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1

[Langerhans cell histiocytosis causing cervical myelopathy].  

PubMed

Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corporectomy and fusion. An 8-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying upper and lower limbs motor weakness. CT scans revealed destruction of C5 body and magnetic resonance imaging showed a tumoral process at C5 with cord compression. Interbody fusion using anterior cervical plate packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of limbs. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered. PMID:22552159

Doléagbénou, A K; Mukengeshay Ntalaja, J; Derraz, S; El Ouahabi, A; El Khamlichi, A

2012-05-01

2

Synovial cyst in the cervical region causing severe myelopathy.  

PubMed

The authors describe a case of an 80-year-old man with a gradual weakness of the lower extremities not linked to any known traumatic episode over the 2 weeks before admission. CT scan and MRI of the spine revealed a cystic formation, measuring about 1 cm in diameter, at C7-T1 at the left posterolateral site at the level of the articular facet. During surgery, the mass appeared to be in the ligamentum flavum at the level of the articular facet and was in contact with the dura mater. After the removal of the mass, there was an immediate and significant improvement of the patient's symptoms. Histopathologic examination showed the cyst to be composed of nonspecific degenerative fibrous tissue with mild inflammatory change and confirmed the cyst as a synovial cyst. Synovial cyst in the cervical region is a very rare lesion causing myelopathy. Surgical removal of the cyst and decompression of the spinal cord results in good neurological recovery. PMID:15227744

Cho, Bo Young; Zhang, Ho Yeol; Kim, Han Sung

2004-06-30

3

Decompression for cervical myelopathy  

Microsoft Academic Search

Background contextCervical spondylotic myelopathy is a degenerative condition of the cervical spine. Surgical decompression is considered the gold standard of treatment, yet multiple published studies failed to yield consistent clinical results. Properly designed clinical outcomes studies using physiological, functional, and self-reported measures have the ability to define the best intervention for this disease entity. Many validated outcomes measures for cervical

Brian T. Jankowitz; Peter C. Gerszten

2006-01-01

4

Surgical Management of Cervical Spondylotic Myelopathy  

PubMed Central

Cervical spondylosis is a common degenerative condition that is a significant cause of morbidity. This review discusses the pathophysiology and natural history of cervical spondylotic myelopathy and focuses on the current literature evaluating the clinical management of these patients.

Hsu, Wesley; Dorsi, Michael J.; Witham, Timothy F.

2010-01-01

5

Cervical myelopathy caused by dropped head syndrome. Case report and review of the literature.  

PubMed

The authors present a rare case of cervical myelopathy caused by dropped head syndrome. This 68-year-old woman presented with her head hanging forward. After 1 month, she was admitted to the medical service because of head drop progression. Examination of biopsy specimens from her cervical paraspinal muscles showed nonspecific myopathic features without inflammation, and isolated neck extensor myopathy was diagnosed. The patient's condition did not respond to the administration of corticosteroids. During follow up as an outpatient, the patient's head drop continued to gradually progress. At 1 year after onset, she developed bilateral weakness of the upper and lower extremities, clumsiness of the hands, and gait disturbance. A radiograph of the cervical spine obtained in a standing position showed a pronounced kyphotic deformity and instability at the level of C4-5. Magnetic resonance imaging demonstrated spinal cord compression at C-3 and C-4. The patient underwent a C3-4 laminectomy and occipitocervicothoracic fixation. Gait and hand coordination gradually improved, and she was able to walk with no support 1 month postoperatively. Surgical fixation was beneficial in this patient with dropped head syndrome, myelopathy, and cervical instability. PMID:17330586

Nakanishi, Kinya; Taneda, Mamoru; Sumii, Toshihisa; Yabuuchi, Tomonari; Iwakura, Norihiro

2007-02-01

6

Prevalence of cervical spondylotic myelopathy.  

PubMed

BACKGROUND: Patients with signs and/or symptoms of cervical spondylotic myelopathy are frequently encountered in spinal practice. Exact numbers of prevalence or incidence are not known. METHODS: A literature search was performed by an experienced librarian in Pubmed, Embase, and Scopus. After selection of articles based on titles and abstracts, a full text review was performed. The prevalence of people needing surgical treatment was also estimated in a neurosurgical practice with a population adherence of 1.7 million people and a known referral pattern of the neurologists; all patients operated upon because of cervical spondylotic myelopathy between July 2009 and July 2012 were collected and prevalence calculated. RESULTS: The search of the literature did not reveal any article reporting an incidence or prevalence of cervical spondylotic myelopathy. Eighty of 5,992 patients were operated upon because of a cervical spondylotic myelopathy: 1.6 per 100,000 inhabitants. CONCLUSION: Surprisingly, an extensive search of the literature did not reveal exact data about the incidence or prevalence of cervical spondylotic myelopathy. The prevalence of surgically treated cervical spondylotic myelopathy was estimated as 1.6 per 100,000 inhabitants. Although the population adherence to the surgical practice is reasonably fixed and referral patterns are known, this estimate will still be too low for various reasons. At best, this estimate is the minimal prevalence of cervical spondylotic myelopathy that has been operated upon. To address the exact incidence or prevalence of cervical spondylotic myelopathy in general or needing surgical treatment, other investigations are warranted. PMID:23616201

Boogaarts, Hieronymus D; Bartels, Ronald H M A

2013-04-25

7

Pathophysiology and treatment for cervical flexion myelopathy  

Microsoft Academic Search

Previous studies have suggested that spinal cord compression by the vertebral bodies and intervertebral discs during neck flexion cause cervical flexion myelopathy (CFM). However, the exact pathophysiology of CFM is still unknown, and surgical treatment for CFM remains controversial. We examined retrospectively patients with CFM based on studies of the clinical features, neuroradiological findings, and neurophysiological assessments. The objectives of

Yoshinori Fujimoto; Shinichi Oka; Nobuhiro Tanaka; Kohichiro Nishikawa; Hiroyuki Kawagoe; Itsushi Baba

2002-01-01

8

Atlas Hypoplasia and Ossification of the Transverse Atlantal Ligament: A Rare Cause of Cervical Myelopathy  

PubMed Central

Myelopathy at the level of the atlas is rarely encountered by the practicing spine surgeon. Due to the region's unique anatomy, compression of the cord at this level is either caused by a large compressing lesion or an abnormally stenotic canal. We describe a rare instance of a congenitally stenotic canal due to a hypoplastic intact posterior arch of atlas, coexisting with an extremely rare ossified transverse ligament of the atlas. The coexistence of these two lesions has only been documented thrice before. We describe the clinical presentation, imaging findings, and favorable response to surgery.

Bokhari, Rakan

2012-01-01

9

Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty  

PubMed Central

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

Braly, Brett A.; Lunardini, David; Cornett, Chris; Donaldson, William F.

2012-01-01

10

Pathogenesis of cervical spondylotic myelopathy.  

PubMed Central

OBJECTIVE: To determine whether either of two mechanical theories predicts the topographic pattern of neuropathology in cervical spondylotic myelopathy (CSM). The compression theory states that the spinal cord is compressed between a spondylotic bar anteriorly and the ligamenta flava posteriorly. The dentate tension theory states that the spinal cord is pulled laterally by the dentate ligaments, which are tensed by an anterior spondylotic bar. METHODS: The spinal cord cross section, at the level of a spondylotic bar, is modelled as a circular disc subject to forces applied at its circumference. These forces differ for the two theories. From the pattern of forces at the circumference the distribution of shear stresses in the interior of the disc-that is, over the transverse section of the spinal cord-is calculated. With the assumption that highly stressed areas are most subject to damage, the stress pattern predicted by each theory can be compared to the topographic neuropathology of CSM. RESULTS: The predicted stress pattern of the dentate tension theory corresponds to the reported neuropathology, whereas the predicted stress pattern of the compression theory does not. CONCLUSIONS: The results strongly favour the theory that CSM is caused by tensile stresses transmitted to the spinal cord from the dura via the dentate ligaments. A spondylotic bar can increase dentate tension by displacing the spinal cord dorsally, while the dural attachments of the dentate, anchored by the dural root sleeves and dural ligaments, are displaced less. The spondylotic bar may also increase dentate tension by interfering locally with dural stretch during neck flexion, the resultant increase in dural stress being transmitted to the spinal cord via the dentate ligaments. Flexion of the neck increases dural tension and should be avoided in the conservative treatment of CSM. Both anterior and posterior extradural surgical operations can diminish dentate tension, which may explain their usefulness in CSM. The generality of these results must be tempered by the simplifying assumptions required for the mathematical model. Images

Levine, D N

1997-01-01

11

(iv) Cervical spondylotic myelopathy: a brief review of its pathophysiology, presentation, assessment, natural history and management  

Microsoft Academic Search

Cervical spondylotic myelopathy (CSM) is a debilitating condition associated with spinal cord dysfunction. It frequently occurs in the elderly and accounts for the majority of non-traumatic spastic paraparesis and quadriparesis. Cervical myelopathy refers to the clinical syndrome of long-tract aberrations in both upper and lower extremities arising from cervical spinal cord compression. It is most commonly caused by degenerative spondylosis

Lushun Wang; Hwan Tak Hee; Hee Kit Wong

2011-01-01

12

A rodent model of chronic compressive cervical myelopathy  

Microsoft Academic Search

Degenerative chronic spinal cord compression induced cervical myelopathy is a common cause of spinal cord dysfunction. The disease generally leads to impairment of the sensory and motor function of the cord progressively and insidiously. However, the underlying pathophysiology and the precise mechanism of the disease are still uncertain and remain to be investigated. The establishment of an animal model which

Darrell T. H. Li; Y. Hu; Ed X. Wu; K. D. K. Luk

2009-01-01

13

Development of a self-administered questionnaire to screen patients for cervical myelopathy  

PubMed Central

Background In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy. Methods A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women) with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women) with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, ?-coefficients, and p value, items were chosen and assigned a score. Results Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a specificity of 67.3%. Conclusions We successfully developed a simple self-administered questionnaire to screen for cervical myelopathy.

2010-01-01

14

Cervical Spondylotic Myelopathy: Factors in Choosing the Surgical Approach  

PubMed Central

Cervical spondylotic myelopathy is a progressive disease and a common cause of acquired disability in the elderly. A variety of surgical interventions are available to halt or improve progression of the disease. Surgical options include anterior or posterior approaches with and without fusion. These include anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical disc replacement, laminoplasty, laminectomy with and without fusion, and combined approaches. Recent investigation into the ideal approach has not found a clearly superior choice, but individual patient characteristics can guide treatment.

Yalamanchili, Praveen K.; Vives, Michael J.; Chaudhary, Saad B.

2012-01-01

15

Amyotrophic cervical myelopathy in adolescence.  

PubMed Central

The clinical and radiological features in seven patients who had asymmetric muscular atrophy of the hand and forearm when young are reported and a new hypothesis for its aetiology is proposed. Investigation of body growth curves (a surrogate for velocity of arm growth) showed close relation between (a) the age when the body height increased most rapidly and the onset age of this disorder, and (b) the age when the rapid body growth period ended and the age when symptom progression ceased. Cervical radiological evidence is provided showing asymmetric anterior cord atrophy, disappearance of slackness of dorsal roots in neck extension, and anterior and lateral displacement of the lower cervical cord against the posterior aspects of the vertebral bodies during neck flexion. These results suggest that disproportionate shortening of the dorsal roots is further accentuated during the juvenile growth spurt, which determines the onset and self limited course of the condition, and that repeated neck flexion causes micro-trauma and relative ischaemia of anterior horn cells, which finally results in atrophy of the muscles innervated by motoneurons with long axons. Predisposing anatomical factors are a straight neck due to lack of physiological cervical lordosis and the presence of foreshortened dorsal roots. Images

Toma, S; Shiozawa, Z

1995-01-01

16

Cervical myelopathy due to degenerative spondylolisthesis  

PubMed Central

Objective To investigate clinical-radiological features of cervical myelopathy due to degenerative spondylolisthesis (DSL). Methods A total of 448 patients were operated for cervical myelopathy at Nishitaga National Hospital between 2000 and 2003. Of these patients, DSL at the symptomatic disc level was observed in 22 (4.9%) patients. Clinical features were investigated by medical records, and radiological features were investigated by radiographs. Results Disc levels of DSL were C3/4 in 6 cases and C4/5 in 16 cases. Distance of anterior slippage was 2 to 5 mm (average 2.9 mm) in flexion position. Space available for the spinal cord (SAC) was 11 to 15 mm (average 12.8 mm) in flexion position and 11 to 18 mm (average14.6 mm) in extension position; 11 cases were reducible and 11 cases were irreducible in extension position. Myelograms demonstrated compression of spinal cord by the ligamentum flavum in extension position. Compression of spinal cord was not demonstrated in flexion position. C5-7 lordosis angle was lower than control. C5-7 range of motion (ROM) was reduced compared to controls. These alterations were statistically significant. Conclusions DSL occurs in the mid-cervical spine. Lower cervical spine demonstrated restricted ROM and lower lordosis angle. Pathogenesis of cervical myelopathy due to DSL is compression of spinal cord by the ligamentum flavum in extension position and not by reduced SAC in flexion position.

2011-01-01

17

Operative Outcomes for Cervical Myelopathy and Radiculopathy  

PubMed Central

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

Galbraith, J. G.; Butler, J. S.; Dolan, A. M.; O'Byrne, J. M.

2012-01-01

18

Laminoplasty versus Laminectomy and Fusion for Multilevel Cervical Spondylotic Myelopathy  

Microsoft Academic Search

Background  Cervical spondylotic myelopathy is increasingly prevalent in the elderly and is the leading cause of spinal cord dysfunction\\u000a in this population. Laminectomy with fusion and laminoplasty halt progression of myelopathy in these patients; however, both\\u000a procedures have well-documented complications and associated morbidity and it is unclear which might be most advantageous.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore compared the pain, function and alignment of

Barrett I. Woods; Justin Hohl; Joon Lee; William Donaldson III; James Kang

2011-01-01

19

Surgical management of cervical spondylotic myelopathy.  

PubMed

Introduction: The surgical procedure by the anterior, posterior and combined antero-posterior approaches had applied for the treatment of cervical spondylotic myelopathy. Methods: During the treatment process, all patients were pre-operatively as well post-operatively graded according to Japanese Orthopaedics Association. Several surgical methods such as anterior approach, posterior approach, and combined antero-posterior approach have been addressed for CSM patients, with the choice based on the pathogenesis of the myelopathy. The main indications for surgery were evidence of myelopathy on physical examinations, a JOA score below 13 points help with spinal cord compression observed on plain X-ray, CT scan, MRI studies. Results: The pre-operative JOA scores were 7.60±1.23 in laminoplasty, 8.30±1.03 in diskectomy and corpectomy and 7.10±1.20 in combined antero-posterior approach patients. At the follow-up after three months the JOA scores were laminoplasty 13.30±1.30, diskectomy and corpectomy 13.55±1.15 and combined antero-posterior 13.50±1.08. The JOA recovery rate averaged, 61.08±11.25% in laminoplasty, 60.67±10.60% in diskectomy and corpectomy and 64.67±10.72% in combined antero-posterior approach. The high- signal intensity changed to normal in 18 out of 28 and no any kyphotic change and instability were found in cervical spine at the follow up. Conclusions: Patients with OPLL (continuous, segmental and mixed type), stenosis of cervical spinal canal, multilevel cervical spondylosis, large and high ossification of IVDP with stenosis were improved with laminoplasty. Patients with PIVD, CSM with kyphosis, post laminectomy , OPLL herniated type, unstable vertebral alignment, stenosis by osteophytes, were improved with anterior approach . Ossified or deformed OPLL, unstable vertebral with stenosis ,OPLL or OYL with cervical meandearing (swan-neck) were improved with Combined anterior and posterior approach. Keywords: Cervical spondylotic mylopathy, anterior cervical diskectomy and fusion, corpectomy. PMID:23591248

Sah, S; Wang, L; Dahal, M; Acharya, P; Dwivedi, R

20

Cervical myelopathy from calcium pyrophosphate dihydrate crystal deposition: a case report  

Microsoft Academic Search

Calcification of the ligamentum flavum secondary to calcium pyrophosphate dihydrate (CPPD) deposition may be a rare cause\\u000a of cervical myelopathy. We present a 56-year-old man with spinal stenosis secondary to CPPD disease and subacute cervical\\u000a myelopathy following minor trauma. The patient had no history of CPPD disease. Posterior C4-C6 decompression and instrumented\\u000a fusion were performed. Intraoperative findings were densely thickened

Andreas F. Mavrogenis; Panayiotis J. Papagelopoulos; Demetrios S. Korres; Spyridon Pneumaticos

2010-01-01

21

Cervical arthroplasty for myelopathy adjacent to previous multisegmental fusion  

Microsoft Academic Search

In recent years, there has been increasing interest in the use of cervical arthroplasty for the treatment of degenerative cervical pathology. In its relative infancy, the applications for this technique are still being explored. In this report, we present the use of cervical arthroplasty in the treatment of progressive cervical myelopathy due to adjacent segment disease related to previous multisegmental

Ralph J. Mobbs; Nicholas Mehan; Peter Khong

2009-01-01

22

Cervical Spondylotic Myelopathy: Pathophysiology, Diagnosis, and Surgical Techniques  

PubMed Central

Cervical spondylotic myelopathy is a degenerative spinal disease which may lead to significant clinical morbidity. The onset of symptoms is usually insidious, with long periods of fixed disability and episodic worsening events. Regarding the pathophysiology of CSM, the repeated injuries to the spinal cord are caused by both static and dynamic mechanical factors. The combination of these factors affects the spinal cord basically through both direct trauma and ischemia. Regarding the diagnosis, both static and dynamics X-rays, as well as magnetic resonance imaging are important for preoperative evaluation as well as individualizing surgical planning. The choice of the most appropriate technique is affected by patient's clinical condition radiologic findings, as well as surgeon's experience. In opposition to the old belief that patients presenting mild myelopathy should be treated conservatively, there has progressively been amount of evidence indicating that the clinical course of this disease is progressive deterioration and that early surgical intervention improves long-term functional recovery and neurological prognosis.

Mattei, Tobias A.; Goulart, Carlos R.; Milano, Jeronimo B.; Dutra, Luis Paulo F.; Fasset, Daniel R.

2011-01-01

23

Imaging Modalities for Cervical Spondylotic Stenosis and Myelopathy  

PubMed Central

Cervical spondylosis is a spectrum of pathology presenting as neck pain, radiculopathy, and myelopathy or all in combination. Diagnostic imaging is essential to diagnosis and preoperative planning. We discuss the modalities of imaging in common practice. We examine the use of imaging to differentiate among central, subarticular, and lateral stenosis and in the assessment of myelopathy.

Green, C.; Butler, J.; Eustace, S.; Poynton, A.; O'Byrne, J. M.

2012-01-01

24

Radiculopathy and Myelopathy in Patients with Primary Cervical Dystonia  

Microsoft Academic Search

In a prospective series of 34 incident patients with primary cervical dystonia (CD), 6 showed clinical or radiological signs of cervical radiculopathy (RP) or myelopathy (MP) during the course of their movement disorder. Age at onset in these patients was in the range reported for pure spondylotic cervical RP without an accompanying movement disorder. Radiologically, spondylosis was mild in 1

Johann M. Hagenah; Alexandra Vieregge; Peter Vieregge

2001-01-01

25

Surgical and conservative treatment of cervical spondylotic radiculopathy and myelopathy  

Microsoft Academic Search

Summary One hundred and fourteen patients were admitted to our department for evaluation of their cervical spondylogenetic symptoms, including local cervical pain, radiculopathy and myelopathy. This retrospective study gives the results, expressed as improved, unchanged or worse, of anterior surgery, posterior surgery and conservative treatment. Local cervical pain improved in about half of the patients, without any difference between the

O. Arnasson; C. A. Carlsson; L. Pellettieri

1987-01-01

26

Clinical outcomes of microendoscopic decompression surgery for cervical myelopathy  

Microsoft Academic Search

Retrospective study on the results of microendoscopic decompression surgery for the treatment of cervical myelopathy. The\\u000a purpose of this study was to describe the microendoscopic laminoplasty (MEL) technique as the surgical method in the treatment\\u000a of cervical myelopathy, and to document the clinical outcomes for MEL surgery. Endoscopic surgery poses several challenges\\u000a for the aspiring endoscopic surgeons, the most critical

Akihito Minamide; Munehito Yoshida; Hiroshi Yamada; Yukihiro Nakagawa; Kazuhiro Maio; Masaki Kawai; Hiroshi Iwasaki

2010-01-01

27

An outcome measure for patients with cervical myelopathy: Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): Part 1  

Microsoft Academic Search

Background  An outcome measure to evaluate the neurological function of cervical myelopathy was proposed by the Japanese Orthopaedic Association\\u000a in 1975 (JOA score), and has been widely used in Japan. However, the JOA score does not include patients’ satisfaction, disability,\\u000a handicaps, or general health, which can be affected by cervical myelopathy. The purpose of this study was to develop a new

Mitsuru Fukui; Kazuhiro Chiba; Mamoru Kawakami; Shin-ichi Kikuchi; Shin-ichi Konno; Masabumi Miyamoto; Atsushi Seichi; Tadashi Shimamura; Osamu Shirado; Toshihiko Taguchi; Kazuhisa Takahashi; Katsushi Takeshita; Toshikazu Tani; Yoshiaki Toyama; Eiji Wada; Kazuo Yonenobu; Takashi Tanaka; Yoshio Hirota

2007-01-01

28

Neurogenic bladder in patients with cervical compressive myelopathy.  

PubMed

We examined the urinary disturbances in 56 consecutive patients with cervical compressive myelopathy using the latest International Continence Society classification. Of the 56 patients with cervical compressive myelopathy, 29 (52%) had some urinary subjective complaints, whereas the remaining 27 (48%) had none. Urologic examination indicated that 8 of these 29 (28%) patients with urinary complaints had urologic disorders other than neurogenic bladder. Of the remaining 21 patients, only 6 (25%) were judged to have neurogenic bladder on urodynamic study. Urodynamic study may be of limited value in diagnosing urinary disturbance in cervical myelopathy. Further, four cases (83%) showed underactive bladder activity in voiding phase, and only one case (17%) showed overactive bladder activity in filling phase. These results were contrary to those of previous studies indicating that cervical compressive myelopathy is associated with overactive bladder activity in filling phase. There were no significant differences in motor or sensory Japanese Orthopedic Association scores between the patients with and without urinary complaints. However, the patients with urinary complaints had significantly longer durations of myelopathy and delayed motor evoked potential latencies than those without urinary complaints. After surgery, 19 of the 21 (90%) patients with urinary complaints showed recovery from urinary disturbance. Operations in patients with cervical myelopathy were also effective against urinary disturbance. Urinary complaints may be an indication for surgical treatment despite the results of urodynamic study. PMID:16021011

Misawa, Tomoko; Kamimura, Mikio; Kinoshita, Tetsuya; Itoh, Hidehiro; Yuzawa, Yohei; Kitahara, Jun

2005-08-01

29

Correlation between pyramidal signs and the severity of cervical myelopathy  

PubMed Central

A retrospective study was performed to determine the sensitivities of the pyramidal signs in patients with cervical myelopathy, focusing on those with increased signal intensity (ISI) in T2-weighted magnetic resonance imaging (MRI). The relationship between prevalence of the pyramidal signs and the severity of myelopathy was investigated. We reviewed the records of 275 patients with cervical myelopathy who underwent surgery. Of these, 143 patients were excluded from this study due to comorbidities that might complicate neurological findings. The MR images of the remaining 132 patients were evaluated in a blinded fashion. The neurological findings of 120 patients with ISI (90 men and 30 women; mean age 61 years) were reviewed for hyperreflexia (patellar tendon reflex), ankle clonus, Hoffmann reflex, and Babinski sign. To assess the severity of myelopathy, the motor function scores of the upper and lower extremities for cervical myelopathy set by the Japanese Orthopaedic Association (m-JOA score) were used. The most prevalent signs were hyperreflexia (94%), Hoffmann reflex (81%), Babinski sign (53%), and ankle clonus (35%). Babinski sign (P < 0.001), ankle clonus, and Hoffmann reflex showed significant association with the lower m-JOA score. Conversely, no association was found with the upper m-JOA score. In patients with cervical myelopathy, hyperreflexia showed the highest sensitivity followed by Hoffmann reflex, Babinski sign, and ankle clonus. The prevalence of the pyramidal signs correlated with increasing severity of myelopathy. Considering their low sensitivity in patients with mild disability, the pyramidal signs may have limited utility in early diagnosis of cervical myelopathy.

Seichi, Atsushi; Takeshita, Katsushi; Shoda, Naoki; Ono, Takashi; Matsudaira, Ko; Kawaguchi, Hiroshi; Nakamura, Kozo

2010-01-01

30

Ubiquitin expression in degenerating axons of equine cervical compressive myelopathy.  

PubMed

Neuropathologic examination revealed axonal swelling and breakdown leading to Wallerian degeneration of affected myelinated nerve fibers in the spinal cord white matter of four young horses with equine cervical compressive myelopathy. Immunohistochemical reactions for the cell stress protein ubiquitin revealed an enhanced presence in the swollen axons, which may reflect a role for ubiquitin in the neuronal catabolic process of axonal compression and degeneration in this myelopathy. PMID:8740714

Jortner, B S; Scarratt, W K; Modransky, P D; Walton, A; Perkins, S K

1996-05-01

31

Pallidal deep brain stimulation in patients with cervical dystonia and severe cervical dyskinesias with cervical myelopathy  

PubMed Central

Objectives: Surgical treatment of complex cervical dystonia and of cervical dyskinesias associated with cervical myelopathy is challenging. In this prospective study, the long term effect of chronic pallidal stimulation in cervical dystonia and on combining the technique with spinal surgery in patients with severe cervical dyskinesias and secondary cervical myelopathy is described. Methods: Eight patients with a history of chronic dystonia who did not achieve adequate benefit from medical treatment or botulinum toxin injection participated in the study. Five patients had complex cervical dystonia with tonic postures and phasic movements. Three patients had rapidly progressive cervical myelopathy secondary to severe cervical dyskinesias and dystonia in the context of a generalised movement disorder. Quadripolar electrodes were implanted in the posteroventral lateral globus pallidus internus with stereotactic CT and microelectrode guidance. In the three patients with secondary cervical myelopathy, spinal surgery was performed within a few weeks and included multilevel laminectomies and a four level cervical corporectomy with spinal stabilisation. Results: Improvement of the movement disorder was noted early after pallidal surgery, but the full benefit could be appreciated only with a delay of several months during chronic stimulation. Three months after surgery, patients with cervical dystonia had improved by 38% in the severity score, by 54% in the disability score, and by 38% in the pain score of a modified version of the Toronto western spasmodic torticollis rating scale. At a mean follow up of 20 months, the severity score had improved by 63%, the disability score by 69%, and the pain score by 50% compared with preoperatively. There was also sustained amelioration of cervical dyskinesias in the three patients who underwent spinal surgery. Lead fractures occurred in two patients. The mean amplitude needed for chronic deep brain stimulation was 3.8 V at a mean pulse width of 210 µs, which is higher than that used for pallidal stimulation in Parkinson's disease. Conclusions: Chronic pallidal stimualtion is effective for complex cervical dystonia and it is a useful adjunct in patients with cervical dyskinesias and secondary cervical myelopathy who undergo spinal surgery.

Krauss, J; Loher, T; Pohle, T; Weber, S; Taub, E; Barlocher, C; Burgunder, J

2002-01-01

32

Functional outcome of corpectomy in cervical spondylotic myelopathy  

PubMed Central

Background: Cervical spondylotic myelopathy (CSM) is serious consequence of cervical intervertebral disk degeneration. Morbidity ranges from chronic neck pain, radicular pain, headache, myelopathy leading to weakness, and impaired fine motor coordination to quadriparesis and/or sphincter dysfunction. Surgical treatment remains the mainstay of treatment once myelopathy develops. Compared to more conventional surgical techniques for spinal cord decompression, such as anterior cervical discectomy and fusion, laminectomy, and laminoplasty, patients treated with corpectomy have better neurological recovery, less axial neck pain, and lower incidences of postoperative loss of sagittal plane alignment. The objective of this study was to analyze the outcome of corpectomy in cervical spondylotic myelopathy, to assess their improvement of symptoms, and to highlight complications of the procedure. Materials and Methods: Twenty-four patients underwent cervical corpectomy for cervical spondylotic myelopathy during June 1999 to July 2005.The anterior approach was used. Each patient was graded according to the Nuricks Grade (1972) and the modified Japanese Orthopaedic Association (mJOA) Scale (1991), and the recovery rate was calculated. Results: Preoperative patients had a mean Nurick's grade of 3.83, which was 1.67 postoperatively. Preoperative patients had a mean mJOA score of 9.67, whereas postoperatively it was 14.50. The mean recovery rate of patients postoperatively was 62.35% at a mean follow-up of 1 year (range, 8 months to 5 years).The complications included one case (4.17%) of radiculopathy, two cases (8.33%) of graft displacement, and two cases (8.33%) of screw back out/failure. Conclusions: Cervical corpectomy is a reliable and rewarding procedure for CSM, with functional improvement in most patients.

Williams, Kanishka E; Paul, Rajesh; Dewan, Yashbir

2009-01-01

33

A comparative study of surgical approaches for cervical compressive myelopathy.  

PubMed

Since 1986, the authors have used anterior decompression and fusion to treat patients with one- or two-level lesions without spinal canal stenosis (Group A) and laminoplasty for patients with more than three-level lesions or spinal canal stenosis (Group P). The aim of this study was to compare surgical outcomes of anterior and posterior approaches for patients with cervical myelopathy because of spondylosis and disc herniation and to determine the cause of poor neurologic recovery after surgery. One hundred thirty-six patients were followed up for an average of 5.6 years. There were no significant differences in gender, preoperative neurologic deficits, axial symptoms, or duration of symptoms before surgery between the two groups. Mean recovery rates for disc herniations were 71.1% and 71.9% in Groups A and P, respectively. For spondylosis, mean recovery rates were 49.0% and 58.6% in Groups A and P, respectively. There were no differences in recovery rate for patients with either spinal disorder between Groups A and P. The neurologic recovery of patients with kyphotic spinal cord was inferior to that of patients with lordotic or straight spinal cord. It is possible that acquisition and maintenance of lordosis result in improvement of clinical outcomes after surgery for patients with myelopathy. PMID:11127649

Kawakami, M; Tamaki, T; Iwasaki, H; Yoshida, M; Ando, M; Yamada, H

2000-12-01

34

Surgical outcomes of elderly patients with cervical spondylotic myelopathy  

Microsoft Academic Search

BackgroundCervical spondylotic myelopathy is a potentially serious neurologic disorder that commonly presents with gait difficulty and hand dysfunction. Because the development of CSM is in large part related to advanced spondylosis and degenerative disk disease, elderly patients appear to be at an increased risk to develop this condition. The surgical outcomes of this patient population have been understudied; the authors

Langston T. Holly; Parham Moftakhar; Larry T. Khoo; A. Nick Shamie; Jeffrey C. Wang

2008-01-01

35

Cervical myelopathy in an adolescent with hallervorden-spatz disease  

Microsoft Academic Search

Hallervorden-Spatz disease is a rare neurodegenerative disorder characterized by progressive dystonia, rigidity, and dementia. In these patients, chronic repeated dystonic movements, especially of the head and neck, can lead to excessive stress on the cervical spine, resulting in early degenerative changes and myelopathy. This report focuses on a young patient with Hallervorden-Spatz disease who presented with C4 to C5 cervical

Genevieve Po Gee Fung; Kwok Yin Chan

2003-01-01

36

Presymptomatic spondylotic cervical myelopathy: an updated predictive model  

PubMed Central

Spondylotic cervical cord compression detected by imaging methods is a prerequisite for the clinical diagnosis of spondylotic cervical myelopathy (SCM). Little is known about the spontaneous course and prognosis of clinically “silent” presymptomatic spondylotic cervical cord compression (P-SCCC). The aim of the present study was to update a previously published model predictive for the development of clinically symptomatic SCM, and to assess the early and late risks of this event in a larger cohort of P-SCCC subjects. A group of 199 patients (94 women, 105 men, median age 51 years) with magnetic resonance signs of spondylotic cervical cord compression, but without clear clinical signs of myelopathy, was followed prospectively for at least 2 years (range 2–12 years). Various demographic, clinical, imaging, and electrophysiological parameters were correlated with the time for the development of symptomatic SCM. Clinical evidence of the first signs and symptoms of SCM within the follow-up period was found in 45 patients (22.6%). The 25th percentile time to clinically manifested myelopathy was 48.4 months, and symptomatic SCM developed within 12 months in 16 patients (35.5%). The presence of symptomatic cervical radiculopathy and electrophysiological abnormalities of cervical cord dysfunction detected by somatosensory or motor-evoked potentials were associated with time-to-SCM development and early development (?12 months) of SCM, while MRI hyperintensity predicted later (>12 months) progression to symptomatic SCM. The multivariate predictive model based on these variables correctly predicted early progression into SCM in 81.4% of the cases. In conclusion, electrophysiological abnormalities of cervical cord dysfunction together with clinical signs of cervical radiculopathy and MRI hyperintensity are useful predictors of early progression into symptomatic SCM in patients with P-SCCC. Electrophysiological evaluation of cervical cord dysfunction in patients with cervical radiculopathy or back pain is valuable. Meticulous follow-up is justified in high-risk P-SCCC cases.

Kadanka, Zdenek; Dusek, Ladislav; Kerkovsky, Milos; Vohanka, Stanislav; Novotny, Oldrich; Urbanek, Igor; Kratochvilova, Dagmar

2008-01-01

37

MRI in the management of suspected cervical spondylotic myelopathy.  

PubMed Central

One hundred and two patients with suspected cervical spondylotic myelopathy were prospectively investigated using MRI as the initial imaging technique. The aim was to discover if clinicians could manage patients with MRI alone, or if they would find a second investigation necessary. Eighty two patients were managed using MRI alone, 34 of whom were treated surgically. Twenty patients had a second investigation: a myelogram in 18 and a CT myelogram in two. This was performed in nine patients to exclude structural pathology in the thoracic or lumbar region (which was not examined with MRI), and in 11 to obtain more specific information about the cervical region. Only five of these 20 patients had surgical treatment. The diagnosis changed after the second investigation in four patients, but management was not influenced in any of these. MRI is a satisfactory alternative to myelography for most patients with suspected cervical spondylotic myelopathy. Images

Statham, P F; Hadley, D M; Macpherson, P; Johnston, R A; Bone, I; Teasdale, G M

1991-01-01

38

Myelopathy and spinal deformity: relevance of spinal alignment in planning surgical intervention for degenerative cervical myelopathy.  

PubMed

Surgical management of degenerative cervical myelopathy requires careful pathoanatomic consideration to select between various surgical options from both anterior and posterior approach. Hitherto, unexplored is the relevance of cervical deformity to the pathophysiology of such neurological disability, and whether correction of that deformity should be a surgical objective when planning for reconstruction after spinal cord decompression. Such correction could address both the static cord compression and the dynamic repetitive cord injury, while also restoring more normal biomechanics to the cervical spine. The articles in this focus issue's section on cervical spinal deformity reveal that cervical sagittal alignment is geometrically related to thoracolumbar spinal pelvic alignment and to T1 slope, and that it is further clinically correlated to regional disability and general health scores and to myelopathy severity. These conclusions are based on narrative reviews and a selection of primary research data, reflecting the nascency of this field. They further recommend for preoperative assessment of spinal alignment when significant deformity is suspected, and that correction of cervical kyphosis should be an objective when surgery is planned. PMID:23963013

Shamji, Mohammed F; Ames, Christopher P; Smith, Justin S; Rhee, John M; Chapman, Jens R; Fehlings, Michael G

2013-10-15

39

Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications  

Microsoft Academic Search

Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment\\u000a of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients’ quality of life.\\u000a A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was

Dan S. Heffez; Ruth E. Ross; Yvonne Shade-Zeldow; Konstantinos Kostas; Mary Morrissey; Dean A. Elias; Alan Shepard

2007-01-01

40

C3-4 level cervical spondylotic myelopathy  

Microsoft Academic Search

Cervical spondylotic myelopathy (CSM) is uncommon at the C3-4 level. Fourteen patients with C3-4 CSM were treated over a period of 3 years. The radiological factors contribut- ing to CSM at the C3-4 level were studied. These factors included the assessment of static and dynamic canal diam- eters, retrolisthesis, posterior osteophytes and degenera- tive spinal segmental fusion on plain X-rays;

K. H. Vyas; Deepu Banerji; S. Behari; S. Jain; V. K. Jain; D. K. Chhabra

41

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment  

Microsoft Academic Search

Age-related changes in the spinal column result in a degenerative cascade known as spondylosis. Genetic, environmental, and\\u000a occupational influences may play a role. These spondylotic changes may result in direct compressive and ischemic dysfunction\\u000a of the spinal cord known as cervical spondylotic myelopathy (CSM). Both static and dynamic factors contribute to the pathogenesis.\\u000a CSM may present as subclinical stenosis or

Darren R. Lebl; Alex Hughes; Frank P. Cammisa; Patrick F. O’Leary

2011-01-01

42

Successful treatment of cervical myelopathy with minimal morbidity by circumferential decompression and fusion  

PubMed Central

Circumferential cervical decompression and fusion (CCDF) is an important technique for treating patients with severe cervical myelopathy. While circumferential cervical decompression and fusion may provide improved spinal cord decompression and stability compared to unilateral techniques, it is commonly associated with increased morbidity and mortality. We performed a retrospective analysis of patients undergoing CCDF at the University of California, San Francisco (UCSF) between January 2003 and December 2004. We identified 53 patients and reviewed their medical records to determine the effectiveness of CCDF for improving myelopathy, pain, and neurological function. Degree of fusion, functional anatomic alignment, and stability were also assessed. Operative morbidity and mortality were measured. The most common causes of cervical myelopathy, instability, or deformity were degenerative disease (57%) and traumatic injury (34%). Approximately one-fifth of patients had a prior fusion performed elsewhere and presented with fusion failure or adjacent-level degeneration. Postoperatively, all patients had stable (22.6%) or improved (77.4%) Nurick grades. The average preoperative and postoperative Nurick grades were 2.1 ± 1.9 and 0.4 ± 0.9, respectively. Pain improved in 85% of patients. All patients had radiographic evidence of fusion at last follow-up. The most common complication was transient dysphagia. Our average clinical follow-up was 27.5 ± 9.5 months. We present an extensive series of patients and demonstrate that cervical myelopathy can successfully be treated with CCDF with minimal operative morbidity. CCDF may provide more extensive decompression of the spinal cord and may be more structurally stable. Concerns regarding operation-associated morbidity should not strongly influence whether CCDF is performed.

Sanchez-Mejia, Rene O.; Ben-Haim, Sharona; Ames, Christopher P.

2007-01-01

43

Manual therapy and therapeutic exercise in patient with symptomatic cervical spondylotic myelopathy: A case report.  

PubMed

Cervical spondylotic myelopathy (CSM) is caused by narrowing of the cervical spinal canal, although surgical decompression is an obvious indication for spinal cord stenosis, there are not enough data to determine that surgery is the most indicated intervention for milder forms. The purpose of the present case report was to describe the outcomes results of the physical therapy treatment with emphasis on manual therapy and therapeutic exercise for a patient with CSM. A 58-year-old male patient attended the physical therapy clinic due to pain and paresthesia in the upper and lower limbs. The magnetic resonance imaging was compatible with spondylotic myelopathy. Following physical therapy treatment, the patient exhibited an improvement in functional capacity (triangle step test and timed 10-m walk), pain, paresthesia, mJOA scale and Neck Disability Index. Based on the lack of rapid evolution of neurological impairment, physical therapy treatment was indicated, which achieved satisfactory results. PMID:24139010

Almeida, Gabriel Peixoto Leão; Carneiro, Kysia Karine Almeida; Marques, Amélia Pasqual

2013-04-10

44

Cervical radiculopathy and myelopathy: when and what can surgery contribute to treatment?  

Microsoft Academic Search

Indications and timing ¶of surgical treatment for cervical radiculopathy and myelopathy, and the long-term results for the\\u000a conditions, were reviewed. Advances in spinal imaging and accumulation of clinical experience have provided some clues as\\u000a to indications and timing of surgery for cervical myelopathy. Duration of myelopathy prior to surgery and the transverse area\\u000a of the spinal cord at the maximum

Kazuo Yonenobu

2000-01-01

45

Cervical spondylotic radiculo-myelopathy in patients with athetoid-dystonic cerebral palsy: clinical evaluation and surgical treatment.  

PubMed Central

The acute onset of symptoms of severe cervical radiculo-myelopathy in four patients with athetoid-dystonic cerebral palsy is reported. Neurological and radiological examination showed that the spondylotic changes of the cervical spine were responsible for new neurological deficits leading to the patients being bedridden. Dystonic-athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result in early degenerative changes of the vertebrae which may enhance the radiculo-myelopathy. The four patients were treated with an anterior discectomy with interbody fusion. They were bedridden pre-operatively but all have since been able to walk with or without a cane. It is concluded that early anterior decompression with interbody fusion is a treatment of choice for cervical spondylotic radiculo-myelopathy in association with athetoid cerebral palsy. Images

Hirose, G; Kadoya, S

1984-01-01

46

Cervical spondylotic radiculo-myelopathy in patients with athetoid-dystonic cerebral palsy: clinical evaluation and surgical treatment.  

PubMed

The acute onset of symptoms of severe cervical radiculo-myelopathy in four patients with athetoid-dystonic cerebral palsy is reported. Neurological and radiological examination showed that the spondylotic changes of the cervical spine were responsible for new neurological deficits leading to the patients being bedridden. Dystonic-athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result in early degenerative changes of the vertebrae which may enhance the radiculo-myelopathy. The four patients were treated with an anterior discectomy with interbody fusion. They were bedridden pre-operatively but all have since been able to walk with or without a cane. It is concluded that early anterior decompression with interbody fusion is a treatment of choice for cervical spondylotic radiculo-myelopathy in association with athetoid cerebral palsy. PMID:6470718

Hirose, G; Kadoya, S

1984-08-01

47

Laminoplasty and laminectomy for cervical sponydylotic myelopathy: a systematic review.  

PubMed

BACKGROUND: Cervical spondylotic myelopathy is frequently encountered in neurosurgical practice. The posterior surgical approach includes laminectomy and laminoplasty. OBJECTIVE: To perform a systematic review evaluating the effectiveness of posterior laminectomy compared with posterior laminoplasty for patients with cervical spondylotic myelopathy. METHODS: An extensive search of the literature in Pubmed, Embase, and Cochrane library was performed by an experienced librarian. Risk of bias was assessed by two authors independently. The quality of the studies was graded, and the following outcome measures were retrieved: pre- and postoperative (m)JOA, pre- and postoperative ROM, postoperative VAS neck pain, and Ishira cervical curvature index. If possible data were pooled, otherwise a weighted mean was calculated for each study and a range mentioned. RESULTS: All studies were of very low quality. Due to inadequate description of the data in most articles, pooling of the data was not possible. Qualitative interpretation of the data learned that there were no clinically important differences, except for the higher rate of procedure-related complications with laminoplasty. CONCLUSION: Based on these results, a claim of superiority for laminoplasty or laminectomy was not justified. The higher number of procedure-related complications should be considered when laminoplasty is offered to a patient as a treatment option. A study of robust methodological design is warranted to provide objective data on the clinical effectiveness of both procedures. PMID:23575659

Bartels, Ronald H M A; van Tulder, Maurits W; Moojen, Wouter A; Arts, Mark P; Peul, Wilco C

2013-04-11

48

Clustered clinical findings for diagnosis of cervical spine myelopathy  

PubMed Central

Cervical spine myelopathy (CSM) is a clinical diagnosis made with imaging confirmation. At present, most clinical tests used to identify CSM are specific and no clusters of tests have proven more beneficial than stand alone tests in guiding treatment decision making. This study endeavored to produce a cluster of predictive clinical findings for a sample of patients using a clinical diagnosis/imaging confirmation as the reference standard for cervical spine myelopathy. Data from 249 patients with various conditions associated with cervical spine dysfunction were analyzed to determine which clinical tests and measures, when clustered together, were most diagnostic for CSM. Using multivariate regression analyses and calculations for sensitivity, specificity, and positive and negative likelihood ratios, a definitive cluster was identified. Thirteen clinical findings were investigated for capacity to diagnosis CSM. Five clinical: (1) gait deviation; (2) +Hoffmann’s test; (3) inverted supinator sign; (4) +Babinski test; and (5) age >45 years, were demonstrated the capacity when clustered into one of five positive tests to rule out CSM (negative likelihood ratio?=?0.18; 95% CI?=?0.12–0.42), and when clustered into three of five positive findings to rule in CSM (positive likelihood ratio?=?30.9; 95% CI?=?5.5–181.8). This study found clustered combinations of clinical findings that could rule in and rule out CSM. These clusters may be useful in identifying patients with this complex diagnosis in similar patient populations.

Cook, Chad; Brown, Christopher; Isaacs, Robert; Roman, Matthew; Davis, Samuel; Richardson, William

2010-01-01

49

Surgical management of degenerative cervical myelopathy: a consensus statement.  

PubMed

Degenerative cervical myelopathy (DCM), including cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament, presents a heterogenous set of variables reflecting its complex nature. Multiple studies in the past have attempted to elucidate an ideal surgical algorithm that surgeons may use when treating these patients, unfortunately all studies to date, including the rigorous systematic review used in this focus issue, have fallen short in identifying a superior approach when addressing DCM. Likely because of a superior approach being nonexistent because there are multiple pathoanatomical considerations. In addition to the multitude of variables that spine surgeons face when deciding the treatment options for patients with DCM, the previous studies that have been published, unfortunately, lack in consistent outcome and complication reporting. Therefore, synthesizing a treatment algorithm remains difficult, however, the articles in this focus issue use the GRADE system to assess the overall quality (strength) of available evidence and, where appropriate, formulate evidence-based recommendations. Factors that should be included in surgical decision making are the sagittal alignment, anatomical location of the compressive pathology, number of levels of compression, presence of absence or instability or subluxation, the type compressive pathology (e.g., spondylosis vs. ossification of the posterior longitudinal ligament), neck anatomy, bone quality, and surgeon experience or preference. Fortunately, as reviewed in the accompanying articles, a number of excellent surgical options exist that can be selected on the basis of the aforementioned pathoanatomical considerations. PMID:23963012

Lawrence, Brandon D; Shamji, Mohammed F; Traynelis, Vincent C; Yoon, S Tim; Rhee, John M; Chapman, Jens R; Brodke, Darrel S; Fehlings, Michael G

2013-10-15

50

Symptomatic progression of cervical myelopathy and the role of nonsurgical management: a consensus statement.  

PubMed

This section of the cervical spondylotic myelopathy Spine focus issue collates the existing evidence related to natural history and nonoperative management. In the case of patients with symptomatic cervical spondylotic myelopathy treated nonoperatively, while 20% to 62% will deteriorate at 3 to 6 years of follow-up, no specific patient or disease characteristics have been shown to predict this change reliably. For patients without myelopathy with spondylotic cord compression, the rate of myelopathy development is approximately 8% at 1 year and approximately 23% at 4 years of follow-up. Clinical and/or electrophysiological evidence of cervical radiculopathy has been shown to predict such progression and should prompt strong consideration of surgical decompression. With respect to nonoperative care, in the case of mild myelopathy, there is low evidence that such treatment may have a role; for moderate and severe myelopathy, this treatment results in outcomes inferior to those of surgery and is not recommended. Given the unpredictably progressive nature of cervical myelopathy, the indications for nonoperative management are ostensibly limited. Finally, the preclinical rationale and clinical translation of a putative neuroprotective drug, which may one day serve to augment the effects of surgery in the treatment of cervical spondylotic myelopathy, is presented and discussed. PMID:23963011

Fehlings, Michael G; Wilson, Jefferson R; Yoon, S Tim; Rhee, John M; Shamji, Mohammed F; Lawrence, Brandon D

2013-10-15

51

Anterolisthesis and retrolisthesis of the cervical spine in cervical spondylotic myelopathy in the elderly  

Microsoft Academic Search

Background  Degenerative spondylolisthesis of the cervical spine has received insufficient attention in contrast to that of the lumbar\\u000a spine. The authors analyzed the functional significance of anterior and posterior degenerative spondylolisthesis (anterolisthesis\\u000a and retrolisthesis) of the cervical spine to elucidate its role in the development of cervical spondylotic myelopathy (CSM)\\u000a in the elderly.\\u000a \\u000a \\u000a \\u000a Methods  A total of 79 patients aged 65 or

Motohiro Kawasaki; Toshikazu Tani; Takahiro Ushida; Kenji Ishida

2007-01-01

52

A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy  

Microsoft Academic Search

Background  The optimal surgical approach for multilevel cervical spondylotic myelopathy (CSM) has not been defined, and the relative\\u000a merits of multilevel anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy (2-level or skip 1-level\\u000a corpectomy) and fusion (ACCF) remain controversial. However, few comparative studies have been conducted on these two surgical\\u000a approaches.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This study retrospectively reviewed the case histories of

Qiushui Lin; Xuhui Zhou; Xinwei Wang; Peng Cao; Nicholas Tsai; Wen Yuan

53

Myelopathy caused by nitrous oxide toxicity.  

PubMed

We describe a case of myeloneuropathy resulting from nitrous oxide abuse. MR imaging of the spine revealed symmetric abnormal signal in the posterior columns of the cervical cord. Myeloneuropathy is caused by inactivation of vitamin B12 by nitrous oxide. This syndrome can also be seen in patients with borderline vitamin B12 deficiency who have recently been anesthetized with nitrous oxide. PMID:9613506

Pema, P J; Horak, H A; Wyatt, R H

1998-05-01

54

Myelopathy Caused by Nitrous Oxide Toxicity  

Microsoft Academic Search

Summary: We describe a case of myeloneuropathy result- ing from nitrous oxide abuse. MR imaging of the spine revealed symmetric abnormal signal in the posterior col- umns of the cervical cord. Myeloneuropathy is caused by inactivation of vitamin B12 by nitrous oxide. This syndrome can also be seen in patients with borderline vitamin B12 deficiency who have recently been anesthetized

Peter J Pema; Holli A Horak; Robert H. Wyatt

55

Cervical spondylotic myelopathy with occult foramen magnum meningioma--a case for MRI?  

Microsoft Academic Search

A fatal case of occult foramen magnum meningioma is described which presented with features of cervical myelopathy confirmed by cervical myelogram. Surgical decompression led to initial improvement followed by progressive deterioration and death. Postmortem examination revealed a 4 cm diameter foramen magnum meningioma. The dangers of using only standard radiographic investigations of the cervical cord are discussed.

K. Chakravarty; D. G. Scott; D. Dick; J. Visick

1993-01-01

56

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

PubMed Central

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

Aizawa, Toshimi; Ozawa, Hiroshi; Hoshikawa, Takeshi; Kusakabe, Takashi; Itoi, Eiji

2009-01-01

57

Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): Part 2. Endorsement of the alternative item  

Microsoft Academic Search

Background  A new self-administered questionnaire as an outcome measure for patients with cervical myelopathy was drawn up in Part 1 (Japanese\\u000a Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, JOACMEQ). Because a question with regard to driving\\u000a a car (C-41) was not suitable for this patient group, the authors composed an alternative question related to neck motion\\u000a (C-41-2). The purposes of the present

Mitsuru Fukui; Kazuhiro Chiba; Mamoru Kawakami; Shin-ichi Kikuchi; Shin-ichi Konno; Masabumi Miyamoto; Atsushi Seichi; Tadashi Shimamura; Osamu Shirado; Toshihiko Taguchi; Kazuhisa Takahashi; Katsushi Takeshita; Toshikazu Tani; Yoshiaki Toyama; Eiji Wada; Kazuo Yonenobu; Takashi Tanaka; Yoshio Hirota

2007-01-01

58

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy  

Microsoft Academic Search

Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years\\u000a old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate\\u000a the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications\\u000a of anterior corpectomy in aged

Jun Lu; Xiaotao Wu; Yonggang Li; Xiangfei Kong

2008-01-01

59

Subacute myelopathy caused by spinal venous infarction.  

PubMed Central

A 44 year old female presented with a subacute myelopathy in association with pelvic venous thrombosis. It is inferred from the temporal relationship of these events that the patient suffered a subacute spinal venous infarction. This is discussed along with the aetiology, anatomical distribution and management of the condition. Images Figure 1

Clarke, C. E.; Cumming, W. J.

1987-01-01

60

Clinical features of the localized girdle sensation of mid-trunk (false localizing sign) appeared in cervical compressive myelopathy patients.  

PubMed

Cervical compressive myelopathy patients sometimes show localized girdle sensation in the mid trunk (so-called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism of this symptom are still unclear. We investigated the clinical features and possible mechanism. In each of five cases of cervical compressive myelopathy disease with and without mid-truncal girdle sensation, the clinical features, degree and shape of cord compression were analysed. The girdle sensation was expressed as a vague or burning sensation, and was localized with a width of 3 or 4 dermatomes from the T3 to T11 level. There was no correlation between the appearance of the girdle sensation and etiology and level of cervical cord compression. Pyramidal tract signs and disturbance of superficial sensation were observed in all cases. Furthermore, on axial MRI, the midline ventral surface of the cervical cord was remarkably compressed in cases with girdle sensation, as if the compressive lesion entered the anterior medial fissure of the cervical cord. From these findings, this false localizing sign may be caused by severe compression of midline ventral structure of the cervical cord. Ischemia of the thoracic watershed zone of the anterior spinal artery from the compression of the anterior spinal artery at the cervical level might also be considered to be a possible cause. PMID:12021944

Ochiai, Hidenobu; Yamakawa, Yuzo; Minato, Seiichiro; Nakahara, Keiichi; Nakano, Shinichi; Wakisaka, Shinichiro

2002-05-01

61

Influence of intramedullary stress on cervical spondylotic myelopathy.  

PubMed

Study design:A cross-sectional analysis.Objective:To examine whether intramedullary stress is related to the appearance of symptoms in cervical spondylotic myelopathy (CSM).Setting:Japan.Methods:Thirty-three consecutive patients with CSM and 30 consecutive patients without CSM were enrolled. A total of 99 disc levels from C3 to C6 in 33 patients with CSM were divided into two groups: 33 disc levels with high signal intensity (HSI) on T2-weighted magnetic resonance image (HSI group) and 66 disc levels without HSI (Non-HSI group). Ninety disc levels from C3 to C6 in patients without CSM were set up in a control group. Intramedullary stress value at each level was analyzed using the finite element method. Stress was compared among the three groups. A cutoff value of stress to present HSI was investigated from receiver operator characteristics (ROC) curve.Results:In all the patients with CSM, the disc level with HSI presented the highest stress among the three disc levels evaluated. The stress was 3.16±0.86?kPa (mean±s.d.) in the HSI group, 1.81±0.72?kPa in the Non-HSI group and 1.01±0.37?kPa in the control group. The stress differed significantly among the three groups (P<0.0001). The qualified cutoff value derived from the ROC curve was 2.30?kPa (sensitivity 78.8%, specificity 91.9%). None of the disc levels in the control group exceeded 2.30?kPa.Conclusion:HSI was strongly associated with intramedullary stress. Threshold of intramedullary stress to present HSI that related closely to the symptoms of myelopathy was revealed. PMID:23999109

Takahashi, K; Ozawa, H; Sakamoto, N; Minegishi, Y; Sato, M; Itoi, E

2013-09-03

62

Regional impairment of 18 F-FDG uptake in the cervical spinal cord in patients with monosegmental chronic cervical myelopathy  

Microsoft Academic Search

Objective  The aim of this preliminary report was to assess glucose metabolism in the cervical spine of patients with chronic compressive\\u000a myelopathy by using FDG PET.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Ten patients with monosegmental chronic degenerative stenosis and local cord compression of the upper\\/middle cervical spine\\u000a with signs of myelopathy on MRI and 10 control patients without known cervical abnormalities were investigated by FDG PET.

Frank Willi Floeth; Gabriele Stoffels; Jörg Herdmann; Paul Jansen; Wolfgang Meyer; Hans-Jakob Steiger; Karl-Josef Langen

2010-01-01

63

Motor evoked potentials in the post-surgical follow-up of cervical spondylotic myelopathy  

Microsoft Academic Search

Eighteen patients (6 female, 12 male; average age 51 years, range 37–79) with clinical and radiological evidence (MRI) of cervical spondylotic myelopathy (CSM) were examined. The subjects were divided into two groups depending on whether radiology indicated single level (9 patients) or multilevel (9 patients) compression of the cervical cord. All of the patients underwent surgical decompression. Seriate exam with

M. De Mattei; B. Paschero; D. Cassano; A. Campanella; L. Rizzo; E. Morgando

1995-01-01

64

Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy  

Microsoft Academic Search

PurposeIntervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of

Andresa Braga-Baiak; Anand Shah; Ricardo Pietrobon; Larissa Braga; Arnolfo Carvalho Neto; Chad Cook

2008-01-01

65

A Prospective, Randomized Trial Comparing Expansile Cervical Laminoplasty versus Cervical Laminectomy and Fusion for Multi-level Cervical Myelopathy.  

PubMed

BACKGROUND:: Controversy exists as to the best posterior operative procedure to treat multi-level compressive cervical spondylotic myelopathy. OBJECTIVE:: To determine clinical, radiological and patient satisfaction outcomes between these two surgical procedures. METHODS:: We performed a prospective, randomized study of Expansile Cervical Laminoplasty (ECL) vs. Cervical Laminectomy and Fusion (CLF) in patients suffering from cervical spondylotic myelopathy. End-points included the SF-36, the NDI, VAS, modified JOA score, Nurick score and radiographic measures. RESULTS:: A survey of academic North American spine surgeons (n=30) demonstrated that CLF is the most commonly used (70%) posterior procedure to treat multi-level spondylotic cervical myelopathy. A total of 16 patients were randomized: CLF (n=7) / ECL (n=9). Both groups showed improvements in their Nurick grade and JOA score postoperatively, but only the improvement in the Nurick grade for the ECL group was statistically significant (p<0.05). The cervical ROM between C2 and C7 was reduced by 75% in the CLF group and by only 20% in the ECL group when comparing pre- and post-op range of motion. The overall increase in canal area was significantly (p<0.001) greater in the CLF, but there was a suggestion that the adjacent level was more narrowed in the CLF group in as little as 1 year post-operative. CONCLUSION:: ECL compares favorably in many respects to CLF. While patient numbers are small, there were significant improvements in pain measures in the ECL group while still maintaining range of motion. Restoration of spinal canal area was superior in the CLF group. PMID:21817931

Manzano, Glen R; Casella, Gizelda; Wang, Michael Y; D O D C, Steven Vanni; Levi, Allan D

2011-08-02

66

Successful treatment of cervical myelopathy with minimal morbidity by circumferential decompression and fusion  

Microsoft Academic Search

Circumferential cervical decompression and fusion (CCDF) is an important technique for treating patients with severe cervical\\u000a myelopathy. While circumferential cervical decompression and fusion may provide improved spinal cord decompression and stability\\u000a compared to unilateral techniques, it is commonly associated with increased morbidity and mortality. We performed a retrospective\\u000a analysis of patients undergoing CCDF at the University of California, San Francisco

Henry E. Aryan; Rene O. Sanchez-Mejia; Sharona Ben-Haim; Christopher P. Ames

2007-01-01

67

Metrizamide CT myelography in cervical myelopathy and radiculopathy: correlation with conventional myelography and surgical findings  

SciTech Connect

Conventional myelography, metrizamide computed tomographic (CT) myelography, and surgical findings were correlated in 30 patients with cervical radiculopathy and/or myelopathy. In 60% of patients, metrizamide CT myelography provided significant additional information including better characterization of the abnormality, lateralization if the conventional myelogram was indeterminate, more definitive demonstration of cord atrophy, foraminal narrowing not appreciated on myelography, and demonstration of abnormalities distal to a myelographic block. In no case was a myelographic abnormality not detected on metrizamide CT meyelography. In patients with cervical myelopathy, a cross-sectional diameter of the cord equaling less than 50% of the subarachnoid space is predictive of poor patient response to surgical intervention.

Badami, J.P.; Norman, D.; Barbaro, N.M.; Cann, C.E.; Weinstein, P.R.; Sobel, D.F.

1985-04-01

68

The natural history of asymptomatic lumbar canal stenosis in patients undergoing surgery for cervical myelopathy.  

PubMed

We retrospectively examined the prevalence and natural history of asymptomatic lumbar canal stenosis in patients treated surgically for cervical compressive myelopathy in order to assess the influence of latent lumbar canal stenosis on the recovery after surgery. Of 214 patients who had undergone cervical laminoplasty for cervical myelopathy, we identified 69 (32%) with myelographically documented lumbar canal stenosis. Of these, 28 (13%) patients with symptomatic lumbar canal stenosis underwent simultaneous cervical and lumbar decompression. Of the remaining 41 (19%) patients with asymptomatic lumbar canal stenosis who underwent only cervical surgery, 39 were followed up for ? 1 year (mean 4.9 years (1 to 12)) and were included in the analysis (study group). Patients without myelographic evidence of lumbar canal stenosis, who had been followed up for ? 1 year after the cervical surgery, served as controls (135 patients; mean follow-up period 6.5 years (1 to 17)). Among the 39 patients with asymptomatic lumbar canal stenosis, seven had lumbar-related leg symptoms after the cervical surgery. Kaplan-Meier analysis showed that 89.6% (95% confidence interval (CI) 75.3 to 96.0) and 76.7% (95% CI 53.7 to 90.3) of the patients with asymptomatic lumbar canal stenosis were free from leg symptoms for three and five years, respectively. There were no significant differences between the study and control groups in the recovery rate measured by the Japanese Orthopaedic Association score or improvement in the Nurick score at one year after surgery or at the final follow-up. These results suggest that latent lumbar canal stenosis does not influence recovery following surgery for cervical myelopathy; moreover, prophylactic lumbar decompression does not appear to be warranted as a routine procedure for coexistent asymptomatic lumbar canal stenosis in patients with cervical myelopathy, when planning cervical surgery. PMID:22371547

Tsutsumimoto, T; Shimogata, M; Yui, M; Ohta, H; Misawa, H

2012-03-01

69

Cervical Cord Compressive Myelopathy in a Man With a Primary Complaint of Knee Pain  

PubMed Central

Background: Diagnosing patients with cervical cord compressive myelopathy in a timely manner can be challenging due to varying clinical presentations, the absence of pathognomonic findings, and symptoms that are usually insidious in nature. Objective: To describe the clinical course of a patient with primary complaint of left medial knee pain that was nonresponsive to surgical and conservative measures; the patient was subsequently diagnosed with cervical cord compressive myelopathy. Design: Case report. Subject: A 63-year-old man with a primary complaint of left medial knee pain. Findings: Physical examination of the left knee was normal except for slight palpable tenderness over the medial joint line. During treatment, he noted loss of balance during activities of daily living. Reassessment revealed bilateral upper extremity hyperreflexia, bilateral Babinski reflex, and positive bilateral Hoffman reflex. Magnetic resonance imaging of the cervical spine demonstrated moderately severe spinal stenosis at the C3-C4, C5-C6, and C6-C7 levels. After C3-C7 laminoplasty for cervical cord compressive myelopathy, he reported substantial improvement of his left medial knee. Three years later, he had no complaint of knee pain. Conclusion: Appropriate diagnosis and treatment of cervical cord compressive myelopathy may avoid unnecessary diagnostic imaging, medical evaluations, invasive procedures, and potential neurologic complications.

Ross, Michael D; Elliott, Ryan

2010-01-01

70

Long Term Results of Anterior Corpectomy and Fusion for Cervical Spondylotic Myelopathy  

Microsoft Academic Search

BackgroundResults showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate

Rui Gao; Lili Yang; Huajiang Chen; Yang Liu; Lei Liang; Wen Yuan

2012-01-01

71

Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese  

Microsoft Academic Search

OBJECTIVES: To investigate clinical effects and manual operational point of Bryan cervical disc prosthesis in Chinese, to observe the stability and range of movement (ROM) post-operatively. METHODS AND MATERIALS: From 2003,12 to 2005,12, Bryan disc prosthesis replacement applied in 83 cases (102 levels) of cervical spondylotic myelopathy (CSM) after anterior decompression in our hospital. Clinical (JOA grade and Odom's scale)

Yan Wang; Xuesong Zhang; Songhua Xiao; Ning Lu; Zheng Wang; Mi Zhou

2006-01-01

72

Predictors of outcome of surgery for cervical compressive myelopathy: retrospective analysis and prospective study.  

PubMed

The outcomes of surgical treatment in 80 patients with cervical compressive myelopathy were retrospectively reviewed to examined the correlations between surgical outcomes and the following seven predictive factors: age at surgery, duration of symptoms, severity of myelopathy, number of compressed segments, intramedullary high intensity segments on T(2)-weighted magnetic resonance (MR) imaging, surgical method, and the type of disease. The recovery rates were evaluated at 3 months after the surgery. Significant correlations were observed between recovery rate and duration of symptoms, severity of myelopathy, and high intensity segments on T(2)-weighted MR imaging. No statistical correlation was observed with the other factors. Multivariate analysis revealed significant correlations between recovery rate and duration of symptoms and number of high intensity segments on T(2)-weighted MR imaging. The multiple regression equation was expressed as follows: recovery rate = 82.981 + 0.101 x (age) - 0.675 x (duration) - 1.452 x (number of compressed segments) - 1.451 x (preoperative Neurosurgical Cervical Spine Scale) - 13.826 x (number of high intensity segments). Based on this predicted formula, we compared the predicted and actual recovery rates for 17 patients treated recently. The two values were similar except in two patients with long duration of symptoms. We conclude that the surgical outcome can be predicted to a certain extent and this information could be provided to patients considering surgery for cervical compressive myelopathy. PMID:16723815

Park, Young-Su; Nakase, Hiroyuki; Kawaguchi, Shoichiro; Sakaki, Toshisuke; Nikaido, Yuji; Morimoto, Tetsuya

2006-05-01

73

Gait analysis of spastic walking in patients with cervical compressive myelopathy.  

PubMed

To assess neurological status and to evaluate the effect of surgical decompression in patients with cervical myelopathy, we performed computerized gait analysis in 24 patients with cervical compressive myelopathy who showed spastic walking. Gait analysis was repeated during neurological follow-up that averaged 32.4 months. The gait pattern in patients with severe myelopathy was characterized by hyperextension of the knee in the stance phase without plantar flexion of the ankle in the swing phase, significantly reduced walking speed and step length, prolonged stance phase duration and decreased single-stance phase duration, and increased step width. The angle of flexion of the knee joint in the stance phase was significantly correlated with the Japanese Orthopaedic Association (JOA) score. Postoperative neurological improvement was associated with increased walking speed and decreased extension angle of the knee joint (single-stance phase and swing phase). Postoperatively, 12 patients had normalized extension of the knee in stance phase and their walking speed, cadence, stance phase duration, and single-stance phase duration, as well as step length and width, showed nonsignificant differences from these parameters in healthy controls. Our results show that kinesiological gait analysis is clinically useful for the functional assessment of the severity of spastic walking in cervical myelopathy. PMID:11845345

Maezawa, Y; Uchida, K; Baba, H

2001-01-01

74

Cervical myelopathy in athetoid and dystonic cerebral palsy: retrospective study and literature review  

PubMed Central

The early onset of degenerative cervical lesions has been well described in patients suffering from athetoid or dystonic cerebral palsy. Myelopathy can occur and aggravate of their unstable neurological status. Diagnosis and treatment are delayed and disrupted by the abnormal movements. This retrospective study was implemented to evaluate the symptoms, the anatomical findings, and the surgical management of seven patients from 20 to 56 years old suffering from cervical myelopathy and athetoid or dystonic cerebral palsy. The mean delay in diagnosis was 15 months and the mean follow-up was 33 months. The initial symptoms were spasticity, limbs weakness, paresthesias and vesico-sphinteric dysfunction. In addition to abnormal movements, imaging demonstrated disc herniation, spinal stenosis and instability. All patients were managed surgically by performing simultaneous spinal cord decompression and fusion. Two patients benefited from preoperative botulinum toxin injections, which facilitated postoperative care and immobilization. Strict postoperative immobilization was achieved for 3 months by a Philadelphia collar or a cervico-thoracic orthosis. All patients improved functionally with a mean Japanese Orthopaedic Association score gain of 1.5 points, in spite of the permanent disabilities of the myelopathy. Complications occurred with wound infection, metal failure and relapse of cervical myelopathy at an adjacent level in one case each. All the previous authors advised against isolated laminectomy but no consensus emerged from the literature analysis. Spinal fusion is usually recommended but can be complicated by degenerative adjacent deterioration. Surgical management provides good outcomes but requires a long-term follow-up.

Rech, Celia; Garreau de Loubresse, Christian

2010-01-01

75

Cervical disc arthroplasty for the treatment of spondylotic myelopathy and radiculopathy.  

PubMed

The concept of cervical disc arthroplasty (CDA) for the anterior treatment of cervical pathology has existed for approximately half a decade. In this time, multiple devices have been developed for this purpose, with the ultimate aim to provide an alternative to fusion. Fifty-five patients with cervical spondylotic radiculopathy and myelopathy underwent CDA over a 5year period. Data was collected on 46 patients, which included Visual Analogue Scale scores for neck pain and arm pain, Neck Disability Index scores, Short Form-36 v2 (SF-36) and Nurick grades for myelopathy patients. Preoperative data and data obtained at the latest clinical follow-up (median 48months, range, 10-76months) were analysed to assess the intermediate term efficacy of the procedure. In patients with radiculopathy, arm pain improved by 88% (p<0.001). In those presenting with myelopathy, the Nurick grades improved from a median of 1 to 0 (p<0.001). In both groups of patients, improvements in pain and neurologic deficit were accompanied by significant improvements in multiple domains of the SF-36. Using a composite system which considered neck pain, arm pain, function and myelopathy, we arrived at an overall success rate of 73%. We concluded that CDA is an effective intervention for improving neurologic deficit, arm pain and local neck symptoms that translated into improvements in physical and social functioning in the intermediate term. PMID:23871454

Khong, Peter; Bogduk, Nikolai; Ghahreman, Ali; Davies, Mark

2013-07-17

76

Anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate for cervical spondylotic myelopathy in elderly osteoporosis patients  

Microsoft Academic Search

Objective  This retrospective study was to evaluate the relationship between osteoporosis and dynamic cervical plates in screw–plate\\u000a or screw–bone interface of elderly cervical spondylotic myelopathy (CSM) patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Retrospective study was conducted on elderly CSM patients, treated by anterior corpectomy and reconstruction with titanium\\u000a mesh cages (TMC) and dynamic cervical plate between July 2004 and June 2007. All patients underwent bone mineral

Denglu Yan; Zhaojie Wang; Shaojie Deng; Jian Li; Chenglong Soo

77

Imaging of spinal stenosis: neurogenic intermittent claudication and cervical spondylotic myelopathy.  

PubMed

Spinal stenosis in either the cervical or lumbar spinal segments is one of the most common indications for spine imaging and intervention, particularly among the elderly. This article examines the pathophysiology and imaging of the corresponding clinical syndromes, cervical spondylotic myelopathy or neurogenic intermittent claudication. The specificity fault of spine imaging is readily evident in evaluation of spinal stenosis, as many patients with anatomic cervical or lumbar central canal narrowing are asymptomatic. Imaging also may be insensitive to dynamic lesions. Those imaging features that identify symptomatic patients, or predict response to interventions, are emphasized. PMID:22643390

Maus, Timothy P

2012-07-01

78

Risk factors for development of cervical spondylotic myelopathy: results of a systematic review  

PubMed Central

Study design:?Systematic review. Study rationale:?Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction that may be asymptomatic or may present with severe symptoms. Since CSM has an insidious manifestation, identification of risk factors associated with this condition may aid clinicians in monitoring high-risk patients and implementing appropriate management strategies. Objective:?To assess sociodemographic, clinical, radiographic, and genetic risk factors associated with presence of CSM in patients 18 years or older. Methods:?A systematic review of the literature was performed using PubMed, the National Guideline Clearinghouse Databases, and bibliographies of key articles to assess risk factors associated with CSM. Articles were reviewed by two independent reviewers based on predetermined inclusion and exclusion criteria. Each article was evaluated using a predefined quality-rating scheme. Results:?From 486 citations, eight articles met all inclusion and exclusion criteria. Larger vertebral body and smaller spinal canal and Torg/Pavlov ratio were associated with CSM diagnosis, while gender was not associated with a CSM diagnosis across multiple studies. There were inconsistent reports with respect to increased age as a risk factor for CSM diagnosis. Conclusion:?The limited data available suggests that inherent anatomical features that may contribute to congenital cervical stenosis may be associated with CSM. This systematic review is limited by the small number of high-quality studies evaluating prognostic factors for CSM. The overall strength of evidence for all risk factors evaluated is low.

Singh, Anoushka; Tetreault, Lindsay; Fehlings, Michael G.; Fischer, Dena J.; Skelly, Andrea C.

2012-01-01

79

Cervical Pedicle Screw Fixation Combined with Laminoplasty for Cervical Spondylotic Myelopathy with Instability  

PubMed Central

Study Design A retrospective study. Purpose To evaluate the surgical results of cervical pedicle screw (CPS) fixation combined with laminoplasty for treating cervical spondylotic myelopathy (CSM) with instability. Overview of Literature Cervical fixation and spinal cord decompression are required for CSM patients with instability. However, only a few studies have reported on CPS fixation combined with posterior decompression for unstable CSM patients. Methods Thirteen patients that underwent CPS fixation combined with laminoplasty for CSM with instability were evaluated in this study. We assessed the clinical and radiological results of the surgical procedures. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the clinical results. The percentages of sli p, difference in sli p angle between maximum flexion and maximum extension of unstable intervertebrae, and perforation rate of CPS were evaluated. Results The mean JOA scores before surgery, immediately after surgery, and at final follow-up were 9.1, 13.3, and 12.6, respectively. The mean percentages of sli p before surgery, immediately after surgery, and at final follow-up were 9.1%, 3.2%, and 3.5%, respectively; there were significant improvements immediately after surgery and at final follow-up. The difference in sli p angle between the maximum flexion and maximum extension of the unstable intervertebrae changed from 9.0° before surgery to 1.6° at the final follow-up. The perforation rate of CPS was 10.9%. Conclusions The results suggest that CPS fixation combined with laminoplasty is an effective surgical procedure for treating CSM with instability.

Uehara, Masashi; Ogihara, Nobuhide; Hirabayashi, Hiroki; Hashidate, Hiroyuki; Mukaiyama, Keijiro; Shimizu, Masayuki; Kato, Hiroyuki

2012-01-01

80

Anterior versus posterior surgery for multilevel cervical myelopathy, which one is better? A systematic review  

Microsoft Academic Search

The objective of the study is to perform a systematic review to compare the clinical outcomes and complications of anterior\\u000a surgery with posterior surgery for multilevel cervical myelopathy (MCM). MEDLINE, EMBASE databases and other databases were\\u000a searched for all the relevant original articles published from January 1991 to November 2009 comparing anterior with posterior\\u000a surgery for MCM. Subgroup analysis was

Tao Liu; Wen Xu; Tao Cheng; Hui-Lin Yang

2011-01-01

81

Cervical myelopathy in athetoid and dystonic cerebral palsy: retrospective study and literature review  

Microsoft Academic Search

The early onset of degenerative cervical lesions has been well described in patients suffering from athetoid or dystonic cerebral\\u000a palsy. Myelopathy can occur and aggravate of their unstable neurological status. Diagnosis and treatment are delayed and disrupted\\u000a by the abnormal movements. This retrospective study was implemented to evaluate the symptoms, the anatomical findings, and\\u000a the surgical management of seven patients

Raphael Jameson; Celia Rech; Christian Garreau de Loubresse

2010-01-01

82

Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients  

Microsoft Academic Search

The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical\\u000a spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There\\u000a are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients (>65 years old) who eventually\\u000a had surgical treatment for

Hideki Shigematsu

2010-01-01

83

Static versus dynamic factors for the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament  

Microsoft Academic Search

We studied 27 patients with cervical ossification of the posterior longitudinal ligament (OPLL) but no clinical symptoms of myelopathy. We investigated the occupation ratio of the spinal canal by OPLL with cervical radiographs, assessed the morphological types of OPLL, and measured the segmental range of motion (ROM) at the level of maximum cord compression on flexion and extension radiographs. Patients

Takayuki Fujiyoshi; Masashi Yamazaki; Akihiko Okawa; Junko Kawabe; Koichi Hayashi; Tomonori Endo; Takeo Furuya; Masao Koda; Kazuhisa Takahashi

2010-01-01

84

Clinical long-term results of anterior discectomy without fusion for treatment of cervical radiculopathy and myelopathy  

Microsoft Academic Search

Summary Between 1976 and 1983, 251 patients underwent surgery for the treatment of cervical degenerative disc disease. Anterior microsurgical discectomy at one or more cervical segments without interbody fusion was performed in each case. 109 patients with radiculopathy and 55 patients with myelopathy were followed up clinically 1 to 8 years postoperatively. A soft disc lesion was found in 72,

H. Bertalanffy; H.-R. Eggert

1988-01-01

85

Tandem spinal stenosis: a case of stenotic cauda equina syndrome following cervical decompression and fusion for spondylotic cervical myelopathy  

PubMed Central

Tandem spinal stenosis is a clinical phenomenon which may cause a functional loss related to neurologic compression in numerous areas of the spinal cord. In this phenomenon, the second area of symptomatic neurologic insult is not revealed until the primary symptomatic area has been treated. This case describes a 71-year-old male referred to physical therapy 4 weeks following a combined anterior/posterior C3/4 decompression and fusion for treatment of cervical spondylotic myelopathy. Approximately 8 weeks post-operatively (4 weeks after initiation of physical therapy), the patient began to complain of bilateral lower extremity weakness, primarily with climbing stairs. At 12 weeks post-operatively, the patient developed bowel incontinence and saddle paresthesia. Magnetic resonance imaging revealed multiple levels of critical stenosis of the lower thoracic and upper lumbar spine, which resulted in referral for surgical intervention. Following surgical decompression there was complete recovery of lower extremity strength, saddle area sensation and bowel function. This case highlights the need for the clinician to remain vigilant for concomitant pathology despite successful surgical intervention. A thorough knowledge of the presentation of various spinal disorders, as well as a thorough neurologic examination, is required to accurately recognize both candid and subtle red flags requiring immediate referral for surgical intervention.

Swanson, Brian T

2012-01-01

86

Tandem spinal stenosis: a case of stenotic cauda equina syndrome following cervical decompression and fusion for spondylotic cervical myelopathy.  

PubMed

Tandem spinal stenosis is a clinical phenomenon which may cause a functional loss related to neurologic compression in numerous areas of the spinal cord. In this phenomenon, the second area of symptomatic neurologic insult is not revealed until the primary symptomatic area has been treated. This case describes a 71-year-old male referred to physical therapy 4 weeks following a combined anterior/posterior C3/4 decompression and fusion for treatment of cervical spondylotic myelopathy. Approximately 8 weeks post-operatively (4 weeks after initiation of physical therapy), the patient began to complain of bilateral lower extremity weakness, primarily with climbing stairs. At 12 weeks post-operatively, the patient developed bowel incontinence and saddle paresthesia. Magnetic resonance imaging revealed multiple levels of critical stenosis of the lower thoracic and upper lumbar spine, which resulted in referral for surgical intervention. Following surgical decompression there was complete recovery of lower extremity strength, saddle area sensation and bowel function. This case highlights the need for the clinician to remain vigilant for concomitant pathology despite successful surgical intervention. A thorough knowledge of the presentation of various spinal disorders, as well as a thorough neurologic examination, is required to accurately recognize both candid and subtle red flags requiring immediate referral for surgical intervention. PMID:23372394

Swanson, Brian T

2012-02-01

87

Scheie syndrome: enzyme replacement therapy does not prevent progression of cervical myelopathy due to spinal cord compression.  

PubMed

Hurler-Scheie syndrome is caused by alpha-l-iduronidase deficiency. Enzyme replacement therapy (ERT) can improve physical capacity and reduces organomegaly. However, the effect on bradytrophic connective tissue is limited. As intravenously administered enzyme cannot cross the blood-brain barrier, the therapy of choice for the more severe Hurler syndrome is haematopoietic stem cell transplantation (HCT). In the more attenuated Scheie syndrome, neurological impairment is less severe; therefore, ERT may be appropriate to treat these patients. Information on long-term outcome in Scheie patients undergoing ERT is scarce. We report a 38-year-old female Scheie patient who has been on ERT for 8 years. While non-neurological symptoms improved, she developed paresthesias in her hands and feet and progressive pain in her legs. Somatosensory evoked potentials were abnormal, suggesting dysfunction of the dorsal funiculus and lemniscus medialis. After 6 years of ERT, a spinal MRI showed dural thickening at the upper cervical spine. These soft-tissue deposits are presumably due to the accumulation of mucopolysaccharides. Intramedullary hyperintensities at the level of C1/2 revealed cervical myelopathy. An MRI before the start of ERT had shown milder spinal lesions. Cystic lesions in the white matter of the centrum semiovale due to dilated Virchow-Robin spaces were essentially unchanged compared with the MRI scan before ERT. Decompression of the spinal cord resulted in clinical improvement. In an adult patient with Scheie syndrome, ERT failed to prevent progression of cervical myelopathy. Clinical significance of cerebral changes is unclear. Whether early HCT or intrathecal ERT could have prevented these lesions remains speculative. PMID:19894140

Illsinger, S; Lücke, T; Hartmann, H; Mengel, E; Müller-Forell, W; Donnerstag, F; Das, A M

2009-11-04

88

Fluorotic cervical compressive myelopathy, 20 years after laminectomy: A rare event  

PubMed Central

Background: Spinal cord compression in flourosis is a common complication. These complications are mainly due to compression of the spinal cord by thickening and ossification of posterior longitudinal ligament and ligamentum flavum. Surgical decompression is the treatment of choice for fluorotic spinal cord compression. The recurrence of spinal cord compression after surgical decompression in flourosis is a rare event. Case Description: We are presenting a case of a 63-year-old man who belonged to Kanpur, an endemic fluorosis region in India, with symptoms of cervical cord compression cranial to the operative site, 20 years after laminectomy for cervical fluorotic myelopathy. Urinary and serum fluoride levels were elevated. The patient underwent a skeletal survey: computed tomography and magnetic resonance imaging of the cervical spine showed a postoperative defect of laminectomy, osteosclerosis, osteophyte formation, calcification of the intraosseus membrane in the forearm, thickening and ossification of the posterior longitudinal ligament at C1, thickening and ossification of the residual ligamentum flavum at C1/C2, and dural calcification at the C2 vertebral level and compressive myelopathy. The patient refused surgical decompression and was managed with tizanidine HCl (an antispasticity medicine), a sublingual single night dose, 8 mg for symptomatic relief. Conclusion: The recurrence of spinal cord compression in the fluorotic spine 20 years after laminectomy is a very unusual event and hence the patient should be kept under observation for a long duration. This case report contributes to the literature associated with the management of fluorotic spine.

Kumar, Praveen; Gupta, AK; Sood, Shashank; Verma, Ashok Kumar

2011-01-01

89

Chronic cervical compressive myelopathy in horses: patterns of astrocytosis in the spinal cord.  

PubMed

The distribution and morphology of fibrous astrocytes in the cervical spinal cord of normal horses and horses with chronic compressive myelopathy were demonstrated using immunohistochemical staining for glial fibrillary acidic protein. In the spinal cord from normal horses, astrocytes with stellate cell bodies and short processes were irregularly distributed in grey matter. In the white matter, their cell bodies were small and angular in areas adjacent to grey matter and larger and more stellate-shaped in the subpial area. Astrocyte processes were fine, and evenly distributed in a predominantly radial pattern in transverse sections of cord. Gliosis was marked in the spinal cords of horses with cervical compressive myelopathy. In the grey matter at the level of compression astrocytes were often enlarged and rounded, with short, blunt processes, but the gliosis was generally mild. In the white matter, gliosis was obvious in areas of nerve fibre swelling and degeneration at the level of compression and in areas of ascending and descending Wallerian degeneration. The fine radial pattern of astrocyte fibres was replaced by a dense, irregular arrangement. Gliosis persisted in the cords of chronically affected horses after active nerve fibre degeneration had subsided. The areas of gliosis coincided with the areas of Marchi staining for degenerating myelin and with areas of myelin loss in osmium tetroxide post-fixed tissue. Histological observations were consistent with astrocytes replacing areas of extracellular space that remained after nerve fibre degeneration. it is concluded that astrocytic gliosis is a prominent and persistent alteration of the spinal cord of horses with chronic cervical compressive myelopathy. PMID:1755785

Yovich, J V; Gould, D H; LeCouteur, R A

1991-10-01

90

Evaluation of conservative treatment and timing of surgical intervention for mild forms of cervical spondylotic myelopathy  

PubMed Central

The optimal management approach for patients with mild forms of cervical spondylotic myelopathy (MCSM) has not been well established. The aim of the present study was to investigate the outcome of conservative treatment, identify prognostic factors and provide evidence for the timing of surgical intervention. A total of 90 patients with MCSM attending hospital between February 2007 and January 2009 were prospectively enrolled. Initially, all patients received conservative treatment and were followed up periodically. When a deterioration in myelopathy was clearly identified, surgical treatment was conducted. Clinical and radiological factors correlating with the deterioration were examined, and final clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score. At the end of January 2012, follow-ups of >3 years were completed. Seventy-eight patients were available for data analysis. Only 21 patients (26.9%) deteriorated and underwent surgery thereafter (group A), while the remaining 57 patients (73.1%) were treated conservatively throughout (group B). Statistical analysis revealed that segmental instability and cervical spinal stenosis were adverse factors for the prognosis of conservative treatment. Although the JOA scores of the patients in group A declined initially, following surgical intervention, no significant differences were identified in JOA scores between the two groups at the time of the final follow-up (P=0.46). In summary, conservative treatment is effective in MCSM patients. Patients with segmental instability and cervical spinal stenosis have a tendency to deteriorate, but conservative treatment remains the recommendation for the first action. If the myelopathy deteriorates during conservative treatment, timely surgical intervention is effective.

KONG, LING-DE; MENG, LING-CHEN; WANG, LIN-FENG; SHEN, YONG; WANG, PAN; SHANG, ZI-KUN

2013-01-01

91

Comparative study of anterior versus posterior decompression in elderly patients of cervical myelopathy with co-morbid conditions  

Microsoft Academic Search

Study design  Prospective.\\u000a \\u000a \\u000a \\u000a Objective  To assess the results of laminectomy in patients suffering from multilevel multidirectional compressive cervical myelopathy\\u000a with co-morbid conditions and to compare results of anterior and laminectomy clinically, radiologically and functionally.\\u000a \\u000a \\u000a \\u000a Summary of background data  Cervical myelopathy or myeloradiculopathy is a progressive degenerative disorder that usually starts in the middle age. It\\u000a leads to circumferential cord compression leading to a

Sudeep Jain; Saurabh Singh; Anil Kumar Joshi; Chirayu Pamecha; Bharat Dave; Pankaj Patel

2009-01-01

92

Decompressive laminoplasty in multisegmental cervical spondylotic myelopathy: bilateral cutting versus open-door technique  

Microsoft Academic Search

Purpose  The aim of the study was to evaluate patients with multisegmental cervical spondylotic myelopathy (MCM) surgically treated\\u000a via a dorsal approach. Two different laminoplasty techniques were compared by assessment of enlargement of the spinal canal\\u000a and the neurological outcome.\\u000a \\u000a \\u000a \\u000a Methods  Thirteen patients (mean age 49 years, 11 males) underwent decompressive laminoplasty over a 7-year period. The average duration\\u000a of symptoms was 21 months.

Siamak Asgari; Hischam Bassiouni; Nagi Massoud; Marc Schlamann; Dietmar Stolke; I. Erol Sandalcioglu

2009-01-01

93

[Clinical studies on the significance of en bloc laminoplasty for cervical compressive myelopathy].  

PubMed

The aim of this study was clinical evaluation of en bloc laminoplasty for compressive myelopathy. Subjects were 55 patients with severe myelopathy due to ossification of posterior longitudinal ligament or spinal canal stenosis in the cervical spine. The average age at surgery was 58 years old and average follow-up period 25 months. Stable expansion of the spinal canal was shown and the average extent of the canal enlargement in sagittal diameter was 4.8 +/- 1.8 mm roentgenologically. Symmetrical expansion of the canal, good bony fusion and remodelling of the posterior elements of the spine were observed in CT. No marked malalignment or instability of the cervical spine were found, but limitation of flexion-extension movement was noticed. Neurological recovery was remarkable; 44 patients were rated as excellent or good by Robinson's criteria. The average recovery rate was 76.4 +/- 20.1% according to the evaluation system of Japanese Orthopaedic Association (JOA). En-bloc laminoplasty can accomplish a stable expansion of the canal with adequate decompression of the spinal cord. PMID:3819538

Itoh, T

1986-11-01

94

Computed tomography in cervical spondylotic myelopathy and radiculopathy: visualisation of structures, myelographic comparison, cord measurements and clinical utility  

Microsoft Academic Search

Sixty-nine patients with cervical spondylotic myelopathy (CSM), radiculopathy (CSR), or both (CSMR) were studied with computed tomography (CT). Computer-assisted myelography (CAM) accurately determines the site and nature of spondylotic protrusions and provides good visualisation of the subarachnoid space and cord deformities even in areas with dilute metrizamide. However, excessive vertebral movement and bulging ligamenta flava with their effects on cord

Y. L. Yu; G. H. Boulay; J. M. Stevens; B. E. Kendall

1986-01-01

95

MRI findings in Hirayama’s disease: flexion-induced cervical myelopathy or intrinsic motor neuron disease?  

Microsoft Academic Search

Hirayama’s disease is a benign juvenile form of focal amyotrophy affecting the upper limbs. Previous studies have suggested\\u000a that the disorder is a neck flexion induced cervical myelopathy. We report clinical and magnetic resonance imaging findings\\u000a in nine patients with Hirayama’s disease. Cervical imaging of seven patients revealed spinal cord changes consisting of focal\\u000a atrophy and foci of signal alterations.

Rolf Schröder; Ewald Keller; Sebastian Flacke; Stephan Schmidt; Christoph Pohl; Thomas Klockgether; Uwe Schlegel

1999-01-01

96

Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients  

PubMed Central

The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients (>65 years old) who eventually had surgical treatment for CSM were evaluated. A slippage displacement of more than 2.5 mm at least at one level was classified to have a positive DS on flexion/extension radiographs (DS group). A slippage displacement less than 1.0 mm was considered a negative DS (non-DS group). Seventeen patients who had slippage of 1.0–2.5 mm were excluded from the study. The DS group (n = 15) included cases with DS at preoperation, while the remaining cases (n = 17) belonged to the non-DS group. The flexion/extension radiographs of the two groups were compared for range of motion and clinical results at 3 years after the operation. Of all elderly patients, 30.6% had DS. There was no significant difference between the two groups based on the clinical results. The range of motion of all cervical spines (DS group and non-DS group) was significantly limited. However, there was no significant difference between the two groups. New postoperative DS appeared in four patients, of which two were from the DS group and two from the non-DS group. These data suggest that degenerative spondylolisthesis does not influence surgical results in elderly cervical spondylotic myelopathy patients.

2010-01-01

97

Long Term Results of Anterior Corpectomy and Fusion for Cervical Spondylotic Myelopathy  

PubMed Central

Background Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD). Methods This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA) scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. Findings Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA) and the sagittal alignment of the whole cervical spine (SACS) increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8±1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ?9 were important predictors of the fair recovery rate (?50%). Repeated surgery due to ASD was performed in 7 (4.8%) cases. Conclusions ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory.

Chen, Huajiang; Liu, Yang; Liang, Lei; Yuan, Wen

2012-01-01

98

Cervical Myelopathy Secondary to Atlas Hypoplasia - Reports of 3 Adult Cases -  

PubMed Central

There have been paucity of reports on atlas hypoplasia, and as a result this condition is not clearly defined, nor well understood. The authors reported three cases of atlas hypoplasia that were found in adults who presented with myelopathic symptoms. On radiographic examination, it was found that the anterior-posterior diameter of the atlas was remarkably narrower in all three cases in comparison with normal persons. The MRI in all three cases also revealed intramedullary high signal lesions at the levels where severe spinal cord compression was present. This led to our diagnosis of atlas hypoplasia causing myelopathy.

Cho, Woo-Jin; Park, Jong-Beom; Moon, Myung-Sang; Chae, Jong-Woo; Ryu, Jong-Seon; Kang, Hyun-Suk

2007-01-01

99

Tumor necrosis factor-?, interleukin-1?, and interleukin-6 in the cerebrospinal fluid of patients with cervical myelopathy and lumbar radiculopathy  

Microsoft Academic Search

There have been few reports describing cytokines in the cerebrospinal fluid (CSF) of patients with spinal degenerative disorders.\\u000a This study investigated whether interleukin-1? (IL-1?), interleukin-6 (IL-6), and tumor necrosis factor-? (TNF-?) could be\\u000a detected in CSF of patients with cervical myelopathy or lumbar radiculopathy and whether the concentrations of those cytokines\\u000a correlated with the severity of disease conditions. CSF samples

Hideki Nagashima; Yasuo Morio; Koji Yamane; Yoshiro Nanjo; Ryota Teshima

2009-01-01

100

Effectiveness of multiple-level decompression in laminoplasty and simultaneous C1 laminectomy for patients with cervical myelopathy  

Microsoft Academic Search

A retrospective study to investigate the relationship between the surgical levels and decompression effects was performed in patients with cervical myelopathy who had undergone Tension-band laminoplasty (TBL) with\\/without simultaneous C1 laminectomy. One hundred and sixty-eight patients (115 males, 53 females; age: 31–80 years, average 58.9 years; follow-up period: 12–120 months, average 20 months) were divided into three groups according to the range of the

Junwei Zhang; Shigeru Hirabayashi; Kunio Saiki; Hiroya Sakai

2006-01-01

101

Surgical approach to cervical spondylotic myelopathy on the basis of radiological patterns of compression: prospective analysis of 129 cases  

Microsoft Academic Search

This is a prospective analysis of 129 patients operated for cervical spondylotic myelopathy (CSM). Paucity of prospective\\u000a data on surgical management of CSM, especially multilevel CSM (MCM), makes surgical decision making difficult. The objectives\\u000a of the study were (1) to identify radiological patterns of cord compression (POC), and (2) to propose a surgical protocol\\u000a based on POC and determine its

Mihir R. Bapat; Kshitij Chaudhary; Amit Sharma; Vinod Laheri

2008-01-01

102

Cervical spondylotic myelopathy with vitamin B12 deficiency: Two case reports  

PubMed Central

Although it has been observed that a vitamin B12 (VB12) deficiency may lead to defects in the nervous system, there is a lack of studies elucidating whether VB12 has a role in the pathogenesis of cervical spondylotic myelopathy (CSM). The present study describes two cases of CSM observed in the clinic, where the patients presented with common characteristics of the typical clinical symptoms; however, T2-weighted magnetic resonance imaging examinations revealed that although the degree of spinal cord compression was not serious, the spinal cord exhibited significant high signal changes. At the same time, the serum VB12 levels of the two patients were lower compared with those of normal controls. The symptoms of the patients improved following anterior cervical decompression surgery and VB12 replacement therapy. The incidence of CSM in the two patients may have been correlated with a lack of VB12. Therefore, it is recommended that the serum VB12 levels are checked in cases of CSM where the standard imaging and clinical manifestations do not fully match.

XU, YAO; CHEN, WENJUN; JIANG, JIANYUAN

2013-01-01

103

Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese  

PubMed Central

Objectives To investigate clinical effects and manual operational point of Bryan cervical disc prosthesis in Chinese, to observe the stability and range of movement (ROM) post-operatively. Methods and materials From 2003,12 to 2005,12, Bryan disc prosthesis replacement applied in 83 cases (102 levels) of cervical spondylotic myelopathy (CSM) after anterior decompression in our hospital. Clinical (JOA grade and Odom's scale) and radiological (X-ray of flexion, extension; left and right bending position) follow-up was performed. Systemic radiographic study about stability and ROM of replaced level post operationally were measured. CT or MRI scans were applied in all cases to evaluate the signs of the prosthesis deflexion and hetero-ossification in the replaced levels. Results At least 12 months follow-up were done in 65/83 of these paients. All of 83 patients were improved according to Odsm's scale. JOA score increased from average 8.7 to 15.5. There was no prosthesis subsidence. Replaced segment achieved stability and restored partial of normal ROM 4.73°(3.7°–5.9°) early postoperation and 8.12°(5.8°–13.6°) more than 12 months postoperation in flex and extension position. No obvious loss of lordosis was found. CT or MRI follow-up shows position deflexion of the prosthesis metal endplates (<1.5 mm) in 14/77 levels and (1.5~3 mm) in 4/77. heter-ossification was found in the replaced levels only in 2 cases. Conclusion Byran cervical disc prosthesis restored motion to the level of the intact segment in flexion-extension and lateral bending in post-operative images. At the same time, it can achieve good anterior decompression treatment effect and immediate stability in replaced 1 or 2 levels, and which is a new choice for the treatment of CSM.

Wang, Yan; Zhang, Xuesong; Xiao, Songhua; Lu, Ning; Wang, Zheng; Zhou, Mi

2006-01-01

104

Chronic cervical compressive myelopathy in horses: clinical correlations with spinal cord alterations.  

PubMed

Histological examination was performed on the cervical spinal cord from 13 horses with chronic cervical compressive myelopathy of 4 to 29 months duration. Structural alterations were correlated with clinical features. At the level of compression, the spinal cord was grossly deformed. Histological alterations included nerve fibre swelling and degeneration, occasional spheroids, astrocytic gliosis, increased macrophage activity and increased perivascular collagen. Myelin degeneration or loss at the level of the compressive lesion was greatest in the ventral and lateral funiculi and less consistently present in the dorsal funiculi. Asymmetry of lesions in the dorsal funiculi was associated with asymmetry of clinical signs in 5 horses. Histological alterations in areas of Wallerian degeneration were similar to that at the level of spinal cord compression, except that perivascular collagen was not increased. Wallerian degeneration was present cranial to the compressed site in the superficial portions of the lateral funiculi and in the middle of the dorsal funiculi. Caudal to the compressed site it was present in the ventral funiculi adjacent to the ventral median fissure and in the middle of the lateral funiculi. Deformation of the spinal cord did not correlate with the severity or duration of clinical signs but was positively correlated with the amount of perivascular collagen increase. The amount of nerve fibre swelling was not correlated with the severity of clinical signs but was negatively correlated with their duration. A rapid loss of nerve fibres apparently occurred early in the course of compression, since there was a marked decrease in the amount of nerve fibre swelling and Marchi stained degenerating myelin with increasing clinical duration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1755784

Yovich, J V; leCouteur, R A; Gould, D H

1991-10-01

105

Measuring Surgical Outcomes in Cervical Spondylotic Myelopathy Patients Undergoing Anterior Cervical Discectomy and Fusion: Assessment of Minimum Clinically Important Difference  

PubMed Central

Object The concept of minimum clinically important difference (MCID) has been used to measure the threshold by which the effect of a specific treatment can be considered clinically meaningful. MCID has previously been studied in surgical patients, however few studies have assessed its role in spinal surgery. The goal of this study was to assess the role of MCID in patients undergoing anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). Methods Data was collected on 30 patients who underwent ACDF for CSM between 2007 and 2012. Preoperative and 1-year postoperative Neck Disability Index (NDI), Visual-Analog Scale (VAS), and Short Form-36 (SF-36) Physical (PCS) and Mental (MCS) Component Summary PRO scores were collected. Five distribution- and anchor-based approaches were used to calculate MCID threshold values average change, change difference, receiver operating characteristic curve (ROC), minimum detectable change (MDC) and standard error of measurement (SEM). The Health Transition Item of the SF-36 (HTI) was used as an external anchor. Results Patients had a significant improvement in all mean physical PRO scores postoperatively (p<0.01) NDI (29.24 to 14.82), VAS (5.06 to 1.72), and PCS (36.98 to 44.22). The five MCID approaches yielded a range of values for each PRO: 2.00–8.78 for PCS, 2.06–5.73 for MCS, 4.83–13.39 for NDI, and 0.36–3.11 for VAS. PCS was the most representative PRO measure, presenting the greatest area under the ROC curve (0.94). MDC values were not affected by the choice of anchor and their threshold of improvement was statistically greater than the chance of error from unimproved patients. Conclusion SF-36 PCS was the most representative PRO measure. MDC appears to be the most appropriate MCID method. When MDC was applied together with HTI anchor, the MCID thresholds were: 13.39 for NDI, 3.11 for VAS, 5.56 for PCS and 5.73 for MCS.

Auffinger, Brenda M.; Lall, Rishi R.; Dahdaleh, Nader S.; Wong, Albert P.; Lam, Sandi K.; Koski, Tyler; Fessler, Richard G.; Smith, Zachary A.

2013-01-01

106

Ossification of the proximal thoracic ligamenta flava causing acute myelopathy in a Caucasian: case report and literature review  

Microsoft Academic Search

Study design:Case report and literature review.Objective:To illustrate that ossification of the proximal thoracic ligamenta flava can be a rare cause of acute myelopathy in a Caucasian patient and that timely surgery can lead to a good outcome.Setting:Nottingham, UK.Methods:Proximal multiple contiguous ossified thoracic ligamenta flava from T3\\/T4 to T5\\/T6 causing acute myelopathy was diagnosed in a Caucasian man based on history

D P Tokala; K S Lam; H G Prince

2007-01-01

107

Cervical myelopathy due to nuclear herniations in young adults: clinical and radiological profile, results of microdiscectomy without interbody fusion.  

PubMed Central

A study was made of the clinical and radiological characteristics and the results of microsurgical discectomy without interbody fusion, of 26 young adults, who presented with cervical myelopathy due to nuclear herniations. Neck trauma was not a significant aetiological factor. The disease produced moderate to very severe functional disability in most patients (73%), in a relatively short period (mean symptom duration 6.3 months). Radiological assessment revealed the presence of canal stenosis, significant disc protrusions with paucity of spondylotic changes in most patients. At operation, soft disc lesions were found in 85% and sequestrated discs in 31%. Microsurgical discectomy without fusion produced gratifying recovery of functional disability without significant deleterious effects on the cervical spine. Images

Selladurai, B M

1992-01-01

108

Is there any relationship between proinflammatory mediator levels in disc material and myelopathy with cervical disc herniation and spondylosis? A non-randomized, prospective clinical study  

Microsoft Academic Search

The proinflammatory mediator (PIM) levels were assessed in surgically removed samples of herniated cervical intervertebral\\u000a discs. The objective of this study was to investigate if there is a correlation between the levels of PIMs in disc material\\u000a and myelopathy associated with cervical intervertebral disc herniation and spondylosis. The role of proinflammatory mediators\\u000a in the degeneration of intervertebral disc and the

Mehmet Nusret Demircan; Alparslan Asir; Ahmet Cetinkal; Nursal Gedik; Ahmet Murat Kutlay; Ahmet Çolak; Sedat Kurtar; Hakan Simsek

2007-01-01

109

Lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy: A magnetic resonance imaging study  

Microsoft Academic Search

We investigated lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy. Fifty-five patients (32 men and 23 women) were studied, with an average follow-up of 2.4 years. Radiological examination included evaluation of lordosis of the cervical spine and spinal cord, degree of enlargement of bony spinal canal, and the magnitude of posterior

Hisatoshi Baba; Kenzo Uchida; Yasuhisa Maezawa; Nobuaki Furusawa; Miki Azuchi; Shinichi Imura

1996-01-01

110

A new rabbit model for the study on cervical compressive myelopathy.  

PubMed

Development process and pathology of myelopathy due to chronic spinal cord compression have not been fully elucidated. This study was conducted in order to establish an experimental model which can efficiently produce myelopathy and be useful in the studies on myelopathy due to chronic spinal cord compression. Under electrophysiological monitoring of the spinal cord, anterior compression was produced on C5 using a plastic screw. Two weeks later, a plastic plate was inserted under the C5 arch. For the subsequent 10 months on average, walking pattern and MR images were periodically monitored. Before the sacrifice, electrophysiological test was performed and then histopathological examination was done. Palsy appeared at 5 months on average after the addition of posterior compression. Mean compression ratio of the spinal cord calculated on MR images was 34%. All animals with compression showed a high intramedullary signal intensity, and the mean contrast-to-noise ratio (CNR) in the compressed area was 49%. Electrophysiological test showed a significant decrease in the amplitude of spinal cord evoked potentials (SCEPs) at the given compression level. Histology showed flattening of the anterior horn, disappearance and necrosis of anterior horn cells in the gray matter; and demyelination and axonal degeneration in the white matter. The antero-posterior compression produces the condition of spinal canal stenosis. Repeated antero-posterior compression to the spinal cord is important in establishing myelopathy. The present animal model was evaluated to be useful in the studies on myelopathy. PMID:11518269

Kanchiku, T; Taguchi, T; Kaneko, K; Yonemura, H; Kawai, S; Gondo, T

2001-07-01

111

Cervical canal stenosis caused by progressive fusion and enlargement of cervical vertebrae with features of Proteus syndrome and Klippel-Feil syndrome.  

PubMed

We report the case of a female who presented with progressive fusion and an enlargement of the cervical vertebrae. Her cervical deformity gradually progressed with age, and the abnormal bony protrusion into the spinal canal caused myelopathy. We resected the affected vertebrae to decompress the spinal cord and performed combined anterior-posterior spinal fusion. The progression of the spinal deformity and enlargement of vertebrae stopped after surgery. The enlargement of vertebrae in the present case resembled that observed in Proteus syndrome; however, autonomous vertebral fusion has not been reported previously in patients with this condition. Our report may help expand the knowledge on developmental spine disorders. PMID:23760594

Sugita, Shurei; Chikuda, Hirotaka; Ohya, Junichi; Taniguchi, Yuki; Takeshita, Katsushi; Haga, Nobuhiko; Ushiku, Tetsuo; Tanaka, Sakae

2013-06-13

112

Anterior cervical discectomy and fusion for the management of axial neck pain in the absence of radiculopathy or myelopathy  

PubMed Central

Study design:?Systematic review Study rationale:?Anterior cervical discectomy and fusion (ACDF) is a proven, effective treatment for relieving neck pain due to degenerative conditions of the cervical spine. Since most patients also present with radiculopathy or myelopathy, little is known as to the effectiveness of ACDF to relieve pain and improve function in patients without radicular or myelopathic symptoms. Objective:?To examine the clinical outcome in patients undergoing (ACDF) for axial neck pain without radicular or myelopathic symptoms. Methods:?A systematic review was undertaken for articles published up to March 2010. Electronic databases and reference lists of key articles were searched to identify studies evaluating ACDF for the treatment of axial neck pain only. Radiculopathy and myelopathy, patients who suffered severe trauma, or with tumor/metastatic disease or infection were excluded. Two independent reviewers assessed the strength of evidence using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus. Results:?No comparative studies were identified. Three case series met our inclusion criteria and were evaluated. All studies showed a mean improvement of pain of at least 50% approximately 4-years following surgery. Functional outcomes improved between 32% and 52% from baseline. Most patients reported satisfaction with surgery, 56% in one study and 79% in another. Complications varied among studies ranging from 1% to 10% and included pseudoarthrosis (9%), nonunion and revision (3%) and screw removal (1%). Conclusion:?There is low evidence suggesting that patients with axial neck pain without radicular or myelopathic symptoms may receive some improvement in pain and function following ACDF. However, whether this benefit is greater than nontreatment or other treatments cannot be determined with the present literature.

Riew, K Daniel; Ecker, Erika; Dettori, Joseph R.

2010-01-01

113

Laminoplasty and pedicle screw fixation for cervical myelopathy associated with athetoid cerebral palsy: minimum 5-year follow-up.  

PubMed

Study design. Retrospective case series.Objective. To evaluate the outcomes following laminoplasty and posterior spinal fusion utilizing pedicle screws for cervical myelopathy associated with athetoid cerebral palsy.Summary of Background data. A variety of surgical procedures have been reported including decompression without fusion, spinal fusion by anterior, posterior or circumferential approach in this population. However, involuntary neck movements bring risk of postoperative neurological deterioration due to progression of kyphosis, pseudoarthrosis or adjacent segmental degeneration.Methods. A consecutive series of 17 patients who underwent midline T-saw laminoplasty and posterior spinal fusion using pedicle screws were retrospectively reviewed. There were 8 female and 9 male with a mean age at the time of surgery of 52 years. The mean follow-up was 71 months. Radiographic measures were made in change of Cobb angle of sagittal plane from C2 to C7 and accuracy of pedicle screws. Barthel index (BI) which shows independence in activities of daily life and the Japanese Orthopaedic Association (JOA) score were also evaluated.Results. Preoperative Cobb angle of sagittal plane from C2 to C7 measured 11.0 ± 14.5 degrees of kyphosis which improved to 1.5 ± 12.7 degrees postoperatively (p<0.05). Solid posterior bony fusion was achieved in all cases without rigid orthosis such as Halo vest. There were two cases of adjacent segmental instability, which required additional surgery. Nineteen (13%) out of the 138 screws showed deviation from the pedicle with postoperative computed tomography. However, there were no neurovascular complications during or after the surgery in any cases. Postoperative JOA score and BI significantly improved in 32 ± 16%, and 48 ± 26% respectively.Conclusions. laminoplasty and pedicle screw fixation provided strong internal fixation and improved neurological function and activities of daily living for cervical myelopathy associated with athetoid cerebral palsy. PMID:24042720

Demura, Satoru; Murakami, Hideki; Kawahara, Norio; Kato, Satoshi; Yoshioka, Katsuhito; Tsuchiya, Hiroyuki

2013-09-15

114

Anterior versus posterior surgery for multilevel cervical myelopathy, which one is better? A systematic review  

PubMed Central

The objective of the study is to perform a systematic review to compare the clinical outcomes and complications of anterior surgery with posterior surgery for multilevel cervical myelopathy (MCM). MEDLINE, EMBASE databases and other databases were searched for all the relevant original articles published from January 1991 to November 2009 comparing anterior with posterior surgery for MCM. Subgroup analysis was performed according to the follow-up years. The following end points were mainly evaluated: final follow-up JOA (Japanese Orthopaedic Association) scale, recovery rate and complication outcomes. Ten articles fulfilled all inclusion criteria. For multilevel CSM patients, the final follow-up JOA score for the anterior group was significantly higher than the posterior group (p < 0.05, WMD 0.83 [0.24, 1.43]) in the ‘follow-up time ?5 years’ subgroup, but had no significant differences in the ‘follow-up time >5 years’ subgroup (p > 0.05). The recovery rate for the anterior group was significantly higher than the posterior group (p < 0.05, WMD 10.08 [1.39, 18.78]) in the ‘follow-up time ?5 years’ subgroup. No study reported the recovery rate for the follow-up time >5 years. For multilevel OPLL patients, the final follow-up JOA score and recovery rate for the anterior group were both significantly higher than the posterior group in the ‘follow-up time ?5 years’ subgroup (p < 0.05, WMD 2.50 [0.16, 4.85]; p < 0.05, WMD 29.48 [29.09, 29.87], respectively). One study [31] which mean follow-up time was 6 years was enrolled in the ‘follow-up time >5 years’ subgroup. The results showed there was no significant difference in final follow-up JOA score and recovery rate between anterior and posterior group for patients with occupying ratio of OPLL <60% (p > 0.05), while in patients with occupying ratio ?60%, the final follow-up JOA score and recovery rate of anterior surgery were both superior to that of posterior surgery (p < 0.05). For both multilevel CSM and OPLL patients, the complications for the anterior group were significantly more than the posterior group in the ‘follow-up time ?5 years’ subgroup (p < 0.05, OR 7.33 [2.96, 18.20] for CSM patients; p < 0.05, OR 4.44 [1.80, 10.98] for OPLL patients), but were similar to the posterior group in the ‘follow-up time >5 years’ subgroup (p > 0.05). In conclusion, anterior surgery had better clinical outcomes and more complications at the early stage after operation for both multilevel CSM and OPLL patients. At the late stage, posterior surgery had similar clinical outcomes and complications to anterior surgery for CSM patients, and OPLL patients with occupying ratio of OPLL <60%. While for OPLL patients with occupying ratio ?60%, anterior surgery had superior clinical outcome to posterior surgery.

Liu, Tao; Xu, Wen; Cheng, Tao

2010-01-01

115

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?  

Microsoft Academic Search

Some controversy still exists over the optimal treatment time and the surgical approach for cervical myelopathy due to ossification\\u000a of the posterior longitudinal ligament (OPLL). The aim of the current study was first to analyze the effect of intramedullary\\u000a spinal cord changes in signal intensity (hyperintensity on T2-weighted imaging and hypointensity on T1-weighted imaging) on\\u000a magnetic resonance imaging (MRI) on

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

116

The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy  

Microsoft Academic Search

Purpose  We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid\\u000a (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive\\u000a myelopathy (CCM) patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion\\u000a (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was

Yong Eun Cho; Jun Jae Shin; Keun Su Kim; Dong Kyu Chin; Sung Uk Kuh; Ji Hae Lee; Woo Ho Cho

117

A role for motor and somatosensory evoked potentials during anterior cervical discectomy and fusion for patients without myelopathy: Analysis of 57 consecutive cases  

PubMed Central

Background: Although the usage of combined motor and sensory intraoperative monitoring has been shown to improve the surgical outcome of patients with cervical myelopathy, the role of transcranial electric motor evoked potentials (tceMEP) used in conjunction with somatosensory evoked potentials (SSEP) in patients presenting with radiculopathy but without myelopathy has been less clear. Methods: We retrospectively reviewed all patients (n = 57) with radiculopathy but without myelopathy, undergoing anterior cervical decompression and fusion at a single institution over the past 3 years, who had intraoperative monitoring with both tceMEPs and SSEPs. Results: Fifty-seven (100%) patients presented with radiculopathy, 53 (93.0%) with mechanical neck pain, 35 (61.4%) with motor dysfunction, and 29 (50.9%) with sensory deficits. Intraoperatively, 3 (5.3%) patients experienced decreases in SSEP signal amplitudes and 4 (6.9%) had tceMEP signal changes. There were three instances where a change in neuromonitoring signal required intraoperative alteration of the surgical procedure: these were deemed clinically significant events/true positives. SSEP monitoring showed two false positives and two false negatives, whereas tceMEP monitoring only had one false positive and no false negatives. Thus, tceMEP monitoring exhibited higher sensitivity (33.3% vs. 100%), specificity (95.6% vs. 98.1%), positive predictive value (33.3% vs. 75.0%), negative predictive value (97.7% vs. 100%), and efficiency (91.7% vs. 98.2%) compared to SSEP monitoring alone. Conclusions: Here, we present a retrospective series of 57 patients where tceMEP/SSEP monitoring likely prevented irreversible neurologic damage. Though further prospective studies are needed, there may be a role for combined tceMEP/SSEP monitoring for patients undergoing anterior cervical decompression without myelopathy.

Xu, Risheng; Ritzl, Eva K.; Sait, Mohammed; Sciubba, Daniel M.; Wolinsky, Jean-Paul; Witham, Timothy F.; Gokaslan, Ziya L.; Bydon, Ali

2011-01-01

118

Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy.  

PubMed

The present study aimed to evaluate the value of pre-operative magnetic resonance imaging (MRI) combined with electromyography (EMG) for predicting clinical outcome following surgical management of cervical spondylotic myelopathy (CSM). A total of 94 patients with cervical compressive myelopathy were prospectively enrolled and treated with anterior, posterior and posterior-anterior united decompression between October 2007 and February 2009. Prior to surgery 1.5-T MRI and EMG were performed in all patients. The patients were classified into four types based on the presence (+) or absence (-) of an increased signal intensity (ISI) on the T2-weighted magnetic resonance (MR) images and also based on the positive (+)/negative (-) results of the EMG. The four types were as follows: Type I, MRI/EMG (-/-); Type II, MRI/EMG (+/-); Type III, MRI/EMG (-/+); and Type IV, MRI/EMG (+/+). The clinical outcome was also graded according to a modified Japanese Orthopedic Association (JOA) scoring system. Furthermore, pre- and post-operative clinical data were statistically analyzed to explore the correlation between the factors. There were 36 cases (38%) of Type I, 16 (17%) of Type II, 13 (14%) of Type III and 29 (31%) of Type IV. According to the analysis of the clinical data between the four types, there were significant differences in the disability classifications, pre-operative JOA scores and disease duration (P<0.05), but there were no significant differences in gender, age or cord compression ratios (P>0.05). Until the final follow-up, there was a significant difference in the recovery ratio between the four study groups (Hc=27.46, P<0.05). Further comparison showed that the surgical outcome was best in Type I patients and worst in Type IV patients. In conclusion, there was a distinct correlation between classification and the rate of clinical improvement. Patients who had a negative EMG and those without an ISI on T2-weight images tended to suffer only mild symptoms, a short disease duration and, most significantly, experience a good surgical outcome. PMID:23596492

Liu, Fa-Jing; Sun, Ya-Peng; Shen, Yong; Ding, Wen-Yuan; Wang, Lin-Feng

2013-01-30

119

The genetic association of Vitamin D receptor polymorphisms and cervical spondylotic myelopathy in Chinese subjects  

Microsoft Academic Search

BackgroundThe association of vitamin D receptor (VDR) gene polymorphisms to the lumbar degenerative disc disease has been previously studied; however, the role of VDR gene polymorphisms in cervical spondylosis remains unknown.

Zhan Chao Wang; Xiong Sheng Chen; Da Wei Wang; Jian Gang Shi; Lian Shun Jia; Guang Hui Xu; Jian Hou Huang; Lei Fan

2010-01-01

120

Cervical myelopathy due to single level prolapsed disc and spondylosis: a comparative study on outcome between two groups  

Microsoft Academic Search

This article describes a retrospective study on myelopathy, induced by monosegmental prolapsed disc and spondylosis. To assess\\u000a pre- and postoperative clinical and radiological findings related to myelopathy, and factors influencing the outcome, 20 disc\\u000a herniation (group A) and 11 spondylosis patients (group B) were studied. Average duration of myelopathy in groups A and B\\u000a were 3 and 8.7 months, respectively. Anterior

Jong-Seon Ryu; Jong-Woo Chae; Woo-Jin Cho; Han Chang; Myung-Sang Moon; Sung-Soo Kim

2010-01-01

121

[Cervicogenic headache caused by lower cervical spondylosis].  

PubMed

We report a rare case of severe facial pain and headache due to cervical spondylosis successfully treated by surgical intervention. A 48-year-old woman had been suffering from severe left side facial pain and headache since she was 44 years old. Analgesics were not effective. At 48 years of age, a magnetic resonance imaging of the cervical spine revealed a degenerated disk at the C5/6 level with encroachment on the foramina and the cord. Anesthetic blockade to the C5/6 facet joint was effective, but was temporary. After the anterior decompression and stabilization using a titanium cage, the pain disappeared completely and has not recurred through 1 year of follow up. This report indicates that lower cervical root compression may cause cervicogenic headache, which can be treated effectively by surgical intervention. PMID:19432099

Kawabori, Masahito; Hida, Kazutoshi; Yano, Shunsuke; Iwasaki, Yoshinobu

2009-05-01

122

Reversal of lifelong mutism after anterior cervical discectomy and fusion for myelopathy.  

PubMed

A 34-year-old man with a history of spina bifida occulta, fetal alcohol syndrome and mutism presented with an acute on chronic decline of unsteady gait and right arm and leg weakness over the period of a few months. The patient was non-verbal and communicated using hand gestures. MRI of the cervical spine showed severe stenosis at C4-5 with T2 signal abnormalities. Brain MRI demonstrated mild ventriculomegaly. The patient underwent an anterior cervical discectomy and fusion for severe cervical spine stenosis. Postoperatively the patient's myelopathic symptoms improved. He also became verbal and engaged in conversation. Ten months after surgery, the patient who had previously been non-verbal had developed a vocabulary of more than 50 words. PMID:22674701

Babu, Ranjith; Grunch, Betsy H; Bagley, Carlos A; Gottfried, Oren N

2011-11-21

123

[Laryngopyocele. Rare cause of relapsing cervical infections].  

PubMed

A laryngopyocele forms when a laryngocele, as a dilatation of the laryngeal ventricle, becomes infected and fills with mucopus. Laryngopyoceles are rare, as only few cases have been previously reported in the literature. The case of a 75-year-old woman who was treated twice because of a deep cervical infection is described. First of all the cause remained unknown but 3 years after the first manifestation air could be aspirated from a now non-infected neck swelling. A laryngocele was revealed as the cause of the relapsing infection. The surgical resection led to a final healing and the patient remained free from disease. When dealing with a clinical picture of an unknown deep cervical infection, an external or mixed laryngocele should be considered in the differential diagnosis as a rare cause. PMID:20204316

Ludwig, A; Chilla, R

2010-03-01

124

Texture-based characterization of pre- and post-operative T2-weighted magnetic resonance signals of the cervical spinal cord in cervical spondylotic myelopathy  

NASA Astrophysics Data System (ADS)

The utility of texture analysis regarding the provision of quantitative prognostic factors, potentially valuable to the prediction of the post-operative outcome of cervical spondylotic myelopathy (CSM) patients, is investigated. The clinical sample of the study comprised six subjects, who had undergone surgical therapeutic intervention for CSM. Following a specific imaging protocol, a pair of MR images of the cervical spine, corresponding to pre- and post-operative MR scans, was obtained for each of the patients. Accordingly, 12 sagittal T2-weighted magnetic resonance (MR) images were studied. Employing custom developed software, a Region Of Interest (ROI) within the spinal cord, corresponding to the region of the high-intensity CSM MR signal, was segmented on each image, according to the region growing method. Utilizing custom developed algorithms, the following sets of textural features were generated from the segmented ROIs: (i) gradient features, (ii) mean values of features from co-occurrence matrices (co-occurrence features) and (iii) range values of co-occurrence features. Utilizing each one of these sets of features, as well as the least-squares minimum distance and the quadratic classification algorithms, pattern recognition classification schemes were implemented for the discrimination between pre-operative and post-operative MR signals. Statistical analysis revealed the existence of statistically significant differences (p < 0.05) between textural features generated from pre-operative and post-operative high-intensity MR signals. The classification accuracies accomplished ranged from 75% to 100%. Textural features, descriptive of relevant properties of the high-intensity MR signal in CSM, may be considered as quantitative information of potential value for the prediction of the post-operative outcome of CSM patients.

Boniatis, Ioannis; Klironomos, George; Gatzounis, George; Panayiotakis, George

2009-10-01

125

Predictors of outcome in patients with degenerative cervical spondylotic myelopathy undergoing surgical treatment: results of a systematic review.  

PubMed

PURPOSE: To conduct a systematic review of the literature to determine important clinical predictors of surgical outcome in patients with cervical spondylotic myelopathy (CSM). METHODS: A literature search was performed using MEDLINE, MEDLINE in Process, EMBASE and Cochrane Database of Systematic Reviews. Selected articles were evaluated using a 14-point modified SIGN scale and classified as either poor (<7), good (7-9) or excellent (10-14) quality of evidence. For each study, the association between various clinical factors and surgical outcome, evaluated by the (modified) Japanese Orthopaedic Association scale (mJOA/JOA), Nurick score or other measures, was defined. The results from the EXCELLENT studies were compared to the combined results from the EXCELLENT and GOOD studies which were compared to the results from all the studies. RESULTS: The initial search yielded 1,677 citations. Ninety-one of these articles, including three translated from Japanese, met the inclusion and exclusion criteria and were graded. Of these, 16 were excellent, 38 were good and 37 were poor quality. Based on the excellent studies alone, a longer duration of symptoms was associated with a poorer outcome evaluated on both the mJOA/JOA scale and Nurick score. A more severe baseline score was related with a worse outcome only on the mJOA/JOA scale. Based on the GOOD and EXCELLENT studies, duration of symptoms and baseline severity score were consistent predictors of mJOA/JOA, but not Nurick. Age was an insignificant predictor of outcome on any of the functional outcomes considered. CONCLUSION: The most important predictors of outcome were preoperative severity and duration of symptoms. This review also identified many other valuable predictors including signs, symptoms, comorbidities and smoking status. PMID:23386279

Tetreault, Lindsay A; Karpova, Alina; Fehlings, Michael G

2013-02-01

126

Synovial cysts of the cervicothoracic junction causing myelopathy: report of 3 cases and review of the literature.  

PubMed

Synovial cysts are uncommon pathological entities in patients with cervical degenerative spinal disease, and there are only a few reports in the literature. Treatment typically involves decompression; however, biomechanical data indicate that laminectomies in the cervical spine also result in cervical instability, specifically within the cervicothoracic junction, supporting the use of fusion as well. The authors describe the use of fusion with decompression in the treatment of 3 patients with cervicothoracic synovial cysts that presented in an acute fashion with associated myelopathy and neurological decline, and they review the diagnostic elements, histopathology, and treatment of these cysts. All 3 of the patients did well with decompression via a posterior approach with a single-level instrumented fusion from C-7 to T-1. Each patient regained complete neurological function and had no residual neurological deficits. These results are promising, although the sample size of 3 cases is too small to make any conclusive evaluations. Future studies incorporating Class I and Class II data are imperative to make firm conclusions regarding general management of this rare entity. PMID:23815248

Bisson, Erica F; Sauri-Barraza, José-Carlos; Niazi, Toba; Schmidt, Meic H

2013-07-01

127

Copper deficiency myelopathy  

Microsoft Academic Search

Acquired copper deficiency has been recognised as a rare cause of anaemia and neutropenia for over half a century. Copper\\u000a deficiency myelopathy (CDM) was only described within the last decade, and represents a treatable cause of non-compressive\\u000a myelopathy which closely mimics subacute combined degeneration due to vitamin B12 deficiency. Here, 55 case reports from the\\u000a literature are reviewed regarding their

Stephan R. JaiserGavin; Gavin P. Winston

2010-01-01

128

Is there a benefit to operating on patients (bedridden or in wheelchairs) with advanced stage cervical spondylotic myelopathy?  

PubMed Central

Surgical treatment of cervical spondylotic myelopathy (CSM) aims to prevent or delay the progression of the disease. Many patients are diagnosed in advanced stages of the disease, presenting severe functional disability and extensive radiologic changes, which suggests clinical irreversibility. There are doubts about the real benefit of surgery in patients who are seriously ill, bedridden or in a wheelchair. The objective of the study is to evaluate the effects of surgical treatment in the clinical outcomes of patients severely affected by CSM. We analyzed patients with CSM who received an operation at a single institution between 1996 and 2008. Cases with a preoperative Nurick score equal to 5 were studied. We describe postoperative clinical improvement and compare the demographics and clinical data between the patients who improved and those who had no improvement. Radiological findings were also analyzed. We evaluated 55 patients operated on. Nine presented with preoperative Nurick score of 5 (16.3%). The mean age was 69.77 ± 6.6 years (95% CI 64.65–79.90). The mean follow-up was 53.44 ± 35.09 months (CI 26.46–80.42). Six patients (66.6%) achieved functional improvement when assessed by the Nurick scale, regaining the ability to walk. All patients improved on the JOAm scale, except one. The mean preoperative Nurick score was 5, while the mean postoperative Nurick score was 4.11 ± 0.92 (95% CI 3.39–4.82) (Wilcoxon p = 0.027). The mean preoperative JOAm score was 6.4, and postoperative was 9.88 ± 2.31 (CI 95% 8.10–11.66) (Wilcoxon p = 0.011). All spinal cords presented high-intensity signal on T2-weighted images. There was no correlation between the number of spinal cord high-intensity signal levels and clinical improvement. Three out of seven patients (whose image was adequate for analysis) had evident spinal cord atrophy, and two of them did not improve clinically. In the whole sample of patients, the mean length of disease for those who improved was 9.25 ± 7.31 months (95% CI 1.56–16.93), and for those who did not improve was 38.00 ± 19.28 months (95% CI 9.91–85.91) (Mann–Whitney p = 0.02). In conclusion, two-thirds of patients with CSM Nurick scores of 5 who were either bedridden or in wheelchairs at the time of diagnosis improved at least one degree on the Nurick scale after surgical treatment, thus returning to walking. The JOAm scale was more sensitive to clinical changes than the Nurick scale. Patients with longer lengths of disease had worse outcomes.

Rocha, Leonardo Poubel; Barcelos, Alecio Cristino Evangelista Santos; Rotta, Jose Marcus; Botelho, Ricardo Vieira

2010-01-01

129

Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament  

Microsoft Academic Search

We evaluated the clinical results of posterior decompression with instrumented fusion (PDF) for thoracic myelopathy due to\\u000a ossification of the posterior longitudinal ligament (OPLL). A total of 24 patients underwent PDF, and their surgical outcomes\\u000a were evaluated by the Japanese Orthopaedic Association (JOA) scores (0–11 points) and by recovery rates calculated at 3, 6,\\u000a 9 and 12 months after surgery and

Masashi Yamazaki; Akihiko Okawa; Takayuki Fujiyoshi; Takeo Furuya; Masao Koda

2010-01-01

130

Early treatment causes clinicoradiological reversal of myelopathy due to vitamin B12 deficiency.  

PubMed

Vitamin B12 deficiency has a wide spectrum of clinical presentation with a variety of neurological symptoms and signs. As a result, many patients lack classic features of advanced severe deficiency. Early diagnosis and treatment are crucial in order to prevent the irreversible damage to the nervous system. We describe a 25-year-old man, who presented with predominant sensory symptoms without any signs on clinical evaluation. His serum vitamin B12 levels were low and neuroimaging revealed myelopathy. The patient was treated promptly with cyanocobalamin injections, which lead to a rapid resolution of symptoms and radiological abnormalities. PMID:23715834

Verma, Rajesh; Kori, Prakash; Patil, Tushar B; Praharaj, Heramba Narayan

2013-05-27

131

Cervical myelopathy due to single level prolapsed disc and spondylosis: a comparative study on outcome between two groups  

PubMed Central

This article describes a retrospective study on myelopathy, induced by monosegmental prolapsed disc and spondylosis. To assess pre- and postoperative clinical and radiological findings related to myelopathy, and factors influencing the outcome, 20 disc herniation (group A) and 11 spondylosis patients (group B) were studied. Average duration of myelopathy in groups A and B were 3 and 8.7 months, respectively. Anterior decompression and fusion were performed. Pre- and postoperative clinical and radiological findings and outcomes were assessed. Average preoperative disc heights were 85.9% of normal in group A and 72.7% in group B. Average anteroposterior canal diameter and Pavlov ratio at diseased level were 13.9 mm and 0.81 in group A, respectively, and 12.1 mm and 0.78 in group B. Five group A (25.0%) and four group B cases (36.4%) had radiculopathy. Cord compressions among 20 group A patients were median in seven and paramedian in 13. In the 11 group B patients, nine were median and two were paramedian. High signal intensity was observed in 19 group A and ten group B patients. Postoperative regression of T2-weighted high signal intensity in 14 group A (73.7%) and two group B patients (20.0%) was observed. Preoperative JOA scores in groups A and B were 10.3 and 12.8, respectively, which became 66.2 and 22.5 postoperatively. Neurological recovery was poorer in group B than in group A. Outcome was influenced by chronicity of myelopathy.

Ryu, Jong-Seon; Chae, Jong-Woo; Cho, Woo-Jin; Chang, Han; Kim, Sung-Soo

2010-01-01

132

Sympathetic skin response in myelopathies  

Microsoft Academic Search

Autonomic dysfunctions cause significant morbidity and mortality among patients with spinal cord disorders. Sympathetic skin response (SSR), a simple, noninvasive electrophysiological technique, may be useful for assessing sympathetic functions in patients with myelopathies. Our aim was to study SSR in patients with myelopathy and correlate it with clinical features, severity of the impairment, somatosensory evoked potentials. and outcome. Thirty patients

K. P. S. Nair; A. B. Taly; G. R. Arunodaya; Shivaji Rao; T. Murali

1998-01-01

133

Cervical myelo-radiculopathy in athetoid cerebral palsy  

Microsoft Academic Search

Cervical myelopathy complicating athetoid cerebral palsy has not been adequately highlighted in the literature. We report two cases of patients with athetoid cerebral palsy and long histories of involuntary movements who developed cervical myelo-radiculopathy. Dystonic athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result

Y. Mikawa; R. Watanabe; J. Shikata

1997-01-01

134

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy  

Microsoft Academic Search

The objective of the article is to verify the hypothesis that the dorsal multilevel laminectomy and rod-screw-instrumented\\u000a fusion (DLF) for multilevel spondylotic cervical myelopathy (MSCM) is less strenuous for patients, and less prone to perioperative\\u000a complications, than ventral multilevel corpectomy and plate-screw-instrumented fusion (VCF), while clinical outcome is comparable.\\u000a One hundred and three successive patients were treated for at least

Rudolf Andreas Kristof; Thomas Kiefer; Marcus Thudium; Florian Ringel; Michael Stoffel; Attlila Kovacs; Christian-Andreas Mueller

2009-01-01

135

Dropped Shoulder Syndrome: A Cause of Lower Cervical Radiculopathy  

PubMed Central

Background and Purpose Cervical radiculopathy is a pathological process involving a nerve root of the cervical spine. The most common causes of radiculopathy are cervical disc herniation followed by cervical spondylosis. The aim of this study was to determine the effect of dropped shoulder as a cause of lower cervical radiculopathy. Methods In total, 132 patients, comprising 105 women (79.5%) and 27 men (20.5%; female : male ratio of 4 : 1) and a mean age of 36.7 years (range 18-58 years), were included in this study. All of the patients presented with shoulder pain, and were investigated by cervical X-ray, cervical magnetic resonance imaging, serum muscle enzymes, and electromyography (EMG)/nerve-conduction studies. Results Ninety six patients (72.7%) exhibited visually detectable dropped shoulder. The lateral view X-ray of the cervical region revealed eight or more vertebrae. In 119 patients (90.2%), the EMG revealed a mild-to-moderate or moderate denervation patterns in the abductor digiti minimi, first dorsal interosseous, and flexor carpi ulnaris muscles, while the abductor pollicis brevis, extensor carpi radialis, and triceps brachii were denervated in 102 patients (77.3%). All of the patients had lower cervical paraspinal muscles with a denervation pattern. Conclusions Three criteria for diagnosing dropped shoulder syndrome have been suggested: pain with consistent anatomical distribution, X-ray abnormalities, and EMG abnormalities. Compression of the cervical roots by muscle spasm has been proposed as the cause of dropped shoulder syndrome; this possibility is discussed herein.

2011-01-01

136

Outcome of cervical spine surgery in patients with rheumatoid arthritis  

PubMed Central

OBJECTIVES—Cervical spine instability in patients with rheumatoid arthritis (RA) may lead to cervical myelopathy or occipital neuralgia, or both. Morbidity and mortality in patients with RA treated with cervical spine surgery during two years of follow up were evaluated.?METHODS—Between 1992 and 1996 55 patients with RA underwent cervical spine surgery because of occipital neuralgia or cervical myelopathy, or both. Patients were classified according to the Ranawat criteria for pain and neurological assessment before operation and three months and two years postoperatively. For occipital neuralgia a successful operation was defined as complete relief of pain and for cervical myelopathy as neurological improvement.?RESULTS—Occipital neuralgia was present in 17 patients, cervical myelopathy in 14 patients, and 24 had both. Surgical treatment in the patients with symptoms of occipital neuralgia who were still alive two years after surgery was successful in 18/29 (62%). In the surviving patients with cervical myelopathy neurological improvement of at least one Ranawat class was seen in 16/24 (67%). Postoperative mortality within six weeks was 3/51 (6%). Within two years after the operation 14 /51 (27%) of the patients had died; in most patients the cause of death was not related to surgery. The highest mortality (50%) was found in the group of six patients with quadriparesis and very poor functional capacity (Ranawat IIIB).?CONCLUSION—Cervical spine surgery in patients with RA performed because of occipital neuralgia or cervical myelopathy, or both, is successful in most patients who are alive two years after surgery. However, the mortality rate during these two years is relatively high, which seems to be largely related to the severity of the underlying disease and not to the surgery itself.??

van Asselt, K M; Lems, W; Bongartz, E; Hamburger, H; Drossaers-Bakker, K; Dijkmans, B; van Soesbergen, R M

2001-01-01

137

The ‘human tail’ causing tethered cervical cord  

Microsoft Academic Search

Study design:Human tails continue to elicit curiosity till the present times. A unique case of human cervical dysraphism is described.Objectives:In addition to the cosmetic stigma, these cutaneous markers provide a lead to reach the underlying spinal dysraphic states.Setting:Plains of North India.Methods:A case of human tail at the neck region is presented, whose cutaneous deformity lead the clinicians to his underlying

S Mohindra

2007-01-01

138

High-resolution nuclear magnetic resonance spectroscopic study of metabolites in the cerebrospinal fluid of patients with cervical myelopathy and lumbar radiculopathy  

PubMed Central

There have been few reports describing substances related to oxidative and intermediary metabolism in the cerebrospinal fluid (CSF) in patients with spinal degenerative disorders. This study investigated whether the concentrations of metabolites in the CSF differed between patients with spinal degenerative disorders and controls, and whether the concentrations of these metabolites correlated with the severity of symptoms. CSF samples were obtained from 30 patients with cervical myelopathy (Group M), 30 patients with lumbar radiculopathy (Group R), and 10 volunteers (control). Metabolites in these CSF samples were measured by nuclear magnetic resonance spectroscopy. There were no differences in the concentrations of lactate, alanine, acetate, glutamate, pyruvate, or citrate between Groups M and R, between Group M and the control, or between Group R and the control. In Group M, neither symptom duration nor the Japanese Orthopaedic Association score correlated with the concentration of any metabolite. In Group R, the symptom duration positively correlated with the concentration of lactate, glutamate, and citrate in CSF. The duration of nerve root block showed a negative correlation with the concentrations of acetate in CSF of the patients in Group R. In patients with lumbar radiculopathy, there is a possibility of increased aerobic metabolic activity or decreased gluconeogenic activity in patients with shorter symptom duration, and increased aerobic metabolic activity in patients with severe inflammation around a nerve root.

Morio, Yasuo; Meshitsuka, Shunsuke; Yamane, Koji; Nanjo, Yoshiro; Teshima, Ryota

2010-01-01

139

A new minimally invasive posterior approach for the treatment of cervical radiculopathy and myelopathy: surgical technique and preliminary results  

Microsoft Academic Search

Degenerative cervical disorders predominantly lead to anterior spinal cord compression (by bony spurs at the posterior margin of the vertebral body or by degenerated disc), which may be central and\\/or foraminal. In a smaller percentage of cases, there is encroachment of the canal mainly from posterior by bulging yellow ligaments or bony appositions, resulting in compression syndromes of roots or

H. Boehm; R. Greiner-Perth; H. El-Saghir; Y. Allam

2003-01-01

140

Clinical and radiological profile of Hirayama disease: A flexion myelopathy due to tight cervical dural canal amenable to collar therapy  

PubMed Central

Background: Hirayama disease (HD) is benign focal amyotrophy of the distal upper limbs, often misdiagnosed as motor neuron disease. Routine magnetic resonance imaging (MRI) is often reported normal. Objective: To study the clinicoradiological profile of hand wasting in young males. Materials and Methods: Patients presenting with insidious-onset hand wasting from March 2008 to May 2011 were evaluated electrophysiologically. Cervical MRI in neutral position was done in 11 patients and flexion contrast imaging was done in 10 patients. Results: All patients were males less than 25 years of age, with median age 23 years, except one patient who was 50 years old. Duration of illness was 3 months to 3 years. All (100%) had oblique amyotrophy, four (36%) cold paresis, 10 (91%) minipolymyoclonus and three (27%) had fasciculations. Regional reflexes were variably absent. Two patients (18%) had brisk reflexes of lower limbs with flexor plantars. Electromyography (EMG) showed chronic denervation in the C7-T1 myotomes. Neutral position MRI showed loss of cervical lordosis in 10/11 (91%), localized lower cervical cord atrophy in 9/11 (82%), asymmetric cord flattening in 11/11 (100%) and intramedullary hyperintensity in 2/11 (18%); flexion study showed loss of dural attachment, anterior displacement of dorsal dura, epidural flow voids in 9/10 (90%) and enhancing epidural crescent in 10/10 (100%). Clinical profile, imaging and electrophysiological findings of the patient aged 50 years will be described in detail as presentation at this age is exceptional. Collar therapy slowed progression in most cases. Conclusion: Clinical features of HD corroborated well with electrophysiological diagnosis of anterior horn cell disease of lower cervical cord. While dynamic contrast MRI is characteristic, routine studies have a high predictive value for diagnosis. Prompt diagnosis is important to institute early collar therapy.

Hassan, K. M.; Sahni, Hirdesh; Jha, Atul

2012-01-01

141

Cervical spine injuries caused by diving into water  

Microsoft Academic Search

In 1965-1978, 194 patients with cervical spine injuries, caused by diving into water, were treated. In 182 cases, spinal fracture was accompanied by spinal cord injury. This paper presents mechanism of trauma, in connection with observed degree of neurological disturbances as well as further life of this group of patients in relation to the degree of spinal cord damage.

Jerzy Kiwerski

1980-01-01

142

Inadequate cervical mucus--a cause of "idiopathic" infertility.  

PubMed

The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from inadequate cervical mucus, was found. Hormone investigations revealed that these patients could be divided into two groups: those with low sex steroid profiles despite apparent ovulation, and a second group with normal sex steroid profiles. All patients were treated with ovulation-inducing agents in an attempt to produce "controlled" ovarian hyperstimulation and an improved cervical mucus. Four of six patients conceived. The rationale behind the use of ovulation-inducing agents in this situation is discussed. PMID:955130

Sher, G; Katz, M

1976-08-01

143

Cervical radiculopathy.  

PubMed

The history, pathoanatomy and pathophysiology, clinical picture, differential diagnosis, diagnostic evaluation, and treatment of cervical radiculopathy are reviewed. The review is based on a 10-year Medline literature search, review of bibliographies in textbooks, and bibliographies in articles obtained through the search. Cervical radiculopathy, although recognized early in the 20th century, was first associated with disc pathology in the mid-1930s. It is most commonly caused by disc herniation or cervical spondylosis. History and physical examination using pain location, manual muscle testing, and specialized testing (Spurling's maneuver) will usually suffice to diagnose the radiculopathy and determine the root level involved. Diagnostic imaging such as magnetic resonance imaging, computed tomography, or myelography should be used as presurgical evaluative tools or when tumor or other etiology besides disc herniation or spondylosis is suspected. Electromyography is of benefit in distinguishing various entities that clinically present similar to cervical radiculopathy and can also help to "date" the lesion. Treatment of this disorder has not been systematically studied in a controlled fashion. However, using a variety of different treatments, the radiculopathy usually improves without the need for surgery. Indications for surgery are unremitting pain despite a full trial of non-surgical management, progressive weakness, or new or progressive cervical myelopathy. Prospective studies evaluating the various treatment options would be of great benefit in guiding practitioners toward optimum cost-effective evaluation and care of the patient with cervical radiculopathy. PMID:8129590

Ellenberg, M R; Honet, J C; Treanor, W J

1994-03-01

144

Acute myelopathy with normal imaging.  

PubMed

A 17-year-old girl presented with rapidly progressive quadriparesis and ventilatory failure. The clinical findings indicated a spinal level, but the diagnosis of myelopathy was not supported by her initial spinal imaging and cerebrospinal fluid studies. She had completed treatment for Guillain-Barré syndrome before a follow-up spinal imaging study showed interval expansion and enhancement of the cervical cord. PMID:22752484

Holland, Neil R

2012-06-29

145

Factors related to the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament.  

PubMed

This study evaluates factors related to myelopathic symptoms in patients with ossification of the posterior longitudinal ligament (OPLL). A total of 87 patients with OPLL were included. Of these, 53 (Group I) had no symptoms or presented with neck pain and radiculopathy and 34 (Group II) had myelopathic symptoms. Gender, age, and history of trauma were evaluated in the two groups. The range of movement of the cervical spine was measured using plain radiographs. The number of involved segments, type of OPLL, and maximal compression ratio were analysed using CT and signal change in the spinal cord was evaluated using MRI. The patients' age was found to be significant (p = 0.001). No difference was found between gender and the range of movement in the two groups. The maximum compression of the spinal canal showed a difference (p = 0.03). The signal change of the spinal cord was different between the two groups. In patients with OPLL of the cervical spine, myelopathic symptoms are not related to the range of movement or the number of involved segments. PMID:22733951

Chang, H; Song, K-J; Kim, H-Y; Choi, B-W

2012-07-01

146

Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review  

PubMed Central

Extramedullary hemopoiesis (EMH) is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

Dewan, Udita; Kumari, Niraj; Jaiswal, Awadesh; Behari, Sanjay; Jain, Manoj

2010-01-01

147

Spinal cord herniation: a misdiagnosed and treatable cause of thoracic myelopathy  

Microsoft Academic Search

This study is a case report and review of the literature. Spinal cord herniation is a rare, although increasingly recognized,\\u000a cause of spinal cord dysfunction. It is due to an anterior dural defect, through which the spinal cord herniates. The purpose\\u000a of this article is to report the authors’ experience and to provide insight on clinical presentation and radiological signs

Fahed Zairi; Laurent Thines; Philippe Bourgeois; Olivier Dereeper; Richard Assaker

2010-01-01

148

A Case Report of Reiter's Syndrome with Progressive Myelopathy  

PubMed Central

Reiter's syndrome belongs to the family of spondyloarthropathies that usually present with a triad of arthritis, urethritis, and uveitis. The diagnostic criteria include clinical, radiological, and genetic findings, and the response to treatment. Nervous system involvement in Reiter's syndrome is extremely rare. We report here on a 36-year-old man who initially presented with progressive cervical myelopathy and was diagnosed as Reiter's syndrome 2 years later. The myelopathy was stable after treatment with methotrexate and sulfasalazine. This case suggests that Reiter's syndrome can present as progressive myelopathy and should be considered in the differential diagnosis of treatable myelopathies.

Kim, Soo Kyoung; An, Jae Young; Park, Min Soo

2007-01-01

149

Myelopathy Associated With Melorheostosis: A Case Report  

Microsoft Academic Search

Reznik M, Fried GW. Myelopathy associated with melorheostosis: a case report.A man in his mid thirties presented with lower-extremity weakness and spasticity because of a myelopathy caused by a rare disorder of bone known as melorheostosis. The primary pathology involved was compression of the cord at the cervicothoracic levels by dystrophic osseous formation within the vertebral bodies. Based on a

Mark Reznik; Guy W. Fried

2005-01-01

150

Vitamin B12 extensive thoracic myelopathy: clinical, radiological and prognostic aspects. Two cases report and literature review.  

PubMed

The myelopathy caused by vitamin B12 deficiency is known as subacute combined degeneration. It is rare, but a well known cause of demyelination of the dorsal columns of the spinal cord. The magnetic resonance imaging is characterized by an increased signal on T2-weighted images involving the posterior columns of cervical and thoracic cord. There have been few cases in literature with extensive lesions (more than seven levels) of the thoracic spinal cord. The clinical and radiological improvements are possible if the replacement of vitamin B12 is initiated precocious. We present two rare cases of extensive thoracic myelopathy due to vitamin B12 deficiency. The first is a young woman with complete clinical recovery and important radiologic improvement after early treatment. In addition, the second case is an older man with partial response to the treatment. Those cases illustrate the importance of considering vitamin B12 deficiency in any patient, who presents with myelopathy. PMID:23468407

de Medeiros, Frederico Carvalho; de Albuquerque, Lucas Alverne Freitas; de Souza, Renata Brant; Gomes Neto, Antonio Pereira; Christo, Paulo Pereira

2013-03-07

151

Transient tetraplegia and vegetative dysfunction depending on cervical positioning caused by a cervical spinal chordoma.  

PubMed

A 39-year-old man with acquired torticollis suffering from cervicobrachialgia and neurological deficits is presented. Due to a change in head position a transient reproducible tetraplegia and severe vegetative dysfunctions were caused. The origin of this uncommon serious combination of symptoms and signs was a chordoma of the upper cervical spine. After surgical decompression the patient was free of neurological deficit and pain. Review of the literature did not reveal any similar case. PMID:16328772

Schulte, T L; Hammersen, S; Heidenreich, J O; Pietilä, T A

2005-11-17

152

Cervical spondylosis: ventral or dorsal surgery.  

PubMed

Cervical spondylosis is a result of degenerative changes of the cervical spine. Neurological symptoms of myelopathy result from the narrowing of the spinal canal, causing spinal cord compression. Surgical management of cervical stenosis requires an understanding of the interplay between multiple pathological and biomechanical factors contributing to this disease process. Surgical decompression can be addressed from a ventral, dorsal, or combined approach. The authors discuss the technical aspects of the surgical decision making process regarding the decision to approach the spine from a ventral or dorsal orientation. PMID:17204873

Witwer, Brian P; Trost, Gregory R

2007-01-01

153

Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks  

Microsoft Academic Search

Objective: To describe the use of intermittent cervical traction in managing 4 patients with cervical radiculopathy and large-volume herniated disks. Clinical Features: Four patients had neck pain radiating to the arm. The clinical examination was typical in all cases for radiculopathy of cervical origin. Magnetic resonance imaging (MRI) of the cervical spine revealed large-volume herniated disks in all patients. Intervention

Constantine Constantoyannis; Demetres Konstantinou; Harry Kourtopoulos; Nicolas Papadakis

2002-01-01

154

The causes, sequelae and attempts at prevention of cervical spine injuries in Poland  

Microsoft Academic Search

There are certain differences between the causes of spinal injuries in Poland and in the developed countries of the West. The most common causes of injuries to the cervical spine in Poland are: falls from a horse-cart, diving into shallow water and automobile accidents. This paper presents an analysis of the causes of cervical spine injuries in a series of

J E Kiwerski

1993-01-01

155

Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.  

PubMed

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

2012-01-22

156

Cervical Disc Herniation Causing Brown-S?quard's Syndrome: A Case Report and Literature Review  

PubMed Central

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

2011-01-01

157

Metabolic, nutritional, and toxic myelopathies.  

PubMed

This review article identifies and describes the clinical manifestations of various metabolic, nutritional, and toxic conditions that result in symptoms of myelopathy and, in some cases, myeloneuropathy. It includes discussions of the clinical pictures that occur secondary to these causes. Familiarity with the clinical symptoms may lead to accurate diagnosis through laboratory and imaging studies and to treatment with successful identification of the underlying causes. PMID:23186901

Schwendimann, Robert N

2013-02-01

158

Anterior cervical discectomy without fusion: a comparison with Cloward's procedure.  

PubMed

The antero-medial microsurgical disc or osteophyte removal without formal interbody fusion is a surgical alternative in the treatment of cervical discs causing radicular compression or cervical myelopathy. In the past 20 years 379 patients underwent anterior surgery, including 240 microdiscectomies without graft and 139 Cloward's dowel procedures. The long-term results of both procedures are compared in patients suffering from radicular compression, dominant myelopathy and radiculo-myelopathy. We found no statistically significant differences between the two methods treating three different conditions. The improvement rate in patients with soft and sequestrated discs is generally better compared to those with hard discs and spondylotic changes. Functional stability of the cervical spine is present in 92% of cases treated without interbody fusion immediately after surgery. A complete osseous fusion after a period of 6-12 months was found in 90% of Cloward procedures and in 81% of discectomy without graft. No definite correlation was found between the clinical improvement and the radiological results. According to our experience the Cloward's fusion procedure has no long-term advantages over discectomy without graft except in cases of severe myelopathy caused by multilevel ventral compression due to osteophytes. No permanent postoperative complication was encountered. Most of the treated patients returned to their previous activities. PMID:18638979

Husag, L; Costabile, G; Vanloffeld, W; Keller, R J; Landolt, H

1997-07-01

159

Mutations in TGFBR2 gene cause spontaneous cervical artery dissection.  

PubMed

Mutations in the genes encoding transforming growth factor ? receptors 1 and 2 (TGFBR1 and TGFBR2) have recently been associated with hereditary connective tissue disorders with widespread vascular involvement, including arterial dissection. To determine whether mutations in these genes cause spontaneous cervical artery dissection (sCAD), all coding exons of TGFBR1 and TGFBR2 were sequenced in 56 consecutive patients with sCAD. Novel TGFBR2 disease causing mutations were found in two patients. The two mutations were the pK327R substitution affecting the kinase domain of TGFBR2 and the pC138R substitution falling in the extracellular domain of the protein, involved in TGF? binding and signalling. No TGFBR1 mutation was found. The findings indicate that TGFBR2 gene mutations are responsible for sCAD in 3.6% (95% CI 0.0 to 8.4) of cases, have implications in understanding the role of TGF? signalling in the pathogenesis of sCAD and emphasise the importance of considering molecular characterisation of the TGFBR2 gene in these patients, regardless of the presence of clinical features suggestive of hereditary connective tissue disorders. PMID:21270064

Pezzini, Alessandro; Drera, Bruno; Del Zotto, Elisabetta; Ritelli, Marco; Carletti, Monica; Tomelleri, Gianpaolo; Bovi, Paolo; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Magoni, Mauro; Padovani, Alessandro; Barlati, Sergio; Colombi, Marina

2011-01-26

160

Upper limbs dysmetria caused by cervical spinal cord injury: a case report  

PubMed Central

Background Upper limbs dysmetria caused by spinal cord injury is very rare. We will discuss the associated mechanism in our articles. Case presentation A 51-year-old male had sudden onset of weakness, dysmetria over bilateral upper limbs and ataxia after he fell accidentally. Brain magnetic resonance imaging (MRI) revealed no specific findings. C-spine MRI revealed C1 myelopathy and C4-6 spinal cord compression by bulged disc. The symptoms subsided after surgical intervention. Conclusion Sudden onset of upper limbs dysmetria is a sign of dysfunction in cerebellum and its associated pathway. However, lesion in spinal cord can also cause cerebellar signs such as dysmetria.

Lin, Hsun-Chang; Chen, Chun-Hung; Khor, Gim-Thean; Huang, Poyin

2009-01-01

161

A unique case of cervical osteochondroma causing dysphagia.  

PubMed

Osteochondroma of the spine is a rare condition. It may present in solitary form or with multiple exostoses or hereditary multiple exostoses. In this article, we report a 22-year-old male case who was diagnosed with cervical osteochondroma, originating from the third and fourth cervical vertebra. PMID:23834138

Gulati, Ajay; Mittal, Amit; Singal, Rikki; Gupta, Samita; Garg, Varun

162

Cervical spondylotic radiculomyelopathy in patients with athetoid-dystonic cerebral palsy: clinical evaluation and surgical treatment  

Microsoft Academic Search

The acute onset of symptoms of severe cervical radiculo-myelopathy in four patients with athetoid-dystonic cerebral palsy is reported. Neurological and radiological examination showed that the spondylotic changes of the cervical spine were responsible for new neurological deficits leading to the patients being bedridden. Dystonic-athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of

G Hirose; S Kadoya

1984-01-01

163

HPV types and cofactors causing cervical cancer in Peru  

Microsoft Academic Search

We conducted a hospital-based case-control study in Peru of 198 women with histologically confirmed cervical cancer (173 squamous cell carcinomas and 25 cases of adenocarcinoma\\/adenosquamous carcinoma) and 196 control women. Information on risk factors was obtained by personal interview. Using PCR-based assays on exfoliated cervical cells and biopsy specimens, HPV DNA was detected in 95.3% of women with squamous cell

C Santos; N Muñoz; S Klug; M Almonte; I Guerrero; M Alvarez; C Velarde; O Galdos; M Castillo; J Walboomers; C Meijer; E Caceres

2001-01-01

164

Bacterial vaginosis and cervical intraepithelial neoplasia--cause or coincidence?  

PubMed

Evidence regarding a causal relationship between bacterial vaginosis and cervical intraepithelial neoplasia has so far been incomplete and conflicting. To determine whether bacterial vaginosis is associated with cervical intraepithelial neoplasia a retrospective study was conducted at the Genitourinary Medicine Clinic at Southlands Hospital, Shoreham-by-Sea, UK. Three hundred patients who presented to the clinic with a first diagnosis of genital warts in the absence of other sexually transmitted diseases were recruited. Results of cervical cytology and where abnormal, histology on colposcopically directed punch biopsies were collected. Bacterial vaginosis was diagnosed by the detection of clue cells on Gram-staining of a high vaginal swab, positive amine test, vaginal pH above 4.5 and the presence of characteristic vaginal discharge. Odds ratio showed an increased prevalence of cervical intraepithelial neoplasia associated with bacterial vaginosis. The results suggest that a prospective cross sectional study should be performed to formally test the hypothesis that bacterial vaginosis predisposes to cervical intraepithelial neoplasia. PMID:15512183

Uthayakumar, S; Boyle, D C; Barton, S E; Nayagam, A T; Smith, J R

1998-11-01

165

Postoperative Urinary Retention Following Anterior Cervical Spine Surgery for Degenerative Cervical Disc Diseases  

PubMed Central

Background Postoperative urinary retention (POUR) may cause bladder dysfunction, urinary tract infection, and catheter-related complications. It is important to be aware and to be able to identify patients at risk of developing POUR. However, there has been no study that has investigated the incidence and risk factors for the development of POUR following anterior cervical spine surgery for degenerative cervical disc disease. Methods We included 325 patients (164 male and 161 female), who underwent anterior cervical spine surgery for cervical radiculopathy or myelopathy due to primary cervical disc herniation and/or spondylosis, in the study. We did not perform en bloc catheterization in our patients before the operation. Results There were 36 patients (27 male and 9 female) that developed POUR with an overall incidence of 11.1%. The mean numbers of postoperative in-and-out catheterizations was 1.6 times and mean urine output was 717.7 mL. Thirteen out of 36 POUR patients (36%) underwent indwelling catheterization for a mean 4.3 days after catheterization for in-and-out surgery, because of persisting POUR. Seven out of 36 POUR patients (19%) were treated for voiding difficulty, urinary tract irritation, or infection. Chi-square test showed that patients who were male, had diabetes mellitus, benign prostate hypertrophy or myelopathy, or used Demerol were at higher risk of developing POUR. The mean age of POUR patients was higher than non-POUR patients (68.5 years vs. 50.8 years, p < 0.01). Conclusions To avoid POUR and related complications as a result of anterior cervical spine surgery for degenerative cervical disc disease, we recommend that a catheter be placed selectively before the operation in at-risk patients, the elderly in particular, male gender, diabetes mellitus, benign prostate hypertrophy, and myelopathy. We recommend that Demerol not be used for postoperative pain control.

Jung, Hyun Ju; Kong, Chae-Gwan; Kim, Young-Yul; Park, Jangsu; Kim, Jong Bun

2013-01-01

166

Stent-Graft Repair of a Large Cervical Internal Carotid Artery Pseudoaneurysm Causing Dysphagia  

SciTech Connect

Pseudoaneurysms of the cervical internal carotid artery (ICA) are rare and most frequently result from trauma, infection, or sometimes spontaneously. They have the potential to cause life-threatening hemorrhage; thus, their immediate management is necessary. Endovascular treatment by stent graft placement in the affected artery appears to be a safe and effective treatment option. We present a case of a child who presented with neck swelling and dysphagia caused by a ruptured cervical ICA pseudoaneurysm which was managed by stent graft placement.

Gupta, Vivek, E-mail: drvivekgupta.pgi@gmail.com; Niranjan, Khandelwal; Rawat, Lokesh [Postgraduate Institute of Medical Education and Research, Department of Radiodiagnosis and Imaging (India); Gupta, A. K. [Postgraduate Institute of Medical Education and Research, Department of Otolaryngology (India)

2009-05-15

167

Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years  

PubMed Central

Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicular screws of the 70 pedicles of the 10 patients we operated due to degenerative stenosis in the cervical region, were investigated. Fixation was performed between C3 and C7, and we used resected lamina bone chips for fusion. Clinical indicators included age, gender, neurologic status, surgical indication, and number of levels stabilized. Dominant vertebral artery of all the patients was evaluated with Doppler ultrasonography. Preoperative and postoperative Nurick grade of each patient was documented. Results: No patients experienced neurovascular injury as a result of pedicle screw placement. Two patients had screw malposition, which did not require reoperation due to minor breaking. Most patients had 32-mm screws placed. Postoperative computed tomography scanning showed no compromise of the foramen transversarium. A total of 70 pedicle screws were placed. Good bony fusion was observed in all patients. At follow-up, 9/10 (90%) patients had improved in their Nurick grades. The cases were followed-up for an average of 35.7 months (30–37 months). Conclusions: Use of the cervical pedicular fixation (CPF) provides a very strong three-column stabilization but also carries vascular injury without nerve damage. Laminectomies technique may reduce the risk of malposition due to visualization of the spinal canal. CPF can be performed in a one-stage posterior procedure. This technique yielded good fusion rate without complications and can be considered as a good alternative compared other techniques.

Kotil, Kadir; Ozyuvaci, Emine

2011-01-01

168

Histologically proven venous congestive myelopathy without concurrent vascular malformation: Case reports and review of the literature  

PubMed Central

Background: Venous congestive myelopathy is a progressive myelopathy that is generally caused by a spinal dural arteriovenous fistula. Case Description: We report a patient with histologically confirmed venous congestive myelopathy without concurrent vascular malformations in radiological and intraoperative findings. Conclusions: The definitive underlying etiology of this congestive myelopathy was unclear. However, this case report highlights the possibility of venous congestive myelopathy with etiology other than a dural arteriovenous fistula. Further, a systematic and elaborate examination should be undertaken to explore the underlying pathology whenever this type of spinal parenchymal lesion is detected.

Matsubara, Teppei; Akutsu, Hiroyoshi; Watanabe, Shinya; Nakai, Kei; Ayuzawa, Satoshi; Matsumura, Akira

2012-01-01

169

Weakness of the neck extensors, possible causes and relation to adolescent idiopathic cervical kyphosis.  

PubMed

Cervical kyphosis may be congenital, or occur as a result of laminectomy, post-traumatic deformity, infection, neuromuscular disorders such as muscular dystrophies, motor neuron disorders such as amyotrophic lateral sclerosis, tumor, and inflammation such as ankylosing spondylitis. Furthermore, adolescent idiopathic cervical kyphosis was defined as cervical kyphotic deformity of adolescent patient without any cause such as those previously described. As no standard values for "cervical kyphosis" could be found in the literature, many reported studies only report a subjective classification, "kyphotic, straight or lordotic". But this method had proven to be unreliable. Grob et al. defined "straight" for the global curvature as +4° to -4°, and lordotic and kyphotic as <-4° and >+4°, respectively. The etiology and pathogenesis of adolescent idiopathic cervical kyphosis remain little understood. Weakness of the neck extensors can result in "dropped head syndrome", a rare disorder characterized by weakness of neck extensor muscles causing an inability to extend the neck and resulting in a chin-on-chest deformity. The purpose of this paper is to propose a possible mechanical cause leading to the kyphotic deformity. We hypothesize that weakness of the neck extensors could be the initiating factor for adolescent idiopathic cervical kyphosis. PMID:21764523

Xiaolong, Shen; Xuhui, Zhou; Jian, Chen; Ye, Tian; Wen, Yuan

2011-07-18

170

Thoracic juxtafacet cyst (JFC) as a rare cause of myelopathy – An additional reference to support the instability theory  

Microsoft Academic Search

Several causes for the development of a juxtafacet cyst (JFC) of the spine have been discussed, with a focus on instability with overload of the facet joints. In the thoracic spine, JFC is a very rare space-occupying lesion, which can lead to spinal canal stenosis with pain, myelopathic signs and neurological deficits. We report a case of a 70-year-old woman

Dorothea Daentzer; Doris Stüder

2010-01-01

171

Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.  

PubMed

Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients. PMID:23270699

Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

2012-12-25

172

Clinical study Posterior cervical decompression and fusion for circumferential spondylotic cervical stenosis: Review of 50 consecutive cases  

Microsoft Academic Search

Purpose of Study: This study presents a clinical and radiological evaluation of 50 consecutive patients with symptomatic spondylotic cervical myelopathy and circumferential spinal cord compression who were managed with a single stage wide posterior laminectomy and lateral mass instrumented fusion. Methods Used: 50 consecutive patients (33 male, 17 female) over a 4 year period presenting with symptomatic cervical myelopathy due

Lali H. S. Sekhon

173

Extracranial vertebral artery dissection causing cervical root lesion.  

PubMed

The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. Color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals. PMID:10800269

Fournier, J Y; Amsler, U; Weder, B; Heilbronner, R; Hildebrandt, G

2000-04-01

174

Metabolic and toxic myelopathies.  

PubMed

The myelopathies discussed in this article have an underlying metabolic or toxic etiology. They have many clinical, electrophysiologic, and neuropathologic similarities. Preferential involvement of the dorsal columns and/or corticospinal tracts is commonly seen. Variable degrees of peripheral nerve and/or optic nerve involvement may be present. In the presence of clinical or electrophysiologic evidence of peripheral nerve involvement, the term myeloneuropathy is commonly used. The metabolic and toxic myelopathies discussed here are divided into three categories: disorders due to an identified nutrient deficiency such as the subacute combined degeneration of cobalamin/vitamin B12 or copper deficiency, disorders that have a geographical predilection and are due to a suspected toxin such as lathyrism, and disorders due to a possible toxin but without a geographical predilection such as hepatic myelopathy (Table 1). PMID:22961187

Kumar, Neeraj

2012-09-08

175

Myelopathy in Marfan's syndrome  

PubMed Central

A patient with Marfan's syndrome and a myelopathy is reported, and the association of multiple spinal arachnoid cysts noted. It is proposed that the basic connective tissue defect in Marfan's syndrome may predispose to the formation of arachnoid diverticuli and that in this case spinal cord damage was the sequel. Images

Newman, P. K.; Tilley, P. J. B.

1979-01-01

176

A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy.  

PubMed

Cervical radiculopathy secondary to compression from congenital anomalous vertebral arteries (VAs) is a known entity. Patients present with a variety of symptoms ranging from upper-extremity numbness to true occipital neuralgia. Treatment options for extracranial tortuous VAs include conservative management or some form of surgical microvascular decompression (MVD). The authors report on a patient with a congenital anomalous VA loop causing cervical nerve root compression. Successful MVD was conducted with relief of the patient's symptoms. A novel sling technique was used for mobilization of the VA. To the authors' knowledge, this is the first MVD described utilizing this technique. PMID:23991815

Tandon, Adesh; Chandela, Sid; Langer, David; Sen, Chandranath

2013-09-01

177

Effects on the maxilla and cranial base caused by cervical headgear: A longitudinal study  

PubMed Central

Objectives: The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. Study design: a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, pubescent or post-pubescent. Cephalometric parameters were compared in both groups in order to measure the cranial base angle and the vertical and sagittal position of the maxilla. Additionally, cephalometric superimpositions taken at the beginning and end of the study were compared. Results: results revealed significant differences in the cranial base angle and in the SNA angle (p<0.05). However, no differences were observed in the variables that measure the maxillomandibular relationship. While no changes were noted in the palatal plane slope, a flattening of the cranial base was found caused by the cervical headgear, in addition to a retrusion of point A that does not mean there was a reduction in the maxillomandibular relationship. Conclusions: cervical headgear treatment induces cephalometric flattening of the cranial base and a decrease of the SNA angle. Key words:Orthodontics, cervical headgear, class II treatment, cephalometry, superimposition.

Iglesias-Conde, Carmen; Lorenzo-Pernia, Jose; Iglesias-Linares, Alejandro; Mendoza-Mendoza, Asuncion; Solano-Reina, Enrique

2012-01-01

178

Improved medical and surgical management of cervical spine disease in patients with rheumatoid arthritis over 10 years  

Microsoft Academic Search

OBJECTIVES(1) To compare clinical outcome and symptomatology of rheumatoid cervical myelopathy between patients managed conservatively and surgically. (2) To determine if surgical outcome has improved since the series published from this unit in 1987. (3) To examine the role of magnetic resonance imaging (MRI) in the diagnosis of cervical myelopathy.METHODSPatients undergoing MRI of the cervical spine between 1991 and 1996

Jennifer D Hamilton; Margaret-Mary Gordon; Iain B McInnes; Robin A Johnston; Rajan Madhok; Hilary A Capell

2000-01-01

179

Cervical root injury caused by vertebral artery dissection  

Microsoft Academic Search

Vertebral artery dissection is a common cause of posterior circulation strokes in young and middle-aged adults. Peripheral motor deficits have been rarely described in association with vertebral artery dissection. Peripheral motor involvement may be due to compression of the spinal nerves by an enlarged vertebral artery. It may also result from ischaemia of the anterior horn or the spinal nerves

Arun Aggarwal; Keith Burton

1999-01-01

180

A rare case of Brown-Sequard syndrome caused by cervical disc herniation: a case report  

PubMed Central

Abstract: Brown-Sequard syndrome is a rare neurological disorder characterized by ipsilateral motor paralysis caused by a lesion through corticospinal tract and contralateral loss of pain and temperature sensation due to the involvement of spinothalamic tract. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. This paper aims to report a case of Brown-Sequard syndrome that occurred in a patient suffering from CHD. In this case, using a rapid and urgent intervention we could prevent permanent neurologic deficit in the patient. Case: A 56-year-old woman complained about a sudden paresis in her right leg lasting for 4 days. Her pain was progressively worsening until she couldn’t walk without assistance. There was no history of trauma in the neck. Neurological examinations revealed right side spastic hemi-paresis as well as loss of pain and temperature sensation below T4 dermatome in the left side. The case was diagnosed as Brown-Sequard syndrome and cervical magnetic resonance imaging scan showed a disc herniation at C5/C6 and C6/C7 levels. Surgery was performed via anterior cervical microdiscectomy and fusion. After a 2-month period of follow-up, neurological assessments showed that motor and sensory functions of the patient returned to the normal condition. Although cervical disc herniation as a cause of Brown-Sequard syndrome is relatively rare, early diagnosis accompanied by an urgent treatment can prevent neurological complications in such cases. Keywords: Brown-Sequard Syndrome, Cervical Disc Herniation, Surgery, Ipsilateral motor paralysis

Ghasemi, Amir Abbas

2012-01-01

181

Spontaneous CSF Collection in the Cervical Spine may Cause Neurological Deficit and Intra-cranial Hypotension  

PubMed Central

Objective: a case is described of a spontaneously occurring cerebrospinal fluid collection in the ventral cervical spine which caused radiculopathy and spontaneous intracranial hypotension. Case: a sixty eight year old Caucasian man presented with a 2 year history of proximal upper limb weakness with a his-tory of trivial cervical trauma many years previously. Methods: the patient was investigated with blood tests for causes of peripheral neuropathy, nerve conduction and electro-myography studies, lumbar puncture and MRI of the brain and spine with contrast. Results: a cerebrospinal fluid collection was identified in the ventral cervical spinal cord causing mass effect associated with cord atrophy and there were signs of spontaneous intracranial hypotension on the MRI brain including subdural cere-brospinal fluid collections, meningeal enhancement and slumped posterior fossa. Conclusions: this is the first description of a spontaneous spinal fluid collection causing direct compression and cord sig-nal change, manifest as a motor deficit, with intracranial signs of spontaneous hypotension. Spinal imaging is recom-mended in cases of spontaneous intracranial hypotension and cerebrospinal fluid collections in the spine may rarely be a cause of radiculopathy in such cases.

Zakaria, Rasheed; Wilby, Martin; Fletcher, Nicholas A

2013-01-01

182

Mutations in CIZ1 cause adult-onset primary cervical dystonia  

PubMed Central

Objective Primary dystonia is usually of adult onset, can be familial, and frequently involves the cervical musculature. Our goal was to identify the causal mutation in a family with adult-onset, primary cervical dystonia. Methods Linkage and haplotype analyses were combined with solution-based whole-exome capture and massively parallel sequencing in a large Caucasian pedigree with adult-onset, primary cervical dystonia to identify a cosegregating mutation. High-throughput screening and Sanger sequencing were completed in 308 Caucasians with familial or sporadic adult-onset cervical dystonia and matching controls for sequence variants in this mutant gene. Results Exome sequencing led to the identification of an exonic splicing enhancer mutation in Exon 7 of CIZ1 (c.790A>G, p.S264G) which encodes CIZ1, Cip1-interacting zinc finger protein 1. CIZ1 is a p21Cip1/Waf1-interacting zinc finger protein expressed in brain and involved in DNA synthesis and cell-cycle control. Using a minigene assay, we showed that c.790A>G altered CIZ1 splicing patterns. The p.S264G mutation also altered the nuclear localization of CIZ1. Screening in subjects with adult-onset cervical dystonia identified two additional CIZ1 missense mutations (p.P47S and p.R672M). Interpretation Mutations in CIZ1 may cause adult-onset, primary cervical dystonia, possibly by precipitating neurodevelopmental abnormalities that manifest in adults and/or G1/S cell-cycle dysregulation in the mature central nervous system.

Xiao, Jianfeng; Uitti, Ryan J.; Zhao, Yu; Vemula, Satya R.; Perlmutter, Joel S.; Wszolek, Zbigniew K.; Maraganore, Demetrius M.; Auburger, Georg; Leube, Barbara; Lehnhoff, Katja; LeDoux, Mark S.

2012-01-01

183

Rupture of the dura mater in two dogs caused by the peracute extrusion of a cervical disc  

Microsoft Academic Search

A rupture of the dura mater caused by the peracute extrusion of a cervical disc was diagnosed by myelography in two dogs. In both cases traction on the cervical spine resulted in contrast medium entering the ruptured intervertebral disc from the subarachnoid space. Both dogs became suddenly tetraparetic and unable to ambulate during vigorous exercise, but regained the ability to

W. M. McKee; C. J. Downes

2008-01-01

184

Cervical Cancer  

MedlinePLUS

... 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, ...

185

Cervical spondylosis  

MedlinePLUS

... on the cartilage and bones of the neck (cervical vertebrae). It is a common cause of chronic neck ... spondylosis is caused by chronic wear on the cervical spine. This includes the disks or cushions between the ...

186

Multiple intracranial hemorrhages after cervical spinal surgery.  

PubMed

A 69-year-old woman presented with a rare case of multiple supra- and infratentorial intracranial hemorrhages after cervical laminoplasty for cervical spondylotic myelopathy without intraoperative liquorrhea. A wound drainage tube under negative pressure was placed with subsequent 380 ml of drainage in the first 12 hours. She had no complaint of headache and nausea at that time. Computed tomography of the brain obtained at 15 hours after surgery demonstrated cerebellar hemorrhage, acute subdural hemorrhage, subarachnoid hemorrhage, supratentorial intraparenchymal hemorrhage, and pneumocephalus. She was treated medically without consequent neurological deficits other than right hemianopsia. Overdrainage of cerebrospinal fluid through an occult dural tear might cause severely low intracranial pressure with subsequent multiple intracranial hemorrhages. Wound drainage should be controlled thoroughly even in patients without intraoperative liquorrhea. PMID:23006877

Takahashi, Yuichi; Nishida, Kenki; Ogawa, Koichi; Yasuhara, Takao; Kumamoto, Shinji; Niimura, Tatsuomi; Tanoue, Takashi

2012-01-01

187

Antimicrobial efficacies of several antibiotics against uterine cervicitis caused by Mycoplasma genitalium.  

PubMed

Mycoplasma genitalium has been shown to be one of the pathogens responsible for uterine cervicitis by many studies. However, there are no clinical recommendations for treating M. genitalium-positive uterine cervicitis. Our study retrospectively investigated the antimicrobial efficacies of several antibiotics against uterine cervicitis caused by M. genitalium. We studied a total of 257 women with M. genitalium-positive uterine cervicitis, except for those with chlamydial and gonococcal infections, who were treated with one of the following antibacterial therapies: azithromycin extended release formulation (AZM-SR) 2 g single dose, azithromycin (AZM) 1 g single dose, clarithromycin (CAM) 400 mg/day for 7 days, CAM 400 mg/day for 14 days, moxifloxacin (MFLX) 400 mg/day for 7 days, MFLX 400 mg/day for 14 days, levofloxacin (LVFX) 500 mg/day for 7 days, LVFX 500 mg/day for 14 days, sitafloxacin (STFX) 200 mg/day for 7 days, and STFX 200 mg/day for 14 days. A PCR-based assay was performed to evaluate the microbiological efficacy of eradication in these patients. M. genitalium was eradicated from the uterine cervix in 19 of the 21 (90.5%) patients treated with AZM-SR 2 g single dose, in 38 of the 42 (90.5%) patients treated with MFLX 400 mg/day for 7 days, in 42 of the 42 (100%) patients treated with MFLX 400 mg/day for 14 days, and in 12 of the 13 (92.3%) patients treated with STFX 200 mg/day for 14 days. In conclusion, AZM-SR 2 g single dose, MFLX 400 mg/day for 14 days, and STFX 200 mg/day for 14 days would each be an effective treatment for M. genitalium infection. PMID:22020630

Terada, Michinori; Izumi, Koji; Ohki, Emiko; Yamagishi, Yuka; Mikamo, Hiroshige

2011-10-22

188

Double-door laminoplasty in managing multilevel myelopathy: technique description and literature review  

Microsoft Academic Search

Cervical laminoplasty has become a popular technique for the treatment of cervical myelopathy resulting from multilevel canal\\u000a stenosis. The goal of this technique is to increase the spinal canal space and to reconstruct the posterior bony arch at the\\u000a same time. The most common reason for laminoplasty failure is restenosis because of hinge closure. In the present report,\\u000a the authors

M. Orabi; S. Chibbaro; O. Makiese; J. F. Cornelius; B. George

2008-01-01

189

Correlative study of nerve root palsy and cervical posterior decompression laminectomy and internal fixation.  

PubMed

This study investigates the probable causes of nerve root palsy through the retrospective study of pre- and postoperative cervical curvature change for patients with cervical spondylosis and incidences of nerve root palsy. A consecutive series of 91 patients with cervical compressive myelopathy treated by laminectomy and internal fixation were reviewed. Nerve root palsy developed in 21 of 91 patients (23%) (group A). The other 70 patients, 41 men and 29 women, were chosen as controls (group B). A neutral lateral cervical spine radiograph was taken of all patients. The overall curvature of the cervical spine, the cervical curvature index, and the change rate were measured and compared.The pre- and postoperative change rate of cervical curvatures in groups A and B was 19.17+/-7.62 and 18.03+/-7.62, respectively. The difference was not statistically significant (P>.05). The pre- and postoperative cervical curvature index change rate in groups A and B was 17.52+/-3.46 and 12.43+/-4.12, respectively. There were statistically significant differences between the 2 groups (P<. 05). This indicated the cervical alignment of patients in group A was changed greatly by traction during operation.In this study, we found that tethering the nerve root caused C5 palsy, but excessive intraoperative traction and the use of internal fixation may be one of the most important reasons for this. The cervical curvature index change rate reflected both a change in cervical height and a change in the overall cervical curvature. It is more sensitive in reflecting the degree of cervical traction and the change of the cervical alignment. PMID:20704111

Liu, Tielong; Zou, Weiwei; Han, Yu; Wang, Yan

2010-08-11

190

Anterior decompressive microsurgery and osteosynthesis for the treatment of multi-segmental cervical spondylosis  

Microsoft Academic Search

Summary Surgical treatment of cervical myelopathy due to multi-segmental cervical spondylosis (MSCS) is currently performed by either anterior or posterior approaches. Considering the complex nature of the underlying disease involving more than one cervical segment, as well as the patho-biomechanical features of the spondylotic cervical spine, adequate decompression of the spinal cord and correction of hypermobility should be achieved by

V. Seifert

1995-01-01

191

Pediatric cervical spine fracture caused by an adult 3-point seatbelt.  

PubMed

The development and use of seatbelts has saved numerous lives and prevented serious injuries in the setting of automobile crashes. However, restraints designed for adults are not necessarily effective in preventing injury to small children and may actually be harmful. Here, we present a case of upper cervical spine fracture in a 5-year-old female patient caused by neck flexion over an inappropriately applied adult 3-point seatbelt during a motor vehicle collision. The American Academy of Pediatrics currently advises against the use of vehicle safety belts until the shoulder belt can be positioned across the chest with the lap belt snug across the thighs. As clinicians who care for children, it is imperative that we continue to educate parents about proper use of age-appropriate child safety restraints. PMID:18277848

Deutsch, Robert Jay; Badawy, Mohamed K

2008-02-01

192

Straightened cervical lordosis causes stress concentration: a finite element model study.  

PubMed

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24-33 %, but the stress increased by 5-95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature. PMID:23355324

Wei, Wei; Liao, Shenhui; Shi, Shiyuan; Fei, Jun; Wang, Yifan; Chen, Chunyue

2013-01-25

193

Multiple myeloma-associated solitary epidural amyloidoma of C2-C3 without bony connection or myelopathy: Case report and review of the literature  

Microsoft Academic Search

BackgroundA large solitary amyloidoma in the cervical epidural space without bony connection and with minimal spinal cord compression and no myelopathy, as a first manifestation of disseminated amyloidosis in a multiple myeloma patient, has not been reported previously; this case is thereby distinct from the seven prior reports in the world literature, of a solitary amyloidoma of the cervical spine.

Carl J. Belber; David L. Graham

2004-01-01

194

High-Level Cervical Spinal Cord Stimulation Used to Treat Intractable Pain Arising from Transverse Myelitis Caused by Schistosomiasis  

PubMed Central

The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.

Kim, Jin Kyung; Hong, Seok Ho

2010-01-01

195

Intracranial Hypotension as a Cause of Radiculopathy from Cervical Epidural Venous Engorgement: Case Report  

Microsoft Academic Search

Summary: We describe the case of a 40-year-old man with spontaneous intracranial hypotension who presented with cervical radiculopathy associated with epidural venous en- gorgement. Epidural venous engorgement can occur sec- ondary to intracranial hypotension and manifests intracra- nially as pachymeningeal venous engorgement. In the cervical spine, two cases of epidural venous engorgement due to intracranial hypotension have been reported in

Sait Albayram; Bruce A. Wasserman; David M. Yousem; Robert Wityk

196

Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis  

PubMed Central

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.

Mitsunaga, Lance K.; Klineberg, Eric O.; Gupta, Munish C.

2012-01-01

197

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

PubMed

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

Scher, A T

1982-06-12

198

Intracranial Hypotension Caused by Cervical Cerebrospinal Fluid Leak: Treatment with Epidural Blood Patch  

Microsoft Academic Search

This report describes treatment with cervical epidural blood patch of low cerebrospinal fluid (CSF) pressure headache resulting from spontaneous CSF leak via a tear in a cervical dural cuff. The leak was diagnosed by a dynamic computed tomography (CT)-myelography study followed by gadolinium enhanced magnetic res- onance imaging(MRI)-scan. The epidural needle was inserted with the aid of image intensifier and

Michael J. Cousins; David Brazier; Raymond Cook

2004-01-01

199

Longitudinal length of the spinal cord after cervical laminoplasty  

Microsoft Academic Search

Purpose of study: In cases of cervical myelopathy, the relationship between surgical outcome after laminoplasty and the sagittal alignment is controversial. In our cases with OPLL of unexpected poor surgical outcome, we often found a straight, tense spinal cord on postoperative magnetic resonance imaging, (MRI). So we tried to measure a longitudinal length of the cervical spinal cord (LSC) as

Toru Yokoyama; Kazumasa Ueyama; Akihiro Okada; Takashi Tomita

2002-01-01

200

Nontraumatic Myelopathy Associated With Surfing  

PubMed Central

Background/Objective: Ischemic nontraumatic spinal cord injury associated with surfing is a novel diagnosis believed to be related to prolonged spine hyperextension while lying prone on the surfboard. Only 9 cases have been documented. This report features possible risk factors, etiology, diagnostic imaging, and outcomes of surfer's myelopathy. Design: Case report. Results: A 37-year-old man developed T11 American Spinal Injury Association (ASIA) A paraplegia shortly after surfing. The clinical history and magnetic resonance imaging findings were compatible with an ischemic insult to the distal thoracic spinal cord. Our patient did not have any of the proposed risk factors associated with this condition, and, contrary to most reports, he sustained a complete spinal cord lesion without neurological recovery by 8 weeks post injury. Conclusions: Surfer's myelopathy, because of its proposed mechanism of injury, is amenable to medical intervention. Increased awareness of this condition may lead to early recognition and treatment, which should contribute to improved neurological outcomes.

Aviles-Hernandez, Israel; Garcia-Zozaya, Inigo; DeVillasante, Jorge M

2007-01-01

201

Microsurgery of the cervical spine in elderly patients Part 1: Surgery of degenerative disease  

Microsoft Academic Search

Summary The results of microsurgery for degenerative disease of the cervical spine are reported in 84 consecutive patients being 65 years of age or older at the time of surgery. Patients were suffering from either soft or hard disc disease or from advanced forms of cervical myelopathy. In 60 patients microsurgical resection of the involved cervical disc and posterior osteophytes

V. Seifert; F. M. van Krieken; M. Zimmermann; D. Stolke; S. D. Bao

1994-01-01

202

Surgical Management of Cervical Spinal Epidural Abscess Caused by Brucella Melitensis : Report of Two Cases and Review of the Literature  

PubMed Central

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

Ozbek, Zuhtu; Gokoglu, Abdulkerim; Menku, Ahmet

2012-01-01

203

Syringobulbia Caused by Delayed Postoperative Tethering of the Cervical Spinal Cord – Delayed Complication of Foramen Magnum Decompression for Chiari Malformation  

Microsoft Academic Search

Summary  ?Postoperative tethering of the high cervical spinal cord is a rare cause of neurological deterioration after foramen magnum\\u000a decompression (FMD) with duraplasty for Chiari type I malformation. A review of the literature revealed that only 5 cases\\u000a have been reported. This entity is not widely known to occur as a complication of the common surgical procedure for Chiari\\u000a type I

Y. Takahashi; Y. Tajima; S. Ueno; T. Tokutomi; M. Shigemori

1999-01-01

204

Myelopathy due to atlanto-axial dislocation in a patient with Down's syndrome and rheumatoid arthritis.  

PubMed

A case of Down's syndrome in association with rheumatoid arthritis is described. The patient has spastic diplegia and atlanto-axial dislocation, probably the result of ligamentous laxity which is common in both Down's syndrome and rheumatoid arthritis. This laxity may have been enhanced by tonsillar or deep cervical infection. The myelopathy was thought to be due to the atlanto-axial dislocation. Spinal fusion may reverse the neurological abnormality in some cases. PMID:6454603

Andrews, L G

1981-06-01

205

Myelopathy but normal MRI: where next?  

Microsoft Academic Search

For most patients presenting with a spinal cord syndrome MR scanning has become the key investigation in establishing the diagnosis. However, myelopathy with normal spinal imaging remains a common clinical conundrum. In this review we discuss the diagnoses to consider for the neurologist presented with a patient with “MR normal myelopathy”. We will illustrate this scenario with a series of

S H Wong; M Boggild; T P Enevoldson; N A Fletcher

2008-01-01

206

Effectiveness of acupuncture intervention for neck pain caused by cervical spondylosis: study protocol for a randomized controlled trial  

PubMed Central

Background Neck pain caused by cervical spondylosis has become a common health problem worldwide among >40-year-old adults. Acupuncture intervention is one of the most popular treatment measures for this disorder. However, evidence for its efficacy in relieving neck pain and recovering neck physiological function has not been established in randomized, placebo-controlled trials. The primary aim of this trial is to assess the efficacy and safety of active acupuncture compared with sham acupuncture intervention for neck pain caused by cervical spondylosis. Methods/Design We will conduct a randomized, double-blind, parallel-group, placebo-controlled trial comparing active acupuncture with placebo (sham acupuncture). A total of 456 patients with neck pain caused by cervical spondylosis who meet the eligibility criteria from outpatient clinics of the Second People’s Hospital of Fujian Province and the Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine will be recruited and randomized into an active acupuncture or sham acupuncture group. The participants will undergo treatment sessions with either active or sham acupuncture intervention five times a week for 2 weeks. Evaluation by blinded assessors at baseline and at intervention for 1 and 2 weeks will include demographic characteristics, validated questionnaires (Northwick Park Neck Pain Questionnaire (NPQ) scale, Short-Form 36 (SF-36) scale, and McGill pain scale), examination of neck physiological function, and adverse events. All included patients will be followed up and investigated for relapse of neck pain at 4, 8, and 12 weeks after intervention. Discussion This paper describes the rationale and design of a randomized double-blind, placebo-controlled trial that aims to determine the efficacy and safety of acupuncture intervention for neck pain caused by cervical spondylosis. The primary outcomes are changes in the NPQ score and neck physiological function. Secondary outcome measures include quality of life, adverse events, and relapse of neck pain. If successful, this project will provide evidence of the efficacy and safety of acupuncture for neck pain caused by cervical spondylosis. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-12002206. Registration date: 11 May 2012.

2013-01-01

207

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease. PMID:24009460

Albayrak, Ilknur; Ba?cac?, Sinan; Sall?, Ali; Kucuksen, Sami; U?urlu, Hatice

2013-08-14

208

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Bagcac?, Sinan; Sall?, Ali; Kucuksen, Sami; Ugurlu, Hatice

2013-01-01

209

Posterior approach to the degenerative cervical spine  

Microsoft Academic Search

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

Kazuo Yonenobu; Takenori Oda

2003-01-01

210

Posterior approach to the degenerative cervical spine  

Microsoft Academic Search

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

Kazuo Yonenobu; Takenori Oda

211

Stretch-induced nerve injury as a cause of paralysis secondary to the anterior cervical approach  

Microsoft Academic Search

The anterior approach to the cervical spine, first described 40 years ago, has become a popular and widely used procedure by spine surgeons to expose the anterior vertebral bodies from C3 to T1. A significant complication of this procedure is transient or permanent ipsilateral recurrent laryngeal nerve paralysis. In a previous review at our institution of patients with hoarseness after

NOAH KAWIKA WEISBERG; DAN M. SPENGLER; JAMES L. NETTERVILLE

1997-01-01

212

In silico DNA vaccine designing against human papillomavirus (HPV) causing cervical cancer  

Microsoft Academic Search

HPV vaccines available in the market are not effective against different strains of papillomavirus, therefore, there is a need to develop a new prophylactic DNA vaccine which can work against different strains of HPVs and may lead to protection of cervical cancer against new pandemic viruses. We designed a potential prophylactic DNA vaccine by using all the consensus epitopic sequences

Shishir Kumar Gupta; Archana Singh; Mugdha Srivastava; Shailendra K. Gupta; Bashir Akhlaq Akhoon

2009-01-01

213

Prevent Cervical Cancer  

MedlinePLUS

... professional printing [PDF-2.7MB] Cancer Home “Prevent Cervical Cancer” Infographic Prevent Cervical Cancer with the Right Test at the Right Time ... is cervical. HPV is the main cause of cervical cancer. HPV is a very common virus, passed from ...

214

Clinical and Radiological Outcomes of Anterior Cervical Interbody Fusion Using Hydroxyapatite Spacer  

PubMed Central

Objective This is retrospective study of clinical and radiological outcomes of anterior cervical fusion using Bongros-HA™ (BioAlpha, Seongnam, Korea) which is a type of synthetic hydroxyapatite (HA) spacer to evaluate the efficacy in its clinical application and usefulness as a reliable alternative to autograft bone. Methods Twenty-nine patients were enrolled in this study and 40 segments were involved. All patients were performed anterior cervical interbody fusion using HA spacer and plating system. Indications for surgery were radiculopathy caused by soft-disc herniation or spondylosis in 18 patients, spondylotic myelopathy in 1 patient, and spinal trauma in 10 patients. Cervical spine radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months in all patients to evaluate intervertebral disc height, and the degrees of lordosis. Cervical computed tomography was done at postoperative 12 month in all patients to confirm the fusion status. The mean period of clinical follow-up was 17 months. Results Complete interbody fusion was achieved in 100% of patients. Preoperative kyphotic deformities were corrected in all cases after surgery. Intervertebral disc height was well maintained during follow up period. There were no cases of graft extrusion, graft deterioration and graft fracture. Conclusion HA spacer is very efficient in achieving cervical fusion, maintaining intervertebral disc height, and restoring lordosis. When combined with the placement of a cervical plate, immediate stability can be achieved and graft related complication can be prevented.

Kim, Sung Chul; Kang, Sung Won; Kim, Se Hyuk; Cho, Ki Hong

2009-01-01

215

Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis  

Microsoft Academic Search

Background contextAlthough anterior cervical decompression and fusion has been used successfully in the treatment of symptomatic radiculopathy and\\/or myelopathy, biomechanical studies have suggested possible deleterious effects of cervical fusion on adjacent level kinematics. The emergence of cervical arthroplasty as an alternative to arthrodesis may restore a more normal spinal movement and reduces a kinematic strain on adjacent segments. To date,

Junjie Du; Mo Li; Hao Liu; Hao Meng; Qizhen He; Zhuojing Luo

2011-01-01

216

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. Clinical, neuroradiological and neurophysiological study on 9 cases  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is considered to be uncommon in western countries, although widely known and studied in Japan. We report on 9 cases of OPLL cervical myelopathy, investigated by x-ray films and cervical CT and by somatosensory evoked potentials. The patients reported spastic tetraparesis, sensory disorders of the limbs and, in one

L. Conte; T. Tassinari; M. Trucco; O. Serrato; R. Badino

1992-01-01

217

Teaching NeuroImages: intermittent symptomatic occlusion of the vertebral artery caused by a cervical osteophyte.  

PubMed

A 77-year-old man presented with 2 episodes of waking up with symptoms of vertebrobasilar ischemia (figure, A and B) within 6 months. A CT angiogram showed narrowing of the right vertebral artery due to extrinsic compression by an osteophyte of the superior articular process of the fourth cervical vertebra, compromising the foramen transversarium (figure, C and D). Dynamic angiography demonstrated intermittent vascular occlusion associated with head turning (figure, E-G). After recurrence, surgical decompression of the vertebral artery was performed. Extrinsic compressions of the vertebral artery is rare.(1) The most frequent signs are those of vertebrobasilar insufficiency. Surgical treatment has been proposed when conservative management fails.(1). PMID:23359379

Mourand, Isabelle; Azakri, Souhayla; Boniface, Guillaume; Bonafé, Alain; Maldonado, Igor Lima

2013-01-29

218

Tri-level surgical treatment of cervical spinal cord compression in a Thoroughbred yearling.  

PubMed

A Thoroughbred yearling was presented with neurological, radiographic, and myelographic abnormalities consistent with cervical vertebral stenotic myelopathy. Surgical correction was performed by using ventral cervical interbody fusion at 3 intervertebral spaces. The patient recovered uneventfully from surgery. The neurological status remained unchanged initially; however, significant improvement was noted 37 weeks postoperatively. PMID:17616065

Huggons, Nick

2007-06-01

219

Influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine  

Microsoft Academic Search

The influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine was evaluated retrospectively. Out of 118 patients treated in our clinic for cervical OPLL between 1976 and 1992, 27 had sustained minor trauma to the cervical spine. Of these 27 patients, 13 developed myelopathy,

S Katoh; T Ikata; N Hirai; Y Okada; K Nakauchi

1995-01-01

220

Cervical spinal cord injury caused by vertebral body fracture in a patient with concomitant OALL and OPLL  

Microsoft Academic Search

We encountered a case of cervical spinal cord injury associated with cervical vertebral dislocation fracture that occurred\\u000a in a patient with concomitant ossification of the anterior and posterior longitudinal ligaments. The cervical vertebrae were\\u000a injured by hyperextension in a car accident. On admission, shearing fracture was noted in the OALL region and vertebral body\\u000a OPLL region over the posterior column

O. Obayashi; K. Kaneko; M. Yokoyama; Y. Shimamura; T. Muta; A. Itoi; H. Kurosawa

2008-01-01

221

Cervical spine disorders in farm workers requiring neck extension actions  

Microsoft Academic Search

Background  Cervical extension is considered a risk factor for provoking radicular and spinal cord compromise. However, there have been\\u000a no reports on the relation between extension strain (ES) and cervical spine disorders: degenerative cervical spine disorders,\\u000a dynamic canal stenosis (DCS), and cervical myelopathy. We performed a cross-sectional study to investigate the relation.\\u000a \\u000a \\u000a \\u000a Methods  Orthopedic examinations were performed on 177 grape-growers (ES-exposed group)

Yoshiaki Takamiya; Kensei Nagata; Katsuhiro Fukuda; Akira Shibata; Tatsuya Ishitake; Takajiro Suenaga

2006-01-01

222

Patient perceived outcome after central corpectomy for cervical spondylotic myelopathy  

Microsoft Academic Search

BackgroundPatient perception of outcome after decompressive surgery for CSM is infrequently reported. We evaluated a simple, quantitative patient-reported assessment of outcome after CC for CSM by comparing it with the NGRR.

Vedantam Rajshekhar; Jayaprakash Muliyil

2007-01-01

223

MRI in Vitamin B12 Deficiency Myelopathy  

Microsoft Academic Search

Background: Little is known about vitamin B 12 deficiency myelopathy's magnetic reso- nance imaging (MRI) manifestations and their relationship to the onset, evolution, and resolution of neuro - logic signs and symptoms. Methods: We present a case and review eleven additional reported cases of subacute combined degeneration of the spinal cord detected by MRI. Results: Our patient had increased T2-weighted

Eduardo R. Locatelli; Robert Laureno; Pamela Ballard; Alexander S. Mark

224

Theaflavins depolymerize microtubule network through tubulin binding and cause apoptosis of cervical carcinoma HeLa cells.  

PubMed

Here we studied the antiproliferative activity of theaflavins in cervical carcinoma HeLa cells by investigating their effects on cellular microtubules and purified goat brain tubulin. Theaflavins inhibited proliferation of HeLa cells with IC(50) value of 110 ± 2.1 ?g/mL (p = < 0.01), caused cell cycle arrest at G(2)/M phase and induced apoptosis with alteration of expression of pro- and antiapoptotic proteins. Along with these antiproliferative activities, theaflavins act as microtubule depolymerizers. Theaflavins disrupted the microtubule network accompanied by alteration of cellular morphology and also decreased the polymeric tubulin mass of the cells. The polymerization of cold treated depolymerized microtubules in HeLa cells was prevented in the presence of theaflavins. In vitro polymerization of purified tubulin into microtubules was also inhibited by theaflavins with an IC(50) value of 78 ± 2.43 ?g/mL (P < 0.01). Thus, disruption of cellular microtubule network of HeLa cells through microtubule depolymerization may be one of the possible mechanisms of antiproliferative activity of theaflavins. PMID:21323312

Chakrabarty, Subhendu; Das, Amlan; Bhattacharya, Abhijit; Chakrabarti, Gopal

2011-02-16

225

Degenerative spondylolisthesis of the cervical spine — symptoms and surgical strategies depending on disease progress  

Microsoft Academic Search

Background  Degenerative spondylolisthesis of the cervical spine is rare. Patients show signs of progredient myelopathy, radiculopathy\\u000a and pain. Treatment strategies include ventral, dorsal and combined fusion techniques with or without repositioning and decompression.\\u000a \\u000a \\u000a \\u000a Methods  In this study, we present 16 patients with degenerative cervical spondylolisthesis. The leading symptom was severe myelopathy\\u000a in 8 patients, radiculomyelopathy in 5 patients and neck pain in

Christian Woiciechowsky; Ulrich-Wilhelm Thomale; Stefan-Nikolaus Kroppenstedt

2004-01-01

226

Cervical Spondylosis: Recognition, Differential Diagnosis, and Management  

PubMed Central

In contemporary clinical practice, the prevalence of neck pain in the general population is approximately 15%. The challenge for the primary care specialist is to be able to recognize the more serious disorders that require early referral. Additionally, it is important to have the confidence to institute specific treatment for nonurgent conditions in order to avoid unnecessary referral of patients with generally self-limiting conditions. Cervical spondylosis is a general and nonspecific term that encompasses a broad spectrum of afflictions but, for purposes of clarity, can be organized into three clinical syndromes: Type I Syndrome (Cervical Radiculopathy); Type II Syndrome (Cervical Myelopathy); and Type III Syndrome (Axial Joint Pain). It is important to remember that shoulder problems can masquerade as cervical problems, and vice versa (e.g. adhesive capsulitis, recurrent anterior subluxation, impingement syndrome, rotator cuff tear, etc.). A number of management options, including pharmaceutical, physical therapy, and psychological therapies, are available once a diagnosis has been made.

Voorhies, Rand M.

2001-01-01

227

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

PubMed

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

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

2013-02-13

228

Research on the effectiveness of intermittent cervical traction therapy, using short-latency somatosensory evoked potentials.  

PubMed

Short-latency somatosensory evoked potentials (SSEPs) were measured before and after intermittent cervical traction therapy to serve as objective indicators of therapy effectiveness. The subjects were 29 patients with myelopathy, 23 with cervical radiculopathy, 28 with cervical sprain, and 26 healthy individuals. SSEPs were recorded by stimulating the median nerve, and the negative potentials elicited from the brachial plexus (N9), neck (N11, lcN13, ucN13), and somatosensory area (N18) were measured to determine interpeak latencies and then corrected latency. As to the changes in SSEPs following traction, the N11-lcN13 and lcN13-ucN13 interpeak latencies for patients with type I and II myelopathy decreased, and the severity of myelopathy was inversely related to the degree of decrease. The ucN13-N18 interpeak latency for some patients with severe myelopathy increased. The N9-N11 and N11-lcN13 interpeak latencies for patients with cervical radiculopathy decreased, and the ucN13-N18 for patients with cervical sprain accompanied by autonomic nervous symptoms also decreased. Traction therapy might improve conduction disturbance primarily by increasing the amount of blood flow from the nerve roots to the spinal parenchyma. PMID:11956981

Hattori, Mikihiko; Shirai, Yasumasa; Aoki, Takafumi

2002-01-01

229

Axial pain after posterior cervical spine surgery: a systematic review  

PubMed Central

Posterior operative approach has been the standard treatment for cervical compressive myelopathy, and axial pain after laminoplasty or laminectomy as a postoperative complication is now gradually receiving more and more attention. The objective of this study was to provide a systematic review of the current understanding of axial pain after cervical laminoplasty and laminectomy, and summarize clinical features, influence factors and preventive measures of axial pain after posterior decompressive surgery based on a review of literature published in the English language. Axial pain distributes over nuchal, periscapular and shoulder regions. Posterior surgery is not the major cause of axial pain, but axial pain can be worsened by the procedure. There are many clinical factors that influence postoperative axial pain such as age, preoperative axial pain, different surgical technique and postoperative management, but most of them are still controversial. Several surgical modifications have been innovated to reduce axial pain. Less invasive surgery, reconstruction of the extensor musculature, avoiding detachment of the semispinalis cervicis muscle and early removal of external immobilization have proved to be effective. Axial pain is under the influence of multiple factors, so comprehensive methods are required to reduce and avoid the postoperative axial pain. Because of methodological shortcomings in publications included in this systematic review, different results from different studies may be produced due to differences in study design, evaluation criteria, sample size, and incidence or severity of axial pain. More high-quality studies are necessary for drawing more reliable and convincing conclusions.

Wang, Shan-Jin; Jiang, Sheng-Dan; Jiang, Lei-Sheng

2010-01-01

230

Axial pain after posterior cervical spine surgery: a systematic review.  

PubMed

Posterior operative approach has been the standard treatment for cervical compressive myelopathy, and axial pain after laminoplasty or laminectomy as a postoperative complication is now gradually receiving more and more attention. The objective of this study was to provide a systematic review of the current understanding of axial pain after cervical laminoplasty and laminectomy, and summarize clinical features, influence factors and preventive measures of axial pain after posterior decompressive surgery based on a review of literature published in the English language. Axial pain distributes over nuchal, periscapular and shoulder regions. Posterior surgery is not the major cause of axial pain, but axial pain can be worsened by the procedure. There are many clinical factors that influence postoperative axial pain such as age, preoperative axial pain, different surgical technique and postoperative management, but most of them are still controversial. Several surgical modifications have been innovated to reduce axial pain. Less invasive surgery, reconstruction of the extensor musculature, avoiding detachment of the semispinalis cervicis muscle and early removal of external immobilization have proved to be effective. Axial pain is under the influence of multiple factors, so comprehensive methods are required to reduce and avoid the postoperative axial pain. Because of methodological shortcomings in publications included in this systematic review, different results from different studies may be produced due to differences in study design, evaluation criteria, sample size, and incidence or severity of axial pain. More high-quality studies are necessary for drawing more reliable and convincing conclusions. PMID:20941514

Wang, Shan-Jin; Jiang, Sheng-Dan; Jiang, Lei-Sheng; Dai, Li-Yang

2010-10-13

231

Bioresorbable anterior cervical plate device for multi-level degenerative disc disease: Case report with 8-year follow-up  

Microsoft Academic Search

Anterior cervical decompression and fusion is most successful when bone graft is combined with stabilizing instrumentation. The use of bioresorbable anterior cervical plates has been reported recently instead of the traditional titanium plate. We report a novel application of a bioresorbable plate in the management of a 69-year-old Caucasian female with multi-level, long-standing cervical spondylotic myelopathy. The patient previously had

Robert G. Whitmore; Elana S. Tykocinski; Matthew R. Sanborn; William C. Welch

232

Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis  

Microsoft Academic Search

Canine degenerative myelopathy (DM) is a fatal neurodegenerative disease prevalent in several dog breeds. Typically, the initial progressive upper motor neuron spastic and general proprioceptive ataxia in the pelvic limbs occurs at 8 years of age or older. If euthanasia is delayed, the clinical signs will ascend, causing flaccid tetraparesis and other lower motor neuron signs. DNA samples from 38

Tomoyuki Awano; Gary S. Johnson; Claire M. Wade; Martin L. Katz; Gayle C. Johnson; Jeremy F. Taylor; Michele Perloski; Tara Biagi; Izabella Baranowska; Sam Long; Philip A. March; Natasha J. Olby; G. Diane Shelton; Shahnawaz Khan; Dennis P. O'Brien; Kerstin Lindblad-Toh; Joan R. Coates

2009-01-01

233

METHANOL EXPOSURE DURING GASTRULATION CAUSES HOLOPROSENCEPHALY, FACIAL DYSGENESIS AND CERVICAL VERTEBRAL MALFORMATIONS IN C57BL/6J MICE  

EPA Science Inventory

Exposure of pregnant CD-1 mice to methanol during the period of gastrulation results in exencephaly, cleft palate, and cervical vertebra malformations (Rogers and Mole, 1997, Teratology 55, 364). C57BL/6J mice are sensitive to the teratogenicity of ethanol; fetuses of this strai...

234

The optimized acupuncture treatment for neck pain caused by cervical spondylosis: a study protocol of a multicentre randomized controlled trial  

PubMed Central

Background Neck pain is one of the chief symptoms of cervical spondylosis (CS). Acupuncture is a well-accepted and widely used complementary therapy for the management of neck pain caused by CS. In this paper, we present a randomized controlled trial protocol evaluating the use of acupuncture for CS neck pain, comparing the effects of the optimized acupuncture therapy in real practice compared with sham and shallow acupuncture. Methods/Design This trial uses a multicentre, parallel-group, randomized, sham acupuncture and shallow acupuncture, controlled single-blind design. Nine hospitals are involved as trial centres. 945 patients who meet inclusion criteria are randomly assigned to receive optimized acupuncture therapy, sham acupuncture or shallow acupuncture by a computerized central randomization system. The interventions past for 4 weeks with eight to ten treatments in total. The group allocations and interventions are concealed to patients and statisticians. The Northwick Park Neck Pain Questionnaire (NPQ) is used as the primary outcome measure, and the McGill Pain Questionnaire (MPQ) and The Short Form (36) Health Survey (SF-36) are applied as secondary outcome measures. The evaluation is performed at baseline, at the end of the intervention, and at the end of the first month and the third month during follow-up. The statistical analyses will include baseline data comparison and repeated measures of analysis of variance (ANOVA) for primary and secondary outcomes of group and time differences. Adverse events (AEs) will be reported if they occur. Discussion This trial is a multicentre randomized control trial (RCT) on the efficacy of acupuncture for CS neck pain and has a large sample size and central randomization in China. It will strictly follow the CONSORT statement and STRICTA extension guideline to report high-quality study results. By setting the control groups as sham and shallow acupuncture, this study attempts to reveal the effects of real acupuncture versus placebo or non-classic acupuncture treatment and evaluate whether classic Chinese medical acupuncture is effective on CS neck pain. This study will provide evidence for the effects of acupuncture on CS neck pain. Trial Registration Chinese Clinical Trial Registry: ChiCTR-TRC-00000184.

2012-01-01

235

Long term outcome of anterior cervical discectomy and fusion using coral grafts  

Microsoft Academic Search

Background  To determine the long term efficacy of coral grafts in anterior cervical discectomy and fusion.\\u000a \\u000a \\u000a \\u000a Methods  In this prospective longitudinal study, All patients presenting with myelopathy and\\/or radiculopathy due to discal hernia\\u000a or cervical spondylosis underwent anterior cervical microdiscectomy, arthrodesis with coral, and stabilization with anterior\\u000a cervical locking plates. Clinical and radiological post-operative evaluations were performed at 2 days, 3, 6, and

Najib Ramzi; Geraldo Ribeiro-Vaz; Edward Fomekong; Frédéric E. Lecouvet; Christian Raftopoulos

2008-01-01

236

Possible gabapentin and ketamine interaction causing prolonged central nervous system depression during post-operative recovery following cervical laminoplasty: a case report  

Microsoft Academic Search

Introduction  The drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or\\u000a not gabapentin and ketamine interact to cause prolonged depression of the central nervous system.\\u000a \\u000a \\u000a \\u000a \\u000a Case Presentation  The following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress\\u000a disorder and chronic pain underwent a cervical

Ali R Elyassi; Robert P Long; Robert P Bejnarowicz; Bruce A Schoneboom

2011-01-01

237

Posttraumatic pseudomenigocoele of cervical spine in a patient with skeletal fluorosis. Case report.  

PubMed

A case of fluorotic cervical compressive myelopathy precipitated by trauma is reported. The delayed neurological deterioration was due to a posttraumatic pseudomenincocele, the prompt treatment of which resulted in recovery. Posttraumatic pseudomeningocele is very rate; and certainly so in fluorosis, and thus has not been reported in the literature to date. PMID:7997344

Prasad, V S; Reddy, D R

1994-09-01

238

Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports  

Microsoft Academic Search

Blankenship LD, Basford JR, Strommen JA, Andersen RJ. Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports. Arch Phys Med Rehabil 2002;83:269-72. Rheumatoid arthritis (RA) involvement of the cervical spine is a well-known but perhaps underappreciated phenomenon. Neurologic complications of this involvement include pain, myelopathy, and cranial nerve (CN) palsies. However, hypoglossal nerve palsy (CN XII)

Lisa D. Blankenship; Jeffrey R. Basford; Jeffrey A. Strommen; Renee J. Andersen

2002-01-01

239

Dysphagia and hypervitaminosis A: Cervical hyperostosis  

Microsoft Academic Search

Vertebral hyperostosis typically predominates at the thoracic spine and causes only minor symptoms. Involvement of the cervical spine may cause dysphagia due to pressure on the esophagus. We report three cases of dysphagia revealing cervical hyperostosis.

Daniel Wendling; Chafika Hafsaoui; Jean-Marie Laurain; Michel Runge; Nadine Magy-Bertrand; Clément Prati

2009-01-01

240

Clinical presentation of a patient with thoracic myelopathy at a chiropractic clinic  

PubMed Central

Introduction The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic. Case Report/Methods After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult. Results Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement. Conclusion It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment.

Gay, Charles W.; Bishop, Mark D.; Beres, Jacqueline L.

2012-01-01

241

[Evoked somatosensory plexus and cervical evoked potentials in cervicobrachialgia].  

PubMed

The authors study the sensitive potential evoked from point of Erb and from cervical spine in C6-C7, obtained by stimulation of median nerve in a control group (normals) and in a greater group of 40 cases from patients affected by radiculopathie with or without discal protrusion and by myelopathie spondiloartrosic. The date supply significant informations and are (obicurred in analytique) analyzed with accuracy. PMID:6879059

Rossi, L; Ubiali, E; Merli, R; Rottoli, M R

242

Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine.  

PubMed

We report a case of 73-year-old man with massive hyperostosis of the cervical spine associated with diffuse idiopathic skeletal hyperostosis (DISH), resulting in dysphagia, hoarseness and acute respiratory insufficiency. An emergency operation was performed, which involved excision of osteophytes at the level of C6-C7, compressing the trachea against enlarged sternoclavicular joints, also affected by DISH. Approximately 3 years later, the patient sustained a whiplash injury in a low impact car accident, resulting in a C3-C4 fracture dislocation, which was not immediately diagnosed because he did not seek medical attention after the accident. For the next 6 months, he had constant cervical pain, which was growing worse and eventually became associated with dysphagia and dyspnoea, ending once again in acute respiratory failure due to bilateral palsy of the vocal cords. The patient underwent a second operation, which comprised partial reduction and combined anteroposterior fixation of the fractured vertebrae. Twenty months after the second operation, mild hoarseness was still present, but all other symptoms had disappeared. The clinical manifestations, diagnosis and treatment of the two unusual complications of DISH are discussed. PMID:19798518

Vengust, Rok; Mihalic, René; Turel, Matjaz

2009-10-02

243

Possible gabapentin and ketamine interaction causing prolonged central nervous system depression during post-operative recovery following cervical laminoplasty: a case report  

PubMed Central

Introduction The drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or not gabapentin and ketamine interact to cause prolonged depression of the central nervous system. Case Presentation The following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress disorder and chronic pain underwent a cervical laminoplasty procedure. The patient presented post-operatively in a dissociative state with paralysis, anarthria and preservation of consciousness. All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction. A new onset conversion disorder could also not be excluded. Conclusion Although this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

2011-01-01

244

Past, present, and future of cervical arthroplasty.  

PubMed

Cervical arthroplasty was developed in an attempt to maintain cervical motion and potentially to avoid or minimize adjacent-segment degeneration. If cervical arthroplasty is successful, the long-term results of surgery for cervical disc disease should improve. However, problems associated with cervical arthroplasty have been reported: these include kyphosis, heterotopic ossification-induced motion limitation, no motion preservation even at the index level, and a higher revision rate in a limited number of cases compared with anterior cervical discectomy and fusion (ACDF). In addition, for degenerative cervical disc disorders, the risk of developing adjacent segment degeneration more than 2 years after surgery is reportedly similar for ACDF and cervical arthroplasty. Cervical disc arthroplasty is an emerging motion-sparing technology and is currently undergoing evaluation in many countries as an alternative to arthrodesis for the treatment of cervical radiculopathy and myelopathy. The decision whether to use arthrodesis or arthroplasty is a difficult one. The achievement of good prosthetic performance demands exacting implantation techniques to ensure correct placement. This fact underlines the increasing importance of special instrumentation and surgical skills that involve an understanding of prosthetic lubrication, wear, and biologic effects and familiarity with currently available information regarding kinematics, basic science, testing, and early clinical results. Fortunately, a number of devices are at the late preclinical study stage or at the early clinical trial stage, and results in many cases are promising. In the near future, it is likely that new designs will be produced to replace spinal discs totally or partially in a pathologic entity-specific manner. PMID:23803346

Hyun Oh, Chang; Hwan Yoon, Seung

2013-01-01

245

Spontaneous Cervical Epidural Hematoma Presenting as Brown-Sequard Syndrome Following Repetitive Korean Traditional Deep Bows  

PubMed Central

Spontaneous cervical epidural hematoma (SCEH) is an uncommon cause of acute nontraumatic myelopathy. SCEH presenting as Brown-Sequard syndrome is extremely rare. A 65-year-old man had motor weakness in the left extremities right after his mother's funeral. He received thrombolytic therapy under the impression of acute cerebral infarction at a local hospital. However, motor weakness of the left extremities became aggravated without mental change. After being transferred to our hospital, he showed motor weakness in the left extremities with diminished pain sensation in the right extremities. Diagnosis of SCEH was made by cervical magnetic resonance imaging. He underwent left C3 to C5 hemilaminectomy with hematoma removal. It is important for physicians to be aware that SCEH can be considered as one of the differential diagnoses of hemiplegia, since early diagnosis and management can influence the neurological outcome. We think that increased venous pressure owing to repetitive Korean traditional deep bows may be the cause of SCEH in this case.

Seon, Hyo-Jeong; Song, Min-Keun; Han, Jae-Young; Choi, In-Sung

2013-01-01

246

“Double cervical rib with uncommon presentation”  

Microsoft Academic Search

Double or Bilateral cervical ribs. Pseudo arthrosis of cervical rib with first rib causing neurovascular complication is a\\u000a rare congenital anomaly. We report a case of young man who presented with intermittent claudication in the right hand and\\u000a involvement of peripheral nerves. He had bilateral cervical ribs. Left side cervical rib was small. Right side cervical rib\\u000a had pseudo arthrosis

Mahadev Dixit; Mohan Gan; Narendra Nishanimath; Bhaskar Venkatakrishnaiah Bhagyalakshmi; Prashant Sajjan; Aruneshwari Dayal

2010-01-01

247

Intradural tumor and concomitant disc herniation of cervical spine  

PubMed Central

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.

Bapat, Mihir R; Rathi, Prasanna; Pawar, Uday; Chaudhary, Kshitij

2011-01-01

248

Tetraparesis following dental extraction: case report and discussion of preventive measures for cervical spinal hyperextension injury.  

PubMed

This concerns a patient with compression myelopathy following passive hyperextension of the cervical spine during a dental procedure. Although he had been asymptomatic prior to the procedure, subsequent cervical spinal imaging revealed advanced spondylosis and spinal stenosis. Spinal stenosis is often asymptomatic for a long time. However, when radiculomyelopathy occurs after minor trauma to the head or neck, the patient is often found to have spinal stenosis. Specifically, hyperextension of a cervical spine with spondylotic changes can lead to compression myelopathy. Acquired spinal stenosis correlates positively with aging. As the size of the elderly population continues to increase the prevalence of cervical spondylotic radiculo-myelopathy will likely increase as well. Since appropriate precautions against potential neurologic damage can be undertaken, we suggest radiographic screening for pre-existing spinal stenosis prior to a procedure requiring hyperextension of the neck. Preventive measures for individuals with asymptomatic spondylotic changes and education of all health-care professionals to avoid abrupt or prolonged hyperextension of the cervical spine is emphasized. PMID:9360224

Whiteson, J H; Panaro, N; Ahn, J H; Firooznia, H

1997-10-01

249

Spinal Cord Infarction Caused by Non-dissected and Unruptured Thoracoabdominal Aortic Aneurysm with Intraluminal Thrombus  

PubMed Central

Spinal cord infarction, especially anterior spinal artery syndrome, is a relatively rare disease. We report a case of spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus. A 52-year-old man presented with sudden onset paraplegia. At first, he was diagnosed with cervical myelopathy due to a C6-7 herniated intervertebral disc, and had an operation for C6-7 discetomy and anterior interbody fusion. Approximately 1 month after the operation, he was transferred to the department of rehabilitation in our hospital. Thoracoabdominal aortic aneurysm with intraluminal thrombus was found incidentally on an enhanced computed tomography scan, and high signal intensities were detected at the anterior horns of gray matter from the T8 to cauda equina level on T2-weighted magnetic resonance imaging. There was no evidence of aortic rupture, dissection, or complete occlusion of the aorta. We diagnosed his case as a spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus.

Ki, Young Jin; Jeon, Byoung Hyun

2012-01-01

250

The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine  

PubMed Central

A congenitally narrow cervical spinal canal has been established as an important risk factor for the development of cervical spondylotic myelopathy. However, few reports have described the mechanism underlying this risk. In this study, we investigate the relationship between cervical spinal canal narrowing and pathological changes in the cervical spine using positional magnetic resonance imaging (MRI). Two hundred and ninety-five symptomatic patients underwent cervical MRI in the weight-bearing position with dynamic motion (flexion, neutral, and extension) of the cervical spine. The sagittal cervical spinal canal diameter and cervical segmental angular motion were measured and calculated. Each segment was assessed for the extent of intervertebral disc degeneration and cervical cord compression. Based on the sagittal canal diameter, the subjects were classified into three groups: A, subjects with a congenitally narrow canal, diameter of less than 13 mm; B, subjects with a normal canal, diameter of 13–15 mm; C, subjects with a wide canal, diameter of more than 15 mm. When compared with Groups A and B, the disc degeneration grades at the C3-4, C5-6, and C6-7 segments and the cervical cord compression scores at the C3-4 and C5-6 segments showed significant differences. Additionally, when compare with Groups A and C, the disc degeneration grades at all segments, except C2-3, and the cervical cord compression scores at all segments, except C2-3, showed significant differences. With respect to the cervical kinematics, few differences in the kinematics were observed between Groups B and C, however, the kinematics in Group A was different with other two groups. In Group A, the segmental mobility at the C4-5 and C6-7 segments were significantly higher than those observed in Group B, and the segmental mobility at the C3-4 segment was significantly lower than that observed in Groups B or C. We demonstrated the unique pathological and kinematic traits of cervical spine that exist in a congenitally narrow canal. We hypothesize that kinematic trait associated with a congenitally narrow canal may greatly contribute to pathological changes in the cervical spine. Our results suggest that cervical spinal canal diameter of less than 13 mm may be associated with an increased risk for development of pathological changes in cervical intervertebral discs. Subsequently, the presence of a congenitally narrow canal can expose individuals to a greater risk of developing cervical spinal stenosis.

Morishita, Yuichiro; Naito, Masatoshi; Hymanson, Henry; Miyazaki, Masashi; Wu, Guizhong

2009-01-01

251

Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical\\u000a myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the\\u000a latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a\\u000a retrospective study on

Hai-song YangDe-yu; De-yu Chen; Xu-hua Lu; Wang-jun Yan; Wen Yuan; Yu Chen

2010-01-01

252

Radiolucent cage for cervical vertebral reconstruction: A prospective study of 17 cases with 2-year minimum follow-up  

Microsoft Academic Search

In cervical spondylotic myelopathy, extended anterior spinal cord decompression necessitates subsequent stable vertebral reconstruction.\\u000a Reconstruction with an iliac crest graft and screw-plate fixation gives satisfactory clinical and radiological results, but\\u000a they are often compromised by morbidity involving the bone harvest. The purpose of this study was to evaluate the contribution\\u000a to cervical reconstruction of a biocompatible, radiolucent cage combined with

C. H. Söderlund; V. Pointillart; M. Pedram; G. Andrault; J. M. Vital

2004-01-01

253

Comparison of CT Myelography Performed in the Prone and Supine Positions in the Detection of Cervical Spinal Stenosis  

Microsoft Academic Search

AIM: To quantify the change in the cross-sectional area of the cervical spinal cord and subarachnoid space (SAS) in the supine neutral vs prone extension positions in patients with myelopathy undergoing cervical CT myelography.MATERIAL AND METHODS: Axial CT myelgrams of 21 myelopathic patients were performed in both the supine neutral and prone extension positions. The SAS and cord cross-sectional areas

COLE BLEASE GRAHAM III; FRANZ J. WIPPOLD II; KYONGTAE T. BAE; THOMAS K. PILGRAM; ALI SHAIBANI; DANIEL K. KIDO

2001-01-01

254

Cervical Fracture  

MedlinePLUS

... Copyright 2007 American Academy of Orthopaedic Surgeons Cervical Fracture (Broken Neck) The seven bones in the neck ... connect it to the shoulders and body. A fracture, or break, in one of the cervical vertebrae ...

255

Cervical dysplasia  

MedlinePLUS

... No. 99: management of abnormal cervical cytology and histology. Obstet Gynecol . 2008;112(6):1419-1444. Wright ... consensus guidelines for abnormal cervical screening: tests andcervical histology. Am Fam Physician . 2009;80:147-155.

256

Spinal dural ossification causing neurological signs in a cat.  

PubMed

A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat's locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats. PMID:23777582

Antila, Johanna M; Jeserevics, Janis; Rakauskas, Mindaugas; Anttila, Marjukka; Cizinauskas, Sigitas

2013-06-19

257

NIH Research Leads to Cervical Cancer Vaccine  

MedlinePLUS

... Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents ... in women, the cause of the majority of cervical cancers. Photo courtesy of Judy Folkenberg, NLM Writer By ...

258

[Monosegmental , degenerative, cervical discopathy treated by surgery with insertion of an intervertebral cage].  

PubMed

Monosegmental, degenerative, cervical discopathy may become symptomatic because of spinal instability or neurocompression and may present as cervicalgia, radiculopathy and myelopathy. Conservative therapy of these conditions is indicated only in case of minor symptoms. In patients with radiculopathy, this treatment may be used for a longer period of time than in individuals with myelopathy. However, the disorder may progress and lead to irreversible complaints, especially in case of myelopathy. Therefore, the surgical treatment is preferred: if conservative therapy does not improve symptoms within a short period of time and if the patient continues to suffer, surgery is clearly indicated. Only recently, novel surgical methods such as microtechniques and cage surgery were introduced. The results of these types of surgery in this indications are very favourable with respect to recovery from pain, paresis and sensory deficits, rates of fusion of the motion segment, morbidity and mortality. PMID:12212492

Wenger, Markus

2002-07-01

259

Adjacent level spondylodiscitis after anterior cervical decompression and fusion  

PubMed Central

Postoperative spondylodiscitis after anterior cervical decompression and fusion (ACDF) is rare, but the same occurring at adjacent levels without disturbing the operated level is very rare. We report a case, with 5 year followup, who underwent ACDF from C5 to C7 for cervical spondylotic myelopathy. He showed neurological improvement after surgery but developed discharging sinus after 2 weeks, which healed with antibiotics. He improved on his preoperative symptoms well for the first 2 months. He started developing progressive neck pain and myelopathy after 3 months and investigations revealed spondylodiscitis at C3 and C4 with erosion, collapse, and kyphosis, without any evidence of implant failure or graft rejection at the operated level. He underwent reexploration and implant removal at the operated level (there was good fusion from C5 to C7) followed by debridement/decompression at C3, C4 along with iliac crest bone grafting and stabilization with plate and screws after maximum correction of kyphosis. The biopsy specimen grew Pseudomonas aeruginosa and appropriate sensitive antibiotics (gentamycin and ciprofloxacin) were given for 6 weeks. He was under regular followup for 5 years his myelopathy resolved completely and he is back to work. Complete decompression of the cord and fusion from C2 to C7 was demonstrable on postoperative imaging studies without any evidence of implant loosening or C1/C2 instability at the last followup.

Basu, Saumyajit; Sreeramalingam, Rathinavelu

2012-01-01

260

Fusion of the occiput to the upper cervical spine. A review of 37 cases.  

PubMed

This is the first report of a large series of patients undergoing preoperative traction to reduce spinomedullary compression from cranial settling. In all cases, an attempt was made to reduce the malalignment with Gardner-Wells or halo traction before posterior fusion. One patient required an anterior retropharyngeal decompression of the odontoid performed as a one-stage procedure at the time of the posterior operation, and two required subsequent anterior transoral-transpharyngeal resection of the odontoid. From 1974 to 1989, 37 patients underwent posterior occipital cervical arthrodesis. All cases presented with neurologic deficit, and most had signs of brain stem compression, such as L'hermitte's sign or Ondine's curse. The most common cause of basilar impression was rheumatoid arthritis, neoplastic destruction, previously failed C1-C2 fusion, or Down's syndrome. Mean postoperative follow-up was 2 years and 10 months; the patients with less than 2 years' follow-up were followed until successful fusion. Eight of 9 patients with L'hermitte's sign or Ondine's curse and 10 of 12 patients with intractable occipital pain were relieved of their symptoms after reduction and triple-wire stabilization-fusion. Eighteen of 25 patients with long tract signs improved after surgery. Interestingly, 14 (93.3%) of 15 patients with myelopathy improved when successful preoperative reduction of their deformity occurred, whereas only 4 (40%) of 10 patients with fixed basilar impression improved (chi 2 = 8.57, P = .014). Symptoms such as Ondine's curse, L'hermitte's sign, intractable occipital headache, and myelopathy are usually relieved by skeletal traction and posterior fusion without need of an additional transmucosal anterior procedure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1801259

McAfee, P C; Cassidy, J R; Davis, R F; North, R B; Ducker, T B

1991-10-01

261

Thoracic spinal stenosis and myelopathy: report of two rare cases and review of the literature.  

PubMed

The authors report two cases of thoracic spinal canal stenosis (SCS) and myelopathy. One is extremely unusual because of degenerative changes occurred in the upper thoracic spine. The other because of its multiple etiology among which calcification and ossification of the ligamentum flavum (OLF) in a Caucasian man. Both patients presented with an history of slowly progressive spastic paraparesis. In the first case computed tomography (CT) scans and magnetic resonance (MR) images revealed hypertrophy of the legamentum flavum and laminae causing compression of the spinal cord at T2-T3. In the second case diagnostic imaging showed three levels of stenosis in the lower thoracic spine due to degenerative changes, calcification and OLF with cord damage at T9-T10. A decompressive laminectomy and medial facetectomy was performed in both patients. The ligamentum flavum, hypertrophied and infolded in the first case and calcified and ossified in the second, was removed with careful dissection of the dural adhesions. Both patients showed a rapid post-operative recovery and regained autonomous walking within 1 month of surgery. Thoracic spinal cord stenosis is a rare and complex disorder because of differential diagnosis, neuroimaging features and treatment options. Regardless of its cause, prompt surgical decompression plays a key role in improving the functional outcome of myelopathy. PMID:23111299

Amato, V; Giannachi, L; Irace, C; Corona, C

2012-12-01

262

Cervical Cancer (PDQ): Screening  

MedlinePLUS

... These are called diagnostic tests . General Information About Cervical Cancer Cervical cancer is a disease in which malignant (cancer) cells ... Cervical Cancer Prevention Cervical Cancer Treatment Screening for cervical cancer using the Pap test has decreased the number ...

263

Posterior stabilization of the cervical spine with hooks and screws. A clinical evaluation of 26 patients with traumatic, degenerative or metastatic lesions, using a new implant system  

Microsoft Academic Search

We operated on 26 patients with cervical spine disorders (13 with traumatic lesions, 3 with spinal stenosis and myelopathy, 1 with osteomyelitis and 9 with metastasis) with posterior stabilization. A new implant system (Cervi-Fix) based on rods, enabling a choice of either screw or laminar hook fixation in a free combination, was used. The system was evaluated for ease of

Christer Hildingsson; Håkan Jonsson

2001-01-01

264

Relapsing hypocupraemic myelopathy requiring high-dose oral copper replacement  

Microsoft Academic Search

Adult-onset copper deficiency with neurological manifestations is a newly recognised syndrome. Long-term oral copper replacement therapy has been the mainstay of treatment in the literature. A case of relapsing hypocupraemic myelopathy responsive to increased doses of copper replacement is reported. Standard doses of copper may not be sufficient for all patients.

C I Prodan; S S Bottomley; N R Holland; S E Lind

2006-01-01

265

Relapsing hypocupraemic myelopathy requiring high-dose oral copper replacement  

PubMed Central

Adult?onset copper deficiency with neurological manifestations is a newly recognised syndrome. Long?term oral copper replacement therapy has been the mainstay of treatment in the literature. A case of relapsing hypocupraemic myelopathy responsive to increased doses of copper replacement is reported. Standard doses of copper may not be sufficient for all patients.

Prodan, C I; Bottomley, S S; Holland, N R; Lind, S E

2006-01-01

266

Two-level contiguous cervical disc disease treated with peek cages packed with demineralized bone matrix: results of 3-year follow-up  

Microsoft Academic Search

Interbody cages are widely used instruments for cervical fusion operations. Long-term follow-up studies are needed to clarify\\u000a if these devices are dependable. In this prospective study, 79 patients (42 women and 37 men) with a mean age of 51 years\\u000a operated between January 2000 and December 2005 for treatment of degenerative cervical disc disease and spondylosis associated\\u000a with radiculopathy or myelopathy

K?vanç Topuz; Ahmet Çolak; Serdar Kaya; Hakan ?im?ek; Murat Kutlay; Mehmet Nusret Demircan; Murat Velio?lu

2009-01-01

267

Cervical pharyngostomy.  

PubMed Central

The technique of cervical pharyngostomy is presented as a safe alternative procedure to the nasogastric tube for patients requiring prolonged periods of gastrointestinal decompression or tube feeding. The results in 21 cases are described. The complication rate is low and the use of cervical pharyngostomy is therefore justified in that it reduces patient discomfort and makes treatment more efficient. Images Fig. 3 Fig. 4

Farndon, J. R.; Taylor, R. M.

1977-01-01

268

Cervical cancer.  

PubMed

Squamous cell cervical cancer incidence and mortality have been reduced dramatically as a result of successful screening in many countries. The incidence of cervical adenocarcinoma continues to increase. There has been concentrated effort toward improving early detection and screening by utilizing molecular biomarker assays. The FIGO staging system for cervical cancer was revised in 2009. Fertility preservation can be offered to patients with early-stage cervical cancer through radical trachelectomy, although radical hysterectomy remains the surgical standard of care. Concurrent chemotherapy with radiation has been shown to have a survival advantage in patients with advanced-stage disease. Improvements in radiation techniques and molecular targeted therapy are the current research venues in cervical cancer. PMID:22640713

Lea, Jayanthi S; Lin, Ken Y

2012-04-24

269

Dynamic somatosensory evoked potentials to determine electrophysiological effects on the spinal cord during cervical spine extension.  

PubMed

Object The goal of this prospective study was to investigate somatosensory evoked potentials (SSEPs) during dynamic motion of the cervical spine and to evaluate the efficacy of analyzing dynamic SSEPs for predicting dynamic effects on the spinal cord in patients with cervical spondylotic myelopathy (CSM). Methods In total, 40 human subjects (20 CSM patients and 20 healthy volunteers as a control group) were examined prospectively using dynamic SSEPs with median nerve stimulation. The CSM patients showed cervical myelopathy due to cervical cord compression at the C4-5 segment. The SSEPs were examined with the cervical spine in a neutral position and at a 20° extension for 10 and 20 minutes. Changes in the N20 latency and amplitude were determined and analyzed. The authors defined the changes in the N20 latency and N20 amplitude between the neutral and extension positions of the cervical spine as percent latency and amplitude, respectively. Results In the CSM patients, SSEPs tended to deteriorate after cervical spine extension, and a statistically significant deterioration of the N20 amplitude after the extension was observed. Moreover, the percent latency and amplitude progressively increased during cervical spine extension in these patients. In the healthy controls, SSEPs tended to deteriorate with cervical spine extension, but these changes did not result in statistically significant differences. Moreover, in this group the percent latency and amplitude were almost identical during the extension. When the CSM patients and the healthy controls were compared, a significant difference in the percent amplitude was observed between the 2 groups during the cervical spine extension. Conclusions This study suggests the potential of dynamic SSEPs as a useful neurophysiological technique to detect the effect of dynamic factors on the pathogenesis of CSM. PMID:23848352

Morishita, Yuichiro; Maeda, Takeshi; Ueta, Takayoshi; Naito, Masatoshi; Shiba, Keiichiro

2013-07-12

270

Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament  

Microsoft Academic Search

Background context: The diagnosis and treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL) is continuing to evolve as its effects become more readily recognized and surgical alternatives expand.Purpose: To review the clinical, neurodiagnostic and surgical management of OPLL. Study design\\/setting: Patients with early OPLL, often in their mid-forties, present with radiculopathy or mild\\/moderate myelopathy. Radiographically, hypertrophy of

Nancy Epstein

2002-01-01

271

Congestive myelopathy (Foix-Alajouanine Syndrome) due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature  

PubMed Central

Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients’ symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

Krishnan, Prasad; Banerjee, Tapas Kumar; Saha, Manash

2013-01-01

272

Abnormalities of spinal magnetic resonance images implicate clinical variability in human T-cell lymphotropic virus type I-associated myelopathy.  

PubMed

This study investigated the role of human T-cell lymphotropic virus type I HTLV-I infection in 11 patients who developed slowly progressive myelopathy with abnormal spinal cord lesions. The authors performed clinical and neuroradiological examinations and calculated the odds that an HTLV-I-infected individual of a specific genotype, age, and provirus load has HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Anti-HTLV-I antibodies were present in both the serum and cerebrospinal fluid in all of the patients. Abnormal magnetic resonance imaging (MRI) lesions were classified as cervical to thoracic type (CT type), cervical type (C type), and thoracic type (T type). In each type, there was swelling of the spinal cords with high-intensity lesions, which were located mainly in bilateral posterior columns, posterior horns, or lateral columns. Virological and immunological analyses revealed that all patients showed a high risk of developing HAM/TSP. These 11 patients may have developed HAM/TSP, as manifested by spinal cord abnormalities shown on MRI. These MRIs implicate clinical variability of HAM/TSP, which may indicate active-early stages of HAM/TSP lesions. PMID:17613716

Umehara, Fujio; Nose, Hirohisa; Saito, Mineki; Fukuda, Michinari; Ogino, Mieko; Toyota, Tomoko; Yuhi, Tomoaki; Arimura, Kimiyoshi; Osame, Mitsuhiro

2007-06-01

273

Axial Neck Pain after Cervical Laminoplasty  

PubMed Central

Objective It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. Methods A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n = 16) and in patients in which the C7 spinous process was sacrificed (group 2, n = 15). Results Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p = 0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p = 0.002). Conclusion The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.

Cho, Chul Bum; Oh, Jong Yang; Park, Hae Kwan; Lee, Kyung Jin; Rha, Hyoung Kyun

2010-01-01

274

Cervical Cancer  

MedlinePLUS

... Centers for Disease Control and Prevention’s (CDC) Inside Knowledge: Get the Facts About Gynecologic Cancer campaign. The ... the facts about gynecologic cancer, providing important “inside knowledge” about their bodies and health. What is cervical ...

275

Cervical Adenocarcinoma  

MedlinePLUS

... The most common subtype of cervical cancer, called squamous cell carcinoma, arises from the surface lining of the ectocervix, ... successful at decreasing the number of patients with squamous cell carcinoma of the cervix, it has not yet been ...

276

Cervical Cancer  

MedlinePLUS

... by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV), the herpes virus, or many other infections. Abnormal cells. These changes are called cervical dysplasia. The cells ...

277

Cervical Cap  

MedlinePLUS

... girl for a cervical cap. During a pelvic exam, the doctor will determine which size cap is ... About Sexually Transmitted Diseases (STDs) Breast and Pelvic Exams Female Reproductive System Emergency Contraception Birth Control Pill ...

278

Radiation myelopathy: new perspective on an old problem.  

PubMed

This article discusses recent advances in basic research that alter the view of the pathogenesis of radiation myelopathy and summarizes the available data from developmental neurobiology and preclinical studies on demyelinating diseases. These studies have produced interesting insights into oligodendrocyte development, intercellular signaling pathways, and myelination processes. Current findings suggest that administration of cytokines as platelet-derived growth factor and basic fibroblast growth factor could increase proliferation of oligodendrocyte progenitors, enhance their differentiation, up-regulate synthesis of myelin constituents, and promote myelin regeneration in the adult central nervous system (CNS). Other compounds might also be able to modulate the progression of pathogenic processes that lead to myelopathy. In addition, several possible biological prevention or treatment strategies, for example stimulation of endogenous cellular regeneration and glial cell transplantation, are discussed. Rationally designed animal experiments pursuing such strategies could further elucidate the pathogenesis of radiation-induced CNS damage. PMID:10492160

Nieder, C; Ataman, F; Price, R E; Ang, K K

1999-01-01

279

Thoracic myelopathy secondary to seizure following scoliosis surgery.  

PubMed

The incidence of spinal injuries is increased in people with epilepsy although compressive thoracic myelopathy has not been reported. We describe a 15-year-old girl with SCN1A mutation (Dravet syndrome), refractory generalized tonic-clonic seizures, and prior posterior instrumentation and fusion for scoliosis, who presented with progressive lower extremity weakness. Junctional kyphosis with disc herniation and spinal cord compression directly rostral to the instrumentation was apparent on imaging. On history, the patient had suffered a particularly severe convulsive seizure just before developing symptoms. Surgical decompression and stabilization led to a complete neurologic recovery. This unusual presentation of myelopathy illustrates the need to consider this complication in patients with epilepsy and spinal instrumentation. PMID:22140129

Myers, Kenneth A; Payne, Eric T; Esser, Michael J; Kirton, Adam; Howard, Jason J

2011-12-02

280

Cervical Cancer Screening  

MedlinePLUS

What is cervical cancer screening? Cervical cancer screening is used to find changes in the cells of the cervix that could lead ... includes the FAQ Human Papillomavirus Infection]. How is cervical cancer screening done? Cervical cancer screening is simple and ...

281

Cervical Cancer Symptoms  

MedlinePLUS

... Foundation for Women’s Cancer Home Types of Gynecologic Cancers Cervical Cancer Diagnosis and Treatment Symptoms Symptoms Cervical cancer ... Stay Connected About Gynecologic Cancers Types of Gynecologic Cancers Cervical Cancer Screening and Prevention Primary Prevention with Cervical ...

282

Long-term outcome of acute and subacute myelopathies  

Microsoft Academic Search

We aimed to evaluate the long-term (>2 years) outcome of acute and subacute myelopathies (ASM). We systematically followed-up\\u000a consecutive patients presenting with a first episode of ASM, defined by spinal cord symptoms with an onset <3 weeks and duration\\u000a ?48 h. Patients with compressive or traumatic spinal cord lesions are excluded from this report. Our cohort consisted of 170\\u000a patients (median age 39.0 years,

S. Debette; J. de Sèze; J.-P. Pruvo; H. Zephir; F. Pasquier; D. Leys; P. Vermersch

2009-01-01

283

Neurological complications of endemic skeletal fluorosis, with special emphasis on radiculo-myelopathy.  

PubMed

The results of surveys carried out between 1976 and 1985 in the fluorosis-endemic area of the Ethiopian Rift Valley is summarised, with emphasis on the neurological complications resulting from the crippling osteofluorosis. The neurological manifestations in the forms of myelopathy with and without radiculopathy (respectively 72% and 28%) occurred after exposure to high fluoride (greater than 4 ppm) for longer than 10 years. These deficits were clearly found to be a consequence of fluoride deposition in bones, resulting in generalised sclerosis and osteophytosis, with reduction in the diameter of the intervertebral foramina and of the spinal conal. Advanced osteosclerosis commonly causes severe spastic quadriparesis in flexion, accompanied by distressing spasms and urinary incontinence. The dilemma of these medical problems in relation to the agro-industrial economic developments of the Ethiopian Rift Valley is discussed. PMID:2172892

Haimanot, R T

1990-05-01

284

Author’s reply to the letter to the editor of Hiroyuki Yoshihara concerning “C5 palsy following anterior decompression and spinal fusion for cervical degenerative diseases” by M. Hashimoto et al. (2010) Eur Spine J 19:1702–1710  

Microsoft Academic Search

We thank Dr. Yoshihara for his comments on our manuscript and below provide our responses to his remarks. It appears that cervical myelopathy is more prevalent in Japan than in the US [1]. This is partly because the Japanese people have narrower spinal canal diameter [2] and a higher incidence of patients have ossification of the posterior longitudinal ligament [3];

Mitsuhiro Hashimoto

285

How will HPV vaccines affect cervical cancer?  

Microsoft Academic Search

Cancer of the uterine cervix is the second largest cause of cancer deaths in women, and its toll is greatest in populations that lack screening programmes to detect precursor lesions. Persistent infection with 'high risk' genotypes of human papillomavirus (HPV) is necessary, although not sufficient, to cause cervical carcinoma. Therefore, HPV vaccination provides an opportunity to profoundly affect cervical cancer

Richard Roden; T.-C. Wu

2006-01-01

286

Fractures of the cervical spine  

PubMed Central

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

Marcon, Raphael Martus; Cristante, Alexandre Fogaca; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcisio Eloy Pessoa

2013-01-01

287

Cervical arthroplasty: the beginning, the middle, the end?  

PubMed

Cervical arthroplasty has developed as an alternative to spinal fusion for the treatment of cervical radiculopathy and myelopathy. The popularity of artificial discs has grown as the evidence of complications following arthrodesis has increased, making the theoretical advantages (motion preservation, altering the natural history of disease, prevention of adjacent segment disease) of disc replacement more attractive. However, as more discs are implanted and the length of follow-up increases, reported complications such as heterotopic ossification, device migration and spontaneous fusion of arthroplasty devices are growing. As a result, surgeons and patients face a challenge when deciding between motion-preserving or fusion surgery. Currently, there is inadequate evidence to promote extensive use of artificial discs for cervical spondylosis, despite promising short-term and intermediate clinical outcomes. However, there is also insufficient evidence to cease using them completely. The use of arthroplasty over fusion in the long term can only be justified if the incidence of adjacent segment disease decreases as a result. Despite the level of investment and research into arthroplasty outcomes, long-term follow-up has yet to be completed and has not convincingly demonstrated the effect of artificial discs on adjacent segment disease. Further long-term randomised trials are necessary to determine whether cervical arthroplasty is able to reduce the incidence of adjacent segment disease and, in doing so, replace arthrodesis as the gold standard treatment for cervical spondylosis. PMID:21815734

Richards, O; Choi, D; Timothy, J

2011-08-04

288

Cervical Cancer  

MedlinePLUS

... DS00167 ">Cervical cancer Guidelines for sites linking to MayoClinic.com Advertisement Mayo Clinic Store Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Try Mayo Clinic Health Letter ... answers to live stronger, longer and healthier at any age ...

289

Cervical Cryotherapy  

MedlinePLUS

Cervical Cryotherapy What is cryotherapy? Cryotherapy or a freezing treatment is a safe and effective way to destroy abnormal cells that have been found on ... simple procedure to do. Why do I need cryotherapy? Your last Pap smear detected abnormal cells on ...

290

Revision cervical spine surgery using transarticular or pedicle screws under a computer-assisted image-guidance system  

Microsoft Academic Search

Background  The exact insertion of a cervical screw is technically demanding, especially when normal anatomic landmarks have been obscured\\u000a and are difficult to identify, such as in revision surgery. The purpose of this study was to evaluate the efficacy of an image-guidance\\u000a system to aid placement of transarticular and pedicular screws for revision cervical spine surgery.\\u000a \\u000a \\u000a \\u000a Methods  Ten patients with recurrent myelopathy,

Atsushi Seichi; Katsushi Takeshita; Susumu Nakajima; Toru Akune; Hiroshi Kawaguchi; Kozo Nakamura

2005-01-01

291

Cervical Cancer: Screening and Therapeutic Perspectives  

Microsoft Academic Search

Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia, Africa and Latin America, despite the fact that it is an eminently preventable cancer. While cytology screening programmes have resulted in a substantial reduction of cervical cancer mortality in developed countries, they have been shown

Rengaswamy Sankaranarayanan; Somanathan Thara; Pulikottil Okkuru Esmy; Partha Basu

2008-01-01

292

Analysis on risk factors for cervical cancer using induction technique  

Microsoft Academic Search

Cervical cancer is a leading cause of cancer deaths in woman worldwide. New approach to the analysis of risk factors and management of cervical cancer is discussed in this study. We identified the combined patterns of cervical cancer risk factors including demographic, environmental and genetic factors using induction technique. We compared logistic regression and a decision tree algorithm, CHAID (Chi-squared

Seung Hee Ho; Sun Ha Jee; Jong-eun Lee; Jong Sup Park

2004-01-01

293

Cervical chemonucleolysis.  

PubMed

Forty patients with 44 cervical disc herniations were injected with 1500 to 1800 U of chymopapain from September 1988 to March 1992. After prophylactic H1-H2 receptor antagonist administration and under neuroleptanalgesia, a needle was inserted into the disk through an anterolateral approach, guided by x-ray monitoring. The discography performed before the enzyme injection confirmed the herniation in every case. The diagnosis was established by radiculography, computerized tomography (CT) scan, radiculo-CT scan, magnetic resonance imaging (MRI), or discography. Average follow up was 21.4 months (range: 3 to 43). Overall, there were 34 (85%) satisfactory results, 3 fair (7.5%), and 3 poor (7.5%) results. There were no complications, and the average hospital stay was 26 hours. Post-injection MRI performed in 18 cases confirmed the complete disappearance of the herniation in 13 cases. These data support the efficacy and innocuity of chymopapain chemonucleolysis in managing soft cervical disk herniations. PMID:7761313

Gomez-Castresana, F B; Vazquez Herrero, C; Baltes Horche, J L

1995-03-01

294

Delayed radiation myelopathy: Differential diagnosis with positron emission tomography/computed tomography examination.  

PubMed

Myelopathy is a rare but serious complication of radiation therapy (RT). Radiation myelopathy is white matter damage to the spinal cord developed after a certain period of application of ionizing radiation. Factors such as radiation dose and time between applications affect the occurrence as well as the severity of myelopathy. In those patients, positron emission tomography/computed tomography examination has a very important role both in the diagnosis and in the differential diagnosis of lesions. In this case report, the case of progressive paraparesis, developed in a 52-year-old female patient operated with pulmonary mucinous cystadenocarcinoma diagnosis and who received chemotherapy and RT following surgery, has been reported. PMID:23559989

Kadir, Tufan; Sarica, Feyzi Birol; Ozgur, Kardes; Cekinmez, Melih; Nur, Altinors Mehmet

2012-10-01

295

Delayed radiation myelopathy: Differential diagnosis with positron emission tomography/computed tomography examination  

PubMed Central

Myelopathy is a rare but serious complication of radiation therapy (RT). Radiation myelopathy is white matter damage to the spinal cord developed after a certain period of application of ionizing radiation. Factors such as radiation dose and time between applications affect the occurrence as well as the severity of myelopathy. In those patients, positron emission tomography/computed tomography examination has a very important role both in the diagnosis and in the differential diagnosis of lesions. In this case report, the case of progressive paraparesis, developed in a 52-year-old female patient operated with pulmonary mucinous cystadenocarcinoma diagnosis and who received chemotherapy and RT following surgery, has been reported.

Kadir, Tufan; Sarica, Feyzi Birol; Ozgur, Kardes; Cekinmez, Melih; Nur, Altinors Mehmet

2012-01-01

296

Histomorphometric study of iliac bones in cervical myelopathy with ossification of the posterior longitudinal ligament  

Microsoft Academic Search

:   To investigate whether there was any abnormal systemic bone metabolism in patients with ossification of the posterior longitudinal\\u000a ligament (OPLL), we measured various histomorphometric indices of the iliac trabecular bones in 19 patients with OPLL (14\\u000a men, 5 women). For each index, the Z-score for each patient was calculated, using the SD and mean value for non-OPLL control\\u000a group

Ikuo Aita; Atsuya Ohno; Hitoshi Amagai; Hiroyuki Hirabayashi; Koichiro Hayashi

1998-01-01

297

Lifelines: Cervical Cancer  

Cancer.gov

Lifelines: Cervical Cancer Play Pause Volume Up Volume Down Mute Unmute Fast Forward Rewind Lifelines™ Cancer Education Series: Resources for Multicultural Media Breast Cancer Cervical Cancer Colorectal Cancer

298

Leprotic cervical spondylodiscitis.  

PubMed

Leprosy is a chronic infectious disease caused by the Mycobacterium leprae that leads to leprotic neuropathy involving the peripheral nerve and several characteristic skin lesions. Skeletal involvement can occur in peripheral joints, such as the wrist and the ankle. However, there is no report of an axial leprotic lesion involving the spine or paraspinal soft tissue. The authors report the first case of a leprotic cervical lesion involving the axial skeletal system. A 48-year-old male presented with neck pain and severe pain in the right suprascapular area and left arm. Preoperative MRI of the cervical spine revealed signal changes in the prevertebral soft tissue at the level of the C3, 4, 5 vertebral bodies. There were a lower signal intensity on T1-weighted image and high signal intensity on T2WI of the bone marrow at the level of the C5 and C6 vertebral bodies, and a C5/6 segmental ossification of the posterior longitudinal ligament. There were herniated cervical disc on the left C5/6 with C6 root and the right side of C6/7 with a C7 root compression. He was previously diagnosed with leprosy when he was 14 years old and received treatment intermittently over the course of 7 years. But patient did not disclose his past history. Surgical intervention was conducted using an anterior cervical approach. An incision was made in the anterior longitudinal ligament at C5/6, and a pinkish gray friable gelatinous material was observed on the C5/6 disc and on the anterior lower one-third surface of the C5 vertebral body. Specimens were obtained and subjected to pathological evaluation and microbiological culture. After C5/6 and C6/7 discectomies, nerve root decompression and autologous iliac bone grafting were performed at the C5/6 and C6/7 levels. The C5-6-7 vertebrae were fixed with an Atlantis cervical locking plate and a screw system. The pathological report indicated chronic inflammation with heavy plasma cell infiltration on the specimen. We sent the specimens to the Institute of Hansen's Disease, and polymerase chain reaction for leprosy tested positive. After surgery, his pain disappeared and he was given a prescription for antileprotic drugs. The authors describe the first case of leprotic cervical spondylodiscitis that was operatively treated in a 48-year-old patient with known leprosy history since his 14 years old. PMID:20372941

Kim, Sang Jin; Lee, Tae Hoon; Shin, Jun Jae; Chae, Gue Tae

2010-04-07

299

Diffusion tensor imaging in the cervical spinal cord.  

PubMed

There are discrepancy between MR findings and clinical presentations. The compressed cervical cord in patients of the spondylotic myelopathy may be normal on conventional MRI when it is at the earlier stage or even if patients had severe symptoms. Therefore, it is necessary to take a developed MR technique--diffusion tensor imaging (DTI)--to detect the intramedullary lesions. Prospective MR and DTI were performed in 53 patients with cervical compressive myelopathy and twenty healthy volunteers. DTI was performed along six non-collinear directions with single-shot spin echo echo-planar imaging (EPI) sequence. Intramedullary apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured in four segments (C2/3, C3/4, C4/5, C5/6) for volunteers, in lesions (or the compressed cord) and normal cord for patients. DTI original images were processed to produce color DTI maps. In the volunteers' group, cervical cord exhibited blue on the color DTI map. FA values between four segments had a significant difference (P < 0.01), with the highest FA value (0.85 ± 0.03) at C2/3 level. However, ADC value between them had no significant difference (P > 0.05). For patients, only 24 cases showed hyperintense on T2-weighted image, while 39 cases shown patchy green signal on color DTI maps. ADC and FA values between lesions or the compressed cord and normal spinal cord of patients had a significant difference (both P < 0.01). FA value at C2/3 cord is the highest of other segments and it gradually decreases towards the caudal direction. Using single-shot spin echo EPI sequence and six non-collinear diffusion directions with b value of 400 s mm(-2), DTI can clearly show the intramedullary microstructure and more lesions than conventional MRI. PMID:20938788

Song, Ting; Chen, Wen-Jun; Yang, Bo; Zhao, Hong-Pu; Huang, Jian-Wei; Cai, Ming-Jin; Dong, Tian-Fa; Li, Tang-Sheng

2010-10-13

300

Traumatic cervical artery dissection.  

PubMed

Traumatic cervical artery dissection (TCAD) is a complication of severe blunt head or neck trauma, the main cause being motor vehicle accidents. TCAD are increasingly recognized, and incidences of up to 0.86% for internal carotid and 0.53% for traumatic vertebral artery dissections (TVAD) among blunt trauma victims are reported. Diagnostic evaluation for TCAD is mandatory in the presence of (1) hemorrhage of potential arterial origin originating from the nose, ears, mouth, or a wound; (2) expanding cervical hematoma; (3) cervical bruit in a patient >50 years of age; (4) evidence of acute infarct at brain imaging; (5) unexplained central or lateralizing neurological deficit or transient ischemic attack, or (6) Horner syndrome, neck or head pain. In addition, a number of centers screen asymptomatic patients with blunt trauma for TCAD. Catheter angiography is the standard of reference for diagnosis of TCAD. Color duplex ultrasound, computed tomographic, and magnetic resonance angiography are noninvasive screening alternatives, but each method has its diagnostic limitations compared to catheter angiography. Anticoagulants and antiplatelet drugs may prevent ischemic stroke, but bleeding from traumatized tissues may offset the benefits of antithrombotic treatment. Endovascular therapy of dissected vessels, thrombarterectomy, direct suture of intimal tears, and extracranial-intracranial bypass should be considered in exceptional cases. Neurological outcome is probably worse in TCAD compared to spontaneous CAD, although it is unclear whether this is due to dissection-induced ischemic stroke or associated traumatic lesions. PMID:17290111

Nedeltchev, Krassen; Baumgartner, Ralf W

2005-01-01

301

Quantitative assessment of myelopathy patients using motor evoked potentials produced by transcranial magnetic stimulation  

PubMed Central

Motor evoked potentials (MEPs) study using transcranial magnetic stimulation (TMS) may give a functional assessment of corticospinal conduction. But there are no large studies on MEPs using TMS in myelopathy patients. The purpose of this study is to confirm the usefulness of MEPs for the assessment of the myelopathy and to investigate the use of MEPs using TMS as a screening tool for myelopathy. We measured the MEPs of 831 patients with symptoms and signs suggestive of myelopathy using TMS. The MEPs from the abductor digiti minimi (ADM) and abductor hallucis (AH) muscles were evoked by transcranial magnetic brain stimulation. Central motor conduction time (CMCT) is calculated by subtracting the peripheral conduction time from the MEP latency. Later, 349 patients had surgery for myelopathy (operative group) and 482 patients were treated conservatively (nonoperative group). CMCTs in the operative group and nonoperative group were assessed. MEPs were prolonged in 711 patients (86%) and CMCTs were prolonged in 493 patients (59%) compared with the control patients. CMCTs from the ADM and AH in the operative group were significantly more prolonged than that in the nonoperative group. All patients in the operative group showed prolongation of MEPs or CMCTs or multiphase of the MEP wave. MEP abnormalities are useful for an electrophysiological evaluation of myelopathy patients. Moreover, MEPs may be effective parameters in spinal pathology for deciding the operative treatment.

Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Fujimoto, Yoshinori; Sasaki, Hirofumi; Kamei, Naosuke; Hamasaki, Takahiko; Yamada, Kiyotaka; Yamamoto, Risako; Izumi, Bunichiro; Ochi, Mitsuo

2009-01-01

302

Cervical intraepithelial neoplasia.  

PubMed Central

The theoretical and practical reasons for replacing the terms "cervical dysplasia" and "cervical carcinoma in situ" by the single diagnostic entity of "cervical intraepithelial neoplasia" are reviewed and the advantages and drawbacks of this newer terminology discussed. The histological characteristics and cytological features of the various grades of cervical intraepithelial neoplasia are described and the differential diagnosis of this lesion is considered. Images

Buckley, C H; Butler, E B; Fox, H

1982-01-01

303

Relation between the painful shoulder and the cervical spine with narrow canal in patients without obvious radiculopathy  

Microsoft Academic Search

It is well known that cervical radiculopathy sometimes causes shoulder pain. Hypothesizing that the cause of painful shoulder is related to the cervical spine in the absence of obvious radiculopathy, we measured the anteroposterior diameter of the spinal canal and the range of motion of the cervical spine in patients with painful shoulder on lateral cervical radiographs of the spine.

Kou Mimori; Takeshi Muneta; Hiromichi Komori; Atsushi Okawa; Kenichi Shinomiya

1999-01-01

304

Cervical angina.  

PubMed

Cervical angina, resembling true angina pectoris, but resulting from cervical spondylosis and nerve root compression, is also known as pseudoangina. This report describes 164 patients treated over a 22-year period. Patients included 103 men and 61 women, with ages ranging from 45 to 68 years and averaging 54 years of age. The duration of symptoms prior to definitive diagnosis averaged ten months and ranged from ten to 18 months. Most patients had consulted at least two cardiologists prior to diagnosis. The results of stress testing were abnormal in ten patients, but none underwent angiography. Symptoms common to all patients, in varying severity, included neck pain and stiffness, occipital headache, arm pain with sensory symptoms. Neurologic deficit was found in only three instances. The majority of patients responded satisfactorily to a standard nonsurgical regimen, employed for at least three months, involving the use of a hard collar, intermittent traction, isometric exercise, and a combination of anti-inflammatory and muscle relaxant medications. In cases where disability persisted, myelography was usually employed and when confirming nerve root compression, anterior disc excision and spine fusion were performed. Such treatment was required in only 38 cases and resulted in complete relief of complaints in all but five instances in which fusion failure required re-operation with ultimate success. Fusion usually was completed in three months, during which time the patient was required to wear a hard collar. PMID:2296405

Jacobs, B

1990-01-01

305

Cervical and mediastinal hematoma: presentation of an asymptomatic cervical parathyroid adenoma: case report and literature review  

Microsoft Academic Search

The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to emphasize that a failure to consider this diagnosis may result in delayed operative intervention with potentially fatal complications.

Michele Tonerini; Eugenio Orsitto; Luisa Fratini; Alessandra Tozzini; Andrea Chelli; Stefano Santi; Mauro Rossi

2004-01-01

306

HPV vaccination and cervical cancer.  

PubMed

Cervical cancer is the third most common cancer in women worldwide and often affects women under 40 years with young families. Vaccination against the human papillomavirus (HPV) is a major advance, since it offers primary prevention against the infectious agent that is the main cause of the disease. Two prophylactic vaccines have shown great promise in clinical trials. One of these (Gardasil(®)) contains all four HPV types, offering protection against genital warts (types 6 and 11) as well as cervical cancer (types 16 and 18). The other (Cervarix(®)) contains types 16 and 18, targeting cervical cancer alone, but also has a degree of cross-protection against types 31 and 45, which could significantly increase the level of protection. Adolescent girls remain the primary target of vaccination programmes, but the issues of vaccinating boys and older women are increasingly debated. PMID:22890794

Szarewski, Anne

2012-12-01

307

Cervical radiculopathy: current diagnostic and treatment options.  

PubMed

Cervical nerve root compression, in contrast to nerve root irritation, results in an objective neurologic deficit of the affected nerve root. The purpose of this article is to highlight current diagnostic and treatment options that have proven efficient and safe in managing cervical root compression. The natural history of cervical disc disease and the clinical patterns and causes of cervical radiculopathy are reviewed. Electromyography and reformatted mutiplanar CT scans in addition to MRI are valuable diagnostic modalities. Although anterior cervical discectomy and interbody fusion remains the gold standard of treatment, microendoscopic foraminotomies and discectomies done from posterior and anterior approaches are effective and safe. The role of disc arthroplasty in the treatment of radiculopathy is evolving. PMID:19327260

Nasca, Richard J

2009-01-01

308

Congenital stenosis and adjacent segment disease in the cervical spine.  

PubMed

Symptomatic adjacent segment disease (ASD) after anterior cervical fusion (ACF) is reported in 25% of patients at 10 years postoperatively. Debate continues as to whether this degeneration is due to the natural history of the disk or the changed biomechanics after ACF. This study explored whether congenital stenosis predisposes patients to an increased incidence of ASD after ACF. A retrospective review of 635 patients with myelopathy or radiculopathy was performed; 364 patients had complete records for review. Patients underwent 1- to 5-level ACF (94 one-level, 145 two-level, 79 three-level, 45 four-level, and 1 five-level). Radiographs were evaluated for bony congenital stenosis using validated parameters, and ASD was measured according to Hilibrand's criteria and correlated with symptomatic ASD. Congenital stenosis was found in 21.7% of patients and radiographic ASD in 33.5%, with a significant association between these parameters. However, symptomatic ASD occurred in 11.8% of patients; no association between congenital stenosis and symptomatic ASD or myelopathy and ASD was found. Clinical results demonstrated excellent or good Robinson scores in 86.2% of patients and Odom scores in 87% of patients. Despite mostly excellent to good outcomes, symptomatic ASD is common after ACF. Although congenital stenosis appears to increase the incidence of radiographic ASD, it does not appear to predict symptomatic ASD. PMID:24093699

Eubanks, Jason David; Belding, Jon; Schnaser, Erik; Rowan, Andrew; Moffitt, Gable; Weaver, John; Reich, Michael S; Bechtel, Chris; Xie, Ke; Gande, Abhiram; Hohl, Justin; Braly, Brett; Hilibrand, Alan; Kang, James D

2013-10-01

309

Possible etiologies for tropical spastic paraparesis and human T lymphotropic virus I-associated myelopathy.  

PubMed

The epidemiology of tropical spastic paraparesis/human T lymphotropic virus I (HTLV-I)-associated myelopathy (TSP/HAM) is frequently inconsistent and suggests environmental factors in the etiology of these syndromes. The neuropathology corresponds to a toxometabolic or autoimmune process and possibly not to a viral disease. Some logical hypotheses about the etiology and physiopathology of TSP and HAM are proposed. Glutamate-mediated excitotoxicity, central distal axonopathies, cassava, lathyrism and cycad toxicity may explain most cases of TSP. The damage caused to astrocytes and to the blood-brain barrier by HTLV-I plus xenobiotics may explain most cases of HAM. Analysis of the HTLV-I/xenobiotic ratio clarifies most of the paradoxical epidemiology of TSP and HAM. Modern neurotoxicology, neuroimmunology and molecular biology may explain the neuropathology of TSP and HAM. It is quite possible that there are other xenobiotics implicated in the etiology of some TSP/HAMs. The prevention of these syndromes appears to be possible today. PMID:14689037

Zaninovic', V

2003-12-18

310

New insights into cervical cancer screening  

PubMed Central

Worldwide, cervical cancer is a leading cause of cancer related morbidity and mortality. For over 50 years, cervical cytology has been the gold standard for cervical cancer screening. Because of its profound effect on cervical cancer mortality in nations that have adopted screening programs, the Pap smear is widely accepted as the model screening test. Since its introduction, many studies have analyzed the Pap smear and found that it is not without its shortcomings including low sensitivity for detection of cervical intraepithelial neoplasia 2/3. Additionally, the discovery of infection with the human papillomavirus (HPV) as a necessary step in the development of cervical cancer has led to the development of HPV testing as an adjunct to cytology screening. More recently, researchers have compared HPV testing and cytology in the primary screening of cervical cancer. In this review, we will discuss cytologic testing limitations, the role of HPV DNA testing as an alternative screening tool, the impact of the HPV vaccine on screening, and future directions in cervical cancer screening.

Boone, Jonathan D.; Erickson, Britt K.

2012-01-01

311

Cervical laminoplasty (Hattori's method). Procedure and follow-up results.  

PubMed

Posterior decompression plus posterior reconstruction (laminoplasty) is a useful surgical method for treatment of cervical compressive myelopathy. There are many laminoplasty procedures. This paper describes the Z-shaped laminoplasty developed by Hattori in 1971, and presents a clinical follow-up of the authors' experience with 130 patients. The procedure involves grinding the laminae down with an air drill and making a Z-shaped cut into the thinned laminae without excising the laminae. This technique enlarges the spinal canal. The purpose of this technique is to decompress the spinal cord and at the same time maintain clinical stability. Postoperative results were satisfactory without any major complication. Follow-up study was conducted in 78 cases with a minimal follow-up period of more than 2 years. Satisfactory clinical results were maintained for long periods postoperatively, and the enlargement of the spinal canal was well maintained as demonstrated on follow up X-ray study. PMID:3144758

Kawai, S; Sunago, K; Doi, K; Saika, M; Taguchi, T

1988-11-01

312

Posterior Cervical Bone Screws  

Center for Biologics Evaluation and Research (CBER)

Text Version... Smith MD et al, Spine 1993: 18, 1984. Page 3. POSTERIOR CERVICAL BONE SCREWS ... Page 4. POSTERIOR CERVICAL BONE SCREWS ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

313

ICSN - Cervical Cancer  

Cancer.gov

Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Cervical

314

Smoking and Cervical Cancer  

MedlinePLUS

Smoking and Cervical Cancer If you smoke, you have an increased chance of developing precancerous lesions of the cervix (called moderate or ... and an increase in the chance of developing cervical cancer. Smoking greatly increases your risk for dysplasia and ...

315

Cervical Radiculopathy (Pinched Nerve)  

MedlinePLUS

... Copyright 2010 American Academy of Orthopaedic Surgeons Cervical Radiculopathy (Pinched Nerve) Some people have neck pain that ... The medical term for this condition is cervical radiculopathy. Understanding your spine and how it works can ...

316

Anterior cervical fusion with interbody cage containing ?-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up  

PubMed Central

A variety of bone graft substitutes, interbody cages, and anterior plates have been used in cervical interbody fusion, but no controlled study was conducted on the clinical performance of ?-tricalcium phosphate (?-TCP) and the effect of supplemented anterior plate fixation. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting interbody fusion cage containing ?-TCP for the treatment of cervical radiculopathy and/or myelopathy, and the fusion rates and outcomes in patients with or without randomly assigned plate fixation. Sixty-two patients with cervical radiculopathy and/or myelopathy due to soft disc herniation or spondylosis were treated with one- or two-level discectomy and fusion with interbody cages containing ?-TCP. They were randomly assigned to receive supplemented anterior plate (n = 33) or not (n = 29). The patients were followed up for 2 years postoperatively. The radiological and clinical outcomes were assessed during a 2-year follow-up. The results showed that the fusion rate (75.0%) 3 months after surgery in patients treated without anterior cervical plating was significantly lower than that (97.9%) with plate fixation (P < 0.05), but successful bone fusion was achieved in all patients of both groups at 6-month follow-up assessment. Patients treated without anterior plate fixation had 11 of 52 (19.2%) cage subsidence at last follow-up. No difference (P > 0.05) was found regarding improvement in spinal curvature as well as neck and arm pain, and recovery rate of JOA score at all time intervals between the two groups. Based on the findings of this study, interbody fusion cage containing ?-TCP following one- or two-level discectomy proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Supplemented anterior plate fixation can promote interbody fusion and prevent cage subsidence but do not improve the 2-year outcome when compared with those treated without anterior plate fixation.

Jiang, Lei-Sheng

2008-01-01

317

Adrenomyeloneuropathy: a neuropathologic review featuring its noninflammatory myelopathy.  

PubMed

The neuropathologic features of adrenomyeloneuropathy (AMN) are reviewed by supplementing those few previously published cases with 5 additional cases collected over the years. The endocrine involvement in AMN is briefly presented to serve as a pathogenetic backdrop and to emphasize that most of the lesions in AMN, as in adreno-leukodystrophy (ALD), are noninflammatory in the traditional sense of the word. The myeloneuropathy is emphasized, but the dysmyelinative/inflammatory demyelinative lesions also are presented. The preponderance of available data indicates that the myeloneuropathy of AMN is a central-peripheral distal (dying-back) axonopathy, as was originally proposed. The severity of the myeloneuropathy does not appear to correlate with the duration or severity of endocrine dysfunction. Microglia are the dominant participating cells in the noninflammatory myelopathy. Abnormalities in the ALD gene, which encodes a peroxisomal ABC half-transporter, do not correlate with clinical phenotypes. The relationship of the gene product, ALDP, to the peroxisomal very long chain fatty acid (VLCFA) synthetase, the activity of which is deficient in ALD/AMN, is unclear. An ALD-knockout mouse model has developed axonal degeneration, particularly in spinal cord, and is therefore more reminiscent of AMN than ALD. We continue to postulate that the fundamental defect in the myeloneuropathy of AMN is an axonal or neuronal membrane abnormality perhaps due to the incorporation of VLCFA-gangliosides, which perturbs the membrane's microenvironment and leads to dysfunction and atrophy. PMID:10749098

Powers, J M; DeCiero, D P; Ito, M; Moser, A B; Moser, H W

2000-02-01

318

Cervical cancer in India and HPV vaccination  

PubMed Central

Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine's efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context.

Kaarthigeyan, K.

2012-01-01

319

Cervical spinal cord injury in sapho syndrome.  

PubMed

Cervical spinal fracture and pseudarthrosis are previously described causes of spinal cord injury (SCI) in patients with spondylarthropathy. SAPHO (Synovitis Acne Pustulosis Hyperostosis Osteitis) syndrome is a recently recognized rheumatic condition characterized by hyperostosis and arthro-osteitis of the upper anterior chest wall, spinal involvement similar to spondylarthropathies and skin manifestations including palmoplantar pustulosis and pustular psoriasis. We report the first case of SAPHO syndrome disclosed by SCI related to cervical spine ankylosis. PMID:10338354

Deltombe, T; Nisolle, J F; Boutsen, Y; Gustin, T; Gilliard, C; Hanson, P

1999-04-01

320

Le rachis cervical rhumatoïde  

Microsoft Academic Search

Cervical spine involvement occurs in over half of patients with rheumatoid arthritis (RA). The most common abnormality is atlantoaxial dislocation, followed by atlantooccipital arthritis with cranial settling and by lesions of the lower cervical spine. Cervical spine involvement usually occurs in patients with severe RA. Pain and evidence of spinal cord injury are the main symptoms. The presence of symptoms

Agnès Bouchaud-Chabot; Frédéric Lioté

2002-01-01

321

Hypertrophic Synovitis of the Facet Joint Causing Root Pain  

Microsoft Academic Search

Osteoarthritic changes in the facet joints are common in the presence of degenerative disc disease. Changes in the joint capsule accompany changes in the articular surfaces. Intraspinal synovial cysts that cause radicular pain, cauda equina syndrome, and myelopathy have been reported; however, there have been few reports in orthopedic or neurosurgical literature regarding hypertrophic synovitis of the facet joint presenting

Koichi Iwatsuki; Toshiki Yoshimine; Masanori Aoki; Kazuhiro Yoshimura

2008-01-01

322

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

PubMed

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

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

2006-09-01

323

Genetic events in cervical carcinoma  

SciTech Connect

Cervical carcinoma is the fifth most common cancer world-wide and the second major cause of cancer related death in women. Recent studies have suggested that chromosome 10, particularly the short arm, may be significant in the pathogenesis of the disease. The relationship has not, however, been investigated directly in cervical tumor material. We analyzed 21 paired blood and tumor samples from patients with cervical carcinoma for allele loss on chromosome 10. Ten polymorphic loci spanning the length of chromosome 10 were used including 4 RFLPs and 4 microsatellite markers. Tumor samples were carefully dissected to remove the majority of contaminating normal tissue. Twenty of the 21 pairs were heterozygous for at least one locus. Loss of heterozygosity for one or more chromosome 10 loci was observed in 5 out of the 20 informative cases (25%). One sample showed the apparent loss of an entire copy of chromosome 10. In 3 cases allele loss was confined to loci on the short arm of chromosome 10. We are currently using further markers mapped to chromosome 10p to define the shortest consistent region of allele loss. We suggest that this region may contain one or more tumor suppressor genes involved in the development and/or progression of cervical carcinoma.

Sarkar, S.; Tai, C.C.; Mowatt, J. [Univ. of Cambridge (United Kingdom)] [and others

1994-09-01

324

Molecular Genetics of Cervical Cancer  

Microsoft Academic Search

The carcinoma of the uterine cervix is the second most common cancer among women worldwide, with its higher incidence in developing\\u000a countries (1). Strong clinical and experimental evidence demonstrated that the high-risk (HR) types of human papilloma virus (HPV) play\\u000a a central role in causing cervical cancer, although a role of multiple risk factors has been suggested too. Not only

Valeria Masciullo; Antonio Giordano

325

A rat model of human T lymphocyte virus type I (HTLV-I) infection. 1. Humoral antibody response, provirus integration, and HTLV-I-associated myelopathy/tropical spastic paraparesis-like myelopathy in seronegative HTLV-I carrier rats  

PubMed Central

Human T lymphocyte virus type I (HTLV-I) can be transmitted into several inbred strains of newborn and adult rats by inoculating newly established HTLV-I-immortalized rat T cell lines or the human T cell line MT-2. The transmission efficiency exceeds 80%, regardless of strain differences or the age at transmission. The production of anti- HTLV-I antibodies significantly differs among the strains and depends on the age at the time of transmission. Rats neonatally inoculated with HTLV-I-positive rat or human cells generally become seronegative HTLV-I carriers throughout their lives, whereas adult rats inoculated with HTLV-I-positive cells at 16 wk of age become seropositive HTLV-I carriers. The HTLV-I provirus genome is present in almost all organs, regardless of whether the carriers are seronegative or seropositive. According to antibody titers to HTLV-I, there are three groups of inbred rat strains: ACI, F344, and SDJ (high responders); WKA, BUF, and LEJ (intermediate responders); and LEW (low responder). Three of three 16-mo-old seronegative HTLV-I carrier rats of the WKA strain developed spastic paraparesis of the hind legs. Neuropathological examinations revealed that the lesions were confined primarily to the lateral and anterior funiculi of the spinal cord. Both myelin and axons were extensively damaged in a symmetrical fashion, and infiltration with massive foamy macrophages was evident. The most severe lesions were at levels of the thoracic cord and continued from the cervical to the lumbar area. These histopathological features as well as clinical symptoms largely parallel findings in humans with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). These HTLV-I carrier rats, in particular the WKA rats described above, can serve as a useful animal model for investigating virus-host interactions in the etiopathogenesis of HTLV-I-related immunological diseases, particularly HAM/TSP.

1992-01-01

326

Single Stage Circumferential Cervical Surgery (Selective Anterior Cervical Corpectomy with Fusion and Laminoplasty) for Multilevel Ossification of the Posterior Longitudinal Ligament with Spinal Cord Ischemia on MRI  

PubMed Central

Objective Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience. Methods Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological, and surgical data was conducted. Results There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection. Conclusion Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.

Son, Seong; Yoo, Chan Jong; Park, Chan Woo; Kim, Woo Kyung

2010-01-01

327

HPV - a vaccine against cervical cancer  

Microsoft Academic Search

Most cervical cancer is caused by Human papillomavirus (HPV). Protection against the major cancer-causing serotypes of this virus by vaccination is now a reality for New Zealand women. Internationally two manufacturers have candidate HPV vaccines: the bivalent Cervarix (GlaxoSmith Kline) and the tetravalent Gardasil (CSL and Merck & Co). This article focuses on Gardasil, as this vaccine is now available

N. Desmond; H. Petousis-Harris; N. Turner

2006-01-01

328

Spinal cord compression caused by the rod of a Harrington instrumentation device: a late complication in scoliosis surgery.  

PubMed

We report a unique complication caused by the rod of a Harrington instrumentation device, which resulted in spinal stenosis and myelopathy. A literature review revealed no previous causes of direct spinal cord impingement caused by the rod of a Harrington device. In this case, years after the initial operation, the rod penetrated the lamina at the junction between a thoracic and a lumbar curve, causing spinal stenosis and myelopathy. We conclude that regular control of the position of the device and awareness of possible late neurological complications are necessary to identify such complications as early as possible. PMID:9258642

Krödel, A; Rehmet, J C; Hamburger, C

1997-01-01

329

The natural history of cervical HPV infection: unresolved issues  

Microsoft Academic Search

The identification of high-risk human papillomavirus (HPV) types as a necessary cause of cervical cancer offers the prospect of effective primary prevention and the possibility of improving the efficiency of cervical screening programmes. However, for these opportunities to be realized, a more complete understanding of the natural history of HPV infection, and its relationship to the development of epithelial abnormalities

Stuart I. Collins; Lawrence S. Young; Ciaran B. J. Woodman

2007-01-01

330

Genital warts and cervical neoplasia: An epidemiological study  

Microsoft Academic Search

Cervical carcinoma and cervical intra-epithelial neoplasia (CIN) are likely to be associated with all sexually transmitted diseases (STDs). To help discover which (if any) of the recognised STDs might actually cause these conditions, a key question is whether one particular such association is much stronger than the others. The present study is therefore only of women newly attending an STD

S Franceschi; R Doll; J Gallwey; C La Vecchia; R Peto; A I Spriggs

1983-01-01

331

Human papillomavirus vaccine as a new way of preventing cervical cancer: a dream or the future?  

Microsoft Academic Search

Cervical cancer is the major cause of death in women of reproductive age in parts of the developing world. Thanks to the effectiveness of national screening programs, the incidence and mortality rates for cervical cancer have declined dramatically in developed countries. According to many researchers, human papillomavirus (HPV) infection has an important role in the development of cervical neoplasm. The

A. Mandic; T. Vujkov

2004-01-01

332

The effect of cervical traction combined with neural mobilization on pain and disability in cervical radiculopathy. A case report.  

PubMed

Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of cervical traction combined with neural mobilization on pain and disability in a patient experiencing cervical radiculopathy. A 52-year-old woman presented with a 2 month history of neurological cervico-brachial pain and whose presentation was consistent with cervical radiculopathy. Cervical traction and a slider neural mobilization of the medial nerve were applied simultaneously to reduce the patient's pain and disability measured at baseline and at 2 and 4 weeks using the Numeric Pain Rating Scale, the Neck Disability Index and the Patient-Specific Functional Scale. Improvements in all outcome measures were noted over a period of four weeks. Scores in all outcome measures revealed that the patient's pain had almost disappeared and that she was able to perform her household chores and job tasks without difficulties and limitations. In conclusion, the findings of this study support that the application of cervical traction combined with neural mobilization can produce significant improvements in terms of pain and disability in cervical radiculopathy. PMID:22818658

Savva, Christos; Giakas, Giannis

2012-07-18

333

Severity score system for progressive myelopathy: development and validation of a new clinical scale.  

PubMed

Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies. PMID:22570090

Castilhos, R M; Blank, D; Netto, C B O; Souza, C F M; Fernandes, L N T; Schwartz, I V D; Giugliani, R; Jardim, L B

2012-05-10

334

Cervical spondylotic amyotrophy  

Microsoft Academic Search

Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower\\u000a limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One\\u000a is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn\\u000a cell. Cervical spondylotic amyotrophy is classified

Sheng-Dan Jiang; Lei-Sheng Jiang; Li-Yang Dai

2011-01-01

335

Baguera cervical disc prosthesis  

Microsoft Academic Search

A new high performance tool, the disc prosthesis, endows the degenerative cervical rachidian pathology. It allows us to fill\\u000a the fusions’ lacunas by protecting the adjacent levels from an accelerated degeneration while preserving the anatomical and\\u000a physiological characteristics of the cervical spine, especially its mobility. At the present time, there exist several models\\u000a of cervical disc prosthesis on the market.

M. Benmekhbi; J. Mortada; G. Lungu; D. Eichler; R. Srour; J. M. Vital

2008-01-01

336

Cervical enamel: a danger zone.  

PubMed

The British Standards Institutions's document (1974) recommending toothpaste specifications states that 'There is no evidence that any toothpaste ever produces a level of abrasion causing harm to dental enamel'. This paper questions the assumption that the enamel crown, especially at the cervical margin, is able to cope with modern dietary insult and a 'good' oral hygiene regimen, regardless of the enamel abrasivity of the dentifrice used. Once the enamel crown is breached the underlying dentine is sensitive and vulnerable to physical damage. In this work the potential rates of erosive and abrasive loss are related to the thickness of the protective enamel and to the relevance of fluoride treatments for adults. It is suggested that improvements in dental care and an increased tooth life expectancy now make the loss of tooth tissues at the cervical margin more important than is apparent at first sight. PMID:291708

Davis, W B

1979-10-01

337

Spinal cord compression caused by the rod of a Harrington instrumentation device: A late complication in scoliosis surgery  

Microsoft Academic Search

We report a unique complication caused by the rod of a Harrington instrumentation device, which resulted in spinal stenosis and myelopathy. A literature review revealed no previous causes of direct spinal cord impingement caused by the rod of a Harrington device. In this case, years after the initial operation, the rod penetrated the lamina at the junction between a thoracic

A. Krödel; J. C. Rehmet; C. Hamburger

1997-01-01

338

Surgical resection of neoplastic cervical spine lesions in relation to the vertebral artery V2 segment.  

PubMed

Neoplastic cervical spine lesions are seen infrequently by the spinal surgeon. The surgical management of these tumors, particularly with associated neurovascular compromise, is challenging in terms of achieving proper resection and spinal stabilization and ensuring no subsequent recurrence or failure of fixation. In this report we highlight some of the problems encountered in the surgical management of tumors involving the cervical spine with techniques applied for gross total resection of the tumor without compromising the vertebral arteries. Ten patients with neoplastic cervical spine lesions were managed in our study. The common cardinal presentation was neck and arm pain with progressive cervical radiculo-myelopathy. All patients had plain X-rays, computer tomography scans, and magnetic resonance imaging of the cervical spine. Digital subtraction or magnetic resonance angiograms were performed on both vertebral arteries when the pathology was found to be in proximity to the vertebral artery. When a tumor blush with feeders was evident, endovascular embolization to minimize intraoperative bleeding was also considered. A single approach or a combined anterior cervical approach for corpectomy and cage-with-plate fixation and posterior decompression for resection of the rest of the tumor with spinal fixation was then accomplished as indicated. All cases made a good neurological recovery and had no neural or vascular complications. On the long-term follow-up of the survivors there was no local recurrence or surgical failure. Only three patients died: two from the primary malignancy and one from pulmonary embolism. This report documents a safe and reliable way to deal with neoplastic cervical spine lesions in proximity to vertebral arteries with preservation of both arteries. PMID:21577335

Al Barbarawi, Mohamed; Odat, Ziad; Alheis, Mwaffaq; Qudsieh, Suhair; Qudsieh, Tareq

2010-06-21

339

Surgical resection of neoplastic cervical spine lesions in relation to the vertebral artery V2 segment  

PubMed Central

Neoplastic cervical spine lesions are seen infrequently by the spinal surgeon. The surgical management of these tumors, particularly with associated neurovascular compromise, is challenging in terms of achieving proper resection and spinal stabilization and ensuring no subsequent recurrence or failure of fixation. In this report we highlight some of the problems encountered in the surgical management of tumors involving the cervical spine with techniques applied for gross total resection of the tumor without compromising the vertebral arteries. Ten patients with neoplastic cervical spine lesions were managed in our study. The common cardinal presentation was neck and arm pain with progressive cervical radiculo-myelopathy. All patients had plain X-rays, computer tomography scans, and magnetic resonance imaging of the cervical spine. Digital subtraction or magnetic resonance angiograms were performed on both vertebral arteries when the pathology was found to be in proximity to the vertebral artery. When a tumor blush with feeders was evident, endovascular embolization to minimize intraoperative bleeding was also considered. A single approach or a combined anterior cervical approach for corpectomy and cage-with-plate fixation and posterior decompression for resection of the rest of the tumor with spinal fixation was then accomplished as indicated. All cases made a good neurological recovery and had no neural or vascular complications. On the long-term follow-up of the survivors there was no local recurrence or surgical failure. Only three patients died: two from the primary malignancy and one from pulmonary embolism. This report documents a safe and reliable way to deal with neoplastic cervical spine lesions in proximity to vertebral arteries with preservation of both arteries.

Al Barbarawi, Mohamed; Odat, Ziad; Alheis, Mwaffaq; Qudsieh, Suhair; Qudsieh, Tareq

2010-01-01

340

Cervical Radiculopathy: Surgical Treatment Options  

MedlinePLUS

... Copyright 2010 American Academy of Orthopaedic Surgeons Cervical Radiculopathy: Surgical Treatment Options When symptoms of cervical radiculopathy persist or worsen despite nonsurgical treatments, surgical options ...

341

Hydroxyapatite ceramics in multilevel cervical interbody fusion - is there a role?  

PubMed

The aim of this study is to evaluate the efficacy of hydroxyapatite grafts in multilevel cervical interbody fusion during the one year follow-up. A total of 86 patients with degenerative cervical disc disease underwent all together 224 cervical interbody fusion procedures in which either Smith-Robinson or Cloward type hydroxyapatite grafts were used. The surgeries included radiculopathy in 38 cases, myelopathy in 20 cases and myeloradicuopathy in 28 patients. In 65 out of 86 patients, fusion was followed by an anterior instrumentation (plating). Postoperatively, patients were followed for a mean of 15.64 (range 11-23.3) months. All patients underwent radiography to evaluate fusion and the axis curvature. Excellent clinical results (86%), described as a complete or partial relief of symptoms with full return to preop activity, were obtained in patients with radiculopathy. There were 5 grafts mobilizations and one graft fracture. Two grafts extruded in non-instrumented patients and required repeated surgery. There were other three reoperations due to the hardware problems. One year fusion rate was obtained at 86% for two-level surgery, 80.1% for three-level surgery and 74% for four-level surgery. The mean (SD) hospital stay was 3.8 (0.7) days. A hydroxyapatite cheramic can be a very effective synthetic material for multilevel cervical interbody fusion. It is characterized by a high fusion rate and a small percentage of graft-related complications, especially when fusion procedure is followed by plating. PMID:21648347

Vuki?, Miroslav; Walters, Beverly C; Radi?, Ankica; Jurjevi?, Ivana; Marasanov, Sergej M; Rozankovi?, Marjan; Jednacak, Hrvoje

2011-01-01

342

Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis  

PubMed Central

Canine degenerative myelopathy (DM) is a fatal neurodegenerative disease prevalent in several dog breeds. Typically, the initial progressive upper motor neuron spastic and general proprioceptive ataxia in the pelvic limbs occurs at 8 years of age or older. If euthanasia is delayed, the clinical signs will ascend, causing flaccid tetraparesis and other lower motor neuron signs. DNA samples from 38 DM-affected Pembroke Welsh corgi cases and 17 related clinically normal controls were used for genome-wide association mapping, which produced the strongest associations with markers on CFA31 in a region containing the canine SOD1 gene. SOD1 was considered a regional candidate gene because mutations in human SOD1 can cause amyotrophic lateral sclerosis (ALS), an adult-onset fatal paralytic neurodegenerative disease with both upper and lower motor neuron involvement. The resequencing of SOD1 in normal and affected dogs revealed a G to A transition, resulting in an E40K missense mutation. Homozygosity for the A allele was associated with DM in 5 dog breeds: Pembroke Welsh corgi, Boxer, Rhodesian ridgeback, German Shepherd dog, and Chesapeake Bay retriever. Microscopic examination of spinal cords from affected dogs revealed myelin and axon loss affecting the lateral white matter and neuronal cytoplasmic inclusions that bind anti-superoxide dismutase 1 antibodies. These inclusions are similar to those seen in spinal cord sections from ALS patients with SOD1 mutations. Our findings identify canine DM to be the first recognized spontaneously occurring animal model for ALS.

Awano, Tomoyuki; Johnson, Gary S.; Wade, Claire M.; Katz, Martin L.; Johnson, Gayle C.; Taylor, Jeremy F.; Perloski, Michele; Biagi, Tara; Baranowska, Izabella; Long, Sam; March, Philip A.; Olby, Natasha J.; Shelton, G. Diane; Khan, Shahnawaz; O'Brien, Dennis P.; Lindblad-Toh, Kerstin; Coates, Joan R.

2009-01-01

343

Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis.  

PubMed

Canine degenerative myelopathy (DM) is a fatal neurodegenerative disease prevalent in several dog breeds. Typically, the initial progressive upper motor neuron spastic and general proprioceptive ataxia in the pelvic limbs occurs at 8 years of age or older. If euthanasia is delayed, the clinical signs will ascend, causing flaccid tetraparesis and other lower motor neuron signs. DNA samples from 38 DM-affected Pembroke Welsh corgi cases and 17 related clinically normal controls were used for genome-wide association mapping, which produced the strongest associations with markers on CFA31 in a region containing the canine SOD1 gene. SOD1 was considered a regional candidate gene because mutations in human SOD1 can cause amyotrophic lateral sclerosis (ALS), an adult-onset fatal paralytic neurodegenerative disease with both upper and lower motor neuron involvement. The resequencing of SOD1 in normal and affected dogs revealed a G to A transition, resulting in an E40K missense mutation. Homozygosity for the A allele was associated with DM in 5 dog breeds: Pembroke Welsh corgi, Boxer, Rhodesian ridgeback, German Shepherd dog, and Chesapeake Bay retriever. Microscopic examination of spinal cords from affected dogs revealed myelin and axon loss affecting the lateral white matter and neuronal cytoplasmic inclusions that bind anti-superoxide dismutase 1 antibodies. These inclusions are similar to those seen in spinal cord sections from ALS patients with SOD1 mutations. Our findings identify canine DM to be the first recognized spontaneously occurring animal model for ALS. PMID:19188595

Awano, Tomoyuki; Johnson, Gary S; Wade, Claire M; Katz, Martin L; Johnson, Gayle C; Taylor, Jeremy F; Perloski, Michele; Biagi, Tara; Baranowska, Izabella; Long, Sam; March, Philip A; Olby, Natasha J; Shelton, G Diane; Khan, Shahnawaz; O'Brien, Dennis P; Lindblad-Toh, Kerstin; Coates, Joan R

2009-02-02

344

Women's perspectives on illness when being screened for cervical cancer  

PubMed Central

Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide whether to participate in cervical cancer screening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings of vulnerability and an increased need to care for themselves. Later on, an understanding of HPV as the basis for diagnosis and the realization that disease might not be accompanied by symptoms developed. The outcome for participants was a life experience, which they used to encourage others to participate in screening and to suggest ways that information about screening and HPV might reach a wider Greenlandic population. Conclusion Women living through the process of cervical disease, treatment and follow-up develop knowledge about HPV, cervical cell changes, cervical disease and their connection, which, if used to inform cervical screening programmes, will improve the quality of information about HPV, cervical cancer and screening participation. This includes that verbal and written information given at the point of screening and diagnosis needs to be complemented by visual imagery.

Hounsgaard, Lise; Augustussen, Mikaela; M?ller, Helle; Bradley, Stephen K.; M?ller, Suzanne

2013-01-01

345

A comprehensive review on host genetic susceptibility to human papillomavirus infection and progression to cervical cancer  

PubMed Central

Cervical cancer is the second most common cancer in women worldwide. This is caused by oncogenic types of human papillomavirus (HPV) infection. Although large numbers of young sexually active women get HPV-infected, only a small fraction develop cervical cancer. This points to different co-factors for regression of HPV infection or progression to cervical cancer. Host genetic factors play an important role in the outcome of such complex or multifactor diseases such as cervical cancer and are also known to regulate the rate of disease progression. The aim of this review is to compile the advances in the field of host genetics of cervical cancer. MEDLINE database was searched using the terms, ‘HPV’, ‘cervical’, ‘CIN’, ‘polymorphism(s)’, ‘cervical’+ *the name of the gene* and ‘HPV’+ *the name of the gene*. This review focuses on the major host genes reported to affect the progression to cervical cancer in HPV infected individuals.

Chattopadhyay, Koushik

2011-01-01

346

Human T Lymphotropic Virus Type I Associated Myelopathy and Myasthenia gravis: A Possible Association?  

Microsoft Academic Search

We report the first known patient with human T lymphotropic virus type I (HTLV-I) associated myelopathy (HAM) and myasthenia gravis (MG). A 50-year-old woman developed fluctuating muscle weakness with easy fatigability, transient bilateral blepharoptosis and double vision. Spastic paraparesis complicated these symptoms. Neurological assessments and specific laboratory findings revealed that the patient had definite HAM and MG. By inference from

T. Fukui; K. Sugita; H. Ichikawa; A. Negishi; H. Kasai; H. Tsukagoshi

1994-01-01

347

Patterns of non-traumatic myelopathies in Yaoundé (Cameroon): a hospital based study  

Microsoft Academic Search

BackgroundThe relative frequency of compressive and non-compressive myelopathies and their aetiologies have not been evaluated extensively in most sub-Saharan African countries. The case of Cameroon is studied.MethodsAdmission registers and case records of patients in the neurology and neurosurgery departments of the study hospital were reviewed from January 1999 to December 2006.Results224 (9.7% of all admissions) cases were non-traumatic paraplegia\\/paraparesis or

Alain Zingraff Lekoubou Looti; André Pascal Kengne; Vincent de Paul Djientcheu; Callixte T Kuate; Alfred K Njamnshi

2010-01-01

348

Hypothesis on the pathogenesis of vacuolar myelopathy, dementia, and peripheral neuropathy in AIDS  

PubMed Central

Certain aspects of the clinical syndrome of dementia, cerebral atrophy, predominantly sensory neuropathy, and vacuolar myelopathy in AIDS resemble those seen in vitamin B12 deficiency. Pathologically, there are similarities not only in the changes in the spinal cord, but also in the brain and peripheral nerves. The pathogenesis of vacuolar myelopathy may be secondary to a combination of immune mediated myelin and oligodendrocyte injury, and simultaneous impairment of repair mechanisms due to a deficiency of S-adenosylmethionine (SAM). Products derived from macrophages may interfere directly with the methyl transfer cycle through the generation of reactive oxygen intermediates and reactions involving nitric oxide and peroxynitrite which may limit the supply of methionine for conversion to SAM, both by direct interaction as well as through inhibition of methionine synthase. Macrophage activation with secretion of cytokines and other biologically reactive substances within the nervous system is sustained in the late stages of HIV infection by the general effects of immune depletion, including loss of T cells (with concomitant reduction of macrophage regulatory molecules) and recurrent opportunistic infections, and may be further augmented by the local presence of the virus itself (or its surface glycoprotein gp120). This would account for the common, but not exclusive, occurrence of vacuolar myelopathy in AIDS. The ability of the virus and its products to stimulate macrophage and microglial activation may also explain the association between severity ofvacuolar myelopathy and the presence of HIV encephalitis. A similar mechanism may underlie the pathogenesis of dementia, cerebral atrophy, and peripheral neuropathy. Local factors or differential susceptibility between the central and peripheral nervous system may determine whether myelinotoxic or neurotoxic processes predominate; the prominence of myelin involvement in the spinal cord, and axonal involvement peripherally may reflect both ends of this range, with the brain manifesting a more equal balance of both processes. ??

Tan, S; Guiloff, R

1998-01-01

349

Human T Cell Lymphotropic Virus Type 1Associated Myelopathy in São Paulo, Brazil  

Microsoft Academic Search

We report epidemiologic and clinical features of human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy\\/tropical spastic paraparesis in a Brazilian cohort of 86 patients from a university hospital. Cerebrospinal fluid (CSF) abnormalities and magnetic resonance imaging (MRI) findings were correlated with neurologic signs and symptoms. The patients’ mean age at disease onset was 43.2 years and the female to

Antonio C. P. Milagres; Maria Lúcia S. G. Jorge; Paulo E. Marchiori; Aluisio A. C. Segurado

2002-01-01

350

Widespread active inflammatory lesions in a case of HTLV-I-associated myelopathy lasting 29 years  

Microsoft Academic Search

An autopsy case of human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM) of 29 years’ duration is reported. The patient had no history of surgery or blood transfusion and likely contracted HTLV-I sexually while traveling in an endemic area. At age 45, the patient began to experience gait disturbance; he later developed spastic tetraparesis. Autopsy revealed marked gross spinal cord atrophy,

Yasushi Iwasaki; Koichi Sawada; Ikuko Aiba; Eiichiro Mukai; Mari Yoshida; Yoshio Hashizume; Gen Sobue

2004-01-01

351

Progression of spinal cord atrophy by traumatic or inflammatory myelopathy in the pediatric patients: case series  

Microsoft Academic Search

Study design:Case series.Objective:To present spinal cord atrophy in pediatric patients who had spinal cord injury developed after trauma or acute transverse myelitis, and had no motor recovery later.Setting:Department of Rehabilitation Medicine, Tertiary National University Children's Hospital, Seoul, Korea.Methods:Case series.Results:Two pediatric patients with paraplegia due to acute transverse myelitis and one pediatric patient with paraplegia due to traumatic myelopathy were included

M S Bang; S J Kim

2009-01-01

352

Transverse myelopathy in systemic lupus erythematosus: an analysis of 14 cases and review of the literature  

Microsoft Academic Search

OBJECTIVETo give a comprehensive review of transverse myelopathy (TM), a rare but serious condition reported in 1–2% of patients with systemic lupus erythematosus (SLE).METHODS14 patients with SLE and TM were evaluated and 91 additional cases published in the English and German literature reviewed.RESULTSTM presented either as the initial manifestation or within five years of the diagnosis of SLE. Most patients

Birgit Kovacs; Thomas L Lafferty; Lawrence H Brent; Raphael J DeHoratius

2000-01-01

353

Schistosomal myelopathy in childhood: magnetic resonance imaging findings in 26 cases  

Microsoft Academic Search

Magnetic resonance image findings of 26 children (16 males, average age 9,4y) with schistosomal myelopathy are described. All children lived in Pernambuco state, Brazil - an endemic area of mansoni schistosomiasis. Imaging abnormalities were identified in 92.3% children. The most frequent findings were: (1) enlargement of the spinal cord at thoracic level, usually below T8, in 23\\/24 (96%) of patients;

Adelia Maria de Miranda Henriques-Souza; Marcelo Moraes Valença

354

The Efficacy and Persistence of Selective Nerve Root Block under Fluoroscopic Guidance for Cervical Radiculopathy  

PubMed Central

Study Design Retrospective study. Objectives To investigate the outcomes of fluoroscopically guided selective nerve root block as a nonsurgical treatment for cervical radiculopathy. Overview of Literature Only a few studies have addressed the efficacy and persistence of cervical nerve root block. Methods This retrospective study was conducted on 28 consecutive patients with radicular pain due to cervical disc disease or cervical spondylosis. Myelopathy was excluded. Cervical nerve root blocks were administered every 2 weeks, up to 3 times. Outcomes were measured by comparing visual analogue scale (VAS) scores, patient satisfaction, and medication usage before the procedure and at 1 week and 3, 6, and 12 months after the procedure. In addition, complications associated with the procedure and need for other treatments were evaluated. Results The average preoperative VAS score was 7.8 (range, 5 to 10), and this changed to 2.9 (range, 1 to 7) at 3 months and 4.6 (range, 2 to 7) at 12 months. Patient satisfaction was 71% at 3 months and 50% at 12 months. Five patients used medication at 3 months, whereas 13 used medication at 12 months. Average symptom free duration after the procedure was 7.8 months (range, 1 to 12 months). Two patients were treated surgically. Only two minor complications were noted; transient ptosis with Horner's syndrome and transient causalgia. Conclusions Although selective nerve root block for cervical radiculopathy is limited as a definitive treatment, it appears to be useful in terms of providing relief from radicular pain in about 50% of patients at 12 months.

Chung, Jae-Yoon; Seo, Hyoung-Yeon; Kim, Sung-Kyu; Cho, Kyu-Jin

2012-01-01

355

Cervical spine injury.  

PubMed

Once a child is determined to be at risk of having a cervical spine injury, clinicians must take appropriate precautions to avoid potential worsening of neurologic deficits. Occasionally these decisions are made in the absence of adequate cervical spine imaging when dealing with a child's unstable airway or other life-threatening injuries. Furthermore, clinicians have to make decisions regarding appropriate diagnostic testing to evaluate for potential injury. Decisions regarding testing should take into consideration the clinical presentation of the patient, aiming to order appropriate testing for those at risk and avoid unnecessary testing for those without signs of cervical spine injury. PMID:24093899

Leonard, Julie C

2013-08-20

356

Cervical osteoplastic laminotomy using autogenous bone.  

PubMed

Cervical foraminotomies are performed from the fifth to the eighth cervical nerve roots on both sides. On the side with more marked radiculopathies the laminae are osteotomized to the full extent, but not so completely on the other side. The mass of laminae from C-3 to C-7 is lifted up using the incompletely severed side of the laminae as the fulcrum. The removed spinous processes of C-6 and C-7 are adjusted and fixed between the articular joints and the lifted laminae from C-4 to C-6. This procedure prevents extradural scar formation, there are no complications caused by foreign bodies, postoperative neuroimaging is possible because no metallic artifact is formed, and extensive decompression is achieved for the cervical cord and nerve roots. PMID:8907015

Yamagami, T; Handa, H; Higashi, K; Nishihara, K

1996-02-01

357

Progesterone signaling inhibits cervical carcinogenesis in mice.  

PubMed

Human papillomavirus is the main cause of cervical cancer, yet other nonviral cofactors are also required for the disease. The uterine cervix is a hormone-responsive tissue, and female hormones have been implicated in cervical carcinogenesis. A transgenic mouse model expressing human papillomavirus oncogenes E6 and/or E7 has proven useful to study a mechanism of hormone actions in the context of this common malignancy. Estrogen and estrogen receptor ? are required for the development of cervical cancer in this mouse model. Estrogen receptor ? is known to up-regulate expression of the progesterone receptor, which, on activation by its ligands, either promotes or inhibits carcinogenesis, depending on the tissue context. Here, we report that progesterone receptor inhibits cervical and vaginal epithelial cell proliferation in a ligand-dependent manner. We also report that synthetic progestin medroxyprogesterone acetate promotes regression of cancers and precancerous lesions in the female lower reproductive tracts (ie, cervix and vagina) in the human papillomavirus transgenic mouse model. Our results provide the first experimental evidence that supports the hypothesis that progesterone signaling is inhibitory for cervical carcinogenesis in vivo. PMID:24012679

Yoo, Young A; Son, Jieun; Mehta, Fabiola F; Demayo, Francesco J; Lydon, John P; Chung, Sang-Hyuk

2013-09-05

358

What Is Cervical Cancer?  

MedlinePLUS

... About 80% to 90% of cervical cancers are squamous cell carcinomas. These cancers develop in the squamous cells that ... up of cells that are like squamous cells. Squamous cell carcinomas most often begin where the exocervix joins the ...

359

The cervical cap (image)  

MedlinePLUS

The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self-inserted over the cervix ... left in place several hours after intercourse. The cap is a prescribed device fitted by a health ...

360

Cervical Cancer Other Characteristics  

Cancer.gov

Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Other

361

Cervical cancer screening  

Microsoft Academic Search

Although primary prevention of human papillomavirus (HPV) infections that are causally associated with invasive cervical cancer\\u000a may be within our grasp, it is unlikely that these approaches will replace existing cervical cancer screening strategies for\\u000a many years. Experts agree and data support periodic cytology screening for young-adult women using one of several technologies.\\u000a Recent analyses of cost-effectiveness suggest that the

Dorothy J. Wiley; Bradley J. Monk; Emmanuel Masongsong; Kristina Morgan

2004-01-01

362

[Personal experience with surgical treatment of degenerative diseases of the cervical spine using an anterior approach].  

PubMed

In 1995 to 1999 the authors operated on account of cervical spondylosis, using an anterior approach and methylmethacryl filling of the intervertebral space 57 patients. The mean period of hospitalization was 6.2 days (4-9 days). The clinical condition was evaluated 1, 3, 6, and 12 months after surgery. In 55 patients also X-ray pictures were evaluated. One year after surgery in a group of 14 patients with radiculipathy complete restoration of the condition occurred in 13 patients, improvement was recorded in one patient. In a group of 4 patients with myelopathy the condition did not change in two patients and in two deterioration was recorded. In a group of 39 patients with radiculo- and myelopathy improvement of the condition was recorded in 30 and the condition was unaltered in 9 patients. X-ray examination revealed bridging of the intervertebral space in 11 patients, mobility in the operated segment in 8 and a slight shift of the graft in three instances. The submitted results are comparable with those of other authors. PMID:11367609

Levkus, P; Výrostko, J; Kat'uch, M; Kollová, A; Ménová, K; Kotusová, B

2001-03-01

363

Cervical schistosomiasis as a risk factor of cervical uterine dysplasia in a traveler.  

PubMed

Female genital schistosomiasis (FGS) may be under-recognized in endemic areas as a cause of cervical dysplasia, neoplasia, infertility, and as a facilitator of the transmission of HIV. To the best of our knowledge, few cases of FGS mimicking neoplasia have been reported in travelers. We report a clinical case of a 34-year-old white woman who presented with a severe cervical dysplasia, without any features of human papilloma virus infection, 2 years after bathing in a waterfall, a source of schistosomiasis, in Mali. Schistosomes eggs were found on the conization. Management included conization and medical treatment, resulting in a full clinical and histologic recovery. FGS should be kept in mind as a possible cause of cervical dysplasia in endemic areas. Medical treatment with praziquantel improves this condition. PMID:19815863

Dzeing-Ella, Arnaud; Mechaï, Frédéric; Consigny, Paul-Henri; Zerat, Laurent; Viard, Jean-Paul; Lecuit, Marc; Lortholary, Olivier

2009-10-01

364

[Cervical discopathy, cervical migraine and vertebrobasilar arterial insufficiency: Clinical correlations].  

PubMed

The pathogenesis of cervical migraine may suggest that a connection exists between it and cervical discopathy and also vertebrobasilar arterial insufficiency. This correlation was studied in a group of 103 patients subjected to clinical observations. In 83 of them cervical discopathy was found, in 69 cervical migraine and in 40 vertebrobasilar insufficiency were present. Among those with discopathy migraine was present in 63.6% of cases, and vertebrobasilar insufficiency in 31%. In patients with cervical migraine degenerative changes of the type of cervical discopathy were present in 90% of cases, although in only 56.5% of cases clinical signs were present connected with these changes. Vertebrobasilar insufficiency was present in 45% of patients with cervical migraine, that is more frequently than in discopathy. In the group with vertebrobasilar insufficiency radiological changes in the cervical spine were present in 77.5% of cases and the same proportion of patients in this group had cervical migraine. These numbers confirm the connection between cervical migraine and radiological changes and clinical manifestations of discopathy, and they indicate also that cervical migraine may be a successive stage of vascular changes leading to circulatory failure in the area supplied by vertebral arteries. This failure may have a different course and pathological mechanism. In 12.5% of patients in this group no cervical migraine or radiological changes were demonstrated. The term "cervical migraine" seems inappropriate since this type of headache has another substrate and mechanism than true migraine. PMID:714220

Domza?, T; Zaleska, B; Kwasucki, J

365

Women's lay knowledge of cervical cancer/cervical screening: accounting for non-attendance at cervical screening clinics.  

PubMed

An assessment of women's knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women's knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main 'causes' were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself. PMID:9756225

Neilson, A; Jones, R K

1998-09-01

366

Necrotizing Fasciitis of the Cervical Region following Extravasation Injury  

PubMed Central

Necrotizing fasciitis is a rapidly progressive soft tissue infection that can cause local tissue destruction, necrosis, and life threatening severe sepsis. Necrotizing fasciitis in the head and neck region caused by an extravasation injury is rare. This paper reports a patient with necrotizing fasciitis of the cervical region caused by an extravasation injury which required an early surgical debridement.

Gundeslioglu, Ayse Ozlem; Ozen, Emine Cigdem

2012-01-01

367

The role of complement in gonococcal infection of cervical epithelia.  

PubMed

Neisseria gonorrhoeae is an exclusive human pathogen that causes the sexually transmitted disease, gonorrhea. The gonococcus has developed an exquisite repertoire of mechanisms by which it is able to evade host innate and adaptive immune responses. Our previous data indicate that the predominately asymptomatic nature ofgonococcal cervicitis may, in part, be attributed to the ability of these bacteria to subvert the normal function of complement to promote cervical disease. Herein we describe the interaction of N. gonorrhoeae with the complement alternative pathway with a particular focus on the importance of this interaction in promoting gonococcal cervicitis. PMID:19388166

Edwards, Jennifer L

2008-12-30

368

Cervical Cancer Prevention: New Tools and Old Barriers  

PubMed Central

Cervical cancer is the second most common female tumor worldwide and its incidence is disproportionately high (>80%) in the developing world. In the U.S., where Pap tests have reduced the annual incidence to approximately 11,000 cervical cancers, more than 60% of cases occur in medically-underserved populations as part of a complex of diseases linked to poverty, race/ethnicity, and/or health disparities. Because carcinogenic human papillomavirus (HPV) infections cause virtually all cervical cancer, two new approaches for cervical cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (?18 years old) and 2) carcinogenic HPV detection in older women (?30 years old). Together, HPV vaccination and testing, if used in an age-appropriate manner, have the potential to transform cervical cancer prevention particularly among underserved populations. Yet significant barriers of access, acceptability, and adoption to any cervical cancer prevention strategy remain. Without understanding and addressing these obstacles, these promising new tools for cervical cancer prevention may be futile. We share our experiences in the delivery of cervical cancer prevention strategies to U.S. populations experiencing high cervical cancer burden: African-American women in South Carolina, Alabama, Mississippi; Haitian immigrant women in Miami; Hispanic women in the U.S.-Mexico Border; Sioux/Native American women in the Northern Plains; white women in the Appalachia; and Vietnamese-American women in Pennsylvania and New Jersey. Our goal is to inform future research and outreach efforts to reduce the burden of cervical cancer in underserved populations.

Scarinci, Isabel C.; Garcia, Francisco A. R.; Kobetz, Erin; Partridge, Edward E.; Brandt, Heather M.; Bell, Maria C.; Dignan, Mark; Ma, Grace X.; Daye, Jane L.; Castle, Philip E.

2010-01-01

369

Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance  

Microsoft Academic Search

In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' headache and a questionnaire was used to establish a profile of the headache population.

Dean H Watson; Patricia H Trott

1993-01-01

370

Mathematical Modelling of Cervical Cancer Vaccination in the UK  

Microsoft Academic Search

Human papillomaviruses (HPV) are responsible for causing cervical cancer and anogenital warts. The UK considered a national\\u000a vaccine program introducing one of two licensed vaccines, GardasilTM and CervarixTM. The impact of vaccination is, however, difficult to predict due to uncertainty about the prevalence of HPV infection, pattern\\u000a of sexual partnerships, progression of cervical neoplasias, accuracy of screening as well as

Yoon Hong Choi; Mark Jit

371

Manipulation of the cervical spine  

Microsoft Academic Search

In New Zealand, a new approach to manual therapy of the cervical spine has integrated physiotherapy and osteopathy techniques. The combination of the philosophies of these two professions has added a new dimension to the management of cervical spine pain. Emphasis is placed on issues of safety, such as the degree of cervical rotation and comfort for both the patient

W. A Hing; D. A Reid; M Monaghan

2003-01-01

372

Cervical hibernoma and lipoblastomatosis.  

PubMed

Lipoblastoma and lipoblastomatosis are rare benign soft-tissue tumoral lesions resembling fetal adipose tissue. A total of 16 cases of lipoblastoma of the neck were reported in the literature, and only 3 were described in the posterior side of the neck. Hibernoma is a rare benign adipose tumor composed of brown fat cells and only about ten cases occurring in the cervical area have been reported. We reported two rare cases of adipose tissue tumors. The first case was a male infant aged 12 months who had a cervical mass on the posterior side of the neck. He underwent a complete resection of the lesion and the pathologic study revealed lipoblastomatosis. The second case was a 36-year-old man with an anterior cervical mass, which moved with swallowing. A resection was made and the histological analysis showed hibernoma. PMID:23579754

Nardi, Carlos Eduardo Molinari; Barreto, Leonardo; Carvalho, Leda Viegas de; Guimarães, André Vicente

2013-03-01

373

Acute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin  

PubMed Central

We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration

Riva, Nilo; Riva, Nilo; Morana, Paolo; Cerri, Federica; Gerevini, Simonetta; Amadio, Stefano; Formaglio, Fabio; Comi, Giancarlo; Comola, Mauro; Del Carro, Ubaldo

2009-01-01

374

Minimum 2-year outcome of cervical laminoplasty with deep extensor muscle-preserving approach: impact on cervical spine function and quality of life  

PubMed Central

In this retrospective cohort study, two surgical methods of conventional open-door laminoplasty and deep extensor muscle-preserving laminoplasty were allocated for the treatment of cervical myelopathy, and were specifically compared in terms of axial pain, cervical spine function, and quality of life (QOL) with a minimum follow-up period of 2 years. Eighty-four patients were divided into two groups and received either a conventional open-door laminoplasty (CL group) or laminoplasty using a deep extensor muscle-preserving approach (MP group). The latter approach was performed by preserving multifidus and semispinalis cervicis attachments followed by open-door laminoplasty and re-suture of the bisected spinous processes at each decompression level. The average follow-up period was 38 months (25–53 months). The preoperative and follow-up evaluations included the original Japanese Orthopaedic Association (JOA) score, the new tentative JOA score including cervical spine function and QOL, and the visual analogue scale (VAS) of axial pain. Radiological analyses included cervical lordosis and flexion–extension range of motion (flex–ext ROM) (C2–7), and deep extensor muscle areas on MR axial images. The JOA recovery rates were statistically equivalent between two groups. The MP group demonstrated a statistically superior cervical spine function (84% vs 63%) and QOL (61% vs 45%) when compared to the CL group at final follow-up (P < 0.05). The average VAS scores at final follow-up were 2.3 and 4.9 in MP and CL groups (P < 0.05). The cervical lordosis and flex–ext ROM were statistically equivalent. The percent deep muscle area on MRI demonstrated a significant atrophy in CL group compared to that in MP group (56% vs 88%; P < 0.01). Laminoplasty employing the deep extensor muscle-preserving approach appeared to be effective in reducing the axial pain and deep muscle atrophy as well as improving cervical spine function and QOL when compared to conventional open-door laminoplasty.

Abumi, Kuniyoshi; Ito, Manabu; Sudo, Hideki; Takahata, Masahiko; Ohshima, Shigeki; Hojo, Yoshihiro; Minami, Akio

2009-01-01

375

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up.  

PubMed

A variety of bone graft substitutes, interbody cages, and anterior plates have been used in cervical interbody fusion, but no controlled study was conducted on the clinical performance of beta-tricalcium phosphate (beta-TCP) and the effect of supplemented anterior plate fixation. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting interbody fusion cage containing beta-TCP for the treatment of cervical radiculopathy and/or myelopathy, and the fusion rates and outcomes in patients with or without randomly assigned plate fixation. Sixty-two patients with cervical radiculopathy and/or myelopathy due to soft disc herniation or spondylosis were treated with one- or two-level discectomy and fusion with interbody cages containing beta-TCP. They were randomly assigned to receive supplemented anterior plate (n = 33) or not (n = 29). The patients were followed up for 2 years postoperatively. The radiological and clinical outcomes were assessed during a 2-year follow-up. The results showed that the fusion rate (75.0%) 3 months after surgery in patients treated without anterior cervical plating was significantly lower than that (97.9%) with plate fixation (P < 0.05), but successful bone fusion was achieved in all patients of both groups at 6-month follow-up assessment. Patients treated without anterior plate fixation had 11 of 52 (19.2%) cage subsidence at last follow-up. No difference (P > 0.05) was found regarding improvement in spinal curvature as well as neck and arm pain, and recovery rate of JOA score at all time intervals between the two groups. Based on the findings of this study, interbody fusion cage containing beta-TCP following one- or two-level discectomy proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Supplemented anterior plate fixation can promote interbody fusion and prevent cage subsidence but do not improve the 2-year outcome when compared with those treated without anterior plate fixation. PMID:18301927

Dai, Li-Yang; Jiang, Lei-Sheng

2008-02-27

376

Rare sensory and autonomic disturbances associated with vitamin B12 deficiency  

Microsoft Academic Search

Vitamin B12 deficiency is an important nutritional disorder causing neurological manifestations of myelopathy, neuropathy and dementia. Sub-acute combined degeneration (SCD) with involvement of the posterior columns in the cervical and thoracic cord is a common presentation of this disorder. In this case report, we describe a 43year old woman with pernicious anemia and myelopathy with atypical clinical features. The patient

Preeti Puntambekar; Maysaa M. Basha; Imad T. Zak; Ramesh Madhavan

2009-01-01

377

Childhood indicators of susceptibility to subsequent cervical cancer.  

PubMed

Common warts could indicate cervical cancer susceptibility, as both are caused by human papillomavirus (HPV). Eczema was also investigated, as atopic eczema has been negatively associated with warts, but non-atopic eczema may be associated with compromised host defences, as observed in patients with HIV, suggesting increased susceptibility to HPV infection and cervical cancer. 'Cervical cancer' was self-reported during an interview by 87 of 7594 women members of two longitudinal British birth cohorts. The accuracy of the diagnoses is limited by lack of confirmation using medical records. Odds ratios are adjusted for common warts and eczema in childhood; and cigarette smoking, number of cohabiting partners and social class in early adult life. The odds ratios of warts and eczema with cervical cancer are 2.50 (95% confidence interval 1.14-5.47) and 3.27 (1.95-5.49), respectively. The association of eczema with cervical cancer is independent of hay fever as a marker of atopy, suggesting the importance of non-atopic eczema. Both heavier smoking compared with non-smoking and four or more cohabiting partners compared with one/none have odds ratios for cervical cancer of 8.26 (4.25-15.10) and 4.89 (1.39-17.18), respectively. Common warts in childhood may indicate cervical cancer susceptibility; this and the relationship with eczema deserves investigation. PMID:12434290

Montgomery, S M; Ehlin, A G C; Sparén, P; Björkstén, B; Ekbom, A

2002-10-21

378

Proteomics-based approach to elucidate the mechanism of antitumor effect of curcumin in cervical cancer  

Microsoft Academic Search

Cervical cancer is the second leading cause of cancer death for women in the world. A potential target for preventing and treating cervical cancer is cyclooxygenase-2 (cox-2). Curcumin is an anti-inflammatory agent that is known to have anti-cox-2 activity. In this study we examined the expression of cox-2 in cervical cancer and its precursors by immunohistochemistry. The effect of curcumin

Krystal Madden; Lisa Flowers; Ritu Salani; Ira Horowitz; Sanjay Logan; Kevin Kowalski; Jun Xie; Sulma I. Mohammed

2009-01-01

379

Effect of Acquisition and Treatment of Cervical Infections on HIV-1 Shedding in Women on Antiretroviral Therapy  

PubMed Central

Background Cervicitis increases the quantity of HIV-1 RNA in cervical secretions when women are not taking antiretroviral therapy (ART), and successful treatment of cervicitis reduces HIV-1 shedding in this setting. Objective To determine the effect of acquisition and treatment of cervical infections on genital HIV-1 shedding in women receiving ART. Design Prospective cohort study. Methods We followed 147 women on ART monthly for incident non-specific cervicitis, gonorrhea, and chlamydia. Cervical swabs for HIV-1 RNA quantitation were collected at every visit. The lower limit for linear quantitation was 100 copies/swab. We compared the prevalence of HIV-1 RNA detection before (baseline) versus during and after treatment of cervical infections. Results Thirty women contributed a total of 31 successfully treated episodes of non-specific cervicitis (N=13), gonorrhea (N=17), and chlamydia (N=1). HIV-1 RNA was detected in cervical secretions before, during, and after cervicitis at 1 (3.2%), 5 (16.1%), and 3 (9.7%) visits respectively. Compared to baseline, detection of HIV-1 RNA was increased when cervical infections were present (adjusted odds ratio 5.7, 95% confidence interval 1.0–30.3, P=0.04). However, even in the subset of women with cervical HIV-1 RNA levels above the threshold for quantitation, most had low concentrations during cervical infections (median 115, range 100–820 copies/swab). Conclusions While these data show a statistically significant increase in cervical HIV-1 RNA detection when cervical infections are present, most cervical HIV-1 RNA concentrations were near the threshold for detection, suggesting that infectivity remains low. Antiretroviral therapy appears to limit increases in genital HIV-1 shedding caused by cervical infections.

GITAU, Ruth W.; GRAHAM, Susan M.; MASESE, Linnet N.; OVERBAUGH, Julie; CHOHAN, Vrasha; PESHU, Norbert; RICHARDSON, Barbra A.; JAOKO, Walter; NDINYA-ACHOLA, Jeckoniah O.; MCCLELLAND, R. Scott

2010-01-01

380

Cervical motion segment replacement  

Microsoft Academic Search

When symptoms bring to light a cervical spine degenerative disc process that requires surgical intervention, a symptom relieving procedure such as decompression, followed by functional restoration, arthroplasty, offers the benefit of prophylaxis of accelerated spondylosis at the operated level. In addition, by altering the biomechanical stress factors at adjacent levels, theoretically it should offer prophylactic benefit at these levels as

Vincent E. Bryan Jr; J Goffin; A Casey; P Kehr; K Liebig; C Logroscino; F Van Calenbergh; J van Loon; Universitaire Ziekenhuizen

2002-01-01

381

5. Cervical facet pain.  

PubMed

More than 50% of patients presenting to a pain clinic with neck pain may suffer from facet-related pain. The most common symptom is unilateral pain without radiation to the arm. Rotation and retroflexion are frequently painful or limited. The history should exclude risk factors for serious underlying pathology (red flags). Radiculopathy may be excluded with neurologic testing. Direct correlation between degenerative changes observed with plain radiography, computerized tomography, and magnetic resonance imaging and pain has not been proven. Conservative treatment options for cervical facet pain such as physiotherapy, manipulation, and mobilization, although supported by little evidence, are frequently applied before considering interventional treatments. Interventional pain management techniques, including intra-articular steroid injections, medial branch blocks, and radiofrequency treatment, may be considered (0). At present, there is no evidence to support cervical intra-articular corticosteroid injection. When applied, this should be done in the context of a study. Therapeutic repetitive medial branch blocks, with or without corticosteroid added to the local anesthetic, result in a comparable short-term pain relief (2 B+). Radiofrequency treatment of the ramus medialis of the cervical ramus dorsalis (facet) may be considered. The evidence to support its use in the management of degenerative cervical facet joint pain is derived from observational studies (2 C+). PMID:20415728

van Eerd, Maarten; Patijn, Jacob; Lataster, Arno; Rosenquist, Richard W; van Kleef, Maarten; Mekhail, Nagy; Van Zundert, Jan

382

Anterior cervical discectomy plus intervertebral polyetheretherketone cage fusion over three and four levels without plating is safe and effective long-term.  

PubMed

Anterior cervical discectomy and fusion (ACDF) is an established treatment for single-level cervical spondylotic myelopathy and radiculopathy, yet its stand-alone use for multi-level disease of the subaxial cervical spine remains controversial. We report a prospectively studied case series of 30 patients receiving polyetheretherketone (PEEK) cage fusion over three and four cervical levels without anterior plating. Seven (23.3%) four-level procedures (all C3 to C7) were performed, the other 23 (76.7%) being three-level, with 19 (64.4%) at C4 to C7 and four (12.3%) at C3 to C6. Long-term follow-up of more than 2 years was available in 67% of patients. This cohort showed statistically significant improvements in visual analogue score for neck pain (p=0.0006), arm pain (p=0.0003) and Japanese Orthopaedic Association myelopathy score (p=0.002). Fused segment heights increased by 0.6-1.1%. Adjacent segment disease requiring ACDF at C3-4 was seen in 6.7% of patients (one after trauma) at a mean follow-up of 62 months. Same segment recurrence requiring posterior decompression with instrumented fusion was found in 10% of patients at a mean follow-up of 49 months, only one of whom had radiological evidence of cage subsidence. The results suggest the procedure is safe and effective with potentially less morbidity than anterior plating, shorter inpatient stays than posterior approaches, acceptable same segment recurrence and lower than predicted adjacent segment disease rates. PMID:23890411

Pereira, Erlick A C; Chari, Aswin; Hempenstall, Jonathan; Leach, John C D; Chandran, Hari; Cadoux-Hudson, Tom A D

2013-07-23

383

Chemoradiation Therapy and Ipilimumab in Treating Patients With Locally Advanced Cervical Cancer  

ClinicalTrials.gov

Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

2013-06-14

384

Daily C ontrolled Physiotherapy I ncreases S urvival Time in D ogs w ith S uspected Degenerative Myelopathy  

Microsoft Academic Search

The purposes of the study reported here were to evaluate the signalment and clinical presentation in 50 dogs with degenerative myelopathy, to evaluate whether mean survival time was significantly affected by various means of physiotherapy performed in 22 dogs, and to determine whether neurologic status, anatomic localization, or age at onset had an influence on survival time in dogs that

I. Kathmann; S. Cizinauskas; M. G. Doherr; F. Steffen; A. Jaggy

385

Myelopathy secondary to ossification of the posterior longitudinal ligament of the thoracic spine treated by anterior decompression and bony fusion  

Microsoft Academic Search

We examined the utility of anterior decompression and bony fusion via the extrapleural approach in the treatment of thoracic myelopathy secondary to ossification of the posterior longitudinal ligament (OPLL). Patient outcome and complications were analyzed in 48 patients treated with this procedure, with a follow-up of at least 2 years. The Japanese Orthopaedic Association score was used to evaluate the

Y Fujimura; Y Nishi; M Nakamura; M Watanabe; M Matsumoto

1997-01-01

386

Postcoital bleeding due to cervical endometriosis.  

PubMed

Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosis should be considered in the differential diagnosis of cervical masses with postcoital bleeding. PMID:23376669

Seval, Mehmet Murat; Cavkaytar, Sabri; Atak, Zeliha; Guresci, Servet

2013-01-31

387

Change in Angular Alignment is Associated With Early Dysphagia After Anterior Cervical Diskectomy and Fusion.  

PubMed

STUDY DESIGN:: Retrospective analysis of a prospective cohort. OBJECTIVE:: Change in cervical angular alignment may be associated with dysphagia. SUMMARY OF BACKGROUND DATA:: Bony deformities of the cervical spine may be associated with secondary contractures in soft tissues in the neck. Acute surgical deformity correction result in changes in soft tissue tension in the anterior neck, resulting in dysphagia. METHODS:: The study population included patients undergoing one and two level elective anterior cervical discectomy and fusion for cervical myelopathy or radiculopathy. Preoperative and postoperative radiographs at two weeks were measured by a blinded observer for c2-c7 endplate angle, c2-c7 posterior vertebral body length, and occipital condyle plumb line distance on upright lateral radiographs at 2, 6, and 12 weeks postoperatively. Patients were prospectively queried about dysphagia incidence and severity using a numeric rating scale. Multiple linear regression analysis was used to determine the effect of change in radiographic parameters controlling for demographic characteristics. RESULTS:: The study population included 25 patients with complete radiographs. The mean change in C2-C7 angle was -0.6 degrees (Standard Deviation (SD) 9), the mean change in C2-C7 length was 1.7 mm (SD 26), the mean change in occipital condyle plumb line distance was 2,3 mm (SD 20).Mulitple linear regression analysis was performed including operative time, age, gender, number of levels, and change in radiographic parameters as independent variables and using dysphagia score as the dependent variable. The change in C2-C7 angle and operative time were the only statistically significant predictors of change in dysphagia score at 2 and 6 weeks postoperatively. CONCLUSION:: These results indicate that lordotic change in spinal alignment and longer operative time are associated with increased postoperative dysphagia. Surgeons should counsel patients in whom a large angular correction is expected about the possibility for postoperative dysphagia. Furthermore, future studies on dysphagia incidence should include radiographic alignment as an independent predictor of dysphagia. PMID:23511647

Radcliff, Kristen E; Bennett, Jonathan; Stewart, Robert J; Kepler, Chris K; Sidhu, Gursukhman S; Hilibrand, Alan S; Kane, Justin; Albert, Todd J; Vaccaro, Alexander R; Rihn, Jeffrey A

2013-03-18

388

Optical Imaging for Cervical Cancer Detection: Solutions for a Continuing Global Problem  

PubMed Central

Preface Cervical cancer is the leading cause of cancer death for women in developing countries1. Optical technologies can improve the accuracy and availability of cervical cancer screening. For example, battery-powered digital cameras can obtain multi-spectral images of the entire cervix highlighting suspicious areas, and high-resolution optical technologies can further interrogate suspicious areas, providing in vivo diagnosis with high sensitivity and specificity. In addition, targeted contrast agents can highlight changes in biomarkers of cervical neoplasia. Such advances should provide a much needed global approach to cervical cancer prevention.

Thekkek, Nadhi; Richards-Kortum, Rebecca

2009-01-01

389

Potential opportunities to reduce cervical cancer by addressing risk factors other than HPV  

PubMed Central

Cervical cancer is the most common cancer in developing world and 80% of global burden is reported from these nations. Human papillomavirus along with poverty, illiteracy/lower education level and standards, multi-parity, tobacco, malnutrition and poor genital hygiene may act synergistically to cause cervical cancer. Risk factor of cervical cancer may in itself be the reason for non-viability of cervical cancer vaccine program in this part of the world. Interventions to address these risk factors in addition to vaccination of girls before their sexual debut may hold promises of reducing the morbidity and mortality of female genital cancers.

Bhasker, Suman

2013-01-01

390

Potential opportunities to reduce cervical cancer by addressing risk factors other than HPV.  

PubMed

Cervical cancer is the most common cancer in developing world and 80% of global burden is reported from these nations. Human papillomavirus along with poverty, illiteracy/lower education level and standards, multi-parity, tobacco, malnutrition and poor genital hygiene may act synergistically to cause cervical cancer. Risk factor of cervical cancer may in itself be the reason for non-viability of cervical cancer vaccine program in this part of the world. Interventions to address these risk factors in addition to vaccination of girls before their sexual debut may hold promises of reducing the morbidity and mortality of female genital cancers. PMID:24167663

Kumar, Ramaiah Vinay; Bhasker, Suman

2013-10-02

391

Etiology of cervical pregnancy. Association with abortion, pelvic pathology, IUDs and Asherman's syndrome.  

PubMed

Five cases of cervical pregnancy were treated with hysterectomy. In addition to previous pelvic pathology, iatrogenic interventions can be possible predisposing factors in this type of pregnancy. The association of cervical pregnancy and induced abortion, with traumatic curettage damaging the endometrium, rendering it unsuitable for nidation, is well documented. The two cases of severe intrauterine adhesions in our series suggest that partial or complete obliteration of the uterine cavity by such adhesions might be an important cause of cervical pregnancy. The presence of an IUD and the administration of hormonal therapy for the treatment of Asherman's syndrome might have contributed to our cases of cervical pregnancy. PMID:4038744

Dicker, D; Feldberg, D; Samuel, N; Goldman, J A

1985-01-01

392

Optical technologies and molecular imaging for cervical neoplasia: a program project update.  

PubMed

There is an urgent global need for effective and affordable approaches to cervical cancer screening and diagnosis. In developing nations, cervical malignancies remain the leading cause of cancer-related deaths in women. This reality may be difficult to accept given that these deaths are largely preventable; where cervical screening programs have been implemented, cervical cancer-related deaths have decreased dramatically. In developed countries, the challenges of cervical disease stem from high costs and overtreatment. The National Cancer Institute-funded Program Project is evaluating the applicability of optical technologies in cervical cancer. The mandate of the project is to create tools for disease detection and diagnosis that are inexpensive, require minimal expertise, are more accurate than existing modalities, and can be feasibly implemented in a variety of clinical settings. This article presents the status and long-term goals of the project. PMID:21944317

Buys, Timon P H; Cantor, Scott B; Guillaud, Martial; Adler-Storthz, Karen; Cox, Dennis D; Okolo, Clement; Arulogon, Oyedunni; Oladepo, Oladimeji; Basen-Engquist, Karen; Shinn, Eileen; Yamal, José-Miguel; Beck, J Robert; Scheurer, Michael E; van Niekerk, Dirk; Malpica, Anais; Matisic, Jasenka; Staerkel, Gregg; Atkinson, Edward Neely; Bidaut, Luc; Lane, Pierre; Benedet, J Lou; Miller, Dianne; Ehlen, Tom; Price, Roderick; Adewole, Isaac F; MacAulay, Calum; Follen, Michele

2011-09-22

393

Optical Technologies and Molecular Imaging for Cervical Neoplasia: A Program Project Update  

PubMed Central

There is an urgent global need for effective and affordable approaches to cervical cancer screening and diagnosis. For developing nations, cervical malignancies remain the leading cause of cancer death in women. This reality is difficult to accept given that these deaths are largely preventable; where cervical screening programs are implemented, cervical cancer deaths decrease dramatically. In the developed world, the challenges with respect to cervical disease stem from high costs and over-treatment. We are presently eleven years into a National Cancer Institute-funded Program Project (P01 CA82710) that is evaluating optical technologies for their applicability to the cervical cancer problem. Our mandate is to create new tools for disease detection and diagnosis that are inexpensive, require minimal expertise to use, are more accurate than existing modalities, and will be feasibly implemented in a variety of clinical settings. Herein, we update the status of this work and explain the long-term goals of this project.

Buys, Timon P. H.; Cantor, Scott B.; Guillaud, Martial; Adler-Storthz, Karen; Cox, Dennis D.; Okolo, Clement; Arulogon, Oyedunni; Oladepo, Oladimeji; Basen-Engquist, Karen; Shinn, Eileen; Yamal, Jose-Miguel; Beck, J. Robert; Scheurer, Michael E.; van Niekerk, Dirk; Malpica, Anais; Matisic, Jasenka; Staerkel, Gregg; Atkinson, Edward Neely; Bidaut, Luc; Lane, Pierre; Benedet, J. Lou; Miller, Dianne; Ehlen, Tom; Price, Roderick; Adewole, Isaac F.; MacAulay, Calum; Follen, Michele

2011-01-01

394

Cytological diagnosis of tuberculous cervicitis: A case report with review of literature  

PubMed Central

Tuberculosis of cervix is a rare disease. Tuberculosis usually affects women of childbearing age, indicating hormone dependence of infection. The patient presents with menstrual irregularities, infertility or vaginal discharge. Cervical lesions presents as papillary/vegetative growth or ulceration mimicking cervical cancer. Cervical Papanicolaou (Pap) smear plays an important role in diagnosing the disease by non-invasive technique in which the presence of epithelioid cells and Langhan's type of giant cells is diagnostic. However, other causes of granulomatous cervicitis should be considered and ruled out. Ziehl-Neelsen (ZN) stain for acid fast bacilli, fluorescent technique, biopsy and culture help in confirming the disease. We present the case of a 45-year-old female, who presented with vaginal discharge, dysfunctional uterine bleeding, first degree uterine descent with grade II cystocele and rectocele and cervical ulcer. Pap smear revealed epithelioid cells and Langhan's type of giant cells, confirmed by ZN stain of cervical smear, fluorescent technique and culture.

Kalyani, R; Sheela, SR; Rajini, M

2012-01-01

395

Cervical Spondylosis (Arthritis of the Neck)  

MedlinePLUS

... to a cervical disk herniation, also known as radiculopathy or a "pinched nerve." Epidural injection in the ... orthoinfo.aaos.org/topic.cfm?topic=A00575) Cervical Radiculopathy (Pinched Nerve) Cervical Radiculopathy (Pinched Nerve) (http://orthoinfo. ...

396

Prevalence of human papillomavirus cervical infection in an Italian asymptomatic population  

Microsoft Academic Search

BACKGROUND: In the last decade many studies have definitely shown that human papillomaviruses (HPVs) are the major cause of cervical carcinogenesis and, in the last few years, HPV testing has been proposed as a new and more powerful tool for cervical cancer screening. This issue is now receiving considerable attention in scientific and non scientific press and HPV testing could

Maria G Centurioni; Andrea Puppo; Domenico F Merlo; Gennaro Pasciucco; Enzo R Cusimano; Rodolfo Sirito; Claudio A Gustavino

2005-01-01

397

The epidemiology of human papillomavirus infection and its association with cervical cancer  

Microsoft Academic Search

Cervical cancer has been recognized as a rare outcome of a common, sexually transmitted infection whose etiologic association is restricted to a few human papillomavirus (HPV) types. With optimal testing systems HPV DNA can be identified in nearly all specimens of invasive cervical cancer, and it is claimed that infection of the cervix with HPV is a necessary cause of

F. Xavier Bosch; You-Lin Qiao; Xavier Castellsagué

2006-01-01

398

The social context of cervical cancer knowledge and prevention among Haitian immigrant women  

Microsoft Academic Search

Cervical cancer is the primary cause of cancer deaths among Haitian women; however, the social context of cervical cancer among Haitian immigrant women has not been systematically examined. The ways in which women assign meaning to this disease, understand its causality and situate it within the broader context of gynecological health are poorly understood. Further, Haitian immigrant women's perceptions of

Janelle Marie Menard

2008-01-01

399

Prostitution, Condom Use, and Invasive Squamous Cell Cervical Cancer in Thailand  

Microsoft Academic Search

Cervical cancer is probably caused by a sexually transmitted agent. A case-control study was conducted in three hospitals in Thailand to investigate further the role of male sexual behavior, particularly regarding sexual contacts with prostitutes, in the development of this disease. Data were obtained from interviews with 225 manned women with invasive squamous cell cervical carcinoma and 791 hospitalized controls,

David B. Thomas; Roberta M. Ray; Tieng Pardthaisong; Supawat Chutivongse; Supom Koetsawang; Suporn Silpisornkosol; Pramuan Virutamasen; William M. Christopherson; Joseph L. Melnick; Olav Meirik; Timothy M. M. Farley; Gustave Riotton

400

Human papillomavirus and the value of screening: young women's knowledge of cervical cancer  

Microsoft Academic Search

The study reports a questionnaire survey of female university students intended (1) to delin- eate their knowledge of cervical cancer and screening, and (2) to impute their valuation of the introduction of human papillomavirus (HPV) testing. It was found that almost 80% of respondents thought cervical cancer was a leading cause of cancer death amongst women. Most subjects consistently over-estimated

Stacy Johnson; Mark Avis; David K. Whynes

2003-01-01

401

Prompt restoration of airway along with rapid neurological recovery following ultrasonography-guided needle aspiration of a tubercular retropharyngeal abscess causing airway obstruction.  

PubMed

Upper respiratory obstruction in cervical spine tuberculosis rarely occurs due to retropharyngeal cold abscess or secondarily from its rupture. Options for securing the airway are intubation, tracheostomy and needle aspiration or surgical drainage. A young boy presented with neck pain, quadriparesis and stridor, suggesting subacute airway obstruction in advanced tubercular spondylodiscitis of cervical spine C3-C4 (cervical 3rd and 4th level) with extradural compressive myelopathy (C3-C5) and a large retropharyngeal cold abscess. An urgent ultrasonography-guided needle aspiration with a head low position through the left posterior triangle was performed with adequate precautions and back-up for advanced airway management. Needle aspiration yielded 200 ml of pus. Stridor and hoarseness of voice decreased immediately. Within two-and-a-half hours, the patient improved neurologically. Although guided needle aspiration is one of the treatment options, there is a strong tendency to undermine this technique in favour of other options, especially surgery. PMID:22173262

Borgohain, B

2011-11-01

402

Causes, prevention, and treatment of dentin hypersensitivity.  

PubMed

This article presents an overview of dentin hypersensitivity, including its causes, prevention, and treatment. The author provides information on hypersensitivity associated with exposed cervical dentin, tooth-whitening procedures, and direct and indirect restorations. PMID:15645869

Swift, Edward J

2004-02-01

403

Cervical and Thoracic Spine Injuries  

Microsoft Academic Search

\\u000a Cervical spine injuries are very common in contact sports such as wrestling, football, hockey, and rugby. It has been estimated\\u000a that up to 15% of football athletes suffer from some cervical spine injury. The National Center for Catastrophic Sports Injury\\u000a reported over the 12-yr period between 1982 and 1994 there were 450 catastrophic injuries, and 75% involved the cervical spine

Pierre d’Hemecourt; Jessica Flynn Deede

404

Synthetic cervical mucus formulation  

Microsoft Academic Search

A synthetic formulation has been developed with viscosity, spinnbarkeit, and pH comparable to that reported for human cervical mucus. The formulation contains guar gum crosslinked with borate ion, mucin (dried porcine gastric), and a mixed preservative system in pH 7.4, 0.1M phosphate buffer. The guar gum source, mucin concentration, and method of preparation were shown to be critical factors in

Br??d T Burruano; Roger L Schnaare; Daniel Malamud

2002-01-01

405

Recurrent cervical cancer  

Microsoft Academic Search

Opinion statement  There are limited treatment options for patients with recurrent cervical carcinoma. Because of low response rates and a negligible\\u000a impact on long-term survival, the use of chemotherapy in patients with unresectable recurrent disease should be considered\\u000a palliative. Generally, radiation therapy in previously irradiated patients is considered palliative. For patients who develop\\u000a recurrent disease after definitive surgery who have not

Mario M. Leitao; Dennis S. Chi

2002-01-01

406

Cervical Primitive Neuroectodermal Tumor  

Microsoft Academic Search

Background.Primitive neuroectodermal tumors (PNETs) are rare and potentially aggressive malignancies.Case. A 24-year-old woman in her eighth week of pregnancy presented with a cervical mass. Tissue biopsy demonstrated poorly differentiated carcinosarcoma with neuroendocrine features. Immunohistochemical studies confirmed the diagnosis of PNET. Treatment included alternating courses of cyclophosphamide, adriamycin, vincristine (CAV) and ifosfamide, etoposide (IE). A radical hysterectomy with bilateral ovarian transposition

Anne S. Tsao; Lawrence M. Roth; Alan Sandler; Jean A. Hurteau

2001-01-01

407

Disparities and Cervical Cancer  

Microsoft Academic Search

\\u000a Cervical cancer became a preventable disease with the introduction of the Papanicolaou smear (Pap smear) in the 1940s. Trend\\u000a data show that incidence rates have decreased steadily over the past several decades in both white and African American women\\u000a living in the United States (American Cancer Society 2007). Mortality rates have declined steadily over the past several decades\\u000a as well

Marcela del Carmen; Teresa Diaz-Montez

408

Cervical cancer risk levels in Turkey and compliance to the national cervical cancer screening standard.  

PubMed

Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of ?zmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard. Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05). A logistic regression model was constructed including age, education level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (p< 0.05). Not having Pap smear test in 35-39 age group more than other groups might result from lack of information on the cervical cancer national screening standard and the necessity of having Pap smear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve the inequalities due to age and educational differences. PMID:21790227

Açikgöz, Ayla; Ergör, Gül

2011-01-01

409

[Papillomavirus and cervical cancer in Chile].  

PubMed

Molecular, clinical and epidemiological studies have established beyond doubt that human papiloma viruses (HPV) cause cervical cancer. The virus is also associated with genital warts and other less common cancers in oropharynx, vulva, vagina and penis. Worldwide, VPH genotypes 16 and 18 are the most common high risk genotypes, detected in near 70% of women with cervical cancer. The discovery of a cause-effect relationship between several carcinogenic microorganisms and cancer open avenues for new diagnostic, treatment and prevention strategies. In this issue of Revista Médica de Chile, two papers on HPV are presented. Guzman and colleagues demonstrate that HPV can be detected in 66% to 77% of healthy male adolescents bypolymerase chain reaction and that positivity depends on the site of the penis that is sampled. These results support the role of male to female transmission of high risk HPVs in Chile and should lead to even more active educational campaigns. The second paper provides recommendations for HPV vaccine use in Chile, generated by the Immunization Advisory Committee of the Chilean Infectious Disease Society. To issue these recommendations, the Committee analyzes the epidemiological information available on HPV infection and cervical cancer in Chile, vaccine safety and effectiveness data, and describes cost-effectiveness studies. Taking into account that universal vaccination is controversial, the Committee favors vaccine use in Chile and it's incorporation into a national program. However, there is an indication that the country requires the implementation of an integrated surveillance approach including cross matching of data obtained from HPV genotype surveillance, monitoring of vaccination coverage, and surveillance of cervical cancer. The final decision of universal vaccine use in Chile should be based on a through analysis of information.ev Mid Chile PMID:19301766

O'Ryan, Miguel; Valenzuela, María Teresa

2008-11-01

410

Classification and management of cervical paragangliomas  

PubMed Central

INTRODUCTION Cervical paragangliomas are slow-growing tumours that eventually cause lower cranial nerve palsies and infiltrate the skull base. Surgical treatment may cause the same deficits and, in some, risks more serious neurological deficits. We describe a classification used to guide investigation, consent and management of cervical paragangliomas based on extensive experience. METHODS The case notes of patients managed by the senior author at a tertiary referral skull base unit between 1987 and 2010 were reviewed retrospectively. A total of 87 cervical paragangliomas were identified in 70 patients (mean age: 46 years, range: 13–77 years). Of these, 35 patients had 36 vagal paragangliomas, 43 patients had 50 carotid body paragangliomas and 8 had both. One cervical paraganglioma arose from neither the carotid body nor the nodose ganglion. The main outcome measures were death, stroke, gastrostomy and tracheotomy. RESULTS All tumours were classified pre-operatively based on their relationship to the carotid artery, skull base and lower cranial nerves. Type 1 tumours were excised with a transcervical approach, type 2 with a transcervical-parotid approach and type 3 with a combined transcervical-parotid and infratemporal fossa approach. Type 4 patients underwent careful assessment and genetic counselling before any treatment was undertaken. There were no peri-operative deaths; two patients had strokes, one required a long-term feeding gastrostomy and none required a tracheotomy. CONCLUSIONS The use of a pre-operative classification system guides management and surgical approach, improves accuracy of consent, facilitates audit and clarifies which patients should be referred to specialised centres.

Obholzer, RJ; Hornigold, R; Connor, S; Gleeson, MJ

2011-01-01

411

Three-level anterior cervical discectomy and fusion in elderly patients with wedge shaped tricortical autologous graft: A consecutive prospective series  

PubMed Central

Background: Treatment of multilevel cervical spondylotic myelopathy/radiculopathy is a matter of debate, more so in elderly patients due to compromised physiology. We evaluated the clinical and radiological results of cervical fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy in elderly patients. Materials and Methods: Twelve elderly patients with mean age of 69.7 years (65–76 years) were treated between April 2000 and March 2005, for three-level anterior cervical discectomy and fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate. Outcome was recorded clinically according to Odom's criteria and radiologically in terms of correction of lordosis angle and intervertebral disc height span at the time of bony union. The mean follow-up was 29.8 months (12–58 months). Results: All the patients had a complete recovery of clinical symptoms after surgery. Postoperative score according to Odom's criteria was excellent in six patients and good in remaining six. Bony union was achieved in all the patients with average union time of 12 weeks (8–20 weeks). The mean of sum of three segment graft height collapse was 2.50 mm (SD = 2.47). The average angle of lordosis was corrected from 18.2° (SD = 2.59°) preoperatively to 24.9° (SD = 4.54°) at the final follow-up. This improvement in the radiological findings is statistically significant (P < 0.05). Conclusion: Cervical fusion with wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy is an acceptable technique in elderly patients. It gives satisfactory results in terms of clinical outcome, predictable early solid bony union, and maintenance of disc space height along with restoration of cervical lordosis.

Lee, Suk Ha; Oh, Kwang Jun; Yoon, Kwang Su; Lee, Sung Tae; Pandher, Dilbans S

2008-01-01

412

Current status of cervical cancer and HPV infection in Korea  

PubMed Central

Cervical cancer is an important cause of cancer-related deaths in women in developing countries. In Korea, cervical cancer is the third leading cancer among females and is fifth highest in mortality. The persistent oncogenic human papillomavirus (HPV) infections are the greatest risk of developing cervical intraepithelial neoplasia and invasive cancer. The overall prevalence of HPV was 10.4% in Korea and strong risk factors for HPV infection included a young age at sexual debut. The National Cancer Screening Program, which includes cervical cancer screening, has the following principles: the main screening tool is the Papanicolaou test conducted by gynecologists, which targets all women age 30 and over, and which is done every 2 years. HPV DNA tests have not yet been permitted as a screening test for cervical cancer in Korea; however, these are conducted along with a Pap test for screening cervical cancer in the clinic. The use of prophylactic HPV vaccine has been accepted in Korea; The Korean Society of Gynecologic Oncology and Colposcopy's recommendation for routine vaccination is for females aged 15-17 years with a catch-up vaccination recommended for females aged 18-26 years who have not been previously vaccinated. However, many people in Korea are not familiar with the HPV vaccine. Therefore, it is necessary to improve awareness for the disease and HPV vaccination and to establish the effective strategies to obtain funding for HPV vaccination. In the future, cervical cancer is expected to disappear throughout the world, including the Asia Pacific region, through a combination of vaccination and qualified screening programs for cervical cancer.

2009-01-01

413

Solitary osteochondroma of the thoracic spine with compressive myelopathy; a rare presentation.  

PubMed

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient's symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma. PMID:24046783

Mehrian, Payam; Karimi, Mohammad Ali; Kahkuee, Shahram; Bakhshayeshkaram, Mehrdad; Ghasemikhah, Reza

2013-05-20

414

Steroid-responsive paraneoplastic demyelinating neuropathy and myelopathy associated with breast carcinoma.  

PubMed

Paraneoplastic myeloneuropathy has rarely been reported with breast cancer. We report the case of a 59-year-old woman who presented with a peripheral neuropathy and cranial involvement and later developed a myelopathy. The neuropathy was found to be electrophysiologically and histologically demyelinating in nature. Magnetic resonance imaging studies failed to identify any structural brain or spinal cord abnormalities. The patient was diagnosed with breast carcinoma 4 months after initial presentation and underwent resective surgery, radiotherapy, and hormonotherapy. Paraneoplastic antibodies (anti-Hu, anti-Yo, anti-Ri, anti-CV2, anti-Ma, and anti-amphiphysin) were all negative. Her condition did not progress further after cancer treatment. Partial neurologic improvement occurred with oral steroid therapy, with subsequent deterioration on treatment withdrawal. PMID:19169093

Rajabally, Yusuf A; Qaddoura, Bassel; Abbott, Richard J

2008-12-01

415

Immunohistochemical observation of canine degenerative myelopathy in two Pembroke Welsh Corgi dogs.  

PubMed

Immunohistochemistry was performed to assess whether oxidative stress and/or denatured proteins play roles in the pathogenesis of canine degenerative myelopathy (DM). Two Pembroke Welsh Corgi (PWC) dogs with a homozygous mutation (c.118G>A) in the canine superoxide dismutase 1 (SOD1) gene were examined. The pathological features of the dogs were consistent with those of previous cases of DM in PWC. In the spinal lesions, diffuse SOD1 expression was observed in the neurons while no inclusion-like aggregates had formed, which disagreed with the findings of a previous study. A unique inducible nitric oxide synthase (iNOS) staining pattern in reactive astrocytes and a significant increase in ubiquitin immunoreactivity in the spinal lesions were also observed. These findings indicate the involvement of oxidative stress and the accumulation of ubiquitinated proteins in the pathogenesis of canine DM, whereas the role of SOD1 remains unclear. PMID:21628865

Ogawa, Mizue; Uchida, Kazuyuki; Park, Eun-Sil; Kamishina, Hiroaki; Sasaki, Jun; Chang, Hye-Sook; Yamato, Osamu; Nakayama, Hiroyuki

2011-05-30

416

A Critical Review of Non-carious Cervical (Wear) Lesions and the Role of Abfraction, Erosion, and Abrasion  

Microsoft Academic Search

The terms ‘abfraction’ and ‘abrasion’ describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion

D. W. Bartlett; P. Shah

2006-01-01

417

Microsurgical anterior decompression and internal fixation with iliac bone graft and titanium plates for treatment of cervical intervertebral disc herniation.  

PubMed

42 cervical interbody fusions with iliac bone graft and titanium plate fixation were performed between October 1991 and March 1994. The mean follow up period in this study was 10.7 months. In 32 cases fusion was done for 1 and in 10 cases for 2 segments. 2 different types of plates were used. In 25 cases micro-osteosynthesis plates and screws with 2.7 mm diameter were used, and in 17 cases cervical H-plates and screws with 3.5 mm diameter. A favourable outcome was achieved in 31 of 42 cases (74%). Satisfactory pain relief was achieved in 90%. For radicular motor deficit good results were obtained in 84% and for cervical myelopathy in 54%. The 2 different types of plates showed a remarkable difference in the clinical outcome. The results were regarded favourable in 15 of 25 microplate fusions (60%) and in 16 of 17 H-plate fusions (94%). Compression of the bone graft was seen in 5 patients of the micro plate group, however, radiological signs for fusion were present in all 42 cases at follow up. Major surgical complications, damage to neural structures or neurological deterioration did not occur in this study. Plate fixation in cervical interbody fusions seems to be a safe procedure and may reduce graft related complications at the fusion site if the plates and screws are sufficiently well proportioned. A favourable impact upon the results for cervical interbody fusion might be expected and should be further investigated in a long term follow up study. PMID:8748783

Muhlbauer, M; Saringer, W; Aichholzer, M; Sunder-Plassmann, M

1995-01-01

418

Human papillomavirus and cervical cancer.  

PubMed

Cervical cancer is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and clears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16, 18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved. PMID:23618600

Crosbie, Emma J; Einstein, Mark H; Franceschi, Silvia; Kitchener, Henry C

2013-04-23

419

Cervical SNAGs: a biomechanical analysis  

Microsoft Academic Search

A sustained natural apophyseal glide (SNAG) is a mobilization technique commonly used in the treatment of painful movement restrictions of the cervical spine. In the manual therapy literature, the biological basis and empirical efficacy of cervical SNAGs have received scant attention. In particular, an examination of their potential biological basis in order to stimulate informed discussion seems overdue. This paper

A. Hearn; D. A. Rivett

2002-01-01

420

Skin Relapse from Cervical Cancer  

Microsoft Academic Search

Background. Cutaneous lymphangitis carcinomatosis from cervical carcinoma is a very rare form of tumor metastatization; only anecdotal cases are reported in the literature. Most of the patients with skin relapse experienced metastasis as a single or multiple nodules.Case. A case of cutaneous lymphangitis carcinomatosis mimicking contact dermatitis was diagnosed at our institution in a patient affected by cervical carcinoma stage

Innocenza Palaia; Roberto Angioli; Giuseppe Cutillo; Natalina Manci; Pierluigi Benedetti Panici

2002-01-01

421

Optimal Positioning for Cervical Immobilization  

Microsoft Academic Search

Study objective: We hypothesized that optimal positioning of the head and neck to protect the spinal cord during cervical spine immobilization can be determined with reference to external landmarks. In this study we sought to determine the optimal position for cervical spine immobilization using magnetic resonance imaging (MRI) and to define this optimal position in a clinically reproducible fashion. Methods:

Robert A. De Lorenzo; James E. Olson; Mike Boska; Renate Johnston; Glenn C. Hamilton; James Augustine

1996-01-01

422

Polyetheretherketone (PEEK) Spacers for Anterior Cervical Fusion: A Retrospective Comparative Effectiveness Clinical Trial  

PubMed Central

Background: Anterior cervical decompression and fusion (ACDF) is the standard surgical treatment for radiculopathy and myelopathy. Polyetheretherketone (PEEK) has an elasticity similar to bone and thus appears well suited for use as the implant in ACDF procedures. The aim of this study is to examine the clinical and radiographic outcome of patients treated with standing alone PEEK spacers without bone morphogenic protein (BMP) or plating and to examine the influence of the different design of the two spacers on the rate of subsidence and dislocation. Methods: This retrospective comparative study reviewed 335 patients treated by ACDF in a specialized urban hospital for radiculopathy or myelopathy due to degenerative pathologies. The Intromed PEEK spacer was used in 181 patients from 3/2002 to 11/2004, and the AMT SHELL spacer was implanted in 154 patients from 4/2004 to 12/2007. The follow-up rate was 100% at three months post-op and 82.7% (277 patients) at one year. The patients were assessed with the Japanese Orthopedic Association (JOA) questionnaire and radiographically. Results: At the one-year follow-up there were 118/277 patients with an excellent clinical outcome on the JOA, 112/277 with a good outcome, 20/277 with a fair outcome, and 27/277 with a poor outcome. Subsidence was observed in 13.3% of patients with the Intromed spacer vs 8.4% of the patients with the AMT SHELL. Dislocation of the spacer was observed in 10 of the 181 patients with Intromed spacers but in none of the 154 patients with Shell spacers. Conclusion: The study demonstrates that ACDF with standing alone PEEK cages leads to excellent and good clinical outcomes. The differences we observed in the subsidence rate between the two spacers were not significant and cannot be related to a single design feature of the spacers.

Lemcke, Johannes; Al-Zain, Ferass; Meier, Ullrich; Suess, Olaf

2011-01-01

423

Prevalence of human papillomavirus types in cervical lesions from women in rural Western India.  

PubMed

Cervical cancer is the most common cancer among women in many areas of India which contributes for a fifth of the global burden of disease. Persistent infection with one of the high-risk human papillomaviruses (HPV) has been established as the cause for cervical cancer and the documentation of the prevalence of HPV types in cervical cancer in different regions of India is useful for a prevention program combining both screening and vaccination. In this study, the HPV type distribution and the frequency of p16(INK4a) immunoexpression have been determined in 125 cases of inflammatory lesions or grade 1 cervical intraepithelial neoplasia, 74 cases of grade 2, 72 cases of grade 3, and 113 cervical cancer cases diagnosed among women from rural Solapur and Osmanabad districts, Maharashtra. The overall prevalence of high-risk HPV was 37.6% in inflammatory lesions or grade 1 cervical intraepithelial neoplasia, 63.5% in grade 2, 97.2% in grade 3 and 92% in cervical cancer cases. HPV 16 and HPV 18 were detected in 80.6% of grade 3 cervical intraepithelial neoplasia and 86.5% of cervical cancer cases. 94.7% of the cervical cancer and 84.4% of the high grade lesions with a strong and full thickness staining for p16(INK4a) were positive for HPV infection; p16(INK4a) immunoexpression increased with worsening grade of cervical intraepithelial neoplasia. The HPV genotyping data showing a high HPV 16 and 18 prevalence in cancer specimens indicate that prophylactic HPV 16/18 vaccination would have a significant impact on the prevention of cervical cancer in India. PMID:22585722

Deodhar, Kedar; Gheit, Tarik; Vaccarella, Salvatore; Romao, Christine Carreira; Tenet, Vanessa; Nene, Bhagwan M; Jayant, Kasturi; Kelkar, Rohini; Malvi, Sylla G; Sylla, Bakary S; Franceschi, Silvia; Jeronimo, Jose; Shastri, Surendra; Sankaranarayanan, Rengaswamy; Tommasino, Massimo

2012-07-01

424

An autopsy case of human T lymphotropic virus type I-associated myelopathy (HAM) with a duration of 28 years  

Microsoft Academic Search

An autopsy case of human T lymphotropic virus I-associated myelopathy (HAM) of a duration of 28 years in a 61-year-old man with serological confirmation of HTLV-I infection was reported. The spinal cord was grossly atrophic. There was severe symmetrical degeneration of the lateral funiculi, particularly of the bilateral pyramidal tracts, involving all levels of the spinal cord, but anterior horn

S. Sasaki; T. Komori; S. Maruyama; M. Takeishi; Y Iwasaki

1990-01-01

425

Pathological mechanisms of human T-cell lymphotropic virus type I-associated myelopathy (HAM\\/TSP)  

Microsoft Academic Search

The recent studies have greatly improved our understanding of the pathological mechanisms of human T cell lymphotropic virus\\u000a type I (HTLV-I)-associated myelopathy\\/tropical spastic paraparesis (HAM\\/TSP). The pathological mechanisms of HAM\\/TSP based\\u000a on the histopathological, immunological, and molecular analysis with emphasis on the longitudinal alterations of the disease\\u000a will be discussed. Immunohistological examination revealed the existence and the activation both of

Mitsuhiro Osame

2002-01-01

426

Modulation of T Cell Responses in HTLV1 Carriers and in Patients with Myelopathy Associated with HTLV1  

Microsoft Academic Search

Objective: Human T lymphotropic virus-type 1 (HTLV-1) activates the immune system leading to a persistent and exacerbated T-cell response with increased production of IFN-? and TNF-?. Overproduction of pro-inflammatory cytokines is correlated with the development of HTLV-1-associated myelopathy\\/tropical spastic paraparesis (HAM\\/TSP), although some HTLV-1 carriers also show high levels of these cytokines. In this study, the ability of regulatory cytokines

Silvane B. Santos; Aurélia F. Porto; André Luiz Muniz; Tania Luna; Márcia C. Nascimento; Jaqueline B. Guerreiro; Jamary Oliveira-Filho; Daniel J. Morgan; Edgar M. Carvalho

2006-01-01

427

Histone deacetylase-mediated transcriptional activation reduces proviral loads in HTLV1-associated myelopathy\\/tropical spastic paraparesis patients  

Microsoft Academic Search

Epigenetic modifications of chromatin may play a role in maintaining viral latency and thus persistence of the hu- man T-lymphotropic virus type 1 (HTLV- 1), which is responsible for HTLV-asso- ciated myelopathy\\/tropical spastic paraparesis (HAM\\/TSP).Amajor determi- nant of disease progression is increased peripheral blood proviral load (PVL), possibly via the accumulation of in- fected cells in the central nervous sys-

Agnes Lezin; Nicolas Gillet; Stephane Olindo; Nathalie Grandvaux; Olivier Verlaeten; Gildas Belrose; Marcelo de Carvalho Bittencourt; John Hiscott; Becca Asquith; Arsene Burny; Didier Smadja; Raymond Cesaire; Luc Willems; Hôpital St Luc

2007-01-01

428

Natural history and epidemiology of HPV infection and cervical cancer  

Microsoft Academic Search

Cervical cancer is the most common cancer affecting women in developing countries. It has been estimated to have been responsible for almost 260 000 deaths annually, of which about 80% occurred in developing countries.Persistent infection by certain oncogenic HPV types is firmly established as the necessary cause of most premalignant and malignant epithelial lesions of the cervix and of a

Xavier Castellsagué

2008-01-01

429

The role of complement in gonococcal infection of cervical epithelia  

Microsoft Academic Search

Neisseria gonorrhoeae is an exclusive human pathogen that causes the sexually transmitted disease, gonorrhea. The gonococcus has developed an exquisite repertoire of mechanisms by which it is able to evade host innate and adaptive immune responses. Our previous data indicate that the predominately asymptomatic nature of gonococcal cervicitis may, in part, be attributed to the ability of these bacteria to

Jennifer L. Edwards

2008-01-01

430

Halifax clamps: efficacy and complications in posterior cervical stabilization  

Microsoft Academic Search

BACKGROUND Trauma, neoplasia, rheumatoid arthritis. Down's syndrome, and inflammatory conditions are well-known causes of spinal instability. The Halifax clamp is a method of posterior cervical stabilization that is attached to the adjoining laminae and tightened until no movement between involved vertebrae is possible. Our experience with cases that have utilized Halifax interlaminar clamps, their results and complications are presented.METHODS We

Allen H. Maniker; Michael Schulger; Harry L. Duran

1995-01-01

431

Prevalence of type-specific HPV infection by age and grade of cervical cytology: data from the ARTISTIC trial  

Microsoft Academic Search

Human papillomavirus (HPV) infection causes cervical cancer and premalignant dysplasia. Type-specific HPV prevalence data provide a basis for assessing the impact of HPV vaccination programmes on cervical cytology. We report high-risk HPV (HR-HPV) type-specific prevalence data in relation to cervical cytology for 24 510 women (age range: 20–64; mean age 40.2 years) recruited into the ARTISTIC trial, which is being

A Sargent; A Bailey; M Almonte; A Turner; C Thomson; J Peto; M Desai; J Mather; S Moss; C Roberts; H C Kitchener

2008-01-01

432

Cervical foraminal selective nerve root block: a 'two-needle technique' with results  

PubMed Central

Several techniques have been described for selective nerve root blocks. We describe a novel ‘two-needle technique’, performed through the postero-lateral route with the patient in lateral position under C-arm guidance. The aim of the current study is to highlight the effectiveness and safety of cervical selective nerve root block for radiculopathy using this technique. We present results of a retrospective 2-year follow-up study of 33 injections carried out on 33 patients with radiculopathy due to cervical disc disease and or foraminal stenosis using this procedure. Patients with myelopathy, gross motor weakness and any other pathology were excluded. The outcome was measured comparing ‘Visual Analogue Score’ (VAS) and ‘Neck Disability Index’ (NDI) before the procedure with those at 6 weeks and 12 months after the procedure. Thirty patients were included in the final analysis. Average pre-operative VAS score was 7.4 (range 5–10), which improved to 2.2 (range 0–7) at 6 weeks and 2.0 (range 0–4) at 1 year and the mean NDI score prior to intervention was 66.9 (range 44–84), which improved to 31.7 (range 18–66) at 6 weeks and 31.1 (range 16–48) at 1 year. The improvements were statistically significant. Patients with involvement of C6 or C7 nerve roots responded slightly better at 6 weeks with regards to VAS improvement. Mean duration of radiation exposure during the procedure was 27.8 s (range 10–90 s). Only minor complications were noted—transient dizziness in two and transient nystagmus in one patient. Our ‘two-needle technique’ is a new, safe and effective non-surgical treatment for cervical radiculopathy.

Gowda, Veda

2008-01-01

433

Radiological cervical arthritis in populations.  

PubMed Central

The prevalence of cervical rheumatoid arthritis and its relationship to rheumatoid serum factors and erosive arthritis in peripheral joints has been studied in radiographs of the cervical spine and of the hands and feet drawn from 12 population samples. The changes were graded in accordance with the Atlas of Standard Radiographs of Arthritis. Rheumatoid arthritis of the cervical spine (grades 2-4) was observed in 4.1% of males and 4.7% of females aged 15 and over. Prevalence was greatest in those born before 1900, 15% of whom were affected. There was a significant association with the sheep cell agglutination test but not with the bentonite flocculation test, though the latter correlated well with erosive arthritis in the joints of the hands and feet. Arthritis of the cervical spine showed a significant correlation with both seropositive and seronegative erosive arthritis in the peripheral joints. A significantly higher prevalence of cervical arthritis than expected was noted in two population samples, one in Germany and the other in West Africa, though in neither was there a high prevalence of peripheral arthritis. The German population had relatively high antistreptolysin titres. A low prevalence of cervical arthritis was noted in populations in Czechoslovakia and in Arizona. 'Congenital' block vertebra had a prevalence of 0.9% in persons born before 1935, but none was observed in those born since. The figures suggest that environmental influences predisposing to cervical arthritis and block vertebra have changed in the last 40 years.

Lawrence, J S

1976-01-01

434

Studying Biomarkers in Diagnosing Cervical Lesions in Patients With Abnormal Cervical Cells  

ClinicalTrials.gov

Atypical Endocervical Glandular Cell of Undetermined Significance; Atypical Endometrial Hyperplasia; Atypical Glandular Cell of Undetermined Significance; Cervical Cancer; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Human Papilloma Virus Infection

2013-08-01

435

Roles of plant extracts and constituents in cervical cancer therapy.  

PubMed

Cervical cancer is a major health problem worldwide and is the most frequent cause of cancer in women in India. Early detection and affordable drugs with clinical efficacy have to go hand-in-hand in order to comprehensibly address this serious health challenge. Plant-based drugs with potent anticancer effects should add to the efforts to find a cheap drug with limited clinical side effects. Keeping this very purpose in mind, an attempt has been made in this review to explore the potential of plant extracts or constituents known to exhibit antitumorigenic activity or exert cytotoxic effect in human cervical carcinoma cells. Alkaloids such as those isolated from C. vincetoxicum and T. Tanakae, naucleaorals A and B, isolated from the roots of N. orientalis, (6aR)-normecambroline, isolated from the bark of N. dealbata appear promising in different human cervical carcinoma cells with the IC50 of 4.0-8 ?g/mL. However, other compounds such as rhinacanthone and neolignans isolated from different plants are not far behind and kill cervical cancer cells at a very low concentrations. Among plant extracts or its constituents that enhance the effect of known anticancer drugs, noni, derived from the plant M. citrifolia perhaps is the best candidate. The cytotoxic potency and apoptotic index of cisplatin was found to significantly enhanced in combination with noni in different human cervical carcinoma cells and it therefore holds significance as promising herbal-based anticancer agent. However, efficacy needs to be further investigated in various cervical cell lines and more importantly, in in vivo cervical cancer models for possible use as an alternative and safe anticancer drug. PMID:23886123

Kma, Lakhan

2013-01-01

436

Childhood indicators of susceptibility to subsequent cervical cancer  

PubMed Central

Common warts could indicate cervical cancer susceptibility, as both are caused by human papillomavirus (HPV). Eczema was also investigated, as atopic eczema has been negatively associated with warts, but non-atopic eczema may be associated with compromised host defences, as observed in patients with HIV, suggesting increased susceptibility to HPV infection and cervical cancer. ‘Cervical cancer’ was self-reported during an interview by 87 of 7594 women members of two longitudinal British birth cohorts. The accuracy of the diagnoses is limited by lack of confirmation using medical records. Odds ratios are adjusted for common warts and eczema in childhood; and cigarette smoking, number of cohabiting partners and social class in early adult life. The odds ratios of warts and eczema with cervical cancer are 2.50 (95% confidence interval 1.14–5.47) and 3.27 (1.95–5.49), respectively. The association of eczema with cervical cancer is independent of hay fever as a marker of atopy, suggesting the importance of non-atopic eczema. Both heavier smoking compared with non-smoking and four or more cohabiting partners compared with one/none have odds ratios for cervical cancer of 8.26 (4.25–15.10) and 4.89 (1.39–17.18), respectively. Common warts in childhood may indicate cervical cancer susceptibility; this and the relationship with eczema deserves investigation. British Journal of Cancer (2002) 87, 989–993. doi:10.1038/sj.bjc.6600585 www.bjcancer.com © 2002 Cancer Research UK

Montgomery, S M; Ehlin, A G C; Sparen, P; Bjorksten, B; Ekbom, A

2002-01-01

437

Recurrent cervical carcinoma presenting as a primary aortoduodenal fistula.  

PubMed

Aortoduodenal fistula is a rare cause of gastrointestinal (GI) bleeding, and carries high morbidity and mortality even in modern practice. Cervical carcinoma is a major health threat among adult women, and its recurrence is not uncommon. We herein present a case of primary aortoduodenal fistula because of recurrent cervical carcinoma. Our case demonstrated that diagnosis of primary aortoenteric fistula requires a high index of suspicion and a combination of diagnostic modalities to establish the diagnosis. Prompt diagnosis and rapid treatment are critical in reducing mortality and morbidity. Although rare, metastatic c