterior bone graft and plate fixation in treatment of traumatic cervical disc disease. Methods The 31 patients with traumatic cervical disc herniation with spinal cord injury were divided into A,B,C,D,E class function according to Franke,taking anterior surgical decompression,observed and recorded the clinical efficacy. Results Most patients recoverred after 1 to 2 grade,with an average fol ow-up of(15±0.4)months,the phenomenon of nonunion or steel loose or broken were not occurred. Conclusion The most effective means of treatment of traumatic cervical disc herniation with spinal cord injury is anterior bone graft and plate fixation,it has significant decompression effect, and good effect of postoperative spine injury and spinal cord recovery.

  17. The potential contributing effect of ketorolac and fluoxetine to a spinal epidural hematoma following a cervical interlaminar epidural steroid injection: a case report and narrative review.

    Science.gov (United States)

    Chien, George C Chang; McCormick, Zack; Araujo, Marco; Candido, Kenneth D

    2014-01-01

    Cervical interlaminar epidural steroid injections (ESIs) are commonly performed as one part of a multi-modal analgesic regimen in the management of upper extremity radicular pain. Spinal epidural hematoma (SEH) is a rare complication with a reported incidence ranging from 1.38 in 10,000 to 1 in 190,000 epidurals. Current American Society of Regional Anesthesia (ASRA), American Society of Interventional Pain Physicians (ASIPP), and the International Spine Intervention Society (ISIS) recommendations are that non-steroidal anti-inflammatory drugs (NSAIDs) do not need to be withheld prior to epidural anesthesia. We report a case wherein intramuscular ketorolac and oral fluoxetine contributed to a SEH and tetraplegia following a cervical interlaminar (ESI). A 66 year-old woman with chronic renal insufficiency and neck pain radiating into her right upper extremity presented for evaluation and was deemed an appropriate CESI candidate. Cervical magnetic resonance imaging (MRI) revealed multi-level neuroforaminal stenosis and degenerative intervertebral discs. Utilizing a loss of resistance to saline technique, an 18-gauge Tuohy-type needle entered the epidural space at C6-7. After negative aspiration, 4 mL of saline with 80 mg of methyl-prednisolone was injected. Immediately thereafter, the patient reported significant spasmodic-type localized neck pain with no neurologic status changes. A decision was made to administer 30 mg intramuscular ketorolac as treatment for the spasmodic-type pain. En route home, she developed a sudden onset of acute tetraplegia. She was brought to the emergency department for evaluation including platelet and coagulation studies which were normal. MRI demonstrated an epidural hematoma extending from C5 to T7. She underwent a bilateral C5-T6 laminectomy with epidural hematoma evacuation and was discharged to an acute inpatient rehabilitation hospital. Chronic renal insufficiency, spinal stenosis, female gender, and increasing age have been

  18. 颈髓髓内血管母细胞瘤的显微外科治疗%Microsurgery for intrameduallary hemangioblastoma in cervical spinal cord

    Institute of Scientific and Technical Information of China (English)

    王一芳; 谭启富; 王正伟; 许爱刚; 吴章泽

    2015-01-01

    目的:探讨颈髓髓内血管母细胞瘤的手术治疗。方法回顾性分析5例颈髓髓内血管母细胞瘤患者的临床特征、影像学表现、肿瘤切除情况以及手术前后神经功能改变。结果4例患者肿瘤全切除,1例患者次全切除。次全切除患者术后辅以直线加速器放射治疗。术后神经功能改善4例、无改善0例、加重1例。行放射治疗的患者复查未见肿瘤增大。结论颈髓髓内血管母细胞瘤的诊断主要依靠MRI,正确的手术策略与熟练的显微手术技巧至关重要。对于残留肿物可行直线加速器放射治疗。%Objective To study the microsurgical treatment of the intrameduallary hemangioblastoma of cervical spinal cord .Methods Clinical manifestation , imaging features and managements of 5 patients with intrameduallary hemangioblastoma in cervical spinal cord were analyzed retrospectively .The preoprative and postoprative nervous function were evaluated .Results Gross total resection was achieved in 4 cases and subtotal resection in 1 case .The patient was performed linear accelerator-based radiosurgery following the subtotal resection .Postoperative clinical symptoms were improved in 4 cases,unchanged in 0 and aggravted in 1.The residual tumor was not enlarged after irradiation .Conclusions MRI is recommended as the principal diagnostic method for the intrameduallary hemangioblastoma of cervical spinal cord .Approprite operative strategies and skillful microsurgical rechniques are the base of the successful operation .Linear accelerator-based irradiation is suggested for the residual tumor .

  19. Laminar hook instrumentation in the cervical spine. An experimental study on the relation of hooks to the spinal cord

    OpenAIRE

    Fagerström, T.; Hedlund, R.; Bancel, P.; Robert, R; Dupas, B.

    2001-01-01

    Several anterior and posterior methods are today available for stabilization of the cervical spine. Factors such as level and degree of instability, method of decompression, bone quality, length of fixation and safety factors influence the choice of method for a particular patient. The use of laminar hooks in the cervical spine has been restricted by fear of cord compression with the potential of tetraplegia. The aim of the present study was to assess the safety and determine the anatomical r...

  20. 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...

  1. 颈髓损伤后呼吸肌功能障碍修复的研究进展%Advance in Restoration of Respiratory Muscle Dysfunction after Cervical Spinal Cord Injury (review)

    Institute of Scientific and Technical Information of China (English)

    周雅; 洪毅; 姜树东; 白金柱

    2014-01-01

    颈髓损伤后呼吸功能障碍是伤后早期死亡的首要原因,可通过电刺激、磁刺激、神经移位术、细胞移植等手段对患者的呼吸功能进行修复。本文将颈髓损伤后呼吸肌功能障碍的解剖基础、临床表现、修复技术方法等做一综述。%Respiratory dysfunction is the primary cause of death early after cervical spinal cord injury, and it can be restored by electri-cal stimulation, magnetic stimulation, nerve transfer surgery, and cell transplantation. This paper reviewed the anatomy, clinical manifesta-tions, and associated restoration techniques of respiratory muscle dysfunction after cervical spinal cord injury.

  2. 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

    Diffusion tensor imaging has been used in a number of spinal cord studies, but severe distortions caused by susceptibility induced field inhomogeneities limit its applicability to investigate small volumes within acceptable acquisition times. A way to evaluate image distortions is to map the poin...

  3. 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

  4. 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

  5. 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.

  6. The delayed post-injury administration of soluble fas receptor attenuates post-traumatic neural degeneration and enhances functional recovery after traumatic cervical spinal cord injury.

    Science.gov (United States)

    Robins-Steele, Sherri; Nguyen, Dung Hoang; Fehlings, Michael G

    2012-05-20

    Spinal cord injury (SCI) is a devastating condition that currently lacks clinically-relevant and effective neuroprotective therapeutic options. Optimal therapeutic agents for clinical translation should show efficacy in a cervical compression/contusion model using a clinically-relevant post-injury therapeutic time window. To date, few compounds have met that rigorous standard. The objective of this work was to evaluate the efficacy of delayed post-injury administration of soluble Fas receptor (sFasR) via intrathecal catheter following acute cervical SCI in a clinically-relevant contusion/compression model. Female Wistar rats were given a C7-T1 moderately severe clip compression injury, followed by either 8-h or 24-h delayed treatment initiation. Long-term neurobehavioral analysis of motor recovery and neuropathic pain development was undertaken. The extent of oligodendrocyte and neuron survival was assessed in peri-lesional cord sections 8 weeks post-SCI. This was complemented by an evaluation of the level of tissue preservation at and adjacent to the site of injury. In animals treated with sFasR delayed 8 h post-injury, significant behavioral effects were observed, coinciding with enhanced cell survival, peri-lesional tissue sparing, and enhanced integrity of descending fiber tracts compared to control treatments. Animals treated with sFasR delayed by 24 h showed more modest improvements in behavioral recovery, and had consistent improvements in cell survival and tissue preservation. This work has shown for the first time that the Fas-mediated apoptotic pathway can be therapeutically targeted in a clinically-relevant time window post-SCI. PMID:22260324

  7. Trans aqueductal, third ventricle – Cervical subarachnoid stenting: An adjuvant cerebro spinal fluid diversion procedure in midline posterior fossa tumors with hydrocephalus: The technical note and case series

    Science.gov (United States)

    Teegala, Ramesh

    2016-01-01

    Background: Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle – Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Materials and Methods: Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. Results: There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. Conclusions: This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique. PMID:27366254

  8. 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.)

  9. 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.

  10. Morphometric study of cervical anterior horn cells and pyramidal tracts in medulla oblongata and the spinal cord in patients with cerebrovascular diseases.

    Science.gov (United States)

    Qiu, Y; Wada, Y; Otomo, E; Tsukagoshi, H

    1991-04-01

    To clarify the effect of damage to the upper motor neurons on lower motor neurons, quantitative studies were made regarding the cross-sectional area and the number of the individual anterior horn cells in the lateral nuclear cell groups of the 5th segment of the cervical spinal cord (C5), and regarding the cross-sectional areas of the pyramidal tract in the medulla, and in the spinal cord at the C5 and L2 levels. The subjects included 45 patients with cerebrovascular disease (CVD), and 50 age-matched controls without neurological disease. The medullary pyramid (MP) and the ventral funiculus (VF), ipsilateral to the hemispheric lesion, were compared with the MP and VF of the other, unaffected, side. The ventro-lateral funiculus (VLF), anterior horn (AH) and C5 anterior horn cell (AHC), contralateral to the lesion, were also compared with the VLF, AH, and AHC of the other, unaffected, side. The AHC area (mean cross-sectional area of anterior horn cells) and the MP area, VF area, VLF area, AH area (mean cross-sectional areas of MP, VF, VLF and AH) associated with the hemispheric lesional side were significantly decreased, compared with those of the unaffected sides and the controls. However, there was no significant difference in AHC number between the affected and unaffected sides in patients with CVD, nor between the affected side and the controls. In order to examine the relationship between a decrease in AHC area and degree of paralysis, CVD patients were divided into two groups according to degree of muscle strength: the severe and mild paralysis groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2072114

  11. Spinal angiography. Anatomy, technique and indications

    International Nuclear Information System (INIS)

    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.)

  12. Syringomyelia Associated with a Spinal Arachnoid Cyst

    OpenAIRE

    Kim, Min-Su; Kim, Seong-Ho

    2009-01-01

    While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed t...

  13. A Noninvasive Neuroprosthesis Augments Hand Grasp Force in Individuals with Cervical Spinal Cord Injury: The Functional and Therapeutic Effects

    OpenAIRE

    Rune Thorsen; Davide Dalla Costa; Sara Chiaramonte; Luca Binda; Ettore Beghi; Tiziana Redaelli; Eugenio Occhi; Maurizio Ferrarin

    2013-01-01

    Objectives. The primary purpose of this study was to evaluate myoelectrically controlled functional electrical stimulation (MeCFES) for enhancing the tenodesis grip in people with tetraplegia. The second aim was to estimate the potential number of candidates for the MeCFES device. The application of MeCFES provides the user with direct control of the grasp force as opposed to triggered FES systems. Methods. Screening 253 medical records of C5 to C7 spinal cord injury resulted in 27 participan...

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

    Directory of Open Access Journals (Sweden)

    Marieke G . M. Kloosterman, PT, MSc

    2010-09-01

    Full Text Available 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.

  15. A hypothesis on possible neurochemical mechanisms of action of cervical spinal cord stimulation in prevention and treatment of cerebral arterial vasospasm after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Yin, D; Slavin, K V

    2015-09-01

    Subarachnoid hemorrhage (SAH) is associated with the high incidence of development of cerebral vasospasm that results in morbidity and mortality due to delayed cerebral ischemia. So far there are no consistently effective therapies for treatment of vasospasm in patients suffering from SAH. It is well known that cervical spinal cord stimulation (SCS) can induce vasodilatation and increase cerebral blood flow (CBF). Based on the experiments in animals and the studies in humans, we have proposed the possibility to use SCS as a therapeutic strategy for prevention and treatment of cerebral vasospasm after SAH. However, the physiological mechanisms of action of SCS in this regard are poorly understood. Better understanding of the pathophysiology of vasospasm after SAH may provide insight into the role of SCS in such conditions. We hypothesize that effect of SCS on vasodilatation may be related to modulation of activity of phosphodiesterases 5 (PDE-5) and nitric oxide synthase (eNOS), resulting in enhancement of nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) pathway, which may help prevent and/or treat vasospasm after SAH. Further investigations on the physiological mechanisms of action of SCS would be necessary to support this hypothesis. PMID:26141634

  16. 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. PMID:21110258

  17. Anterior surgical treatment of cervical spondylosis of spinal cord and nerve root type%脊髓型及神经根型颈椎病的前路手术治疗

    Institute of Scientific and Technical Information of China (English)

    刘向阳; 杨宝来; 张辉

    2015-01-01

    Objective To analyze the curative effect of anterior operation in treatment of spinal cord and nerve root type cervical spondylosis.Methods Choose our hospital 16 cases of cervical spinal cord and nerve root type of cervical spondylosis patients as the observation object (December 2014 to February 2012), in fact, the implementation of anterior surgery for treatment, observe the effect of surgery.Results The average intraoperative blood loss was (90.12±15.34) ml, the average JOA score was (14.58±1.34), the cure rate was93.75%. Conclusion Spinal cord and nerve root type of cervical spondylosis anterior surgery treatment effect is remarkable, safe and reliable, it is worth promoting.%目的:分析前路手术治疗脊髓型及神经根型颈椎病的疗效。方法选择2012年2月~2014年12月我院收治的脊髓型及神经根型颈椎病患者16例作为研究对象,对其实施前路手术进行治疗,并观察手术效果。结果患者术中平均出血量为(90.12±15.34)mL,JOA平均评分为(14.58±1.34)分,治愈率为93.75%。结论脊髓型及神经根型颈椎病的前路手术疗效显著,安全可靠,值得临床推广应用。

  18. Treatment of Cervicogenic Headache with Cervical Epidural Steroid Injection

    OpenAIRE

    Wang, Eugene; Wang, Dajie

    2014-01-01

    Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat th...

  19. Recurrent Autonomic Dysreflexia due to Chronic Aortic Dissection in an Adult Male with Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2008-01-01

    Full Text Available Autonomic dysreflexia is a hypertensive clinical emergency for persons with spinal cord injury at T-6 level or above. Recurrent autonomic dysreflexia is uncommon in spinal cord injury patients and is usually caused by noxious stimuli that cannot be removed promptly, e.g., somatic pain, abdominal distension. A 61-year-old man, who sustained tetraplegia at C-5 (ASIA-A 38 years ago, was admitted with chest infection. Computerised tomography (CT of the chest showed the ascending aorta to measure 4 cm in anteroposterior diameter; descending thoracic aorta measured 3.5 cm. No dissection was seen. Normal appearances of abdominal aorta were seen. He was treated with noninvasive ventilation, antibiotics, and diuretics. Nineteen days later, when there was sudden deterioration in his clinical condition, CT of the pulmonary angiogram was performed to rule out pulmonary embolism. This showed no pulmonary embolus, but the upper abdominal aorta showed some dissection with thrombosis of the false lumen. Blood pressure was controlled with perindopril 2 mg, once a day, doxazosin 4 mg, twice a day, and furosemide 20 mg, twice a day. Since this patient did not show clinical features of mesenteric or lower limb ischaemia, the vascular surgeon did not recommend subdiaphragmatic aortic replacement.

  20. 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

  1. Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

    Science.gov (United States)

    Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

    2016-05-01

    Objective To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia.Method As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used.Results Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results.Conclusion Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. PMID:26156192

  2. Modular organization of the multipartite central pattern generator for turtle rostral scratch: knee-related interneurons during deletions.

    Science.gov (United States)

    Stein, Paul S G; Daniels-McQueen, Susan; Lai, Jessica; Liu, Z; Corman, Tanya S

    2016-06-01

    Central pattern generators (CPGs) are neuronal networks in the spinal cord that generate rhythmic patterns of motor activity in the absence of movement-related sensory feedback. For many vertebrate rhythmic behaviors, CPGs generate normal patterns of motor neuron activities as well as variations of the normal patterns, termed deletions, in which bursts in one or more motor nerves are absent from one or more cycles of the rhythm. Prior work with hip-extensor deletions during turtle rostral scratch supports hypotheses of hip-extensor interneurons in a hip-extensor module and of hip-flexor interneurons in a hip-flexor module. We present here single-unit interneuronal recording data that support hypotheses of knee-extensor interneurons in a knee-extensor module and of knee-flexor interneurons in a knee-flexor module. Members of knee-related modules are not members of hip-related modules and vice versa. These results in turtle provide experimental support at the single-unit interneuronal level for the organizational concept that the rostral-scratch CPG for the turtle hindlimb is multipartite, that is, composed of more than two modules. This work, when combined with experimental and computational work in other vertebrates, does not support the classical view that the vertebrate limb CPG is bipartite with only two modules, one controlling all the flexors of the limb and the other controlling all the extensors of the limb. Instead, these results support the general principle that spinal CPGs are multipartite. PMID:27030737

  3. Spinal CT scan, 1

    International Nuclear Information System (INIS)

    Methods of CT of the cervical and thoracic spines were explained, and normal CT pictures of them were described. Spinal CT was evaluated in comparison with other methods in various spinal diseases. Plain CT revealed stenosis due to spondylosis or ossification of posterior longitudinal ligament and hernia of intervertebral disc. CT took an important role in the diagnosis of spinal cord tumors with calcification and destruction of the bone. CT scan in combination with other methods was also useful for the diagnosis of spinal injuries, congenital anomalies and infections. (Ueda, J.)

  4. 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

  5. Spinal accessory nerve neuropathy following neck dissection Neuropatia do nervo acessório espinhal secundária à cirurgia de esvaziamento cervical

    Directory of Open Access Journals (Sweden)

    Luciana Pereira de Lima

    2011-04-01

    Full Text Available Tthe most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle. AIM: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection. MATERIALS AND METHODS: Prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. Nerve integrity was evaluated before and after the surgery by means of surface EMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/atrophy of the trapezius muscle. RESULTS: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (pUma das complicações mais comuns do esvaziamento cervical é a disfunção do ombro devido à manipulação do nervo acessório, que resulta na atrofia do músculo trapézio. OBJETIVO: Avaliar com eletromiografia de superfície (EMGs a lesão do XI par decorrente do esvaziamento cervical. MATERIAL E MÉTODO: Estudo prospectivo com 51 pacientes (60 esvaziamentos cervicais tratados de câncer de cabeça e pescoço. A função do nervo acessório foi avaliada no período pré e pós-operatório com registro da atividade elétrica das fibras descendentes do músculo trapézio em contração isométrica voluntária máxima. Os pacientes foram agrupados pelo tipo de esvaziamento e movimento de abdução do braço. RESULTADOS: O potencial de ação apresentou mediana de 54,3 microV no pré-operatório e 11,6 microV no pós-operatório (p<0,001. Os valores registrados no pós-operatório apresentaram decréscimo médio de 70% (20% a 94% em relação aos valores pré-operatórios. Com relação à extensão do EC, foram

  6. Quantitative classification of somatostatin-positive neocortical interneurons identifies three interneuron subtypes

    OpenAIRE

    McGarry, Laura M.; Packer, Adam M.; Elodie Fino; Volodymyr Nikolenko; Tanya Sippy; Rafael Yuste

    2010-01-01

    Deciphering the circuitry of the neocortex requires knowledge of its components, making a systematic classification of neocortical neurons necessary. GABAergic interneurons contribute most of the morphological, electrophysiological and molecular diversity of the cortex, yet interneuron subtypes are still not well defined. To quantitatively identify classes of interneurons, 59 GFP-positive interneurons from a somatostatin-positive mouse line were characterized by whole-cell recordings and anat...

  7. RGMa regulates cortical interneuron migration and differentiation.

    Directory of Open Access Journals (Sweden)

    Conor O'Leary

    Full Text Available The etiology of neuropsychiatric disorders, including schizophrenia and autism, has been linked to a failure to establish the intricate neural network comprising excitatory pyramidal and inhibitory interneurons during neocortex development. A large proportion of cortical inhibitory interneurons originate in the medial ganglionic eminence (MGE of the ventral telencephalon and then migrate through the ventral subventricular zone, across the corticostriatal junction, into the embryonic cortex. Successful navigation of newborn interneurons through the complex environment of the ventral telencephalon is governed by spatiotemporally restricted deployment of both chemorepulsive and chemoattractive guidance cues which work in concert to create a migratory corridor. Despite the expanding list of interneuron guidance cues, cues responsible for preventing interneurons from re-entering the ventricular zone of the ganglionic eminences have not been well characterized. Here we provide evidence that the chemorepulsive axon guidance cue, RGMa (Repulsive Guidance Molecule a, may fulfill this function. The ventricular zone restricted expression of RGMa in the ganglionic eminences and the presence of its receptor, Neogenin, in the ventricular zone and on newborn and maturing MGE-derived interneurons implicates RGMa-Neogenin interactions in interneuron differentiation and migration. Using an in vitro approach, we show that RGMa promotes interneuron differentiation by potentiating neurite outgrowth. In addition, using in vitro explant and migration assays, we provide evidence that RGMa is a repulsive guidance cue for newborn interneurons migrating out of the ganglionic eminence ventricular zone. Intriguingly, the alternative Neogenin ligand, Netrin-1, had no effect on migration. However, we observed complete abrogation of RGMa-induced chemorepulsion when newborn interneurons were simultaneously exposed to RGMa and Netrin-1 gradients, suggesting a novel mechanism for

  8. Partial Conservation between Mice and Humans in Olfactory Bulb Interneuron Transcription Factor Codes.

    Science.gov (United States)

    Fujiwara, Nana; Cave, John W

    2016-01-01

    The mammalian main olfactory bulb (OB) has a large population of GABAergic inhibitory interneurons that contains several subtypes defined by the co-expression other neurotransmitters and calcium binding proteins. The three most commonly studied OB interneuron subtypes co-express either Calretinin, Calbindin, or Tyrosine hydroxylase (Th). Combinations of transcription factors used to specify the phenotype of progenitors are referred to as transcription factor codes, and the current understanding of transcription factor codes that specify OB inhibitory neuron phenotypes are largely based on studies in mice. The conservation of these transcription factor codes in the human OB, however, has not been investigated. The aim of this study was to establish whether transcription factor codes in OB interneurons are conserved between mice and humans. This study compared the co-expression of Foxp2, Meis2, Pax6, and Sp8 transcription factors with Calretinin, Calbindin, or Th in human and mouse OB interneurons. This analysis found strong conservation of Calretinin co-expression with Sp8 and Meis2 as well as Th co-expression with Pax6 and Meis2. This analysis also showed that selective Foxp2 co-expression with Calbindin was conserved between mice and humans, which suggests Foxp2 is a novel determinant of the OB Calbindin interneuron phenotype. Together, the findings in this study provide insight into the conservation of transcription codes for OB interneuron phenotypes between humans and mice, as well as reveal some important differences between the species. This advance in our understanding of transcription factor codes in OB interneurons provides an important complement to the codes that have been established for other regions within the mammalian central nervous system, such as the cortex and spinal cord. PMID:27489533

  9. Neuronal activity is required for the development of specific cortical interneuron subtypes.

    Science.gov (United States)

    De Marco García, Natalia V; Karayannis, Theofanis; Fishell, Gord

    2011-04-21

    Electrical activity has been shown to regulate development in a variety of species and in various structures, including the retina, spinal cord and cortex. Within the mammalian cortex specifically, the development of dendrites and commissural axons in pyramidal cells is activity-dependent. However, little is known about the developmental role of activity in the other major cortical population of neurons, the GABA-producing interneurons. These neurons are morphologically and functionally heterogeneous and efforts over the past decade have focused on determining the mechanisms that contribute to this diversity. It was recently discovered that 30% of all cortical interneurons arise from a relatively novel source within the ventral telencephalon, the caudal ganglionic eminence (CGE). Owing to their late birth date, these interneurons populate the cortex only after the majority of other interneurons and pyramidal cells are already in place and have started to functionally integrate. Here we demonstrate in mice that for CGE-derived reelin (Re)-positive and calretinin (Cr)-positive (but not vasoactive intestinal peptide (VIP)-positive) interneurons, activity is essential before postnatal day 3 for correct migration, and that after postnatal day 3, glutamate-mediated activity controls the development of their axons and dendrites. Furthermore, we show that the engulfment and cell motility 1 gene (Elmo1), a target of the transcription factor distal-less homeobox 1 (Dlx1), is selectively expressed in Re(+) and Cr(+) interneurons and is both necessary and sufficient for activity-dependent interneuron migration. Our findings reveal a selective requirement for activity in shaping the cortical integration of specific neuronal subtypes. PMID:21460837

  10. Probing diversity within subpopulations of locomotor-related V0 interneurons.

    Science.gov (United States)

    Griener, Anna; Zhang, Wei; Kao, Henry; Wagner, Christine; Gosgnach, Simon

    2015-11-01

    The V0 interneuronal population is derived from Dbx1 expressing progenitors. Initial studies on these interneurons in the mouse spinal cord demonstrated that they project commissural axons and are involved in coordinating left-right alternation during locomotion. Subsequent work has indicated that the V0 population can be divided into genetically distinct ventral (V0V) and dorsal (V0D) subpopulations, and experimental evidence suggests that each is responsible for left-right alternation at different locomotor speeds. In this study, we perform a series of experiments to probe the location and connectivity of these subpopulations in neonatal mice and demonstrate that they are more diverse than previously predicted. While the distribution of either subpopulation remains consistent along the extent of the lumbar spinal cord, a cluster of V0D cells lateral to the central canal receive substantial input from primary afferents. Retrograde tracing and activity dependent labeling experiments demonstrate that a group of V0 interneurons located in this same region preferentially project axons towards contralateral motoneurons via an oligosynaptic pathway, and are active during fictive locomotion. Our results suggest that this subset of V0 interneurons may be primarily responsible for coordination of left-right alternation during locomotion. Furthermore these experiments indicate that while genetic identity is one determinant of the function of a neuron during locomotion, the specific position in which the cell is located may also play a key role. PMID:25649879

  11. Different Approaches for Treating Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 153 Cases from a Single Spinal Center.

    Directory of Open Access Journals (Sweden)

    Xiumao Li

    Full Text Available The optimal surgical treatment for multilevel cervical spondylotic myelopathy (MCSM remains controversial. This study compared the outcomes of three surgical approaches for MSCM treatment, focusing on the efficacy and safety of a combined approach.This retrospective study included 153 consecutive MCSM patients (100 men, 53 women; mean age ± standard deviation, 55.7 ± 9.4 years undergoing operations involving ≥3 intervertebral segments. The patients were divided into three groups according to surgical approach: anterior (n = 19, posterior (n = 76, and combined (n = 58. We assessed demographic variables, perioperative parameters, and clinical outcomes ≥12 months after surgery (20.5 ± 7.6 months, including Japanese Orthopaedic Association (JOA score, improvement, recovery rate, and complications.The anterior group had the most favorable preoperative conditions, including the highest preoperative JOA score (12.95 ± 1.86, p = 0.046. In contrast, the combined group had the highest occupancy ratio (48.0% ± 11.6%, p = 0.002. All groups showed significant neurological improvement at final follow-ups, with JOA recovery rates of 59.7%, 54.6%, and 68.9% in the anterior, posterior, and combined groups, respectively (p = 0.163. After multivariable adjustments, the groups did not have significantly different clinical outcomes (postoperative JOA score, p = 0.424; improvement, p = 0.424; recovery rate, p = 0.080. Further, subgroup analyses of patients with occupancy ratios ≥50% showed similar functional outcomes following the posterior and combined approaches. Overall complication rates did not differ significantly among the three approaches (p = 0.600. Occupancy ratios did not have a significant negative influence on postoperative recovery following the posterior approach.If applied appropriately, all three approaches are effective for treating MCSM. All three approaches had equivalent neurological outcomes, even in subgroups with high occupancy

  12. 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

  13. Spinal accessory nerve neurilemmoma

    International Nuclear Information System (INIS)

    A neurilemmoma of the spinal accessory nerve extending from the lower brain stem to the high cervical region, without typical jugular foramen syndome is presented. Preoperative diagnosis is difficult but should be considered in the differential diagnosis of a high cervical intradural extramedullary lesion in patients with lower cranial nerve(s) dysfunction. The value of intrathecal and intravenous contrast enhancement computed tomography (CT) myelogram is emphasized. 13 refs.; 3 figs

  14. 手术治疗急性无骨折脱位型颈髓损伤的回顾性分析%Retrospective analysis of treatment of acute cervical spinal cord injury without fracture and dislocation by surgery

    Institute of Scientific and Technical Information of China (English)

    祁文; 唐晓菊; 刘汝专; 潘汉升

    2011-01-01

    [目的] 分析前路和后路内固定治疗急性无骨折脱位型颈髓损伤的临床治疗效果.[方法]对56例急性无骨折脱位型颈髓损伤的患者进行颈椎前路减压、植骨及颈椎前路带锁钢板内固定术或后路减压侧块钢板螺钉内固定术.术后定期X线片观察损伤节段的稳定性和融合情况以及有无内置物并发症,以JOA评分判定脊髓功能恢复情况.[结果]56例获得随访,时间13 ~48个月.平均26个月.56例患者均损伤节段稳定,植骨愈合良好,无内置物并发症,脊髓功能JOA评分平均提高5.78分,取得满意疗效;前路术式与后路术式在改善脊髓功能方面无明显差异(P>0.05).[结论]颈椎前路和后路术式治疗无骨折脱位型颈髓损伤,能使损伤节段获得即刻、坚强的稳定,解除颈髓压迫,为颈髓功能的恢复提供了有利条件.%[Objective] To observe the results of the treatment of acute cervical spinal cord injury without fracture and dislocation by the anterior plate internal fixation the posterior lateral mass plate fixation. [ Method ] Fifty-six cases of acute cervical spinal cord injury without fracture and dislocation were treated by anterior decompression,bone graft,and cervical spine plate fixation, or posterior extensive laminectomy decompression and lateral mass plate fixation. The stability and fusion of the injured segments and the complications of the hardware were observed on the X-ray film postoperatively. The function of the spinal cord was evaluated with JOA scores. [ Result] Fifty-six cases were followed up from 13 to 48 months (average 26 months). The injured segments were stable, the bone grafting fused completely, and the complications of the hardware were not observed. The function of the spinal cord improved by 5. 78 scores. The clinical outcomes were excellent. There were not difference on improving spinal cord function between the anterior plate internal fixation and the posterior lateral mass

  15. Neuronal degeneration in spinal multiple sclerosis

    OpenAIRE

    Bernhardt, Lydia

    2010-01-01

    To elucidate neuronal degeneration in spinal multiple sclerosis the spinal cord of 27 post mortem patients of the years 1997 to 2000 was investigated in comparison to 29 controls matched for sex, age and year of death. In addition to immunohistochemical examinations and demonstration of pathological cell changes, we also quantified the neurons of the cervical and thoracic spinal cord. In comparison to controls, MS-patients show a significant loss of 43% of the cervical neurons and a signif...

  16. 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

  17. Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study.

    Science.gov (United States)

    Chen, Li-Fu; Tu, Tsung-Hsi; Chen, Yu-Chun; Wu, Jau-Ching; Chang, Peng-Yuan; Liu, Laura; Huang, Wen-Cheng; Lo, Su-Shun; Cheng, Henrich

    2016-06-01

    OBJECTIVE This study aimed to estimate the risk of spinal cord injury (SCI) in patients with cervical spondylotic myelopathy (CSM) with and without ossification of posterior longitudinal ligament (OPLL). Also, the study compared the incidence rates of SCI in patients who were managed surgically and conservatively. METHODS This retrospective cohort study covering 15 years analyzed the incidence of SCI in patients with CSM. All patients, identified from the National Health Insurance Research Database, were hospitalized with the diagnosis of CSM and followed up during the study period. These patients with CSM were categorized into 4 groups according to whether they had OPLL or not and whether they received surgery or not: 1) surgically managed CSM without OPLL; 2) conservatively managed CSM without OPLL; 3) surgically managed CSM with OPLL; and 4) conservatively managed CSM with OPLL. The incidence rates of subsequent SCI in each group during follow-up were then compared. Kaplan-Meier and Cox regression analyses were performed to compare the risk of SCI between the groups. RESULTS Between January 1, 1999, and December 31, 2013, there were 17,258 patients with CSM who were followed up for 89,003.78 person-years. The overall incidence of SCI in these patients with CSM was 2.022 per 1000 person-years. Patients who had CSM with OPLL and were conservatively managed had the highest incidence of SCI, at 4.11 per 1000 person-years. Patients who had CSM with OPLL and were surgically managed had a lower incidence of SCI, at 3.69 per 1000 person-years. Patients who had CSM without OPLL and were conservatively managed had an even lower incidence of SCI, at 2.41 per 1000 person-years. Patients who had CSM without OPLL and were surgically managed had the lowest incidence of SCI, at 1.31 per 1000 person-years. The Cox regression model demonstrated that SCIs are significantly more likely to happen in male patients and in those with OPLL (HR 2.00 and 2.24, p risk for approximately 50

  18. 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.

  19. Schwann cells generated from neonatal skin-derived precursors or neonatal peripheral nerve improve functional recovery after acute transplantation into the partially injured cervical spinal cord of the rat.

    Science.gov (United States)

    Sparling, Joseph S; Bretzner, Frederic; Biernaskie, Jeff; Assinck, Peggy; Jiang, Yuan; Arisato, Hiroki; Plunet, Ward T; Borisoff, Jaimie; Liu, Jie; Miller, Freda D; Tetzlaff, Wolfram

    2015-04-29

    The transplantation of Schwann cells (SCs) holds considerable promise as a therapy for spinal cord injury, but the optimal source of these cells and the best timing for intervention remains debatable. Previously, we demonstrated that delayed transplantation of SCs generated from neonatal mouse skin-derived precursors (SKP-SCs) promoted repair and functional recovery in rats with thoracic contusions. Here, we conducted two experiments using neonatal rat cells and an incomplete cervical injury model to examine the efficacy of acute SKP-SC transplantation versus media control (Experiment 1) and versus nerve-derived SC or dermal fibroblast (Fibro) transplantation (Experiment 2). Despite limited graft survival, by 10 weeks after injury, rats that received SCs from either source showed improved functional recovery compared with media- or fibroblast-treated animals. Compared with media treatment, SKP-SC-transplanted rats showed enhanced rubrospinal tract (RST) sparing/plasticity in the gray matter (GM) rostral to injury, particularly in the absence of immunosuppression. The functional benefits of SC transplantations over fibroblast treatment correlated with the enhanced preservation of host tissue, reduced RST atrophy, and/or increased RST sparing/plasticity in the GM. In summary, our results indicate that: (1) early transplantation of neonatal SCs generated from skin or nerve promotes repair and functional recovery after incomplete cervical crush injury; (2) either of these cell types is preferable to Fibros for these purposes; and (3) age-matched SCs from these two sources do not differ in terms of their reparative effects or functional efficacy after transplantation into the injured cervical spinal cord. PMID:25926450

  20. 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

    OpenAIRE

    Subramanian Vaidyanathan; von Unruh, Gerd E.; Watson, Ian D.; Norbert Laube; Steve Willets; Soni, Bakul L.

    2006-01-01

    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 ure...

  1. Common and Rare Causes of Spinal Dumbbell-Shaped Lesions Including a Chondrosarcoma That Primarily Developed in the Cervical Spine: A Case Report

    Directory of Open Access Journals (Sweden)

    Amirhossein Ghazavi

    2009-01-01

    Full Text Available Various neoplastic, vascular and developmental causes may lead to spinal neural foraminal widening. Schwanomas and neurofibromas are the most common causes of spinal dumbbell-shaped lesions. Occasionally, some other slow-growing tumors may cause neural foraminal widening."nWe report an exceptional case of a spinal chondrosarcoma of the neural arcus of C5. The lesion passed through the C4-C5 foramen, producing a dumbbell mass.

  2. Posterior approach to the degenerative cervical spine

    OpenAIRE

    Yonenobu, Kazuo; Oda, Takenori

    2003-01-01

    Laminoplasty has been gradually accepted as a treatment for choice for cervical compression myelopathy. The historical perspective of laminoplasty is described. The aims of laminoplasty are to expand the spinal canal, to secure spinal stability, to preserve the protective function of the spine, and to preserve spinal mobility. Laminoplasty is indicated in myelopathic patients with a developmentally narrow spinal canal or multiple-level involvement combined with a relatively narrow canal. Seve...

  3. 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.

  4. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  5. 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

  6. Lateral Mass Fixation in Subaxial Cervical Spine: Anatomic Review

    OpenAIRE

    Mohamed, Elrahmany; Ihab, Zidan; Moaz, Anwar; Ayman, Nabawi; Haitham, Abo-elw

    2012-01-01

    Introduction The cervical spine is a highly mobile segment of the spinal column, liable to a variety of diseases and susceptible to trauma. It is a complex region where many vital structures lie in close proximity. Lateral mass screw fixation has become the method of choice in stabilizing subaxial cervical spine among other posterior cervical fixation techniques whenever the posterior elements are absent or compromised. Objective This study examined cervical specimens of cadavers and cervical...

  7. 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.

  8. Safety and efficacy of rhBMP2 in posterior cervical spinal fusion for subaxial degenerative spine disease: Analysis of outcomes in 204 patients

    OpenAIRE

    Xu, Risheng; Bydon, Mohamad; Sciubba, Daniel M.; Witham, Timothy F.; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali

    2011-01-01

    Background: Many studies offer excellent demonstration of the ability of bone morphogenic protein (BMP) to enhance fusion rates in anterior as well as posterior lumbar surgery. Recently, BMP has also been shown to increase arthrodesis rates in anterior cervical surgery, albeit with concomitant increases in complication rates. To date, however, few studies have investigated the safety and efficacy of BMP in cervical surgeries approached posteriorly. Methods: We retrospectively reviewed 204 con...

  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. 颈脊髓外伤后气管切开指征的影响因素分析%Factors influencing the indication for tracheostomy following cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    刘瑞端; 靳安民

    2015-01-01

    Objective To determine the factors influencing the indication for tracheostomy following cervical spinal cord injury.Methods A retrospective study was performed to analyze the 118 patients who had been treated for cervical fracture/dislocation along with cervical spinal cord injury from July 2004 to June 2014 and whose abbreviated injury scale score (AISS) was lower than 3.They were 96 men and 22 women,19 to 68 years of age (average,45.2 years).The patients were divided into a tracheostomy group (n = 28) and a non-tracheostomy group (n =90).The 2 groups were compared in terms of gender,age,presence or absence of complete spinal cord injury at admission,injured segment,injury mechanism,smoking history,injury severity score (ISS),motor AISS,systolic pressure at admission,hospital stay,and ICU stay to determine the factors influencing allocation of tracheostomy.Results Compared with the non-tracheostomy group,the tracheostomy group had a higher rate of complete spinal cord injury at admission,a higher rate of smoking,a higher ISS at admission,a lower motor AISS,and longer hospital and ICU stay,with statistically significant differences (P < 0.05).There were no significant differences between the 2 groups in gender,age,injured segment,injury mechanism,or systolic pressure at admission (P > 0.05).Increased severity of cervical spinal cord injury was associated with significantly decreased motor AISA,increased rate of tracheostomy and increased ISS (P < 0.05).Conclusion The influencing factors for indication of tracheostomy after cervical spinal cord injury are complete cervical spinal cord injury irrespective of the level of injury,ISS,motor AISS,and history of smoking.%目的 分析颈脊髓外伤后气管切开指征的影响因素. 方法 回顾性研究2004年7月至2014年6月收治的颈椎以外的部位简明损伤评分小于3分的118例颈椎骨折脱位伴有脊髓损伤患者资料,男96例,女22例;年龄19 ~68岁,平均45.2岁.将患者根据

  11. Production and organization of neocortical interneurons

    OpenAIRE

    Sultan, Khadeejah T.; Song-Hai Shi

    2013-01-01

    Inhibitory GABA (γ-aminobutyric acid)-ergic interneurons are a vital component of the neocortex responsible for shaping its output through a variety of inhibitions. Consisting of many flavors, interneuron subtypes are predominantly defined by their morphological, physiological, and neurochemical properties that help to determine their functional role within the neocortex. During development, these cells are born in the subpallium where they then tangentially migrate over long distances befo...

  12. 颈椎创伤合并脊髓损伤手术治疗的预后和影响因素%Prognosis and influencing factors of cervical spinal cord injury patients with trauma operation

    Institute of Scientific and Technical Information of China (English)

    何小勇

    2015-01-01

    Objective Observation and analysis of influencing factors of spinal cord injury, provides references for the clinical treatment. Methods 237 patients of in our hospital in last 10 years of with cervical trauma complicated with spinal cord injury were collected, multiple factor correlation analysis was used to analyze the prognosis through the age, sex, cause of injury, the time of referral, operation start time, the injury site (section), complications, spinal canal encroachment rate, hormone applicationuse of hormones within the 8h, prehospital cervical support, preoperative traction, and the operation mode of this injury prognosis. Results By single factor analysis of 12 factors influenced, the referral time, preoperative history of injury, operation start time, spinal canal encroachment rate and hormone application within 8h, pre hospital neck support, whether preoperative traction (P≤0.1), the other factors had poor correlation with the prognosis of the patients:age (P=0.203), gender (P=0.982), the damage stage (P=0.774), operation mode(P=0. 189). The influencing factors on screening of multiple factor Logistic regression analysis found that referral time, operation start time, spinal canal encroachment rate and hormone use application within 8h were cClosely related to the prognosis (P<0.05). Conclusion The main factors that influence the prognosis of patients with cervical spine trauma complicated with spinal cord injury were: the referral time, operation start time, spinal canal encroachment rate and hormone application within 8h. Fast and effective pre-hospital aid, the appropriate operation time, timely decompression of the spinal cord and the early application of hormone could effectively improve the prognosis of cervical vertebra trauma complicated with spinal cord injury.%目的 观察分析颈椎创伤合并脊髓损伤手术治疗的预后和影响因素,为临床治疗该类疾病提供参考. 方法 收集本院10年来颈椎创

  13. 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

    OpenAIRE

    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 le...

  14. Analysis of risk factors of respiratory failure after cervical spinal cord injury%颈脊髓损伤合并呼吸衰竭的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    穆智平; 张正丰; 刘超; 李杰

    2015-01-01

    Objective To analyze the risk factors of respiratory failure after cervical spinal cord injury ( SCI) . Methods A total of 294 patients with cervical spinal cord injury from January 2009 and December 2013 were analyzed. 52 cases were rolled into the respiratory failure group, 242 cases were rolled into group without respiratory failure. The epidemiological factors in two groups were analyzed to find the the factors of respiratory failure. Results The differences in indexes of smoking, injury reason, injury level, grade of ASIA, fracture dislo-cation were significant (P<0. 05), which suggested the above factors were associated with the occurrence of respiratory failure. The multi-factor regression analysis in respiratory group found that factors such as aged over 60 years, smoking, multiple trauma, fracture dislocation, spinal cord injury above C4 level and pamplegia were of statistically significance (P<0. 10). Conclusion Advanced age, smoking, pample-gia, spinal cord injury above C4 leve, multiple trauma and fracture dislocation are the high risk factors of the respiratory failure after cervical spinal cord injury.%目的:探讨颈脊髓损伤各种危险因素与呼吸衰竭的相关性。方法回顾分析我院2009年1月至2013年12月颈脊髓损伤患者294例,根据是否合并呼吸衰竭分组,合并呼吸衰竭组52例,未合并呼吸衰竭组242例。比较2组各项流行病学指标的差异,分析导致呼吸衰竭的危险因素。结果合并呼吸衰竭组与未合并呼吸衰竭组比较,吸烟史、不同受伤原因、颈脊髓损伤不同平面、ASIA分级、骨折脱位指标具有显著性差异(P<0.05),提示上述因素与呼吸衰竭的发生关系密切。合并呼吸衰竭组的多因素Logistic回归分析结果提示,年龄大于60岁、吸烟史、合并多发伤、骨折脱位、颈4损伤平面以上、全瘫指标具有统计学意义(P<0.10)。结论高龄、吸烟、全瘫、颈4损伤平面以上、合并多

  15. 颈椎椎板成形术后脊髓后移的相关因素分析%Analysis of related factors of posterior shifting of the spinal cord after cervical laminoplasty

    Institute of Scientific and Technical Information of China (English)

    刁垠泽; 孙宇; 王少波; 张凤山; 潘胜发; 刘晓光; 刘忠军

    2013-01-01

    目的 探讨颈后路单开门椎板成形术后脊髓后移的影响因素及其规律.方法 2008年2月至2010年10月收治的压迫性颈脊髓病患者经筛选后43例纳入本研究,均接受C3~C7后路单开门椎板成形术,男32例,女11例;年龄33~78岁,平均57.9岁.脊髓型颈椎病伴发育性颈椎管狭窄30例,颈椎后纵韧带骨化症13例.门轴侧关节突螺钉锚定法21例,保留门轴侧肌肉韧带复合体的钛缆悬吊法22例.术前、术后3个月颈椎中立位MRI正中矢状面测量各节段代表脊髓及硬膜囊后移的参数:脊髓前缘后移,脊髓后缘后移,硬膜囊前缘后移,硬膜囊后缘后移;将齿突与T1椎体后下角的连线定义为E线,其长度为E值,从每个基准点向E线作垂线,每个垂线段的长度为Px(x=1~6),得到代表每个节段局部曲度的参数100×Px/E);以颈椎曲度指数(curvature index,CI)表示颈椎整体曲度.对以上参数进行线性相关分析.结果 硬膜囊前缘后移在不同水平无明显变化,脊髓前缘后移、脊髓后缘后移与硬膜囊后缘后移则随所处节段不同而相应发生变化,且三者的变化具有一致性.脊髓后缘后移最大值位于C5,6水平,但C5,6水平脊髓后缘后移与CI无相关性.相关分析表明脊髓后缘后移与硬膜囊后缘后移呈高度线性相关,与(100×Px/D)具有较低的相关性.结论 颈椎单开门椎管扩大成形术后脊髓的后移程度与同水平硬膜囊的后移程度高度相关,与局部曲度相关性较弱,与颈椎整体曲度无相关性.%Objectives To investigate influencing factors and pattern of posterior shifting of the spinal cord after cervical laminoplasty.Methods Forty three patients with compressive cervical myelopathy,including 32 males and 11 females,aged from 33 to 78 years (average,57.9 years),treated with open-door laminoplasty from C3 to C7 between February 2008 and October 2010,were enrolled in this study.There were 30 cases of cervical

  16. Rheumatoid cervical myelopathy

    International Nuclear Information System (INIS)

    Rheumatoid cervical myelopathy was studied in 14 patients, clinically, radiographically and by computerized tomography with multiplanar reconstruction (CT/MPR). CT/MPR demonstrated significant unsuspected areas of compromise in 9 of the 14 patients, and altered the surgical procedure in 7 of these 9 patients. CT/MPR clearly identifies all levels of involvement including rotary subluxation. CT/MPR also allows assessment of the spinal nerve canal/foramen and the alignment of the foramina transversaria. CT/MPR is an essential addition to the evaluation of rheumatoid cervical myelopathy

  17. Motoneurons of the adult marmoset can grow axons and reform motor endplates through a peripheral nerve bridge joining the locally injured cervical spinal cord to the denervated biceps brachii muscle.

    Science.gov (United States)

    Emery, E; Rhrich-Haddout, F; Kassar-Duchossoy, L; Lyoussi, B; Tadié, M; Horvat, J C

    2000-12-15

    Reconnection of the injured spinal cord (SC) of the marmoset with the denervated biceps brachii muscle (BB) was obtained by using a peripheral nerve (PN) bridge. In 13 adult males, a 45 mm segment of the peroneal nerve was removed: one end was implanted unilaterally into the cervical SC of the same animal (autograft), determining a local injury, although the other end was either directly inserted into the BB (Group A) or, alternatively, sutured to its transected motor nerve, the musculocutaneous nerve (Group B). From 2-4 months post-surgery, eight out of the 10 surviving animals responded by a contraction of the BB to electrical stimulations of the PN bridge. All ten were then processed for a morphological study. As documented by retrograde axonal tracing studies using horse radish peroxidase or Fast Blue (FB), a mean number of 314 (Group A) or 45 (Group B) spinal neurons, mainly located close to the site of injury and grafting, re-expressed a capacity to grow and extend axons into the PN bridge. Most of these regenerated axons were able to grow up to the BB and form or reform functional motor endplates. Many of the spinal neurons that were retrogradely labeled with FB simultaneously displayed immunoreactivity for choline acetyl-transferase and consequently were assumed to be motoneurons. Reinnervation and regeneration of the BB were documented by methods revealing axon terminals, endplates and myofibrillary ATPase activity. Our results indicate that motoneurons of the focally injured SC of a small-sized primate can, following the example of the adult rat, re-establish a lost motor function by extending new axons all the way through a PN bridge connected to a denervated skeletal muscle. PMID:11107167

  18. Spinal stenosis

    Science.gov (United States)

    ... medicine directly into the space around your spinal nerves or spinal cord. Spinal stenosis symptoms often become worse over ... Surgery is done to relieve pressure on the nerves or spinal cord. You and your doctor can decide when ...

  19. 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.

  20. 非手术脊柱减压系统牵引与普通牵引对颈棘旁肌表面肌电信号的影响%Nonsurgical spinal decompression and common cervical traction compared

    Institute of Scientific and Technical Information of China (English)

    徐洋; 贾功伟; 谭波涛; 王愉乐; 代良波; 虞乐华

    2014-01-01

    Objective To compare the effects of nonsurgical spinal decompression system (SDS) cervical traction and common cervical traction using surface electromyography (sEMG).Methods Twenty-two volunteers' sEMG signals were recorded before,during and after two modes of cervical traction:the conventional traction in sitting and SDS traction in supine.The interval between the two modes of traction was no shorter than 24 hours.The mean and peak amplitudes of their sEMG signals were observed before,during and after traction.The sEMG signals of the posterior cervical muscle while sitting or lying were compared at different stages of the traction.Results There was no statistically significant difference in sEMG signals between the subjects' right and left posterior cervical muscles.The sEMG signals decreased significantly during both traction trials.With common cervical traction the mean and peak amplitudes of the left posterior cervical muscle pre-and post-traction were higher than during traction,and the same as that of the right posterior cervical muscle.In the SDS trials the sEMG signals during traction and post-traction were significantly lower than those pre-traction.After traction the sEMG signals while sitting (common cervical traction) were significantly higher than those post-traction while lying (SDS cervical traction),and the sEMG signals post-traction while either lying or sitting were stronger than during traction while lying.The post-traction signals in sitting were stronger than those in lying.Conclusions Both nonsurgical SDS and common cervical traction can relax the posterior cervical muscles.The effect of nonsurgical SDS was better than that of common cervical traction.%目的 观察非手术脊柱减压系统(SDS)牵引及普通牵引对颈棘旁肌表面肌电信号的影响.方法 随机选取健康青年志愿者22例,采用SDS和普通牵引对受试者进行测试,不同测试间需相隔24 h以上,测试时利用表面肌电图仪对受试者双侧颈

  1. Corticospinal tract insult alters GABAergic circuitry in the mammalian spinal cord

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Russ

    2013-09-01

    Full Text Available During perinatal development, corticospinal tract (CST projections into the spinal cord help refine spinal circuitry. Although the normal developmental processes that are controlled by the arrival of corticospinal input are becoming clear, little is known about how perinatal cortical damage impacts specific aspects of spinal circuit development, particularly the inhibitory microcircuitry that regulates spinal reflex circuits. In this study, we sought to determine how ischemic cortical damage impacts the synaptic attributes of a well-characterized population of inhibitory, GABAergic interneurons, called GABApre neurons, which modulates the efficiency of proprioceptive sensory terminals in the sensorimotor reflex circuit. We found that putative GABApre interneurons receive CST input and, using an established mouse model of perinatal stroke, that cortical ischemic injury results in a reduction of CST density within the intermediate region of the spinal cord, where these interneurons reside. Importantly, CST alterations were restricted to the side contralateral to the injury. Within the synaptic terminals of the GABApre interneurons, we observed a dramatic upregulation of the 65-isoform of the GABA synthetic enzyme glutamic acid decarboxylase (GAD65. In accordance with the CST density reduction, GAD65 was elevated on the side of the spinal cord contralateral to cortical injury. This effect was not seen for other GABApre synaptic markers or in animals that received sham surgery. Our data reveal a novel effect of perinatal stroke that involves severe deficits in the architecture of descending spinal pathways, which in turn appear to promote molecular alterations in a specific spinal GABAergic circuit.

  2. 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

  3. Congenital absence of corticospinal tract does not severely affect plastic changes of the developing postnatal spinal cord.

    Science.gov (United States)

    Huang, L; Xian, Q; Shen, N; Shi, L; Qu, Y; Zhou, L

    2015-08-20

    The arrival and refinement of corticospinal afferents are likely to influence the maturation of the spinal cord and sensory-motor networks. To understand this better, we studied the revision of monosynaptic muscle afferents, the expression of activity-related genes, neurotrophins and their receptors in the cervical spinal cord from postnatal day (P) 0 to 21. We compared control and Celsr3|Emx1 mice, in which corticospinal axons never develop. The corticospinal tract (CST), labeled by anti-protein kinase C gamma (PKCγ) antibody in the dorsal funiculus, increased gradually in the control, but was never visible in the mutant. Using anti-parvalbumin and choline acetyltransferase double immunostaining, close contacts between proprioceptive afferent fibers and spinal motor neurons appeared at P0 and were gradually eliminated thereafter, with no difference between control and mutant mice. In both genotypes, the number of parvalbumin-positive interneurons increased similarly from P7 to P21, and a comparable upregulation of c-Jun protein was seen at P7. Contrary to control samples, in which ciliary neurotrophic factor (CNTF) protein levels increased from P0 to P7 and gradually decreased after P14, CNTF concentrations were time-invariant in mutant samples. The dynamic profile of neurotrophin-3 (NT3) expression was also moderately affected in mutant mice. In control spinal cord, NT3 was increased at P7 and decreased at P14, but remained more stable in mutant samples. In contrast, expression profiles of brain-derived neurotrophic factor (BDNF), tropomyosin-related kinase (Trk) B, TrkC, p75 neurotrophin receptor (p75(NTR)) and glial cell-line-derived neurotrophic factor (GDNF) were similar in both genotypes. In conclusion, with the possible exception of CNTF and NT3 expression, most events that accompany maturation of the spinal cord appear largely independent of corticospinal inputs. PMID:26079333

  4. Solitary fibrous tumour of the spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Mordani, J.P. [City General Hospital, Stoke-on-Trent (United Kingdom). Dept. of Radiology; Haq, I.U. [North Staffordshire Royal Infirmary, Stoke-on-Trent (United Kingdom). Dept. of Neuroradiology; Singh, J. [North Staffordshire Royal Infirmary, Stoke-on-Trent (United Kingdom). Dept. of Neurosurgery

    2000-09-01

    We report an intramedullary primary solitary fibrous tumour of the cervical spinal cord in a 33-year-old man. The tumour predominantly consisted of monomorphic spindle cells with a storiform pattern. MRI demonstrated an inhomogeneously enhancing cervical intramedullary tumour. The patient was well without recurrence 18 months after surgery. (orig.)

  5. 枕颈融合联合枕下减压术治疗枕颈畸形并脊髓损伤%Treatment of occipital -cervical deformity and spinal cord injury with foramen magnum decompression combined with occipital -cervical fusion

    Institute of Scientific and Technical Information of China (English)

    喻志; 刘学森; 严鹏辉; 郝志全; 李兵兵; 黄宗强

    2016-01-01

    目的:探讨枕颈融合联合枕下减压内固定术治疗枕颈畸形并脊髓损伤的临床疗效及安全性。方法选择郑州大学第一附属医院2011年7月至2014年7月收治的38例枕颈畸形并脊髓损伤患者作为研究对象,男22例,女16例,年龄16~57(38.2±12.1)岁,入院后均行枕颈融合联合枕下减压植骨融合钛板内固定术。通过随访对术前、术后JOA 评分进行对比,评估患者神经功能改善情况。根据术后随访影像学资料评价椎管减压、植骨融合等情况。结果所有病例均获随访,平均15.6个月。术中未出现脊髓、椎动脉损伤等严重并发症。术后螺钉位置良好,无松动、断钉,均呈骨性愈合。所有患者神经功能恢复良好,JOA 评分:术前5~12(7.1±1.8)分,术后12个月8~17(14.9±1.6)分,差异有统计学意义(P <0.05)。结论枕颈融合联合枕下减压内固定术是治疗枕颈畸形并脊髓损伤的简单、安全、有效方法,值得临床推广。%Objective To investigate the clinical efficacy and safety of foramen magnum decompression combined with occipital -cervical fusion for the treatment of occipital -cervical deformity and spinal cord injury.Methods 38 patients with occipital -cervical deformity and spinal cord injury from July of 201 1 to July of 201 4 were selected as the research objects, including 22 males and 1 6 females,aged 1 6 ~57(38.2 ±1 2.1 )years old.All the patients were treated with foramen magnum decompression combined with occipital -cervical fusion with internal fixation.The improvement of neurological function was eval-uated by the comparison of preoperative JOA scores and postoperative JOA scores.The spinal canal decompression and bone graft fusion were monitored by radiology or computed tomography.Results All cases were followed up for an average of 1 5.6 months. There was no serious complication such as spinal cord and vertebral

  6. Neurological Recovery after Traumatic Cervical Spinal Cord Injury Is Superior if Surgical Decompression and Instrumented Fusion Are Performed within 8 Hours versus 8 to 24 Hours after Injury: A Single Center Experience.

    Science.gov (United States)

    Jug, Marko; Kejžar, Nataša; Vesel, Miloš; Al Mawed, Said; Dobravec, Marko; Herman, Simon; Bajrović, Fajko F

    2015-09-15

    A prospective study was performed to evaluate the impact of surgical decompression (SD) and instrumented fusion within 8 h versus 8-24 h after injury on neurological recovery after cervical traumatic spinal cord injury (tSCI) in patients operated on in the UMC Ljubljana, Slovenia. Only patients with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A through C and with MRI-confirmed spinal cord compression were enrolled. The primary outcome was the change in AIS grade at the 6-month follow-up. Of the 48 enrolled patients, 22 patients who underwent surgery within 8 h (group 8 h) and 20 patients who underwent surgery between 8 and 24 h (Group 8-24 h) after injury concluded the study. At admission, there was no statistically significant difference in AIS grade between the study groups. At the 6-month follow-up, an improvement of at least two AIS grades was found in 45.5% of patients in group 8 h and in 10% of patients in group 8-24 h (p=0.017). The median improvement in the ASIA motor score was 38.5 (10.0-61.0) motor points in group 8 h and 15.0 (8.8-34.0) motor points in group 8-24 h (p=0.0468). In a multivariate analysis, adjusted for the preoperative AIS grade and the degree of spinal canal compromise, the odds of an at least two-grade AIS improvement were at least 106% higher for patients in group 8 h than for patients in group 8-24 h (odds ratio=11.08, p=0.004). No statistically significant difference was found in the rate of perioperative complications, pneumonia, and the number of ventilator-dependent days or the mortality between the groups. Our results suggest that the patients with tSCI who undergo SD within 8 h after injury have superior neurological outcomes than patients who undergo SD 8-24 h after injury, without any increase in the rate of adverse effects. PMID:25658291

  7. The degenerative cervical spine.

    Science.gov (United States)

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

  8. Spinal canal narrowing during simulated frontal impact

    OpenAIRE

    Ivancic, Paul C.; Panjabi, Manohar M.; Tominaga, Yasuhiro; Pearson, Adam M.; Elena Gimenez, S.; Maak, Travis G.

    2005-01-01

    Between 23 and 70% of occupants involved in frontal impacts sustain cervical spine injuries, many with neurological involvement. It has been hypothesized that cervical spinal cord compression and injury may explain the variable neurological profile described by frontal impact victims. The goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to quantify canal pinch diameter (CPD) narrowing during frontal impact and to evaluate the potent...

  9. Subarachnoid disseminative hemangiopericytoma of the spinal cord

    Institute of Scientific and Technical Information of China (English)

    LIN Guo-zhong; WANG Zhen-yu; LI Zhen-dong; ZHONG Yan-feng; WANG Lei-ming

    2010-01-01

    @@ Hemangiopericytomas (HPCs) originating from central nervous system were increasingly reported recently.1 Intravertebral HPCs are predominantly epidural. Primary intradural HPCs of spinal cord are rare.2-5 Little subarachnoid dissemination has been reported. We reported a HPC of the cervical spinal cord with subarachnoid dissemination.

  10. 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

  11. Imaging in spinal trauma

    International Nuclear Information System (INIS)

    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

  12. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  14. 颈脊髓损伤患者营养状况变化及其与死亡率的关系%Nutritional status changes of patients with cervical spinal cord injury and its relation with mortality

    Institute of Scientific and Technical Information of China (English)

    陈晓斌; 刘智; 孙天胜; 郑龙龙; 王晓伟

    2013-01-01

    目的 研究颈脊髓损伤患者营养状况的动态变化,分析其对患者死亡率的影响.方法 将128例颈脊髓损伤依治疗结果分为非死亡组和死亡组.记录两组一般信息和血清总蛋白、血清白蛋白和血清前白蛋白水平.比较两组血清蛋白水平动态变化,分析其与死亡的关系.结果 入院早期,血清总蛋白水平在死亡组降低;3~5 d后,3种蛋白水平在死亡组均低于非死亡组(P<0.05),死亡组下降幅度较大;患者较低的血清蛋白水平是死亡的危险因素.结论 颈脊髓损伤患者伤后低蛋白血症在死亡患者中更为明显;低蛋白血症是此类患者死亡的危险因素.%Objective To assess the nutrition status changes in patients after cervical spinal cord injury, and determine which influences on the mortality. Methods All of 128 patients with cervical spinal cord injury were divided into two groups, death group and survivor group. For each patient, the general conditions and the serum biochemical parameters including serum total protein, serum albumin, serum prealbumin were measured after hospitalization. The dynamic changes of nutrition status were compared between the two groups, and a multivariate logistic regression analyses were done to identify the contribution of nutrition status on mortality. Results During the 14 days after hospitalization, the serum total protein level presented a decreased trend in the death group. After the 3~5 days of hospitalization, all the three serum protein level in death group were significantly lower than which in survivor group, an apparently reduce were found in the death group compared with survivor group. In the two groups, the averaged level of the three serum protein were both lower than the criterion standard of the hypoproteinemia and the malnutrition, and the death group were lower (P <0.05). Multivariate logistic regression identified the lower serum total protein level, serum albumin and serum prealbumin

  15. Fixed cord in spinal stenosis

    International Nuclear Information System (INIS)

    This paper evaluates patients with cervical spinal canal compromise due to congenital anomalies (achondroplasia, Chiari malformation) and degenerative diseases using MR cord motion and cerebrospinal fluid (CSF) flow studies. Pulsatile longitudinal motion of the cervical cord was determined by means of cardiac-gated velocity phase contrast methods, including cine. Pathology included dwarfism (n = 15), Chiari malformation (n = 10), spondylosis (n = 10), and acute cord compression (n = 9). Symptomatic cases of congenital cervical stenosis had decreased cord motion, although CSF flow was not always significantly compromised. Postoperative cases demonstrated good cord and CSF motion, unless compression or obstruction was present

  16. 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

    OpenAIRE

    Savni R Satoskar; Aimee A Goel; Mehta, Pooja H.; Atul Goel

    2014-01-01

    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 distrac...

  17. Vertebral spinal osteophytes.

    Science.gov (United States)

    Klaassen, Zachary; Tubbs, R Shane; Apaydin, Nihal; Hage, Robert; Jordan, Robert; Loukas, Marios

    2011-03-01

    Osteoarthritis is a common complication in the elderly and is often associated with osteophyte growth on vertebral bodies. The clinical presentation of vertebral osteophytes is related to anatomical structures adjacent to the spinal column. For instance, cervical osteophytes potentially involve the pharynx and esophagus, leading to dysphagic symptoms that may be accompanied by food aspiration, vocal fold paralysis and obstructive sleep apnea. In addition to anterior cervical osteophytes, posterior and uncinate process osteophytes may form, compressing the spinal cord and vertebral artery blood supply, respectively. Cervical osteophytes have also been shown to form an accessory median atlanto-occipital joint when the relationship between the atlas, dens and basiocciput is involved. In the thorax, the esophagus is often affected by osteophytes and may result in dysphagia. Traumatic and non-traumatic thoracic aorta pseudoaneurysm formation has been attributed to sharp osteophytes lacerating the aorta, a direct complication of the relationship between the aorta anterior vertebral column. Additionally, aspiration pneumonia was reported in patients with compression of a main stem bronchus, due to mechanical compression by thoracic osteophytes. In the lumbar spinal region, the two major structures in close proximity to the spine are the inferior vena cava and abdominal aorta, both of which have been reported to be affected by osteophytes. Treatment of osteophytes is initially conservative with anti-inflammatory medications, followed by surgical removal. Increasing obesity and geriatric populations will continue to result in an array of osteoarthritic degenerative changes such as osteophyte formation. PMID:20383671

  18. Hybrid手术治疗脊髓型颈椎病的临床疗效分析%Clinical efficacy analysis of hybrid spinal fusion surgery in the treatment of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    马迅; 梅军; 冯皓宇; 张丽; 关晓明

    2013-01-01

    Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46%,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious

  19. Clinical significance of MRI/{sup 18}F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi [University of Fukui, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Okazawa, Hidehiko [University of Fukui, Department of Biomedical Imaging Research Center, Eiheiji, Fukui (Japan); Kimura, Hirohiko [University of Fukui, Departments of Radiology, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Kudo, Takashi [Nagasaki University, Department of Radioisotope Medicine, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki (Japan)

    2012-10-15

    {sup 18}F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/{sup 18}F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on {sup 18}F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and {sup 18}F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and {sup 18}F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV{sub max}). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV{sub max} was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV{sub max} with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV{sub max}. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated

  20. Clinical significance of MRI/18F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

    International Nuclear Information System (INIS)

    18F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/18F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on 18F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and 18F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and 18F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUVmax). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUVmax was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUVmax with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUVmax. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated with a poor postoperative neurological outcome. SUVmax

  1. 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.

  2. 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)

  3. Neuroimaging for spine and spinal cord surgery

    International Nuclear Information System (INIS)

    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. One Stage Surgical Treatment of Combined Posterior and Anterior Approach for Myelogenous Cervical Spondylosis of Spinal Stenosis combining Huge Herniated Disk%一期后前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    修海军

    2012-01-01

    Objective: To investigate the clinical effects and application of one stage surgical treatment of combined posterior and anterior approach for myelogenous cervical spondylosis of spinal stenosis combining huge herniated disk. Method: Analyze the clinical date of 25 patients who had the surgery from January 2007 to June 2010 respectively. There were 17 males and 8 females with the average age of 60. 4 years and the age ranging from 56 to 74. Result: 25 patients were followed up for 3 , 6 and 24 months, and the average improvement rate of JOA score were 63. 5% , 74. 4% and 76. 5% respectively. X-ray and MRI after the surgery had shown that no looseness of the internal fixation was found, cervical spinal cord compression was relieved and the cylinder could be seen again. Conclusion: It was an effective surgery of one stage surgical treatment of combined posterior and anterior approach for myelogenous cervical spondylosis of spinal stenosis combining huge herniated disk and it could relieve cervical spinal cord compression and rebuild the stability of cervical vertebrae. The advantages were as follows: shortening the treatment period; easing the pain for secondary surgery and saving medical cost.%目的:探讨一期后、前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病的临床疗效和应用价值.方法:回顾分析2007年1月至2010年6月接受该术式的25例患者的临床资料,男17例,女8例,年龄56-74岁,平均60,4岁.结果:本组25例患者经3、6、24月的随访,JOA评分平均改善率分别为63.5%,74.4%,76.5%,术后行X线,MRI复查,内固定无松动,颈髓压迫解除,恢复了圆柱形状.结论:一期后、前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病是一种有效可行的手术方法,能充分解除脊髓压迫,重建颈椎稳定性.优点:缩短治疗周期,消除了二次手术的痛苦,节省了医疗费用.

  5. 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.

  6. 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, ...

  7. Firing regulation of fast-spiking interneurons by autaptic inhibition

    OpenAIRE

    Guo, Daqing; Chen, Mingming; Perc, Matjaz; Wu, Shengdun; Xia, Chuan; Zhang, Yangsong; Xu, Peng; Xia, Yang; Yao, Dezhong

    2016-01-01

    Fast-spiking (FS) interneurons in the brain are self-innervated by powerful inhibitory GABAergic autaptic connections. By computational modelling, we investigate how autaptic inhibition regulates the firing response of such interneurons. Our results indicate that autaptic inhibition both boosts the current threshold for action potential generation as well as modulates the input-output gain of FS interneurons. The autaptic transmission delay is identified as a key parameter that controls the f...

  8. 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.

  9. Efficacy of PEEK Cages and Plate Augmentation in Three-Level Anterior Cervical Fusion of Elderly Patients

    OpenAIRE

    Song, Kyung Jin; Kim, Gyu Hyung; Choi, Byeong Yeol

    2011-01-01

    Background To evaluate the clinical efficacy of three-level anterior cervical arthrodesis with polyethyletherketone (PEEK) cages and plate fixation for aged and osteoporotic patients with degenerative cervical spinal disorders. Methods Twenty one patients, who had undergone three-level anterior cervical arthrodesis with a cage and plate construct for degenerative cervical spinal disorder from November 2001 to April 2007 and were followed up for at least two years, were enrolled in this study....

  10. Serotonin Promotes Development and Regeneration of Spinal Motor Neurons in Zebrafish

    Directory of Open Access Journals (Sweden)

    Antón Barreiro-Iglesias

    2015-11-01

    Full Text Available In contrast to mammals, zebrafish regenerate spinal motor neurons. During regeneration, developmental signals are re-deployed. Here, we show that, during development, diffuse serotonin promotes spinal motor neuron generation from pMN progenitor cells, leaving interneuron numbers unchanged. Pharmacological manipulations and receptor knockdown indicate that serotonin acts at least in part via 5-HT1A receptors. In adults, serotonin is supplied to the spinal cord mainly (90% by descending axons from the brain. After a spinal lesion, serotonergic axons degenerate caudal to the lesion but sprout rostral to it. Toxin-mediated ablation of serotonergic axons also rostral to the lesion impaired regeneration of motor neurons only there. Conversely, intraperitoneal serotonin injections doubled numbers of new motor neurons and proliferating pMN-like progenitors caudal to the lesion. Regeneration of spinal-intrinsic serotonergic interneurons was unaltered by these manipulations. Hence, serotonin selectively promotes the development and adult regeneration of motor neurons in zebrafish.

  11. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  12. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  13. 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.

  14. Degenerative cervical myelopathy.

    Science.gov (United States)

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  15. 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.

  16. 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

  17. Concomitance of cervical intramedullary traumatic neuroma and cervical cord herniation in a tetraplegic woman.

    Science.gov (United States)

    Su, Hui-Yi; Wu, Yung-Tsan; Liu, Ming-Ying; Lin, Yu-Chun; Chu, Heng-Yi; Chang, Shin-Tsu

    2013-01-01

    We present the first case of concomitant intramedullary traumatic neuroma and spinal cord herniation. A 57-year-old woman injured her cervical spine with subluxation and cord compression at the C5-C6 level. After the operation, the patient received intensive rehabilitation for one year with well response. Unfortunately, she experienced weakness and progressive numbness extending to all the limbs later. Cervical magnetic resonance imaging revealed spinal cord herniation at the C5-C6 level and pathology proved intramedullary traumatic neuroma. After the second operation, the paresthesia over the trunk and limbs persisted, and the patient was nearly totally assisted in her activities of daily living. The intramedullary traumatic neuroma and spinal cord herniation are rare causes in patients with spinal cord dysfunction. The case presented here indicates the possibility of the coexisting conditions leading to progressive neurologic deficits in patients with old spinal cord injury. PMID:23887176

  18. 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.

  19. “White Cord Syndrome” of Acute Tetraplegia after Anterior Cervical Decompression and Fusion for Chronic Spinal Cord Compression: A Case Report

    Directory of Open Access Journals (Sweden)

    Kingsley R. Chin

    2013-01-01

    Full Text Available Paralysis is the most feared postoperative complication of ACDF and occurs most often due to an epidural hematoma. In the absence of a clear etiology, inadequate decompression or vascular insult such as ischemia/reperfusion injury are the usual suspects. Herewith we report a case of complete loss of somatosensory evoked potentials (SSEPs during elective ACDF at C4-5 and C5-6 followed by postoperative C6 incomplete tetraplegia without any discernible technical cause. A postoperative MRI demonstrated a large area of high signal changes on T2-weighted MRI intrinsic to the cord “white cord syndrome” but no residual compression. This was considered consistent with spinal cord gliosis with possible acute edema. The acute decompression of the herniated disc resulted in cord expansion and rush-in reperfusion. We postulate that this may have led to disruption in the blood brain barrier (BBB and triggered a cascade of reperfusion injuries resulting in acute neurologic dysfunction. At 16 months postoperatively our patient is recovering slowly and is now a Nurick Grade 4.

  20. Diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    High resolution CT easily localized lesions including soft tissues of the bone such as disc protrusion and thickening of the yellow ligament. In all cases, myelography demonstrated compression of the nerve roots of the spinal cord which corresponded to CT findings at the level where plain CT revealed a lesion. However, CT metrizamide myelography demonstrated the lesion more clearly than did conventional myelography. CT metrizamide myelography also outlined compression of the nerve roots satisfactorily and demonstrated compressed findings of the spinal cord in the dynamic study. Thus, high resolution CT was useful for screening of cervical disc disease, and CT metrizamide myelography, for identification of lesions of the nerve roots. (Chiba, N.)

  1. AN AMAZINGCASE REPORT OF CERVICAL SHWANNOMA

    OpenAIRE

    Ruqia Asna; Shakeel Ahmed; Khudsia; Baig,

    2014-01-01

    This is a case report of a patient with history of vague chest pain and facial numbness. When the patient was subjected for evaluation he was found to have cervical Schwannoma. He was operated and was successfully treated. Schwannomas are extramedullary-intradural tumors composed of Schwann cells, which can arise from spinal nerves at any level (cervical, thoracic, lumbar, or cauda equina) and most often arise from a posterior (sensory) nerve root. The most common initial ...

  2. Delayed Esophageal Perforation after Cervical Spine Plating

    OpenAIRE

    Kim, Seong Jung; Ju, Chang Il; Kim, Dong Min; Kim, Seok Won

    2013-01-01

    Although anterior approaches to the cervical spine are popular and safe, they cause some of complications. Esophageal perforation after anterior spinal fusion is a rare but potentially life-threatening complication. We present a rare case of delayed esophageal perforation caused by a cervical screw placed via the anterior approach. A 43-year-old man, who had undergone surgery for complete cord injury at another orthopedic department 8 years previously, was admitted to our institute due to pai...

  3. Cervical degenerative intraspinal cyst: a case report and literature review involving 132 cases

    OpenAIRE

    Machino, Masaaki; YUKAWA, YASUTSUGU; ITO, KEIGO; KATO, FUMIHIKO

    2012-01-01

    Intraspinal and extradural cysts in the cervical spine are rare disorders that may cause myelopathy or radiculopathy. A synovial cyst or ganglion derived from the facet joint and that from a ligamentum flavum have been reported. We report a surgical case of degenerative intraspinal cyst, causing cervical myelopathy. MRI of a case revealed cystic lesion at C4–5. Spinal cord was compressed by cyst and symptoms of myelopathy were also observed. The patient with cervical spinal canal stenosis und...

  4. 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.

  5. Heterogeneity And Diversity Of Striatal GABAergic Interneurons

    Directory of Open Access Journals (Sweden)

    Fatuel Tecuapetla

    2010-12-01

    Recent advances in technological approaches, most notably the generation of several BAC transgenic mouse strains which express a fluorescent marker, enhanced green fluorescent protein, specifically and selectively only in neurons of a certain genetic makeup (e.g., parvalbumin-, neuropeptide Y-, or tyrosine hydroxylase-expressing neurons etc. have led to the ability of electrophysiologists to visualize and patch specific neuron types in brain slices with epifluorescence illumination. This has led to a rapid expansion of the number of neurochemically and/or electrophysiologically identified interneuronal cell types in the striatum and elsewhere....

  6. Computed tomography in the evaluation of caudal cervical spondylomyelopathy of the Doberman Pinscher

    International Nuclear Information System (INIS)

    Caudal cervical spondylomyelopathy is a common neurologic disorder of Doberman pinschers which has a number of striking similarities to cervical spondylotic myelopathy in humans. Diagnosis of this human disease is facilitated considerably by the use of computed tomographic (CT) myelography. Sixteen Doberman pinscher dogs with caudal cervical spondylomyelopathy were studied by conventional myelography followed by CT myelography. A close correlation was noted between the CT myelographic appearance of the cervical spinal cord in these dogs, and that reported for human cervical spondylotic myelopathy. Five dogs had atrophy of the spinal cord, and in another there was an accumulation of contrast medium within the spinal cord. These features are often associated with a poor response to surgical decompression in humans with cervical spondylotic myelopathy. The CT examination provided information that could not be obtained by conventional myelography alone and should be considered as an additional diagnostic procedure in dogs with caudal cervical spondylomyelopathy

  7. Operative stabilization of the cervical spine in cases of metastases

    International Nuclear Information System (INIS)

    Because of intraspinal space requirement or instability of the cervical spine, metastases may lead to a compression of the spinal cord and/or the nerve roots. Early decompression and stabilization prevents unavoidable tetraparesis. In most cases quality of life can be maintained. The indication and methodology of cervical spine stabilization as well as the results of treatment in 18 patients are demonstrated. (orig.)

  8. Pseudarthrosis of the Cervical Spine: Risk Factors, Diagnosis and Management

    Science.gov (United States)

    Leven, Dante

    2016-01-01

    Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis. PMID:27559462

  9. Cervical myelopathy: magnetic imaging findings

    International Nuclear Information System (INIS)

    69 patients with clinical signs of cervical myelopathy were examined using magnetic imaging (T1- and T2-suspended tomograms of the sagittal and transverse section using a device with 0.04 T field intensity). Vertebral disk hernias were revealed in 35 patients, compression of the spinal cord with metastases into vertebral body in 2, extramedullary tumor in 11, intramedullary tumor in 9, and syringomyelia in 12 patients. T2-suspended tomograms proved to be more informative due to their higher sensitivity to aqueous content. T1-suspended tomograms help assess the degree of spinal cord compression and the direction of the disk protrusion. Magnetic imaging is an informative method used for objective identification of the cases of myelopathy of cervical localization

  10. CERVICAL STENOTIC MYELOPATHY IN HORSES – REPORT OF 7 CASES MIELOPATIA CERVICAL ESTENÓTICA EM EQUINOS – ESTUDO DE 7 CASOS

    OpenAIRE

    Carlos Eduardo Wayne Nogueira; Márcio Nunes Corrêa; Luiz Paiva Carapeto; Janaína da Rosa Velho; Luciana Araujo Lins

    2009-01-01

    In this case report, methods to accomplish differential diagnosis for Cervical Stenotic Myelopathy with other diseases with similar symptomatology are described. Cervical Stenotic Myelopathy is an affection characterized by the narrowing of the cervical vertebrae canal, causing a spinal cord compression. This abnormality usually results of a cervical vertebral malformation during the development of the animal. Nutritional imbalances are straightly related to the development of this s...

  11. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  12. Classification of neocortical interneurons using affinity propagation

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    Roberto eSantana

    2013-12-01

    Full Text Available In spite of over a century of research on cortical circuits, it is still unknown how many classes of cortical neurons exist. Neuronal classification has been a difficult problem because it is unclear what a neuronal cell class actually is and what are the best characteristics are to define them. Recently, unsupervised classifications using cluster analysis based on morphological, physiological or molecular characteristics, when applied to selected datasets, have provided quantitative and unbiased identification of distinct neuronal subtypes. However, better and more robust classification methods are needed for increasingly complex and larger datasets. We explored the use of affinity propagation, a recently developed unsupervised classification algorithm imported from machine learning, which gives a representative example or exemplar for each cluster. As a case study, we applied affinity propagation to a test dataset of 337 interneurons belonging to four subtypes, previously identified based on morphological and physiological characteristics. We found that affinity propagation correctly classified most of the neurons in a blind, non-supervised manner. In fact, using a combined anatomical/physiological dataset, our algorithm differentiated parvalbumin from somatostatin interneurons in 49 out of 50 cases. Affinity propagation could therefore be used in future studies to validly classify neurons, as a first step to help reverse engineer neural circuits.

  13. Intraoperative and pathological findings of intramedullary amputation neuroma associated with spinal ependymoma

    OpenAIRE

    Arishima, Hidetaka; Takeuchi, Hiroaki; Tsunetoshi, Kenzo; Kodera, Toshiaki; Kitai, Ryuhei; Kikuta, Ken-ichiro

    2012-01-01

    Amputation neuromas typically arise in injured peripheral nerves; rarely, however, they arise in the spinal cord. We report a rare case of intramedullary amputation neuroma associated with ependymoma in the cervical spinal cord. A 73-year-old woman presented with a 5-year history of progressive gait disturbance. Neurological examination revealed complete motor deficit of her hands and legs. Magnetic resonance imaging of the cervical spine revealed an enhancing mass within the spinal cord at t...

  14. 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.

  15. 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.

  16. Acute spontaneous spinal epidural haematoma in a child

    International Nuclear Information System (INIS)

    Spontaneous spinal epidural haematomas rarely occur. Patients tend to be in their sixties or seventies. Acute spontaneous spinal epidural haematomas in children without a predisposition for bleeding disorders, trauma, vascular malformations or anticoagulant therapy have seldom been described. We present a case of a 4-year-old girl with a spontaneous cervical epidural haematoma diagnosed with MR. (orig.)

  17. 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.

  18. Substance P Depolarizes Lamprey Spinal Cord Neurons by Inhibiting Background Potassium Channels

    OpenAIRE

    Thörn Pérez, Carolina; Hill, Russell H.; Grillner, Sten

    2015-01-01

    Substance P is endogenously released in the adult lamprey spinal cord and accelerates the burst frequency of fictive locomotion. This is achieved by multiple effects on interneurons and motoneurons, including an attenuation of calcium currents, potentiation of NMDA currents and reduction of the reciprocal inhibition. While substance P also depolarizes spinal cord neurons, the underlying mechanism has not been resolved. Here we show that effects of substance P on background K+ channels are the...

  19. Cervical Cancer

    Science.gov (United States)

    ... to see your doctor. www.cdc.gov/cancer/knowledge 1-800-CDC-INFO Are there tests that can prevent cervical cancer or find it early? There are two tests that can either help prevent cervical cancer or find it early: • The Pap test (or Pap smear)looks for precancers, cell changes, on the cervix ...

  20. Hilar GABAergic interneuron activity controls spatial learning and memory retrieval.

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    Yaisa Andrews-Zwilling

    Full Text Available BACKGROUND: Although extensive research has demonstrated the importance of excitatory granule neurons in the dentate gyrus of the hippocampus in normal learning and memory and in the pathogenesis of amnesia in Alzheimer's disease (AD, the role of hilar GABAergic inhibitory interneurons, which control the granule neuron activity, remains unclear. METHODOLOGY AND PRINCIPAL FINDINGS: We explored the function of hilar GABAergic interneurons in spatial learning and memory by inhibiting their activity through Cre-dependent viral expression of enhanced halorhodopsin (eNpHR3.0--a light-driven chloride pump. Hilar GABAergic interneuron-specific expression of eNpHR3.0 was achieved by bilaterally injecting adeno-associated virus containing a double-floxed inverted open-reading frame encoding eNpHR3.0 into the hilus of the dentate gyrus of mice expressing Cre recombinase under the control of an enhancer specific for GABAergic interneurons. In vitro and in vivo illumination with a yellow laser elicited inhibition of hilar GABAergic interneurons and consequent activation of dentate granule neurons, without affecting pyramidal neurons in the CA3 and CA1 regions of the hippocampus. We found that optogenetic inhibition of hilar GABAergic interneuron activity impaired spatial learning and memory retrieval, without affecting memory retention, as determined in the Morris water maze test. Importantly, optogenetic inhibition of hilar GABAergic interneuron activity did not alter short-term working memory, motor coordination, or exploratory activity. CONCLUSIONS AND SIGNIFICANCE: Our findings establish a critical role for hilar GABAergic interneuron activity in controlling spatial learning and memory retrieval and provide evidence for the potential contribution of GABAergic interneuron impairment to the pathogenesis of amnesia in AD.

  1. Design of Lamifuse : a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Verbeek, A.L.M.; Grotenhuis, J.A.

    2007-01-01

    BACKGROUND: laminectomy is a valuable surgical treatment for some patients with a cervical radiculomyelopathy due to cervical spinal stenosis. More recently attention has been given to motion of the spinal cord over spondylotic spurs as a cause of myelopathic changes. Immobilisation by fusion could

  2. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

    1994-03-01

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

  3. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    International Nuclear Information System (INIS)

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: 1) discontinuity of injured disc, 2) anterior indentation of spinal cord at the site of dislocated vertebral body, and 3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author)

  4. [Clinical and technical assessment of the cervical spine].

    Science.gov (United States)

    Dvorak, J

    1996-11-01

    In analysis of the cervical and cervicobrachial syndrome with or without signs of compression of the nerve root or spinal cord, functional assessment of the cervical spine is of great importance. Comparisons between actively performed and passively induced motion can be verified by using standardized computer-assisted assessment allowing precise documentation of the range of motion and coupled motion. The age-related normal values should be considered. The neurological assessment includes not only the cranial nerves and upper extremities but also lower extremities to avoid overlooking the signs of cervical myelopathy. In patients with compression of nerve roots or the spinal cord neurophysiology might be helpful in identifying or verifying compression. In patients with suspected myelopathy sensory evoked potentials will allow assessment of the function of the ascending spinal pathways and motor evoked potentials, assessment of the function of the descending cortical spinal pathways. PMID:8999404

  5. Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

    OpenAIRE

    Dağlı, Murat; Er, Uygur; Şimşek, Serkan; Bavbek, Murad

    2013-01-01

    Study Design Retrospective analysis. Purpose To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. Overview of Literature Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their ...

  6. Idiopathic cervical osteomyelitis presenting as dysphagia

    OpenAIRE

    Ghaly GA; Espeso A; Fish B

    2010-01-01

    We discuss a case of idiopathic cervical epidural abscess, complicated by osteomyelitis, presenting with dysphagia as the main complaint. No predisposing factors were identified and blood cultures were negative. Case was treated conservatively by long course of IV antibiotics. We present a review of presentation of spinal epidural abscesses and indications for surgical intervention.

  7. Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study

    OpenAIRE

    Popovic, Milos R.; Zivanovic, Vera; Taufik A. Valiante

    2016-01-01

    Non-traumatic spinal cord pathology is responsible for 25–52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16–21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials,...

  8. Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study

    OpenAIRE

    Popovic, Milos R.; Vera Zivanovic; Taufik A. Valiante

    2016-01-01

    Non-traumatic spinal cord pathology is responsible for 25 to 52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16 to 21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders such as myelopathy secondary to cervical spondylosis. Motivated by our prior successful clinical trials, including two randomized control trials showing that fun...

  9. Three-Dimensional Distribution of Sensory Stimulation-Evoked Neuronal Activity of Spinal Dorsal Horn Neurons Analyzed by In Vivo Calcium Imaging

    OpenAIRE

    NISHIDA, Kazuhiko; Matsumura, Shinji; Taniguchi, Wataru; Uta, Daisuke; Furue, Hidemasa; Ito, Seiji

    2014-01-01

    The spinal dorsal horn comprises heterogeneous populations of interneurons and projection neurons, which form neuronal circuits crucial for processing of primary sensory information. Although electrophysiological analyses have uncovered sensory stimulation-evoked neuronal activity of various spinal dorsal horn neurons, monitoring these activities from large ensembles of neurons is needed to obtain a comprehensive view of the spinal dorsal horn circuitry. In the present study, we established i...

  10. Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass.

    Science.gov (United States)

    Giger, Roland; Szalay-Quinodoz, Ildiko; Haenggeli, André; Dulguerov, Pavel

    2002-01-01

    Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed. PMID:12430135

  11. A Novel Vertebral Stabilization Method for Producing Contusive Spinal Cord Injury

    OpenAIRE

    Walker, Melissa J.; Chandler L Walker; Zhang, Y. Ping; Shields, Lisa B. E.; Shields, Christopher B.; Xu, Xiao-Ming

    2015-01-01

    Clinically-relevant animal cervical spinal cord injury (SCI) models are essential for developing and testing potential therapies; however, producing reliable cervical SCI is difficult due to lack of satisfactory methods of vertebral stabilization. The conventional method to stabilize the spine is to suspend the rostral and caudal cervical spine via clamps attached to cervical spinous processes.  However, this method of stabilization fails to prevent tissue yielding during the contusion as the...

  12. Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass

    OpenAIRE

    Giger, Roland; Szalay-Quinodoz, Ildiko; Haenggeli, André; Dulguerov, Pavel

    2002-01-01

    Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed.

  13. Langerhans cell histiocytosis of the cervical spine in an adult: a case report.

    Science.gov (United States)

    Sayhan, Salih; Altinel, Deniz; Erguden, Cenk; Kizmazoglu, Ceren; Guray, Merih; Acar, Umit

    2010-07-01

    We present a case of a 47-year-old-woman with a complaint of cervical pain with paresthetic appearance on her left arm. She was treated with analgetics. Further radiological evaluation because of the persistent pain revealed an osteolytic destruction of the fourth cervical vertebra. The patient underwent anterior cervical corpectomy with total excision of the tumor. Stabilization of the cervical spine was performed. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH) of the cervical spine. This case report presents the histopathological evaluation, diagnostic work-up and the treatment procedures because of rarity of cervical spinal LCH cases in the literature. PMID:20669118

  14. Immunohistochemical visualization of mouse interneuron subtypes [v1; ref status: indexed, http://f1000r.es/4em

    Directory of Open Access Journals (Sweden)

    Simon Molgaard

    2014-10-01

    Full Text Available The activity of excitatory neurons is controlled by a small, but highly diverse population of inhibitory interneurons. These cells show a high level of physiological, morphological and neurochemical heterogeneity, and play highly specific roles in neuronal circuits. In the mammalian hippocampus, these are divided into 21 different subtypes of GABAergic interneurons based on their expression of different markers, morphology and their electrophysiological properties. Ideally, all can be marked using an antibody directed against the inhibitory neurotransmitter GABA, but parvalbumin, calbindin, somatostatin, and calretinin are also commonly used as markers to narrow down the specific interneuron subtype. Here, we describe a journey to find the necessary immunological reagents for studying GABAergic interneurons of the mouse hippocampus. Based on web searches there are several hundreds of different antibodies on the market directed against these four markers. Searches in the literature databases allowed us to narrow it down to a subset of antibodies most commonly used in publications. However, in our hands the most cited ones did not work for immunofluorescence stainings of formaldehyde fixed tissue sections and cultured hippocampal neurons, and we had to immunostain our way through thirteen different commercial antibodies before finally finding a suitable antibody for each of the four markers. The antibodies were evaluated based on signal-to-noise ratios as well as if positive cells were found in layers of the hippocampus where they have previously been described. Additionally, the antibodies were also tested on sections from mouse spinal cord with similar criteria for specificity of the antibodies. Using the antibodies with a high rating on pAbmAbs, stainings with high signal-to-noise ratios and location of the immunostained cells in accordance with the literature could be obtained, making these antibodies suitable choices for studying the

  15. Apical versus Basal Neurogenesis Directs Cortical Interneuron Subclass Fate

    Directory of Open Access Journals (Sweden)

    Timothy J. Petros

    2015-11-01

    Full Text Available Fate determination in the mammalian telencephalon, with its diversity of neuronal subtypes and relevance to neuropsychiatric disease, remains a critical area of study in neuroscience. Most studies investigating this topic focus on the diversity of neural progenitors within spatial and temporal domains along the lateral ventricles. Often overlooked is whether the location of neurogenesis within a fate-restricted domain is associated with, or instructive for, distinct neuronal fates. Here, we use in vivo fate mapping and the manipulation of neurogenic location to demonstrate that apical versus basal neurogenesis influences the fate determination of major subgroups of cortical interneurons derived from the subcortical telencephalon. Somatostatin-expressing interneurons arise mainly from apical divisions along the ventricular surface, whereas parvalbumin-expressing interneurons originate predominantly from basal divisions in the subventricular zone. As manipulations that shift neurogenic location alter interneuron subclass fate, these results add an additional dimension to the spatial-temporal determinants of neuronal fate determination.

  16. Magnetic resonance imaging of traumatic cervical injury

    International Nuclear Information System (INIS)

    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

  17. 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.

  18. 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.

  19. Rugby injuries of the upper cervical spine. Case reports.

    Science.gov (United States)

    Scher, A T

    1983-09-17

    Fractures and dislocations of the upper cervical spine (atlas and axis) differ markedly from those of the lower cervical spine (C3 - C7) because of the unique anatomy and function of these two vertebrae. Case reports of 4 rugby players who sustained serious injuries of the upper cervical spine are presented. The role of the high tackle in causing these injuries is described and the association of head and upper cervical spinal trauma is emphasized. The radiological management of the player with suspected injury is outlined. PMID:6623223

  20. 呼吸道系统管理模式对降低颈脊髓完全损伤气管切开风险的意义%Strengthened respiratory management for lower tracheostomy risks in patients with complete cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    朱巍; 阚利胜; 孙延卿; 陈雄生; 袁文; 贾连顺

    2014-01-01

    目的 分析通过呼吸道系统管理模式降低颈脊髓完全损伤气管切开率的可行性.方法 回顾性分析2006至2012年上海长征医院骨科239例采用呼吸道系统管理模式的颈脊髓完全损伤病例的临床资料包括年龄、性别、受伤原因、颈髓损伤节段、手术情况、气管切开情况及预后情况,统计气管切开率及死亡率,并与1991至2005年大宗病例的回顾性研究数据进行比较.对严重颈脊髓损伤我院近年采用了呼吸道系统管理模式,包括强化体内充足能量及水份、预防或解除支气管痉挛、稀释痰液、加强翻身拍背、经鼻吸痰管或纤支镜吸痰、深呼吸及咳嗽训练、严格气管切开指征、必要时术后可短时间保留气管插管.结果 32例患者被实施气管切开,气管切开率12.6%.10例死亡,死亡率为4.2%.而1991至2005年的气管切开率为19.1%,死亡率为21.4%.颈脊髓完全损伤气管切开率较前明显降低,而存活率明显提高.结论 合理的呼吸道系统管理模式可有效降低颈脊髓完全损伤的气管切开率,提高救治存活率.%Objective To access the feasibility of reducing tracheostomy rates in patients with complete cervical spinal cord injury through a systemic respiratory management mode.Methods A retrospective review was performed for 239 patients on a systemic respiratory management mode after complete cervical spinal cord injury in Shanghai Changzheng Hospital from 2006 to 2012.Their demographic and clinical data,including age,gender,cause of injury,level of cervical spinal cord injuries,surgical approaches,tracheostomy rates and mortality rates,were collected and analyzed.Tracheostomy rates were compared with those of patients with complete cervical spinal cord injury.Tracheostomy rates were compared with those patients with complete cervical spinal cord injury from 1991 to 2005.The new respiratory management mode for patients with severe cervical spinal cord

  1. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  2. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  3. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

  4. Early Somatostatin Interneuron Connectivity Mediates the Maturation of Deep Layer Cortical Circuits.

    Science.gov (United States)

    Tuncdemir, Sebnem N; Wamsley, Brie; Stam, Floor J; Osakada, Fumitaka; Goulding, Martyn; Callaway, Edward M; Rudy, Bernardo; Fishell, Gord

    2016-02-01

    The precise connectivity of somatostatin and parvalbumin cortical interneurons is generated during development. An understanding of how these interneuron classes incorporate into cortical circuitry is incomplete but essential to elucidate the roles they play during maturation. Here, we report that somatostatin interneurons in infragranular layers receive dense but transient innervation from thalamocortical afferents during the first postnatal week. During this period, parvalbumin interneurons and pyramidal neurons within the same layers receive weaker thalamocortical inputs, yet are strongly innervated by somatostatin interneurons. Further, upon disruption of the early (but not late) somatostatin interneuron network, the synaptic maturation of thalamocortical inputs onto parvalbumin interneurons is perturbed. These results suggest that infragranular somatostatin interneurons exhibit a transient early synaptic connectivity that is essential for the establishment of thalamic feedforward inhibition mediated by parvalbumin interneurons. PMID:26844832

  5. Fusion protein Isl1–Lhx3 specifies motor neuron fate by inducing motor neuron genes and concomitantly suppressing the interneuron programs

    Science.gov (United States)

    Lee, Seunghee; Cuvillier, James M.; Lee, Bora; Shen, Rongkun; Lee, Jae W.; Lee, Soo-Kyung

    2012-01-01

    Combinatorial transcription codes generate the myriad of cell types during development and thus likely provide crucial insights into directed differentiation of stem cells to a specific cell type. The LIM complex composed of Isl1 and Lhx3 directs the specification of spinal motor neurons (MNs) in embryos. Here, we report that Isl1–Lhx3, a LIM-complex mimicking fusion, induces a signature of MN transcriptome and concomitantly suppresses interneuron differentiation programs, thereby serving as a potent and specific inducer of MNs in stem cells. We show that an equimolar ratio of Isl1 and Lhx3 and the LIM domain of Lhx3 are crucial for generating MNs without up-regulating interneuron genes. These led us to design Isl1–Lhx3, which maintains the desirable 1:1 ratio of Isl1 and Lhx3 and the LIM domain of Lhx3. Isl1–Lhx3 drives MN differentiation with high specificity and efficiency in the spinal cord and embryonic stem cells, bypassing the need for sonic hedgehog (Shh). RNA-seq analysis revealed that Isl1–Lhx3 induces the expression of a battery of MN genes that control various functional aspects of MNs, while suppressing key interneuron genes. Our studies uncover a highly efficient method for directed MN generation and MN gene networks. Our results also demonstrate a general strategy of using embryonic transcription complexes for producing specific cell types from stem cells. PMID:22343290

  6. Fusion protein Isl1-Lhx3 specifies motor neuron fate by inducing motor neuron genes and concomitantly suppressing the interneuron programs.

    Science.gov (United States)

    Lee, Seunghee; Cuvillier, James M; Lee, Bora; Shen, Rongkun; Lee, Jae W; Lee, Soo-Kyung

    2012-02-28

    Combinatorial transcription codes generate the myriad of cell types during development and thus likely provide crucial insights into directed differentiation of stem cells to a specific cell type. The LIM complex composed of Isl1 and Lhx3 directs the specification of spinal motor neurons (MNs) in embryos. Here, we report that Isl1-Lhx3, a LIM-complex mimicking fusion, induces a signature of MN transcriptome and concomitantly suppresses interneuron differentiation programs, thereby serving as a potent and specific inducer of MNs in stem cells. We show that an equimolar ratio of Isl1 and Lhx3 and the LIM domain of Lhx3 are crucial for generating MNs without up-regulating interneuron genes. These led us to design Isl1-Lhx3, which maintains the desirable 1:1 ratio of Isl1 and Lhx3 and the LIM domain of Lhx3. Isl1-Lhx3 drives MN differentiation with high specificity and efficiency in the spinal cord and embryonic stem cells, bypassing the need for sonic hedgehog (Shh). RNA-seq analysis revealed that Isl1-Lhx3 induces the expression of a battery of MN genes that control various functional aspects of MNs, while suppressing key interneuron genes. Our studies uncover a highly efficient method for directed MN generation and MN gene networks. Our results also demonstrate a general strategy of using embryonic transcription complexes for producing specific cell types from stem cells. PMID:22343290

  7. 人工椎体配合中药在颈椎前路减压融合术中的应用%Application of the Vertebral Body Replacement in the Intervertebral Fusion Road ahead the Close with Traditional Chinese Medicine Treatment Spinal Cord Cervical Vertebra

    Institute of Scientific and Technical Information of China (English)

    华江; 杜文喜

    2011-01-01

    [Objective] Discussion on the sick application effect of the Vertebral Body Replacement, VBR, in the intervertebral fusion road ahead the close with traditional Chinese medicine treatment spinal cord cervical vertebra. [ Method ] To 3 spinal cord cervical vertebra sickness patients undergoing ahead centrum excision, VBR intervertebral fusion, in titanium board road ahead fixed, coordinate traditional Chinese medicine treatment, revisit at least 6 months, after the technique, makes a follow-up visit the observation nerve function to restore the situation and the fusion effect.[Result] 3 example patient technique, the symptom is improved, a follow-up 6-10 months not to have the recrudescence, attain the fusion, the cervical vertebra intervertebral, the cervical vertebra stability maintains highly good, does not have the submersion, the collapse occurrence, after complete patient technique, has not seen any allergy, the repel or the toxic response. After the technique, make a follow-up visit the JOA grading to enhance from the technique previous point to the technique latterpoint, the difference has statistics significance. [Conclusion] VBR plants the bone fusion rate to be high, the security is reliable, is one kind of ideal artificial centrum substitute, the union traditional Chinese medicine may treat the spinal cord cervical vertebra sickness effectively, the promotion centrum fusion and the maintenance cervical vertebra intervertebral altitude.%[目的]探讨人工椎体(VBR)椎间融合前路内固定配合中药治疗脊髓型颈椎病的治疗效果.[方法]对3例脊髓型颈椎病患者行前路椎体切除、VBR椎间融合、钛板前路内固定,配合中药治疗,随访至少6个月,术后随访观察神经功能恢复情况及融合效果.[结果]3例患者术前症状均得到改善,随访6~10个月无复发,均获融合,优2例,良1例.颈椎椎间高度、颈椎稳定性均维持良好,无下沉、塌陷发生.JOA评分较术前明显提高(P<0

  8. An interneuron progenitor maintains neurogenic potential in vivo and differentiates into GABAergic interneurons after transplantation in the postnatal rat brain.

    Science.gov (United States)

    Wang, Qi; Hong, Peiwei; Gao, Hui; Chen, Yuntian; Yang, Qi; Jiang, Mei; Li, Hedong

    2016-01-01

    Dysfunction of cortical GABAergic interneurons are involved in numerous neurological disorders including epilepsy, schizophrenia and autism; and replenishment of these cells by transplantation strategy has proven to be a feasible and effective method to help revert the symptoms in several animal models. To develop methodology of generating transplantable GABAergic interneurons for therapy, we previously reported the isolation of a v-myc-induced GABAergic interneuron progenitor clone GE6 from embryonic ganglionic eminence (GE). These cells can proliferate and form functional inhibitory synapses in culture. Here, we tested their differentiation behavior in vivo by transplanting them into the postnatal rat forebrain. We found that GE6 cells migrate extensively in the neonatal forebrain and differentiate into both neurons and glia, but preferentially into neurons when compared with a sister progenitor clone CTX8. The neurogenic potential of GE6 cells is also maintained after transplantation into a non-permissive environment such as adult cortex or when treated with inflammatory cytokine in culture. The GE6-derived neurons were able to mature in vivo as GABAergic interneurons expressing GABAergic, not glutamatergic, presynaptic puncta. Finally, we propose that v-myc-induced human interneuron progenitor clones could be an alternative cell source of transplantable GABAergic interneurons for treating related neurological diseases in future clinic. PMID:26750620

  9. 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.

  10. Spinal cord motion. Influence of respiration and cardiac cycle

    Energy Technology Data Exchange (ETDEWEB)

    Winklhofer, S. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Schoth, F. [RWTH Aachen University Hospital (Germany). Dept. of Diagnostic Radiology; Stolzmann, P. [University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Krings, T. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology; Mull, M.; Wiesmann, M. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Stracke, C.P. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Alfried-Krupp-Hospital, Essen (Germany). Dept. of Neuroradiology

    2014-11-15

    To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements. Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion. A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion. MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

  11. Spinal cord motion. Influence of respiration and cardiac cycle

    International Nuclear Information System (INIS)

    To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements. Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion. A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion. MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

  12. General Information about Cervical Cancer

    Science.gov (United States)

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Key Points Cervical cancer is ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  13. Cervical myelography with iohexol in horses

    International Nuclear Information System (INIS)

    Five horses, weighing 337 to 400 kg, were used in this research, one of them being used as control. Cervical myelography with iohexol (Omnipaque) was performed on four horses tranquilized with flunitrazepan before induction of anesthesia with sodium thiopental. Anesthesia was maintained with fluothane and oxygen. Cerebrospinal fluid (CSF) was analysed before and after an injection of ioxheol into the subarachnoid space. The animals received 25 to 50 ml of iohexol, after removal of 20 ml cerebrospinal fluid. Radiographies were taken with the horses at lateral recumbency, and the cranial, central and caudal regions of the cervical spine being focalized. No significant changes occurred in the cerebrospinal fluid after injecting the contrast medium. Pathologic changes were not found by gross or microscopic examination of the brain and the cervical spinal cord. Radiographies of good to excellent image quality were obtained. At autopsy, radiographic diagnosis of cervical vertebral instability was confirmed in the animal that had pelvic limb ataxia

  14. Striatal cholinergic interneuron regulation and circuit effects

    Directory of Open Access Journals (Sweden)

    Sean Austin Lim

    2014-10-01

    Full Text Available The striatum plays a central role in motor control and motor learning. Appropriate responses to environmental stimuli, including pursuit of reward or avoidance of aversive experience all require functional striatal circuits. These pathways integrate synaptic inputs from limbic and cortical regions including sensory, motor and motivational information to ultimately connect intention to action. Although many neurotransmitters participate in striatal circuitry, one critically important player is acetylcholine (ACh. Relative to other brain areas, the striatum contains exceptionally high levels of ACh, the enzymes that catalyze its synthesis and breakdown, as well as both nicotinic and muscarinic receptor types that mediate its postsynaptic effects. The principal source of striatal ACh is the cholinergic interneuron (ChI, which comprises only about 1-2% of all striatal cells yet sends dense arbors of projections throughout the striatum. This review summarizes recent advances in our understanding of the factors affecting the excitability of these neurons through acute effects and long term changes in their synaptic inputs. In addition, we discuss the physiological effects of ACh in the striatum, and how changes in ACh levels may contribute to disease states during striatal dysfunction.

  15. Clinical picture of spinal tumors; Klinik spinaler Raumforderungen

    Energy Technology Data Exchange (ETDEWEB)

    Block, F. [Helios-Kliniken, Neurologische Klinik, Schwerin (Germany)

    2006-12-15

    Spinal tumors may present with symptoms such as pain and motor and sensory deficits. Sphincter dysfunction may also occur. The clinical picture depends upon the size and localization of the tumor in relation to the cross section and the height along the longitudinal axis of the spinal cord. Typical symptoms due to transverse damage of the spinal cord are complete lesion, Brown-Sequard syndrome, a lesion of the central spinal cord, and posterior cord syndrome. Tetraparesis, spastic, or flaccid paraparesis result from lesions at the cervical spine, thoracic spine, or below the first lumbar vertebral body, respectively. (orig.) Schmerzen, Paresen und Sensibilitaetsstoerungen stellen die wesentlichen und haeufigen Symptome spinaler Raumforderungen dar. Blasen- und Mastdarmstoerungen sind weitere moegliche Symptome. Ausdehnungen der Raumforderungen im Querschnitt und im Hinblick auf die Laengsachse des Rueckenmarks bestimmen das klinische Bild. Kompletter Querschnitt, Brown-Sequard-Syndrom, zentrale Rueckenmarkschaedigung und Hinterstrangsyndrom sind haeufige Auspraegungen entsprechend der Querschnittslaesion. Tetraparese, spastische oder schlaffe Paraparese resultieren aus Laesionen in Hoehe HWS, BWS bzw. unterhalb von LWK1. (orig.)

  16. Revisiting the enigmatic cortical calretinin-expressing interneurons

    Directory of Open Access Journals (Sweden)

    Bruno Cauli

    2014-06-01

    Full Text Available Cortical calretinin (CR-expressing interneurons represent a heterogeneous subpopulation of about 10-30% of GABAergic interneurons, which altogether total ca. 12-20% of all cortical neurons. In the rodent neocortex, CR cells display different somatodendritic morphologies ranging from bipolar to multipolar but the bipolar cells and their variations dominate. They are also diverse at the molecular level as they were shown to express numerous neuropeptides in different combinations including vasoactive intestinal polypeptide (VIP, cholecystokinin (CCK, neurokinin B (NKB corticotrophin releasing factor (CRF, enkephalin (Enk but also neuropeptide Y (NPY and somatostatin (SOM to a lesser extent. CR-expressing interneurons exhibit different firing behaviors such as adapting, bursting or irregular. They mainly originate from the caudal ganglionic eminence (CGE but a subpopulation also derives from the dorsal part of the medial ganglionic eminence (MGE. Cortical GABAergic CR-expressing interneurons can be divided in two main populations: VIP-bipolar interneurons deriving from the CGE and SOM-Martinotti-like interneurons originating in the dorsal MGE. Although bipolar cells account for the majority of CR-expressing interneurons, the roles they play in cortical neuronal circuits and in the more general metabolic physiology of the brain remain elusive and enigmatic. The aim of this review is, firstly, to provide a comprehensive view of the morphological, molecular and electrophysiological features defining this cell type. We will, secondly, also summarize what is known about their place in the cortical circuit, their modulation by subcortical afferents and the functional roles they might play in neuronal processing and energy metabolism.

  17. Cholinergic interneurons are differentially distributed in the human striatum.

    Directory of Open Access Journals (Sweden)

    Javier Bernácer

    Full Text Available BACKGROUND: The striatum (caudate nucleus, CN, and putamen, Put is a group of subcortical nuclei involved in planning and executing voluntary movements as well as in cognitive processes. Its neuronal composition includes projection neurons, which connect the striatum with other structures, and interneurons, whose main roles are maintaining the striatal organization and the regulation of the projection neurons. The unique electrophysiological and functional properties of the cholinergic interneurons give them a crucial modulating function on the overall striatal response. METHODOLOGY/PRINCIPLE FINDINGS: This study was carried out using stereological methods to examine the volume and density (cells/mm(3 of these interneurons, as visualized by choline acetyltransferase (ChAT immunoreactivity, in the following territories of the CN and Put of nine normal human brains: 1 precommissural head; 2 postcommissural head; 3 body; 4 gyrus and 5 tail of the CN; 6 precommissural and 7 postcommissural Put. The distribution of ChAT interneurons was analyzed with respect to the topographical, functional and chemical territories of the dorsal striatum. The CN was more densely populated by cholinergic neurons than the Put, and their density increased along the anteroposterior axis of the striatum with the CN body having the highest neuronal density. The associative territory of the dorsal striatum was by far the most densely populated. The striosomes of the CN precommissural head and the postcommissural Put contained the greatest number of ChAT-ir interneurons. The intrastriosomal ChAT-ir neurons were abundant on the periphery of the striosomes throughout the striatum. CONCLUSIONS/SIGNIFICANCE: All these data reveal that cholinergic interneurons are differentially distributed in the distinct topographical and functional territories of the human dorsal striatum, as well as in its chemical compartments. This heterogeneity may indicate that the posterior aspects of

  18. THE DIAGNOSIS OF MAGNETIC RESONANCE IMAGING FOR SPINAL CAVERNOUS ANGIOMAS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To assess the characteristics of magnetic resonance imaging (MRI) for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance (MR) were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.

  19. Dopamine from the brain promotes spinal motor neuron generation during development and adult regeneration.

    Science.gov (United States)

    Reimer, Michell M; Norris, Anneliese; Ohnmacht, Jochen; Patani, Rickie; Zhong, Zhen; Dias, Tatyana B; Kuscha, Veronika; Scott, Angela L; Chen, Yu-Chia; Rozov, Stanislav; Frazer, Sarah L; Wyatt, Cameron; Higashijima, Shin-ichi; Patton, E Elizabeth; Panula, Pertti; Chandran, Siddharthan; Becker, Thomas; Becker, Catherina G

    2013-06-10

    Coordinated development of brain stem and spinal target neurons is pivotal for the emergence of a precisely functioning locomotor system. Signals that match the development of these far-apart regions of the central nervous system may be redeployed during spinal cord regeneration. Here we show that descending dopaminergic projections from the brain promote motor neuron generation at the expense of V2 interneurons in the developing zebrafish spinal cord by activating the D4a receptor, which acts on the hedgehog pathway. Inhibiting this essential signal during early neurogenesis leads to a long-lasting reduction of motor neuron numbers and impaired motor responses of free-swimming larvae. Importantly, during successful spinal cord regeneration in adult zebrafish, endogenous dopamine promotes generation of spinal motor neurons, and dopamine agonists augment this process. Hence, we describe a supraspinal control mechanism for the development and regeneration of specific spinal cell types that uses dopamine as a signal. PMID:23707737

  20. Effects of acute spinalization on neurons of postural networks.

    Science.gov (United States)

    Zelenin, Pavel V; Lyalka, Vladimir F; Hsu, Li-Ju; Orlovsky, Grigori N; Deliagina, Tatiana G

    2016-01-01

    Postural limb reflexes (PLRs) represent a substantial component of postural corrections. Spinalization results in loss of postural functions, including disappearance of PLRs. The aim of the present study was to characterize the effects of acute spinalization on two populations of spinal neurons (F and E) mediating PLRs, which we characterized previously. For this purpose, in decerebrate rabbits spinalized at T12, responses of interneurons from L5 to stimulation causing PLRs before spinalization, were recorded. The results were compared to control data obtained in our previous study. We found that spinalization affected the distribution of F- and E-neurons across the spinal grey matter, caused a significant decrease in their activity, as well as disturbances in processing of posture-related sensory inputs. A two-fold decrease in the proportion of F-neurons in the intermediate grey matter was observed. Location of populations of F- and E-neurons exhibiting significant decrease in their activity was determined. A dramatic decrease of the efficacy of sensory input from the ipsilateral limb to F-neurons, and from the contralateral limb to E-neurons was found. These changes in operation of postural networks underlie the loss of postural control after spinalization, and represent a starting point for the development of spasticity. PMID:27302149

  1. Direct and indirect regulation of spinal cord Ia afferent terminal formation by the γ-Protocadherins

    Directory of Open Access Journals (Sweden)

    Tuhina ePrasad

    2011-12-01

    Full Text Available The Pcdh-γ gene cluster encodes 22 protocadherin adhesion molecules that interact as homophilic multimers and critically regulate synaptogenesis and apoptosis of interneurons in the developing spinal cord. Unlike interneurons, the two primary components of the monosynaptic stretch reflex circuit, dorsal root ganglion sensory neurons and ventral motor neurons, do not undergo excessive apoptosis in Pcdh-γdel/del null mutants, which die shortly after birth. However, as we show here, mutants exhibit severely disorganized Ia proprioceptive afferent terminals in the ventral horn. In contrast to the fine net-like pattern observed in wild-type mice, central Ia terminals in Pcdh-γ mutants are expanded, clumped, and fill the space between individual motor neurons; quantitative analysis shows a ~2.5 fold increase in the area of terminals. Concomitant with this, there is a 70% loss of the collaterals that Ia afferents extend to ventral interneurons, many of which undergo apoptosis in the mutants. The Ia afferent phenotype is ameliorated, though not entirely rescued, when apoptosis is blocked in Pcdh-γ null mice by introduction of a Bax null allele. This indicates that loss of ventral interneurons, which act as intermediate Ia afferent targets, contributes to the disorganization of terminals on motor pools. Restricted mutation of the Pcdh-γ cluster using conditional mutants and multiple Cre transgenic lines (Wnt1-Cre for sensory neurons; Pax2-Cre for ventral interneurons; Hb9-Cre for motor neurons also revealed a direct requirement for the γ-Pcdhs in Ia neurons and ventral interneurons, but not in motor neurons themselves. Together, these genetic manipulations indicate that the γ-Pcdhs are required for the formation of the Ia afferent circuit in two ways: First, they control the survival of ventral interneurons that act as intermediate Ia targets; and second, they provide a homophilic molecular cue between Ia afferents and target ventral interneurons.

  2. Spinal anaesthesia for spinal surgery.

    Science.gov (United States)

    Jellish, W Scott; Shea, John F

    2003-09-01

    Spinal anaesthesia for spinal surgery is becoming increasingly more popular because this anaesthetic technique allows the patient to self-position and avoid neurological injury that may occur with prone positioning under general anaesthesia. Spinal anaesthesia reduces intraoperative surgical blood loss, improves perioperative haemodynamic stability and reduces pain in the immediate postoperative period. This leads to a reduced need for analgesics and a reduction in the incidence of nausea and vomiting in the postoperative setting. Spinal anaesthesia for lumbar spine surgery also decreases the incidence of lower extremity thrombo-embolic complications and does not increase the occurrence of problems with micturition. These benefits increase the patient's satisfaction, and they expedite discharge of the patient from the hospital. Combination anaesthetic techniques, using both subarachnoid and epidural dosing schemes, may be beneficial for improving postoperative pain control and add further to the benefit of spinal anaesthesia for lumbar spine surgical procedures. PMID:14529005

  3. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

    OpenAIRE

    Corleto, Jose A.; Mariana Bravo-Hernández; Kota Kamizato; Osamu Kakinohana; Camila Santucci; Navarro, Michael R.; Oleksandr Platoshyn; Dasa Cizkova; Nadezda Lukacova; Julian Taylor; Martin Marsala

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection mode...

  4. Spinal Column

    Science.gov (United States)

    ... curve of the neck is described as a lordosis or lordotic curve, and looks like a “C” ... like the cervical spine, creating a normal lumbar lordosis. The five lumbar vertebral bodies are the weight- ...

  5. 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.

  6. The interneuron energy hypothesis: Implications for brain disease.

    Science.gov (United States)

    Kann, Oliver

    2016-06-01

    Fast-spiking, inhibitory interneurons - prototype is the parvalbumin-positive (PV+) basket cell - generate action potentials at high frequency and synchronize the activity of numerous excitatory principal neurons, such as pyramidal cells, during fast network oscillations by rhythmic inhibition. For this purpose, fast-spiking, PV+ interneurons have unique electrophysiological characteristics regarding action potential kinetics and ion conductances, which are associated with high energy expenditure. This is reflected in the neural ultrastructure by enrichment with mitochondria and cytochrome c oxidase, indicating the dependence on oxidative phosphorylation for adenosine-5'-triphosphate (ATP) generation. The high energy expenditure is most likely required for membrane ion transport in dendrites and the extensive axon arbor as well as for presynaptic release of neurotransmitter, gamma-aminobutyric acid (GABA). Fast-spiking, PV+ interneurons are central for the emergence of gamma oscillations (30-100Hz) that provide a fundamental mechanism of complex information processing during sensory perception, motor behavior and memory formation in networks of the hippocampus and the neocortex. Conversely, shortage in glucose and oxygen supply (metabolic stress) and/or excessive formation of reactive oxygen and nitrogen species (oxidative stress) may render these interneurons to be a vulnerable target. Dysfunction in fast-spiking, PV+ interneurons might set a low threshold for impairment of fast network oscillations and thus higher brain functions. This pathophysiological mechanism might be highly relevant for cerebral aging as well as various acute and chronic brain diseases, such as stroke, vascular cognitive impairment, epilepsy, Alzheimer's disease and schizophrenia. PMID:26284893

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Psychological Issues After Spinal Cord Injury Psychological Health After Spinal Cord Injury Psychological Health After Spinal Cord Injury The Psychologist's Role After ...

  8. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Psychological Realities After Spinal Cord Injury Psychology of Spinal Cord Injury Rehabilitation Psychology of Spinal Cord Injury Rehabilitation How Psychologists Help ...

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Psychological Realities after Spinal Cord Injury Psychology of Spinal Cord Injury Rehabilitation Psychology of Spinal Cord Injury Rehabilitation How Psychologists Help ...

  10. Astrocytoma with involvement of medulla oblongata, spinal cord and spinal nerves in a raccoon (Procyon lotor)

    Science.gov (United States)

    Neoplasms affecting the central and peripheral nervous systems of wild animals are extremely rare. Described are clinical signs, pathologic and immunohistochemical findings in an adult female raccoon (Procyon lotor) with an astrocytoma which involved brainstem, cervical spinal cord and roots of the ...

  11. Myelopathy hand in cervical radiculopathy

    International Nuclear Information System (INIS)

    The so-called 'myelopathy hand', or characteristic finger paralysis, often recognized in cervical compression myelopathy, has been considered a unique manifestation of cervical myelopathy. We used our original grip and release test, a 15-second test in which finger motion is captured with a digital camera, to investigate whether cervical radiculopathy has the same characteristics as myelopathy hand. Thirty patients with pure radiculopathy, id est (i.e.), who had radiating arm pain and evidence of corresponding nerve root impingement on X-ray images or MRI scans, but did not have spinal cord compression, served as the subjects. In contrast to other radiculopathies, C7 radiculopathy was manifested by a significant reduction in the number of finger motion cycles on the affected side in comparison with the unaffected side, the same as in myelopathy hand. Uncoordinated finger motion was significantly more frequent on the affected side in C6 radiculopathy than on the unaffected side. These findings contradict the conventional notion that myelopathy hand is a unique manifestation of cervical myelopathy, but some radiculopathies manifested the same kinds of finger paralysis observed in myelopathy hand. (author)

  12. Comparison of Cervical Spine Anatomy in Calves, Pigs and Humans.

    Directory of Open Access Journals (Sweden)

    Sun-Ren Sheng

    Full Text Available Animals are commonly used to model the human spine for in vitro and in vivo experiments. Many studies have investigated similarities and differences between animals and humans in the lumbar and thoracic vertebrae. However, a quantitative anatomic comparison of calf, pig, and human cervical spines has not been reported.To compare fundamental structural similarities and differences in vertebral bodies from the cervical spines of commonly used experimental animal models and humans.Anatomical morphometric analysis was performed on cervical vertebra specimens harvested from humans and two common large animals (i.e., calves and pigs.Multiple morphometric parameters were directly measured from cervical spine specimens of twelve pigs, twelve calves and twelve human adult cadavers. The following anatomical parameters were measured: vertebral body width (VBW, vertebral body depth (VBD, vertebral body height (VBH, spinal canal width (SCW, spinal canal depth (SCD, pedicle width (PW, pedicle depth (PD, pedicle inclination (PI, dens width (DW, dens depth (DD, total vertebral width (TVW, and total vertebral depth (TVD.The atlantoaxial (C1-2 joint in pigs is similar to that in humans and could serve as a human substitute. The pig cervical spine is highly similar to the human cervical spine, except for two large transverse processes in the anterior regions ofC4-C6. The width and depth of the calf odontoid process were larger than those in humans. VBW and VBD of calf cervical vertebrae were larger than those in humans, but the spinal canal was smaller. Calf C7 was relatively similar to human C7, thus, it may be a good substitute.Pig cervical vertebrae were more suitable human substitutions than calf cervical vertebrae, especially with respect to C1, C2, and C7. The biomechanical properties of nerve vascular anatomy and various segment functions in pig and calf cervical vertebrae must be considered when selecting an animal model for research on the spine.

  13. 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.

  14. Only fixation for cervical spondylosis: Report of early results with a preliminary experience with 6 cases

    OpenAIRE

    Atul Goel

    2013-01-01

    Aim: The author reports early post-operative outcome and preliminary experience with an alternative form of treatment of cervical degenerative or spondylotic disease leading to spinal canal stenosis that involves fixation-arthrodesis of the affected spinal segment using one or two (double insurance) transarticular screws for each joint. Materials and Methods: During the period of months from March 2013 to July 2013, six patients having cervical spondylotic cord compression were treated with t...

  15. Cervical Disc Herniation as a Cause of Brown-Séquard Syndrome

    OpenAIRE

    Choi, Kyeong Bo; Lee, Choon Dae; Chung, Dai-Jin; Lee, Sang-Ho

    2009-01-01

    The possible causes of Brown-Séquard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and senso...

  16. Multi-dimensional classification of GABAergic interneurons with Bayesian network-modeled label uncertainty

    OpenAIRE

    Mihaljević, Bojan; Bielza, Concha; Benavides-Piccione, Ruth; DeFelipe, Javier; Larrañaga, Pedro

    2014-01-01

    Abstract Interneuron classification is an important and long-debated topic in neuroscience. A recent study provided a data set of digitally reconstructed interneurons classified by 42 leading neuroscientists according to a pragmatic classification scheme composed of five categorical variables, namely, of the interneuron type and four features of axonal morphology. From this data set we now learned a model which can classify interneurons, on the basis of their axonal morphometric parameter...

  17. Multi-dimensional classification of GABAergic interneurons with Bayesian network-modeled label uncertainty

    OpenAIRE

    Bojan eMihaljević; Concha eBielza; Ruth eBenavides-Piccione; Javier eDeFelipe; Pedro eLarrañaga

    2014-01-01

    Interneuron classification is an important and long-debated topic in neuroscience. A recent study provided a data set of digitally reconstructed interneurons classified by 42 leading neurocientists according to a pragmatic classification scheme composed of five categorical variables, namely, of the interneuron type and four features of axonal morphology. From this data set we now learned a model which can classify interneurons, on the basis of their axonal morphometric parameters, into these ...

  18. Spinal fusion

    Science.gov (United States)

    ... the wound or vertebral bones Damage to a spinal nerve, causing weakness, pain, loss of sensation, problems with your bowels or bladder The vertebrae above and below the fusion are more likely to wear away, leading to more problems later

  19. Spinal stenosis

    Science.gov (United States)

    ... make some changes in their activities or work. Spine surgery will often partly or fully relieve symptoms in ... disease of the bone Spinal fusion Patient Instructions Spine surgery - discharge Update Date 7/13/2015 Updated by: ...

  20. 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

  1. Pyramidal Cell-Interneuron Interactions Underlie Hippocampal Ripple Oscillations

    Science.gov (United States)

    Stark, Eran; Roux, Lisa; Eichler, Ronny; Senzai, Yuta; Royer, Sebastien; Buzsáki, György

    2015-01-01

    SUMMARY High-frequency ripple oscillations, observed most prominently in the hippocampal CA1 pyramidal layer, are associated with memory consolidation. The cellular and network mechanisms underlying the generation, frequency control, and spatial coherence of the rhythm are poorly understood. Using multisite optogenetic manipulations in freely behaving rodents, we found that depolarization of a small group of nearby pyramidal cells was sufficient to induce high-frequency oscillations, whereas closed-loop silencing of pyramidal cells or activation of parvalbumin-(PV) or somatostatin-immunoreactive interneurons aborted spontaneously occurring ripples. Focal pharmacological blockade of GABAA receptors abolished ripples. Localized PV inter-neuron activation paced ensemble spiking, and simultaneous induction of high-frequency oscillations at multiple locations resulted in a temporally coherent pattern mediated by phase-locked inter-neuron spiking. These results constrain competing models of ripple generation and indicate that temporally precise local interactions between excitatory and inhibitory neurons support ripple generation in the intact hippocampus. PMID:25033186

  2. Glycine Receptor α2 Subunit Activation Promotes Cortical Interneuron Migration

    Directory of Open Access Journals (Sweden)

    Ariel Avila

    2013-08-01

    Full Text Available Glycine receptors (GlyRs are detected in the developing CNS before synaptogenesis, but their function remains elusive. This study demonstrates that functional GlyRs are expressed by embryonic cortical interneurons in vivo. Furthermore, genetic disruption of these receptors leads to interneuron migration defects. We discovered that extrasynaptic activation of GlyRs containing the α2 subunit in cortical interneurons by endogenous glycine activates voltage-gated calcium channels and promotes calcium influx, which further modulates actomyosin contractility to fine-tune nuclear translocation during migration. Taken together, our data highlight the molecular events triggered by GlyR α2 activation that control cortical tangential migration during embryogenesis.

  3. Wnt5a controls neurite development in olfactory bulb interneurons

    Directory of Open Access Journals (Sweden)

    Youngshik Choe

    2011-06-01

    Full Text Available Neurons born in the postnatal SVZ (subventricular zone must migrate a great distance before becoming mature interneurons of the OB (olfactory bulb. During migration immature OB neurons maintain an immature morphology until they reach their destination. While the morphological development of these cells must be tightly regulated, the cellular pathways responsible are still largely unknown. Our results show that the non-canonical Wnt pathway induced by Wnt5a is important for the morphological development of OB interneurons both in vitro and in vivo. Additionally, we demonstrate that non-canonical Wnt signalling works in opposition to canonical Wnt signalling in neural precursors from the SVZ in vitro. This represents a novel role for Wnt5a in the development of OB interneurons and suggests that canonical and non-canonical Wnt pathways dynamically oppose each other in the regulation of dendrite maturation.

  4. GABAergic Interneurons in the Neocortex: From Cellular Properties to Circuits.

    Science.gov (United States)

    Tremblay, Robin; Lee, Soohyun; Rudy, Bernardo

    2016-07-20

    Cortical networks are composed of glutamatergic excitatory projection neurons and local GABAergic inhibitory interneurons that gate signal flow and sculpt network dynamics. Although they represent a minority of the total neocortical neuronal population, GABAergic interneurons are highly heterogeneous, forming functional classes based on their morphological, electrophysiological, and molecular features, as well as connectivity and in vivo patterns of activity. Here we review our current understanding of neocortical interneuron diversity and the properties that distinguish cell types. We then discuss how the involvement of multiple cell types, each with a specific set of cellular properties, plays a crucial role in diversifying and increasing the computational power of a relatively small number of simple circuit motifs forming cortical networks. We illustrate how recent advances in the field have shed light onto the mechanisms by which GABAergic inhibition contributes to network operations. PMID:27477017

  5. AN AMAZINGCASE REPORT OF CERVICAL SHWANNOMA

    Directory of Open Access Journals (Sweden)

    Ruqia Asna

    2014-05-01

    Full Text Available This is a case report of a patient with history of vague chest pain and facial numbness. When the patient was subjected for evaluation he was found to have cervical Schwannoma. He was operated and was successfully treated. Schwannomas are extramedullary-intradural tumors composed of Schwann cells, which can arise from spinal nerves at any level (cervical, thoracic, lumbar, or cauda equina and most often arise from a posterior (sensory nerve root. The most common initial symptom therefore is pain in a radicular distribution. Early detection and surgery gives excellent results in such cases.

  6. Cervical spine injuries in rugby players.

    Science.gov (United States)

    Sovio, O M; Van Peteghem, P K; Schweigel, J F

    1984-03-15

    Nine patients with serious cervical spine injuries that occurred while they were playing rugby were seen in a British Columbia acute spinal cord injury unit during the period 1975-82. All the injuries had occurred during the "scrum" or the "tackle". Two of the patients were rendered permanently quadriplegic, and one patient died. There is a need for a central registry that would record all cervical spine injuries in rugby players as well as for changes in the rules of the game. PMID:6697282

  7. Spinal cysticercosis

    International Nuclear Information System (INIS)

    Spinal cysticercosis is an extremely uncommon condition. We have examined four patients with complaints that resembled nervous root compression by disk herniation. Myelography was shown to be an efficient method to evaluate spinal involvement, that was characterized by findings of multiple filling defect images (cysts) plus signs of adhesive arachnoiditis. One cyst was found to be mobile. Because of the recent development of medical treatment, a quick and precise diagnosis is of high importance to determine the prognosis of this condition. (author)

  8. Spinal vascular malformations; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  9. Local connections of layer 5 GABAergic interneurons to corticospinal neurons

    Directory of Open Access Journals (Sweden)

    Yasuyo H Tanaka

    2011-09-01

    Full Text Available In the local circuit of the cerebral cortex, GABAergic inhibitory interneurons are considered to work in collaboration with excitatory neurons. Although many interneuron subgroups have been described in the cortex, local inhibitory connections of each interneuron subgroup are only partially understood with respect to the functional neuron groups that receive these inhibitory connections. In the present study, we morphologically examined local inhibitory inputs to corticospinal neurons (CSNs in motor areas using transgenic rats in which GABAergic neurons expressed fluorescent protein Venus. By analysis of biocytin-filled axons obtained with whole-cell recording/staining in cortical slices, we classified fast-spiking (FS neurons in layer (L 5 into two types, FS1 and FS2, by their high and low densities of axonal arborization, respectively. We then investigated the connections of FS1, FS2, somatostatin-immunopositive (SOM and other (non-FS/non-SOM interneurons to CSNs that were retrogradely labeled in a Golgi-like manner in motor areas. When close appositions between the axon boutons of the intracellularly labeled interneurons and the somata/dendrites of the retrogradely labeled CSNs were examined electron-microscopically, 74% of these appositions made symmetric synaptic contacts. The axon boutons of single FS1 neurons were 2–4-fold more frequent in appositions to the somata/dendrites of CSNs than those of FS2, SOM and non-FS/non-SOM neurons. Axosomatic appositions were most frequently formed with axon boutons of FS1 and FS2 neurons (approximately 30% and least frequently formed with those of SOM neurons (7%. In contrast, SOM neurons most extensively sent axon boutons to the apical dendrites of CSNs. These results might suggest that motor outputs are controlled differentially by the subgroups of L5 GABAergic interneurons in cortical motor areas. 

  10. Cervical disc herniation manifesting as a Brown-Sequard syndrome

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2012-01-01

    Full Text Available Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained.

  11. Cervical facet joint kinematics during bilateral facet dislocation

    OpenAIRE

    Panjabi, Manohar M.; Simpson, Andrew K.; Ivancic, Paul C.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet s...

  12. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Substance Abuse and Spinal Cord Injury How Family Life Changes After Spinal Cord Injury How Family Life Changes After Spinal Cord Injury Empowering the Patient After Spinal ...

  13. Intradural tumor and concomitant disc herniation of cervical spine

    Directory of Open Access Journals (Sweden)

    Mihir R Bapat

    2011-01-01

    Full Text Available We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.

  14. 术中椎间盘造影辅助确定无骨折脱位型颈脊髓损伤的责任节段%Intraoperative discography for determining responsible segments in cervical spinal cord injury without fracture and dislocation

    Institute of Scientific and Technical Information of China (English)

    张继东; 夏群; 吉宁; 刘艳成; 宁尚龙

    2013-01-01

    identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53%,68% and 76% respectively.Mean operation

  15. Methods for evaluating cervical range of motion in trauma settings

    OpenAIRE

    Voss Sarah; Page Michael; Benger Jonathan

    2012-01-01

    Abstract Immobilisation of the cervical spine is a common procedure following traumatic injury. This is often precautionary as the actual incidence of spinal injury is low. Nonetheless, stabilisation of the head and neck is an important part of pre-hospital care due to the catastrophic damage that may follow if further unrestricted movement occurs in the presence of an unstable spinal injury. Currently available collars are limited by the potential for inadequate immobilisation and complicati...

  16. Modified steel basket technique for the treatment of equine cervical vertebral stenotic myelopathy - a case report

    OpenAIRE

    Frederico Fernandes Araújo; Monalisa Lukascek Castro; Luciane Laskoski; Mariana Pavelski; Ivan Deconto; Peterson Triches Dornbusch

    2015-01-01

    Cervical vertebral stenotic myelopathy (CVSM), also known as cervical ataxia or wobbler syndrome, is caused by the narrowing of the medullary canal due to a malformation of the cervical vertebrae, resulting in compression of the spinal cord and neurological alterations such as ataxia, hypermetria, weakness, and abnormal stance. The treatment options can be conservative or surgical, with varied effectiveness. The most appropriate surgical technique in the majority of cases is arthrodesis, prov...

  17. Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

    OpenAIRE

    Friedman Jonathan A; Briner Rudy P; Liu Jeffrey T

    2009-01-01

    Abstract Background Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P). Methods All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF) were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structur...

  18. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    OpenAIRE

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

  19. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... Treatment Cervical Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Screening (PDQ®)–Patient Version What is screening? Screening ... These are called diagnostic tests . General Information About Cervical Cancer Key Points Cervical cancer is a disease in ...

  20. Computed tomography of a post traumatic spinal arachnoid cyst

    International Nuclear Information System (INIS)

    We decribe the CT findings of a cervical arachnoid cyst with haemorrhagic contents, that was diagnosed after trauma and which clinically presented itself as a high spinal cord compression syndrome. In our case, the diagnosis was only possible by means of CT-myelography, which displayed a haemorrhagic closed pouch in the cervical subarachnoid space, thus changing our initial neuroradiological suggestion of epidural haematoma, made because of its location and shape. (orig.)

  1. Computed tomography of a post traumatic spinal arachnoid cyst

    Energy Technology Data Exchange (ETDEWEB)

    Teruel Agustin, J.J.; Gomez Martinench, E.; Castanyer Corretger, F.; Cando Salcines, L.; Davalos Errando, A.

    1989-09-01

    We decribe the CT findings of a cervical arachnoid cyst with haemorrhagic contents, that was diagnosed after trauma and which clinically presented itself as a high spinal cord compression syndrome. In our case, the diagnosis was only possible by means of CT-myelography, which displayed a haemorrhagic closed pouch in the cervical subarachnoid space, thus changing our initial neuroradiological suggestion of epidural haematoma, made because of its location and shape. (orig.).

  2. Cervical spine CT scan

    Science.gov (United States)

    ... cervical spine; Computed tomography scan of cervical spine; CT scan of cervical spine; Neck CT scan ... Risks of CT scans include: Being exposed to radiation Allergic reaction to contrast dye CT scans expose you to more radiation than ...

  3. Spinal trauma. An imaging approach

    International Nuclear Information System (INIS)

    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.)

  4. Chronic spinal cord injury treated with transplanted autologous bone marrow-derived mesenchymal stem cells tracked by magnetic resonance imaging: a case report

    OpenAIRE

    Chotivichit, Areesak; Ruangchainikom, Monchai; Chiewvit, Pipat; Wongkajornsilp, Adisak; Sujirattanawimol, Kittipong

    2015-01-01

    Introduction Intrathecal transplantation is a minimally invasive method for the delivery of stem cells, however, whether the cells migrate from the lumbar to the injured cervical spinal cord has not been proved in humans. We describe an attempt to track bone marrow-derived mesenchymal stem cells in a patient with a chronic cervical spinal cord injury. Case presentation A 33-year-old Thai man who sustained an incomplete spinal cord injury from the atlanto-axial subluxation was enrolled into a ...

  5. 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.

  6. Classification of acute subaxial cervical spine injury

    OpenAIRE

    2012-01-01

    Abstract Study Design Literature review Objective The aim of this thesis is to compare the main classification systems available for classifying acute subaxial cervical spinal injury and compare their relative strengths and weaknesses, especially in their ability to guide treatment and predict prognosis. Methods A PICO question was formulated and used to select search terms. The search terms were used to search the online database Pubmed/Medline for English language revi...

  7. Laminoplasty for Cervical Myelopathy

    OpenAIRE

    Ito, Manabu; Nagahama, Ken

    2012-01-01

    This article reviews cervical laminoplasty. The origin of cervical laminoplasty dates back to cervical laminectomy performed in Japan ~50 years ago. To overcome poor surgical outcomes of cervical laminectomy, many Japanese orthopedic spine surgeons devoted their lives to developing better posterior decompression procedures for the cervical spine. Thanks to the development of a high-speed surgical burr, posterior decompression procedures for the cervical spine showed vast improvement from the ...

  8. 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.

  9. Prdm12 specifies V1 interneurons through cross-repressive interactions with Dbx1 and Nkx6 genes in Xenopus.

    Science.gov (United States)

    Thélie, Aurore; Desiderio, Simon; Hanotel, Julie; Quigley, Ian; Van Driessche, Benoit; Rodari, Anthony; Borromeo, Mark D; Kricha, Sadia; Lahaye, François; Croce, Jenifer; Cerda-Moya, Gustavo; Ordoño Fernandez, Jesús; Bolle, Barbara; Lewis, Katharine E; Sander, Maike; Pierani, Alessandra; Schubert, Michael; Johnson, Jane E; Kintner, Christopher R; Pieler, Tomas; Van Lint, Carine; Henningfeld, Kristine A; Bellefroid, Eric J; Van Campenhout, Claude

    2015-10-01

    V1 interneurons are inhibitory neurons that play an essential role in vertebrate locomotion. The molecular mechanisms underlying their genesis remain, however, largely undefined. Here, we show that the transcription factor Prdm12 is selectively expressed in p1 progenitors of the hindbrain and spinal cord in the frog embryo, and that a similar restricted expression profile is observed in the nerve cord of other vertebrates as well as of the cephalochordate amphioxus. Using frog, chick and mice, we analyzed the regulation of Prdm12 and found that its expression in the caudal neural tube is dependent on retinoic acid and Pax6, and that it is restricted to p1 progenitors, due to the repressive action of Dbx1 and Nkx6-1/2 expressed in the adjacent p0 and p2 domains. Functional studies in the frog, including genome-wide identification of its targets by RNA-seq and ChIP-Seq, reveal that vertebrate Prdm12 proteins act as a general determinant of V1 cell fate, at least in part, by directly repressing Dbx1 and Nkx6 genes. This probably occurs by recruiting the methyltransferase G9a, an activity that is not displayed by the amphioxus Prdm12 protein. Together, these findings indicate that Prdm12 promotes V1 interneurons through cross-repressive interactions with Dbx1 and Nkx6 genes, and suggest that this function might have only been acquired after the split of the vertebrate and cephalochordate lineages. PMID:26443638

  10. Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

    Directory of Open Access Journals (Sweden)

    Lance K. Mitsunaga

    2012-01-01

    Full Text Available Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation and to preserve postoperative cervical stability and alignment. With the right surgical indications, reliable results can be expected with laminoplasty in treating patients with multilevel cervical myelopathy.

  11. Postoperative cine-MRI for patients with cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Honjo, Yasuomi [Okayama Univ. (Japan). School of Medicine

    1995-07-01

    The usefulness of cine-MRI using motion pictures was studied on 75 patients with postoperative cervical myelopathy, and morphology of cervical spine and cervical cord, postoperative MRI, and postoperative outcome were investigated. T1-weighted images by SE method and T2-weighted images by gradient field echo were obtained. Cine-MR images were classified into 5 according to the site of cerebrospinal fluid flow void and its degree (anterior type, 21; anteroposterior type, 30; posterior type, 7; incomplete block type, 15; complete block type, 2), and relationship between clinical features were studied. This method enabled dynamic noninvasive evaluation of spinal cord compression by cerebrospinal fluid flow. (S.Y.).

  12. Relationships between radiography of cervical vertebrae and histopathology of the cervical cord in wobbling 19 foals

    International Nuclear Information System (INIS)

    Nineteen wobbling foals (17 males and 2 females) showing lameness of hindlimbs at 6 to 21 months of age were investigated radiographically and histopathologically. Minimum sagittal diameter (MSD), minimum flexion diameter (MFD) and minimum dural sagittal diameter (MDD) were measured on plain radiograms or myelograms taken at neutral and flexed positions as indicators of narrowed vertebral canal. After necropsy, the cervical spines and the spinal cord were examined macroscopically and respectively the relationships between radiographic findings and the corresponding morphological lesions were evaluated. Radiographically, lower values than each minimum reference limits were recorded in 14 foals in MSD, 5 foals in MFD and 6 foals in MDD, respectively. According to the histopathologic examination, the disappearance of axons and myelin sheaths, vacuolated spongy degeneration and appearance of macrophages were recognized symmetrically in the white matter of the cervical cord. These lesions were centrally located at the spinal cord radiographically demonstrated as compressed sites in 12 out of 17 foals examined. Macroscopically, asymmetrical overgrowth of one side of the process, encroachment of articular processes into the intervertebral foramina and proliferation of bone around articular facets were observed in the articular processes of bone specimens in the caudal neck of 6 foals. In conclusion, the equine incoordination might mainly be caused by the cervical stenotic myelopathy resulting from cervical vertebral malformation, and therefore the cervical vertebral radiography, especiallymyelography, is quite very important and effective for the diagnosis of wobbling foals

  13. Cervical Spine Stenosis Measures in Normal Subjects.

    Science.gov (United States)

    Tierney, Ryan T; Maldjian, Catherine; Mattacola, Carl G; Straub, Stephen J; Sitler, Michael R

    2002-06-01

    OBJECTIVE: To compare 2 methods of determining cervical spinal stenosis (Torg ratio, space available for the cord [SAC]); determine which of the components of the Torg ratio and the SAC account for more of the variability in the measures; and present standardized SAC values for normal subjects using magnetic resonance imaging (MRI). DESIGN AND SETTING: The research design consisted of a posttest-only, comparison-group design. The independent variable was method of measurement (Torg ratio and SAC). The dependent variables were Torg ratio and SAC scores. SUBJECTS: Fourteen men (age = 24.4 +/- 2.5 years, height = 181.0 +/- 5.8 cm, weight = 90 +/- 13.5 kg) participated in this study. The C3 to C7 vertebrae were examined in each subject (n = 70). MEASUREMENTS: The Torg ratio was determined by dividing the sagittal spinal-canal diameter by the corresponding sagittal vertebral-body diameter. The SAC was determined by subtracting the sagittal spinal-cord diameter from the corresponding sagittal spinal-canal diameter. The Torg ratio and SAC were measured in millimeters. RESULTS: The SAC ranged from 2.5 to 10.4 mm and was greatest at C7 in 71% (10 of 14) of the subjects. The SAC was least at C3 or C5 in 71% (10 of 14) of the subjects. A Pearson product moment correlation revealed a significant relationship between the Torg ratio and SAC (r =.53, P SAC than the spinal cord (r (2) =.23). CONCLUSIONS: The SAC measure relies more on the spinal canal compared with the Torg ratio and, therefore, may be a more effective indicator of spinal stenosis. This is relevant clinically because neurologic injury related to stenosis is a function of the spinal canal and the spinal cord (not the vertebral body). Further research must be done, however, to validate the SAC measure. PMID:12937434

  14. Spinal neurons bursting in phase with fictive scratching are not related to spontaneous cord dorsum potentials.

    Science.gov (United States)

    Cuellar, C A; Trejo, A; Linares, P; Delgado-Lezama, R; Jiménez-Estrada, I; Abyazova, L M; Baltina, T V; Manjarrez, E

    2014-04-25

    Spontaneous cord dorsum potentials (spontaneous CDPs) are produced by the activation of dorsal horn neurons distributed along the L4 to S1 spinal cord segments, in Rexed's laminae III-VI, in the same region in which there are interneurons rhythmically bursting during fictive scratching in cats. An interesting observation is that spontaneous CDPs are not rhythmically superimposed on the sinusoidal CDPs generated during fictive scratching episodes, thus suggesting that the interneurons producing both types of CDPs belong to different spinal circuits. In order to provide experimental data to support this hypothesis, we recorded unitary activity of neurons in the L6 spinal cord segment. We found that the neurons firing rhythmically during the sinusoidal CDPs associated with the extensor, flexor or intermediate phases of scratching were not synchronized with the spontaneous CDPs. Moreover, we found that the neurons firing during the spontaneous CDPs were not synchronized with the sinusoidal CDPs. These results suggest that the neurons involved in the occurrence of spontaneous CDPs are not part of the spinal cord central pattern generators (CPGs). This study will be relevant for understanding the relationships between the spinal cord neuronal populations firing spontaneously and the CPGs, in the intact and injured spinal cord. PMID:24530658

  15. Cervical Meningomyelitis After Lumbar Epidural Steroid Injection.

    Science.gov (United States)

    Lee, Yujin; Kim, Joon-Sung; Kim, Ji Yeon

    2015-06-01

    Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement. PMID:26161360

  16. 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.).

  17. Magnetic resonance imaging of spinal cord injury in chronic stage

    International Nuclear Information System (INIS)

    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.)

  18. Pre- and post-alpha motoneuronal control of the soleus H-reflex during sinusoidal hip movements in human spinal cord injury

    OpenAIRE

    Knikou, Maria; Chaudhuri, Debjani; Kay, Elizabeth; Schmit, Brian D.

    2006-01-01

    The aim of this study was to establish the contribution of hip-mediated sensory feedback to spinal interneuronal circuits during dynamic conditions in people with incomplete spinal cord injury (SCI). Specifically, we investigated the effects of synergistic and antagonistic group I afferents on the soleus H-reflex during imposed sinusoidal hip movements. The soleus H-reflex was conditioned by stimulating the common peroneal nerve (CPN) at short (2, 3, and 4 ms) and long (80, 100, and 120 ms) c...

  19. The majority of dorsal spinal cord gastrin releasing peptide is synthesized locally whereas neuromedin B is highly expressed in pain- and itch-sensing somatosensory neurons

    OpenAIRE

    Fleming, Michael S; Ramos, Daniel; Han, Seung Baek; Zhao, JianYuan; Son, Young-Jin; Luo, Wenqin

    2012-01-01

    Background Itch is one of the major somatosensory modalities. Some recent findings have proposed that gastrin releasing peptide (Grp) is expressed in a subset of dorsal root ganglion (DRG) neurons and functions as a selective neurotransmitter for transferring itch information to spinal cord interneurons. However, expression data from public databases and earlier literatures indicate that Grp mRNA is only detected in dorsal spinal cord (dSC) whereas its family member neuromedin B (Nmb) is high...

  20. The majority of dorsal spinal cord gastrin releasing peptide is synthesized locally whereas neuromedin B is highly expressed in pain- and itch-sensing somatosensory neurons

    OpenAIRE

    Fleming Michael S; Ramos Daniel; Han Seung; Zhao Jianyuan; Son Young-Jin; Luo Wenqin

    2012-01-01

    Abstract Background Itch is one of the major somatosensory modalities. Some recent findings have proposed that gastrin releasing peptide (Grp) is expressed in a subset of dorsal root ganglion (DRG) neurons and functions as a selective neurotransmitter for transferring itch information to spinal cord interneurons. However, expression data from public databases and earlier literatures indicate that Grp mRNA is only detected in dorsal spinal cord (dSC) whereas its family member neuromedin B (Nmb...

  1. 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.

  2. Common surgical complications in degenerative spinal surgery

    OpenAIRE

    Papadakis, Michael; Aggeliki, Lianou; Papadopoulos, Elias C.; Girardi, Federico P.

    2013-01-01

    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 sur...

  3. Spinal injuries in sports in the UK.

    OpenAIRE

    Silver, J R

    1993-01-01

    An analysis was made of 150 rugby, trampolining, gymnastics and horse-riding injuries between 1952 and 1985, resulting in severe spinal injury. The individual analyses of the separate sports had been published previously. There are common factors to all these sports. Of those injured 121 had cervical injuries often as a result of participation in sport by young impetuous people, and causes included: inadequate supervision; motivation to attempt tasks beyond their abilities; a mismatch between...

  4. Feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction%低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性

    Institute of Scientific and Technical Information of China (English)

    刘明明; 程建; 华臻

    2015-01-01

    Objective:To explore the feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction.Methods:20 patients with spine and spinal cord trauma in cervicothoracic junction were selected.All patients were treated with low anterior cervical approach decompression and bone graft fusion for internal fixation.We discussed the efficacy and postoperative recovery of the patients. Results:All patients recovered well,and there was no case with loosening of the screws,loss of the titanium plate,the fracture of the titanium plate and other circumstances.Only 1 case with the position of titanium mesh not well fixed when detected by X tablets after operation.It has been adjusted after six months of surgery,after 1 year of operation,it recovered well,no titanium mesh moved. Conclusion:Patients with spine and spinal cord trauma in cervicothoracic junction with low anterior cervical approach decompression and bone graft fusion and internal fixation for the treatment can effectively promote the patients with cervicothoracic spine sequence returned to normal,and improve the patients' postoperative recovery.%目的:探讨低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性。方法:收治颈胸段脊柱脊髓损伤患者20例,实施低位颈前入路减压植骨融合内固定治疗,对术后疗效及恢复情况进行探讨。结果:所有患者恢复良好,无一例患者出现螺钉松动、脱落、钛板断裂等情况,只有1例在术后经过X片检测后发现其钛网位置固定不佳,术后0.5年对其进行了调整,术后1年检测见其恢复良好,没有出现钛网移动情况。结论:颈胸段脊柱脊髓损伤患者采用低位颈前入路减压植骨融合内固定治疗,可以有效促进患者颈胸段脊柱序列恢复正常,改善患者的术后恢复情况。

  5. [Spinal and spinal cord injuries. Therapeutic approach in Gabon].

    Science.gov (United States)

    Loembe, P M; Bouger, D; Dukuly, L; Ndong-Launay, M

    1991-01-01

    The authors present their experience with 81 cases (66.4%) of acute cervical spine injuries (C.S.I.) and 41 cases (33.6%) of acute thoracolumbar spine injuries (T.L.S.I.) treated by a multidisciplinary approach, at Jeanne Ebori Hospital (Libreville, Gabon) between the years 1981 and 1987. Traffic accidents were the leading cause of injury. The largest group consisted of patients in their third decade. The anatomic localizations were: upper cervical spine: 22 cases (27%); lower cervical spine: 56 (69%); upper thoracic spine: 11 (26.8%); lower thoracic spine or thoracolumbar area: 19 (46.3%); lumbar spine: 7 (17%). There were osteoligamental lesions in 3 cases (3.7%) of C.S.I. and 4 (9.7%) of T.L.S.I. Clinically, 44 patients (54.3%) with C.S.I. and 37 (90.2%) with T.L.S.I. had neurological deficits. Surgical indications depended upon the osseous as well as neurologic lesions. There were five important steps in the treatment of spinal injuries associated with neurological deficit: (1) immobilization, (2) medical stabilization, (3) spinal alignment (skeletal traction), (4) operative decompression if there was proven cord compression, and (5) spinal stabilization. Twenty patients (24.6%) with cervical injuries were treated conservatively (traction, collar, kinesitherapy); 53 (65.4%) underwent a surgical intervention (anterior approach - 21, posterior fusion - 30, combined approach - 2); and in 8 patients (9.8%) refraining from surgery seemed the best alternative. After lengthy multidisciplinary discussion, the authors elected not to operate on tetraplegic patients with respiratory problems that necessitated assisted ventilation, because of its fatal outcome. Of injuries to the thoracolumbar spine, 13 (31.7%) were treated conservatively (bedrest, orthopedic treatment). Twenty-eight patients (68.2%) with unstable thoracic and lumbar fractures associated with neurologic deficit required acute surgical intervention (stabilization with or without decompression of the neural

  6. Effect of Spinal Cord Compression on Local Vascular Blood Flow and Perfusion Capacity

    OpenAIRE

    Mohammed Alshareef; Vibhor Krishna; Jahid Ferdous; Ahmed Alshareef; Mark Kindy; Kolachalama, Vijaya B.; Tarek Shazly

    2014-01-01

    Spinal cord injury (SCI) can induce prolonged spinal cord compression that may result in a reduction of local tissue perfusion, progressive ischemia, and potentially irreversible tissue necrosis. Due to the combination of risk factors and the varied presentation of symptoms, the appropriate method and time course for clinical intervention following SCI are not always evident. In this study, a three-dimensional finite element fluid-structure interaction model of the cervical spinal cord was de...

  7. 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.

  8. Spinal Cord Injury 101

    Medline Plus

    Full Text Available Experts \\ Spinal Cord Injury 101 Topics Adult Injuries Spinal Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation ... in countries outside the US ? A spinal cord injury affects the entire family FacingDisability is designed to ...

  9. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury How does the spinal cord work? What is a spinal cord injury? Why is the level of a spinal cord ... stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell ...

  10. Chx10 Consolidates V2a Interneuron Identity through Two Distinct Gene Repression Modes.

    Science.gov (United States)

    Clovis, Yoanne M; Seo, So Yeon; Kwon, Ji-Sun; Rhee, Jennifer C; Yeo, Sujeong; Lee, Jae W; Lee, Seunghee; Lee, Soo-Kyung

    2016-08-01

    During development, two cell types born from closely related progenitor pools often express identical transcriptional regulators despite their completely distinct characteristics. This phenomenon implies the need for a mechanism that operates to segregate the identities of the two cell types throughout differentiation after initial fate commitment. To understand this mechanism, we investigated the fate specification of spinal V2a interneurons, which share important developmental genes with motor neurons (MNs). We demonstrate that the paired homeodomain factor Chx10 functions as a critical determinant for V2a fate and is required to consolidate V2a identity in postmitotic neurons. Chx10 actively promotes V2a fate, downstream of the LIM-homeodomain factor Lhx3, while concomitantly suppressing the MN developmental program by preventing the MN-specific transcription complex from binding and activating MN genes. This dual activity enables Chx10 to effectively separate the V2a and MN pathways. Our study uncovers a widely applicable gene regulatory principle for segregating related cell fates. PMID:27477290

  11. Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia

    OpenAIRE

    Yang, Hai-song; Chen, De-yu; Lu, Xu-hua; Yang, Li–li; Yan, Wang-Jun; Yuan, Wen; Chen, Yu

    2009-01-01

    Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a retrospective study on 142 patients with radiologically proven OPLL who had received surgery between January 2004 and Janua...

  12. Investigation with 18FDG and high resolution PET for cervical compressive myelopathy

    International Nuclear Information System (INIS)

    In the case of cervical spine myelopathy, alteration of glucose metabolism rate, image findings and clinical manifestation were compared with those of healthy volunteer by high resolution 18FDG-PET. Authors investigated in 21 healthy volunteers, and 22 patients with cervical spine myelopathy. Patients had cervical spondylosis myelopathy (12 cases), cervical spine herniated disk (8 cases), posterior longitudinal ligament osteosis (2 cases). MRI image was observed after and before surgery, medulla spinalis configuration and brightness alteration after decomposition were checked. Standardized uptake value (SUV) of glucose by cervical spinal cord in radiculopathy group (n=4) was similar to that in normal group but that in myelopathy group (n=14) was decreased significantly (p18FDG represents degree of a critical condition of cervical myelopathy, and consequence assessment of cervical myelopathy is possible by SUV. (K.H.)

  13. Perturbed cholesterol homeostasis in aging spinal cord.

    Science.gov (United States)

    Parkinson, Gemma M; Dayas, Christopher V; Smith, Doug W

    2016-09-01

    The spinal cord is vital for the processing of sensorimotor information and for its propagation to and from both the brain and the periphery. Spinal cord function is affected by aging, however, the mechanisms involved are not well-understood. To characterize molecular mechanisms of spinal cord aging, microarray analyses of gene expression were performed on cervical spinal cords of aging rats. Of the metabolic and signaling pathways affected, cholesterol-associated pathways were the most comprehensively altered, including significant downregulation of cholesterol synthesis-related genes and upregulation of cholesterol transport and metabolism genes. Paradoxically, a significant increase in total cholesterol content was observed-likely associated with cholesterol ester accumulation. To investigate potential mechanisms for the perturbed cholesterol homeostasis, we quantified the expression of myelin and neuroinflammation-associated genes and proteins. Although there was minimal change in myelin-related expression, there was an increase in phagocytic microglial and astrogliosis markers, particularly in the white matter. Together, these results suggest that perturbed cholesterol homeostasis, possibly as a result of increased inflammatory activation in spinal cord white matter, may contribute to impaired spinal cord function with aging. PMID:27459933

  14. Roentgenosemiotics of GI tract functional obstruction determined by birth injuries of the spinal column and spinal cord in children

    International Nuclear Information System (INIS)

    Experiments on animals and the results of combined clinico-roentgenological investigation of 150 children with birth injuries of the spinal column and cord and 40 children with invagination and consequences of the cervical spine and cord, made it possible to study roentgenosemiotics and to establish pathogenetic interrelationship of natal injuries of the spinal column, spinal cord and GI tract functional obstruction in the form of polyspasm, spastic-hypo- and atonic intestinal dyskenesia, gastroesophageal reflux, aspiration pneumonia with the development of intestinal invagination

  15. Spinal cord ischemia: aetiology, clinical syndromes and imaging features

    International Nuclear Information System (INIS)

    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. 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.

  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. 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

    The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H]Epibatid......The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H......]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....... The administered [(3)H]epibatidine was found to be distributed to the area closest to the dialysis probe and not dispersed along the spinal cord, and the distribution was equal for all concentrations. The data presented in this investigation provide information, which is important for interpretation of data from...

  19. 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...

  20. Local dynamics of gap-junction-coupled interneuron networks

    Science.gov (United States)

    Lau, Troy; Gage, Gregory J.; Berke, Joshua D.; Zochowski, Michal

    2010-03-01

    Interneurons coupled by both electrical gap-junctions (GJs) and chemical GABAergic synapses are major components of forebrain networks. However, their contributions to the generation of specific activity patterns, and their overall contributions to network function, remain poorly understood. Here we demonstrate, using computational methods, that the topological properties of interneuron networks can elicit a wide range of activity dynamics, and either prevent or permit local pattern formation. We systematically varied the topology of GJ and inhibitory chemical synapses within simulated networks, by changing connection types from local to random, and changing the total number of connections. As previously observed we found that randomly coupled GJs lead to globally synchronous activity. In contrast, we found that local GJ connectivity may govern the formation of highly spatially heterogeneous activity states. These states are inherently temporally unstable when the input is uniformly random, but can rapidly stabilize when the network detects correlations or asymmetries in the inputs. We show a correspondence between this feature of network activity and experimental observations of transient stabilization of striatal fast-spiking interneurons (FSIs), in electrophysiological recordings from rats performing a simple decision-making task. We suggest that local GJ coupling enables an active search-and-select function of striatal FSIs, which contributes to the overall role of cortical-basal ganglia circuits in decision-making.

  1. Local dynamics of gap-junction-coupled interneuron networks

    International Nuclear Information System (INIS)

    Interneurons coupled by both electrical gap-junctions (GJs) and chemical GABAergic synapses are major components of forebrain networks. However, their contributions to the generation of specific activity patterns, and their overall contributions to network function, remain poorly understood. Here we demonstrate, using computational methods, that the topological properties of interneuron networks can elicit a wide range of activity dynamics, and either prevent or permit local pattern formation. We systematically varied the topology of GJ and inhibitory chemical synapses within simulated networks, by changing connection types from local to random, and changing the total number of connections. As previously observed we found that randomly coupled GJs lead to globally synchronous activity. In contrast, we found that local GJ connectivity may govern the formation of highly spatially heterogeneous activity states. These states are inherently temporally unstable when the input is uniformly random, but can rapidly stabilize when the network detects correlations or asymmetries in the inputs. We show a correspondence between this feature of network activity and experimental observations of transient stabilization of striatal fast-spiking interneurons (FSIs), in electrophysiological recordings from rats performing a simple decision-making task. We suggest that local GJ coupling enables an active search-and-select function of striatal FSIs, which contributes to the overall role of cortical-basal ganglia circuits in decision-making

  2. MR findings of spinal cord in decompression sickness

    International Nuclear Information System (INIS)

    To determine the MR imaging findings of spinal cord decompression sickness. We retrospectively analysed the spinal MR images of eight patients (M : 6, F : 2) with decompression sickness affecting the cervical spine (n=1) or thoracic spine (n=7). The observed extent, location, continuity, signal intensity and contrast enhancement pattern of spinal cord lesions were analysed. The chief MR finding was continuous (n=2) or non-continuous (n=3) high signal intensity on T2-weighted images in the posterior paramedian spinal cord. In three cases, additional T2 signal abnormality in the ventral horn of the gray matter was observed. There was no signal intensity abnormality on T1-weighted images or abnormal enhancement of post-Gadolinium T1-weighted images. In one case, cord swelling in addition to T2 signal abnormality was observed. MR imaging is useful for evaluating spinal cord lesions in patients with decompression sickness

  3. Spinal Cord Injury 101

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    Full Text Available ... to Social Life in a Wheelchair Adjusting to Social Life in a Wheelchair Substance Abuse and Spinal Cord Injury Substance Abuse and Spinal Cord Injury How Family Life Changes After Spinal Cord Injury How Family ...

  4. Spinal Cord Injury 101

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    Full Text Available ... Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of Spinal Cord Injury Rehabilitation Preventing Pressure Sores Preventing Pressure Sores Transition ...

  5. Avaliação funcional do músculo trapézio e nervo espinhal pós-esvaziamento cervical através da eletroneuromiografia: estudo de 25 pacientes Functional evaluation of trapezius muscle and spinal nerve after neck dissection through eletro-neuromiography (ENM: study of 25 patients

    Directory of Open Access Journals (Sweden)

    José Carlos de Oliveira

    2002-04-01

    Full Text Available OBJETIVO: Foram estudados 25 pacientes portadores de neoplasias malignas da cabeça e pescoço (20 de vias aerodigestivas superiores e cinco da glândula tireóide, submetidos a esvaziamentos cervicais uni ou bilaterais (33 procedimentos, sendo 15 supra-omohióideos, 11 funcionais e sete em campos alargados. MÉTODO: Através da eletroneuromiografia (ENM, foram avaliados funcionalmente o músculo trapézio e o nervo espinhal após os diferentes procedimentos, aos 30 e 180 dias. RESULTADOS: Foram aferidos para as três formas de linfadenectomia 94% de desnervação do músculo trapézio, severa em 68% e moderada 32% (p = 0,001, portanto valores significativos. Quanto à avaliação do tipo de lesão do nervo espinhal, após 30 dias observou-se lesão de axônio (axonotmese em 31 dos 33 procedimentos. Com relação à reinervação, esta foi detectada após 180 dias, sendo boa (21%, moderada (72% e ruim (7% para valores de p = 0,001 de significância estatística. CONCLUSÕES: A eletroneuromiografia foi um método efetivo na avaliação da unidade neuromuscular e o tipo de esvaziamento cervical conservador não foi determinante de alterações destas estruturas.BACKGROUND: Twenty fire patients with malignant head and neck neoplasias (20 from superior aerodigestive tract and 5 from thyroid gland, were submitted to 33 unilateral or bilateral neck node dissection (15 supraomohyoid, 11 modified and 7 wide field, at the Head and Neck Service of Hospital Araújo Jorge, Goiânia, Goiás, Brazil. METHOD: Eletroneuromiography (ENM of the trapezius muscle after spinal nerve dissection. RESULTS: In spite of surgical dissection, 94% of trapezius muscle desnervation were detected, being 38% severe and 62% moderate, (p = 0,001. The degree of lesion for spinal nerve after 30 days, showed axoniumtmese in 31 of 33 procedures, and after 180 days, 21% of severe, 72% of moderate and 7% of unsatisfactory reinervation were diagnosed (p = 0,001. CONCLUSIONS: ENM is an

  6. IgG4-related spinal pachymeningitis.

    Science.gov (United States)

    Lu, Zhang; Tongxi, Liu; Jie, Luo; Yujuan, Jiao; Wei, Jiang; Xia, Liu; Yumin, Zheng; Xin, Lu

    2016-06-01

    The aim of this study is to study the clinical, laboratory, imaging pathology, and prognosis features of IgG4-related spinal pachymeningitis. We worked with a 55-year-old man suffering from IgG4-related spinal pachymeningitis who had the most widespread lesion in his dura mater. We also review previous related studies and discuss the clinical characteristics of this rare disease. In total, eight IgG4-related spinal pachymeningitis patients have been reported in the literature since 2009. They were mostly male patients, 51.7 ± 11.9 years old on average. Cervical and thoracic vertebrae were the most common sites for lesions. The most prominent symptom was varying numbness and weakness of the limbs and/or body associated with spinal cord compression. There was one patient (1/5) with elevated serum IgG4 levels and three patients (3/3) with increased cerebrospinal fluid (CSF) IgG4 index. Positive histopathologic findings are the strongest basis for a diagnosis. All the patients with IgG4-related spinal pachymeningitis responded well to glucocorticoid therapy. IgG4-related spinal pachymeningitis is an orphan disease that mainly occurs in cervical and thoracic vertebrae. Older males are the most susceptible group. Serum IgG4 levels were consistently normal in these cases, so analysis of CSF for IgG4 production (IgG4 index) could become a useful tool. Pathological findings remain the gold standard for diagnosis. Most patients responded favorably to glucocorticoid treatment. PMID:26567899

  7. 牵引和体疗治疗神经根型颈椎病800例%Traction and physical therapy in treatment of cervical spondylopathy of nerve root type

    Institute of Scientific and Technical Information of China (English)

    潘良国; 郑明莹

    2002-01-01

    @@ Background:The mechanism of cervical spondylopathy is very complex.During the retrograde degeneration of the cervical vertebrae hyperosteogeny occurs at the anterior and posterior edges of the vertebrae and the small joints and hyperemia,swelling,fibrosis,calcification or ossification might occur in the around articular ligaments and stimulate or pressure spinal nerve root,the spinal cord,cervical sympathetic nerves and the vertebral artery and cause different clinical manifestations.

  8. From circuit motifs to computations: mapping the behavioral repertoire of cortical interneurons

    OpenAIRE

    Hangya, Balázs; Pi, Hyun-Jae; Kvitsiani, Duda; Ranade, Sachin P.; Kepecs, Adam

    2014-01-01

    The exquisite architecture of cortex incorporates a myriad of inhibitory interneuron types. Until recently, the dearth of techniques for cell type identification in awake animals has made it difficult to link interneuron activity with circuit function, computation and behavior. This situation has changed dramatically in recent years with the advent of novel tools for targeting genetically distinct interneuron types so their activity can be observed and manipulated. The association of differen...

  9. Laminarly orthogonal excitation of fast spiking and low threshold spiking interneurons in mouse motor cortex

    OpenAIRE

    Apicella, Alfonso J; Wickersham, Ian R.; Seung, H. Sebastian; Gordon M. G Shepherd

    2012-01-01

    In motor cortex, long-range output to subcortical motor circuits depends on excitatory and inhibitory inputs converging on projection neurons in layers 5A/B. How interneurons interconnect with these projection neurons, and whether these microcircuits are interneuron- and/or projection-specific, is unclear. We found that fast spiking (FS) interneurons received strong intralaminar (horizontal) excitation from pyramidal neurons in layers 5A/B including corticostriatal and corticospinal neurons, ...

  10. Novel Fast Adapting Interneurons Mediate Cholinergic-Induced Fast GABAA IPSCs In Striatal Spiny Neurons

    OpenAIRE

    Faust, Thomas W.; Assous, Maxime; Shah, Fulva; Tepper, James M.; Koós, Tibor

    2015-01-01

    Previous work suggests that neostriatal cholinergic interneurons control the activity of several classes of GABAergic interneurons through fast nicotinic receptor mediated synaptic inputs. Although indirect evidence has suggested the existence of several classes of interneurons controlled by this mechanism only one such cell type, the neuropeptide-Y expressing neurogliaform neuron, has been identified to date. Here we tested the hypothesis that in addition to the neurogliaform neurons that el...

  11. Spinal Cord Injury 101

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    Full Text Available ... Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of Spinal Cord Injury Rehabilitation Preventing Pressure Sores Preventing Pressure Sores Transition from ...

  12. Spinal Cord Injury 101

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    Full Text Available ... Workers Help Transitions How Social Workers Help Transitions Occupational Therapy After Spinal Cord Injury Occupational Therapy After Spinal Cord Injury How Occupational Therapists Work ...

  13. MRI findings of spinal visceral larva migrans of Toxocara canis

    International Nuclear Information System (INIS)

    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.

  14. 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.

  15. Developmental biomechanics of the human cervical spine.

    Science.gov (United States)

    Nuckley, David J; Linders, David R; Ching, Randal P

    2013-04-01

    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 (pmechanics exhibited significant relationships with age. Nonlinear flexibility curves described the functional response of the cervical 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. PMID:23415075

  16. 成人多节段无骨折脱位型颈脊髓损伤不同治疗方法的疗效对比分析%Comparative analysis of treatment efficacy of different methods on multiple segmental adult cervical spinal cord injury without fracture dislocation

    Institute of Scientific and Technical Information of China (English)

    张广泉; 刘珂; 高延征; 陈书连; 高坤; 赵永强; 高宗炎

    2013-01-01

    Objective To investigate the treatment effects of operation and nerve growth factor on adult multisegmental cervical spinal cord injury without fracture dislocation.Methods Sixty-eight patients with multiple segmental cervical spinal cord injury without fracture dislocation,admitted to our hospital from January 2004 to May 2011,were chosen in our study; according to the will of the patients,18 patients received conservative treatment (group A),25 patients were treated by posterior single open-door laminoplasty (group B) and the other 25 patients were treated with posterior single open-door laminoplasty combined with nerve growth factor (group C,once daily for 4 weeks); their clinical data were retrospectively analyzed.Follow up was performed at 3,6 and 12 months after the treatments;Japanese Orthopaedic Association (JOA) scale was employed to evaluate the clinical efficacy.Results Three,6,12 months after the treatments,the JOA scale scores were statistically different among the three groups (P<0.05); the scores in group B and C were significantly higher than those in group A at all time points (P<0.05); 6 and 12 months after the treatmemts,the JOA scale scores in group C were significantly higher than those in group B (P<0.05).Conclusion To patients with multisegmental cervical spinal cord injury without fracture dislocation,conservative treatment can make the spinal cord function partially restored,but the effect is limited; exogenous nerve growth factor has good repairing effect on spinal cord injury.%目的 探讨手术和神经生长因子应用在治疗成人多节段无骨折脱位型颈脊髓损伤中的作用. 方法 回顾性分析河南省人民医院骨科自2004年1月至2011年5月治疗并获得随访的68例成人多节段无骨折脱位型颈脊髓患者临床资料,根据患者意愿将68例患者分为A、B、C3组,A组18例,采取保守治疗,行颈椎牵引的基础上加用激素、弥可保等药物治疗;B组25例,采用颈3~7后

  17. 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.

  18. Paralysis following stereotactic spinal irradiation in pigs suggests a tolerance constraint for single-session irradiation of the spinal nerve

    International Nuclear Information System (INIS)

    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 bilateral irradiation to levels C5–C8 distributed into three dose groups with mean maximum spinal nerve doses of 16.9 ± 0.3 Gy (n = 5), 18.7 ± 0.5 Gy (n = 5), and 24.3 ± 0.8 Gy (n = 5). Changes developing in the gait of the group of pigs receiving a mean maximum dose of 24.3 Gy after 10–15 weeks led to the irradiation of two additional animals. They received mean maximum dose of 24.9 ± 0.2 Gy (n = 2), targeted to the left spinal nerves of C5–C8. The followup period was one year. Histologic sections from spinal cords and available spinal nerves were evaluated. MR imaging was performed on pigs in the 24.9 Gy group. Results: No pig that received a maximum spinal nerve point dose ⩽19.0 Gy experienced a change in gait while all pigs that received ⩾24.1 Gy experienced paralysis. Extensive degeneration and fibrosis were observed in irradiated spinal nerves of the 24.9 Gy animals. All spinal cord sections were normal. Irradiated spinal nerve regions showed increased thickness and hypointensity on MR imaging. Conclusion: The single-session tolerance dose of the cervical spinal nerves lies between 19.0 and 24.1 Gy for this model

  19. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report

    OpenAIRE

    Tofuku Katsuhiro; Koga Hiroaki; Komiya Setsuro

    2012-01-01

    Abstract Introduction Although uncommon, selective cervical nerve root blocks can have serious complications. The most serious complications that have been reported include cerebral infarction, spinal cord infarction, transient quadriplegia and death. Case presentation A 40-year-old Japanese woman with a history of severe right-sided cervical radicular pain was scheduled to undergo a right-sided C6 selective cervical nerve root block using a transforaminal approach under fluoroscopic guidance...

  20. MR imaging of cervical disc disease

    International Nuclear Information System (INIS)

    Since magnetic resonance imaging (MRI) technology has been greatly improved, MRI for cervical disc disease has become widely used in many facilities. Among non-invasive procedures, MRI is regarded as one of the most useful ones. Conventional myelography, CT myelography, and MRI were performed on 10 patients with cervical disc disease. The authors discussed the correlation between conventional myelography, CT myelography, and MRI as regards their ability to determine the localization and the laterality of disc protrusion and osteophyte. In our MRI study, we use both short-echo (SE) images and GRASS images. The parameters of our GRASS included 5 mm-thick sections. TR=200, TE=20, and flip angles of 10deg. This pulse sequence generates images with high signal cerebrospinal fluid (CSF), resulting in a high-contrast CSF-spinal cord, osteophyte, and disc protrusion. As yet, although it easily shows the localization and laterality of the disc and/or osteophyte, image quality of the GRASS is not yet sufficient to allow us to evaluate detailed deformity of the spinal cord and nerve root. The authors stress the usefulness of this GRASS image for the evaluation of suspected cervical disc disease. (author)