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1

Unusual presentation of spinal lipomatosis  

PubMed Central

Spinal epidural lipomatosis (SEL) is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism. Occasionally, idiopathic SEL will occur in patients with no known risk factors, but cases are more generally reported in obesity and males. We present the case of a 35 year-old non-obese woman found to have rapidly progressive SEL that was not associated with any of the common causes of the disorder.

Stephenson, William; Kauflin, Matthew J

2014-01-01

2

Atypical Presentations of Spinal Cord Tumors in Children  

Microsoft Academic Search

Pain is a frequent presenting symptom of spinal cord tumors in children and usually manifests as local spinal pain in the bony segments overlying the tumor. Two pediatric patients are presented in whom the diagnosis of intramedullary spinal cord tumors was delayed for many months because their pain was atypical. One had recurrent abdominal pain diagnosed as irritable bowel syndrome.

Patricia L. Robertson

1992-01-01

3

Lumbar Spinal Chondroma Presenting with Acute Sciatica  

PubMed Central

A 47-year-old woman visited with lumbago and severe left leg pain that had been presented for 1 week. The patient complained of severe radiating pain on left L3 sensory dermatome area and reported aggravation of leg pain at 20 degrees of hip flexion by straight leg raising test (SLRT). However, there was no motor weakness on neurological examination. Magnetic resonance imaging (MRI) demonstrated contrast enhancing spinal extradural mass at L2-3 level that was iso-signal intensity (SI) on T1-weighted images (WI), hypo-SI on T2WI. She was not able to walk and sleep due to incapacitating pain. Thus, surgical removal was performed via left partial laminectomy. Postoperatively, the radiating pain was relieved completely. Histopathologic examination revealed that the tumor consisted of chondroma, which had mature hyaline cartilage with nests of benign-appearing cells and calcium deposits in lacunae. PMID:24891859

Kim, Dong Hwan; Nam, Kyoung Hyup; Choi, Byung Kwan

2013-01-01

4

Spinal sarcoidosis presenting with epiconus syndrome.  

PubMed

A spinal cord lesion is a rare manifestation of neurosarcoidosis. We herein report a case with dysuria and gradually worsening numbness in both lower extremities. Thoracic magnetic resonance imaging (MRI) revealed a long spinal cord lesion with gadolinium enhancement in the lower part of the lesion. Chest computed tomography demonstrated enlarged hilar lymph nodes, and a biopsy revealed sarcoidosis. Methylprednisolone pulse therapy was started, but a follow-up MRI showed aggravation of the spinal lesion. After the addition of methotrexate to the therapy, the patient's aggravation of the spinal lesion and clinical symptoms ceased. Early diagnosis and treatment using combined methylprednisolone and methotrexate therapy may improve this devastating spinal cord disease. PMID:25366016

Tsuchiya, Atsushi; Akiyama, Hisanao; Hasegawa, Yasuhiro

2014-01-01

5

Presentation and outcome of traumatic spinal fractures  

PubMed Central

Background: Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability. Aim: To define the incidence, causes, and outcome of spinal fractures. Materials and Methods: Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009. Results: Among 3712 patients who were admitted to the section of trauma surgery, 442 (12%) injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5%) and falls from height (19.3%) were the leading causes of cervical injury (P = 0.001). The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04). Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001). Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001). The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%. Conclusions: Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws. PMID:23248500

El-Faramawy, Ahmed; El-Menyar, Ayman; Zarour, Ahmad; Maull, Kimball; Riebe, Jane; Kumar, Krishna; Mathew, John; Parchani, Ashok; Al-Thani, Hassan; Latifi, Rifat

2012-01-01

6

Fibromyalgia and arachnoiditis presented as an acute spinal disorder  

PubMed Central

Background: Adhesive arachnoiditis is a chronic, insidious condition that causes debilitating intractable pain and a range of other neurological problems. Its pathophysiology is not well understood. This manuscript discusses its presentations, which can mimic an acute spinal disorder, its hypothetical pathophysiology, treatment, and its relationship with fibromyalgia. Case Description: The authors present a case of a 47-year-old female who presented with clinical features mimicking an acute spinal disorder but later found to have an adhesive arachnoiditis. She was admitted following a trauma with complaints of back pain and paraplegia. On examination, there was marked tenderness over thoracolumbar spine with lower limbs upper motor neuron weakness. An urgent magnetic resonance imaging (MRI) of the spine revealed multiple lesions at her thoracic and lumbar spinal canals, which did not compress the spinal cord. Therefore, conservative management was initiated. Despite on regular therapies, her back and body pain worsened and little improvement in her limbs power was noted. Laminectomy was pursued and found to have spinal cord arachnoiditis. Subsequently, she was operated by other team members for multiple pelvic masses, which later proved to be benign. After gathering all the clinical information obtained at surgery and after taking detailed history inclusive of cognitive functions, diagnosis of an adhesive arachnoiditis syndrome was made. Currently, she is managed by neuropsychologist and pain specialist. Conclusion: This case report highlights the importance of knowing an adhesive arachnoiditis syndrome – a rarely discussed pathology by the neurosurgeon, which discloses a significant relationship between immune and nervous systems.

Idris, Zamzuri; Ghazali, Faizul H.; Abdullah, Jafri M.

2014-01-01

7

Spinal intramedullary cavernoma: clinical presentation and surgical outcome  

Microsoft Academic Search

Object. Improved neuroimaging techniques have led to an increase in the reported cases of intramedullary caver- nomas. The purpose of this study was to define the spectrum of presenting signs and symptoms in patients with spinal intramedullary cavernomas and to analyze the role of surgery as a treatment for these lesions. Methods. The authors reviewed the charts of 16 patients

Harel Deutsch; George I. Jallo; Alina Faktorovich; Fred Epstein

2000-01-01

8

Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement  

Microsoft Academic Search

Objective. Initial presentation with primary spinal involvement in chronic recurrent multifocal osteomyelitis of childhood (CRMO) is rare. Our objective was to review the imaging appearances of three patients who had CRMO who initially presented with isolated primary spinal involvement.Design and patients. The imaging, clinical, laboratory and histology findings of the three patients were retrospectively reviewed. Imaging included seven spinal MR

S. E. Anderson; P. Heini; M. J. Sauvain; E. Stauffer; L. Geiger; J. O. Johnston; A. Roggo; D. Kalbermatten; L. S. Steinbach

2003-01-01

9

Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome  

PubMed Central

Summary This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord. PMID:20667212

Guest, J.D.; Griesdale, D.E.; Marotta, T.

2000-01-01

10

Neurosarcoidosis presenting with isolated spinal involvement: report of a case and review of the literature.  

PubMed

Spinal sarcoidosis is a rare manifestation of sarcoidosis that can present a major diagnostic challenge. Herein we present a case of a previously healthy 55-year-old man who presented with leg weakness and was found to have diffuse involvement of his spinal cord by neurosarcoidosis. He was treated with steroids and recovered completely. The clinical characteristics, radiographic and laboratory findings of spinal sarcoidosis are discussed. Management strategies, including the use of newer targeted therapies, are also reviewed. PMID:23243761

Kourelis, Taxiarchis V; Manola, Akrivi; Lyons, Robert W; Lahiri, Bimalin

2012-01-01

11

Galanin and Spinal Pain Mechanisms: Past, Present, and Future  

Microsoft Academic Search

\\u000a Since the discovery of galanin in 1983, one of the most frequently suggested physiological function for this peptide is pain\\u000a modulation at the level of the spinal cord. This notion, initially based on the preferential distribution of galanin in dorsal\\u000a spinal cord, has been supported by results from a large number of morphological, molecular, and functional studies. It is\\u000a generally

Xiao-Jun Xu; Tomas Hökfelt; Zsuzsanna Wiesenfeld-Hallin

12

SPINAL CORD 9:00 12:00 Presentations by Residents and Fellows  

E-print Network

SPINAL CORD 9:00 ­ 12:00 Presentations by Residents and Fellows 12:00 ­ 12:45 Lunch 12:15 ­ 12 spinal cord injury Serge Rossignol, Professor Université de Montréal 1:50 ­ 2:15 Childhood Spasticity's Hospital 2:15 ­ 2:40 Imaging the spinal cord lesions Manon Bélair, Radiologist Hôpital Notre-Dame 2:40 ­ 3

Shoubridge, Eric

13

Multiple sclerosis presenting as a spinal cord tumor  

Microsoft Academic Search

Multiple sclerosis, a disorder of central nervous system demyelination, is a leading cause of disability in young people. Lesions of the spinal cord are usually less than two vertebral body segments long, peripherally located, and found in the cervical region. A 30-year-old woman had a 2-month history of back pain, urinary incontinence, and bilateral lower extremity weakness. Magnetic resonance imaging

Debra L. Braverman; Elisabeth A. Lachmann; Richard Tunkel; Willibald Nagler

1997-01-01

14

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series  

Microsoft Academic Search

INTRODUCTION: Perioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published. CASE PRESENTATIONS: A series of four consecutive patients who developed acute lower-limb myoclonus

Olumuyiwa A Bamgbade; John A Alfa; Wael M Khalaf; Andrew P Zuokumor

2009-01-01

15

Spinal cord injury: Present and future therapeutic devices and prostheses  

Microsoft Academic Search

Summary  A range of passive and active devices are under development or are already in clinical use to partially restore function after\\u000a spinal cord injury (SCI). Prosthetic devices to promote host tissue regeneration and plasticity and reconnection are under\\u000a development, comprising bioengineered bridging materials free of cells. Alternatively, artificial electrical stimulation and\\u000a robotic bridges may be used, which is our focus

Simon F. Giszter

2008-01-01

16

Gait ataxia as a presenting symptom of malignant epidural spinal cord compression.  

PubMed Central

A 68 year old man with prostatic carcinoma developed spinal cord compression. The sole presenting feature was painless gait ataxia indistinguishable from cerebellar ataxia. He was investigated for cerebellar disease but the correct diagnosis was made when he subsequently presented with paraplegia and classical signs of spinal cord compression. Surgical decompression failed to produce neurological recovery. We discuss the importance of recognizing this unusual presentation of spinal cord compression, its possible mechanism and evidence that it may be under-reported. Images Figure 1 Figure 2 PMID:3774706

Karp, S. J.; Ho, R. T.

1986-01-01

17

Traumatic bleeding of spinal angiolipoma presenting with subacute paraparesis--a case report and histopathological aspects.  

PubMed

Spinal angiolipoma is a rare benign tumour. It usually presents as a slowly progressive compressive lesion. Bleeding in this tumour is extremely rare and is spontaneous and acute. This is the first reported case of post-traumatic bleeding from a spinal angiolipoma, who developed subacute progressive paraparesis. The pathological definition of this rare entity is not well established. Histologically it is distinct from cutaneous angiolipoma. PMID:20874452

Sankaran, Vijay; Carey, Martyn; Shad, Amjad

2010-12-01

18

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series  

PubMed Central

Introduction Perioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published. Case presentations A series of four consecutive patients who developed acute lower-limb myoclonus following spinal or epidural anaesthesia are described. The case series occurred at three different hospitals and involved four anaesthetists over a 3-year period. Two Caucasian men, aged 90-years-old and 67-years-old, manifested unilateral myoclonus. Two Caucasian women, aged 64-years-old and 53-years-old, developed bilateral myoclonus. Myoclonus was self-limiting in one patient, treated with further regional anaesthesia in one patient and treated with intravenous midazolam in two patients. The overall outcome was good in all patients, with no recurrence or sequelae in any of the patients. Conclusion This case series emphasizes that spinal myoclonus following regional anaesthesia is rare, has diverse pathophysiology and can have diverse presentations. The treatment of perioperative spinal myoclonus should be directed at the aetiology. Anaesthetists and perioperative practitioners who are unfamiliar with this rare complication should be reassured that it may be treated successfully with midazolam. PMID:19830168

2009-01-01

19

Multicentric Spinal Tuberculosis with Sternoclavicular Joint Involvement: A Rare Presentation  

PubMed Central

Background. Tuberculosis is a chronic disease which may have varied presentations. Though pulmonary tuberculosis is the commonest, extrapulmonary tuberculosis involving skeletal system is often seen. Individuals with poor nourishment and immunological status are especially susceptible for disseminated and multicentric tuberculosis. Case Report. We here present a case of tuberculosis involving multiple anatomical locations in an immune-competent patient which was diagnosed with radiological studies and confirmed with histological examination. Patient was put on multidrug antitubercular therapy and responded well to the treatment with improvement in clinical and radiological picture. Clinical Relevance. This report of a rare case makes us aware of the varied presentations which tuberculosis can present with. It should be kept as a differential diagnosis in patients with cough and fever but not responding to conventional treatment. This is even more important in countries with poor socioeconomic conditions. PMID:25389505

Meena, Umesh Kumar; Meena, Ramesh Chand

2014-01-01

20

Vertebral osteomyelitis in an infant presenting with pseudotumor and narrowing of the spinal canal  

Microsoft Academic Search

In an 8-week-old infant, kyphosis caused by destruction of the 7th thoracic vertebra was observed. A paraspinal mass and narrowing of the spinal canal due to vertebral osteomyelitis were present. Treatment with antibiotics and bracing was carried out with no evidence of neurologic disturbances over a follow-up period of 24 months.

Ralf-Bodo Tröbs; Werner Handrick; Ina Lotz; Cathleen Bankwitz; Andrea Tannapfel

2005-01-01

21

Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival  

Microsoft Academic Search

To determine the relationship between clinical presentation, radiographic features, pathology, and treatment on overall survival\\u000a of newly diagnosed pediatric primary spinal cord tumors (PSCT). Retrospective analysis of all previously healthy children\\u000a with newly diagnosed PSCT at a single institution from 1995 to present was performed. Twenty-five pediatric patients (15 boys,\\u000a average 7.9 years) were diagnosed with PSCT. Presenting symptoms ranged from

John R. Crawford; Alejandra Zaninovic; Mariarita Santi; Elisabeth J. Rushing; Cara H. Olsen; Robert F. Keating; Gilbert Vezina; Nadja Kadom; Roger J. Packer

2009-01-01

22

A Case Report of Cerebral Venous Thrombosis in Polycythemia Vera Presenting with Intracranial and Spinal Subdural Hematoma  

PubMed Central

Spinal subdural hematoma (SDH) is a rare condition and can be caused by several factors. Concomitant cranial and spinal SDH is even much less common. We present a 77-year-old male patient with lower back pain, paraparesis, and urinary retention following a sudden onset headache. Imaging revealed concomitant cranial and spinal SDH related to cerebral venous thrombosis (CVT) associated with hemorrhagic venous infarct. Laboratory examinations were consistent with polycythemia vera. There was no history of trauma and previous cranial surgery. Brain angiography did not reveal any evidence of arteriovenous fistula or vascular malformation. Since lower back pain occurred shortly after the headache and there was no other reasonable explanation for spinal hemorrhage, we suppose that the mechanism of spinal SDH is the migration of blood from the intracranial compartment. Therefore, this is the first report of concomitant spinal SDH and cerebral hemorrhage associated with CVT in a patient with myeloproliferative disease. PMID:20671855

Sirin, Nermin Gorkem; Yesilot, Nilufer; Ekizoglu, Esme; Keles, Nur; Tuncay, Rezzan; Coban, Oguzhan; Bahar, Sara Zarko

2010-01-01

23

Solitary eosinophilic granuloma causing spinal cord compression in a child presenting with abdominal pain  

Microsoft Academic Search

This report describes a case of an eosinophilic granuloma of T7 causing spinal cord compression in an 8-year-old boy who presented with abdominal pain. The purpose of this report was to illustrate both the variable clinical presentation and the rare incidence of cord compression due to an eosinophilic granuloma. Eosinophilic granuloma is a benign tumour-like condition that produces focal bone

Michael Leonard; Damian McCormack

2006-01-01

24

Intra-medullary tuberculoma of the spinal cord presenting with typhoid and paraplegia: a case report  

PubMed Central

Introduction Intra-medullary spinal tuberculoma is a rare form of tuberculosis, with an incidence of only two in 100,000 patients with tuberculosis. We present a case of intra-medullary tuberculoma from Pakistan, which was diagnosed by radiological findings and analysis of cerebrospinal fluid using polymerase chain reaction testing. Case presentation We present the case of a 28-year-old Sindhi male with intra-medullary tuberculoma of the spinal cord at the C3 level. Our patient was treated solely with anti-tubercular drug therapy with no surgical intervention. Conclusions We discuss the possible clinical management of such rare cases, considering both chemotherapeutic and surgical options. Additionally, diagnostic procedures and findings are discussed; we suggest cerebrospinal fluid analysis via polymerase chain reaction and gadolinium-diethylenetriamine pentaacetic acid magnetic resonance imaging as important chemical and radiological tests to be performed in such cases. PMID:23148826

2012-01-01

25

Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation  

PubMed Central

Spontaneous ventral spinal epidural hematomas are extremely rare in children and clinically recognized by the appearance of acute asymmetric focal motor and sensory involvement. In infants, the initial presenting symptoms are very non-specific and irritability is often the only initial manifestation. Appearance of other neurological signs may be delayed up to hours or even days later. In the absence of significant precipitating factors such as severe trauma or previously known coagulopathies, the diagnosis is usually delayed until the full picture of severe cord compression is developed. The diagnosis is finally made by performing magnetic resonance imaging. We report a 5-month-old infant with spinal epidural hematoma who presented with symmetrical upper limb weakness and diaphragmatic involvement to highlight the importance of recognizing the atypical manifestations for early diagnosis and intervention. PMID:24665297

ABBAS, Asad; AFZAL, Kamran; MUJEEB, Athar Abdul; SHAHAB, Tabassum; KHALID, Mohammad

2013-01-01

26

Alert for perioperative visual loss: an unusual presentation of an orbital haemangioma during spinal surgery.  

PubMed

A 62-year-old man with a history of non-insulin-dependent diabetes mellitus, hypertension and obesity, presented for elective lumbar laminectomy for spinal canal stenosis. Twenty minutes after placement in the prone position, he developed left orbital proptosis. The surgery was deferred and a subsequent CT scan showed an orbital haemangioma. This case highlights the importance of meticulous attention to eye-care for patients in the prone position. PMID:14719433

Greenberg, R; Tymms, A

2003-12-01

27

Donald Munro Lecture. Spinal cord injury--past, present, and future.  

PubMed

This special report traces the path of spinal cord injury (SCI) from ancient times through the present and provides an optimistic overview of promising clinical trials and avenues of basic research. The spinal cord injuries of Lord Admiral Sir Horatio Nelson, President James A. Garfield, and General George Patton provide an interesting perspective on the evolution of the standard of care for SCI. The author details the contributions of a wide spectrum of professionals in the United States, Europe, and Australia, as well as the roles of various government and professional organizations, legislation, and overall advances in surgery, anesthesia, trauma care, imaging, pharmacology, and infection control, in the advancement of care for the individual with SCI. PMID:17591221

Donovan, William H

2007-01-01

28

A 19-year-old man with sickle cell disease presenting with spinal infarction: a case report  

PubMed Central

Introduction Vasculopathy of the large vessels commonly occurs in sickle cell disease, and as a result cerebral infarction is a well characterized complication of this condition. However, spinal infarction appears to be rare. Spinal infarct is infrequent in the non-sickle cell population as well, and accounts for only about 1 percent of all central nervous system infarcts. Case presentation In the present work, we report the case of a 19-year-old African-American man with sickle cell disease who experienced an anterior spinal infarct and subsequent quadriplegia. He was incidentally noted to be a heterozygote for factor V Leiden. We also reviewed the literature and found two previous cases of spinal cord infarction and sickle hemoglobin. Our literature search did not demonstrate that heterozygocity for factor V Leiden plays an important role in spinal cord infarction. Conclusions The paucity of cases associated with sickle hemoglobin does not allow us to postulate any particular risk factors with sickle cell disease that might predispose patients to spinal cord infarction. Our patient’s case raises the question as to whether spinal cord infarction is being missed in individuals with sickle cell disease and neurologic symptoms. PMID:23972124

2013-01-01

29

Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?  

PubMed Central

Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

2014-01-01

30

Hypertrophic pachymeningitis associated with cerebral spinal fluid hypovolemia as initial presentation of systemic lupus erythematous.  

PubMed

We report a case of a 61-year-old man with thickening of the dura mater associated with the presence of subdural collections as a consequence of cerebral spinal fluid hypovolemia (CSFH) and hypertrophic pachymeningitis (HP) as presentation of systemic lupus erythematous (SLE). The patient complained about fatigue, musculoskeletal pain, headache and skin lesions. In the laboratory tests minimal normocytic anemia, mild leukopenia, polyclonal hypergammaglobulinemia and antinuclear antibodies (ANA), anti-double-stranded DNA antibodies (dsDNA), antibodies against extractable nuclear antigens (ENA) type SSA-Ro, anti-Smith antigen antibodies (anti-Sm) and anti-ribonucleoprotein antibodies (anti-RNP) were detected. Cranial magnetic resonance imaging (MRI), with and without gadolinium enhancement, revealed generalized thickening of the dura mater more severe at the right parieto-occipital lobes with the presence of subdural collections. The patient was diagnosed with SLE associated both with CSFH and HP. A conservative treatment with prednisone 60 mg daily, mycophenolate mofetil (MMF) 1 g daily and hydroxychloroquine 200 mg twice a day was started with significant clinical and radiological improvement (almost complete resolution of the subdural collections and clear decrease of meningeal thickness). The authors emphasize that HP associated with CSFH in the context of SLE is a rare entity, which makes this case unique. PMID:24351279

Sanchez-Garcia, Me; Gomez-Delgado, F; Gomez-Garduño, A; Blanco-Molina, A; Puebla, Ra Fernandez de la

2014-02-01

31

Localized pruritus: A presenting symptom of a spinal cord tumor in a child with features of neurofibromatosis  

Microsoft Academic Search

Central nervous system (CNS) and spinal cord tumors are not uncommon in patients with neurofibromatosis (NF); however, it is impossible to select patients with NF who are at a particularly high risk. Localized pruritus may be a clue to the presence of a spinal cord or CNS tumor. This is the first report of an infant with features of NF,

Robert E. Johnson; Nordau D. Kanigsberg; Carmencita L. Jimenez

2000-01-01

32

Scoliosis treatment using spinal manipulation and the Pettibon Weighting System™: a summary of 3 atypical presentations  

Microsoft Academic Search

BACKGROUND: Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25–30° range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis. CASE PRESENTATION: Patient presentation, examination, intervention and outcomes are detailed for each case.

Mark W Morningstar; Timothy Joy

2006-01-01

33

Unusual presentation of spinal cord compression related to misplaced pedicle screws in thoracic scoliosis  

Microsoft Academic Search

Utilization of thoracic pedicle screws is controversial, especially in the treatment of scoliosis. We present a case of a\\u000a 15-year-old girl seen 6 months after her initial surgery for scoliosis done elsewhere. She complained of persistent epigastric\\u000a pain, tremor of the right foot at rest, and abnormal feelings in her legs. Clinical examination revealed mild weakness in\\u000a the right lower

P. Papin; V. Arlet; D. Marchesi; B. Rosenblatt; M. Aebi

1999-01-01

34

Scoliosis treatment using spinal manipulation and the Pettibon Weighting System(TM): a summary of 3 atypical presentations  

PubMed Central

Background Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25–30° range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis. Case presentation Patient presentation, examination, intervention and outcomes are detailed for each case. The types of scoliosis presented here are left thoracic, idiopathic scoliosis after Harrington rod instrumentation, and a left thoracic scoliosis secondary to Scheuermann's Kyphosis. Each case carries its own clinical significance, in relation to clinical presentation. The first patient presented for chiropractic treatment with a 35° thoracic dextroscoliosis 18 years following Harrington Rod instrumentation and fusion. The second patient presented with a 22° thoracic levoscoliosis and concomitant Scheuermann's Disease. Finally, the third case summarizes the treatment of a patient with a primary 37° idiopathic thoracic levoscoliosis. Each patient was treated with a novel active rehabilitation program for varying lengths of time, including spinal manipulation and a patented external head and body weighting system. Following a course of treatment, consisting of clinic and home care treatments, post-treatment radiographs and examinations were conducted. Improvement in symptoms and daily function was obtained in all 3 cases. Concerning Cobb angle measurements, there was an apparent reduction in Cobb angle of 13°, 8°, and 16° over a maximum of 12 weeks of treatment. Conclusion Although mild to moderate reductions in Cobb angle measurements were achieved in these cases, these improvements may not be related to the symptomatic and functional improvements. The lack of a control also includes the possibility of a placebo effect. However, this study adds to the growing body of literature investigating methods by which mild to moderate cases of scoliosis can be treated conservatively. Further investigation is necessary to determine whether curve reduction and/or manipulation and/or placebo was responsible for the symptomatic and functional improvements noted in these cases. PMID:16409627

Morningstar, Mark W; Joy, Timothy

2006-01-01

35

[Physical rehabilitation of the patients presenting with dorsopathies following decompression surgery in the lumbosacral spinal area].  

PubMed

The present study included 80 patients at the age varying from 24 to 59 years examined at different time (from 3 months to 3 years) after the surgical treatment of herniated intervertebral disks, mostly with clinical signs of L(v)-, S1-root radiculopathy. Coordination gymnastics included a complex of specific isotonico-isometric, isometric, and isotonic exercises designed to affect the deep stabilization system. The exercises were performed in five starting positions in a continuous mode with a small or medium amplitude of the movements synchronized with breathing. It was shown that coordination gymnastics in combination with magnetic therapy and iodine-bromine baths results in the statistically significant relief of pain syndrome (p<0.001) and formation of the muscular corset. Moreover, it increases stability of the vertebral column, improves its adaptation to physical activity, eliminates regional postural imbalance, and promotes formation of the proper movement patterns. Taken together, these effects constitute secondary prophylaxis of vertebrogenic pain syndrome and progressive degenerative changes. PMID:24640651

Sichinava, N V; Stiazhkina, E M; Gurkina, M V; Iashina, I V; Nuvakhova, M B

2013-01-01

36

Spinal stenosis  

MedlinePLUS

... spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis ... help your pain during flare-ups. Treatments for back pain caused by spinal stenosis include: Medicines that may ...

37

Spinal fusion  

MedlinePLUS

Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion; Spine surgery - spinal fusion ... Spinal fusion is most often done along with other surgical procedures of the spine. It may be done: With ...

38

Disseminated spinal myxopapillary ependymoma in an adult at initial presentation: a case report and review of the literature.  

PubMed

Disseminated spinal myxopapillary ependymoma (MPE) is extremely rare in adults. We report a 63-year-old man with chronic low-back pain found to have multiple MPEs in the thoracic, lumbar and sacral spine. Diagnostic and management strategies of disseminated MPE are discussed with a review of pertinent literature. PMID:24460084

Straus, David; Tan, Lee A; Takagi, Ippei; O'Toole, John E

2014-10-01

39

Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature  

Microsoft Academic Search

Study design:Case reports and review of the literature.Objective:Intramedullary spinal cord metastases (ISCMs) are rare type of central nervous system (CNS) involvement of systemic malignant tumors. Since the advent of new neuroradiological techniques, their detection have become increasingly diagnosed in recent years and, although somewhat controversial, surgical treatment has been considered a valid option.Setting:Neurosurgical Clinic, Department of Clinic Neuroscience, University of

G Grasso; F Meli; R Patti; F Giambartino; A M Florena; D G Iacopino

2007-01-01

40

Spinal plasticity of acute opioid tolerance  

Microsoft Academic Search

Spinal acute opioid tolerance remains mechanistically undercharacterized. Expanded clinical use of direct spinal administration of opioids and other analgesics indicates that studies to further understand spinal mechanisms of analgesic tolerance are warranted. Rodent models of spinal administration facilitate this objective. Specifically, acute spinal opioid tolerance in mice presents a plasticity-dependent, rapid, and efficient opportunity for evaluation of novel clinical agents.

Carolyn A. Fairbanks; George L. Wilcox

2000-01-01

41

Spinal Metastases  

Microsoft Academic Search

Spinal cord metastases are a common complication of systemic malignancy, most commonly from lung, breast, and prostate cancer.\\u000a Patients may present with a variety of symptoms, most notably pain and weakness. The ultimate goals in managing these patients\\u000a include maximizing neurologic function, length of survival, and quality of life. These goals can best be reached via early,\\u000a accurate diagnosis followed

Jonathan H. Sherman; Dawit G. Aregawi; Mark E. Shaffrey; David Schiff

42

Delayed presentation of cerebellar and spinal cord infarction as a complication of computed tomography-guided transthoracic lung biopsy: a case report  

PubMed Central

Introduction Computed tomography-guided transthoracic needle biopsy is a common diagnostic procedure that is associated with various complications including pneumothorax, parenchymal hemorrhage, and hemoptysis. A systemic air embolism is a very rare (0.06 to 0.21%) but potentially fatal complication. Case presentation A 70-year-old Korean male was admitted to our hospital for evaluation of a solitary pulmonary nodule located adjacent to the right inferior pulmonary vein in the medial basal segment of the right lower lobe. A computed tomography-guided needle biopsy was performed by a radiologist using a coaxial needle. A computed tomography image obtained immediately after the biopsy showed intraluminal free air in the proximal ascending aorta. He complained of a mild electrical current sensation in both lower extremities. After three hours he complained of neurological deficit in both lower extremities as well as voiding difficulty. The brain and spine magnetic resonance images showed a right cerebellar and spinal cord infarction at the T8-10 levels. Conclusions We report a case of air embolism to the cerebellum and spinal cord causing infarction presenting with an initial symptom of mild electrical current sensation in both lower extremities during the transthoracic needle biopsy. For this potentially fatal complication, early recognition, followed by prompt therapy is critical to reducing morbidity and mortality. PMID:25113016

2014-01-01

43

Three-Dimensional Spinal Morphology Can Differentiate Between Progressive and Nonprogressive Patients With Adolescent Idiopathic Scoliosis at the Initial Presentation  

PubMed Central

Study Design. This is a prospective case-control study. Objective. The objective of this study was to compare 3-dimensional (3D) morphological parameters of the spine at the first visit between a nonprogressive (NP) and a progressive (P) group of immature adolescent idiopathic scoliosis (AIS). Summary of Background Data. Prediction of curve progression remains challenging in AIS at the first visit. Prediction of progression is based on curve type, curve magnitude, and skeletal or chronological age. Methods. A prospective cohort of 133 AIS was followed from skeletal immaturity to maturity (mean, 37 mo). The first group was made up of patients with AIS with a minimum 6-degree progression of the major curve between the first and last follow-up (P) (n = 53) and the second group was composed of patients with NP who reached maturity with less than 6-degree progression (n = 81). Computerized measurements were taken on reconstructed 3-dimensional (3D) spine radiographs of the first visit. There were 6 categories of measurements: angle of plane of maximum curvature, Cobb angles (kyphosis, lordosis), 3D wedging (apical vertebra, apical disks), rotation (upper and lower junctional vertebra, apical vertebra, and thoracolumbar junction), torsion, and slenderness (height/width ratio). t tests were also conducted. Results. There was no statistical difference between the 2 groups for age and initial Cobb angle. P presented significant hypokyphosis, and parameters related to rotation presented significant statistical differences between NP and P (plane of maximal curvature, torsion, and apical axial rotation). Depth slenderness also presented statistical differences. Conclusion. This study confirms that even at the initial visit, 3D morphological differences exist between P and NP AIS. It supports the use of 3D reconstructions of the spine in the initial evaluation of AIS to help predict outcome. Level of Evidence: 3 PMID:24776699

Nault, Marie-Lyne; Mac-Thiong, Jean-Marc; Roy-Beaudry, Marjolaine; Turgeon, Isabelle; deGuise, Jacques; Labelle, Hubert

2014-01-01

44

Treatment of spinal cord tumors  

Microsoft Academic Search

Opinion statement  Tumors associated with the spinal cord can have devastating effects on patient function and quality of life. Most of these\\u000a tumors are from metastatic disease, usually to the epidural space. Less frequently, the tumors are intrinsic to the spinal\\u000a cord itself (ie, primary tumor). Regardless of the etiology, spinal cord tumors often present first with progressive local\\u000a or radicular

Brian Vaillant; Monica Loghin

2009-01-01

45

Three-dimensional terminology of spinal deformity. A report presented to the Scoliosis Research Society by the Scoliosis Research Society Working Group on 3-D terminology of spinal deformity.  

PubMed

Conventional terminology of three-dimensional description of spinal deformity is ambiguous and mostly tied to either a frontal or sagittal plane view of the spine. The article proposes a rationalized system for describing the shape of the spine. The spine is viewed as a line in space ('vertebral body line') with three 'angulations' specifying the orientation of each vertebra. Four axis systems are defined for the whole body, the spine, curve regions, and individual vertebrae, respectively. These in turn define the principal planes of the body, spine, curve regions, and vertebrae. Curvature can be defined as a local measure at a point on the vertebral body line, or as a regional measure between specified end vertebrae. Torsion is defined both as a local geometric property of the vertebral body line, and as measure of the relative axial plane angulations between specified vertebrae. Linear distance measures define the deviations of specified vertebrae from the local, regional, spinal, and global axis systems. Practical recommendations for positioning patients are made. This new system of terminology recognizes the 3-dimensional nature of scoliosis and other spinal deformities and is intended to rationalize communication in both research and clinical practice. PMID:8153835

Stokes, I A

1994-01-15

46

Presentations  

Cancer.gov

Presentations Name Position Presentation (ppt) Sudhir Srivastava, PhD, MPH Chief, Cancer Biomarkers Research Group Metabolomics: An Untapped Frontier (ppt, 161kb) John Milner, PhD Chief, Nutritional Sciences research Group Can Metabolomics

47

Spinal Stenosis  

MedlinePLUS

... stenosis most often results from a gradual, degenerative aging process. Either structural changes or inflammation can begin ... spinal cord or nerve roots at that place. Aging with secondary changes is the most common cause ...

48

Spinal Stenosis  

MedlinePLUS

... legs (the hip adductors and abductors, quadriceps and hamstrings). This will improve your balance, ability to walk, ... the tissue around the spinal cord; infection; and injury to the nerve root. While surgery may bring ...

49

Langerhans cell histiocytosis with multiple spinal involvement  

Microsoft Academic Search

To stress the clinical and radiologic presentation and treatment outcome of Langerhans cell histiocytosis (LCH) with multiple\\u000a spinal involvements. A total of 42 cases with spinal LCH were reviewed in our hospital and 5 had multifocal spinal lesions.\\u000a Multiple spinal LCH has been reported in 50 cases in the literature. All cases including ours were analyzed concerning age,\\u000a sex, clinical

Liang Jiang; Xiao Guang Liu; Wo Quan Zhong; Qing Jun Ma; Feng Wei; Hui Shu Yuan; Geng Ting Dang; Zhong Jun Liu

50

Lumbar spinal stenosis.  

PubMed Central

Lumbar spinal stenosis, the results of congenital and degenerative constriction of the neural canal and foramina leading to lumbosacral nerve root or cauda equina compression, is a common cause of disability in middle-aged and elderly patients. Advanced neuroradiologic imaging techniques have improved our ability to localize the site of nerve root entrapment in patients presenting with neurogenic claudication or painful radiculopathy. Although conservative medical management may be successful initially, surgical decompression by wide laminectomy or an intralaminar approach should be done in patients with serious or progressive pain or neurologic dysfunction. Because the early diagnosis and treatment of lumbar spinal stenosis may prevent intractable pain and the permanent neurologic sequelae of chronic nerve root entrapment, all physicians should be aware of the different neurologic presentations and the treatment options for patients with spinal stenosis. Images PMID:8434469

Ciricillo, S F; Weinstein, P R

1993-01-01

51

Clinical radiology of the spine and spinal cord  

SciTech Connect

This book is a source of information about aspects of radiology of the spine and spinal column. It presents coverage of both normal and abnormal conditions. Contents: Spinal fractures and dislocations. Degenerative diseases of the spine. Gross anatomy of the spinal cord and meninges. Intraspinal mass lesions. Spinal dysraphism. Congenital anomalies. Tumors of the vertebral column, and more.

Banna, M.

1985-01-01

52

Intradural spinal endoscopy in children.  

PubMed

Intracranial endoscopy in the treatment of hydrocephalus, arachnoid cysts, or brain tumors has gained wide acceptance, but the use of endoscopy for intradural navigation in the pediatric spine has received much less attention. The aim of the authors' present study was to analyze their experience in using spinal endoscopy to treat various pathologies of the spinal canal. The authors performed a retrospective review of intradural spinal endoscopic cases at their institution. They describe 4 representative cases, including an arachnoid cyst, intrinsic spinal cord tumor, holocord syrinx, and split cord malformation. Intradural spinal endoscopy was useful in treating the aforementioned lesions. It resulted in a more limited laminectomy and myelotomy, and it assisted in identifying a residual spinal cord tumor. It was also useful in the fenestration of a multilevel arachnoid cyst and in confirming communication of fluid spaces in the setting of a complex holocord syrinx. Endoscopy aided in the visualization of the spinal cord to ensure the absence of tethering in the case of a long-length Type II split spinal cord malformation. Conclusions Based on their experience, the authors found intradural endoscopy to be a useful surgical adjunct and one that helped to decrease morbidity through reduced laminectomy and myelotomy. With advances in technology, the authors believe that intradural endoscopy will begin to be used by more neurosurgeons for treating diseases of this anatomical region. PMID:21721897

Chern, Joshua J; Gordon, Amber S; Naftel, Robert P; Tubbs, R Shane; Oakes, W Jerry; Wellons, John C

2011-07-01

53

Modulation of spinal reflexes by pyramidal tract stimulation in an in vitro brainstem-spinal cord preparation from the hamster  

Microsoft Academic Search

Electrophysiological evidence is presented showing that the pyramidal tract (PT) of the hamster modulates spinal reflexes in an in vitro brainstem-spinal cord preparation. Three spinal reflexes were studied. Stimulation of a dorsal root (DR) while recording from a ventral root (VR) of the same spinal segment evoked two reflexes: the monosynaptic reflex, and a long latency polysynaptic reflex. Stimulation of

J. Keifer; K. Kalil

1989-01-01

54

Dorsal epidural spinal lipomatosis  

Microsoft Academic Search

The authors report a case of a thoracic epidural spinal lipomatosis causing severe neurological deficits along the review of pertinent literature. The patient is a 56-year-old woman who presented with acute onset of severe paraparesis; she was investigated with cervical and thoracic MRI and then surgically managed because of an intraspinal mass compressing the cord. The operation consisted in the

S Chibbaro; G Mirone; M Nouri; P Di Emidio; M Polivka; M Marsella; B George

2011-01-01

55

Spinal epidural angiolipoma: A rare cause of spinal cord compression  

PubMed Central

Spinal epidural angiolipomas are rare, benign tumors composed of mature lipocytes admixed with abnormal blood vessels. Only 128 cases of spinal epidural angiolipomas have been reported in literature till now. Spinal angiolipomas are predominantly located in the mid-thoracic region. We report a case of dorsal epidural angiolipoma in a 56-year-old male who presented with paraparesis and was diagnosed to have D4-5 epidural angiolipoma. Total surgical excision of the epidural angiolipoma was done and his paraparesis gradually improved. PMID:23188989

Ghanta, Rajesh K; Koti, Kalyan; Dandamudi, Srinivas

2012-01-01

56

Spinal Bracing  

NASA Technical Reports Server (NTRS)

Dr. Arthur Copes of the Copes Foundation, Baton Rouge, LA, says that 35 percent of the 50 technical reports he received from the NASA/Southern University Industrial Applications Center in Baton Rouge and the Central Industrial Applications Center, Durant, OK, were vital to the development of his Copes Scoliosis Braces, which are custom designed and feature a novel pneumatic bladder that exerts constant corrective pressure to the torso to slowly reduce or eliminate the spinal curve.

1991-01-01

57

Holocord spinal epidural abscess.  

PubMed

Spinal epidural abscess is rare in infants and leads to major permanent neurological deficits if the condition is left untreated. Holocord epidural abscess is extremely rare. We report a patient with methicillin-resistant Staphylococcus aureus septicemia presenting with pneumonia, retroperitoneal abscess, and epidural abscess. A 7-month-old previously healthy girl presented with fever, irritability, tachypnea for 4 days and decreased movement of the right lower limb for 1 day. Magnetic resonance imaging of the spine demonstrated an extensive epidural abscess from second cervical to fifth lumbar vertebrae without osteomyelitis or discitis. The epidural abscess was treated with intravenous antibiotics for 6 weeks. At 3 months follow-up, no neurological deficits were present. Only a few case reports of holocord epidural abscess in children have been published. We present a case of conservatively treated holocord spinal abscess in an infant. PMID:19491119

Ghosh, Partha Sekhar; Loddenkemper, Tobias; Blanco, Manuel Buitrago; Marks, Michelle; Sabella, Camille; Ghosh, Debabrata

2009-06-01

58

[A case presenting with ataxic gait and dementia due to vitamin B?? deficiency without megaloblastic anemia or subacute combined degeneration of the spinal cord].  

PubMed

A 36-year-old man was admitted to our hospital because of subacute progressive ataxic gait and dementia. His blood test results vitamin B?? deficiency due to presence of anti-intrinsic factor antibody and his endoscopic examination findings showed chronic gastritis. Treatment was administered on the bass of on a diagnosis of vitamin B?? deficiency. Consequently, ataxic gait improved and dementia regressed. ¹²³I-IMP cerebral blood flow scintigraphy conducted at 8 months after treatment initiation showed increased blood flow the area around the parietal lobe to the corpus callosum, and flow both temporal lobes to the hippocampus compared. The diagnosis was difficult in this case because the patient did not show the typical symptoms and complications associated with vitamin B?? deficiency, such as megaloblastic anemia, or subacute combined degeneration of the spinal cord. However, the disturbance in cerebral blood flow may be related to the dysfunction of higher brain function caused by vitamin B?? deficiency. PMID:21386128

Iwanami, Hisatake; Tanaka, Michito; Iwakawa, Hideki; Takiguti, Yoshimitu; Inukai, Toshihiko

2011-03-01

59

Spinal cord contusion  

PubMed Central

Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

Ju, Gong; Wang, Jian; Wang, Yazhou; Zhao, Xianghui

2014-01-01

60

Coexistence of amyotrophic lateral sclerosis with neuro-Behçet's disease presenting as a longitudinally extensive spinal cord lesion: clinicopathologic features of an autopsied patient.  

PubMed

We report the clinical and autopsy features of a 65-year-old Japanese man who clinically exhibited overlap of both neuro-Behçet's disease (NBD) and amyotrophic lateral sclerosis (ALS). The patient had a HLA-B51 serotype, a recent history of uveitis and had suffered paraparesis, sensory and autonomic disturbance, frontal signs and tremor. A brain and spine MRI study revealed a longitudinally extensive thoracic cord (Th) lesion, but no apparent intracranial abnormalities. The lesion extended ventrally from Th4 to Th9, exhibiting low intensity on T1-weighted images, high intensity on T2-weighted and fluid-attenuated inversion recovery images and gadolinium enhancement. The patient's upper and lower motor neuron signs and sensory disturbance worsened and he died 16 months after admission. At autopsy, the spinal cord and brain exhibited characteristic histopathological features of both NBD and ALS, including chronic destruction of the ventral thoracic white and gray matter, perivascular lymphocytic infiltration, binucleated neurons, lower and upper motor neuron degeneration, Bunina bodies and skein-like inclusions. Although incidental coexistence of these rare disorders could occur in an individual, this case raises the possibility of a pathomechanistic association between NBD and ALS. PMID:24118427

Sato, Tomoe; Ouchi, Haruka; Shimbo, Junsuke; Sato, Aki; Yamazaki, Motoyoshi; Hashidate, Hideki; Igarashi, Shuichi; Kakita, Akiyoshi

2014-04-01

61

Spinal Cord Stimulation for Chronic Pain Management  

Microsoft Academic Search

This article outlines the role of spinal cord stimulation in contemporary chronic pain management. The anatomical and neurophysiological correlates of stimulation of the intraspinal structures are discussed. The most common indications are presented, including failed back syndrome, reflex sympathetic dystrophy, neurogenic thoracic outlet syndrome, and spinal cord injury, etc. The most common complications are presented, including paralysis, infection, electrode migration,

Giancarlo Barolat

2000-01-01

62

Childhood scoliosis revealing spinal cord tumors  

Microsoft Academic Search

Spinal cord tumors typically show slow and insidious growth and scoliosis may be the only presenting feature of these lesions. The aim of this study is to determine the clinical and\\/or imaging signs that can contribute in uncovering the underlying etiology of a presumed “idiopathic” scoliosis. We retrospectively reviewed seven cases of histologically confirmed spinal cord tumors presenting as scoliosis

M. Chelli Bouaziz; M. S. Daghfous; M. F. Ladeb

2006-01-01

63

Spinal epidural abscess.  

PubMed

Spinal epidural abscess (SEA) remains a relatively infrequent diagnosis. Staphylococcus aureus is the most common organism identified, and the infectious source in SEA emanates from skin and soft tissue infections in about 20 % of instances. The thoracic spine is most often involved followed by the lumbar spine. The classic triad of fever, spinal pain, and neurological deficit is present in but a minority of patients. The appearance of neurological deficits with SEA has a significant impact on the prognosis; therefore, early diagnosis is imperative. Magnetic resonance imaging has permitted earlier diagnosis, although significant delays in diagnosis are common due to the nonspecific symptoms that frequently attend the disorder. Due to the rarity of this condition, there have been few randomized controlled trials to evaluate new treatment strategies, and most recommendations regarding treatment are based on case series studies often derived from the experiences at a single center. PMID:25230605

Krishnamohan, Prashanth; Berger, Joseph R

2014-11-01

64

Spinal infections: clinical and imaging features.  

PubMed

Spinal infections represent a group of rare conditions affecting vertebral bodies, intervertebral discs, paraspinal soft tissues, epidural space, meninges, and spinal cord. The causal factors, clinical presentations, and imaging features are a challenge because the difficulty to differentiate them from other conditions, such as degenerative and inflammatory disorders and spinal neoplasm. They require early recognition because delay diagnosis, imaging, and intervention may have devastating consequences especially in children and the elderly. This article reviews the most common spinal infections, their pathophysiologic, clinical manifestation, and their imaging findings. PMID:25296275

Arbelaez, Andres; Restrepo, Feliza; Castillo, Mauricio

2014-10-01

65

Spontaneous spinal extradural hematomas.  

PubMed

We review three patients who presented with acute spontaneous spinal extradural hematomas (SSEH). We discuss the presentation, imaging and management strategies. All three patients were adult women with thoracic SSEH. All had motor weakness prior to surgery. One patient recovered completely, one partially recovered and one did not recover. SSEH, although rare, should be considered in cases of acute onset paraparesis. The diagnostic modality of choice is magnetic resonance imaging. Favourable outcome is related to aetiology, interval between the ictus and presentation, and the severity of the neurological deficits. Emergent surgical drainage is the treatment of choice. PMID:16503490

Ravi, D; Dwarakanath, S; Satish, R; Gopal, S; Venkataramana, N K

2006-02-01

66

History of spinal osteotomy.  

PubMed

Spinal deformity is one of the oldest known diseases with descriptions documented many of the earliest civilizations. Historical treatments have had little efficacy, especially in adults. However, in the modern era, there has been a rapid expansion of new technologies and surgical techniques aided by advances in supportive care that now allow the spinal surgeon to have powerful tools to correct spinal deformity. In this manuscript, we review the origins of spinal deformity surgery and the development of spinal instrumentation. The focus of the manuscript is to review the relationship of these developments to the implementation of spinal osteotomies for deformity correction. PMID:24390043

Meredith, Dennis S; Vaccaro, Alexander R

2014-07-01

67

Hydrocephalus as a possible early symptom in a child with a spinal cord tumor  

Microsoft Academic Search

Spinal cord tumors are relatively uncommon in children. These tumors have been associated with increased intracranial pressure in both children and adults. An infant presented initially with hydrocephalus and subsequently developed symptoms consistent with spinal cord abnormalities. Various proposed etiologies for increased intracranial pressure in spinal cord tumors are presented. Spinal cord tumors should be considered in the presence of

James A. Caviness; Mark H. Tucker; Suzann K. Pia; David A. Tam

1998-01-01

68

Microsurgical ligation of spinal arteriovenous fistulae: techniques.  

PubMed

Spinal dural arteriovenous fistula (dAVF) is an acquired abnormal arterial-to-venous connection within the spinal dura with a wide range of clinical presentations and natural history. Spinal dAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dura of the nerve root sleeve. Spinal dAVFs are the most common vascular malformation of the spine. The authors present a patient who presented with sudden temporary lower extremity weakness secondary to an L-1 spinal dAVF. The details of microsurgical techniques to disconnect the fistula are discussed in this video. The video can be found here: http://youtu.be/F9Kiffs3s6A . PMID:25175572

Tuchek, Chad A; Cohen-Gadol, Aaron A

2014-09-01

69

Advances in spinal instrumentation  

Microsoft Academic Search

New approaches to the spinal column and the use of spinal fixation have vastly improved our ability to treat spinal pathology. Over the last several decades there has been a rapid expansion in the availability of implants for use in the spine. The empetus behind these advancements is a combination of the ingenuity of surgeons in the drive for better

Warren D. Yu

2003-01-01

70

Resection of spinal hemangioblastoma.  

PubMed

Spinal cord hemangioblastomas occur as sporadic lesions or in the setting of Von Hippel-Lindau disease. In this intraoperative video we present a case of sporadic cervical cord hemangioblastoma and illustrate the main surgical steps to achieve safe and complete resection which include: identification and division of the feeding arteries; careful circumferential dissection of the tumor from the surrounding gliotic cord; identification, isolation and division of the main venous drainage and single piece removal of the tumor. The video can be found here: http://youtu.be/I7DxqRrfTxc. PMID:25175576

Lanzino, Giuseppe; Morales-Valero, Saul F; Krauss, William E

2014-09-01

71

Spinal reflexes in brain death.  

PubMed

Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes. PMID:24604683

Beckmann, Yesim; Ciftçi, Yeliz; Incesu, Tülay Kurt; Seçil, Yaprak; Akhan, Galip

2014-12-01

72

Surgical resection of subependymoma of the cervical spinal cord.  

PubMed

Subependymomas can rarely occur in the spinal cord, and account for about 2% of symptomatic spinal cord tumors. It most often occurs in the cervical spinal cord, followed by cervicothoracic junction, thoracic cord and conus medullaris. It often has an eccentric location in the spinal cord and lacks gadolinium enhancement on magnetic resonance imaging. We present a rare case of symptomatic subependymoma of the cervical spinal cord, which underwent successful gross total resection. Surgical pearls and nuances are discussed to help surgeons to avoid potential complications. The video can be found here: http://youtu.be/Rsm9KxZX7Yo. PMID:25175581

Tan, Lee A; Kasliwal, Manish K; Mhanna, Nakhle; Fontes, Ricardo B V; Traynelis, Vincent C

2014-09-01

73

Spinal epidural extramedullary haematopoiesis in ?-thalassaemia intermedia.  

PubMed

A 22-year-old man known to have ?-thalassaemia intermedia since childhood presented with bilateral lower limb weakness after spinal anaesthesia for an elective minor operation of his left leg. MRI and CT scans were performed to rule out acute epidural haematoma; coincidental imaging features of marrow hyperplasia and spinal epidural extramedullary haematopoiesis were found. This article will present and discuss the imaging features, differential diagnosis, management and literature review of the rare occurrence of extramedullary haematopoiesis in the spinal epidural space. PMID:24390965

Wong, Kin Hoi; Li, Allen; Lui, Tun Hing; Sit, Yan Kit

2014-01-01

74

Primary extramedullary spinal melanoma mimicking spinal meningioma: A case report and literature review  

PubMed Central

Primary spinal melanoma is a rare lesion, which occurs throughout the cranial and spinal regions, however, is primarily observed in the middle or lower thoracic spine. The clinical features of primary spinal melanoma are complex and unspecific, resulting in a high misdiagnosis rate. In the present case report, a rare case of spinal melanoma exhibiting the dural tail sign and mimicking spinal meningioma is reported. The initial diagnosis, using magnetic resonance imaging (MRI), was unclear. Thus, melanin-containing tumors and spinal meningioma should have been considered in the differential diagnosis. The tumor was completely resected using a standard posterior midline approach, which was followed by chemotherapy. Subsequent to the surgery, the patient was discharged with improved motor capacity and a follow-up MRI scan showed no recurrence after six months. The present study demonstrates that it is critical for neurosurgeons to focus on increasing the accuracy of initial diagnoses in order to make informed decisions regarding the requirement for surgical resection. The present case report presents the clinical, radiological and pathological features of primary extramedullary spinal melanoma mimicking spinal meningioma to emphasize the importance of early identification and diagnosis. PMID:24959273

LI, YU-PING; ZHANG, HENG-ZHU; SHE, LEI; WANG, XIAO-DONG; DONG, LUN; XU, ENXI; WANG, XING-DONG

2014-01-01

75

Spinal cord transplants enhance the recovery of locomotor function after spinal cord injury at birth  

Microsoft Academic Search

Fetal spinal cord transplants placed into the site of a neonatal spinal cord lesion alter the response of immature CNS neurons to injury. The transplants prevent the retrograde cell death of immature axotomized neurons and support the growth of axons into and through the site of injury. In the present experiments we used a battery of locomotor tasks to determine

E. Kunkel-Bagden; B. S. Bregman

1990-01-01

76

Degenerative spinal disease in large felids.  

PubMed

Degenerative spinal disorders, including intervertebral disc disease and spondylosis, seldom occur in domestic cats. In contrast, a retrospective study of 13 lions (Panthera leo), 16 tigers (Panthera tigris), 4 leopards (Panthera pardis), 1 snow leopard (Panthera uncia), and 3 jaguars (Panthera onca) from the Knoxville Zoo that died or were euthanatized from 1976 to 1996 indicated that degenerative spinal disease is an important problem in large nondomestic felids. The medical record, radiographic data, and the necropsy report of each animal were examined for evidence of intervertebral disc disease or spondylosis. Eight (three lions, four tigers, and one leopard) animals were diagnosed with degenerative spinal disease. Clinical signs included progressively decreased activity, moderate to severe rear limb muscle atrophy, chronic intermittent rear limb paresis, and ataxia. The age at onset of clinical signs was 10-19 yr (median = 18 yr). Radiographic evaluation of the spinal column was useful in assessing the severity of spinal lesions, and results were correlated with necropsy findings. Lesions were frequently multifocal, included intervertebral disc mineralization or herniation with collapsed intervertebral disc spaces, and were most common in the lumbar area but also involved cervical and thoracic vertebrae. Marked spondylosis was present in the cats with intervertebral disc disease, presumably subsequent to vertebral instability. Six of the animals' spinal cords were examined histologically, and five had acute or chronic damage to the spinal cord secondary to disc protrusion. Spinal disease should be suspected in geriatric large felids with decreased appetite or activity. Radiographic evaluation of the spinal column is the most useful method to assess the type and severity of spinal lesions. PMID:10884118

Kolmstetter, C; Munson, L; Ramsay, E C

2000-03-01

77

Cervical meningocele and associated spinal anomalies.  

PubMed

Simple meningoceles are infrequent forms of dysraphism and are often benign. They have been associated with other spinal anomalies. The uncommon cervical meningocele may have a higher propensity to be associated with other spinal anomalies. Four patients with cervical meningocele are presented with radiographic evaluation and clinical course. Multiple abnormalities were documented radiographically and operatively, including hydrocephalus, Chiari malformation, hydromyelia, lipomeningomyelocele, tethered cord, thickened filum terminale, diastematomyelia, Klippel-Feil syndrome, and thoracic hemivertebrae. Prior to the development of any late neurological abnormality from associated spinal anomalies, magnetic resonance imaging is recommended early in a child born with a simple meningocele. PMID:3652068

Delashaw, J B; Park, T S; Cail, W M; Vollmer, D G

1987-01-01

78

Microsurgical resection of intramedullary spinal cord ependymoma.  

PubMed

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy. The video can be found here: http://youtu.be/lcHhymSvSqU. PMID:25175587

McCormick, Paul C

2014-09-01

79

Dorsal epidural spinal lipomatosis.  

PubMed

The authors report a case of a thoracic epidural spinal lipomatosis causing severe neurological deficits along the review of pertinent literature. The patient is a 56-year-old woman who presented with acute onset of severe paraparesis; she was investigated with cervical and thoracic MRI and then surgically managed because of an intraspinal mass compressing the cord. The operation consisted in the excision of the mass confirmed to be a fibrolipoma by pathological analysis. The patient attained complete neurological recovery and at 18 months follow-up she reported a generalised well-being. Thoracic lipomas are rare lesions that presenting mostly with back pain; however, in rare instances they may cause progressive and/or abrupt neurological dysfunction. Appropriate imaging can help in the diagnosis and management of such cases. PMID:22707370

Chibbaro, S; Mirone, G; Nouri, M; Di Emidio, P; Polivka, M; Marsella, M; George, B

2011-01-01

80

Dorsal epidural spinal lipomatosis  

PubMed Central

The authors report a case of a thoracic epidural spinal lipomatosis causing severe neurological deficits along the review of pertinent literature. The patient is a 56-year-old woman who presented with acute onset of severe paraparesis; she was investigated with cervical and thoracic MRI and then surgically managed because of an intraspinal mass compressing the cord. The operation consisted in the excision of the mass confirmed to be a fibrolipoma by pathological analysis. The patient attained complete neurological recovery and at 18 months follow-up she reported a generalised well-being. Thoracic lipomas are rare lesions that presenting mostly with back pain; however, in rare instances they may cause progressive and/or abrupt neurological dysfunction. Appropriate imaging can help in the diagnosis and management of such cases. PMID:22707370

Chibbaro, S; Mirone, G; Nouri, M; Di Emidio, P; Polivka, M; Marsella, M; George, B

2011-01-01

81

Intramedullary spinal cord tumors  

Microsoft Academic Search

Opinion statement  The three most common types of intramedullary spinal cord tumors are low-grade astrocytomas, ependymomas, and high-grade astrocytomas.\\u000a Surgical extirpation is the necessary and sufficient primary treatment for most intramedullary spinal cord tumors. Radiation\\u000a therapy may also have a role in the management of persistent, recurrent, or progressive low-grade astrocytomas and ependymomas.\\u000a The current treatment of spinal cord high-grade astrocytomas,

Daniel C. Bowers; Bradley E. Weprin

2003-01-01

82

Unusual Spinal Dysraphic Lesions  

PubMed Central

Human tail and multiple spinal dysraphism are unusual congenital malformations. Human tail appeared as a prominent lesion from the lumbosacrococcygeal region, generally without connection between the tail and the neurospinal axis. Spinal dysraphisms are usually isolated, reaching 0.038% of incidence of multiple spinal dysraphisms in the same child. There were three cases described of unusual spinal dysraphic lesions: two cases of human tail and a case of a multiple thoracic myelomeningocele. The literature about diagnosis and treatment was reviewed. Microsurgical technique was performed to provide better exploration of the lesions, and resection could be done in those congenital malformations, without morbidity. PMID:24194997

Pacheco, Pollyana; Wanderley, Luiz Eduardo

2013-01-01

83

Spinal Dysraphism: Trends in Northern India  

Microsoft Academic Search

Objective: To evaluate the clinical profiles, image findings and surgical outcome of 155 cases of spinal dysraphism. Methods: 155 patients were studied prospectively (143) or retrospectively (12). The male to female ratio was 1.5:1. Mean age at presentation was 5.7 years. Out of 155 cases of spinal dysraphism, 119 had open spina bifida [meningomyelocele (MMC) in 113 (72%), meningocele in

Raj Kumar; S. N. Singh

2003-01-01

84

Spinal tuberculosis: A review  

PubMed Central

Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Genetic susceptibility to spinal tuberculosis has recently been demonstrated. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. The thoracic region of vertebral column is most frequently affected. Formation of a ‘cold’ abscess around the lesion is another characteristic feature. The incidence of multi-level noncontiguous vertebral tuberculosis occurs more frequently than previously recognized. Common clinical manifestations include constitutional symptoms, back pain, spinal tenderness, paraplegia, and spinal deformities. For the diagnosis of spinal tuberculosis magnetic resonance imaging is more sensitive imaging technique than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early histopathological diagnosis. Antituberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. With early diagnosis and early treatment, prognosis is generally good. PMID:22118251

Garg, Ravindra Kumar; Somvanshi, Dilip Singh

2011-01-01

85

Cocaine and amphetamine-regulated transcript peptide (CART) is present in peptidergic C primary afferents and axons of excitatory interneurons with a possible role in nociception in the superficial laminae of the rat spinal cord  

Microsoft Academic Search

Cocaine- and amphetamine-regulated transcript peptides (CART) have been implicated in the regulation of several physiological functions, including pain transmission. A dense plexus of CART-immunoreactive fibres has been described in the superficial laminae of the spinal cord, which are key areas in sensory information and pain processing. In this study, we used antibody against CART peptide, together with markers for various

Márk Kozsurek; Erika Lukácsi; Csaba Fekete; Gábor Wittmann; Miklós Réthelyi; Zita Puskár

2007-01-01

86

Spinal Subdural Hematoma Following Meningioma Removal Operation  

PubMed Central

Although blood contamination of cerebrospinal fluid (CSF) after an intracranial operation can occur, the development of a symptomatic spinal hematoma after craniotomy has been anecdotally reported and it is uncommon reported after a supratentorial meningioma removal operation. We report a case of spinal subdural hematoma following a supratentorial meningioma removal operation and discuss the mechanism of spinal subdural hematoma (SSDH) development. A 54-year-old woman presented with lumbago and radicular pain on both legs 4 days after a right parietooccipital craniotomy for meningioma removal. Only the straight leg raising sign was positive on neurologic examination but the magnetic resonance imaging (MRI) demonstrated a lumbosacral spinal subdural hematoma. The patient received serial lumbar tapping, after which her symptoms showed improvement. PMID:24891866

Jun, Hyo Sub; Oh, Jae Keun; Park, Young Seok

2014-01-01

87

Low-level laser therapy for spinal cord injury in rats: effects of polarization  

E-print Network

The effects of laser polarization on the efficacy of near-infrared low-level laser therapy for spinal cord injury (SCI) are presented. Rat spinal cords were injured with a weight-drop device, and the lesion sites were ...

Ando, Takahiro

88

Intramedullary lumbar lesion mimicking spinal cord tumor: a case of non-neoplastic intramedullary spinal cord lesion  

Microsoft Academic Search

Non-neoplastic intramedullary spinal lesion cases are rarely seen in the literature. We would like to present this case for\\u000a differential diagnosis of intramedullary spinal tumors. The aim of this case report is to attract attention on the MRI findings\\u000a with lack of contrast enhancement and long syrinx formation which differs these types of lesions from the intramedullary spinal\\u000a tumors. Intraoperative,

Ilker SolmazMehmet; Mehmet B. Önal; Erdinç Civelek; Sait ?irin; Serdar Kahraman

2010-01-01

89

Spontaneous spinal subdural hematoma concurrent with cranial subdural hematoma.  

PubMed

A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin. PMID:24044087

Moon, Wonjun; Joo, Wonil; Chough, Jeongki; Park, Haekwan

2013-07-01

90

Spinal cord abscess  

MedlinePLUS

... exam may show signs of: Spinal cord compression Paralysis of the lower body (paraplegia) or of the entire trunk, arms, and legs (quadriplegia) Changes in sensation below the area of involvement ...

91

Pregnancy following spinal cord injury.  

PubMed Central

Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about half quadriplegia, 25 pregnancies occurred, with 21 carried to full term. The women delayed pregnancy an average of 6.5 years after their injury, with an average age at first pregnancy of 26.8 years. Cesarean section was necessary in 4 patients because of inadequate progress of labor. In 5 deliveries an episiotomy and local anesthesia were required, 7 required epidural anesthesia, including all cesarean sections, and 10 did not require anesthesia. Several complications have been identified in the antepartum, intrapartum, and postpartum periods including autonomic hyperreflexia, premature labor, pressure sores, urinary tract infections, abnormal presentation, and failure to progress. Ultrasonography and amniocentesis were used selectively. Women with spinal cord injuries can have healthy children, although there are significant risks and these women have special needs. PMID:1866960

Cross, L. L.; Meythaler, J. M.; Tuel, S. M.; Cross, A. L.

1991-01-01

92

Postoperative spinal epidural hematoma resulting in cauda equina syndrome: a case report and review of the literature  

PubMed Central

Spinal epidural hematoma is a well known complication of spinal surgery. Clinically insignificant small epidural hematomas develop in most spinal surgeries following laminectomy. However, the incidence of clinically significant postoperative spinal epidural hematomas that result in neurological deficits is extremely rare. In this report, we present a 33-year-old female patient whose spinal surgery resulted in postoperative spinal epidural hematoma. She was diagnosed with lumbar disc disease and underwent hemipartial lumbar laminectomy and discectomy. After twelve hours postoperation, her neurologic status deteriorated and cauda equina syndrome with acute spinal epidural hematoma was identified. She was immediately treated with surgical decompression and evacuation of the hematoma. The incidence of epidural hematoma after spinal surgery is rare, but very serious complication. Spinal epidural hematomas can cause significant spinal cord and cauda equina compression, requiring surgical intervention. Once diagnosed, the patient should immediately undergo emergency surgical exploration and evacuation of the hematoma. PMID:19830087

Sasani, Mehdi; Oktenoglu, Tunc; Cirak, Bayram; Ozer, Ali Fahir

2009-01-01

93

Exophytic Primitive Neuroectodermal Tumor of the Spinal Cord  

Microsoft Academic Search

Summary: We present a case of an exophytic spinal prim- itive neuroectodermal tumor that, radiologically, simulated an extramedullary nerve sheath tumor, meningioma, or metastatic tumor deposit. MR imaging provided discrete anatomic localization of the tumor, enabling exclusion of multicentricity in the brain and spinal cord. Primitive neuroectodermal tumor (PNET) is a ge- neric term used to describe a group of

Demetrios Papadatos; Stephen Albrecht; Gerard Mohr

94

Clenbuterol, a ? 2Adrenoceptor Agonist, Improves Locomotor and Histological Outcomes after Spinal Cord Contusion in Rats  

Microsoft Academic Search

An important goal of rehabilitation following spinal cord injury is recovery of locomotor function and muscular strength. In the present studies, we determined whether the ?2-agonist, clenbuterol, can improve recovery of locomotor function following spinal cord injury. A model of spinal cord injury was examined in which four graded levels of contusion injury were produced in rats at the level

Richard J. Zeman; Yong Feng; Hong Peng; Joseph D. Etlinger

1999-01-01

95

?-Adrenergic agents modulate the activity of the spinal pattern generator for ejaculation  

Microsoft Academic Search

Spinal cord transection at a thoracic level activates fictive ejaculation (FE) in the male rat. It has earlier been demonstrated that fictive motor patterns may be activated by pharmacological means and that the noradrenergic system seems to be particularly efficient in triggering locomotor fictive patterns in spinal animals. In the present study, the hypothesis was tested that the spinal noradrenergic

M Carro-Juárez; G Rodríguez-Manzo

2006-01-01

96

Spinal metaplastic meningioma with osseous differentiation in the ventral thoracic spinal canal.  

PubMed

Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord. PMID:25338489

Yamane, Kentaro; Tanaka, Masato; Sugimoto, Yoshihisa; Ichimura, Kouichi; Ozaki, Toshifumi

2014-10-01

97

Exercise induces metallothioneins in mouse spinal cord.  

PubMed

Regular exercise has displayed a beneficial effect on the progression of amyotrophic lateral sclerosis (ALS). However, the mechanism is poorly understood. We here present that regular exercise on a treadmill induces metallothioneins (MTs: MT-1, MT-2, and MT-3) in spinal cords of mice. As MTs are strong scavengers of reactive oxygen species and have some neurotrophic activities, exercise may have some beneficial effects on spinal motor neurons in patients with ALS owing to the induction of MTs. The running exercise on a treadmill for 30 min/day increased the mRNA expression levels of MT-1, MT-2, and MT-3 up to 193%, 298%, and 196%, respectively, of the control value 12 h after the start of exercise. After two weeks of daily exercise, Western blotting of the MTs proteins showed that the expression levels of MT-1/2 and MT-3 reached 173% and 146%, respectively, compared with those in sedentary mice. Running exercise on a treadmill for 2 weeks led to the gradual accumulation of MT proteins in the spinal cords of the mice. In addition, MT-1/2 and MT-3 immunoreactivities were enhanced in astrocytes particularly in the gray matter of the spinal cord. We revealed that regular exercise induced transient increases in the expression levels of MT mRNAs and resulted in accumulation of MT proteins in the spinal cords of the normal mice. PMID:19490933

Hashimoto, K; Hayashi, Y; Inuzuka, T; Hozumi, I

2009-09-29

98

Spinal Injuries in Children  

PubMed Central

About 5% of spinal injuries occur in children – however the consequences to the society are devastating, all the more so because the cervical spine is more commonly affected. Anatomical differences with adults along with the inherent elasticity of the pediatric spine, makes these injuries a biomechanically separate entity. Hence clinical manifestations are unique, one of which is the Spinal Cord Injury Without Radiological Abnormality. With the advent of high quality MRI and CT scan along with digital X-ray, it is now possible to exactly delineate the anatomical location, geometrical configuration, and the pathological extent of the injury. This has improved the management strategies of these unfortunate children and the role of surgical stabilization in unstable injuries can be more sharply defined. However these patients should be followed up diligently because of the recognized long term complications of spinal deformity and syringomyelia. PMID:22855681

Basu, Saumyajit

2012-01-01

99

Metastatic Spinal Tumor  

PubMed Central

In accordance with extending survival periods of cancer patients, number of consecutively developing metastatic spinal tumor is also increasing. There have been improvements in the treatment results of metastatic spine tumor by virtue of the developments in diagnostic radiology, chemotherapy, adjuvant treatment, operative device and technique, discrete preoperative plan, and standardized operation. Accordingly, surgical indication has also increased. Clinically, in case of metastatic spine tumor, treatment of tumor itself should be focused on pain relief, preservation of neurologic function, prevention of pathologic fracture, prevention of pathologic fracture, and correction of spinal instability for improving quality of life, rather than for extension of survival. Additionally, etiology of spinal tumor, correct diagnosis and subsequent treatment principles should be thoroughly understood before establishing treatment plans for effective treatments. PMID:22439092

Jung, Chul-Hee

2012-01-01

100

Synaptic Defects in the Spinal and Neuromuscular Circuitry in a Mouse Model of Spinal Muscular Atrophy  

PubMed Central

Spinal muscular atrophy (SMA) is a major genetic cause of death in childhood characterized by marked muscle weakness. To investigate mechanisms underlying motor impairment in SMA, we examined the spinal and neuromuscular circuitry governing hindlimb ambulatory behavior in SMA model mice (SMN?7). In the neuromuscular circuitry, we found that nearly all neuromuscular junctions (NMJs) in hindlimb muscles of SMN?7 mice remained fully innervated at the disease end stage and were capable of eliciting muscle contraction, despite a modest reduction in quantal content. In the spinal circuitry, we observed a ?28% loss of synapses onto spinal motoneurons in the lateral column of lumbar segments 3–5, and a significant reduction in proprioceptive sensory neurons, which may contribute to the 50% reduction in vesicular glutamate transporter 1(VGLUT1)-positive synapses onto SMN?7 motoneurons. In addition, there was an increase in the association of activated microglia with SMN?7 motoneurons. Together, our results present a novel concept that synaptic defects occur at multiple levels of the spinal and neuromuscular circuitry in SMN?7 mice, and that proprioceptive spinal synapses could be a potential target for SMA therapy. PMID:21085654

Zingg, Brian; Feng, Zhihua; Ko, Chien-Ping

2010-01-01

101

A novel rodent model of spinal metastasis and spinal cord compression  

PubMed Central

Background Spinal cord metastatic lesions affect a high number of cancer patients usually resulting in spinal cord compression syndrome. A major obstacle in the research of spinal metastatic disease is the lack of a simple reproducible animal model that mimics the natural course of the disease. In this study, we present a highly reproducible rodent model that can be used for different types of cancers while mimicking the natural course of human metastatic spinal cord compression syndrome. Results All sixteen Fisher 344 rats survived the dorsal approach intraosseous implantation of CRL-1666 adenocarcinoma cells and both rats survived the sham control surgery. By Day 13 functional analysis via the modified Basso-Beattie-Bresnahan (BBB) locomotor rating scale showed significant decrease in motor function; median functional score was 3 for the tumor group (p = 0.0011). Median time to paresis was 8.7 days post-operatively. MR imaging illustrated repeated and consistent tumor formation, furthermore, onset of neurological sequale was the result of tumor formation and cord compression as confirmed by histological examination. Conclusions Analysis of these findings demonstrates a repeatable and consistent tumor growth model for cancer spinal metastases in rats. This novel rat model requires a less intricate surgical procedure, and as a result minimizes procedure time while subsequently increasing consistency. Therefore, this model allows for the preclinical evaluation of therapeutics for spinal metastases that more closely replicates physiological findings. PMID:23116234

2012-01-01

102

Primary extradural spinal ganglioneuroblastoma: a case report.  

PubMed

We report a case of ganglioneuroblastoma of the spinal cord in a 25-year-old man. Clinical history was short with paraparesis and bladder involvement. The MRI picture was that of an extradural solid tumor with extension to both intervertebral foramina, more suggestive of nerve sheath tumour rather than malignant embryonal tumour. Diagnosis was established by histopathological study. We could not find such a presentation of spinal ganglioneuroblastoma as an extradural, primary tumour in the literature. We discuss the radio-pathological features, surgical management and post-operative outcome. PMID:24831370

Patnaik, Ashis; Mishra, Sudhansu S; Mishra, Sanjib; DAS, Srikanta; Deo, Rama C

2014-01-01

103

Transient Neurologic Symptoms After Spinal Anesthesia  

Microsoft Academic Search

- We recently reported several cases consistent with tran- sient radicular irritation after spinal anesthesia with hy- perbaric 5% lidocaine. The present prospective, blind, nonrandomized study was performed to determine the incidence of these transient neurologic symptoms and to identify factors that might be associated with their occurrence. We studied 270 patients scheduled for gy- necologic or obstetric procedures under

Karl F. Hampl; Markus C. Schneider; Wolfgang Ummenhofer; Jurgen Drewe

1995-01-01

104

Congenital narrowing of the spinal canal  

Microsoft Academic Search

Further examples of congenital narrowing of the spinal canal in the lumbar and cervical regions are presented. It is implied that the condition is a nosological entity. Neurogenic intermittent claudication often accompanies the lumbar variety; the diagnosis in the cervical region is, however, radiological. The similarity to some of the features of achondroplasia is stressed. Symptoms are usually relieved by

D O Hancock

1967-01-01

105

Microbiology and Epidemiology of Infectious Spinal Disease  

PubMed Central

Objective Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy. PMID:25289121

Jeong, Se-Jin; Youm, Jin-Young; Kim, Hyun-Woo; Ha, Ho-Gyun; Yi, Jin-Seok

2014-01-01

106

Spinal Deformity and Athletics  

Microsoft Academic Search

Exercise and athletic competition for the young individual has become increasingly more important in society. Scoliosis and Scheurmann kyphosis are spinal deformities prevalent in up to 2% to 3% and 7% of the population respectively, requiring nonoperative and occasionally operative treatment. Curve progression and patient physiologic age dictate treatment regimens. Bracing and physical therapy is the mainstay for nonoperative treatment,

Jonathan R. Schiller; Craig P. Eberson

2008-01-01

107

Anterior spinal artery syndrome  

Microsoft Academic Search

Three patients with symptoms due to the anterior spinal artery syndrome were treated by direct perfusion of dexamethasone sodium phosphate and urokinase into the artery of Adamkiewicz. Their symptoms were paraparesis with dissociated sensory loss and sphincter dysfunction, and there was no evidence of the possible cause. In the early phase of the disease, three consecutive injections were carried out

H. Baba; K. Tomita; T. Kawagishi; S. Imura

1993-01-01

108

Pediatric Extradural Spinal Tumors  

Microsoft Academic Search

We have reviewed 16 children with extradural spinal tumors, both benign and malignant, treated from 1998 to 2006 in Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. The duration of symptomatology, clinical signs, radiological investigations, surgical approach, outcome and histopathological variation from the Western world was noted and evaluated. The age of these children ranged from 3 to 20

Raj Kumar; Pramod J. Giri

2008-01-01

109

Imaging in spinal trauma  

Microsoft Academic Search

Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe

Johan W. M. Van Goethem; Menno Maes; Özkan Özsarlak; Luc van den Hauwe; Paul M. Parizel

2005-01-01

110

Case report of spinal epidural abscess caused by Haemophilus paraphrophilus.  

PubMed Central

Haemophilus paraphrophilus was recovered in pure culture from purulent material collected at surgery from a patient presenting with a spinal epidural abscess and a severe neurological deficit. This is the first report of such an occurrence. PMID:8150977

Scerpella, E G; Wu, S; Oefinger, P E

1994-01-01

111

Spinal cord regeneration.  

PubMed

Three theories of regeneration dominate neuroscience today, all purporting to explain why the adult central nervous system (CNS) cannot regenerate. One theory proposes that Nogo, a molecule expressed by myelin, prevents axonal growth. The second theory emphasizes the role of glial scars. The third theory proposes that chondroitin sulfate proteoglycans (CSPGs) prevent axon growth. Blockade of Nogo, CSPG, and their receptors indeed can stop axon growth in vitro and improve functional recovery in animal spinal cord injury (SCI) models. These therapies also increase sprouting of surviving axons and plasticity. However, many investigators have reported regenerating spinal tracts without eliminating Nogo, glial scar, or CSPG. For example, many motor and sensory axons grow spontaneously in contused spinal cords, crossing gliotic tissue and white matter surrounding the injury site. Sensory axons grow long distances in injured dorsal columns after peripheral nerve lesions. Cell transplants and treatments that increase cAMP and neurotrophins stimulate motor and sensory axons to cross glial scars and to grow long distances in white matter. Genetic studies deleting all members of the Nogo family and even the Nogo receptor do not always improve regeneration in mice. A recent study reported that suppressing the phosphatase and tensin homolog (PTEN) gene promotes prolific corticospinal tract regeneration. These findings cannot be explained by the current theories proposing that Nogo and glial scars prevent regeneration. Spinal axons clearly can and will grow through glial scars and Nogo-expressing tissue under some circumstances. The observation that deleting PTEN allows corticospinal tract regeneration indicates that the PTEN/AKT/mTOR pathway regulates axonal growth. Finally, many other factors stimulate spinal axonal growth, including conditioning lesions, cAMP, glycogen synthetase kinase inhibition, and neurotrophins. To explain these disparate regenerative phenomena, I propose that the spinal cord has evolved regenerative mechanisms that are normally suppressed by multiple extrinsic and intrinsic factors but can be activated by injury, mediated by the PTEN/AKT/mTOR, cAMP, and GSK3b pathways, to stimulate neural growth and proliferation. PMID:24816452

Young, Wise

2014-01-01

112

Surgical Treatment of Spinal Tuberculosis Complicated with Extensive ABSCESS  

PubMed Central

Purpose Tuberculosis can be responsible for extensive spinal lesions. Despite the efficacy of medical treatment, surgery is indicated to avoid or correct significant deformity, treat spinal instability, prevent neurological compromise, and to eradicate an extensive tuberculous abscess. In this paper we present our experience in the surgical management of spinal tuberculosis complicated with large abscess. Patients and Methods Fifteen patients with spinal tuberculosis complicated with extensive abscess were identified; and nine of those patients had extension of the infection into the epidural space. The average age at treatment was 34 years old. Seven patients had thoracic infection, seven patients had lumbar infection and one had thoracolumbar infection. Six patients had neurological deficit at presentation. All patients were surgically treated with abscess debridement, spinal stabilization and concurrent antituberculous chemotherapy. A single anterior surgical approach was used in three cases, a posterior approach was used in four others and a combined approach was performed in eight patients. Results Surgical management allowed for effective abscess debridement and sspinal stabilization in this cohort. In combination with antituberculous drugs, surgical treatment resulted in infection eradication and bone fusion in all patients at 24 month average follow-up. Satisfactory neurological outcomes with improved American Spinal Injury Association (ASIA) scores were observed in 100% of patients. Conclusion Surgical treatment for spinal tuberculosis abscess can lead to satisfactory clinical outcomes.

Brito, Joaquim Soares Do; Tirado, Antonio; Fernandes, Pedro

2014-01-01

113

Compressive myelopathy associated with ectasia of the vertebral and spinal arteries in a dog.  

PubMed

A 4-year-old dog was presented for acute, progressive tetraparesis and cervical hyperesthesia. Symmetrical tubular structures coursing along the lateroventral aspects of the spinal cord at the fourth and fifth cervical vertebrae were identified in magnetic resonance images. At necropsy, vertebral arteries and their spinal branches were severely ectatic bilaterally, and the cervical spinal cord was compressed. Histologically, the ectatic branches of the vertebral and ventral spinal arteries were surrounded by fibrosis with scant mononuclear cell infiltrates and hemorrhage. Spinal branches of the vertebral arteries had focally severe reduction in the tunica media. A thrombus was in an arterial branch. Smaller vessels in adjacent tissue had fibrinoid degeneration. Axonal degeneration was detected in the affected spinal cord and nerve roots. The segmental degenerative radiculomyelopathy in this dog was attributed to anomalous ectasia of the vertebral and ventral spinal arteries. PMID:21856870

Bozynski, C C; Vasquez, L; O'Brien, D P; Johnson, G C

2012-09-01

114

Thoracolumbar spinal vascular malformation as a rare cause of isolated intraventricular hemorrhage.  

PubMed

Spinal vascular malformations are rare vascular lesions that most frequently present with back pain, radiculopathy, and/or myelopathy. Neurological decline is typically secondary to progressive radiculopathy, myelopathy, venous thrombosis, and stroke. Few case reports have described thoracolumbar spinal vascular malformations that present with both subarachnoid and intraventricular hemorrhage. This is the first reported case of a thoracolumbar spinal vascular malformation presenting with isolated intraventricular hemorrhage on initial imaging followed by acute and fatal rehemorrhage. PMID:24784978

Marlin, Evan S; Entwistle, John J; Arnold, Michael A; Pierson, Christopher R; Governale, Lance S

2014-07-01

115

Spinal trauma in children.  

PubMed

Evaluation of the child with suspected spinal injury can be a difficult task for the radiologist. Added to the problems posed by lack of familiarity with the normal appearances of the paediatric spine is anxiety about missing a potentially significant injury resulting in neurological damage. Due to differences in anatomy and function, the pattern of injury in the paediatric spine is different from that in the adolescent or adult. Lack of appreciation of these differences may lead to over investigation and inappropriate treatment. This review attempts to clarify some of the problems frequently encountered. It is based on a review of the literature as well as personal experience. The normal appearances and variants of the spine in children, the mechanisms and patterns of injury are reviewed highlighting the differences between children and adults. Specific fractures, a practical scheme for the assessment of spinal radiographs in children, and the role of cross sectional imaging are discussed. PMID:11685436

Roche, C; Carty, H

2001-10-01

116

Imaging of Spinal Metastatic Disease  

PubMed Central

Metastases to the spine can involve the bone, epidural space, leptomeninges, and spinal cord. The spine is the third most common site for metastatic disease, following the lung and the liver. Approximately 60–70% of patients with systemic cancer will have spinal metastasis. Materials/Methods. This is a review of the imaging techniques and typical imaging appearances of spinal metastatic disease. Conclusions. Awareness of the different manifestations of spinal metastatic disease is essential as the spine is the most common site of osseous metastatic disease. Imaging modalities have complimentary roles in the evaluation of spinal metastatic disease. CT best delineates osseous integrity, while MRI is better at assessing soft tissue involvement. Physiologic properties, particularly in treated disease, can be evaluated with other imaging modalities such as FDG PET and advanced MRI sequences. Imaging plays a fundamental role in not only diagnosis but also treatment planning of spinal metastatic disease. PMID:22312523

Shah, Lubdha M.; Salzman, Karen L.

2011-01-01

117

Non-viral gene therapy for spinal cord regeneration  

PubMed Central

Spinal cord injury normally results in life-long disabilities and a broad range of secondary complications. Advances in therapeutic delivery during the past few decades offer hope for such victims. However, the limited functional improvement shown in in vivo studies hinders effective therapeutic application in clinical practice. Recent studies showed that gene vectors can transfect cells present in the lesion of an injured spinal cord (endogenous cells) and thereby produce therapeutic molecules with long-lasting biological effects that promote neural tissue regeneration. In this article we review recent advances in non-viral gene delivery into neural cells and their use for gene therapy in spinal cord injury. PMID:22634187

Yao, Li; Yao, Sheng; Daly, Bill; Hendry, William; Windebank, Anthony; Pandit, Abhay

2013-01-01

118

Intramedullary Spinal Cord Tumors  

Microsoft Academic Search

\\u000a Intramedullary spinal cord tumors (IMSCT) are rare and account for only 5–6% of all central nervous systems (CNS) tumors (Sloof\\u000a and McCarthy 1964; Goh et al. 1997b; Houten and Weiner 2000). These tumors can occur at any age, but most are identified during\\u000a the first three decades of life. Approximately 100–200 cases of pediatric IMSCT are diagnosed each year in

Isaac Yang; Andrew T. Parsa

119

Spinal cord tumors  

Microsoft Academic Search

.   Spinal cord tumors are rare; however, every radiologist should be able to recognize and readily identify those lesions often\\u000a found in younger patients or children [1, 2, 3, 4, 5, 6, 7, 8,9]. Early diagnosis plays an important role in the management\\u000a of the lesions and interferes with the prognosis and final outcome of the patient [10]. Plain X-ray

D. L. F. Balériaux; Service de Radiologie

1999-01-01

120

Development of AMPA receptor and GABA B receptor-sensitive spinal hyper-reflexia after spinal air embolism in rat: a systematic neurological, electrophysiological and qualitative histopathological study  

PubMed Central

Decompression sickness results from formation of bubbles in the arterial and venous system, resulting in spinal disseminated neurodegenerative changes and may clinically be presented by motor dysfunction, spinal segmental stretch hyper-reflexia (i.e., spasticity) and muscle rigidity. In our current study, we describe a rat model of spinal air embolism characterized by the development of similar spinal disseminated neurodegenerative changes and functional deficit. In addition, the anti-spastic potency of systemic AMPA receptor antagonist (NGX424) or GABA B receptor agonist (baclofen) treatment was studied. To induce spinal air embolism, animals received an intra-aortic injection of air (50–200 ?l/kg). After embolism, the development of spasticity was measured using computer-controlled ankle rotation. Animals receiving 150 or 200 ?l of intra-aortic air injections displayed motor dysfunction with developed spastic (50–60% of animals) or flaccid (25–35% of animals) paraplegia at 5–7 days. MRI and spinal histopathological analysis showed disseminated spinal cord infarcts in the lower thoracic to sacral spinal segments. Treatment with NGX424 or baclofen provided a potent anti-spasticity effect (i.e., stretch hyper-reflexia inhibition). This model appears to provide a valuable experimental tool to study the pathophysiology of air embolism-induced spinal injury and permits the assessment of new treatment efficacy targeted to modulate neurological symptoms resulting from spinal air embolism. PMID:22721766

Kakinohana, Osamu; Scadeng, Miriam; Corleto, Jose A.; Sevc, Juraj; Lukacova, Nadezda; Marsala, Martin

2012-01-01

121

Radionuclide imaging of spinal infections  

Microsoft Academic Search

Background  The diagnosis of spinal infection, with or without implants, has been a challenge for physicians for many years. Spinal infections are now being recognised more frequently, owing to aging of the population and the increasing use of spinal-fusion surgery.Discussion   The diagnosis in many cases is delayed, and this may result in permanent neurological damage or even death. Laboratory evidence of

Filip Gemmel; Nicolas Dumarey; Christopher J. Palestro

2006-01-01

122

Complications in the management of metastatic spinal disease  

PubMed Central

Metastatic spine disease accounts for 10% to 30% of new cancer diagnoses annually. The most frequent presentation is axial spinal pain. No treatment has been proven to increase the life expectancy of patients with spinal metastasis. The goals of therapy are pain control and functional preservation. The most important prognostic indicator for spinal metastases is the initial functional score. Treatment is multidisciplinary, and virtually all treatment is palliative. Management is guided by three key issues; neurologic compromise, spinal instability, and individual patient factors. Site-directed radiation, with or without chemotherapy is the most commonly used treatment modality for those patients presenting with spinal pain, causative by tumours which are not impinging on neural elements. Operative intervention has, until recently been advocated for establishing a tissue diagnosis, mechanical stabilization and for reduction of tumor burden but not for a curative approach. It is treatment of choice patients with diseaseadvancement despite radiotherapy and in those with known radiotherapy-resistant tumors. Vertebral resection and anterior stabilization with methacrylate or hardware (e.g., cages) has been advocated.Surgical decompression and stabilization, however, along with radiotherapy, may provide the most promising treatment. It stabilizes the metastatic deposited areaand allows ambulation with pain relief. In general, patients who are nonambulatory at diagnosis do poorly, as do patients in whom more than one vertebra is involved. Surgical intervention is indicated in patients with radiation-resistant tumors, spinal instability, spinal compression with bone or disk fragments, progressive neurologic deterioration, previous radiation exposure, and uncertain diagnosis that requires tissue diagnosis. The main goal in the management of spinal metastatic deposits is always palliative rather than curative, with the primary aim being pain relief and improved mobility. This however, does not come without complications, regardless of the surgical intervention technique used. These complication range from the general surgical complications of bleeding, infection, damage to surrounding structures and post operative DT/PE to spinal specific complications of persistent neurologic deficit and paralysis. PMID:22919567

Dunning, Eilis Catherine; Butler, Joseph Simon; Morris, Seamus

2012-01-01

123

Adaptation of motor function after spinal cord injury: novel insights into spinal shock.  

PubMed

The mechanisms underlying spinal shock have not been clearly defined. At present, clinical assessment remains the mainstay to describe progression through spinal shock following traumatic spinal cord injury. However, nerve excitability studies in combination with conventional nerve conduction and clinical assessments have the potential to investigate spinal shock at the level of the peripheral axon. Therefore, peripheral motor axon excitability was prospectively and systematically evaluated in more than 400 studies of 11 patients admitted to hospital after traumatic spinal cord injury, with cord lesions above T9 (nine cervical, two thoracic). Recordings commenced within 15 days of admission from the median nerve to abductor pollicis brevis in the upper limb and the common peroneal nerve to tibialis anterior in both lower limbs, and were continued until patient discharge from hospital. Excitability was assessed using threshold tracking techniques and recordings were compared with data from healthy controls. In addition, concurrent clinical measures of strength, serum electrolytes and nerve conduction were collected. High threshold stimulus-response relationships were apparent from the early phase of spinal shock that coincided with depolarization-like features that reached a peak on Day 16.9 (± 2.7 standard error) for the common peroneal nerve and Day 11.8 (± 2.0 standard error) for the median nerve. Overall, changes in the common peroneal nerve were of greater magnitude than for the median nerve. For both nerves, the most significant changes were in threshold electrotonus, which was 'fanned in', and during the recovery cycle superexcitability was reduced (P < 0.001). However, refractoriness was increased only for the common peroneal nerve (P < 0.05). Changes in the spinal injured cohort could not be explained on the basis of an isolated common peroneal nerve palsy. By the time patients with spinal injury were discharged from hospital between Days 68 and 215, excitability for upper and lower limbs had returned towards normative values, but not for all parameters. Electrolyte levels and results for nerve conduction studies remained within normal limits throughout the period of admission. Contrary to prevailing opinion, these data demonstrate that significant changes in peripheral motor axonal excitability occur early during spinal shock, with subsequent further deterioration in axonal function, before recovery ensues. PMID:20952380

Boland, Robert A; Lin, Cindy S-Y; Engel, Stella; Kiernan, Matthew C

2011-02-01

124

Spinal bone density following spinal fusion  

SciTech Connect

Spinal bone densities were assessed in 25 patients following lumbar fusion and bracing, in an attempt to study bone remodeling by noninvasive methods. Dual-photon densitometry was used to study specific areas of autologous bone grafts and adjacent vertebrae above the fusion mass. Measurements were made preoperatively and at 6-week intervals postoperatively. The data for the first 12 months postoperatively are reported here. In all patients there was at first a consistent loss in density in the vertebrae above the fusion mass, averaging 15.7%. This was followed by a gradual density increase such that by 1 year postoperatively, in 60% of the subjects, the density of these vertebrae was higher than the preoperative level. In the grafted areas, bone changes were cyclical, demonstrating a remodeling pattern consistent with that described in animal literature for graft healing and also consistent with modern bone remodeling theory. There was a general tendency toward a gradual increase in the density of the fusion mass.

Lipscomb, H.J.; Grubb, S.A.; Talmage, R.V.

1989-04-01

125

Plasticity of spinal nicotinic acetylcholine receptors following spinal nerve ligation  

Microsoft Academic Search

The nicotinic cholinergic system is known to be important in the processing of nociceptive information. In the spinal cord, nicotinic receptors are expressed on primary afferent terminals, inhibitory interneurons and descending noradrenergic and serotoninergic fibers. Following peripheral nerve injury, the expression of numerous receptors involved in nociceptive processing is altered in the superficial dorsal horn of the spinal cord. However,

Michelle Vincler; James C Eisenach

2004-01-01

126

Plasticity of spinal nicotinic acetylcholine receptors following spinal nerve ligation.  

PubMed

The nicotinic cholinergic system is known to be important in the processing of nociceptive information. In the spinal cord, nicotinic receptors are expressed on primary afferent terminals, inhibitory interneurons and descending noradrenergic and serotoninergic fibers. Following peripheral nerve injury, the expression of numerous receptors involved in nociceptive processing is altered in the superficial dorsal horn of the spinal cord. However, the expression of nicotinic acetylcholine receptor subunits in the lumbar spinal cord following peripheral nerve injury has not been investigated. We examined the expression of the alpha3, alpha4, alpha5, alpha7, beta2, beta3 and beta4 nicotinic subunits in the spinal cord of normal and spinal nerve ligated rats using immunocytochemistry. Two nicotinic subunits were found to have an increased expression following spinal nerve ligation. The number of cells expressing the alpha3 subunit in the dorsal horn increased bilaterally following spinal nerve injury. Also, the number of alpha5 immunoreactive fibers increased significantly ipsilateral to ligation. The expression of the alpha4, alpha7, beta2, beta3 and beta4 subunits was unchanged. We propose that the increased expression of the alpha3 and alpha5 nicotinic subunits may contribute to the mechanical hypersensitivity observed following spinal nerve ligation. PMID:14741388

Vincler, Michelle; Eisenach, James C

2004-02-01

127

Sarcoidosis of the spinal cord: literature review and report of eight cases.  

PubMed Central

Sarcoidosis, which affects African Americans more than it does other racial/ethnic groups, only rarely manifests initially as spinal cord dysfunction. This paper presents the findings of eight patients with spinal cord dysfunction as part of a presentation of sarcoidosis. After reviewing these cases, we devised an algorithm to diagnose and manage spinal cord sarcoidosis. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:16775923

Saleh, Samer; Saw, Chandan; Marzouk, Kamel; Sharma, Om

2006-01-01

128

Postoperative spinal infection mimicking systemic vasculitis with titanium-spinal implants  

PubMed Central

Background Secondary systemic vasculitis after posterior spinal fusion surgery is rare. It is usually related to over-reaction of immune-system, to genetic factors, toxicity, infection or metal allergies. Case Description A 14 year-old girl with a history of extended posterior spinal fusion due to idiopathic scoliosis presented to our department with diffuse erythema and nephritis (macroscopic hemuresis and proteinuria) 5 months post surgery. The surgical trauma had no signs of inflammation or infection. The blood markers ESR and CRP were increased. Skin tests were positive for nickel allergy, which is a content of titanium alloy. The patient received corticosteroids systematically (hydrocortisone 10 mg) for 6 months, leading to total recess of skin and systemic reaction. However, a palpable mass close to the surgical wound raised the suspicion of a late infection. The patient had a second surgery consisting of surgical debridement and one stage revision of posterior spinal instrumentation. Intraoperative cultures were positive to Staphylococcus aureus. Intravenous antibiotics were administered. The patient is now free of symptoms 24 months post revision surgery without any signs of recurrence of either vasculitis or infection. Literature Review Systemic vasculitis after spinal surgery is exceptionally rare. Causative factors are broad and sometimes controversial. In general, it is associated with allergy to metal ions. This is usually addressed with metal on metal total hip bearings. In spinal surgery, titanium implants are considered to be inert and only few reports have presented cases with systemic vasculitides. Therefore, other etiologies of immune over-reaction should always be considered, such as drug toxicity, infection, or genetic predisposition. Purposes and Clinical Relevance Our purpose was to highlight the difficulties during the diagnostic work-up for systemic vasculitis and management in cases of posterior spinal surgery. PMID:21914179

2011-01-01

129

Ossified ligamentum flavum causing spinal cord compression in a patient with acromegaly.  

PubMed

Acromegaly is a relatively rare neuroendocrine disorder associated with diffuse hypertrophy of bony and soft tissues due to growth hormone hypersecretion from a pituitary adenoma. Acromegaly can also cause numerous pathological changes in the spine, including degenerative osteoarticular disease, axial arthropathy, spinal stenosis, vertebral fracture and diffuse idiopathic skeletal hyperostosis (Forestier's disease). Ossified ligamentum flavum (OLF) is a rare disorder that often presents as thoracic spinal stenosis, but to our knowledge has never been described in patients with acromegaly. Previously, no link has been established between these two entities. We present, to our knowledge, the first reported case of OLF in a patient with acromegaly who presented with thoracic spinal cord compression. OLF is a potential spinal manifestation of acromegaly and should be considered in the differential diagnosis of spinal stenosis or spinal cord compression in the context of growth hormone hypersecretion. PMID:23706185

Schmidt, Richard F; Goldstein, Ira M; Liu, James K

2013-11-01

130

Degenerative lumbar spinal stenosis and its imposters: three case studies  

PubMed Central

Degenerative lumbar spinal stenosis causing neurogenic claudicaton is a common condition impacting walking ability in older adults. There are other highly prevalent conditions in this patient population that have similar signs and symptoms and cause limited walking ability. The purpose of this study is to highlight the diagnostic challenges using three case studies of older adults who present with limited walking ability who have imaging evidence of degenerative lumbar spinal stenosis.

Ammendolia, Carlo

2014-01-01

131

Vascular Malformations of the Spine and Spinal Cord  

Microsoft Academic Search

Spinal vascular malformations are rare diseases with a wide variety of neurologic presentations. Their classification depends\\u000a on the differentiation of shunting versus nonshunting lesions, the latter being the spinal cord cavernomas. In the shunting\\u000a lesions, the next step in the proposed classification scheme is related to the feeding artery which can subdivide the dural\\u000a vascular shunts from the pial vascular

Timo Krings

2010-01-01

132

Spinal sagittal mobility and joint laxity in young ballet dancers  

Microsoft Academic Search

The present study compares spinal configuration, spinal range of motion and joint mobility in first-year students of the Swedish Ballet School and in nondancing students of corresponding age and sex in a state school. The study comprises all the first-year (fourth grade) students (n=23) at the Swedish Ballet School: 11 boys and 12 girls. Their dance practice time was 10

C. Nilsson; A. Wykman; J. Leanderson

1993-01-01

133

Update on treatment options for spinal brucellosis.  

PubMed

We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200 mg/day, rifampicin 600 mg/day and streptomycin 1 g/day; doxycycline 200 mg/day, rifampicin 600 mg/day and gentamicin 5 mg/kg; doxycycline 200 mg/day and rifampicin 600 mg/day; doxycycline 200 mg/day and streptomycin 1 g/day; and doxycycline 200 mg/day, rifampicin 600 mg/day and ciprofloxacin 1 g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular. PMID:24118178

Ulu-Kilic, A; Karakas, A; Erdem, H; Turker, T; Inal, A S; Ak, O; Turan, H; Kazak, E; Inan, A; Duygu, F; Demiraslan, H; Kader, C; Sener, A; Dayan, S; Deveci, O; Tekin, R; Saltoglu, N; Ayd?n, M; Horasan, E S; Gul, H C; Ceylan, B; Kadanal?, A; Karabay, O; Karagoz, G; Kayabas, U; Turhan, V; Engin, D; Gulsun, S; Elald?, N; Alabay, S

2014-02-01

134

Abdominal Aortic Aneurysm Presenting as a Claudication  

PubMed Central

Back pain and radiating pain to the legs are the most common symptoms encountered in routine neurosurgical practice and usually originates from neurogenic causes including spinal stenosis. The clinial symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and vascular disease in elderly patients. Because it is not easy to distinguish out the cause of symptoms by only physical examination, routine spinal MRI is checked first to rule out the spinal diseases in most outpatient clinics. Although it is obvious that spinal MRI is a very strong tool to investigate the spinal circumferences, most spine surgeons ignore the importance of looking at all aspects of their imaging and of remembering the extra-spinal causes of radiculopathy. A 68-year-old man who presented with a sudden aggravated both leg claudication. Although his symptom was mimicked for his long standing neurogenic claudication due to spinal stenosis diagnosed previously, abdominal aortic aneurysm(AAA) was found on routine lumbar MRI and it was repaired successfully. We emphasize to spinal surgeons the importance of remembering to look wider on routine MRI images when considering differential diagnoses in the outpatient clinic and to remember the extra-spinal causes of radiculopathy, especially when encountering in elderly patients. PMID:24891862

Son, Si-Hoon; Kim, Kyoung-Tae; Cho, Dae-Chul

2013-01-01

135

Abdominal aortic aneurysm presenting as a claudication.  

PubMed

Back pain and radiating pain to the legs are the most common symptoms encountered in routine neurosurgical practice and usually originates from neurogenic causes including spinal stenosis. The clinial symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and vascular disease in elderly patients. Because it is not easy to distinguish out the cause of symptoms by only physical examination, routine spinal MRI is checked first to rule out the spinal diseases in most outpatient clinics. Although it is obvious that spinal MRI is a very strong tool to investigate the spinal circumferences, most spine surgeons ignore the importance of looking at all aspects of their imaging and of remembering the extra-spinal causes of radiculopathy. A 68-year-old man who presented with a sudden aggravated both leg claudication. Although his symptom was mimicked for his long standing neurogenic claudication due to spinal stenosis diagnosed previously, abdominal aortic aneurysm(AAA) was found on routine lumbar MRI and it was repaired successfully. We emphasize to spinal surgeons the importance of remembering to look wider on routine MRI images when considering differential diagnoses in the outpatient clinic and to remember the extra-spinal causes of radiculopathy, especially when encountering in elderly patients. PMID:24891862

Son, Si-Hoon; Chung, Seok-Won; Kim, Kyoung-Tae; Cho, Dae-Chul

2013-12-01

136

Spinal Injury Rehabilitation in Singapore.  

ERIC Educational Resources Information Center

This study reviewed 231 cases of spinal cord injury treated in Singapore. Data on demographic characteristics, common causes (mostly falls and traffic accidents), types of spinal damage, and outcomes are reported. Following rehabilitation, 68 patients were able to ambulate independently and 45 patients achieved independence in activities of daily…

Yen, H. L.; Chua, K.; Chan, W.

1998-01-01

137

Stereotactic Radiosurgery for Treatment of Spinal Metastases Recurring in Close Proximity to Previously Irradiated Spinal Cord  

SciTech Connect

Purpose: As the spinal cord tolerance often precludes reirradiation with conventional techniques, local recurrence within a previously irradiated field presents a treatment challenge. Methods and Materials: We retrospectively reviewed 51 lesions in 42 patients treated from 2002 to 2008 whose spinal metastases recurred in a previous radiation field (median previous spinal cord dose of 40 Gy) and were subsequently treated with stereotactic radiosurgery (SRS). Results: SRS was delivered to a median marginal dose of 20 Gy (range, 10-30 Gy) in 1-5 fractions (median, 2), targeting a median tumor volume of 10.3 cm{sup 3} (range, 0.2-128.6 cm{sup 3}). Converting the SRS regimens with the linear quadratic model ({alpha}/{beta} = 3), the median spinal cord maximum single-session equivalent dose (SSED) was 12.1 Gy{sub 3} (range, 4.7-19.3 Gy{sub 3}). With a median follow-up of 7 months (range, 2-47 months), the Kaplan-Meier local control and overall survival rates at 6/12 months were 87%/73% and 81%/68%, respectively. A time to retreatment of {<=}12 months and the combination of time to retreatment of {<=}12 months with an SSED of <15 Gy{sub 10} were significant predictors of local failure on univariate and multivariate analyses. In patients with a retreatment interval of <12 months, 6/12 month local control rates were 88%/58%, with a SSED of >15 Gy{sub 10}, compared to 45%/0% with <15 Gy{sub 10}, respectively. One patient (2%) experienced Grade 4 neurotoxicity. Conclusion: SRS is safe and effective in the treatment of spinal metastases recurring in previously irradiated fields. Tumor recurrence within 12 months may correlate with biologic aggressiveness and require higher SRS doses (SSED >15 Gy{sub 10}). Further research is needed to define the partial volume retreatment tolerance of the spinal cord and the optimal target dose.

Choi, Clara Y.H.; Adler, John R. [Department of Neurosurgery, Stanford University Medical Center, Stanford, CA (United States); Gibbs, Iris C. [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States); Chang, Steven D.; Jackson, Paul S. [Department of Neurosurgery, Stanford University Medical Center, Stanford, CA (United States); Minn, A. Yuriko [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States); Lieberson, Robert E. [Department of Neurosurgery, Stanford University Medical Center, Stanford, CA (United States); Soltys, Scott G., E-mail: sgsoltys@stanford.ed [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States)

2010-10-01

138

The use of flexion-extension magnetic resonance imaging for evaluating signal intensity changes of the cervical spinal cord.  

PubMed

The authors present 2 cases involving patients who presented with myelopathy. Magnetic resonance imaging of the cervical spine showed spinal cord signal changes on T2-weighted images without any spinal cord compression. Flexion-extension plain radiographs of the spine showed no instability. Dynamic MR imaging of the cervical spine, however, showed spinal cord compression on extension. Compression of the spinal cord was caused by dynamic anulus bulging and ligamentum flavum buckling. This report emphasizes the need for dynamic MR imaging of the cervical spine for evaluating spinal cord changes on neutral position MR imaging before further workup for other causes such as demyelinating disease. PMID:19441996

Guppy, Kern H; Hawk, Mark; Chakrabarti, Indro; Banerjee, Amit

2009-04-01

139

Heterotopic spinal cord? A curiosity.  

PubMed

Unusual morphological findings were encountered in a high cervical meningomyelocele sac of a neonate. Magnetic resonance imaging revealed a massive liquid-filled sac traversed by a linear structure. The spinal cord was seen to be located normally within the spinal canal. At operation, a spinal cord-like structure was identified within the sac. This cord terminated posteriorly at the neural tissue lining the meningomyelocele sac. There were fibrous strands connecting the cord to the sac like the rigging of a ship. The anterior end of this cord terminated in a fibrous band. It extended upwards into the spinal canal through the narrow neck of the meningomyelocele sac above the arch of the atlas. The whole of this cord, along with the meningomyelocele sac, was excised. Histological analysis confirmed that this spinal cord-like structure consisted of glial tissue with an ependymal-lined cavity. The excised sac was lined by neural tissue. PMID:8697461

Choudhury, A R; Gonog, M A; Mahmood, K

1996-03-01

140

Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis.  

PubMed

The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7-9, the spinal cord was swollen, and a small syrinx was present at T9-10. An S-S bypass was performed from T6-7 to T11-12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass. PMID:25170651

Tachibana, Toshiya; Moriyama, Tokuhide; Maruo, Keishi; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

2014-11-01

141

Historical overview of spinal deformities in ancient Greece  

PubMed Central

Little is known about the history of spinal deformities in ancient Greece. The present study summarizes what we know today for diagnosis and management of spinal deformities in ancient Greece, mainly from the medical treatises of Hippocrates and Galen. Hippocrates, through accurate observation and logical reasoning was led to accurate conclusions firstly for the structure of the spine and secondly for its diseases. He introduced the terms kyphosis and scoliosis and wrote in depth about diagnosis and treatment of kyphosis and less about scoliosis. The innovation of the board, the application of axial traction and even the principle of trans-abdominal correction for correction of spinal deformities have their origin in Hippocrates. Galen, who lived nearly five centuries later impressively described scoliosis, lordosis and kyphosis, provided aetiologic implications and used the same principles with Hippocrates for their management, while his studies influenced medical practice on spinal deformities for more than 1500 years. PMID:19243609

Vasiliadis, Elias S; Grivas, Theodoros B; Kaspiris, Angelos

2009-01-01

142

Spinal Nerve Root Haemangioblastoma Associated with Reactive Polycythemia  

PubMed Central

Haemangioblastomas are uncommon tumours that usually occur in the cerebellum and, less commonly, in the intramedullary spinal cord. The extramedullary spinal canal is an uncommon location for these tumours. Also haemangioblastoma at this site is not known to be associated with polycythemia. We present the clinical, imaging, and histological findings of an adult patient with extramedullary spinal haemangioblastoma and reactive polycythemia. Radiography and computed tomography (CT) revealed a medium-sized tumour that most likely arose from an extramedullary spinal nerve root. This tumour appeared to be slow growing as evidenced by the accompanying well-defined bony resorption with a sclerotic rim and mild neural foraminal widening. Magnetic resonance imaging revealed prominent flow voids consistent with tumoural hypervascularity. CT-guided biopsy was performed. Although preoperative angiographic embolisation was technically successful, excessive intraoperative tumour bleeding necessitated tumour debulking rather than complete tumour resection. Histology of the resected specimen revealed haemangioblastoma. Seven months postoperatively, the patients back pain and polycythemia have resolved.

Law, Eric K. C.; Lee, Ryan K. L.; Griffith, James F.; Siu, Deyond Y. W.; Ng, Ho Keung

2014-01-01

143

Spinal cord injury I: A synopsis of the basic science  

PubMed Central

Substantial knowledge has been gained in the pathological findings following naturally occurring spinal cord injury (SCI) in dogs and cats. The molecular mechanisms involved in failure of neural regeneration within the central nervous system, potential therapeutics including cellular transplantation therapy, neural plasticity, and prognostic indicators of recovery from SCI have been studied. This 2-part review summarizes 1) basic science perspectives regarding treating and curing spinal cord injury, 2) recent studies that shed light on prognosis and recovery from SCI, 3) current thinking regarding standards of care for dogs with SCI, 4) experimental approaches in the laboratory setting, and 5) current clinical trials being conducted in veterinary medicine. Part I presents timely information on the pathophysiology of spinal cord injury, challenges associated with promoting regeneration of neurons of the central nervous system, and experimental approaches aimed at developing treatments for spinal cord injury. PMID:20676289

Webb, Aubrey A.; Ngan, Sybil; Fowler, J. David

2010-01-01

144

Lumbar spinal angiolipoma: case report and review of the literature.  

PubMed

Spinal angiolipomas are extremely rare benign tumors composed of mature lipomatous and angiomatous elements. Most are symptomatic due to progressive spinal cord or root compression. This article describes the case of a 60-year-old woman who presented with a 6-month history of low back pain radiating to her right leg. The pain was multisegmental. The condition had worsened with time. Lumbar magnetic resonance imaging revealed a dorsal epidural mass at L5 and erosion of the lamina of the L5 vertebra. Laminectomy was performed, and an extradural tumor was totally excised. Neuropathologic examination identified it as a lumbar spinal angiolipoma. There was no evidence of recurrence in follow-up 12 months later. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion. PMID:16172903

Konya, Deniz; Ozgen, Serdar; Kurtkaya, Ozlem; Pamir, Necmettin M

2006-06-01

145

Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse.  

PubMed

Posterior spinal artery (PSA) aneurysms are a rare cause of subarachnoid hemorrhage (SAH). The commonly abused street drug 3,4-methylenedioxymethamphetamine (MDMA) or 'Ecstasy' has been linked to both systemic and neurological complications. A teenager presented with neck stiffness, headaches and nausea after ingesting 'Ecstasy'. A brain CT was negative for SAH but a CT angiogram suggested cerebral vasculitis. A lumbar puncture showed SAH but a cerebral angiogram was negative. After a spinal MR angiogram identified abnormalities on the dorsal surface of the cervical spinal cord, a spinal angiogram demonstrated a left PSA 2?mm fusiform aneurysm. The patient underwent surgery and the aneurysmal portion of the PSA was excised without postoperative neurological sequelae. 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, SAH and potentially even de novo aneurysm formation and subsequent rupture. PSA aneurysms may be treated by endovascular proximal vessel occlusion or open surgical excision. PMID:24994748

Johnson, Jeremiah; Patel, Shnehal; Saraf-Lavi, Efrat; Aziz-Sultan, Mohammad Ali; Yavagal, Dileep R

2014-01-01

146

Spinal and Paraspinal Ewing Tumors  

SciTech Connect

Purpose: To perform a review of the 40-year University of Florida experience treating spinal and paraspinal Ewing tumors. Patients and Methods: A total of 27 patients were treated between 1965 and 2007. For local management, 21 patients were treated with radiotherapy (RT) alone and 6 with surgery plus RT. All patients with metastatic disease were treated with RT alone. The risk profiles of each group were otherwise similar. The median age was 17 years, and the most frequent subsite was the sacral spine (n = 9). The median potential follow-up was 16 years. Results: The 5-year actuarial overall survival, cause-specific survival, and local control rate was 62%, 62%, and 90%, respectively. For the nonmetastatic subset (n = 22), the 5-year overall survival, cause-specific survival, and local control rate was 71%, 71%, and 89%, respectively. The local control rate was 84% for patients treated with RT alone vs. 100% for those treated with surgery plus RT. Patients who were >14 years old and those who were treated with intensive therapy demonstrated superior local control. Of 9 patients in our series with Frankel C or greater neurologic deficits at presentation, 7 experienced a full recovery with treatment. Of the 27 patients, 37% experienced Common Toxicity Criteria Grade 3 or greater toxicity, including 2 deaths from sepsis. Conclusion: Aggressive management of spinal and paraspinal Ewing tumors with RT with or without surgery results in high toxicity but excellent local control and neurologic outcomes. Efforts should be focused on identifying disease amenable to combined modality local therapy and improving RT techniques.

Indelicato, Daniel J., E-mail: dindelicato@floridaproton.or [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Keole, Sameer R. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Shahlaee, Amir H. [Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Gibbs, C. Parker; Scarborough, Mark T. [Department of Orthopedic Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Pincus, David W. [Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL (United States); Marcus, Robert B. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

2010-04-15

147

Intramedullary sarcoidosis of the cervical spinal cord.  

PubMed Central

A 26-year-old male with a history of pulmonary sarcoidosis showed clinical, myelographic and intra-operative evidence of a C5-C6 spinal cord tumour, which was diagnosed by biopsy as a pure intramedullary granuloma. Among the 29 published cases of histologically proven cord sarcoidosis, only five presented with pure parenchymatous infiltration without meningeal involvement. Corticosteroids are the most useful therapy, and surgery is indicated only for minimal biopsy when the parenchyma is invaded. Images PMID:3998754

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

1985-01-01

148

A Spinal Arteriovenous Fistula in a 3-Year Old Boy  

PubMed Central

We present a case of a 3-year-old boy with neurodegeneration. Family history reveals Rendu-Osler-Weber disease. Magnetic resonance imaging (MRI) of the spinal cord and spinal angiography showed a spinal arteriovenous fistula with venous aneurysm, causing compression of the lumbar spinal cord. Embolisation of the fistula was executed, resulting in clinical improvement. A week after discharge he was readmitted with neurologic regression. A second MRI scan revealed an intraspinal epidural haematoma and increase in size of the aneurysm with several new arterial feeders leading to it. Coiling of the aneurysm and fistulas was performed. Postoperative, the spinal oedema increased despite corticoids, causing more extensive paraplegia of the lower limbs and a deterioration of his mental state. A laminectomy was performed and the aneurysm was surgically removed. Subsequently, the boy recovered gradually. A new MRI scan after two months showed less oedema and a split, partly affected spinal chord. This case shows the importance of excluding possible arteriovenous malformations in a child presenting with progressive neurodegeneration. In particular when there is a family history for Rendu-Osler-Weber disease, scans should be performed instantly to rule out this possibility. The case also highlights the possibility of good recovery of paraplegia in paediatric Rendu-Osler-Weber patients. PMID:24707424

Crijnen, Thomas E. M.; Voormolen, Maurits H. J.; Robert, Dominique; Jorens, Philippe G.; Ramet, Jose

2014-01-01

149

SIMS and MALDI MS imaging of the spinal cord  

PubMed Central

The application of mass spectrometry to imaging, or MS imaging (MSI), allows for the direct investigation of tissue sections to identify biological compounds and determine their spatial distribution. We present an approach to MSI that combines secondary ion mass spectrometry (SIMS) and MALDI MS for the imaging and analysis of rat spinal cord sections, thereby enhancing the chemical coverage obtained from an MSI experiment. The spinal cord is organized into discrete, anatomically defined areas that include motor and sensory networks composed of chemically diverse cells. The MSI data presented here reveal the spatial distribution of multiple phospholipids, proteins, and neuropeptides obtained within single, 20-?m sections of rat spinal cord. Analyte identities are initially determined by primary mass match and confirmed in follow-up experiments using LC MS/MS from extracts of adjacent spinal cord sections. Additionally, a regional analysis of differentially localized signals serves to rapidly screen compounds of varying intensities across multiple spinal regions. These MSI analyses reveal new insights into the chemical architecture of the spinal cord and set the stage for future imaging studies of the chemical changes induced by pain, anesthesia, and drug tolerance. PMID:18712768

Monroe, Eric B.; Annangudi, Suresh P.; Hatcher, Nathan G.; Gutstein, Howard B.; Rubakhin, Stanislav S.; Sweedler, Jonathan V.

2009-01-01

150

Spinal Muscular Atrophy  

PubMed Central

Spinal muscular atrophy (SMA) is a neurodegenerative disease characterized by loss of motor neurons in the anterior horn of the spinal cord and resultant weakness. The most common form of SMA, accounting for 95% of cases, is autosomal recessive proximal SMA associated with mutations in the survival of motor neurons (SMN1) gene. Relentless progress during the past 15 years in the understanding of the molecular genetics and pathophysiology of SMA has resulted in a unique opportunity for rational, effective therapeutic trials. The goal of SMA therapy is to increase the expression levels of the SMN protein in the correct cells at the right time. With this target in sight, investigators can now effectively screen potential therapies in vitro, test them in accurate, reliable animal models, move promising agents forward to clinical trials, and accurately diagnose patients at an early or presymptomatic stage of disease. A major challenge for the SMA community will be to prioritize and develop the most promising therapies in an efficient, timely, and safe manner with the guidance of the appropriate regulatory agencies. This review will take a historical perspective to highlight important milestones on the road to developing effective therapies for SMA. PMID:21482919

Kolb, Stephen J.; Kissel, John T.

2013-01-01

151

Attitudes Towards Individuals with Spinal Cord Injuries  

ERIC Educational Resources Information Center

This paper will shed light on the lives of persons with spinal cord injuries by revealing the literature on spinal cord injuries that focuses on research that can shed light on attitudes towards persons with spinal cord injuries. The background literature related to incidences, the definition of spinal cord injury, and vocational opportunities are…

Conway, Cassandra Sligh D.; Gooden, Randy; Nowell, Jennifer; Wilson, Navodda

2010-01-01

152

Prenatal ultrasound diagnosis of open spinal dysraphism in the cervical verterbrae. Case report.  

PubMed

Spinal dysraphisms are lesions that can be identified at ultrasound screening examination from the second trimester of pregnancy, the majority being localized in the lumbosacral region. We present the case of prenatal ultrasound diagnosis of a 18 weeks fetus with cervical open dysraphism, a rare localization of open spinal dysraphisms. The alteration of cerebral normal anatomy was first identified; further examination showed the spinal defect with cervical location associated with a posterior cystic mass, the meningomyelocele. PMID:22957334

R?dulescu, Micaela; Ulmeanu, Emil Coriolan

2012-09-01

153

Dual pathology as a result of spinal stenosis and vitamin B12 deficiency  

Microsoft Academic Search

Vitamin B12 deficiency can confound the clinical assessment of patients presenting with features of spinal disorders. Speciality\\u000a practice within spinal surgery may lead the clinician to a focus upon spinal explanations for symptoms and that belief may\\u000a be reinforced by supporting imaging. In the presence of mainly sensory symptoms consideration and exclusion of non surgical\\u000a causes needs to occur. This

Mohammed Shakil Patel; Zurqa Rasul; Philip Sell

154

Electronic bypass of spinal lesions: activation of lower motor neurons directly driven by cortical neural signals  

PubMed Central

Background Lower motor neurons in the spinal cord lose supraspinal inputs after complete spinal cord injury, leading to a loss of volitional control below the injury site. Extensive locomotor training with spinal cord stimulation can restore locomotion function after spinal cord injury in humans and animals. However, this locomotion is non-voluntary, meaning that subjects cannot control stimulation via their natural “intent”. A recent study demonstrated an advanced system that triggers a stimulator using forelimb stepping electromyographic patterns to restore quadrupedal walking in rats with spinal cord transection. However, this indirect source of “intent” may mean that other non-stepping forelimb activities may false-trigger the spinal stimulator and thus produce unwanted hindlimb movements. Methods We hypothesized that there are distinguishable neural activities in the primary motor cortex during treadmill walking, even after low-thoracic spinal transection in adult guinea pigs. We developed an electronic spinal bridge, called “Motolink”, which detects these neural patterns and triggers a “spinal” stimulator for hindlimb movement. This hardware can be head-mounted or carried in a backpack. Neural data were processed in real-time and transmitted to a computer for analysis by an embedded processor. Off-line neural spike analysis was conducted to calculate and preset the spike threshold for “Motolink” hardware. Results We identified correlated activities of primary motor cortex neurons during treadmill walking of guinea pigs with spinal cord transection. These neural activities were used to predict the kinematic states of the animals. The appropriate selection of spike threshold value enabled the “Motolink” system to detect the neural “intent” of walking, which triggered electrical stimulation of the spinal cord and induced stepping-like hindlimb movements. Conclusion We present a direct cortical “intent”-driven electronic spinal bridge to restore hindlimb locomotion after complete spinal cord injury. PMID:24990580

2014-01-01

155

Thoracic Rat Spinal Cord Contusion Injury Induces Remote Spinal Gliogenesis but Not Neurogenesis or Gliogenesis in the Brain  

PubMed Central

After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis) in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC) or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn) of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU) to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord) and unaltered in neurogenic regions (dentate gyrus and SVZ) of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement. PMID:25050623

Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

2014-01-01

156

Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.  

PubMed

After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis) in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC) or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn) of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU) to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord) and unaltered in neurogenic regions (dentate gyrus and SVZ) of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement. PMID:25050623

Franz, Steffen; Ciatipis, Mareva; Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

2014-01-01

157

Multiple nocardial abscesses of cerebrum, cerebellum and spinal cord, causing quadriplegia  

Microsoft Academic Search

In this paper we present a case of a diabetic patient with nocardial abscesses of cerebrum, cerebellum and the spinal cord. The present case is the first case in the literature of solitary intramedullary abscess in cervical spinal cord, causing tetraplegia. Nocardia asteroides grew in a culture of the abscess pus. After either surgical excision or drainage of lesions, a

Ramazan Durmaz; Metin Ant Atasoy; Gül Durmaz; Baki Adapinar; Ali Arslanta?; Aydin Aydinli; Esref Tel

2001-01-01

158

Phenylbutyrate increases SMN expression in vitro: relevance for treatment of spinal muscular atrophy  

Microsoft Academic Search

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease, characterized by degeneration of the anterior horn cells of the spinal cord. SMA presents with a highly variable phenotype ranging from very severe to mild (type I–III). No cure for SMA is available at present. All forms of SMA are caused by homozygous loss of the functional survival motor neuron

Catia Andreassi; Carla Angelozzi; Francesco D Tiziano; Tiziana Vitali; Eleonora De Vincenzi; Alma Boninsegna; Marcello Villanova; Enrico Bertini; Antonella Pini; Giovanni Neri; Christina Brahe

2004-01-01

159

Double spinal dysraphism. Report of three cases.  

PubMed

The simultaneous presence of multiple spinal neural tube defects is unusual. There have been only a few of these cases reported in the literature. The authors report on three cases of double spina bifida cystica. One patient had two myelomeningoceles (MMCs) at the cervical and lumbosacral regions, one was noted to have both thoracolumbar and sacral defects, and the third presented with double MMCs at lumbar and lumbosacral levels. All three neonates in these cases underwent surgical treatment and ventriculoperitoneal (VP) shunt insertion for associated hydrocephalus. One child died at the age of 2 months despite a well-functioning VP shunt. The other two patients had no complications. Current models of neural tube closure do not thoroughly explain the mechanisms of multiple spinal dysraphism, but the multisite closure model provides a better understanding of caudal neural tube closure than other closure-site models. PMID:17465369

Keshavarzi, Sepideh; Nejat, Farideh; Kazemi, Hadi

2007-04-01

160

Potential Clinical Applications for Spinal Functional MRI  

PubMed Central

Functional MRI (fMRI) of the spinal cord is a noninvasive technique for obtaining information regarding spinal cord neuronal function. This article provides a brief overview of recent developments in spinal cord fMRI and outlines potential applications, as well as the limitations that must be overcome, for using spinal fMRI in the clinic. This technique is currently used for research purposes, but significant potential exists for spinal fMRI to become an important clinical tool. PMID:17504642

Kornelsen, Jennifer; Mackey, Sean

2010-01-01

161

Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult.  

PubMed

Neuroimaging studies for persons in the National Collaborative Chicago-Based Congenital Toxoplasmosis Study (NCCCTS) with symptoms and signs referable to the spinal cord were reviewed. Three infants had symptomatic spinal cord lesions, another infant a Chiari malformation, and another infant a symptomatic peri-spinal cord lipoma. One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age. Neuroimaging was used to establish her diagnosis and response to treatment. This 43 year-old woman with congenital toxoplasmosis developed progressive leg spasticity, weakness, numbness, difficulty walking, and decreased visual acuity and color vision without documented re-activation of her chorioretinal disease. At 52 years of age, spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan. Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms, improved her neurologic examination, and resolved her enhancing spinal cord lesions seen on MRI. PMID:23487348

Burrowes, Delilah; Boyer, Kenneth; Swisher, Charles N; Noble, A Gwendolyn; Sautter, Mari; Heydemann, Peter; Rabiah, Peter; Lee, Daniel; McLeod, Rima

2012-03-01

162

Arylsulfatase B Improves Locomotor Function after Mouse Spinal Cord Injury  

PubMed Central

Bacterial chondroitinase ABC (ChaseABC) has been used to remove the inhibitory chondroitin sulfate chains from chondroitin sulfate proteoglycans to improve regeneration after rodent spinal cord injury. We hypothesized that the mammalian enzyme arylsulfatase B (ARSB) would also enhance recovery after mouse spinal cord injury. Application of the mammalian enzyme would be an attractive alternative to ChaseABC because of its more robust chemical stability and reduced immunogenicity. A one-time injection of human ARSB into injured mouse spinal cord eliminated immunoreactivity for chondroitin sulfates within five days, and up to 9 weeks after injury. After a moderate spinal cord injury, we observed improvements of locomotor recovery assessed by the Basso Mouse Scale (BMS) in ARSB treated mice, compared to the buffer-treated control group, at 6 weeks after injection. After a severe spinal cord injury, mice injected with equivalent units of ARSB or ChaseABC improved similarly and both groups achieved significantly more locomotor recovery than the buffer-treated control mice. Serotonin and tyrosine hydroxylase immunoreactive axons were more extensively present in mouse spinal cords treated with ARSB and ChaseABC, and the immunoreactive axons penetrated further beyond the injury site in ARSB or ChaseABC treated mice than in control mice. These results indicate that mammalian ARSB improves functional recovery after CNS injury. The structural/molecular mechanisms underlying the observed functional improvement remain to be elucidated. PMID:23520469

Yoo, Myungsik; Khaled, Muntasir; Gibbs, Kurt M.; Kim, Jonghun; Kowalewski, Bjorn; Dierks, Thomas; Schachner, Melitta

2013-01-01

163

[The clinical usefulness and problem of combined spinal epidural needle].  

PubMed

The clinical usefulness of combined spinal-epidural needles, Portex Spinal/Epidural set (Pencil point tip type and Lancet point tip type), was evaluated on 30 patients undergoing orthopedic lower limb surgeries, hysterectomies or transurethral surgeries. In all the patients, the spinal-epidural needles were successfully inserted with paramedian approach without any problem. The time to appearance of cerebrospinal fluid in the spinal needle hub after removal of the stylet was 15-40 seconds, and no patient in both groups had postspinal headache. Following spinal anesthesia, the local anesthetics injected through the epidural catheter extended the analgesia in the range of 1-2 dermatomes higher in the Lancet point type group in comparison with Pencil point type group. It is possible that the hole in the dura may allow a transfer of local anesthetics into the subarachnoid space. The present study shows that combined spinal-epidural block is clinically useful, and the Pencil point type is safer than the Lancet point type. PMID:8544292

Kitamura, A; Kon, T; Kamiyama, M; Ogawa, R

1995-11-01

164

Spinal Hydatidosis Relapse: A Case Report  

PubMed Central

Human cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the Echinococcus granulosus and the most common sites affected are the liver and lung in approximately 80–90% of cases. The hydatid bone represents the 0.5–2.5% of all cases and localization cord is present about 50% of the time. This benign and commonly asymptomatic disease may simulate an aggressive malignancy because of osseous destruction and aggressive extension. We report a case of a 42-year-old male patient, presented with an unusual spinal hydatidosis relapse, related to anthelmintic drug therapy withdrawal after 10-year treatment. The man had previous excision of chest and hepatic hydatid cysts (resp., 10 and 3 years ago) and after primary mediastinal and spinal involvement (3 years ago) he was lost to follow-up and discontinued drug therapy. The patient underwent surgery and the postoperative histopathology confirmed the diagnosis. The patient recovered with no complications. Despite significant progress in diagnostic imaging, pharmacological and surgical therapy, spinal CE remains associated with high morbidity. PMID:25143850

Fiori, Roberto; Coco, Irene; Kabunda, Gisele; Umana, Giuseppe Emmanuele; Fraioli, Mario Francesco; Simonetti, Giovanni

2014-01-01

165

Unusual imaging findings in brain and spinal cord in two siblings with maple syrup urine disease.  

PubMed

Maple syrup urine disease (MSUD) is a rare metabolic disease affecting the neural tissue. While the brain abnormalities present on MRI are well known, spinal imaging features have not been studied. We herewith report an unusual finding of enlarged Virchow Robin spaces in brain and novel spinal cord changes in two biochemically diagnosed cases of MSUD. To the best of our knowledge, spinal MRI findings in cases of MSUD have not been previously reported. Knowledge of spinal MRI findings may be useful in diagnosis of this rare disorder. PMID:23279201

Bhat, Maya; Prasad, Chandrajit; Bindu, Parayil Sankaran; Aziz, Zarina; Christopher, Rita; Saini, Jitender

2013-10-01

166

Spinal deformity and athletics.  

PubMed

Exercise and athletic competition for the young individual has become increasingly more important in society. Scoliosis and Scheurmann kyphosis are spinal deformities prevalent in up to 2% to 3% and 7% of the population respectively, requiring nonoperative and occasionally operative treatment. Curve progression and patient physiologic age dictate treatment regimens. Bracing and physical therapy is the mainstay for nonoperative treatment, whereas soft tissue releases and fusion with instrumentation are used for operative correction. Athletic activity and sports participation is usually allowed for patients undergoing nonoperative treatment. Return to sport after surgical correction is variable, often decided by the treating surgeon, and based on the level of fusion and sporting activity. Although most treating surgeons promote some form of activity regardless of treatment modality chosen, caution should be taken when deciding on participation in collision activities such as football and wrestling. PMID:18277259

Schiller, Jonathan R; Eberson, Craig P

2008-03-01

167

Therapy of Acute and Delayed Spinal Infections after Spinal Surgery Treated with Negative Pressure Wound Therapy in Adult Patients  

PubMed Central

We present the results of the treatment of infected primary or delayed spine wounds after spinal surgery using negative pressure wound therapy. In our institution (University Hospital Zurich, Switzerland) nine patients (three women and six men; mean age 68.6, range 43-87 years) were treated in the period between January to December 2011 for non-healing spinal wounds. The treatment consisted of repeated debridements, irrigation and temporary closure with negative pressure wound therapy system. Three patients were admitted with a spinal epidural abscess; two with osteoporotic lumbar fracture; two with pathologic vertebra fracture and spinal cord compression, and two with vertebra fracture after trauma. All nine patients have been treated with antibiotic therapy. In one case the hardware has been removed, in three patients laminectomy was performed without instrumentation, in five patients there was no need to remove the hardware. The average hospital stay was 16.6 days (range 11-30). The average follow-up was 3.8, range 0.5-14 months. The average number of negative pressure wound therapy procedures was three, with the range 1-11. Our retrospective study focuses on the clinical problems faced by the spinal surgeon, clinical outcomes after spinal surgery followed by wound infection, and negative pressure wound therapy. Moreover, we would like to emphasize the importance for the patients and their relatives to be fully informed about the increased complications of surgery and about the limitations of treatment of these wounds with negative pressure wound therapy. PMID:24416474

Zwolak, Pawel; Konig, Matthias Alexander; Osterhoff, Georg; Wilzeck, Verena; Simmen, Hans-Peter; Jukema, Gerrolt Nico

2013-01-01

168

Epidural lipomatosis and congenital small spinal canal in spinal anaesthesia: a case report and review of the literature  

PubMed Central

Introduction Complications after lumbar anaesthesia and epidural blood patch have been described in patients with congenital small spinal canal and increased epidural fat or epidural lipomatosis. These conditions, whether occurring separately or in combination, require magnetic resonance imaging for diagnosis and grading, but their clinical significance is still unclear. Case presentation A 35-year-old Caucasian woman who was undergoing a Caesarean section developed a longstanding L4-L5 unilateral neuropathy after the administration of spinal anaesthesia. There were several attempts to correctly position the needle, one of which resulted in paraesthesia. A magnetic resonance image revealed that the patient's bony spinal canal was congenitally small and had excess epidural fat. The cross-sectional area of the dural sac was then reduced, which left practically no free cerebrospinal fluid space. Conclusion The combination of epidural lipomatosis of varying degrees and congenital small spinal canal has not been previously discussed with spinal anaesthesia. Due to the low cerebrospinal fluid content of the small dural sac, the cauda equina becomes a firm system with a very limited possibility for the nerve roots to move away from the puncture needle when it is inserted into the dural sac. This constitutes risks of technical difficulties and neuropathies with spinal anaesthesia. PMID:20062767

2009-01-01

169

Adjustment to Spinal Cord Injury  

MedlinePLUS

... to adjusting to spinal cord injury is personal motivation . Individuals who are newly injured are often motivated ... to find purpose in your life and the motivation to achieve your goals. It may help to ...

170

Depression and Spinal Cord Injury  

MedlinePLUS

... colleagues, with an educational grant from Pfizer Inc. University of Washington-operated SCI Clinics: Harborview Medical Center ... Spinal Cord Injury Clinic nurses: 206-744-5862 University of Washington Medical Center Rehabilitation Medicine Clinic 1959 ...

171

Hyponatraemia after acute spinal injury.  

PubMed

Of 134 patients admitted to the Midlands Centre for Spinal Injuries within 2 days of the spinal injury during 1991-1992, 25 developed hyponatraemia in the acute phase. Hyponatraemia was most common among patients with complete tetraplegia (45 per cent) and these patients tended to be younger as well as have more severe and prolonged hyponatraemia. Overhydration is a common cause of hyponatraemia in this group of patients and should be avoided. PMID:8288360

Biyani, A; Inman, C G; el Masry, W S

1993-12-01

172

Biomechanical implications of lumbar spinal ligament transection.  

PubMed

Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment. PMID:23477405

Von Forell, Gregory A; Bowden, Anton E

2014-11-01

173

Tumefactive demyelinating disease with isolated spinal cord involvement  

PubMed Central

Tumefactive multiple sclerosis (TMS) is an unusual variant of demyelinating disease. TMS has a variable and unknown progression and presents with features similar to a neoplasm making the determination a diagnostic challenge to clinicians. This report presents one of the very few reported cases of isolated spinal cord TMS, and the second case to describe TMS of the lower spinal cord, given that the lesions are typically cervical. This case study presents a diagnostic approach based on clinical, laboratory, and imaging characteristics, as well as sheds some light on the response to therapy and disease evolution. PMID:25298871

Kirsch, Claudia F

2014-01-01

174

Effect of Spinal Cord Compression on Local Vascular Blood Flow and Perfusion Capacity  

PubMed Central

Spinal cord injury (SCI) can induce prolonged spinal cord compression that may result in a reduction of local tissue perfusion, progressive ischemia, and potentially irreversible tissue necrosis. Due to the combination of risk factors and the varied presentation of symptoms, the appropriate method and time course for clinical intervention following SCI are not always evident. In this study, a three-dimensional finite element fluid-structure interaction model of the cervical spinal cord was developed to examine how traditionally sub-clinical compressive mechanical loads impact spinal arterial blood flow. The spinal cord and surrounding dura mater were modeled as linear elastic, isotropic, and incompressible solids, while blood was modeled as a single-phased, incompressible Newtonian fluid. Simulation results indicate that anterior, posterior, and anteroposterior compressions of the cervical spinal cord have significantly different ischemic potentials, with prediction that the posterior component of loading elevates patient risk due to the concomitant reduction of blood flow in the arterial branches. Conversely, anterior loading compromises flow through the anterior spinal artery but minimally impacts branch flow rates. The findings of this study provide novel insight into how sub-clinical spinal cord compression could give rise to certain disease states, and suggest a need to monitor spinal artery perfusion following even mild compressive loading. PMID:25268384

Alshareef, Mohammed; Krishna, Vibhor; Ferdous, Jahid; Alshareef, Ahmed; Kindy, Mark; Kolachalama, Vijaya B.; Shazly, Tarek

2014-01-01

175

Effect of spinal cord compression on local vascular blood flow and perfusion capacity.  

PubMed

Spinal cord injury (SCI) can induce prolonged spinal cord compression that may result in a reduction of local tissue perfusion, progressive ischemia, and potentially irreversible tissue necrosis. Due to the combination of risk factors and the varied presentation of symptoms, the appropriate method and time course for clinical intervention following SCI are not always evident. In this study, a three-dimensional finite element fluid-structure interaction model of the cervical spinal cord was developed to examine how traditionally sub-clinical compressive mechanical loads impact spinal arterial blood flow. The spinal cord and surrounding dura mater were modeled as linear elastic, isotropic, and incompressible solids, while blood was modeled as a single-phased, incompressible Newtonian fluid. Simulation results indicate that anterior, posterior, and anteroposterior compressions of the cervical spinal cord have significantly different ischemic potentials, with prediction that the posterior component of loading elevates patient risk due to the concomitant reduction of blood flow in the arterial branches. Conversely, anterior loading compromises flow through the anterior spinal artery but minimally impacts branch flow rates. The findings of this study provide novel insight into how sub-clinical spinal cord compression could give rise to certain disease states, and suggest a need to monitor spinal artery perfusion following even mild compressive loading. PMID:25268384

Alshareef, Mohammed; Krishna, Vibhor; Ferdous, Jahid; Alshareef, Ahmed; Kindy, Mark; Kolachalama, Vijaya B; Shazly, Tarek

2014-01-01

176

Activation of p38 mitogen-activated protein kinase in spinal microglia is a critical link in inflammation-induced spinal pain processing.  

PubMed

We examined the effect of p38 mitogen-activated protein kinase (MAPK) inhibitors in models of nociception and correlated this effect with localization and expression levels of p38 MAPK in spinal cord. There was a rapid increase in phosphorylated p38 MAPK in spinal cord following intrathecal administration of substance P or intradermal injection of formalin. Immunocytochemistry revealed that phosphorylated p38 MAPK-immunoreactive cells were predominantly present in laminae I-IV of the dorsal horn. Double-staining with markers for neurons, microglia, astrocytes and oligodendrocytes unexpectedly revealed co-localization with microglia but not with neurons or other glia. Pretreatment with p38 MAPK inhibitors (SB20358 or SD-282) had no effect on acute thermal thresholds. However, they attenuated hyperalgesia in several nociceptive models associated with spinal sensitization including direct spinal activation (intrathecal substance P) and peripheral tissue inflammation (intraplantar formalin or carrageenan). Spinal sensitization, manifested by enhanced expression of cyclo-oxygenase-2 and inflammation-induced appearance of Fos-positive neurons, was blocked by pretreatment, but not post-treatment, with p38 MAPK inhibitors. Taken together, these results indicate that spinal p38 MAPK is involved in inflammation-induced pain and that activated spinal microglia play a direct role in spinal nociceptive processing. PMID:12950462

Svensson, Camilla I; Marsala, Martin; Westerlund, Anna; Calcutt, Nigel A; Campana, Wendy M; Freshwater, Jason D; Catalano, Rosanne; Feng, Ying; Protter, Andrew A; Scott, Brian; Yaksh, Tony L

2003-09-01

177

Prophylactic ephedrine and hypotension associated with spinal anesthesia for cesarean delivery  

Microsoft Academic Search

Hypotension commonly accompanies induction of spinal anesthesia for cesarean section. To determine whether intravenous ephedrine prophylaxis would benefit prehydrated obstetrical patients presenting for elective cesarean section, we studied 30 patients randomly assigned to one of three experimental groups. All patients were preloaded with crystalloid (15 ml\\/kg), given spinal anesthesia and positioned with left uterine displacement (LUD). During induction, all patients

S. W. King; M. A. Rosen

1998-01-01

178

In utero Spontaneous Cervical Thoracic Epidural Hematoma Imitating Spinal Cord Birth Injury  

Microsoft Academic Search

A neonate male born cesarian due to a breech presentation was noted to have no spontaneous movements of the limbs after delivery. Radiographs were not demonstrative of pathology. However, MRI revealed a large intraspinal mass with significant distortion of the cervicothoracic spinal cord. At operation, a brown, fibro-gelatinous, moderately adherent mass was evident extradurally dorsal to the spinal cord. It

Jeffrey Blount; Kyle Doughty; R. Shane Tubbs; John C. Wellons; Alyssa Reddy; Charlie Law; Virginia Karle; W. Jerry Oakes

2004-01-01

179

Large subpial lipoma of the dorsolumbar spinal cord in a pediatric patient  

Microsoft Academic Search

BackgroundIsolated spinal cord lipoma in the absence of congenital abnormalities is a rare cause of compressive myeloradiculopathy and accounts only for about 1% of all intraspinal tumors. We present an extensive subpial dorsolumbar spinal cord lipoma in a child with mild neurological symptoms and scoliosis.

Petra Braun; Francisco Menor Serrano; Khuram Kazmi; Jose Joaquín Alvarez-Garrijo

2006-01-01

180

Controlled superfusion of the rat spinal cord for studying non-synaptic transmission: an autoradiographic analysis  

Microsoft Academic Search

Recently, evidence has been raised that long-term changes in the central nervous system are mediated by extrasynaptic spread of neuropeptides (‘volume transmission’). To study the effects of volume transmission in the spinal cord we developed the technique of controlled superfusion of the rat cord dorsum. This paper presents quantitative data about the spread, local spinal tissue concentration and redistribution of

Heidemarie Beck; Helmut Schröck; Jürgen Sandkühler

1995-01-01

181

Assessment of Spinal Curvature: An Evaluation of the Flexicurve and Associated Means of Analysis.  

ERIC Educational Resources Information Center

Several interrelated issues pertaining to the measurement of spinal curvature are discussed, including the inherent limitations of the kyphotic index, the most widely used indicator in the evaluation of kyphosis. The paper suggests use of the Flexicurve to quantify spinal posture, suggests modifications to the Flexicurve, and presents results on…

Caine, M. P.; And Others

1996-01-01

182

Effectiveness of a sex education and counseling program for spinal cord injured patients  

Microsoft Academic Search

While there has been an increase in research and clinical interest in the sexual functioning of spinal cord injured persons and their partners, little has been reported of the effectiveness of sexual education and counseling procedures with this group of patients. The present study reported on a sex education and counseling program for spinal cord patients, an instrument used to

Jo Ann Brockway; Jeffrey C. Steger; Rosemarian Berni; Vione V. Ost; Thomas E. Williamson-Kirkland; Connie L. Peck

1978-01-01

183

Inhibition of tolerance to spinal morphine antinociception by low doses of opioid receptor antagonists  

Microsoft Academic Search

Ultra-low doses of opioid receptor antagonists inhibit development of chronic spinal morphine tolerance. As this phenomenon mechanistically resembles acute tolerance, the present study examined actions of opioid receptor antagonists on acute spinal morphine tolerance. In adult rats, administration of three intrathecal injections of morphine (15 ?g) at 90 min intervals produced a significant decline of the antinociceptive effect and loss of agonist

Benjamin McNaull; Tuan Trang; Maaja Sutak; Khem Jhamandas

2007-01-01

184

Pathophysiology of primary spinal syringomyelia  

PubMed Central

Object The pathogenesis of syringomyelia in patients with an associated spinal lesion is incompletely understood. The authors hypothesized that in primary spinal syringomyelia, a subarachnoid block effectively shortens the length of the spinal subarachnoid space (SAS), reducing compliance and the ability of the spinal theca to dampen the subarachnoid CSF pressure waves produced by brain expansion during cardiac systole. This creates exaggerated spinal subarachnoid pressure waves during every heartbeat that act on the spinal cord above the block to drive CSF into the spinal cord and create a syrinx. After a syrinx is formed, enlarged subarachnoid pressure waves compress the external surface of the spinal cord, propel the syrinx fluid, and promote syrinx progression. Methods To elucidate the pathophysiology, the authors prospectively studied 36 adult patients with spinal lesions obstructing the spinal SAS. Testing before surgery included clinical examination; evaluation of anatomy on T1-weighted MRI; measurement of lumbar and cervical subarachnoid mean and pulse pressures at rest, during Valsalva maneuver, during jugular compression, and after removal of CSF (CSF compliance measurement); and evaluation with CT myelography. During surgery, pressure measurements from the SAS above the level of the lesion and the lumbar intrathecal space below the lesion were obtained, and cardiac-gated ultrasonography was performed. One week after surgery, CT myelography was repeated. Three months after surgery, clinical examination, T1-weighted MRI, and CSF pressure recordings (cervical and lumbar) were repeated. Clinical examination and MRI studies were repeated annually thereafter. Findings in patients were compared with those obtained in a group of 18 healthy individuals who had already undergone T1-weighted MRI, cine MRI, and cervical and lumbar subarachnoid pressure testing. Results In syringomyelia patients compared with healthy volunteers, cervical subarachnoid pulse pressure was increased (2.7 ± 1.2 vs 1.6 ± 0.6 mm Hg, respectively; p = 0.004), pressure transmission to the thecal sac below the block was reduced, and spinal CSF compliance was decreased. Intraoperative ultrasonography confirmed that pulse pressure waves compressed the outer surface of the spinal cord superior to regions of obstruction of the subarachnoid space. Conclusions These findings are consistent with the theory that a spinal subarachnoid block increases spinal subarachnoid pulse pressure above the block, producing a pressure differential across the obstructed segment of the SAS, which results in syrinx formation and progression. These findings are similar to the results of the authors' previous studies that examined the pathophysiology of syringomyelia associated with obstruction of the SAS at the foramen magnum in the Chiari Type I malformation and indicate that a common mechanism, rather than different, separate mechanisms, underlies syrinx formation in these two entities. Clinical trial registration no.: NCT00011245. (http://thejns.org/doi/abs/10.3171/2012.8.SPINE111059) PMID:22958075

Heiss, John D.; Snyder, Kendall; Peterson, Matthew M.; Patronas, Nicholas J.; Butman, John A.; Smith, Rene K.; DeVroom, Hetty L.; Sansur, Charles A.; Eskioglu, Eric; Kammerer, William A.; Oldfield, Edward H.

2013-01-01

185

Dexmedetomidine for an awake fiber-optic intubation of a parturient with Klippel-Feil syndrome, Type I Arnold Chiari malformation and status post released tethered spinal cord presenting for repeat cesarean section  

PubMed Central

Patients with Klippel-Feil Syndrome (KFS) have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, airway management in these patients can be a challenge for the anesthesiologist. We describe a unique case in which a dexmedetomidine infusion was used as sedation for an awake fiber-optic intubation in a parturient with Klippel-Feil Syndrome, who presented for elective cesarean delivery. A 36-year-old female, G2P1A0 with KFS (fusion of cervical vertebrae) who had prior cesarean section for breech presentation with difficult airway management was scheduled for repeat cesarean delivery. After obtaining an informed consent, patient was taken in the operating room and non-invasive monitors were applied. Dexmedetomidine infusion was started and after adequate sedation, an awake fiber-optic intubation was performed. General anesthetic was administered after intubation and dexmedetomidine infusion was continued on maintenance dose until extubation. Klippel-Feil Syndrome (KFS) is a rare congenital disorder for which the true incidence is unknown, which makes it even rare to see a parturient with this disease. Patients with KFS usually have other congenital abnormalities as well, sometimes including the whole thoraco-lumbar spine (Type III) precluding the use of neuraxial anesthesia for these patients. Obstetric patients with KFS can present unique challenges in administering anesthesia and analgesia, primarily as it relates to the airway and dexmedetomidine infusion has shown promising result to manage the airway through awake fiberoptic intubation without any adverse effects on mother and fetus. PMID:24765318

Shah, Tanmay H.; Badve, Manasi S.; Olajide, Kowe O.; Skorupan, Havyn M.; Waters, Jonathan H.; Vallejo, Manuel C.

2011-01-01

186

Fully automatic stitching of diffusion tensor images in spinal cord.  

PubMed

Diffusion tensor imaging (DTI) has become an important tool for studying the spinal cord pathologies. To enable high resolution imaging for modern studies, the DTI technique utilizes a small field of view (FOV) to capture partial human spinal cords. However, normal aging and many other diseases which affect the entire spinal cord increase the desire of acquiring the continuous full-view of the spinal cord. To overcome this problem, this paper presents a novel pipeline for automatic stitching of three-dimensional (3D) DTI of different portions of the spinal cord. The proposed technique consists of two operations, e.g. feature-based registration and adaptive composition to stitch every source image together to create a panoramic image. In the feature-based registration process, feature points are detected from the apparent diffusion coefficient map, and then a novel feature descriptor is designed to characterize feature points directly from a tensor neighborhood. 3D affine transforms are achieved by determining the correspondence matching. In the adaptive composition process, an effective feathering approach is presented to compute the tensors in the overlap region by the Log-Euclidean metrics. We evaluate the algorithm on real datasets from one healthy subject and one adolescent idiopathic scoliosis (AIS) patient. The colored FA maps and fiber tracking results show the effectiveness and accuracy of the proposed stitching framework. PMID:22771288

Wang, Defeng; Kong, Youyong; Shi, Lin; Ahuja, Anil A T; Cheng, Jack C Y; Chu, Winnie C W

2012-08-15

187

Early embryonic development of the camel lumbar spinal cord segment.  

PubMed

The lumbar spinal cord segment of the one-humped camel (Camelus dromedarius) embryos at 2.4- to 28-cm crown vertebral rump length (CVRL) was examined. Major changes are occurring in the organization of the lumbar spinal cord segment at this early developmental period. At first, the spinal cord is flattened from side to side but with increase in gestational age it becomes flattened dorsoventrally. The size and shape of the lumen changes in indifferent stage of development. These changes may be in relation to the decrease of ependymal layer and increase of the mantel layer during the developmental stages. The lumen of the spinal cord is a wide spindle in shape at 2.4-cm CVRL, diamond in shape at 5.5-cm CVRL and narrow oval in shape at 28-cm CVRL. It occupies about the whole, half and one-seventh of the total height of the spinal cord at 2.4-, 5.5- and 28-cm CVRL, respectively. At the 2.4-2.7 CVRL, the spinal cord is formed of six plates: roof, floor, two alar and two basal plates. The present investigation indicates that the distribution of the ependymal, mantle and marginal layers differs in the various developmental stages of the camel embryos. The majority of the cross section of the spinal cord consists at first of ependymal and mantle layers, and a thin outer rim of the marginal layer. With the advancement of age, the ependymal layer diminishes in size, while the mantle and marginal layers increase in size forming the future grey and white matters, respectively. PMID:17266667

Elmonem, M E A; Mohamed, S A; Aly, K H

2007-02-01

188

The role of prophylactic spinal irradiation in localized intracranial ependymoma  

SciTech Connect

A review of the clinical literature on ependymoma, published between 1969 and 1989, was carried out to assess the influence of tumor grade and site, tumor control at the primary site, and extent of irradiation on the incidence of spinal seeding after initial treatment. The pooled data show that the incidence of seeding was 8.4% (7/83) for high grade tumors and 4.5% (6/132) for low grade tumors. Seeding occurred more frequently in infratentorial tumors than in supratentorial tumors. For high grade tumors the incidence was 0% (0/26) for supratentorial and 15.7% (6/38) for infratentorial lesions; for low grade tumors the respective incidence was 2.7% (1/37) and 5.5% (4/73). Spinal seeding was 9.5% (15/157) in the event of failure at the primary site compared to 3.3% (4/122) when local control was achieved. The development of spinal metastases was not influenced by the extent of irradiation. For high grade tumors the incidence was 9.4% (5/53) with spinal irradiation and 6.7% (2/30) without prophylactic treatment; for low grade tumors the respective values were 9.3% (4/43) and 2.2% (2/89). These results indicate that tumor grade, tumor localization, and control of the tumor at the primary site are all factors which may influence the risk of spinal seeding. On the present evidence spinal metastases are not prevented by prophylactic spinal irradiation, regardless of tumor grade and site.

Vanuytsel, L.; Brada, M. (Royal Marsden Hospital, Sutton, Surrey (England))

1991-08-01

189

Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient: Case report.  

PubMed

Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation. The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10-11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs. This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years. PMID:25002238

Dlouhy, Brian J; Awe, Olatilewa; Rao, Rajesh C; Kirby, Patricia A; Hitchon, Patrick W

2014-10-01

190

The role of BDNF in spinal learning  

E-print Network

Previous research in our laboratory has shown that the spinal cord is capable of a simple form of instrumental learning. Spinally transected rats that receive controllable shock to an extended hindlimb exhibit a progressive increase in flexion...

Huie, John Russell

2009-05-15

191

Effect of spinal cord injury upon prostate: adenocarcinoma of prostate in a spinal cord injury patient - a case report  

PubMed Central

Introduction Following spinal cord injury, prostate undergoes atrophy probably due to interruption of neuro-hormonal pathways. The incidence of carcinoma of prostate is lower in patients with spinal cord injury above T-10 than in those with lesion below T-10. Case presentation A Caucasian male sustained T-4 paraplegia in 1991 at the age of 59-years. He had long-term indwelling urethral catheter. In May 1995, routine blood test showed prostate-specific antigen to be 17.7 mg/ml. Prostate biopsy revealed moderately differentiated primary adenocarcinoma of prostate; Gleason score was 3+3. Bone scans showed no evidence of metastatic bone disease. Bilateral orchidectomy was performed in September 1995. MRI of pelvis revealed no evidence of spread beyond prostatic capsule. There was no pelvic lymphadenopathy. In October 1996, this patient got chest infection and recovered fully after taking amoxicillin. In February 2001, he developed pneumonia and was prescribed cefuroxime intravenously. In March 2001, cystoscopy and electrohydraulic lithotripsy of vesical calculi were carried out. In August 2001, this patient was admitted to spinal unit for management of pressure sores. He expired on 28 June 2002 in local hospital. Cause of death was recorded as acute ventricular failure, congestive heart failure, chronic respiratory failure and spinal cord injury. Conclusion Although prostate gland undergoes atrophy in men who sustained spinal cord injury in early age, physicians should be vigilant and look for prostatic diseases particularly in men, who have sustained spinal cord injury during later period of life. Patients with cervical and upper dorsal lesions are at risk of developing potentially life-threatening chest complications after major surgical procedures including radical prostatectomy. Therefore, it may be advisable to consider chemoprevention of prostate cancer with Finasteride, especially in men, who sustained cervical and upper dorsal spinal cord injury during later part of their life. PMID:20062548

2009-01-01

192

Persistent pain is dependent on spinal mitochondrial antioxidant levels.  

PubMed

Reactive oxygen species (ROS) scavengers have been shown to relieve persistent pain; however, the mechanism is not clearly understood. Superoxide produced from mitochondrial oxidative phosphorylation is considered the major source of ROS in neurons during excitation where mitochondrial superoxide levels are normally controlled by superoxide dismutase (SOD-2). The present study hypothesizes that capsaicin-induced secondary hyperalgesia is a consequence of superoxide build-up in spinal dorsal horn neurons and SOD-2 is a major determinant. To test this hypothesis, the spinal levels of SOD-2 activity, inactivated SOD-2 proteins, and mitochondrial superoxide were measured and correlated to the levels of capsaicin-induced secondary hyperalgesia in mice with and without SOD-2 manipulations. The data suggest that superoxide accumulation is a culprit in the abnormal sensory processing in the spinal cord in capsaicin-induced secondary hyperalgesia. Our studies also support the notion that SOD-2 nitration is a critical mechanism that maintains elevated superoxide levels in the spinal cord after capsaicin treatment. Finally, our findings suggest a therapeutic potential for the manipulation of spinal SOD-2 activity in pain conditions. PMID:19129394

Schwartz, Erica S; Kim, Hee Young; Wang, Jigong; Lee, Inhyung; Klann, Eric; Chung, Jin Mo; Chung, Kyungsoon

2009-01-01

193

Aging with Spinal Cord Injury: Selected Topics  

Microsoft Academic Search

Spinal cord injury is a complex condition with many chal- lenging issues and co-morbid conditions. Aging with spinal cord injury adds to the complexity and can threaten the individual's independence. Some common medical complications associated with spinal cord injury and the effects of aging will be highlighted, to include the genitourinary system, the musculoskeletal system and pain, and the skin,

Deborah G. Stewart

194

Stem Cells for Spinal Cord Repair  

Microsoft Academic Search

The spinal cord is the main relay for signals between the brain and the body. Spinal cord injury completely or partially deprives the individual of mobility and sensory input as well as autonomic nervous system control below the level of the lesion. The major- ity of spinal cord injuries affect the cervical segments, leaving the patient para- or tetraplegic depending

Fanie Barnabe; Jonas Frisen

2008-01-01

195

Spinal Exostosis in a Boy with Multiple Hereditary Exostoses  

PubMed Central

We report on a 13-year-old boy who presented with multiple hereditary exostosis and had development of back pain, associated with neurological deficits, and was found to have exostoses in the spinal canal. Spine radiograph showed a cauliflower-like abnormality of multiple exostoses of the posterior arch (pedicle) of the thoracic vertebrae (T3–5). Reformatted CT scanning revealed the simultaneous development of intra- and extraspinal osteochondromatosis of T3–5. The spinal cord was compressed by the intraspinal exostosis. Our patient was surgically treated for intraspinal exostoses and showed cessation of neurological deficits. We report what might be a rare association of spinal cord compression in a patient with multiple hereditary exostoses. PMID:24324905

Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

2013-01-01

196

Spinal fracture in a dog with diffuse idiopathic skeletal hyperostosis.  

PubMed

A six-year-old, spayed female Weimaraner dog was first presented with the complaint of hindlimb paresis and then hindlimb paralysis two years later after colliding with a tree. Radiographs and computed tomography revealed spinal fractures at lumbar vertebrae (L)2-3 and at L4-5. In addition, the spinal column was affected by new bone formation along the vertebral bodies, bridging the disc spaces, as seen in diffuse idiopathic skeletal hyperostosis (DISH). Open reduction and internal fixation was achieved with standard vertebral body plating. This is the first report of DISH-associated spinal fractures after minor trauma in a dog. Surgery resulted in return of the full function after the first, and in improvement of neurologic function after the second incident. PMID:23154408

Kornmayer, M; Burger, M; Amort, K; Brunnberg, L

2013-01-01

197

Isolated spinal neurosarcoidosis: An enigmatic intramedullary spinal cord pathology-case report and review of the literature  

PubMed Central

Isolated spinal cord neurosarcoidosis (NS) in the absence of systemic disease or intracranial involvement is exceptionally rare. Adjunctive laboratory tests though useful may not be reliable and the absence of any pathognomonic radiological features makes the diagnosis difficult. As spinal cord NS may be a presenting feature of systemic sarcoidosis which may be occult on routine workup, 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) may be of value in unraveling this systemic involvement avoiding biopsying the spinal cord. A case of truly isolated NS is described with review of literature on this enigmatic pathology. Long segment intramedullary signal changes with focal parenchymal along with dural/meningeal enhancement in the absence of significant cervical stenosis in a young patient of northern European or African-American decent is very suggestive of NS and although may be presumably treated with steroids; there should be a low threshold for spinal cord biopsy especially in the absence of response to steroids to confirm isolated spinal cord NS in a patient with clinical neurological deterioration. PMID:24744567

Kasliwal, Manish K.; Harbhajanka, Aparna; Nag, Sukriti; O'Toole, John E.

2013-01-01

198

Isolated spinal neurosarcoidosis: An enigmatic intramedullary spinal cord pathology-case report and review of the literature.  

PubMed

Isolated spinal cord neurosarcoidosis (NS) in the absence of systemic disease or intracranial involvement is exceptionally rare. Adjunctive laboratory tests though useful may not be reliable and the absence of any pathognomonic radiological features makes the diagnosis difficult. As spinal cord NS may be a presenting feature of systemic sarcoidosis which may be occult on routine workup, (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) may be of value in unraveling this systemic involvement avoiding biopsying the spinal cord. A case of truly isolated NS is described with review of literature on this enigmatic pathology. Long segment intramedullary signal changes with focal parenchymal along with dural/meningeal enhancement in the absence of significant cervical stenosis in a young patient of northern European or African-American decent is very suggestive of NS and although may be presumably treated with steroids; there should be a low threshold for spinal cord biopsy especially in the absence of response to steroids to confirm isolated spinal cord NS in a patient with clinical neurological deterioration. PMID:24744567

Kasliwal, Manish K; Harbhajanka, Aparna; Nag, Sukriti; O'Toole, John E

2013-07-01

199

Spinal cord stimulation for neuropathic pain: current perspectives  

PubMed Central

Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remains underused. In the last 10 to 15 years, it has undergone constant technical advancement. This review gives an overview of the present practice of spinal cord stimulation for chronic neuropathic pain and current developments such as high-frequency stimulation and peripheral nerve field stimulation.

Wolter, Tilman

2014-01-01

200

Clinical and genetic diversity of SMN1-negative proximal spinal muscular atrophies  

PubMed Central

Hereditary spinal muscular atrophy is a motor neuron disorder characterized by muscle weakness and atrophy due to degeneration of the anterior horn cells of the spinal cord. Initially, the disease was considered purely as an autosomal recessive condition caused by loss-of-function SMN1 mutations on 5q13. Recent developments in next generation sequencing technologies, however, have unveiled a growing number of clinical conditions designated as non-5q forms of spinal muscular atrophy. At present, 16 different genes and one unresolved locus are associated with proximal non-5q forms, having high phenotypic variability and diverse inheritance patterns. This review provides an overview of the current knowledge regarding the phenotypes, causative genes, and disease mechanisms associated with proximal SMN1-negative spinal muscular atrophies. We describe the molecular and cellular functions enriched among causative genes, and discuss the challenges in the post-genomics era of spinal muscular atrophy research. PMID:24970098

Jordanova, Albena

2014-01-01

201

Microsurgical resection of intramedullary spinal cord cavernous malformation. Operative video and technical nuances.  

PubMed

Intramedullary spinal cord cavernous malformations account for approximately 5% of all intraspinal lesions. These lesions can present with either acute neurological compromise secondary to hemorrhage inside the spinal cord, or with chronic progressive myelopathy due to repeated microhemorrhages. Surgical resection of spinal cord cavernous malformations remains the definitive treatment strategy for symptomatic lesions. Because of the intimate relationship with surrounding eloquent neural tissue, these lesions can be technically challenging to remove with a significant risk for morbidity. In this operative video, the author demonstrates an illustrative step-by-step technique for microsurgical resection of a large intramedullary spinal cord cavernous malformation at C4-5 causing progressive myelopathy. Complete resection was achieved without neurologic compromise. The operative technique and surgical nuances, including the surgical approach, intradural cavernoma removal, and spinal stabilization are illustrated. The video can be found here: http://youtu.be/3FUjGSyrKO0. PMID:25175570

Liu, James K

2014-09-01

202

A ‘tool box’ for deciphering neuronal circuits in the developing chick spinal cord  

PubMed Central

The genetic dissection of spinal circuits is an essential new means for understanding the neural basis of mammalian behavior. Molecular targeting of specific neuronal populations, a key instrument in the genetic dissection of neuronal circuits in the mouse model, is a complex and time-demanding process. Here we present a circuit-deciphering ‘tool box’ for fast, reliable and cheap genetic targeting of neuronal circuits in the developing spinal cord of the chick. We demonstrate targeting of motoneurons and spinal interneurons, mapping of axonal trajectories and synaptic targeting in both single and populations of spinal interneurons, and viral vector-mediated labeling of pre-motoneurons. We also demonstrate fluorescent imaging of the activity pattern of defined spinal neurons during rhythmic motor behavior, and assess the role of channel rhodopsin-targeted population of interneurons in rhythmic behavior using specific photoactivation. PMID:25147209

Hadas, Yoav; Etlin, Alex; Falk, Haya; Avraham, Oshri; Kobiler, Oren; Panet, Amos; Lev-Tov, Aharon; Klar, Avihu

2014-01-01

203

Causes of Spinal Cord Injury  

PubMed Central

Background: Knowledge of the causes of spinal cord injury (SCI) and associated factors is critical in the development of successful prevention programs. Objective: This study analyzed data from the National SCI Database (NSCID) and National Shriners SCI Database (NSSCID) in the United States to examine specific etiologies of SCI by age, sex, race, ethnicity, day and month of injury, and neurologic outcomes. Methods: NSCID and NSSCID participants who had a traumatic SCI from 2005 to 2011 with known etiology were included in the analyses (N=7,834). Thirty-seven causes of injury documented in the databases were stratified by personal characteristics using descriptive analysis. Results: The most common causes of SCI were automobile crashes (31.5%) and falls (25.3%), followed by gunshot wounds (10.4%), motorcycle crashes (6.8%), diving incidents (4.7%), and medical/surgical complications (4.3%), which collectively accounted for 83.1% of total SCIs since 2005. Automobile crashes were the leading cause of SCI until age 45 years, whereas falls were the leading cause after age 45 years. Gunshot wounds, motorcycle crashes, and diving caused more SCIs in males than females. The major difference among race/ethnicity was in the proportion of gunshot wounds. More SCIs occurred during the weekends and warmer months, which seemed to parallel the increase of motorcycle- and diving-related SCIs. Level and completeness of injury are also associated with etiology of injury. Conclusions: The present findings suggest that prevention strategies should be tailored to the targeted population and major causes to have a meaningful impact on reducing the incidence of SCI. PMID:23678280

2013-01-01

204

Effects of Verapamil on Spinal Anesthesia with Local Anesthetics  

Microsoft Academic Search

The primary mode of action of local anesthetics is through sodium channel and axonal conduction block- ade. Local anesthetics also have extensive effects on presynaptic calcium channels that must function to stimulate the release of neurotransmitters. Thus, inter- ference with calcium channel conductance may en- hance spinal anesthesia with local anesthetics. The present study was designed to investigate the effects

KEIICHI OMOTE; HIROSHI IWASAKI; MIKITO KAWAMATA; OSAMU SATOH

1995-01-01

205

Protective Effect of Sildenafil (Viagra) in Transient Spinal Cord Ischemia  

Microsoft Academic Search

Prospective study of the neuroprotective activity of sildenafil in a rat spinal ischemia model. The present study involved 21 male Sprague-Dawley rats. The animals were divided into 3 groups. Physiological serum was administered intraperitoneally to the 8 rats in the control group at the beginning of reperfusion for a period of 20 min after abdominal aortal occlusion. Sildenafil (Viagra®) was

Ömer Anlar; Süleyman Özen

2008-01-01

206

Spinal epidural hematoma after intravenous thrombolysis for acute ischemic stroke  

Microsoft Academic Search

Intracranial bleeding is an important and dangerous complication associated with thrombolytic therapy for acute ischemic stroke. Spinal hemorrhage has been reported after systemic thrombolysis for various conditions other than acute ischemic stroke. Our patient presented with an acute ischemic stroke and showed significant clinical recovery during intravenous thrombolysis. CT scan of the brain, performed about 6 h later due to neurological

Leonard L. L. Yeo; Joline Si Jing Lim; Vijay K. Sharma

2009-01-01

207

A novel intradural extramedullary spinal cord tumor in young dogs  

Microsoft Academic Search

We have studied an unusual, spontaneous, intradural extramedullary spinal cord tumor in 12 dogs. Animals presented with paraparesis and ataxia early in life (11\\/12 ranged from 6 to 38 months of age) suggesting that these tumors may be congenital. Various breeds of dogs were represented with four cases in German Shepherds and three in retrievers; there was no sex predisposition.

B. A. Summers; A. deLahunta; M. McEntee; F. P. Kuhajda

1988-01-01

208

Presentations: Giving Effective Presentations  

E-print Network

; o Capture attention of visual learners; o Increase the audience's retention of your presentation? Anecdotes? Visual aids? Statistics? Examples? THE OPENING Prepare this only after forming and organizing

209

Spinal Extradural Arachnoid Cyst: A Case Report  

PubMed Central

Spinal arachnoid cyst is a rare cause of myelopathy secondary to spinal cord compression. We report a case presenting extradural arachnoid cyst of probable traumatic origin leading to irreversible neurological deficits including paraparesis and neurogenic bladder. The patient presented progressive paraparesis and voiding difficulty. Magnetic resonance imaging (MRI) of the spine revealed long segmental cystic lesion of cerebrospinal fluid (CSF) signal intensity at dorsal extramedullary space of T11 to L3 level suggesting arachnoid cyst with diffuse cord compression. On the operation, an ovoid shaped dural defect was identified at right sided dorsolateral aspect of the dura mater between nerve root sleeves at T11 and T12 level. The patient was treated by microsurgical repair of the dural defect and intraoperative findings revealed no further leakage of CSF. The neurological status of the patient was stationary on follow-up examination postoperatively. We postulate that delayed-onset post-traumatic extradural arachnoid cyst should be taken into consideration on the differential diagnosis of intrapinal cysts. PMID:24757455

Kong, Woo-Keun; Cho, Keun-Tae

2013-01-01

210

Assessment of autonomic dysreflexia in patients with spinal cord injury.  

PubMed Central

OBJECTIVES AND METHODS: To assess the impairment of supraspinal control over spinal sympathetic centres and the occurrence of autonomic dysreflexia in patients with spinal cord injury. Autonomic dysreflexia is caused by the disconnection of spinal sympathetic centres from supraspinal control and is characterised by paroxysmal hypertensive episodes caused by non-specific stimuli below the level of the lesion. Therefore, patients with spinal cord injury were examined clinically and by different techniques to assess the occurrence of autonomic dysreflexia and to relate disturbances of the sympathetic nervous system to episodes of autonomic dysreflexia. RESULTS: None of the paraplegic patients, but 59% (13/22) of tetraplegic patients (91% of the complete, 27% of the incomplete patients) presented signs of autonomic dysreflexia during urodynamic examination. Only 62% of the tetraplegic patients complained about symptoms of autonomic dysreflexia. Pathological sympathetic skin responses (SSRs) of the hands were related to signs of autonomic dysreflexia in 93% of cases. No patient with preserved SSR potentials of the hands and feet showed signs of autonomic dysreflexia, either clinically or during urodynamic examination. Ambulatory blood pressure measurements (ABPMs) indicated a loss of circadian blood pressure rhythm (sympathetic control) but preserved heart rate rhythm (parasympathetic regulation) only in patients with complete tetraplegia. Pathological ABPM recordings were seen in 70% of patients with symptoms of autonomic dysreflexia. CONCLUSIONS: The urodynamic examination was more sensitive in indicating signs of autonomic dysreflexia in patients with spinal cord injury, whereas SSR allowed the assessment of the degree of disconnection of the sympathetic spinal centres from supraspinal control. Using ABPM recordings the occurrence of episodes of autonomic dysreflexia over 24 hours and the effectiveness of therapeutical treatment can be assessed. PMID:9153603

Curt, A; Nitsche, B; Rodic, B; Schurch, B; Dietz, V

1997-01-01

211

Idiopathic Hypertrophic Spinal Pachymeningitis with an Osteolytic Lesion  

PubMed Central

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important. PMID:25328657

Jee, Tae Keun; Lee, Sun-Ho; Kim, Eun-Sang

2014-01-01

212

Organization of ascending spinal projections in Caiman crocodilus.  

PubMed

Ascending spinal projections in the caiman (Caiman crocodilus) were demonstrated with Nauta and Fink-Heimer methods following hemisections of the third spinal segment in a series of twelve animals. These results were compared with earlier data in the literature obtained from a turtle, a snake, and a lizard using the same experimental and histological procedures. The results show remarkable similarities considering that each species represents a different reptilian order with different evolutionary history and habitat. However, the caiman displays several important peculiarities. Although the dorsal funiculus of the caiman contains the largest number of ascending spinal projections of the four species examined, this funiculus has not differentiated into cuneate and gracile fasciculi as is the case in the tegu lizard. The ventro-lateral ascending spinal projections follow a fundamentally similar general morphologic pattern in the four species with only minor variations. The anatomical arrangement in the caiman and tegu lizard appears most similar in the high cervical and the medullary regions; however, this is not the case in midbrain and thalamic regions where considerably more extensive projections are seen in the caiman. In the caiman an extensive spinal connection to the ventro-lateral nucleus of the dorsal thalamus is present; this connection is reminiscent of the mammalian spinal projection to the ventro-basal complex. The caiman has in common with the other three reptilian species a small projection to another dorsal thalamic region that is apparently homologous to the mammalian intralaminar nuclei, which are the destination of the mammalian paleospinothalamic tract. PMID:7214482

Ebbesson, S O; Goodman, D C

1981-01-01

213

Identification and surgical treatment of primary thoracic spinal stenosis.  

PubMed

We report the surgical treatment results for 7 patients (4 men, 3 women; mean age, 49 years) who presented with myelopathy caused exclusively by primary thoracic spinal stenosis, predominantly in the lower thoracic spine. (Patients with concurrent ascending lumbosacral degenerative disease were excluded.) All patients received extensive nonoperative treatment before referral to our center. Surgical treatment consisted of wide posterior decompression and instrumented fusion (5 cases), anterior vertebrectomy and fusion (1), and anterior vertebrectomy with autograft strut followed by wide posterior decompression and instrumented fusion (1). Mean operative time was 313 minutes, mean blood loss was 944 mL, and there were no major postoperative complications. Minimum follow-up was 2 years. Five patients had significant improvement in myelopathy and were ambulating normally, 1 had modest improvement in ambulation, and 1 remained wheelchair-bound. All patients achieved solid radiographic fusions. After presenting these case studies, we review the current literature on treatment effectiveness. Primary thoracic spinal stenosis should be considered in patients who present with isolated lower extremity myelopathy, particularly when no significant pathologic findings are identified in the cervical or lumbosacral spine. Expedient wide decompression with concurrent instrumented fusion is recommended to prevent late development of spinal instability and recurrent spinal stenosis. PMID:19104683

Dimar, John R; Bratcher, Kelly R; Glassman, Steven D; Howard, Jennifer M; Carreon, Leah Y

2008-11-01

214

Cytoarchitecture of the spinal cord of the postnatal (P4) mouse.  

PubMed

Interpretation of the new wealth of gene expression and molecular mechanisms in the developing mouse spinal cord requires an accurate anatomical base on which data can be mapped. Therefore, we have assembled a spinal cord atlas of the P4 mouse to facilitate direct comparison with the adult specimens and to contribute to studies of the development of the mouse spinal cord. This study presents the anatomy of the spinal cord of the P4 C57Bl/6J mouse using Nissl and acetyl cholinesterase-stained sections. It includes a detailed map of the laminar organization of selected spinal cord segments and a description of named cell groups of the spinal cord such as the central cervical (CeCv), lateral spinal nucleus, lateral cervical, and dorsal nuclei. The motor neuron groups have also been identified according to the muscle groups they are likely to supply. General features of Rexed's laminae of the P4 spinal cord showed similarities to that of the adult (P56). However, certain differences were observed with regard to the extent of laminae and location of certain cell groups, such as the dorsal nucleus having a more dispersed structure and a more ventral and medial position or the CeCv being located in the medial part of lamina 5 in contrast to the adult where it is located in lamina 7. Motor neuron pools appeared to be more tightly packed in the P4 spinal cord. The dorsal horn was relatively larger and there was more white matter in the P56 spinal cord. PMID:22454209

Sengul, Gulgun; Puchalski, Ralph B; Watson, Charles

2012-05-01

215

Inflammatory cascades mediate synapse elimination in spinal cord compression  

PubMed Central

Background Cervical compressive myelopathy (CCM) is caused by chronic spinal cord compression due to spondylosis, a degenerative disc disease, and ossification of the ligaments. Tip-toe walking Yoshimura (twy) mice are reported to be an ideal animal model for CCM-related neuronal dysfunction, because they develop spontaneous spinal cord compression without any artificial manipulation. Previous histological studies showed that neurons are lost due to apoptosis in CCM, but the mechanism underlying this neurodegeneration was not fully elucidated. The purpose of this study was to investigate the pathophysiology of CCM by evaluating the global gene expression of the compressed spinal cord and comparing the transcriptome analysis with the physical and histological findings in twy mice. Methods Twenty-week-old twy mice were divided into two groups according to the magnetic resonance imaging (MRI) findings: a severe compression (S) group and a mild compression (M) group. The transcriptome was analyzed by microarray and RT-PCR. The cellular pathophysiology was examined by immunohistological analysis and immuno-electron microscopy. Motor function was assessed by Rotarod treadmill latency and stride-length tests. Results Severe cervical calcification caused spinal canal stenosis and low functional capacity in twy mice. The microarray analysis revealed 215 genes that showed significantly different expression levels between the S and the M groups. Pathway analysis revealed that genes expressed at higher levels in the S group were enriched for terms related to the regulation of inflammation in the compressed spinal cord. M1 macrophage-dominant inflammation was present in the S group, and cysteine-rich protein 61 (Cyr61), an inducer of M1 macrophages, was markedly upregulated in these spinal cords. Furthermore, C1q, which initiates the classical complement cascade, was more upregulated in the S group than in the M group. The confocal and electron microscopy observations indicated that classically activated microglia/macrophages had migrated to the compressed spinal cord and eliminated synaptic terminals. Conclusions We revealed the detailed pathophysiology of the inflammatory response in an animal model of chronic spinal cord compression. Our findings suggest that complement-mediated synapse elimination is a central mechanism underlying the neurodegeneration in CCM. PMID:24589419

2014-01-01

216

Anterior cervical arachnoid cyst presenting with traumatic quadriplegia  

Microsoft Academic Search

Introduction Intradural spinal arachnoid cysts are rare. Rarer still are cysts located anterior to the cervical spinal cord. To date, only 10 such cases have been reported in the English-language literature. Case report Two cases of anterior cervical arachnoid cysts that presented as traumatic quadriplegia are reported.

Natarajan Muthukumar

2004-01-01

217

Therapeutic approaches for spinal cord injury  

PubMed Central

This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a “disease that should not be treated.” Over the last two decades, several studies have been performed to obtain more effective treatments for spinal cord injury. Most of these studies approach a patient with acute spinal cord injury in one of four manners: corrective surgery or a physical, biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life. PMID:23070351

Cristante, Alexandre Fogaca; de Barros Filho, Tarcisio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

2012-01-01

218

Extramedullary intradural spinal tumors: a pictorial review.  

PubMed

Defining the location of tumors and mass lesions of the spine in relation to the spinal cord and the dura is of the utmost importance as certain types of lesions tend to occur in certain locations. The differential diagnostic considerations will vary according to location of the mass lesion as will the treatment and prognosis of these various lesions. The category of extramedullary intradural masses includes a variety of lesions from meningiomas and nerve sheath tumors (neurofibromas, schwannomas) to less common tumors (hemangiopericytoma), metastases, benign tumors (lipoma, dermoid, epidermoid), inflammatory disorders (arachnoid adhesions, sarcoidosis), vascular lesions (spinal-dural arteriovenous fistula), and cystic lesions (perineural or Tarlov cysts). Characteristic magnetic resonance imaging findings are helpful for localization and characterization of these lesions before treatment, as well as for follow-up after treatment. We present a pictorial review of the various extramedullary intradural lesions of the spine, with pathologic correlation. We discuss imaging features that are typical for the various entities and describe various therapeutic options that are important considerations for surgical treatment of these lesions. PMID:17765798

Beall, Douglas P; Googe, David J; Emery, Robert L; Thompson, Darin B; Campbell, Scot E; Ly, Justin Q; DeLone, David; Smirniotopoulos, James; Lisanti, Chris; Currie, T Jenks

2007-01-01

219

Atypical Noncontiguous Multiple Spinal Tuberculosis: A Case Report  

PubMed Central

Objective Spinal tuberculosis-associated symptoms are not so unique as to immediately indicate the proper diagnosis in most cases. Distinguishing spinal tuberculosis (Pott's disease) from pyogenic spondylitis is often difficult, and lesions metastatic from systemic malignancy are the other major entity from which spinal tuberculosis must be distinguished. Clinical Presentation A 27-year-old male patient presented with a history of back pain after a minor trauma 1 month ago. Computed tomography and magnetic resonance imaging of the thoracic spine showed multiple osteolytic bone lesions at the bodies of T9, T10 and T11 vertebrae and the spinous processes of T12 and L1. Other noncontiguous osteolytic lesions were noted at S2 body and right sacro-iliac joint. Intervention To confirm the pathologic diagnosis, the patient underwent an open biopsy for the T12 and L1 spinous process lesions and a percutaneous transpedicular biopsy on T9, T10, T11 lesions. Frozen biopsy was reported as compatible with chronic granulomatous caseating necrosis without malignant cells. The final diagnosis was an atypical presentation of multiple spinal tuberculosis. The patient received an appropriate enteral anti-tuberculosis therapy and recovered without any complications. Follow-up MRI taken after a year of medical treatment revealed marked resolution of the lesions. Conclusion Current research indicates the incidence of multi-level noncontiguous, remote vertebral tuberculosis is 1.1% to 16%. Because tuberculous spondylitis could represent variant and atypical pattern, the disease should be considered in differential diagnosis along with other diseases such as metastatic neoplasm, pyogenic spondylitis, especially when the radiologic studies are revealing multiple spinal lesions. PMID:25110488

Kim, Jang-Hoon; Choi, Jong-Il; Lim, Dong-Jun

2014-01-01

220

Whole Spontaneous Spinal Epidural Hematoma  

PubMed Central

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterioration was recovered immediately, and he was discharged without neurological deficits. A drug history of naftazone, which could induce a drug-induced platelet dysfunction, was revealed retrospectively. To our knowledge, this is the first report of whole spontaneous spinal epidural hematoma in a young patient, with a history of hemorrhoid medication. PMID:24967052

Yoon, Kyeong-Wook; Song, Jae Gyok; Ryu, Jae-Wook

2014-01-01

221

Delayed post-traumatic spinal cord infarction in an adult after minor head and neck trauma: a case report  

PubMed Central

Introduction Delayed post-traumatic spinal cord infarction is a devastating complication described in children. In adults, spinal cord ischemia after cardiovascular interventions, scoliosis correction, or profound hypotension has been reported in the literature. However, delayed spinal cord infarction after minor head trauma has not been described yet. Case presentation We report the case of a 45-year-old Hispanic man who had a minor head trauma. He was admitted to our hospital because of paresthesias in his hands and neck pain. A radiological workup showed cervical spinal canal stenosis and chronic cervical spondylotic myelopathy. Twelve hours after admission, our patient became unresponsive and, despite full resuscitation efforts, died. The autopsy revealed spinal cord necrosis involving the entire cervical spinal cord and upper thoracic region. Conclusions This case illustrates the extreme fragility of spinal cord hemodynamics in patients with chronic cervical spinal canal stenosis, in which any further perturbations, such as cervical hyperflexion related to a minor head injury, can have catastrophic consequences. Furthermore, the delayed onset of spinal cord infarction in this case shows that meticulous maintenance of blood pressure in the acute post-traumatic period is of paramount importance, even in patients with minimal post-traumatic symptoms. PMID:22992313

2012-01-01

222

Poly(ADP-ribose) polymerase activity contributes to peroxynitrite-induced spinal cord neuronal cell death in vitro.  

PubMed

Peroxynitrite, which has been implicated in secondary neuronal damage resulting from spinal cord injury, is capable of mediating several toxic interactions including inducing DNA strand breaks and activating the nuclear enzyme, poly (ADP-ribose) polymerase (PARP). In the present study we have tested the hypothesis that peroxynitrite-induced cell death in spinal cord injury is due to activation of PARP. Initially we examined whether peroxynitrite exerts toxic effects on primary cultures of spinal cord neurons and then determined whether the spinal cord neuronal cell death triggered by peroxynitrite was associated with PARP activation. Peroxynitrite dose-dependently reduced the viability of spinal cord neurons in vitro. Furthermore, peroxynitrite exposure markedly increased the number of DNA strand breaks in primary spinal cord neurons, resulting in activation of PARP. To identify whether PARP activation plays a direct role in peroxynitrite-induced neurotoxicity we assessed the effects of the PARP inhibitors, nicotinamide, 3-aminobenzamide and 5-iodo-6-amino-1,2 benzopyrone on cell viability in spinal cord neurons exposed to peroxynitrite. The presence of the PARP inhibitors in the cultures not only inhibited peroxynitrite-induced PARP activity in spinal cord neurons but also protected the cells from the deleterious actions of peroxynitrite. Therefore, our results demonstrate that peroxynitrite exerts toxic effects on spinal cord neurons in vitro at least in part through a PARP-dependent pathway. PMID:15453994

Scott, Gwen S; Szabó, Csaba; Hooper, D Craig

2004-09-01

223

Neurogenic claudication without spinal stenosis arising as a result of lumbar epidural varices.  

PubMed

Neurogenic claudication is most frequently observed in patients with degenerative lumbar spinal stenosis. We describe a patient with lumbar epidural varices secondary to obstruction of the inferior vena cava by pathological lymph nodes presenting with this syndrome. Following a diagnosis of follicular lymphoma, successful chemotherapy led to the resolution of the varices and the symptoms of neurogenic claudication. The lumbar epidural venous plexus may have an important role in the pathogenesis of spinal stenosis. Although rare, epidural venous engorgement can induce neurogenic claudication without spinal stenosis. Further investigations should be directed at identifying an underlying cause. PMID:22933506

Dabasia, H; Rahim, N; Marshall, R

2012-09-01

224

Speckle variance optical coherence tomography of the rodent spinal cord: in vivo feasibility  

PubMed Central

Optical coherence tomography (OCT) has the combined advantage of high temporal (µsec) and spatial (<10µm) resolution. These features make it an attractive tool to study the dynamic relationship between neural activity and the surrounding blood vessels in the spinal cord, a topic that is poorly understood. Here we present work that aims to optimize an in vivo OCT imaging model of the rodent spinal cord. In this study we image the microvascular networks of both rats and mice using speckle variance OCT. This is the first report of depth resolved imaging of the in vivo spinal cord using an entirely endogenous contrast mechanism. PMID:22567584

Cadotte, David W.; Mariampillai, Adrian; Cadotte, Adam; Lee, Kenneth K. C.; Kiehl, Tim-Rasmus; Wilson, Brian C.; Fehlings, Michael G.; Yang, Victor X. D.

2012-01-01

225

The impact of magnetic resonance on the diagnostic evaluation of acute cervicothoracic spinal trauma.  

PubMed

From 1984 to 1987 magnetic resonance (MR) imaging was performed on 100 patients suffering acute spinal trauma. MR demonstrated one or more injuries to the cervicothoracic region in 31 patients. It displayed a spectrum of spinal cord injury ranging from mild compression and swelling to complete transection. MR was also useful in evaluating alignment at the cervicothoracic junction, in depicting ligamentous injury, in establishing the presence of disc herniation, and in identifying unsuspected levels of injury. We present a diagnostic algorithm that incorporates the role of MR in evaluating acute cervicothoracic spinal trauma and emphasizes the replacement of myelography by MR in the initial assessment of neurologic deficit. PMID:3363388

Goldberg, A L; Rothfus, W E; Deeb, Z L; Daffner, R H; Lupetin, A R; Wilberger, J E; Prostko, E R

1988-01-01

226

Blood-spinal cord barrier after spinal cord injury: Relation to revascularization and wound healing  

Microsoft Academic Search

Spinal cord injury produces prominent disruption of the blood-spinal cord barrier. We have defined the blood- spinal cord barrier breakdown to the protein luciferase (61 kDa) in the acutely injured murine spinal cord and during revascularization. We show that newly formed and regenerating blood vessels that have abnormal perme- ability exhibit differential expression of the glucose-1 transporter (Glut-1), and that

William D. Whetstone; Jung-Yu C. Hsu; Manuel Eisenberg; Zena Werb; Linda J. Noble-Haeusslein

2003-01-01

227

Effect of spinal deafferentation on temperature regulation and spinal thermosensitivity in pigeons  

Microsoft Academic Search

1.To study the effect of spinal deafferentation on temperature regulation and spinal thermosensitivity in acute experiments, the spinal cord of pigeons was transected at Th4 and the dorsal roots cut carefully on both sides fromTh4 toC6 orC4 (13 or 15 segments); only afferent signals from the upper neck and the head could reach the CNS. Selective changes of the spinal

R. Necker; W. Rautenberg

1975-01-01

228

Spinal Cord Injury in Youth  

Microsoft Academic Search

To identify special characteristics of the pediatric spinal cord-injured (SCI) population, we analyzed a database of 1,770 traumatic SCI patients; 88 (5%) fell into the two pediatric subgroups: 0-12 years (n = 26) and 13-15 years (n = 62) at time of injury. Differences between age groups were identified with regard to demographics, neurologic characteristics, associated injuries and complications, and

David F. Apple; Carol A. Anson; John D. Hunter; R. Bryan Bell

1995-01-01

229

Why variability facilitates spinal learning.  

PubMed

Spinal Wistar Hannover rats trained to step bipedally on a treadmill with manual assistance of the hindlimbs have been shown to improve their stepping ability. Given the improvement in motor performance with practice and the ability of the spinal cord circuitry to learn to step more effectively when the mode of training allows variability, we examined why this intrinsic variability is an important factor. Intramuscular EMG electrodes were implanted to monitor and compare the patterns of activation of flexor (tibialis anterior) and extensor (soleus) muscles associated with a fixed-trajectory and assist-as-needed (AAN) step training paradigms in rats after a complete midthoracic (T8-T9) spinal cord transection. Both methods involved a robotic arm attached to each ankle of the rat to provide guidance during stepping. The fixed trajectory allowed little variance between steps, and the AAN provided guidance only when the ankle deviated a specified distance from the programmed trajectory. We hypothesized that an AAN paradigm would impose fewer disruptions of the control strategies intrinsic to the spinal locomotor circuitry compared with a fixed trajectory. Intrathecal injections of quipazine were given to each rat to facilitate stepping. Analysis confirmed that there were more corrections within a fixed-trajectory step cycle and consequently there was less coactivation of agonist and antagonist muscles during the AAN paradigm. These data suggest that some critical level of variation in the specific circuitry activated and the resulting kinematics reflect a fundamental feature of the neural control mechanisms even in a highly repetitive motor task. PMID:20702702

Ziegler, Matthias D; Zhong, Hui; Roy, Roland R; Edgerton, V Reggie

2010-08-11

230

New Directions in Spinal Surgery  

Microsoft Academic Search

Evolving technological sophistication has resulted in ongoing modifications of traditional surgical approaches to correct\\u000a disorders of the spinal axis. Advances in instrumentation and pre- and intraoperative imaging have fueled a move toward minimally\\u000a invasive, minimal access spine surgery (1), by which the same surgical goals of conventional open techniques are met through a smaller access corridor. An early and\\u000a now

Ian F. Dunn; Marc E. Eichler

231

Spine day 2012: spinal pain in Swiss school children- epidemiology and risk factors  

PubMed Central

Background The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. Based on the data of Spine Day 2012 (an annual action day where Swiss school children were examined by chiropractors on a voluntary basis for back problems), the aim of the present study was to gain systematic epidemiologic data on adolescent spinal pain in Switzerland and to explore risk factors per gender and per spinal area. Method Data (questionnaires and physical examinations) of 836 school children were descriptively analyzed for prevalence, recurrence and severity of spinal pain. Of those, 434 data sets were included in risk factor analysis. Using logistic regression analysis, psycho-social parameters (presence of parental back pain, parental smoking, media consumption, type of school bag) and physical parameters (trunk symmetry, posture, mobility, coordination, BMI) were analyzed per gender and per spinal area. Results Prevalence of spinal pain was higher for female gender in all areas apart from the neck. With age, a steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites. The increasing impact of spinal pain on quality of life with age was reflected in an increase in recurrence, but not in severity of spinal pain. Besides age and gender, parental back pain (Odds ratio (OR)=3.26, p=0.011) and trunk asymmetry (OR=3.36, p=0.027) emerged as risk factors for spinal pain in girls. Parental smoking seemed to increase the risk for both genders (boys: OR=2.39, p=0.020; girls: OR=2.19, p=0.051). Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038). The risk for TSP was further enhanced by a higher BMI (OR=1.15, p=0.027). Conclusion This study supports the view of adolescent spinal pain as a bio-psycho-social problem that should be investigated per spinal area, age and gender. The role of trunk asymmetry and passive smoking as risk factors as well as the association between BMI and TSP should be further investigated, preferably in prospective studies. PMID:24094041

2013-01-01

232

Antioxidant Therapies for Acute Spinal Cord Injury  

Microsoft Academic Search

Summary  One of the most investigated molecular mechanisms involved in the secondary pathophysiology of acute spinal cord injury (SCI)\\u000a is free radical-induced, iron-catalyzed lipid peroxidation (LP) and protein oxidative\\/nitrative damage to spinal neurons,\\u000a glia, and microvascular cells. The reactive nitrogen species peroxynitrite and its highly reactive free radicals are key initiators\\u000a of LP and protein nitration in the injured spinal cord,

Edward D. Hall

2011-01-01

233

Testosterone Plus Finasteride Treatment After Spinal Cord Injury  

ClinicalTrials.gov

Spinal Cord Injury; Spinal Cord Injuries; Trauma, Nervous System; Wounds and Injuries; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Gonadal Disorders; Endocrine System Diseases; Hypogonadism; Genital Diseases, Male

2014-09-22

234

21 CFR 880.2500 - Spinal fluid manometer.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Spinal fluid manometer. 880.2500 Section 880.2500...Monitoring Devices § 880.2500 Spinal fluid manometer. (a) Identification. A spinal fluid manometer is a device used to measure...

2010-04-01

235

Genetics Home Reference: Spinal muscular atrophy with progressive myoclonic epilepsy  

MedlinePLUS

... catalog Conditions > Spinal muscular atrophy with progressive myoclonic epilepsy On this page: Description Genetic changes Inheritance Diagnosis ... What is spinal muscular atrophy with progressive myoclonic epilepsy? Spinal muscular atrophy with progressive myoclonic epilepsy (SMA- ...

236

Spinal Cholinergic Neurons Activated During Locomotion: Localization and Electrophysiological Characterization  

E-print Network

. The results are consistent with the sugges- tion that cholinergic interneurons in the lumbar spinal cordSpinal Cholinergic Neurons Activated During Locomotion: Localization and Electrophysiological. Fedirchuk, and L. M. Jordan. Spinal cholinergic neurons activated during locomotion: lo- calization

Manitoba, University of

237

Mosaic evolution of neural development in anurans: acceleration of spinal cord development in the direct developing frog Eleutherodactylus coqui  

Microsoft Academic Search

Previous studies have shown that spinal cord development in direct developing frogs of the genus Eleutherodactylus, which have evolutionarily lost the tadpole stage, differs from that in biphasically developing anurans (with the larval and the adult stage separated by metamorphosis). The present study of spinal cord development in Eleutherodactylus coqui provides additional information about neurogenesis, neuronal differentiation and growth analyzed

Gerhard Schlosser

2003-01-01

238

Cardio Respiratory Adaptations with Long Term Personalized Exercise Program in a T12 Spinal Cord Injured Person  

ERIC Educational Resources Information Center

The purpose of this study was to investigate the physiological adaptations in cardio respiratory endurance with a personalized exercise program with arm-cranking exercise in a paraplegic person (incomplete T12 spinal cord injury). A 32 year-old man with spinal cord injury (T12) participated in the present study performing 30 minutes arm cranking…

Vasiliadis, Angelo; Christoulas, Kosmas; Evaggelinou, Christina; Vrabas, Ioannis

2009-01-01

239

Macrophage migration inhibitory factor induces cell death and decreases neuronal nitric oxide expression in spinal cord neurons  

Microsoft Academic Search

Macrophage migration inhibitory factor is a potent proinflammatory cytokine; however, its role in spinal cord injury is poorly understood. Therefore, the aim of the present study was to investigate the effects of macrophage migration inhibitory factor on spinal cord neuron survival and viability. Due to the importance of nitric oxide metabolism in these events, part of our study was also

M. Chalimoniuk; K. King-Pospisil; C. N. Metz; M. Toborek

2006-01-01

240

Diffuse Idiopathic Skeletal Hyperostosis with Cervical Spinal Cord Injury - A Report of 3 Cases and a Literature Review  

Microsoft Academic Search

Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), though common, is often asymptomatic. However, spinal hyperostosis can predispose the affected to chronic myelopathic symptoms and acute spinal cord injury. Clinical Picture: We report on 3 patients with DISH, who sustained traumatic cervical cord injuries. Two were tetraplegic at presentation. The radiologic findings of the patients are also discussed. Treatment: Both the tetraplegic

S Sreedharan

241

Transcutaneous spinal direct current stimulation inhibits nociceptive spinal pathway conduction and increases pain tolerance in humans  

Microsoft Academic Search

Despite concerted efforts from pharmacologic research into neuropathic pain, many patients fail to achieve sufficient pain relief with medication alone. For this reason, increasing interest centres on neurostimulation techniques. We assessed whether transcutaneous spinal direct current stimulation (tsDCS) modulates conduction in ascending nociceptive spinal pathways. We measured changes induced by anodal and cathodal tsDCS over the thoracic spinal cord on

A. Truini; M. Vergari; A. Biasiotta; S. La Cesa; M. Gabriele; G. Di Stefano; C. Cambieri; G. Cruccu; M. Inghilleri; A. Priori

2011-01-01

242

Lineage specification of neuronal precursors in the mouse spinal cord.  

PubMed Central

We have investigated the differentiation potential of precursor cells within the developing spinal cord of mice and have shown that spinal cord cells from embryonic day 10 specifically give rise to neurons when plated onto an astrocytic monolayer, Ast-1. These neurons had the morphology of motor neurons and > 83% expressed the motor neuron markers choline acetyltransferase, peripherin, calcitonin gene-related peptide, and L-14. By comparison, < 10% of the neurons arising on monolayers of other neural cell lines or 3T3 fibroblasts had motor neuron characteristics. Cells derived from dorsal, intermediate, and ventral regions of the spinal cord all behaved similarly and gave rise to motor neuron-like cells when plated onto Ast-1. By using cells that expressed the lacZ reporter gene, it was shown that > 93% of cells present on the Ast-1 monolayers were motor neuron-like. Time-lapse analysis revealed that the precursors on the Ast-1 monolayers gave rise to neurons either directly or following a single cell division. Together, these results indicate that precursors in the murine spinal cord can be induced to differentiate into the motor neuron phenotype by factors produced by Ast-1 cells, suggesting that a similar factor(s) produced by cells akin to Ast-1 may regulate motor neuron differentiation in vivo. Images Fig. 2 Fig. 3 Fig. 5 PMID:7479730

Richards, L J; Murphy, M; Dutton, R; Kilpatrick, T J; Puche, A C; Key, B; Tan, S S; Talman, P S; Bartlett, P F

1995-01-01

243

Recapping hemilaminoplasty for spinal surgical disorders using ultrasonic bone curette  

PubMed Central

Objective: The authors present a novel method of the recapping hemilaminoplasty in a retrospective study of patients with spinal surgical disorders. This report describes the surgical technique and the results of hemilaminoplasty using an ultrasonic bone curette. The aim of this study was to examine the safety and effectiveness of the hemilaminoplasty technique with ultrasonic bone curette. Methods: Between April 2003 and July 2011, 33 patients with various spinal diseases (17 spinal tumors, 5 dural arteriovenous fistulas, 3 syringomyelia, 2 sacral perineural cysts, and 2 arachnoid cysts) were treated microsurgically by using an ultrasonic bone curette with scalpel blade and lightweight handpiece. The ultrasonic bone curette was used for division of lamina. After resection of the lesion, the excised lamina was replaced exactly in situ to its original anatomic position with a titanium plate and screw. Additional fusion technique was not required and the device was easy to handle. All patients were observed both neurologically and radiologically by dynamic plain radiographs and computed tomography (CT) scan. Results: The operation was performed successfully and there were no instrument-related complications such as dural laceration, nerve root injury, and vessels injury. The mean number of resected and restored lamina was 1.7. CT confirmed primary bone fusion in all patients by 12 months after surgery. Conclusion: The ultrasonic bone curette is a useful instrument for recapping hemilaminoplasty in various spinal surgeries. This method allows anatomical reconstruction of the excised bone to preserve the posterior surrounding tissues. PMID:22754735

Matsuoka, Hidenori; Itoh, Yasunobu; Numazawa, Shinichi; Tomii, Masato; Watanabe, Kazuo; Hirano, Yoshitaka; Nakagawa, Hiroshi

2012-01-01

244

Alpha-Synuclein Loss in Spinal Muscular Atrophy  

PubMed Central

Spinal muscular atrophy, the most prevalent hereditary motor neuron disease, is caused by mutations in the survival motor neuron (SMN) 1 gene. A significant reduction in the encoded SMN protein leads to the degeneration of motor neurons. However, the molecular events leading to this process are not well understood. The present study uses a previously developed neuronal cell culture model of spinal muscular atrophy for a multiplex transcriptome analysis. Furthermore, gene expression analysis was performed on in vitro cell cultures, as well as tissue samples of spinal muscular atrophy patients and transgenic mice. RNA and subsequent Western blot protein analyses suggest that low SMN levels are associated with significantly lower alpha-synuclein expression. Examination of two genes related to vesicular transport showed a similar though less dramatic decrease in expression. The 140-amino acid protein alpha-synuclein, dominant mutations of which have previously been associated with an autosomal dominant form of Parkinson's disease, is strongly expressed in select neurons of the brain. Although not well understood, the physiologic functions of alpha-synuclein have been linked to synaptic vesicular neurotransmitter release and neuroprotection, suggesting a possible contribution to Smn-deficient motor neuron pathology. Furthermore, alpha-synuclein may be a genetic modifier or biomarker of spinal muscular atrophy. PMID:20640532

Acsadi, Gyula; Li, Xingli; Murphy, Kelley J.; Swoboda, Kathryn J.

2014-01-01

245

Postoperative Spinal Wound Infections and Postprocedural Diskitis  

PubMed Central

Background/Objective: Postprocedural infections are a significant cause of morbidity after spinal interventions. Methods: Literature review. An extensive literature review was conducted on postprocedural spinal infections. Relevant articles were reviewed in detail and additional case images were included. Results: Clinical findings, laboratory markers, and imaging modalities play important roles in the detection of postprocedural spinal infections. Treatment may range from biopsy and antibiotics to multiple operations with complex strategies for soft tissue management. Conclusions: Early detection and aggressive treatment are paramount in managing postprocedural spinal infections and limiting their long-term sequelae. PMID:18092559

Chaudhary, Saad B; Vives, Michael J; Basra, Sushil K; Reiter, Mitchell F

2007-01-01

246

Computed tomographic evaluation of cervical vertebral canal and spinal cord morphometry in normal dogs  

PubMed Central

The height, width, and cross-sectional area of the vertebral canal and spinal cord along with the area ratio of spinal cord to vertebral canal in the cervical vertebra were evaluated in images obtained using computed tomography (CT). Measurements were taken at the cranial, middle, and caudal point of each cervical vertebra in eight clinically normal small breed dogs (two shih tzu, two miniature schnauzers, and four mixed breed), 10 beagles, and four German shepherds. CT myelography facilitated the delineation of the epidural space, subarachnoid space, and spinal cord except at the caudal portion of the 7th cervical vertebra. The spinal cord had a tendency to have a clear ventral border in the middle portion of the vertebral canal and lateral borders near both end plates. The height, width, and area of the vertebral canal and spinal cord in the cervical vertebra were increased as the size of dog increased. However, the ratio of the spinal cord area to vertebral canal area in the small dogs was higher than that of the larger dogs. Results of the present study could provide basic and quantitative information for CT evaluation of pathologic lesions in the cervical vertebra and spinal cord. PMID:24136210

Seo, Eunjeong; Choi, Jihye; Choi, Mincheol

2014-01-01

247

Emotional modulation of pain and spinal nociception in fibromyalgia  

PubMed Central

Fibromyalgia (FM) is characterized by widespread pain, as well as affective disturbance (e.g., depression). Given that emotional processes are known to modulate pain, a disruption of emotion and emotional modulation of pain and nociception may contribute to FM. The present study used a well-validated affective picture-viewing paradigm to study emotional processing and emotional modulation of pain and spinal nociception. Participants were 18 individuals with FM, 18 individuals with rheumatoid arthritis (RA), and 19 healthy pain-free controls (HC). Mutilation, neutral, and erotic pictures were presented in four blocks; two blocks assessed only physiological-emotional reactions (i.e., pleasure/arousal ratings, corrugator EMG, startle modulation, skin conductance) in the absence of pain and two blocks assessed emotional reactivity and emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations over the sural nerve. In general, mutilation pictures elicited displeasure, corrugator activity, subjective arousal, and sympathetic activation, whereas erotic pictures elicited pleasure, subjective arousal, and sympathetic activation. However, FM was associated with deficits in appetitive activation (e.g., reduced pleasure/arousal to erotica). Moreover, emotional modulation of pain was observed in HC and RA, but not FM, even though all three groups evidenced modulation of NFR. Additionally, NFR thresholds were not lower in the FM group, indicating a lack of spinal sensitization. Together, these results suggest that FM is associated with a disruption of supraspinal processes associated with positive affect and emotional modulation of pain, but not brain-to-spinal cord circuitry that modulates spinal nociceptive processes. PMID:23622762

Rhudy, Jamie L.; DelVentura, Jennifer L.; Terry, Ellen L.; Bartley, Emily J.; Olech, Ewa; Palit, Shreela; Kerr, Kara L.

2013-01-01

248

Segmental thoracic spinal anesthesia in patient with Byssinosis undergoing nephrectomy  

PubMed Central

Byssinosis is an occupational disease occurring commonly in cotton mill workers; it usually presents with features of chronic obstructive pulmonary disease (COPD). The management of patients with COPD presents a significant challenges to the anesthetist. Regional anesthesia is preferred in most of these patients to avoid perioperative and postoperative complications related to general anesthesia. We report a known case of Byssinosis who underwent nephrectomy under segmental spinal anesthesia at the low thoracic level.

Patel, Kiran; Salgaonkar, Sweta

2012-01-01

249

Spinal deformity following surgery for spinal cord tumors and tumorous lesions: analysis based on an assessment of the spinal functional curve  

Microsoft Academic Search

The mechanism of spinal deformity after surgical removal of a cervical spinal cord tumor or tumorous lesions was studied in 36 patients, based on the spinal functional curve prepared from the intersectional angle. The postoperative spinal deformity depends on the surgical level and the type of operation. In the laminectomy group, kyphosis of the upper cervical spine and compensatory increased

Akira Inoue; Takaaki Ikata; Shinsuke Katoh

1996-01-01

250

Presumed intramedullary spinal cord sarcoidosis in a healthy young adult woman.  

PubMed

Sarcoidosis is an inflammatory disease of unknown etiology associated with the development of granulomatous nodules in various organs, most commonly the lungs, eyes, and skin. It rarely affects the central nervous system, with the spinal cord being least common area of involvement. However, when sarcoidosis does affect the central nervous system, it is often the first presentation of the disease, making diagnosis more difficult. Physical examination findings are consistent with spinal cord pathology, and imaging often suggests spinal cord tumor. We present a case of an otherwise healthy young woman with a granulomatous mass in her cervico-thoracic spinal cord presumed to be sarcoid and review the clinical findings, diagnosis, treatment, and prognosis associated with this rare disease. PMID:22257972

Eby, Sarah A; Buchner, Eric J; Bryant, Mary G

2012-09-01

251

Cervicobrachialgia after spinal surgery.  

PubMed

ABSTRACT A case of cervicobrachialgia is presented in which the patient expressed fear of becoming addicted to opioids. Alternative analgesic approaches including anticonvulsants, transcutaneous electrical nerve stimulation (TENS), and physical therapy are discussed. This report is adapted from paineurope 2014; Issue 2, ©Haymarket Medical Publications Ltd, and is presented with permission. Paineurope is provided as a service to pain management by Mundipharma International, LTD and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:25348228

Breivik, Harald

2014-12-01

252

Inhibition of nociceptive responses of spinal cord neurones during hypertension involves the spinal GABAergic system and a pain modulatory center located at the caudal ventrolateral medulla.  

PubMed

The mechanisms of hypertension-induced hypoalgesia were studied in a model of hypertension induced by adenosine receptors blockade with the non-selective antagonist 1,3-dipropyl-8-sulfophenylxanthine (DPSPX) during 7 days. Based on the positive correlation between pain thresholds and noxious-evoked expression of the c-fos protooncogene in spinal cord neurones, we used this marker of nociceptive activation of spinal neurones to evaluate the involvement of the spinal GABAergic system and the caudal ventrolateral medulla (VLM), an important inhibitory component of the supraspinal endogenous pain modulatory system. In DPSPX-treated animals, a 20% increase in blood pressure was achieved along with a decrease in Fos expression in the superficial (laminae I-II) and deep (laminae III-VII) dorsal horn. In these animals, lower percentages of neurones labeled for GABAB receptors that expressed Fos were obtained in the superficial dorsal horn. Lesioning the VLMlat with quinolinic acid prevented the decrease in Fos expression at the spinal cord of DPSPX-hypertensive rats whereas in normotensive animals, no changes in Fos expression were detected. The present results support previous findings that hypertension is associated with a decrease of nociceptive activation of spinal cord neurones, through descending inhibition exerted by the VLMlat. This study further shows that during hypertension a decrease in the expression of GABAB receptors in nociceptive spinal neurones occurs, probably due to changes in the local GABAergic inhibitory system. PMID:16453312

Morato, Manuela; Pinho, Dora; Sousa, Teresa; Tavares, Isaura; Albino-Teixeira, António

2006-03-01

253

History of the spinal cord localization.  

PubMed

The first reference to spinal cord injury is recorded in the Edwin Smith papyrus. Little was known of the function of the cord before Galen's experiments conducted in the second century AD. Galen described the protective coverings of the spinal cord: the bone, posterior longitudinal ligament, dura mater, and pia mater. He gave a detailed account of the gross anatomy of the spinal cord. During the medieval period (AD 700-1500) almost nothing of note was added to Galen's account of spinal cord structure. The first significant work on the spinal cord was that of Blasius in 1666. He was the first to differentiate the gray and white matter of the cord and demonstrated for the first time the origin of the anterior and posterior spinal nerve roots. The elucidation of the various tracts in the spinal cord actually began with demonstrations of pyramidal decussation by Mistichelli (1709) and Pourfoir du Petit (1710). Huber (1739) recorded the first detailed account of spinal roots and the denticulate ligaments. In 1809, Rolando described the substantia gelatinosa. The microtome, invented in 1824 by Stilling, proved to be one of the fundamental tools for the study of spinal cord anatomy. Stilling's technique involved slicing frozen or alcohol-hardened spinal cord into very thin sections and examining them unstained by using the naked eye or a microscope. With improvements in histological and experimental techniques, modern studies of spinal cord anatomy and function were initiated by Brown-Sequard. In 1846, he gave the first demonstration of the decussation of the sensory tracts. The location and direction of fiber tracts were uncovered by the experimental studies of Burdach (1826), Turck (1849), Clarke (1851), Lissauer (1855), Goll (1860), Flechsig (1876), and Gowers (1880). Bastian (1890) demonstrated that in complete transverse lesions of the spinal cord, reflexes below the level of the lesion are lost and muscle tone is abolished. Flatau (1894) observed the laminar nature of spinal pathways. The 20th century ushered in a new era in the evaluation of spinal cord function and localization; however, the total understanding of this remarkable organ remains elusive. Perhaps the next century will provide the answers to today's questions about spinal cord localization. PMID:15264793

Naderi, Sait; Türe, U?ur; Pait, T Glenn

2004-01-15

254

What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review  

Microsoft Academic Search

AimSystematic review of ‘What are the clinical and radiological characteristics of inflicted spinal injury?’MethodsLiterature search of 20 electronic databases, websites, references and bibliographies (1950–2009) using selected keywords. Critical appraisal: by two trained reviewers, (a third review, if discrepant). Inclusion criteria: primary studies of inflicted spinal injury in children <18 years, alive at presentation, with a high surety of diagnosis of

A. M. Kemp; A. H. Joshi; M. Mann; V. Tempest; A. Liu; S. Holden; S. Maguire

2010-01-01

255

Methicillin-resistant Staphylococcus aureus retropharyngeal abscess complicated by a cervical spinal subdural empyema  

Microsoft Academic Search

Methicillin-resistant Staphylococcus aureus (MRSA) cervical spinal subdural empyema as a result of a retropharyngeal abscess has not been reported previously. We present a 65-year-old male intravenous drug user who developed spinal subdural empyema after an operation for a retropharyngeal abscess. Although imaging diagnosis and follow-up surgery were performed quickly, the neurological outcome was poor. We review the literature on retropharyngeal

Shiuan-Horng Chern; Chih-Peng Wei; Ru-Lan Hsieh; Jiun-Ling Wang

2009-01-01

256

Spinal hematoma: a literature survey with meta-analysis of 613 patients  

Microsoft Academic Search

.   Spinal hematoma has been described in autopsies since 1682 and as a clinical diagnosis since 1867. It is a rare and usually\\u000a severe neurological disorder that, without adequate treatment, often leads to death or permanent neurological deficit. Epidural\\u000a as well as subdural and subarachnoid hematomas have been investigated. Some cases of subarachnoid spinal hematoma may present\\u000a with symptoms similar

D. Kreppel; G. Antoniadis; W. Seeling

2003-01-01

257

Role of electrical stimulation for rehabilitation and regeneration after spinal cord injury: an overview  

Microsoft Academic Search

Structural discontinuity in the spinal cord after injury results in a disruption in the impulse conduction resulting in loss\\u000a of various bodily functions depending upon the level of injury. This article presents a summary of the scientific research\\u000a employing electrical stimulation as a means for anatomical or functional recovery for patients suffering from spinal cord\\u000a injury. Electrical stimulation in the

Samar Hamid; Ray Hayek

2008-01-01

258

MRI of spinal cord and brain lesions in subacute combined degeneration  

Microsoft Academic Search

Subacute combined degeneration is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and\\u000a even more rarely of the pyramidal and spinocerebellar tracts and cerebellum. We present the initial and follow-up MRI appearances\\u000a in a patient with subacute combined degeneration of the spinal cord, brain stem and cerebellum, due to vitamin B12 deficiency. The

V. K. Katsaros; F. X. Glocker; B. Hemmer; M. Schumacher

1998-01-01

259

Intramedullary Spinal Cord Metastasis From Rectal Cancer  

PubMed Central

Intramedullary spinal cord metastasis (ISCM) is an uncommon condition of the central nervous system (CNS) cause by systemic malignant tumors. Most ISCM cases are known to occur in patients with lung cancer and breast cancer; however, ISCM also very rarely occurs in patients with colorectal cancer. For the first time in Korea, we experienced a case of ISCM arising from rectal cancer, where a 75-year-old man presented with an abruptly-developed left-foot drop and numbness in both legs. The patient had lung metastases from rectal cancer that had been treated with chemotherapy. Magnetic resonance imaging revealed an intramedullary nodular lesion at the T12 level. ISCM was diagnosed and treated with steroids and radiotherapy. The patient's neurological symptoms were relieved for a while after treatment, but his condition deteriorated progressively. He died 4 months after ISCM had been diagnosed. PMID:25360432

Yang, Kyung Ho; Yi, Seong Yoon; Jung, Joo Hyuk; Kang, Seung Hee; Choi, Pyong Hwa

2014-01-01

260

Intramedullary spinal cord metastasis from rectal cancer.  

PubMed

Intramedullary spinal cord metastasis (ISCM) is an uncommon condition of the central nervous system (CNS) cause by systemic malignant tumors. Most ISCM cases are known to occur in patients with lung cancer and breast cancer; however, ISCM also very rarely occurs in patients with colorectal cancer. For the first time in Korea, we experienced a case of ISCM arising from rectal cancer, where a 75-year-old man presented with an abruptly-developed left-foot drop and numbness in both legs. The patient had lung metastases from rectal cancer that had been treated with chemotherapy. Magnetic resonance imaging revealed an intramedullary nodular lesion at the T12 level. ISCM was diagnosed and treated with steroids and radiotherapy. The patient's neurological symptoms were relieved for a while after treatment, but his condition deteriorated progressively. He died 4 months after ISCM had been diagnosed. PMID:25360432

Yang, Kyung Ho; Lee, Hye Ran; Yi, Seong Yoon; Jung, Joo Hyuk; Kang, Seung Hee; Choi, Pyong Hwa

2014-10-01

261

[Diagnostics and therapy of spinal disc herniation].  

PubMed

Degenerative processes in a movement segment of the vertebral column, which can potentially give rise to herniation of elements of the nucleus pulposus, are complex and of variable clinical and radiological dimensions; however the mere assumption that degenerative changes precede disc herniation remains a matter of debate. By definition, spinal disc herniation (SDH) refers to components of the gelatinous nucleus pulposus protruding beyond the dorsal level of the vertebral body margin through tears in the annulus fibrosus. Clinical presentation may include pain, paresis and sensory disturbances. Magnetic resonance imaging (MRI) is considered the gold standard in the diagnosis of SDH. In the majority of patients a conservative approach with physical therapy exercises and adequate analgesic and antiphlogistic medical treatment results in a substantial improvement of symptoms. PMID:25398570

Zimmer, A; Reith, W

2014-11-01

262

Acute Spinal Rigidity  

Microsoft Academic Search

A 69-year-old woman presented with a 1-year history of low back and leg pain accompanied by progressive difficulty walking.\\u000a Lumbar surgery was undertaken for spondylolisthesis and canal stenosis. Postoperatively, the pain improved but her walking\\u000a continued to deteriorate. She then developed spasms of the back and right leg causing flexion of the trunk, hip, and knee.\\u000a Her mobility deteriorated further.

P. D. Thompson

263

Magnetic resonance imaging of the cervical, thoracic, and lumbar spine in children: spinal incidental findings in pediatric patients.  

PubMed

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

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

2014-12-01

264

Regional Spinal Cord Injury Rehabilitation Center.  

National Technical Information Service (NTIS)

The report consists of two basic parts. The first part deals with the findings and accomplishments which took place during this three-year period. The second part is a description of the spinal injury rehabilitation process, considering the Spinal Injury ...

E. S. Stauffer, N. E. Wilcox, V. L. Nickel, E. R. Erickson

1972-01-01

265

Charcot spinal arthropathy in a diabetic patient.  

PubMed

We report a case of Charcot spinal arthropathy in a diabetic patient and emphasize the clinical reasoning leading to the diagnosis, discuss the differential diagnosis, and insist on the crucial role of the radiologist and pathologist which allows the distinction between Charcot spinal arthropathy and infectious or tumoural disorders of the spine. PMID:25012751

van Eeckhoudt, S; Minet, M; Lecouvet, F; Galant, C; Banse, X; Lambert, M; Lefèbvre, C

2014-08-01

266

Relationship between everyday activities and spinal shrinkage  

Microsoft Academic Search

Background. Purpose of this study was to determine the spinal shrinkage in several activities of daily life and to assess a relationship with intradiscal pressure during these activities. Low back pain is thought to be related to spinal load. In a clinical evaluation of low back pain as provoked by everyday activities, we found a relationship between the amount of

L. L. van Deursen; D. L. van Deursen; C. J. Snijders; H. J. Wilke

2005-01-01

267

Pain Management Following Spinal Cord Injury  

MedlinePLUS

... SCI Care Center Spinal Cord Injury InfoSheet 10 Level - Consumer Pain Management following Spinal Cord Injury coming from somewhere other ... abdomen (stomach area) either above or below the level of injury. The pain is described as burning, ... Pain management usually includes treatment with medications, modified ...

268

Omental transposition in chronic spinal cord injury  

Microsoft Academic Search

The results of omental transposition in chronic spinal cord injury have been reported in 160 patients operated upon in the United States, Great Britain, China, Japan, India and Mexico, with detailed outcomes reported in few studies. Recovery of function to a greater degree than expected by natural history has been reported. In this series, 15 patients with chronic traumatic spinal

G L Clifton; W H Donovan; M M Dimitrijevic; S J Allen; A Ku; J R Potts; F G Moody; C Boake; A M Sherwood; J V Edwards

1996-01-01

269

Management of primary spinal cord tumors  

Microsoft Academic Search

The literature is scarce on surgical and\\/or radiotherapeutic management of primary neoplasms of the spinal cord, a rare form of tumor. We have reviewed retrospectively the records of all patients with spinal cord tumor who were treated at the University of California, San Francisco, from 1950 to 1975, a total of 34 patients. Patients were treated with megavoltage equipment to

J. G. Schwade; W. M. Wara; G. E. Sheline; S. Sorgen; C. B. Wilson

1978-01-01

270

Spinal Cord Stimulation in Deafferentation Pain  

Microsoft Academic Search

Spinal cord stimulation (SCS) was used in 49 cases to control resistant deafferentation pain resulting from causalgia, phantom limb, plexus and nerve root avulsion, postherpetic neuralgia, reflex sympathetic dystrophy and amputation. In all cases, one or two Standard percutaneous leads were introduced into the epidural space and manipulated until the spinal segment at which external stimulation provoked paresthesic sensation in

M. J. Sánchez-Ledesma; G. García-March; P. Diaz-Cascajo; J. Gómez-Moreta; J. Broseta

1989-01-01

271

Treatment of severe pediatric spinal deformities.  

PubMed

The management of severe pediatric spinal deformities continues to evolve as advances in spinal instrumentation, surgical techniques, and neuromonitoring occur. The techniques of spinal osteotomies have been refined to allow surgeons to perform better corrections with less operative time, more safely, and through a posterior approach alone, making multiple patient positioning changes during surgery a less common occurrence. With these techniques comes a learning curve for the entire surgical team, wherein communication and planning can help minimize major complications and morbidity. This overview will review various techniques used in the correction of severe spinal deformities. Topics reviewed include the role of anterior release, traction, posterior releases, and osteotomies. Indications, techniques, and pitfalls will be reviewed. A clear understanding of the patient's deformity, normal sagittal parameters, spinal anatomy, and the principles of neuromonitoring will help improve surgical planning and patient outcome. PMID:25207730

Lewis, Stephen J; Zamorano, Juan Jose; Goldstein, Christina L

2014-01-01

272

Neurotrophic factors in spinal cord injury.  

PubMed

A major challenge in repairing the injured spinal cord is to assure survival of damaged cells and to encourage regrowth of severed axons. Because neurotrophins are known to affect these processes during development, many experimental approaches to improving function of the injured spinal cord have made use of these agents, particularly Brain derived neurotrophic factor (BDNF) and Neurotrophin-3 (NT-3). More recently, neurotrophins have also been shown to affect the physiology of cells and synapses in the spinal cord. The effect of neurotrophins on circuit performance adds an important dimension to their consideration as agents for repairing the injured spinal cord. In this chapter we discuss the role of neurotrophins in promoting recovery after spinal cord injury from both a structural and functional perspective. PMID:24668482

Boyce, Vanessa S; Mendell, Lorne M

2014-01-01

273

Balloon-assisted transarterial embolization of type 1 spinal dural arteriovenous fistula.  

PubMed

Type 1 spinal dural arteriovenous fistula (dAVF) constitute the vast majority of all spinal vascular malformations. Here we present the case of a 71-year-old male with progressive myelopathy, lower-extremity weakness and numbness, and urinary incontinence. MRI imaging of the thoracic spine demonstrated cord edema, and catheter spinal angiography confirmed a type 1 spinal dAVF. The fistula was supplied by small dural branches of the left L-2 segmental artery. Angiographic cure was achieved with a one-stage procedure in which coils were used to occlude the distal segmental vessels, followed by balloon-assisted embolization with Onyx. The video can be found here: http://youtu.be/8aehJbueH0U . PMID:24983724

Lee, Brian; Mehta, Vivek A; Mack, William J; Tenser, Matthew S; Amar, Arun P

2014-07-01

274

Spinal giant cell tumor in tuberous sclerosis: Case report and review of the literature  

PubMed Central

Background Patients affected by tuberous sclerosis (TS) have a greater incidence of tumors than the healthy population. Spinal tumours in TS are reported very rarely and consist mainly of sacrococcygeal and cervical chordomas. Method Case report. Findings A 21-year-old man, affected by TS, presented a spinal dorsal T2 tumor that caused medullary compression. He underwent decompressive laminectomy and microsurgical excision of a giant cell tumor and an associated aneurysmal bone cyst. Postoperative hypofractionated radiotherapy was performed on the surgical field. At 2.4 years of follow-up the patient reported total recovery of neurological deficits and was free from tumor recurrence. Conclusion Considering this association, which is the first reported in the literature, spinal magnetic resonance imaging with gadolinium should be performed at the onset of spinal pain in patients affected by TS. PMID:23809532

Fraioli, Mario Francesco; Lecce, Mario; Fraioli, Chiara; Paolo, Curatolo

2013-01-01

275

Rhythmic motor patterns accompanying ejaculation in spinal cord-transected male rats.  

PubMed

A spinal pattern generator controls the ejaculatory response. Activation of this spinal generator elicits rhythmic motor patterns of the striated musculature that surrounds the genital tract that contributes to the expulsion of seminal secretions. In the present study, we elicited ejaculation in spinal cord-transected male rats by mechanically stimulating the urethra and registered rhythmic motor patterns in the cremasteric, iliopsoas and pubococcygeus muscles. The rhythmic motor activity recorded in these muscles was compared with that elicited in the bulbospongiosus muscles; the results revealed similarities in the motor parameters among all the muscles. Data of this study, showing the occurrence of rhythmic motor behaviour in the cremasteric, iliopsoas and pubococcygeus muscles during ejaculation, suggest that these muscles might be under the control of the spinal generator for ejaculation. PMID:24553429

Carro-Juárez, M; Rodríguez-Manzo, G; de Lourdes Rodríguez Peña, M; Franco, M Á

2014-09-01

276

Human tail with noncontiguous intraspinal lipoma and spinal cord tethering: case report and embryologic discussion.  

PubMed

Children born with a tail-like appendage have a rare malformation that is frequently associated with abnormalities of the spine and spinal cord. A contiguous fibrolipoma is usually seen extending from the subcutaneous portion of the tail into the inferior spinal cord, resulting in tethered cord syndrome. We present the case of a child born with a tail and intraspinal lipoma that were not contiguous with each other, and were separated by an intact layer of lumbosacral fascia. The tail and lipoma were removed and the spinal cord untethered, and the child is neurologically normal 2 years after surgery. The absence of a contiguous lipoma from the tail to the spinal cord suggests that this condition may be principally caused by a disorder of secondary neurulation and/or regression of the normal embryonic tail bud. The embryology of the lower spine is reviewed and possible etiologies discussed. PMID:15886511

Donovan, Daniel J; Pedersen, Robert C

2005-01-01

277

Melanotic cyst of L5 spinal root: A case report and review of literature.  

PubMed

Till date, 85 cases of melanotic schwannoma and 11 cases of spinal root melanoma have been reported in literature. We are reporting a case of a 45-year-old lady who presented with primary low back pain, and magnetic resonance imaging of lumbo-sacral spine showed at left L5-S1 foraminal lesion extending to the para-spinal compartment. Hemi-laminectomy, facetectomy, and excision of the lesion were done. It was primarily a cystic lesion with attachment to the exiting spinal nerve root. Histopathology of the cyst wall showed a fibro-collagenous stroma with no specific cell lining containing melanin pigment suggestive of a melanotic cyst. The patient was completely relieved of the back pain, and had no recurrence over a follow-up period of one and half years. This case is probably the first reported predominantly cystic, pigmented lesion, affecting the spinal root. PMID:23559992

Chakravarthy, Hariprakash

2012-10-01

278

Intramedullary spinal cord metastasis from pancreatic neuroendocrine tumor  

PubMed Central

Intramedullary spinal cord metastasis (ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor (pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic failure due to tumor progression is the major cause of death in cases of pNET. To date, no report has described a case of ISCM from pNET. Although spinal cord metastasis of a solid tumor is uncommon, it is a critical condition that can cause a potentially irreversible loss of neurologic function. Here, we report the case of a 45-year-old man who presented with leg weakness and voiding difficulty, and was found to have ISCM from pNET. Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET. PMID:25320547

Kim, Jung Ho; Hyun, Chang Lim; Han, Sang Hoon

2014-01-01

279

Intramedullary spinal cord metastasis from pancreatic neuroendocrine tumor.  

PubMed

Intramedullary spinal cord metastasis (ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor (pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic failure due to tumor progression is the major cause of death in cases of pNET. To date, no report has described a case of ISCM from pNET. Although spinal cord metastasis of a solid tumor is uncommon, it is a critical condition that can cause a potentially irreversible loss of neurologic function. Here, we report the case of a 45-year-old man who presented with leg weakness and voiding difficulty, and was found to have ISCM from pNET. Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET. PMID:25320547

Kim, Jung Ho; Hyun, Chang Lim; Han, Sang Hoon

2014-10-14

280

Gabapentin inhibits excitatory synaptic transmission in the hyperalgesic spinal cord  

Microsoft Academic Search

In the present study we tested the eÄects of the antihyperalgesic compound gabapentin on dorsal horn neurones in adult spinal cord. Slices were taken from control and hyperalgesic animals suÄering from streptozocin-induced diabetic neuropathy. At concentrations up to 100 mM, bath application failed to aÄect the resting membrane properties of dorsal horn neurones taken from both groups of animal. In

Manoj K. Patel; M. Isabel Gonzalez; Steven Bramwell; Robert D. Pinnock; Kevin Lee

2000-01-01

281

Positron Emission Tomography in Imaging Spinal Cord Tumors  

Microsoft Academic Search

The ability of positron emission tomography (PET) to detect spinal cord tumors was studied prospectively in 14 patients presenting over a 5-year period. Abnormal uptake by [ 18F]-fluorodeoxyglucose (FDG) or 11C-methionine was detected in all except one. These data were assessed in relation to magnetic resonance imaging (MRI) findings with regard to tumor type and extent preoperatively, findings at operation,

Jo M. Wilmshurst; Sally F. Barrington; Dylan Pritchard; Tim Cox; Peter Bullock; Michael Maisey; Richard O. Robinson

2000-01-01

282

Trauma of the spine and spinal cord: imaging strategies  

Microsoft Academic Search

Traumatic injuries of the spine and spinal cord are common and potentially devastating lesions. We present a comprehensive\\u000a overview of the classification of vertebral fractures, based on morphology (e.g., wedge, (bi)concave, or crush fractures)\\u000a or on the mechanism of injury (flexion-compression, axial compression, flexion-distraction, or rotational fracture-dislocation\\u000a lesions). The merits and limitations of different imaging techniques are discussed, including plain

P. M. Parizel; T. van der Zijden; S. Gaudino; M. Spaepen; M. H. J. Voormolen; C. Venstermans; F. De Belder; L. van den Hauwe; J. Van Goethem

2010-01-01

283

A large intramedullary neurofibroma in the thoracic spinal cord: case report.  

PubMed

Neurofibromas are occasionally present in spinal roots; however, an intramedullary neurofibroma is especially rare. Although a few cases of intramedullary neurofibromas in cervical spinal cord have been reported, to the best of our knowledge, there are no reports of intramedullary neurofibromas in thoracic spinal cord, and moreover, no reports have clearly reported immunohistochemical findings. We report a rare case of a large intramedullary neurofibroma in the thoracic spinal cord and show immunohistochemical examination of the tumor. A 52-year-old man presented with a 2-year history of progressive gait disturbance. Neurological examinations demonstrated complete motor and sensory deficit of his legs. Magnetic resonance imaging of the thoracic spine demonstrated an intramedullary enhancing mass within the spinal cord between T4 and T5 levels. The patient underwent T3-T6 laminectomy surgery. The dura mater was opened to reveal fusiform dilatation of the spinal cord and a midline myelotomy was performed. An intramedullary mass was revealed and could be resected totally. Histopathological examination revealed that the tumor cells exhibited spindle-shaped and wavy nuclei with abundant collagen, which resembled schwannoma or fibrous meningioma. By immunohistochemical examination, some tumor cells were positive for S-100 proteins; however, most tumor cells were strongly positive for CD34. From these pathological findings and immunohistochemical reactions, we diagnosed the intramedullary tumor as a neurofibroma. PMID:24418789

Arishima, Hidetaka; Kitai, Ryuhei; Kodera, Toshiaki; Yamada, Shinsuke; Kikuta, Ken-Ichiro

2014-09-15

284

Pure spinal epidural cavernous hemangioma with intralesional hemorrhage: a rare cause of thoracic myelopathy.  

PubMed

Although cavernous hemangiomas occur frequently in the intracranial structures, they are rare in the spine. Most of spinal hemangiomas are vertebral origin and "pure" epidural hemangiomas not originating from the vertebral bone are very rare. Our spinal hemangioma case is extremely rare because of its "pure" epidural involvement and intralesional hemorrhage. A 64-year-old man presented with progressive paraparesis from two months ago. His motor weakness was rated as grade 4/5 in bilateral lower extremities. He also complained of decreased sensation below the T4 sensory dermatome, which continuously progressed to the higher dermatome level. Magnetic resonance imaging demonstrated thoracic spinal tumor at T3-T4 level. The tumor was located epidural space compressing thoracic spinal cord ventrally. The tumor was not involved with the thoracic vertebral bone. We performed T3-5 laminectomy and removed the tumor completely. The tumor was not infiltrating into intradural space or vertebral bone. The histopathologic study confirmed the epidural tumor as cavernous hemangioma. Postoperatively, his weakness improved gradually. Four months later, his paraparesis recovered completely. Here, we present a case of pure spinal epidural cavernous hemangioma, which has intralesional hemorrhage. We believe cavernous hemangioma should be included in the differential diagnosis of the spinal epidural tumors. PMID:25110490

Jang, Donghwan; Kim, Choonghyo; Lee, Seung Jin; Ryu, Young-Joon; Kim, Jiha

2014-06-01

285

Intraoperative measurement of spinal cord blood flow in syringomyelia  

Microsoft Academic Search

The role of spinal cord ischemia in the pathophysiology of syringomyelia remains undetermined. Previous reports in the literature suggest that shunting of syringes can improve spinal cord blood flow. In order to determine the effects of syrinx decompression on spinal cord blood flow in patients with syringomyelia, we prospectively measured regional spinal cord blood flow (RSCBF) intraoperatively pre and post

William F Young; Ronald Tuma; Timothy O’Grady

2000-01-01

286

Kainate-Mediated Excitotoxicity Induces Neuronal Death in the Rat Spinal Cord In Vitro via a PARP1 Dependent Cell Death Pathway (Parthanatos)  

Microsoft Academic Search

Kainate is an effective excitotoxic agent to lesion spinal cord networks, thus providing an interesting model for investigating\\u000a basic mechanisms of spinal cord injury. The present study aimed at revealing the type and timecourse of cell death in rat\\u000a neonatal spinal cord preparations in vitro exposed to 1 h excitotoxic insult with kainate. Substantial numbers of neurons\\u000a rather than glia showed

Anujaianthi Kuzhandaivel; Andrea Nistri; Miranda Mladinic

2010-01-01

287

Characterization of Vascular Disruption and Blood-Spinal Cord Barrier Permeability following Traumatic Spinal Cord Injury  

PubMed Central

Abstract Significant vascular changes occur subsequent to spinal cord injury (SCI), which contribute to progressive pathophysiology. In the present study, we used female Wistar rats (300–350?g) and a 35-g clip-compression injury at T6 to T7 to characterize the spatial and temporal vascular changes that ensue post-SCI. Before sacrifice, animals were injected with vascular tracing dyes (2% Evans Blue (EB) or fluorescein isothiocyanate/Lycopersicon esculentum agglutinin [FITC-LEA]) to assess blood–spinal cord barrier (BSCB) integrity or vascular architecture, respectively. Spectrophotometry of EB tissue showed maximal BSCB disruption at 24?h postinjury, with significant disruption observed until 5 days postinjury (p<0.01). FITC-LEA-identified functional vasculature was dramatically reduced by 24?h. Similarly, RECA-1 immunohistochemistry showed a significant decrease in the number of vessels at 24?h postinjury, compared to uninjured animals (p<0.01), with slight increases in endogenous revascularization by 10 days postinjury. White versus gray matter (GM) quantification showed that GM vessels are more susceptible to SCI. Finally, we observed an endogenous angiogenic response between 3 and 7 days postinjury: maximal endothelial cell proliferation was observed at day 5. These data indicate that BSCB disruption and endogenous revascularization occur at specific time points after injury, which may be important for developing effective therapeutic interventions for SCI. PMID:24237182

Figley, Sarah A.; Khosravi, Ramak; Legasto, Jean M.; Tseng, Yun-Fan

2014-01-01

288

Mechanisms involved in spinal cord central synapse loss in a mouse model of spinal muscular atrophy.  

PubMed

Motoneuron (MN) cell death is the histopathologic hallmark of spinal muscular atrophy (SMA), although MN loss seems to be a late event. Conversely, disruption of afferent synapses on MNs has been shown to occur early in SMA. Using a mouse model of severe SMA (SMN?7), we examined the mechanisms involved in impairment of central synapses. We found that MNs underwent progressive degeneration in the course of SMA, with MN loss still occurring at late stages. Loss of afferent inputs to SMA MNs was detected at embryonic stages, long before MN death. Reactive microgliosis and astrogliosis were present in the spinal cord of diseased animals after the onset of MN loss. Ultrastructural observations indicate that dendrites and microglia phagocytose adjacent degenerating presynaptic terminals. Neuronal nitric oxide synthase was upregulated in SMN?7 MNs, and there was an increase in phosphorylated myosin light chain expression in synaptic afferents on MNs; these observations implicate nitric oxide in MN deafferentation and suggest that the RhoA/ROCK pathway is activated. Together, our observations suggest that the earliest change occurring in SMN?7 mice is the loss of excitatory glutamatergic synaptic inputs to MNs; reduced excitability may enhance their vulnerability to degeneration and death. PMID:24806302

Tarabal, Olga; Caraballo-Miralles, Víctor; Cardona-Rossinyol, Andrea; Correa, Francisco J; Olmos, Gabriel; Lladó, Jerònia; Esquerda, Josep E; Calderó, Jordi

2014-06-01

289

Learning from the spinal cord: How the study of spinal cord plasticity informs our view of learning  

E-print Network

Review Learning from the spinal cord: How the study of spinal cord plasticity informs our view o Article history: Available online xxxx Keywords: Spinal cord Instrumental conditioning Pavlovian training can induce a lasting change in spinal cord function. A framework for the study of learning

Grau, James

290

Stem cell therapy for the spinal cord.  

PubMed

Injury and disease of the spinal cord are generally met with a poor prognosis. This poor prognosis is due not only to the characteristics of the diseases but also to our poor ability to deliver therapeutics to the spinal cord. The spinal cord is extremely sensitive to direct manipulation, and delivery of therapeutics has proven a challenge for both scientists and physicians. Recent advances in stem cell technologies have opened up a new avenue for the treatment of spinal cord disease and injury. Stem cells have proven beneficial in rodent models of spinal cord disease and injury. In these animal models, stem cells have been shown to produce their effect by the dual action of cell replacement and the trophic support of the factors secreted by these cells. In this review we look at the main clinical trials involving stem cell transplant into the spinal cord, focusing on motor neuron diseases and spinal cord injury. We will also discuss the major hurdles in optimizing stem cell delivery methods into the spinal cord. We shall examine current techniques such as functional magnetic resonance imaging guidance and cell labeling and will look at the current research striving to improve these techniques. With all caveats and future research taken into account, this is a very exciting time for stem cell transplant into the spinal cord. We are only beginning to realize the huge potential of stem cells in a central nervous system setting to provide cell replacement and trophic support. Many more trials will need to be undertaken before we can fully exploit the attributes of stem cells. PMID:22776143

Donnelly, Eleanor M; Lamanna, Jason; Boulis, Nicholas M

2012-01-01

291

Stem cell therapy for the spinal cord  

PubMed Central

Injury and disease of the spinal cord are generally met with a poor prognosis. This poor prognosis is due not only to the characteristics of the diseases but also to our poor ability to deliver therapeutics to the spinal cord. The spinal cord is extremely sensitive to direct manipulation, and delivery of therapeutics has proven a challenge for both scientists and physicians. Recent advances in stem cell technologies have opened up a new avenue for the treatment of spinal cord disease and injury. Stem cells have proven beneficial in rodent models of spinal cord disease and injury. In these animal models, stem cells have been shown to produce their effect by the dual action of cell replacement and the trophic support of the factors secreted by these cells. In this review we look at the main clinical trials involving stem cell transplant into the spinal cord, focusing on motor neuron diseases and spinal cord injury. We will also discuss the major hurdles in optimizing stem cell delivery methods into the spinal cord. We shall examine current techniques such as functional magnetic resonance imaging guidance and cell labeling and will look at the current research striving to improve these techniques. With all caveats and future research taken into account, this is a very exciting time for stem cell transplant into the spinal cord. We are only beginning to realize the huge potential of stem cells in a central nervous system setting to provide cell replacement and trophic support. Many more trials will need to be undertaken before we can fully exploit the attributes of stem cells. PMID:22776143

2012-01-01

292

Serotonin affects movement gain control in the spinal cord.  

PubMed

A fundamental challenge for the nervous system is to encode signals spanning many orders of magnitude with neurons of limited bandwidth. To meet this challenge, perceptual systems use gain control. However, whether the motor system uses an analogous mechanism is essentially unknown. Neuromodulators, such as serotonin, are prime candidates for gain control signals during force production. Serotonergic neurons project diffusely to motor pools, and, therefore, force production by one muscle should change the gain of others. Here we present behavioral and pharmaceutical evidence that serotonin modulates the input-output gain of motoneurons in humans. By selectively changing the efficacy of serotonin with drugs, we systematically modulated the amplitude of spinal reflexes. More importantly, force production in different limbs interacts systematically, as predicted by a spinal gain control mechanism. Psychophysics and pharmacology suggest that the motor system adopts gain control mechanisms, and serotonin is a primary driver for their implementation in force production. PMID:25232107

Wei, Kunlin; Glaser, Joshua I; Deng, Linna; Thompson, Christopher K; Stevenson, Ian H; Wang, Qining; Hornby, Thomas George; Heckman, Charles J; Kording, Konrad P

2014-09-17

293

Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review  

PubMed Central

Lumbar spinal stenosis (LSS) is mostly caused by osteoarthritis (spondylosis). Clinically, the symptoms of patients with LSS can be categorized into two groups; regional (low back pain, stiffness, and so on) or radicular (spinal stenosis mainly presenting as neurogenic claudication). Both of these symptoms usually improve with appropriate conservative treatment, but in refractory cases, surgical intervention is occasionally indicated. In the patients who primarily complain of radiculopathy with an underlying biomechanically stable spine, a decompression surgery alone using a less invasive technique may be sufficient. Preoperatively, with the presence of indicators such as failed back surgery syndrome (revision surgery), degenerative instability, considerable essential deformity, symptomatic spondylolysis, refractory degenerative disc disease, and adjacent segment disease, lumbar fusion is probably recommended. Intraoperatively, in cases with extensive decompression associated with a wide disc space or insufficient bone stock, fusion is preferred. Instrumentation improves the fusion rate, but it is not necessarily associated with improved recovery rate and better functional outcome.

Hasankhani, Ebrahim Ghayem; Ashjazadeh, Amir

2014-01-01

294

Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section  

PubMed Central

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthesia for cesarean section. Early recognition of symptoms of neurologic impairment led to an emergency craniotomy for hematoma evacuation with good recovery of neurologic functions. The possibility of subdural hematoma should be considered in any patient complaining of severe persistent headache following regional anesthesia, unrelieved by conservative measures. Only early diagnosis and an appropriate treatment may avoid death or irreversible neurologic damage. PMID:24455348

Schweiger, Vittorio; Zanconato, Giovanni; Lonati, Gisella; Gottin, Leonardo; Polati, Enrico

2013-01-01

295

Spinal glial TLR4-mediated nociception and production of prostaglandin E2 and TNF  

PubMed Central

Background and purpose: Toll-like receptor 4 (TLR4) expressed on spinal microglia and astrocytes has been suggested to play an important role in the regulation of pain signalling. The purpose of the present work was to examine the links between TLR4, glial activation and spinal release of prostaglandin E2 (PGE2) and tumour necrosis factor (TNF), and the role these factors play in TLR4-induced tactile allodynia. Experimental approach: Toll-like receptor 4 was activated by intrathecal (i.t.) injection of lipopolysaccharide (LPS) and KDO2-Lipid A (KDO2) to rats. Tactile allodynia was assessed using von Frey filaments and cerebrospinal fluid collected through spinal dialysis and lumbar puncture. PGE2 and TNF levels were measured by mass spectometry and elisa. Minocycline and pentoxifylline (glia inhibitors), etanercept (TNF-blocker) and ketorolac (COX-inhibitor) were given i.t. prior to injection of the TLR4-agonists, in order to determine if these agents alter TLR4-mediated nociception and the spinal release of PGE2 and TNF. Key results: Spinal administration of LPS and KDO2 produced a dose-dependent tactile allodynia, which was attenuated by pentoxifylline, minocycline and etanercept but not ketorolac. Both TLR4 agonists induced the spinal release of PGE2 and TNF. Intrathecal pentoxifylline blunted PGE2 and TNF release, while i.t. minocycline only prevented the spinal release of TNF. The release of PGE2 induced by LPS and KDO2 was attenuated by i.t. administration of ketorolac. Conclusions and implications: Activation of TLR4 induces tactile allodynia, which is probably mediated by TNF released by activated spinal glia. PMID:20649577

Saito, O; Svensson, CI; Buczynski, MW; Wegner, K; Hua, X-Y; Codeluppi, S; Schaloske, RH; Deems, RA; Dennis, EA; Yaksh, TL

2010-01-01

296

Cannabidiol-treated rats exhibited higher motor score after cryogenic spinal cord injury.  

PubMed

Cannabidiol (CBD), a non-psychoactive constituent of cannabis, has been reported to induce neuroprotective effects in several experimental models of brain injury. We aimed at investigating whether this drug could also improve locomotor recovery of rats submitted to spinal cord cryoinjury. Rats were distributed into five experimental groups. Animals were submitted to laminectomy in vertebral segment T10 followed or not by application of liquid nitrogen for 5 s into the spinal cord at the same level to cause cryoinjury. The animals received injections of vehicle or CBD (20 mg/kg) immediately before, 3 h after and daily for 6 days after surgery. The Basso, Beattie, and Bresnahan motor evaluation test was used to assess motor function post-lesion one day before surgery and on the first, third, and seventh postoperative days. The extent of injury was evaluated by hematoxylin-eosin histology and FosB expression. Cryogenic lesion of the spinal cord resulted in a significant motor deficit. Cannabidiol-treated rats exhibited a higher Basso, Beattie, and Bresnahan locomotor score at the end of the first week after spinal cord injury: lesion + vehicle, day 1: zero, day 7: four, and lesion + Cannabidiol 20 mg/kg, day 1: zero, day 7: seven. Moreover, at this moment there was a significant reduction in the extent of tissue injury and FosB expression in the ventral horn of the spinal cord. The present study confirmed that application of liquid nitrogen to the spinal cord induces reproducible and quantifiable spinal cord injury associated with locomotor function impairments. Cannabidiol improved locomotor functional recovery and reduced injury extent, suggesting that it could be useful in the treatment of spinal cord lesions. PMID:21915768

Kwiatkoski, Marcelo; Guimarães, Francisco Silveira; Del-Bel, Elaine

2012-04-01

297

A Spatiotemporal Pattern of Concurrent Spinal and Supraspinal NF-?B Expression Following Peripheral Nerve Injury  

PubMed Central

The expression of NF-?B in the spinal cord is associated with neuropathic pain. However, little is known about its expression beyond the spinal cord. Here we examined a spatial and temporal pattern of the NF-?B expression in both spinal and supraspinal regions. After chronic constriction injury (CCI) of the sciatic nerve, the NF-?B (p65) expression was significantly increased in the ipsilateral spinal cord. In contrast, the NF-?B expression in the contralateral primary somatosensory cortex was decreased with no significant differences seen in the thalamus. In the contralateral anterior cingulate cortex, the NF-?B expression was increased significantly on day 14 as compared to the sham group. In the contralateral amygdala, the NF-?B expression showed a time-dependent downregulation after CCI, which became significant on day 14. MK-801 reduced nociceptive behaviors and reversed the direction of NF-?B expression. These results indicate that the CCI-induced expression of p65 NF-?B is both time-dependent and region-specific, in areas that process both sensory-discriminative and motivational-affective dimensions of pain. Perspective This article presents a spatiotemporal mapping of the NF-?B expression in spinal and supraspinal regions following peripheral nerve injury. These findings point to an involvement of NF-?B beyond the spinal cord in both the sensory discriminative and emotional affective aspects of neuropathic pain processing. PMID:20537956

Chou, Chiu-Wen; Wong, Gordon T.C.; Lim, Grewo; Wang, Shuxing; Irwin, Michael G.; Mao, Jianren

2010-01-01

298

Air gun impactor--a novel model of graded white matter spinal cord injury in rodents.  

PubMed

Understanding mechanisms of spinal cord injury and repair requires a reliable experimental model. We have developed a new device that produces a partial damage of spinal cord white matter by means of a precisely adjusted stream of air applied under high pressure. This procedure is less invasive than standard contusion or compression models and does not require surgical removal of vertebral bones. We investigated the effects of spinal cord injury made with our device in 29 adult rats, applying different experimental parameters. The rats were divided into three groups in respect to the applied force of the blast wave. Functional outcome and histopathological effects of the injury were analyzed during 12-week follow-up. The lesions were also examined by means of magnetic resonance imaging (MRI) scans. The weakest stimulus produced transient hindlimb paresis with no cyst visible in spinal cord MRI scans, whereas the strongest was associated with permanent neurological deficit accompanied by pathological changes resembling posttraumatic syringomyelia. Obtained data revealed that our apparatus provided a spinal cord injury animal model with structural changes very similar to that present in patients after moderate spinal cord trauma. PMID:22711195

Marcol, Wies?aw; Slusarczyk, Wojciech; Gzik, Marek; Larysz-Brysz, Magdalena; Bobrowski, Micha?; Grynkiewicz-Bylina, Beata; Rosicka, Paulina; Kalita, Katarzyna; W?glarz, W?adys?aw; Barski, Jaros?aw J; Kotulska, Katarzyna; Labuzek, Krzysztof; Lewin-Kowalik, Joanna

2012-10-01

299

Treadmill training enhances the recovery of normal stepping patterns in spinal cord contused rats?  

PubMed Central

Treadmill training is known to improve stepping in complete spinal cord injured animals. Few studies have examined whether treadmill training also enhances locomotor recovery in animals following incomplete spinal cord injuries. In the present study, we compared locomotor recovery in trained and untrained rats that received a severe mid-thoracic contusion of the spinal cord. A robotic device was used to train and to test bipedal hindlimb stepping on a treadmill. Training was imposed for 8 weeks. The robotic device supported the weight of the rats and recorded ankle movements in the hindlimbs for movement analyses. Both the trained and untrained rats generated partial weight bearing hindlimb steps after the spinal cord contusion. Dragging during swing was more prevalent in the untrained rats than the trained rats. In addition, only the trained rats performed step cycle trajectories that were similar to normal step cycle trajectories in terms of the trajectory shape and movement velocity characteristics. In contrast, untrained rats executed step cycles that consisted of fast, kick-like movements during forward swing. These findings indicate that spinal cord contused rats can generate partial weight bearing stepping in the absence of treadmill training. The findings also suggest that the effect of treadmill training is to restore normal patterns of hindlimb movements following severe incomplete spinal cord injury in rats. PMID:19111541

Heng, Chad; de Leon, Ray D.

2012-01-01

300

Failure of spinal paired associative stimulation to induce neuroplasticity in the human corticospinal tract.  

PubMed

Context/Objective Paired associative stimulation (PAS) involves paired-stimulation pulses at both the head (via transcranial magnetic stimulation) and the periphery (via peripheral nerve stimulation). The purpose of PAS, when applied to the spinal cord, is to induce neuroplasticity and upregulate the corticospinal tract leading to effector muscles. While limited research has suggested that it is possible to produce neuroplasticity through spinal PAS, all such studies have provided stimulation at a fixed frequency of 0.1 or 0.2 Hz. Design/Interventions The present study therefore sought to compare the effectiveness of a typical 0.1 Hz paradigm with a 1 Hz paradigm, and a paradigm which provided stimulation in 5 Hz "bursts". Two inter-stimulus intervals were tested: one which was expected to produce synchronous pre- and post-synaptic activation at the spinal synapse, and one which was not. The peripheral stimulation was applied at the wrist, to induce thumb adduction. Results None of the paradigms were able to successfully induce neuroplasticity in a consistent manner. Conclusion The high between-subject variability in this study suggests that responses to the spinal PAS treatment may have been highly individual. This serves to highlight a potential limitation of the spinal PAS treatment, which is that its effectiveness may not be universal, but rather dependent on each specific recipient. This may be a challenge faced by spinal PAS should it continue to be tested as a potential novel therapy. PMID:25229738

McGie, Steven C; Masani, Kei; Popovic, Milos R

2014-09-01

301

Evidence of endothelial progenitor cells in the human brain and spinal cord arteriovenous malformations  

PubMed Central

Objective Brain and spinal cord arteriovenous malformations (AVMs) are characterized by aberrant angiogenesis and vascular remodeling. Endothelial progenitor cells (EPCs) can be recruited by stromal cell-derived factor-1 (SDF-1), and participate in vascular remodeling in both physiological and pathological settings. We hypothesized that there was increased EPC levels in the brain and spinal cord AVM nidus. Methods Microsurgical specimens without endovascular embolization and radiosurgery from the brain (n=12) and spinal cord (n=5) AVMs were examined. Hemangioblastoma, meningioma, cerebral cortex obtained from epilepsy surgery, and the basilar artery (BA) from the autopsy were chosen for control comparisons. EPCs were identified as cells that were double-positive for the stem cell marker CD133 and the endothelial cell marker VEGFR-2 (vascular endothelial growth factor receptor-2 or KDR). In addition, SDF-1 was characterized by immunohistochemistry. Results Both brain and spinal AVM tissues displayed more CD133, SDF-1, and CD68-positive signals than epilepsy and basilar artery control tissues. The level of EPCs was increased in the brain and spinal cord AVM nidus, mainly at the edge of the vessel wall. The expression of SDF-1 was co-localized with CD31-positive and ?-smooth muscle cells, and was predominantly found within the vessel wall. Conclusion Our data demonstrate that EPCs are present in the nidus of the brain and spinal cord AVMs, which may mediate pathological vascular remodeling and impact the clinical course of AVMs. PMID:20881566

Gao, Peng; Chen, Yongmei; Lawton, Michael T.; Barbaro, Nicholas M.; Yang, Guo-Yuan; Su, Hua; Ling, Feng; Young, William L.

2010-01-01

302

Cerebral and spinal vascular involvement in Hereditary Hemorrhagic Telengiectasia: Report of two cases  

PubMed Central

Introduction We present two cases of Hereditary Hemmorhagic Telengiectasia (HHT), one pediatric and the other adult, with a view to highlight the myriad cerebral and spinal vascular manifestations of this disease. The syndrome and its various findings will be reviewed including the utility of angiography in assessing the various vascular abnormalities of the cerebral and spinal vasculature. Methods A review of literature regarding various developmental abnormalities including brain and spinal cord arterio-venous malformations (AVMs), arterio-venous fistulae (AVFs), micro AVMs, micro-fistulae, aneurysms and cavernomas that occur in pediatric and adult population subsets of HHT. Both patients underwent thorough clinical and laboratory evaluation. The pediatric patient underwent a contrast enhanced computed tomography (CECT) of the chest; cerebral, Pulmonary & celiac angiography. The adult patient underwent cerebral and spinal angiography. Conclusion The spectrum of vascular malformations in Hereditary Hemorrhagic Telengiectasia (HHT) is varied.The incidence and manifestations of brain and spinal cord AVMs, AVFs, micro AVMs, micro-fistulae, aneurysms and cavernomas are different in the pediatric and adults affected by the disease. Cerebral and spinal angiography are necessary in characterising the various developmental vascular abnormalities in order to guide further management.

Sivasankar, Rajeev; Saraf, Rashmi; Pawal, Sambhaji; Limaye, Uday S

2014-01-01

303

Human Neural Stem Cell Replacement Therapy for Amyotrophic Lateral Sclerosis by Spinal Transplantation  

PubMed Central

Background Mutation in the ubiquitously expressed cytoplasmic superoxide dismutase (SOD1) causes an inherited form of Amyotrophic Lateral Sclerosis (ALS). Mutant synthesis in motor neurons drives disease onset and early disease progression. Previous experimental studies have shown that spinal grafting of human fetal spinal neural stem cells (hNSCs) into the lumbar spinal cord of SOD1G93A rats leads to a moderate therapeutical effect as evidenced by local ?-motoneuron sparing and extension of lifespan. The aim of the present study was to analyze the degree of therapeutical effect of hNSCs once grafted into the lumbar spinal ventral horn in presymptomatic immunosuppressed SOD1G93A rats and to assess the presence and functional integrity of the descending motor system in symptomatic SOD1G93A animals. Methods/Principal Findings Presymptomatic SOD1G93A rats (60–65 days old) received spinal lumbar injections of hNSCs. After cell grafting, disease onset, disease progression and lifespan were analyzed. In separate symptomatic SOD1G93A rats, the presence and functional conductivity of descending motor tracts (corticospinal and rubrospinal) was analyzed by spinal surface recording electrodes after electrical stimulation of the motor cortex. Silver impregnation of lumbar spinal cord sections and descending motor axon counting in plastic spinal cord sections were used to validate morphologically the integrity of descending motor tracts. Grafting of hNSCs into the lumbar spinal cord of SOD1G93A rats protected ?-motoneurons in the vicinity of grafted cells, provided transient functional improvement, but offered no protection to ?-motoneuron pools distant from grafted lumbar segments. Analysis of motor-evoked potentials recorded from the thoracic spinal cord of symptomatic SOD1G93A rats showed a near complete loss of descending motor tract conduction, corresponding to a significant (50–65%) loss of large caliber descending motor axons. Conclusions/Significance These data demonstrate that in order to achieve a more clinically-adequate treatment, cell-replacement/gene therapy strategies will likely require both spinal and supraspinal targets. PMID:22916141

Hefferan, Michael P.; Galik, Jan; Kakinohana, Osamu; Sekerkova, Gabriela; Santucci, Camila; Marsala, Silvia; Navarro, Roman; Hruska-Plochan, Marian; Johe, Karl; Feldman, Eva; Cleveland, Don W.; Marsala, Martin

2012-01-01

304

Nanomedicine for treating spinal cord injury.  

PubMed

Spinal cord injury results in significant mortality and morbidity, lifestyle changes, and difficult rehabilitation. Treatment of spinal cord injury is challenging because the spinal cord is both complex to treat acutely and difficult to regenerate. Nanomaterials can be used to provide effective treatments; their unique properties can facilitate drug delivery to the injury site, enact as neuroprotective agents, or provide platforms to stimulate regrowth of damaged tissues. We review recent uses of nanomaterials including nanowires, micelles, nanoparticles, liposomes, and carbon-based nanomaterials for neuroprotection in the acute phase. We also review the design and neural regenerative application of electrospun scaffolds, conduits, and self-assembling peptide scaffolds. PMID:23945984

Tyler, Jacqueline Y; Xu, Xiao-Ming; Cheng, Ji-Xin

2013-10-01

305

Microsurgical resection of intramedullary spinal cord hemangioblastoma.  

PubMed

Spinal cord hemangioblastomas account for about 10% of spinal cord tumors. They usually arise from the dorsolateral pia mater and are characterized by their significant vascularity. The principles and techniques of safe resection are different than those employed for the more commonly occurring intramedullary glial tumors (e.g. ependymoma, astrocytoma) and consist of circumferential detachment of the tumor margin from the surrounding normal pia. This video demonstrates the microsurgical techniques of resection of a thoracic spinal cord hemangioblastoma. The video can be found here: http://youtu.be/yT5KLi4VyAo. PMID:25175571

McCormick, Paul C

2014-09-01

306

Extra-intradural Spinal Meningioma: A Case Report.  

PubMed

Extradural spinal meningiomas are uncommon, and their pathophysiology is not entirely understood. Here, we present the case of a 49-year-old woman with low back and left leg pain of 5 years duration. Magnetic resonance imaging revealed a mass, 1.8-cm in size, with rim enhancement in the spinal canal at the T12 level and extending into the left T12-L1 foramen. In the surgical field, the mass presented with the characteristics of an extra-intradural spinal meningioma. The patient underwent a T12 total laminectomy. A linear durotomy was performed at the midline, and the intradural portion was removed. The extradural portion was not separable from the adjacent dura and the left T12 root, and it was removed by dural excision. Pathological examination confirmed the diagnosis of psammomatous meningioma. We also conducted a literature review of similar cases. Based on our experience with this case, we believe that it is important to clearly distinguish extradural meningiomas from other types of tumors as misdiagnosis can change the operative plan. The long term prognosis of extradural meningiomas is not clear but total excision is thought to be essential. PMID:25346770

Jeong, Seong Kyun; Seong, Han Yu; Roh, Sung Woo

2014-09-01

307

Simultaneous discovery of cranial and spinal intradural chordomas: case report.  

PubMed

The present case illustrates the unexpected occurrence of intradural chordomas that were simultaneously discovered in cranial and spinal locations. A 63-year-old female presented with weakness in the left upper extremity. The patient visited a local doctor and underwent brain computerized tomography (CT). CT revealed a brain tumor, and she was referred to our hospital. Brain magnetic resonance imaging (MRI) demonstrated a midline intradural retroclival tumor in addition to an intradural extramedullary mass lesion at the level of C1-C2. The patient developed a spastic gait disturbance that forced her to use a cane. She underwent laminectomy at C1-C2 along with total removal of the tumor and showed no remarkable symptoms after surgery. Histopathological examination confirmed the diagnosis of chordoma. One month after the cervical surgery, the intracranial tumor was subtotally removed in intracranial surgery via the right subtemporal approach. Histopathological data were identical to that of the cervical tumor. The patient consulted another hospital and underwent gamma-knife surgery. Her neurological examination is relatively unchanged 20 months after the cervical surgery. This case suggests that neuroradiological evaluation should also be performed for an intradural spinal chordoma when an intracranial chordoma is detected. Careful determination of the tumor responsible for the symptoms is necessary if an intradural spinal chordoma is simultaneously detected with an intracranial chordoma. PMID:24477062

Kawanabe, Yoshifumi; Ueda, Shigeo; Sasaki, Nobuhiro; Hoshimaru, Minoru

2014-11-15

308

The Reliability of Red Flags in Spinal Cord Compression  

PubMed Central

Background: Acute low back pain is a common cause for presentation to the emergency department (ED). Since benign etiologies account for 95% of cases, red flags are used to identify sinister causes that require prompt management. Objectives: We assessed the effectiveness of red flag signs used in the ED to identify spinal cord and cauda equine compression. Patients and Methods: It was a retrospective cohort study of 206 patients with acute back pain admitted from the ED. The presence or absence of the red flag symptoms was assessed against evidence of spinal cord or cauda equina compression on magnetic resonance imaging (MRI). Results: Overall, 32 (15.5%) patients had compression on MRI. Profound lower limb neurologic examination did not demonstrate a statistically significant association with this finding. The likelihood ratio (LR) for bowel and bladder dysfunction (sensitivity of 0.65 and specificity of 0.73) was 2.45. Saddle sensory disturbance (sensitivity of 0.27 and specificity of 0.87) had a LR of 2.11. When both symptoms were taken together (sensitivity of 0.27 and specificity of 0.92), they gave a LR of 3.46. Conclusions: The predictive value of the two statistically significant red flags only marginally raises the clinical suspicion of spinal cord or cauda equina compression. Effective risk stratification of patients presenting to the ED with acute back pain is crucial; however, this study did not support the use of these red flags in their current form. PMID:25032171

Raison, Nicholas Tobias Johannes; Alwan, Wisam; Abbot, Amit; Farook, Mohamed; Khaleel, Arshad

2014-01-01

309

Extra-intradural Spinal Meningioma: A Case Report  

PubMed Central

Extradural spinal meningiomas are uncommon, and their pathophysiology is not entirely understood. Here, we present the case of a 49-year-old woman with low back and left leg pain of 5 years duration. Magnetic resonance imaging revealed a mass, 1.8-cm in size, with rim enhancement in the spinal canal at the T12 level and extending into the left T12-L1 foramen. In the surgical field, the mass presented with the characteristics of an extra-intradural spinal meningioma. The patient underwent a T12 total laminectomy. A linear durotomy was performed at the midline, and the intradural portion was removed. The extradural portion was not separable from the adjacent dura and the left T12 root, and it was removed by dural excision. Pathological examination confirmed the diagnosis of psammomatous meningioma. We also conducted a literature review of similar cases. Based on our experience with this case, we believe that it is important to clearly distinguish extradural meningiomas from other types of tumors as misdiagnosis can change the operative plan. The long term prognosis of extradural meningiomas is not clear but total excision is thought to be essential.

Jeong, Seong Kyun; Seong, Han Yu

2014-01-01

310

Spinal Epidural Lipomatosis in Korean  

PubMed Central

Spinal epidural lipomatosis (SEL) is a rare disorder, regarded in literature as a consequence of administration of exogenous steroids, associated with a variety of systemic diseases, endocrinopathies and the Cushing's syndrome. Occasionally, SEL may occur in patients not exposed to steroids or suffering from endocrinopathies, namely, idiopathic SEL. Thus far, case studies of SEL among Korean have been published rather sporadically. We reviewed the clinical features of SEL cases, among Koreans with journal review, including this report of three operated cases. According to this study, there were some differences between Korean and western cases. Koreans had higher incidences of idiopathic SEL, predominant involvement in the lumbar segments, very few thoracic involvement and lower MBI, as opposed to westerners.

Yoo, Je Chul; Choi, Jeong Jae; Lee, Dong Woo

2014-01-01

311

Integrating spinal codes into wireless systems  

E-print Network

Rateless spinal codes [47] promise performance gains for future wireless systems. These gains can be realized in the form of higher data rates, longer operational ranges, reduced power consumption, and greater reliability. ...

Iannucci, Peter Anthony

2013-01-01

312

Spinal cord implants for nerve regeneration  

E-print Network

It has only been in the last couple decades that the potential for regeneration in the spinal cord became accepted. However, there is still no proven method for enabling this regeneration. An implant model was developed ...

Abbaschian, Lara Suzanne, 1979-

2004-01-01

313

Spinal Cord Stroke: Acute Imaging and Intervention  

PubMed Central

Spinal cord infarction is an uncommon disease and as such is often a diagnostic challenge for clinicians. It can vary in its onset, severity, outcome, and recovery from patient to patient. Treatment options for this relatively rare condition also remain elusive. Current consensus recommendations are antiplatelet therapy and the symptomatic management of associated complications such as paraplegia and thromboembolic disease. There are multiple studies in surgical literature of a variety of interventions and adjuncts used for reducing the risk of ischemic spinal cord neurological injury, seen most often in the setting of thoracoabdominal aortic repair operations. We report two cases of acute non-surgical-related spinal cord infarcts, where early diagnosis was made and aggressive, early treatments instituted. With often devastating outcomes, we highlight the need for early detection and that interventions, commonly used in preventing neurological injury after high-risk aneurysm repairs, may be beneficial in treating and reducing the severity of disability in acute spinal cord stroke. PMID:22937358

Lynch, Karen; Oster, Joel; Apetauerova, Diana; Hreib, Kinan

2012-01-01

314

Intraspinal microstimulation for the recovery of function following spinal cord injury  

PubMed Central

Spinal cord injury is a devastating neurological trauma, often resulting in the impairment of bladder, bowel, and sexual function as well as the loss of voluntary control of muscles innervated by spinal cord segments below the lesion site. Research is ongoing into several classes of therapies to restore lost function. These include the encouragement of neural sparing and regeneration of the affected tissue, and the intervention with pharmacological and rehabilitative means to improve function. This review will focus on the application of electrical current in the spinal cord in order to reactivate extant circuitry which coordinates and controls smooth and skeletal muscle below the injury. We first present a brief historical review of intraspinal microstimulation (ISMS) focusing on its use for restoring bladder function after spinal cord injury as well as its utilization as a research tool for mapping spinal cord circuits that coordinate movements. We then present a review of our own results related to the use of ISMS for restoring standing and walking movements after spinal cord injury. We discuss the mechanisms of action of ISMS and how they relate to observed functional outcomes in animal models. These include the activation of fibers-in-passage which lead to the transsynaptic spread of activation through the spinal cord and the ability of ISMS to produce fatigue-resistant, weight-bearing movements. We present our thoughts on the clinical potential for ISMS with regard to implantation techniques, stability, and damage induced by mechanical and electrical factors. We conclude by suggesting improvements in materials and techniques that are needed in preparation for a clinical proof-of-principle and review our current attempts to achieve these. PMID:21867807

Bamford, Jeremy A.; Mushahwar, Vivian K.

2011-01-01

315

Spinal cord modulation associated with isometric contractions  

Microsoft Academic Search

Objective: The dual-strategy hypothesis explains single-joint voluntary movement by dividing movements into two different strategies and suggesting that different excitation pulses modulate these movements. The existence of this excitation pulse was evaluated by quantifying magnitude and timing changes in the H-reflex (changes in spinal excitability) prior to a voluntary contraction. These changes in spinal excitability were assessed during a ballistic

Julie A Robichaud; Denis Brunt; L Keith Tennant

2002-01-01

316

Spinal cord blood flow following subarachnoid tetracaine  

Microsoft Academic Search

Spinal cord and spinal durai blood flow in the cervical, thoracic and lumbosacral regions were measured in dogs using the\\u000a radioactive microsphere technique. Measurements were taken before and 20 and 40 minutes after lumbar subarachnoid injection\\u000a of one of the following: (I) physiologic saline; (2) tetracaine 20 mg or (3) tetracaine 20 mg with epinephrine 200 ?g. No\\u000a significant change

Raymond Kozody; Richard J. Palahniuk; Maureen O. Cumming

1985-01-01

317

Metal levels in corrosion of spinal implants  

Microsoft Academic Search

Corrosion affects spinal instrumentations and may cause local and systemic complications. Diagnosis of corrosion is difficult,\\u000a and nowadays it is performed almost exclusively by the examination of retrieved instrumentations. We conducted this study\\u000a to determine whether it is possible to detect corrosion by measuring metal levels on patients with posterior instrumented\\u000a spinal fusion. Eleven asymptomatic patients, with radiological signs of

Javier del Rio; Jose Beguiristain; Julio Duart

2007-01-01

318

Spinal fusion in situ in osteogenesis imperfecta  

Microsoft Academic Search

Summary.   \\u000a Osteogenesis imperfecta in its most severe forms has a devastating effect on the peripheral and central skeleton, and patients\\u000a are unable to walk. Spinal deformity is common and causes difficulty in sitting, pain and potentially life-threatening complications.\\u000a Instrumented spinal fusion might be considered the treatment of choice, but the bone may be too weak to sustain the implants

P. J. Livesley; P. J. Webb

1996-01-01

319

Repair of the Injured Spinal Cord  

Microsoft Academic Search

The myelin protein Nogo-A is a potent inhibitor of neurite outgrowth in the central nervous system, thus contributing to the incapacity of fiber tracts in the adult spinal cord to regenerate after injury. In this review we report on a joint approach of different research groups to develop a therapy applying anti-Nogo-A antibodies to the injured spinal cord. While basic

Anita D. Buchli; Eric Rouiller; Roland Mueller; Volker Dietz; Martin E. Schwab

2007-01-01

320

The outcome of spinal decompression surgery 5 years on  

PubMed Central

Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time. PMID:17520297

Anjarwalla, N. K.; Brown, L. C.

2007-01-01

321

Quantification of Vertebral Involvement in Metastatic Spinal Disease  

PubMed Central

Introduction: For patients with a solitary and well-delimitated spinal metastasis that resides inside the vertebral body, without vertebral canal invasion, and who are in good general health with a long life expectancy, en bloc spondylectomy/total vertebrectomy combined with the use of primary stabilizing instrumentation has been advocated. However, clinical experience suggests that these qualifying conditions occur very rarely. Objective: The purpose of this paper is to quantify the distribution of vertebral involvement in spinal metastases and determine the frequency with which patients can be considered candidates for radical surgery (en bloc spondylectomy). Methods: Consecutive patients were classified accordingly to Enneking’s and Tomita’s schemes for grading vertebral involvement of metastases. Results: Fifty-one (51) consecutive patients were evaluated. Eighty-three percent of patients presented with the involvement of multiple vertebral levels and/or spinal canal invasion. Conclusion: Because of diffuse vertebral involvement of metastases, no patients in this sample were considered to be candidates for radical spondylectomy of vertebral metastasis. PMID:24015159

Botelho, Ricardo Vieira; de Oliveira, Matheus Fernandes; Rotta, Jose Marcus

2013-01-01

322

Autonomic Dysreflexia Causes Chronic Immune Suppression after Spinal Cord Injury  

PubMed Central

Autonomic dysreflexia (AD), a potentially dangerous complication of high-level spinal cord injury (SCI) characterized by exaggerated activation of spinal autonomic (sympathetic) reflexes, can cause pulmonary embolism, stroke, and, in severe cases, death. People with high-level SCI also are immune compromised, rendering them more susceptible to infectious morbidity and mortality. The mechanisms underlying postinjury immune suppression are not known. Data presented herein indicate that AD causes immune suppression. Using in vivo telemetry, we show that AD develops spontaneously in SCI mice with the frequency of dysreflexic episodes increasing as a function of time postinjury. As the frequency of AD increases, there is a corresponding increase in splenic leucopenia and immune suppression. Experimental activation of spinal sympathetic reflexes in SCI mice (e.g., via colorectal distension) elicits AD and exacerbates immune suppression via a mechanism that involves aberrant accumulation of norepinephrine and glucocorticoids. Reversal of postinjury immune suppression in SCI mice can be achieved by pharmacological inhibition of receptors for norepinephrine and glucocorticoids during the onset and progression of AD. In a human subject with C5 SCI, stimulating the micturition reflex caused AD with exaggerated catecholamine release and impaired immune function, thus confirming the relevance of the mouse data. These data implicate AD as a cause of secondary immune deficiency after SCI and reveal novel therapeutic targets for overcoming infectious complications that arise due to deficits in immune function. PMID:23926252

Zhang, Yi; Guan, Zhen; Reader, Brenda; Shawler, Todd; Mandrekar-Colucci, Shweta; Huang, Kun; Weil, Zachary; Bratasz, Anna; Wells, Jonathan; Powell, Nicole D.; Sheridan, John F.; Whitacre, Caroline C.; Rabchevsky, Alexander G.; Nash, Mark S.

2013-01-01

323

Paraplegia by spinal cord compression as the initial manifestation of Hodgkin's disease: a case report.  

PubMed

The 90% of Hodgkin's disease (HD) cases are originated by lymphnodes whereas 10% by extranodal regions as epidural space. Neurologic complications of HD can be classified as directly resulting from the disease or indirectly originated from the disease or from its treatment. Patients very rarely present with spinal cord compression (SCC)  due to epidural HD. Few cases of HD with such presentation have been reported in the literature. Primary spinal extradural HD with no further organ involvement is extremely rare. We report a case of a child with SCC as initial and unique presentation of HD. PMID:25245654

Baroni, Lorenza; Fornaciari, Sara; Predieri, Barbara; Bergonzini, Patrizia; Guerra, Azzurra; Paolucci, Paolo; Iughetti, Lorenzo

2014-01-01

324

Groupwise multi-atlas segmentation of the spinal cord's internal structure.  

PubMed

The spinal cord is an essential and vulnerable component of the central nervous system. Differentiating and localizing the spinal cord internal structure (i.e., gray matter vs. white matter) is critical for assessment of therapeutic impacts and determining prognosis of relevant conditions. Fortunately, new magnetic resonance imaging (MRI) sequences enable clinical study of the in vivo spinal cord's internal structure. Yet, low contrast-to-noise ratio, artifacts, and imaging distortions have limited the applicability of tissue segmentation techniques pioneered elsewhere in the central nervous system. Additionally, due to the inter-subject variability exhibited on cervical MRI, typical deformable volumetric registrations perform poorly, limiting the applicability of a typical multi-atlas segmentation framework. Thus, to date, no automated algorithms have been presented for the spinal cord's internal structure. Herein, we present a novel slice-based groupwise registration framework for robustly segmenting cervical spinal cord MRI. Specifically, we provide a method for (1) pre-aligning the slice-based atlases into a groupwise-consistent space, (2) constructing a model of spinal cord variability, (3) projecting the target slice into the low-dimensional space using a model-specific registration cost function, and (4) estimating robust segmentation susing geodesically appropriate atlas information. Moreover, the proposed framework provides a natural mechanism for performing atlas selection and initializing the free model parameters in an informed manner. In a cross-validation experiment using 67 MR volumes of the cervical spinal cord, we demonstrate sub-millimetric accuracy, significant quantitative and qualitative improvement over comparable multi-atlas frameworks, and provide insight into the sensitivity of the associated model parameters. PMID:24556080

Asman, Andrew J; Bryan, Frederick W; Smith, Seth A; Reich, Daniel S; Landman, Bennett A

2014-04-01

325

Distribution of nitric oxide-producing cells along spinal cord in urodeles  

PubMed Central

Nitric oxide is a unique neurotransmitter, which participates in many physiological and pathological processes in the organism. There are little data about the neuronal nitric oxide synthase immunoreactivity in the spinal cord of amphibians. In this respect, the present study aims to investigate the distribution of nitric oxide producing cells in the spinal cord of urodele and to find out the possibility of a functional locomotory role to this neurotransmitter. The results of the present study demonstrate a specific pattern of NADPH-d labeling in the selected amphibian model throughout the spinal cord length as NADPH-d-producing cells and fibers were present in almost all segments of the spinal cord of the salamander investigated. However, their number, cytological characteristics and labeling intensity varied significantly. It was noticed that the NO-producing cells (NO-PC) were accumulated in the ventral side of certain segments in the spinal cord corresponding to the brachial and sacral plexuses. In addition, the number of NO-PC was found to be increased also at the beginning of the tail and this could be due to the fact that salamanders are tetrapods having bimodal locomotion, namely swimming and walking.

Mahmoud, Mayada A.; Fahmy, Gehan H.; Moftah, Marie Z.; Sabry, Ismail

2014-01-01

326

Value of Prominent Flow Voids without Cord Edema in the Detection of Spinal Arteriovenous Fistulae  

PubMed Central

Purpose To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF. Methods We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion. We calculated the proportion of patients with positive findings for SDAVF on angiography and evaluated the prevalence of SDAVF for this finding alone and in correlation with clinical findings. Results 18 patients underwent spinal angiography for prominent flow voids on imaging without other spinal pathology or imaging findings of SDAVF. Three had a SDAVF detected on angiography. The prevalence of SDAVF in this population was low, only 17% (95% CI 6-39%). All of the patients with positive angiography findings had myelopathy, increasing the prevalence to 100% if the additional clinical finding of myelopathy was present. Conclusions Prominent flow voids without other imaging findings suggestive of SDAVF is poorly predictive of the presence of a SDAVF, unless myelopathy is present clinically. PMID:24905497

Alhilali, Lea M.; Reynolds, Arich R.; Fakhran, Saeed

2014-01-01

327

The safety and efficacy of spinal anesthesia for surgery in infants: the Vermont Infant Spinal Registry.  

PubMed

Studies with modest numbers of patients have suggested that spinal anesthesia in infants is associated with a very infrequent incidence of complications, such as hypoxemia, bradycardia, and postoperative apnea. Although spinal anesthesia would seem to be a logical alternative to general anesthesia for many surgical procedures, it remains an underutilized technique. Since 1978, clinical data concerning all infants undergoing spinal anesthesia at the University of Vermont have been prospectively recorded. In all, 1554 patients have been studied. Anesthesia was performed by anesthesia trainees and attending anesthesiologists. The success rate for LP was 97.4%. An adequate level of spinal anesthesia was achieved in 95.4% of cases. The average time required to induce spinal anesthesia was 10 min. Oxygen hemoglobin desaturation to <90% was observed in 10 patients. Bradycardia (heart rate <100 bpm) occurred in 24 patients (1.6%). This study confirms the infrequent incidence of complications associated with spinal anesthesia in infants. Spinal anesthesia can be performed safely, efficiently, and with the expectation of a high degree of success. Spinal anesthesia should be strongly considered as an alternative to general anesthesia for lower abdominal and lower extremity surgery in infants. PMID:16368805

Williams, Robert K; Adams, David C; Aladjem, Eva V; Kreutz, Joseph M; Sartorelli, Kennith H; Vane, Dennis W; Abajian, J Christian

2006-01-01

328

Assessing small-volume spinal cord dose for repeat spinal stereotactic body radiotherapy treatments.  

PubMed

Spinal cord biologically effective dose (BED) limits are critical to safe spine stereotactic body radiotherapy (SBRT) delivery. In particular, when repeating SBRT to the same site, the problem of adding non-uniform BED distributions within small volumes of spinal cord has yet to be solved. We report a probability-based generalized BED (gBED) model to guide repeat spine SBRT treatment planning. The gBED was formulated by considering the sequential damaging probabilities of repeat spine SBRT treatments. Parameters from the standard linear-quadratic model, such as ?/? = 2 Gy for the spinal cord, were applied. We tested the model based on SBRT specific spinal cord tolerance using a simulated and ten clinical repeat SBRT cases. The gBED provides a consistent solution for superimposing non-uniform dose distributions from different fractionation schemes, analogous to the BED for uniform dose distributions. Based on ten clinical cases, the gBED was observed to eliminate discrepancies in the cumulative BED of approximately 5% to 20% within small volumes (e.g. 0.1-2.0 cc) of spinal cord, as compared to a conventional calculation method. When assessing spinal cord tolerance for repeat spinal SBRT treatments, caution should be exercised when applying conventional BED calculations for small volumes of spinal cord irradiated, and the gBED potentially provides more conservative and consistently derived dose surrogates to guide safe treatment planning and treatment outcome modeling. PMID:23135285

Ma, Lijun; Kirby, Neil; Korol, Renee; Larson, David A; Sahgal, Arjun

2012-12-01

329

Assessing small-volume spinal cord dose for repeat spinal stereotactic body radiotherapy treatments  

NASA Astrophysics Data System (ADS)

Spinal cord biologically effective dose (BED) limits are critical to safe spine stereotactic body radiotherapy (SBRT) delivery. In particular, when repeating SBRT to the same site, the problem of adding non-uniform BED distributions within small volumes of spinal cord has yet to be solved. We report a probability-based generalized BED (gBED) model to guide repeat spine SBRT treatment planning. The gBED was formulated by considering the sequential damaging probabilities of repeat spine SBRT treatments. Parameters from the standard linear-quadratic model, such as ?/? = 2 Gy for the spinal cord, were applied. We tested the model based on SBRT specific spinal cord tolerance using a simulated and ten clinical repeat SBRT cases. The gBED provides a consistent solution for superimposing non-uniform dose distributions from different fractionation schemes, analogous to the BED for uniform dose distributions. Based on ten clinical cases, the gBED was observed to eliminate discrepancies in the cumulative BED of approximately 5% to 20% within small volumes (e.g. 0.1-2.0 cc) of spinal cord, as compared to a conventional calculation method. When assessing spinal cord tolerance for repeat spinal SBRT treatments, caution should be exercised when applying conventional BED calculations for small volumes of spinal cord irradiated, and the gBED potentially provides more conservative and consistently derived dose surrogates to guide safe treatment planning and treatment outcome modeling.

Ma, Lijun; Kirby, Neil; Korol, Renee; Larson, David A.; Sahgal, Arjun

2012-12-01

330

SCIM – spinal cord independence measure: a new disability scale for patients with spinal cord lesions  

Microsoft Academic Search

The Spinal Cord Independence Measure (SCIM) is a new disability scale developed specifically for patients with spinal cord lesions in order to make the functional assessments of patients with paraplegia or tetraplegia more sensitive to changes. The SCIM includes the following areas of function: self-care (subscore 0 – 20), respiration and sphincter management (0 – 40) and mobility (0 –

A Catz; M Itzkovich; E Agranov; H Ring; A Tamir

1997-01-01

331

Sphincter (ring muscle) gymnastics for spinal cord injured and spinal cord transected patients  

Microsoft Academic Search

Sphincter gymnastics seem to be able to recruit central pattern generators – networks of neurons that generate motor patterns – through peripheral rhythmic stimuli and to activate them without supraspinal signals. This physical therapy method is thus suitable for treating spinal cord injured and spinal cord transected patients, for it can reach below the injured segment and feed signals into

S. Yom-Tov

2000-01-01

332

Clinical Assessment Of Stereotactic IGRT: Spinal Radiosurgery  

SciTech Connect

The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited because of the availability of effective target immobilization devices. Recent advances in stereotactic IGRT have allowed for spinal applications. Large clinical experience with spinal radiosurgery to properly assess clinical outcomes has previously been limited. At our institution, we have developed a successful multidisciplinary spinal radiosurgery program in which 542 spinal lesions (486 malignant and 56 benign lesions) were treated with a single-fraction radiosurgery technique. Patient ages ranged from 18 to 85 years (mean 56 years). Lesion location included 92 cervical, 234 thoracic, 130 lumbar, and 86 sacral. The most common metastatic tumors were renal cell (89 cases), breast (74 cases), and lung (71 cases). The most common benign tumors were neurofibroma (24 cases), schwannoma (13 cases), and meningioma (7 cases). Eighty-nine cervical lesions were treated using skull tracking. Thoracic, lumbar, and sacral tumors were tracked relative to either gold or stainless steel fiducial markers. The maximum intratumoral dose ranged from 12.5 to 30 Gy (mean 20 Gy). Tumor volume ranged from 0.16 to 298 mL (mean 47 mL). Three hundred thirty-seven lesions had received prior external beam irradiation with spinal cord doses precluding further conventional irradiation. The primary indication for radiosurgery was pain in 326 cases, as a primary treatment modality in 70 cases, for tumor radiographic tumor progression in 65 cases, for post-surgical treatment in 38 cases, for progressive neurological deficit in 35 cases, and as a radiation boost in 8 cases. Follow-up period was at least 3 to 49 months. Axial and/or radicular pain improved in 300 of 326 cases (92%). Long-term tumor control was demonstrated in 90% of lesions treated with radiosurgery as a primary treatment modality and in 88% of lesions treated for radiographic tumor progression. Thirty of 35 patients (85%) with progressive neurological deficits experienced at least some improvement after treatment. Spinal stereotactic radiosurgery is now a feasible, safe, and clinically effective technique for the treatment of a variety of spinal lesions. The potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with essentially no recovery time and excellent symptomatic response. This technique offers a new therapeutic modality for the primary treatment of a variety of spinal lesions, including the treatment of neoplasms in medically inoperable patients, previously irradiated sites, for lesions not amenable to open surgical techniques, and as an adjunct to surgery.

Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA (United States)], E-mail: gersztenpc@upmc.edu; Burton, Steven A. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

2008-07-01

333

Prenatal and Postnatal Development of GABAergic Neurons in the Spinal Cord Revealed by Green Fluorescence Protein Expression in the GAD67GFP Knock-In Mouse  

Microsoft Academic Search

To gain better insight into the ontogenic function of ?-aminobutyric acid (GABA) in the mouse spinal cord, it is necessary to know the developmental pattern of GABAergic neurons. In the present study, we examined the temporal and spatial developmental changes of GABAergic neurons at the cervical level of the spinal cord by using a glutamic acid decarboxylase 67 (GAD67)-green fluorescence

Jing Huang; Feng Feng; Nobuaki Tamamaki; Yuchio Yanagawa; Kunihiko Obata; Yun-Qing Li; Sheng-Xi Wu

2007-01-01

334

Electro-acupuncture promotes survival, differentiation of the bone marrow mesenchymal stem cells as well as functional recovery in the spinal cord-transected rats  

Microsoft Academic Search

BACKGROUND: Bone marrow mesenchymal stem cells (MSCs) are one of the potential tools for treatment of the spinal cord injury; however, the survival and differentiation of MSCs in an injured spinal cord still need to be improved. In the present study, we investigated whether Governor Vessel electro-acupuncture (EA) could efficiently promote bone marrow mesenchymal stem cells (MSCs) survival and differentiation,

Ying Ding; Qing Yan; Jing-Wen Ruan; Yan-Qing Zhang; Wen-Jie Li; Yu-Jiao Zhang; Yan Li; Hongxin Dong; Yuan-Shan Zeng

2009-01-01

335

Activation and up-regulation of spinal cord nitric oxide receptor, soluble guanylate cyclase, after formalin injection into the rat hind paw  

Microsoft Academic Search

Nitric oxide synthase is expressed abundantly in the spinal cord, and nitric oxide (NO) has been shown to play important roles in the central mechanism of inflammatory hyperalgesia. However, the expression and function of the NO receptor, soluble guanylate cyclase, is not fully understood in this processing at the spinal cord level. In the present study, we report that the

Y.-X. Tao; R. A. Johns

2002-01-01

336

[Tethered spinal cord and lipoma. Contribution of magnetic resonance imaging].  

PubMed

A 12 year-old boy was investigated for progressive deformity of the left foot developing over 2 years. The foot was hollow with equinus varus and claw toes. Signs of a lesion of left L5 and S1 roots were present and spina bifida at L5 was noted on X-rays. Magnetic resonance imaging (MRI) showed a tethered spinal cord associated with a lipoma at the level of the S1 vertebra. Modes of presentation and physiopathology of disorders related to tethered cords are reviewed and the diagnostic value of MRI is emphasized. PMID:3538290

Awada, A; Chatta, G; Majdalani, A; Gautier, J C

1986-01-01

337

Plasticity of the Injured Human Spinal Cord: Insights Revealed by Spinal Cord Functional MRI  

PubMed Central

Introduction While numerous studies have documented evidence for plasticity of the human brain there is little evidence that the human spinal cord can change after injury. Here, we employ a novel spinal fMRI design where we stimulate normal and abnormal sensory dermatomes in persons with traumatic spinal cord injury and perform a connectivity analysis to understand how spinal networks process information. Methods Spinal fMRI data was collected at 3 Tesla at two institutions from 38 individuals using the standard SEEP functional MR imaging techniques. Thermal stimulation was applied to four dermatomes in an interleaved timing pattern during each fMRI acquisition. SCI patients were stimulated in dermatomes both above (normal sensation) and below the level of their injury. Sub-group analysis was performed on healthy controls (n?=?20), complete SCI (n?=?3), incomplete SCI (n?=?9) and SCI patients who recovered full function (n?=?6). Results Patients with chronic incomplete SCI, when stimulated in a dermatome of normal sensation, showed an increased number of active voxels relative to controls (p?=?0.025). There was an inverse relationship between the degree of sensory impairment and the number of active voxels in the region of the spinal cord corresponding to that dermatome of abnormal sensation (R2?=?0.93, p<0.001). Lastly, a connectivity analysis demonstrated a significantly increased number of intraspinal connections in incomplete SCI patients relative to controls suggesting altered processing of afferent sensory signals. Conclusions In this work we demonstrate the use of spinal fMRI to investigate changes in spinal processing of somatosensory information in the human spinal cord. We provide evidence for plasticity of the human spinal cord after traumatic injury based on an increase in the average number of active voxels in dermatomes of normal sensation in chronic SCI patients and an increased number of intraspinal connections in incomplete SCI patients relative to healthy controls. PMID:23029097

Cadotte, David W.; Bosma, Rachael; Mikulis, David; Nugaeva, Natalia; Smith, Karen; Pokrupa, Ronald; Islam, Omar; Stroman, Patrick W.; Fehlings, Michael G.

2012-01-01

338

Proximal spinal muscular atrophy: current orthopedic perspective  

PubMed Central

Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective “survival motor neuron” (SMN) protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. PMID:24399883

Haaker, Gerrit; Fujak, Albert

2013-01-01

339

Low-pressure/spinal fluid leak headache.  

PubMed

Low cerebrospinal fluid (CSF) pressure results in neurologic deficits, of which the most common manifestation is headache. Typically, the headache is postural - and specifically, orthostatic - in presentation. There are three hypotheses to explain the occurrence of headache associated with low CSF fluid. The first is traction on pain-sensitive intracranial and meningeal structures; the second is CSF hypovolemia; and the third is spinal loss of CSF resulting in increased compliance at the caudal end of the CSF space. Spontaneous intracranial hypotension (SIH), once believed to be rare, is now more commonly recognized. It is typically associated with orthostatic headache (although initially it may not be) and one or more other symptoms such as alterations in hearing, nausea, vomiting, neck stiffness, diplopia, and visual field cuts. Magnetic resonance imaging (MRI) of the brain with gadolinium is the first study of choice, which typically reveals diffuse pachymeningeal enhancement and, frequently, cerebellar tonsillar descent and posterior fossa crowding. Epidural blood patch (EBP) is the treatment of choice. Surgery and epidural fibrin glue injection are options for those who fail conservative therapy and/or EBP. PMID:24760494

Spears, Roderick C

2014-06-01

340

Accelerating locomotor recovery after incomplete spinal injury.  

PubMed

A traumatic spinal injury can destroy cells, irreparably damage axons, and trigger a cascade of biochemical responses that increase the extent of injury. Although damaged central nervous system axons do not regrow well naturally, the distributed nature of the nervous system and its capacity to adapt provide opportunities for recovery of function. It is apparent that activity-dependent plasticity plays a role in this recovery and that the endogenous response to injury heightens the capacity for recovery for at least several weeks postinjury. To restore locomotor function, researchers have investigated the use of treadmill-based training, robots, and electrical stimulation to tap into adaptive activity-dependent processes. The current challenge is to maximize the degree of functional recovery. This manuscript reviews the endogenous neural system response to injury, and reviews data and presents novel analyses of these from a rat model of contusion injury that demonstrates how a targeted intervention can accelerate recovery, presumably by engaging processes that underlie activity-dependent plasticity. PMID:23531014

Hillen, Brian K; Abbas, James J; Jung, Ranu

2013-03-01

341

Spinal dysraphism: A challenge continued to be faced by neurosurgeons in developing countries  

PubMed Central

Objectives: The incidence of spinal dysraphism has significantly decreased over the last few decades, all over the world; however, still the incidence is much higher in developing countries with poor socioeconomic status. Materials and Methods: The present study includes all patients managed for spinal dysraphism over a period of one year (January 2011-December 2011). Details including demographics, antenatal care history, site and type of lesion, neurological examination, imaging finding, associated congenital anomalies, management offered, and outcome were recorded. Results: A total of 27 children were operated for spinal dysraphism during the study period (17 males and 11 females). Median age was 120 days (age range, 1 day to 6 years). Mothers of 15 children did not seek any regular antenatal checkup and only 13 mothers received folic acid supplementation during pregnancy. Fourteen children were delivered at home and 13 were at hospital. The most common site was lumbosacral region (67.8%). Seven patients had rupture of the sac at the time of presentation, one child had local infection, and four patients had hydrocephalus (requiring shunt before surgical repair). Two patients developed hydrocephalus at follow up, needing shunt surgery. The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days). Conclusion: Spinal dysraphism is still a major public health problem in developing countries. Management of patients with spinal dysraphism is complex and needs close coordination between pediatrician, neurologist, neurosurgeon, and rehabilitation experts. A large number of factors influence the outcome. PMID:25126121

Agrawal, Amit; Sampley, Sunil

2014-01-01

342

Tolerance of the Spinal Cord to Stereotactic Radiosurgery: Insights From Hemangioblastomas  

SciTech Connect

Purpose: To evaluate spinal cord dose-volume effects, we present a retrospective review of stereotactic radiosurgery (SRS) treatments for spinal cord hemangioblastomas. Methods and Materials: From November 2001 to July 2008, 27 spinal hemangioblastomas were treated in 19 patients with SRS. Seventeen tumors received a single fraction with a median dose of 20 Gy (range, 18-30 Gy). Ten lesions were treated using 18-25 Gy in two to three sessions. Cord volumes receiving 8, 10, 12, 14, 16, 18, 20, 22, and 24 Gy and dose to 10, 100, 250, 500, 1000, and 2000 mm{sup 3} of cord were determined. Multisession treatments were converted to single-fraction biologically effective dose (SFBED). Results: Single-fraction median cord D{sub max} was 22.7 Gy (range, 17.8-30.9 Gy). Median V10 was 454 mm{sup 3} (range, 226-3543 mm{sup 3}). Median dose to 500 mm{sup 3} cord was 9.5 Gy (range, 5.3-22.5 Gy). Fractionated median SFBED{sub 3} cord D{sub max} was 14.1 Gy{sub 3} (range, 12.3-19.4 Gy{sub 3}). Potential toxicities included a Grade 2 unilateral foot drop 5 months after SRS and 2 cases of Grade 1 sensory deficits. The actuarial 3-year local tumor control estimate was 86%. Conclusions: Despite exceeding commonly cited spinal cord dose constraints, SRS for spinal hemangioblastomas is safe and effective. Consistent with animal experiments, these data support a partial-volume tolerance model for the human spinal cord. Because irradiated cord volumes were generally small, application of these data to other clinical scenarios should be made cautiously. Further prospective studies of spinal radiosurgery are needed.

Daly, Megan E. [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States); Choi, Clara Y.H. [Department of Neurosurgery, Stanford University Medical Center, Stanford, CA (United States); Gibbs, Iris C. [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States); Adler, John R.; Chang, Steven D.; Lieberson, Robert E. [Department of Neurosurgery, Stanford University Medical Center, Stanford, CA (United States); Soltys, Scott G., E-mail: sgsoltys@stanford.ed [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States)

2011-05-01

343

A novel preparation to study rat pancreatic spinal and vagal mechanosensitive afferents in vitro.  

PubMed

The management of pancreatic pain is a significant clinical problem so understanding of how sensory signals are generated in pancreatic tissue is fundamental. We aimed to characterize mechanosensitive and chemosensitive properties of pancreatic spinal and vagal afferents in vitro. Spinal and vagal afferent preparations from Sprague-Dawley rats were established incorporating the left splanchnic nerve or vagus nerves respectively. The common bile duct was cannulated for distension of the pancreatic duct with fluid. Nerve discharge evoked by blunt probing, duct distension or electrical stimulation was obtained from teased nerve bundles using standard extra-cellular recording. Discharge from 197 spinal afferent bundles was recorded, of which 57% displayed spontaneous activity. Blunt probing revealed 61 mechanosensitive receptive fields which were associated primarily with arteries/blood vessels (33/61) and the parenchyma (22/61). All mechanosensitive responses were slowly adapting, with 33% continuing to discharge after termination of the stimulus and 60% displaying a response threshold <10 g. Application of chemical mediators (bradykinin, histamine, 5-hydroxytryptamine, cholecystokinin octapeptide) evoked a response from 31/57 units, with 33% excitatory and 23% inhibitory. Spontaneous discharge was recorded from 72% of 135 vagal bundles. Mechanosensitive receptive fields were not identified in the pancreas but were evident in adjacent organs. No spinal or vagal afferent response to duct distension was obtained. In conclusion, pancreatic mechanosensitive spinal afferents are common, in contrast to pancreatic mechanosensitive vagal afferents indicating that pancreatic sensory innervation is predominantly spinal. Chemosensitive spinal afferent nerve endings are present in the pancreas and respond to a variety of inflammatory and physiological mediators. PMID:18482253

Schloithe, A C; Sutherland, K; Woods, C M; Blackshaw, L A; Davison, J S; Toouli, J; Saccone, G T P

2008-09-01

344

Spatio-Temporal Expression Pattern of Frizzled Receptors after Contusive Spinal Cord Injury in Adult Rats  

PubMed Central

Background Wnt proteins are a large family of molecules that are critically involved in multiple central nervous system (CNS) developmental processes. Experimental evidences suggest a role for this family of proteins in many CNS disorders, including spinal cord injury (SCI), which is a major neuropathology owing to its high prevalence and chronic sensorimotor functional sequelae. Interestingly, most Wnt proteins and their inhibitors are expressed in the uninjured spinal cord, and their temporal expression patterns are dramatically altered after injury. However, little is known regarding the expression of their better-known receptors, the Frizzled family, after SCI. Thus, the aim of the present study was to evaluate the expression of Frizzled receptors in the damaged spinal cord. Findings Based on the evidence that Wnts are expressed in the spinal cord and are transcriptionally regulated by SCI in adulthood, we analysed the spatio-temporal mRNA and protein expression patterns of Frizzled receptors after contusive SCI using quantitative RT-PCR and single and double immunohistochemistry, respectively. Our results show that almost all of the 10 known Frizzled receptors were expressed in specific spatial patterns in the uninjured spinal cords. Moreover, the Frizzled mRNAs and proteins were expressed after SCI, although their expression patterns were altered during the temporal progression of SCI. Finally, analysis of cellular Frizzled 5 expression pattern by double immunohistochemistry showed that, in the uninjured spinal cord, this receptor was expressed in neurons, oligodendrocytes, astrocytes, microglia and NG2+ glial precursors. After injury, Frizzled 5 was not only still expressed in oligodendrocytes, astrocytes and NG2+ glial precursors but also in axons at all evaluated time points. Moreover, Frizzled 5 was expressed in reactive microglia/macrophages from 3 to 14 days post-injury. Conclusions Our data suggest the involvement of Frizzled receptors in physiological spinal cord function and in the cellular and molecular events that characterise its neuropathology. PMID:23251385

Arenas, Ernest; Rodriguez, Francisco Javier

2012-01-01

345

Microsurgical resection of cervical spinal arteriovenous malformation: the pial resection technique.  

PubMed

We present the case of a 26-year-old female patient who had two episodes of sudden, left, upper and lower extremity paresthesias and weakness, which resolved completely after 5 months. After recovery, she presented for evaluation. Imaging demonstrated a C3-C6 intra- and extra-axial arteriovenous malformation (AVM) with spinal cord compression and edema. A spinal angiogram showed arterial feeders arising from both vertebral arteries and from the right ascending pharyngeal artery. The AVM had been partially embolized after her first bleeding episode. She underwent C3-C6 laminoplasty and microsurgical resection of the AVM. After locating the main arterial feeders and draining veins, the malformation was resected using the pial resection technique. A postoperative spinal angiogram demonstrated gross total resection. Video used with permission from Barrow Neurological Institute. The video can be found here: http://youtu.be/JbbIwCTUsuI . PMID:25175573

Rangel-Castilla, Leonardo; Spetzler, Robert F

2014-09-01

346

Nerve Regeneration Restores Supraspinal Control of Bladder Function after Complete Spinal Cord Injury  

PubMed Central

A life-threatening disability after complete spinal cord injury is urinary dysfunction, which is attributable to lack of regeneration of supraspinal pathways that control the bladder. Although numerous strategies have been proposed that can promote the regrowth of severed axons in the adult CNS, at present, the approaches by which this can be accomplished after complete cord transection are quite limited. In the present study, we modified a classic peripheral nerve grafting technique with the use of chondroitinase to facilitate the regeneration of axons across and beyond an extensive thoracic spinal cord transection lesion in adult rats. The novel combination treatment allows for remarkably lengthy regeneration of certain subtypes of brainstem and propriospinal axons across the injury site and is followed by markedly improved urinary function. Our studies provide evidence that an enhanced nerve grafting strategy represents a potential regenerative treatment after severe spinal cord injury. PMID:23804083

Lin, Ching-Yi; Jiang, Hai-Hong; DePaul, Marc; Lin, Vernon W.

2013-01-01

347

Epidural hematoma associated with spinal fracture in diffuse idiopathic skeletal hyperostosis.  

PubMed

The authors describe the clinical findings, radiographic appearance and surgical treatment of a spinal epidural hematoma (SEH) associated with spinal fracture in diffuse idiopathic skeletal hyperostosis (DISH). An 81-year-old male patient injured after falling from a 2.5 m tree presented with severe back pain. On plain radiographs and CT images, DISH with anterolateral osteophytes and fused thoracolumbar vertebrae was found along with a T12 fracture. Patient was initially treated with bed rest followed by placement into a body cast. Three weeks later, he presented with incomplete paraplegia of his lower limbs. CT images did not reveal any fracture displacement, but MRI images showed an epidural hematoma compressing the dura mater. The patient was successfully treated by posterior fixation surgery using pedicle screws and rod with vertebroplasty. We aimed to report a unique case of a SEH complicating a spinal fracture in DISH. PMID:24535802

Tauchi, Ryoji; Imagama, Shiro; Satake, Kotaro; Iwase, Toshiki; Ishiguro, Naoki

2014-01-01

348

Photochemically induced cystic lesion in the rat spinal cord. I. Behavioral and morphological analysis  

Microsoft Academic Search

The present study describes the production of a spinal cord lesion which is initiated by vascular occlusion resulting from the interaction between the photosensitizing dye erythrosin B and an argon laser beam. The lesion has characteristics similar to those of the central cavity thought to lead to the production of post-traumatic syringomyelia (PTS) in humans. The present study examines the

Tracy Cameron; Ricardo Prado; Brant D. Watson; Mayra Gonzalez-Carvajal; Vicky R. Holets

1990-01-01

349

Rehabilitation and treatment of spinal cord tumors  

PubMed Central

Context Due to advances in acute oncological treatment, patients with spinal cord tumors exhibit improved survival. However, these patients have not received the full benefits of rehabilitation services to address their neurological deficits and rehabilitation goals. Objective To evaluate the epidemiology and pathophysiology of spinal cord tumors, address methods of acute oncological management, review treatment for neurological sequelae, and understand the implications as they relate to rehabilitation. Methods An extensive literature review was performed regarding the epidemiology, pathophysiology, acute oncological management, neurological sequelae, and rehabilitation for patients with spinal cord tumors. Databases used included pubmed.gov and OVID, as well as individual journal and textbook articles. Results Access to treatment should be increased given improved survival and functional deficits for patients with spinal cord tumors. Individuals can benefit from inpatient rehabilitation programs, in spite of increased medical co-morbidity and neurological deficits. Specific areas of improvement include functionality, mood, quality of life, and survival. Adjustments to treatment plans must incorporate medical complications from cancer and its treatment, perceived quality of life, and prognosis. Conclusions Patients with spinal cord tumors who participate in rehabilitation programs show general improvement in function, mood, quality of life, and survival. Adaptations to care plans should be made to accommodate medical co-morbidities from cancer and its treatment, patient perceptions, and prognosis. PMID:23433329

Raj, Vishwa S.; Lofton, LaTanya

2013-01-01

350

Reticulo-spinal neurons participating in the control of synergic eye and head movements during orienting in the cat  

Microsoft Academic Search

Previously we described physiological properties of pontine reticulo-spinal neurons which generate bursts and decaying tonic discharges related to eye movements and neck muscle activity during ipsiversive gaze shifts (Grantyn and Berthoz 1987). Two of these “eye-neck reticulo-spinal neurons” (EN-RSN) were labeled by intra-axonal injections of HRP. The present report provides a detailed description of their morphology with an emphasis on

A. Grantyn; V. Ong-Meang Jacques; A. Berthoz

1987-01-01

351

Behavioral and Histological Outcomes Following Graded Spinal Cord Contusion Injury in the C57Bl\\/6 Mouse  

Microsoft Academic Search

A computer-controlled electromagnetic spinal cord injury device (ESCID) has been adapted to develop a mouse model of spinal cord contusion injury. In the present study, we have extended this model in C57Bl\\/6 mice with behavioral and histopathological outcome assessment. Three groups of mice received a laminectomy at the T9 vertebral level followed by a contusion injury from a predetermined starting

Manhong Ma; D. Michele Basso; Patricia Walters; Bradford T. Stokes; Lyn B. Jakeman

2001-01-01

352

21 CFR 888.3070 - Pedicle screw spinal system.  

...spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and...spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and...

2014-04-01

353

21 CFR 888.3070 - Pedicle screw spinal system.  

Code of Federal Regulations, 2012 CFR

...spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and...spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and...

2012-04-01

354

21 CFR 888.3070 - Pedicle screw spinal system.  

Code of Federal Regulations, 2013 CFR

...spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and...spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and...

2013-04-01

355

21 CFR 888.3070 - Pedicle screw spinal system.  

Code of Federal Regulations, 2010 CFR

...spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and...spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and...

2010-04-01

356

21 CFR 888.3070 - Pedicle screw spinal system.  

Code of Federal Regulations, 2011 CFR

...spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and...spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and...

2011-04-01

357

Spinal glial regulation of nociceptive processing during inflammation  

E-print Network

tumor necrosis factor dependent AMPA receptor trafficking and Akt phosphorylation in spinal cordtumor necrosis factor-alpha rapidly alters synaptic and sensory transmission in the adult rat spinal cord

Christianson, Christina

2011-01-01

358

What Are the Treatments for Spinal Cord Injury (SCI)?  

MedlinePLUS

... Resources and Publications What are the treatments for spinal cord injury (SCI)? Skip sharing on social media links Share ... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved May 22, 2012, from ...

359

Reduced Pulmonary Function in Patients with Spinal Osteoporotic Fractures  

Microsoft Academic Search

:   Vertebral deformation in spinal osteoporosis results in spinal and thoracic deformation, causing pain, disability and an\\u000a overall decrease in quality of life. We sought to determine whether thoracic spinal deformation may lead to impaired pulmonary\\u000a function. We studied expiratory relaxed vital capacity (VC) and forced expiratory volume in 1 s (FEV1) in 34 patients with\\u000a spinal osteoporotic fractures and

C. Schlaich; H. W. Minne; T. Bruckner; G. Wagner; H. J. Gebest; M. Grunze; R. Ziegler; G. Leidig-Bruckner

1998-01-01

360

Properties and outcomes of spinal rehabilitation units in four countries  

Microsoft Academic Search

Objective:Compare rehabilitation after spinal cord lesions (SCL) in different countries.Design:Multicenter comparative study.Setting:Four spinal rehabilitation units, in Denmark, Russia, Lithuania and Israel.Subjects:199 SCL patients.Interventions:Information was collected about unit properties, rehabilitation objectives, American Spinal Injury Association (ASIA) scale and spinal cord independence measure (SCIM) assessments, and patient data. ?2-test, t-test, ANOVA and ANCOVA were used for statistical analysis.Main outcome measures:Time from lesion

Y Fromovich-Amit; F Biering-Sørensen; V Baskov; A Juocevicius; H V Hansen; I Gelernter; J Hart; A Baskov; O Dreval; P Teres?; A Catz

2009-01-01

361

Spinal Cord Tolerance in the Age of Spinal Radiosurgery: Lessons From Preclinical Studies  

SciTech Connect

Clinical implementation of spinal radiosurgery has increased rapidly in recent years, but little is known regarding human spinal cord tolerance to single-fraction irradiation. In contrast, preclinical studies in single-fraction spinal cord tolerance have been ongoing since the 1970s. The influences of field length, dose rate, inhomogeneous dose distributions, and reirradiation have all been investigated. This review summarizes literature regarding single-fraction spinal cord tolerance in preclinical models with an emphasis on practical clinical significance. The outcomes of studies that incorporate uniform irradiation are surprisingly consistent among multiple small- and large-animal models. Extensive investigation of inhomogeneous dose distributions in the rat has demonstrated a significant dose-volume effect while preliminary results from one pig study are contradictory. Preclinical spinal cord dose-volume studies indicate that dose distribution is more critical than the volume irradiated suggesting that neither dose-volume histogram analysis nor absolute volume constraints are effective in predicting complications. Reirradiation data are sparse, but results from guinea pig, rat, and pig studies are consistent with the hypothesis that the spinal cord possesses a large capacity for repair. The mechanisms behind the phenomena observed in spinal cord studies are not readily explained and the ability of dose response models to predict outcomes is variable underscoring the need for further investigation. Animal studies provide insight into the phenomena and mechanisms of radiosensitivity but the true significance of animal studies can only be discovered through clinical trials.

Medin, Paul M., E-mail: Paul.medin@utsouthwestern.ed [Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX (United States); Boike, Thomas P. [Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX (United States)

2011-04-01

362

Spinal Cord Tolerance in the Age of Spinal Radiosurgery: Lessons from Pre-clinical Studies  

PubMed Central

Clinical implementation of spinal radiosurgery has increased rapidly in recent years but little is known regarding human spinal cord tolerance to single-fraction irradiation. In contrast, preclinical studies in single-fraction spinal cord tolerance have been ongoing since the 1970’s. The influences of field length, dose rate, inhomogeneous dose distributions and reirradiation have all been investigated. This review summarizes literature regarding single-fraction spinal cord tolerance in pre-clinical models with an emphasis on practical clinical significance. The outcomes of studies that incorporate uniform irradiation are surprisingly consistent among multiple small and large animal models. Extensive investigation of inhomogeneous dose distributions in the rat has demonstrated a significant dose-volume effect while preliminary results from one pig study are contradictory. Pre-clinical spinal cord dose-volume studies indicate that dose distribution is more critical than the volume irradiated suggesting that neither dose volume histogram analysis nor absolute volume constraints are effective in predicting complications. Reirradiation data is sparse, but results from guinea pig, rat and pig studies are consistent with the hypothesis that the spinal cord possesses a large capacity for repair. The mechanisms behind the phenomena observed in spinal cord studies are not readily explained and the ability of dose response models to predict outcomes is variable underscoring the need for further investigation. Animal studies provide insight into the phenomena and mechanisms of radiosensitivity but the true significance of animal studies can only be discovered through clinical trials. PMID:21183290

Medin, Paul M.; Boike, Thomas P.

2010-01-01

363

MRI Evaluation of Spinal Length and Vertebral Body Angle During Loading with a Spinal Compression Harness  

NASA Technical Reports Server (NTRS)

Weight bearing by the spinal column during upright posture often plays a role in the common problem of low back pain. Therefore, we developed a non-ferromagnetic spinal compression harness to enable MRI investigations of the spinal column during axial loading. Human subjects were fitted with a Nest and a footplate which were connected by adjustable straps to an analog load cell. MRI scans of human subjects (5 males and 1 female with age range of 27-53 yrs) during loaded and unloaded conditions were accomplished with a 1.5 Tesla GE Signa scanner. Studies of two subjects undergoing sequentially increasing spinal loads revealed significant decreases (r(sup 2) = 0.852) in spinal length between T4 and L5 culminating in a 1.5 to 2% length decrease during loading with 75% body weight. Sagittal vertebral body angles of four subjects placed under a constant 50% body weight load for one hour demonstrated increased lordotic and kyphotic curvatures. In the lumbar spine, the L2 vertebral body experienced the greatest angular change (-3 deg. to -5 deg.) in most subjects while in the thoracic spine, T4 angles increased from the unloaded state by +2 deg. to +9 deg. Overall, our studies demonstrate: 1) a progressive, although surprisingly small, decrease in spinal length with increasing load and 2) relatively large changes in spinal column angulation with 50% body weight.

Campbell, James A.; Hargens, Alan R.; Murthy, G.; Ballard, R. E.; Watenpaugh, D. E.; Hargens, Alan, R.; Sanchez, E.; Yang, C.; Mitsui, I.; Schwandt, D.; Fechner, K. P.; Holton, Emily M. (Technical Monitor)

1998-01-01

364

[Local spinal cord glucose utilization and extracellular potassium activity changes after spinal cord injury in rats].  

PubMed

Spinal microenvironment and metabolic alterations after experimental contusional injury of the spinal cord were evaluated in the same Wistar rats. Severe spinal cord injury was made under light GOF anesthesia with a 10 g weight drop onto the exposed Th-8 spinal cord from a 10 cm height and then halothane was ceased. The author studied extracellular potassium activity ([K+]e) and DC potential for 2 hours after paraplegic spinal cord injury in conscious rats. Furthermore, at 2 hours after cord injury, local spinal cord glucose utilization (1-SCGU) was measured with quantitative autoradiographic 2-[14C] deoxy-glucose method (Sokoloff et al.). [K+]e in injured spinal cords was 59 +/- 5 (mean +/- S.E.M.) mEq at 10 min after injury and was cleared with an exponential half-life of 1 hour. At 2 hours after injury [K+]e was still high with a value of 16 +/- 1 mEq compared with 4 mEq of control animals. DC potential changes was a mirror image of that of [K+]e. DC potential changed by a mean of 10.7 mV positively from 10 min. to 2 hours after injury. 1-SCGU at the impact site was extremely low in both white and gray matters. At 6mm rostral from the impact center 1-SCGU was remarkably reduced in the gray matter, and in the lateral white matter. But at 3 mm rostral 1-SCGU was well preserved. And at 20 mm rostral there was no difference in 1-SCGU with control animals. Massive potassium efflux from the injured spinal cord to the adjacent spinal segment was clarified at this experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1888573

Murai, H; Itoh, C; Wagai, N; Nakamura, T; Yamaura, A; Makino, H

1991-04-01

365

Cholinergic receptor alterations in the brain stem of spinal cord injured rats.  

PubMed

Cholinergic receptors in upper motor neurons of brain stem control locomotion and coordination. Present study unravels cholinergic alterations in brain stem during spinal cord injury to understand signalling pathway changes which may be associated with spinal cord injury mediated motor deficits. We evaluated cholinergic function in brain stem by studying the expression of choline acetyl transferase and acetylcholine esterase. We quantified metabotropic muscarinic cholinergic receptors by receptor assays for total muscarinic, muscarinic M1 and M3 receptor subunits, gene expression studies using Real Time PCR and confocal imaging using FITC tagged secondary antibodies. The gene expression of ionotropic nicotinic cholinergic receptors and confocal imaging were also studied. The results from our study showed metabolic disturbance in cholinergic pathway as choline acetyl transferase is down regulated and acetylcholine esterase is up regulated in spinal cord injury group. The significant decrease in muscarinic receptors showed by decreased receptor number along with down regulated gene expression and confocal imaging accounts for dysfunction of metabotropic acetylcholine receptors in spinal cord injury group. Ionotropic acetylcholine receptor alterations were evident from the decreased gene expression of alpha 7 nicotinic acetylcholine receptors and confocal imaging. The motor coordination was analysed by Grid walk test which showed an increased foot slips in spinal cord injured rats. The significant reduction in brain stem cholinergic function might have intensified the motor dysfunction and locomotor disabilities. PMID:23184186

Romeo, Chinthu; Raveendran, Anju Thoppil; Sobha, Nandhu Mohan; Paulose, Cheramadathukuzhiyil Scaria

2013-02-01

366

Idiopathic Ventral Spinal Cord Herniation: An Increasingly Recognized Cause of Thoracic Myelopathy  

PubMed Central

Idiopathic spinal cord herniation (ISCH), where a segment of the spinal cord has herniated through a ventral defect in the dura, is a rarely encountered cause of thoracic myelopathy. The purpose of our study was to increase the clinical awareness of this condition by presenting our experience with seven consecutive cases treated in our department since 2005. All the patients developed pronounced spastic paraparesis or Brown-Séquard syndrome for several years (mean, 4.7 years) prior to diagnosis. MRI was consistent with a transdural spinal cord herniation in the mid-thoracic region in all the cases. The patients underwent surgical reduction of the herniated spinal cord and closure of the dural defect using an artificial dural patch. At follow-up, three patients experienced considerable clinical improvement, one had slight improvement, one had transient improvement, and two were unchanged. Two of the four patients with sphincter dysfunction regained sphincter control. MRI showed realignment of the spinal cord in all the patients. ISCH is probably a more common cause of thoracic myelopathy than previously recognized. The patients usually develop progressive myelopathy for several years before the correct diagnosis is made. Early diagnosis is important in order to treat the patients before the myelopathy has become advanced. PMID:25336997

Berg-Johnsen, Jon; Ilstad, Eivind; Kolstad, Frode; Zuchner, Mark; Sundseth, Jarle

2014-01-01

367

In vivo imaging of spinal cord in contusion injury model mice by multi-photon microscopy  

NASA Astrophysics Data System (ADS)

Fluorescent imaging technique is a promising method and has been developed for in vivo applications in cellular biology. In particular, nonlinear optical imaging technique, multi-photon microscopy has make it possible to analyze deep portion of tissues in living animals such as axons of spinal code. Traumatic spinal cord injuries (SCIs) are usually caused by contusion damages. Therefore, observation of spinal cord tissue after the contusion injury is necessary for understanding cellular dynamics in response to traumatic SCI and development of the treatment for traumatic SCI. Our goal is elucidation of mechanism for degeneration of axons after contusion injuries by establishing SCI model and chronic observation of injured axons in the living animals. Firstly we generated and observed acute SCI model by contusion injury. By using a multi-photon microscope, axons in dorsal cord were visualized approximately 140 micron in depth from the surface. Immediately after injury, minimal morphological change of spinal cord was observed. At 3 days after injury, spinal cord was swelling and the axons seem to be fragmented. At 7 days after injury, increased degradation of axons could be observed, although the image was blurred due to accumulation of the connective tissue. In the present study, we successfully observed axon degeneration after the contusion SCI in a living animal in vivo. Our final goal is to understand molecular mechanisms and cellular dynamics in response to traumatic SCIs in acute and chronic stage.

Oshima, Y.; Horiuchi, H.; Ogata, T.; Hikita, A.; Miura, H.; Imamura, T.

2014-03-01

368

Unplanned Reoperation within 30 Days of Fusion Surgery for Spinal Deformity  

PubMed Central

No recent studies have analyzed the rates of or reasons for unanticipated revision surgery within 30 days of primary surgery in spinal deformity patients. Our aim was to examine the incidence, characteristics, reasons, and risk factors for unplanned revision surgery in spinal deformity patients treated at one institution. All patients with a diagnosis of spinal deformity presenting for primary instrumented spinal fusion at a single institution from 1998 to 2012 were reviewed. All unplanned reoperations performed within 30 days after primary surgery were analyzed in terms of demographics, surgical data, and complications. Statistical analyses were performed to obtain correlations and risk factors for anticipated revision. Of 2758 patients [aged 16.07 years (range, 2–71), 69.8% female] who underwent spinal fusion surgery, 59 (2.1%) required reoperation within 30 days after primary surgery. The length of follow up for each patient was more than 30 days. Of those that required reoperation, 87.0% had posterior surgery only, 5.7% had anterior surgery, and 7.3% underwent an anteroposterior approach. The reasons for reoperation included implant failure (n?=?20), wound infection (n?=?12), neurologic deficit (n?=?9), pulmonary complications (n?=?17), and coronal plane imbalance (n?=?1). The risk factors for reoperation were age, diagnosis, and surgical procedure with osteotomy. PMID:24595145

Li, Zheng; Shen, Jianxiong; Qiu, Guixing; Yu, Haiquan; Wang, Yipeng; Zhang, Jianguo; Zhao, Hong; Zhao, Yu; Li, Shugang; Weng, Xisheng; Liang, Jinqian; Zhao, Lijuan

2014-01-01

369

Segmental thoracic spinal has advantages over general anesthesia for breast cancer surgery  

PubMed Central

Background: Thoracic spinal anesthesia has been used for laparoscopic cholecystectomy and abdominal surgeries, but not in breast surgery. The present study compared this technique with general anesthesia in breast cancer surgeries. Materials and Methods: Forty patients were enrolled in this comparative study with inclusion criteria of ASA physical status I-III, primary breast cancer without known extension beyond the breast and axillary nodes, scheduled for unilateral mastectomy with axillary dissection. They were randomly divided into two groups. The thoracic spinal group (S) (n = 20) underwent segmental thoracic spinal anesthesia with bupivacaine and fentanyl at T5-T6 interspace, while the other group (n = 20) underwent general anesthesia (G). Intraoperative hemodynamic parameters, intraoperative complications, postoperative discharge time from post-anesthesia care unit (PACU), postoperative pain and analgesic consumption, postoperative adverse effects, and patient satisfaction with the anesthetic techniques were recorded. Results: Intraoperative hypertension (20%) was more frequent in group (G), while hypotension and bradycardia (15%) were more frequent in the segmental thoracic spinal (S) group. Postoperative nausea (30%) and vomiting (40%) during PACU stay were more frequent in the (G) group. Postoperative discharge time from PACU was shorter in the (S) group (124 ± 38 min) than in the (G) group (212 ± 46 min). The quality of postoperative analgesia and analgesic consumption was better in the (S) group. Patient satisfaction was similar in both groups. Conclusions: Segmental thoracic spinal anesthesia has some advantages when compared with general anesthesia and can be considered as a sole anesthetic in breast cancer surgery with axillary lymph node clearance.

Elakany, Mohamed Hamdy; Abdelhamid, Sherif Ahmed

2013-01-01

370

Spinal cord ischemia after aortic surgery.  

PubMed

This article discusses the etiology of spinal cord ischemia (SCI) mechanisms that may lead to paraplegia during open and endovascular repair from an anatomical and physiological perspective as well as the role of various protective measures used in prevention of this dreadful complication of aortic surgery. There are many adjuncts that must be considered to reduce the risk of spinal cord injury, such as revascularisation of intercostal arteries, maintenance of high mean blood pressure, spinal cord drainage and a few new promising models like NIRS and MISACE which usefulness is yet to be determined. These measures and techniques as well as possible etiology mechanisms of SCI are discussed, highlighting the evidence available for each method, the practical ways in which they may be used, giving some new theories and explanations. PMID:25017787

Davidovic, L; Ilic, N

2014-12-01

371

Intractable Pruritus After Traumatic Spinal Cord Injury  

PubMed Central

Background: This report describes a young woman with incomplete traumatic cervical spinal cord injury and intractable pruritus involving her dorsal forearm. Method: Case report. Findings: Anatomic distribution of the pruritus corresponded to the dermatomal distribution of her level of spinal cord injury and vertebral fusion. Symptoms were attributed to the spinal cord injury and possible cervical root injury. Pruritus was refractory to all treatments, including topical lidocaine, gabapentin, transcutaneous electrical nerve stimulation, intravenous Bier block, stellate ganglion block, and acupuncture. Conclusions: Further understanding of neuropathic pruritus is needed. Diagnostic workup of intractable pruritus should include advanced imaging to detect ongoing nerve root compression. If diagnostic studies suggest radiculopathy, epidural steroid injection should be considered. Because the autonomic nervous system may be involved in complex chronic pain or pruritic syndromes, sympatholysis via such techniques as stellate ganglion block might be effective. PMID:19777867

Crane, Deborah A; Jaffee, Kenneth M; Kundu, Anjana

2009-01-01

372

Percutaneous endoscopic decompression for lumbar spinal stenosis.  

PubMed

Percutaneous endoscopic lumbar discectomy has become a representative minimally invasive spine surgery for lumbar disc herniation. Due to the remarkable evolution in the techniques available, the paradigm of spinal endoscopy is shifting from treatments of soft disc herniation to those of lumbar spinal stenosis. Lumbar spinal stenosis can be classified into three categories according to pathological zone as follows: central stenosis, lateral recess stenosis and foraminal stenosis. Moreover, percutaneous endoscopic decompression (PED) techniques may vary according to the type of lumbar stenosis, including interlaminar PED, transforaminal PED and endoscopic lumbar foraminotomy. However, these techniques are continuously evolving. In the near future, PED for lumbar stenosis may be an efficient alternative to conventional open lumbar decompression surgery. PMID:25033889

Ahn, Yong

2014-11-01

373

Spinal ischemia following abdominal aortic surgery.  

PubMed Central

Serious spinal cord ischemia may follow infrarenal abdominal aortic surgery. Five cases are summarized and added to the 23 previously published cases in order to identify this syndrome, emphasize its importance, and draw attention to the possibility of spontaneous recovery which may occur. The multifactorial complex which comprises each patient's clinical picture clouds a precise and specific cause for paraplegia in these cases. However, neither hypotension, steal phenomena nor emboli are necessary for completion of the syndrome. The relevant spinal cord arterial anatomy indicates that the common anomalies which occur favor development of spinal cord ischemia in the arteriosclerotic population which requires aortic surgery. No means of prevention is possible at this time. Images Fig. 1. Fig. 2. PMID:1130846

Ferguson, L R; Bergan, J J; Conn, J; Yao, J S

1975-01-01

374

Towards Optimal Pain Relief: Acupuncture and Spinal Cord Stimulation  

E-print Network

Towards Optimal Pain Relief: Acupuncture and Spinal Cord Stimulation Richard Al'o 1 , Kenneth Al is a discrete optimization problem, e.g., for pain relief methodologies such as acupuncture and spinal cord problems related to pain relief: ffl problems of acupuncture, and ffl problems related to spinal cord

Kreinovich, Vladik

375

Conus medullaris injury following both tetracaine and lidocaine spinal anesthesia  

Microsoft Academic Search

Multiple reports of cauda equina syndrome and transient radicular nerve root irritation have suggested that lidocaine spinal anesthesia may be responsible. In this case report, a patient with a preexisting diabetic neuropathy received a partial block following a tetracaine spinal, which was followed by a lidocaine spinal. Following block resolution, a new conus medullaris syndrome was diagnosed. Because of the

Jonathan H. Waters; Timothy B. Watson; Michael G. Ward

1996-01-01

376

BDNF Facilitates Instrumental Learning and Spinal Plasticity In Vivo.  

E-print Network

of drug treatment was assessed by testing its effect on mechanical reactivity and spinal learning. Spinally transected rats had the BDNF-containing hydrogel applied over the lumbosacral spinal cord. Subjects were tested 3-24 hrs later. Prior work has shown...

Niemerski, Ashley

2014-01-27

377

Imaging Manifestations of Spinal Fractures in Ankylosing Spondylitis  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Spinal fractures in ankylosing spondylitis (AS) were diffi- cult to diagnose before CT and MR imaging were available. The purpose of our investigation was to characterize spinal fractures and determine the value of different imaging modalities in AS. METHODS: Twelve successive cases of spinal fractures were identified in MR imaging files of AS patients. Conventional radiographs were

Yi-Fen Wang; Michael Mu-Huo Teng; Cheng-Yen Chang; Hung-Ta Wu; Shih-Tien Wang

378

Turkish Adaptation of Spinal Cord Independence Measure--Version III  

ERIC Educational Resources Information Center

Various rating scales have been used to assess ability in individuals with spinal cord injury. There is no specific functional assessment scale for Turkish patients with spinal cord injury. The Spinal Cord Independence Measure (SCIM) is a specific test, which has become popular in the last decade. A study was conducted to validate and evaluate the…

Kesiktas, Nur; Paker, Nurdan; Bugdayci, Derya; Sencan, Sureyya; Karan, Ayse; Muslumanoglu, Lutfiye

2012-01-01

379

Compression behavior of porcine spinal cord white matter  

Microsoft Academic Search

Spinal cord injury often results from a compressive load; however, the compression behavior of spinal cord white matter has not been clearly established. Quantifying the compression behavior is important for advancing our understanding of spinal cord injury mechanics and facilitating the use of finite element models to study injury. The objective of this study was to characterize the unconfined compression

Carolyn J. Sparrey; Tony M. Keaveny

2011-01-01

380

[Lumbar spinal stenosis: clinical course, pathophysiology and treatment].  

PubMed

The lumbar spinal stenosis is a radiological description of a pathology that can present clinically by a neurogenic intermittent claudication; its diagnosis is mainly clinical. After listing the main criteria allowing the clinician to make a diagnosis, a review of available treatments is proposed. There are few quality studies and an empirical approach is often necessary. In severe cases, very disabling despite correct treatment, a surgical approach may be considered and discussed with the patient to avoid failure, sometimes linked to excessive expectations. PMID:22455152

Genevay, S; Chevallier-Ruggeri, P; Faundez, A

2012-03-14

381

Prognostic Parameters and Spinal Metastases: A Research Study  

PubMed Central

Object To identify pre-operative prognostic parameters for survival in patients with spinal epidural neoplastic metastasis when the primary tumour is unknown. Methods This study was a retrospective chart review of patients who underwent surgery for spinal epidural neoplastic metastases between February 1997 and January 2011. The inclusion criteria were as follows: known post-operative survival period, a Karnofsky Performance Score equal to or greater than 30 points and a post-operative neoplastic metastasis histological type. The Kaplan-Meier method was used to estimate post-operative survival, and the Log-Rank test was used for statistical inference. Results A total of 52 patients who underwent 52 surgical procedures were identified. The mean age at the time of spinal surgery was 53.92 years (std. deviation, 19.09). The median survival after surgery was 70 days (95% CI 49.97–90.02), and post-operative mortality occurred within 6 months in 38 (73.07%) patients. Lung cancer, prostate cancer, myeloma and lymphoma, the 4 most common primary tumour types, affected 32 (61.53%) patients. The three identified prognostic parameters were the following: pre-operative walking incapacity (American Spinal Injury Association, A and B), present in 86.53% of the patients (p-value?=?0.107); special care dependency (Karnofsky Performance Score, 10–40 points), present in 90.38% of the patients (p-value?=?0.322); and vertebral epidural neoplastic metastases that were in contact with the thecal sac (Weinstein-Boriani-Biagini, sector D), present in 94.23% of the patients (p-value?=?0.643). When the three secondary prognostic parameters were combined, the mean post-operative survival was 45 days; when at least one was present, the survival was 82 days (p-value?=?0.175). Conclusions Walking incapacity, special care dependency and contact between the neoplastic metastases and the thecal sac can help determine the ultimate survival of this patient population and, potentially, which patients would benefit from surgery versus palliation alone. A 2- to 3-month post-operative survival period justified surgical treatment. PMID:25310095

Daniel, Jefferson W.; Veiga, Jose C. E.

2014-01-01

382

Spinal deformity after resection of cervical intramedullary spinal cord tumors in children  

Microsoft Academic Search

Objective  Progressive spinal deformity after cervical intramedullary spinal cord tumor (IMSCT) resection requiring subsequent fusion\\u000a occurs in many cases among pediatric patients. It remains unknown which subgroups of patients represent the greatest risk\\u000a for progressive spinal deformity.\\u000a \\u000a \\u000a \\u000a Materials and methods  The data for 58 patients undergoing surgical resection of cervical IMSCT at a single institution were retrospectively collected\\u000a and analyzed for development

Matthew J. McGirt; Kaisorn L. Chaichana; Frank Attenello; Timothy Witham; Ali Bydon; Kevin C. Yao; George I. Jallo

2008-01-01

383

Delivery presentations  

MedlinePLUS

... for the delivery progress. If the presenting part lies above the ischial spines, the station is reported ... number is a centimeter). If the presenting part lies below the ischial spines, the station is reported ...

384

Bradykinin antagonist decreases early disruption of the blood–spinal cord barrier after spinal cord injury in mice  

Microsoft Academic Search

Bradykinin is one of the key molecules involved in the disruption of the blood–brain barrier and blood–spinal cord barrier occurring after spinal cord injury (SCI). Previously we have shown a biphasic opening of the blood–spinal cord barrier as well as increased transport of tumor necrosis factor-? (TNF?) after SCI by compression of the lumbar spinal cord in mice. To evaluate

Weihong Pan; Abba J Kastin; Lajos Gera; John M Stewart

2001-01-01

385

Dropped-head syndrome resulting from injury to the central spinal cord at the upper cervical level.  

PubMed

There are many causes of paraspinal muscle weakness which give rise to the dropped-head syndrome. In the upper cervical spine the central portion of the spinal cord innervates the cervical paraspinal muscles. Dropped-head syndrome resulting from injury to the central spinal cord at this level has not previously been described. We report two patients who were treated acutely for this condition. Both presented with weakness in the upper limbs and paraspinal cervical musculature after a fracture of C2. Despite improvement in the strength of the upper limbs, the paraspinal muscle weakness persisted in both patients. One ultimately underwent cervicothoracic fusion to treat her dropped-head syndrome. While the cause of the dropped-head syndrome cannot be definitively ascribed to the injuries to the spinal cord, this pattern is consistent with the known patho-anatomical mechanisms of both injury to the central spinal cord and dropped-head syndrome. PMID:21464490

Rust, C L; Ching, A C; Hart, R A

2011-04-01

386

Independent evaluation of the anatomical and behavioral effects of Taxol in rat models of spinal cord injury.  

PubMed

The goal of the current manuscript was to replicate published data that show intrathecal infusions of Taxol® (paclitaxel), an anti-neoplastic microtubule stabilizing agent, reduce fibrogliotic scarring caused by a dorsal spinal hemisection (DHx) injury and increase functional recovery and growth of serotonergic axons after moderate spinal contusion injury. These experiments were completed as part of an NIH-NINDS contract entitled "Facilities of Research Excellence in Spinal Cord Injury (FORE-SCI) - Replication". Here, data are presented that confirm the anti-scarring effects of Taxol after DHx injury; however, Taxol did not confer neuroprotection or promote serotonergic axon growth nor did it improve functional recovery in a model of moderate spinal contusion injury. Thus, only partial replication was achieved. Possible explanations for disparate results in our studies and published data are discussed. PMID:24999028

Popovich, Phillip G; Tovar, C Amy; Lemeshow, Stanley; Yin, Qin; Jakeman, Lyn B

2014-11-01

387

Syringomyelia and Arnold-Chiari malformation associated with neck pain and left arm radiculopathy treated with spinal manipulation.  

PubMed

An 18-year-old female patient presented with left dominant neck pain after a motor vehicle collision. Her cervical spine MRI revealed syringomyelia with associated Type I Arnold-Chiari malformation. Some researchers have reported that these might be considered contraindications to spinal manipulation. Nevertheless, her benign and functional clinical examination suggested otherwise and she underwent four manipulative treatments in 2?weeks. By the end of the treatment plan and after 1-month follow-up, she was asymptomatic, no adverse effects were noted and her outcome assessment score decreased from 56% to 0%. This case illustrates that spinal manipulation may be a useful adjunctive treatment procedure for spinal pain, even in the presence of syringomyelia and Chiari malformation, which may not necessarily be a contraindication to spinal manipulation, when performed by a skilled and well-trained physician. PMID:25385566

Tieppo Francio, Vinicius

2014-01-01

388

Chronic Spinal Compression Model in Minipigs: A Systematic Behavioral, Qualitative, and Quantitative Neuropathological Study  

PubMed Central

Abstract The goal of the present study was to develop a porcine spinal cord injury (SCI) model, and to describe the neurological outcome and characterize the corresponding quantitative and qualitative histological changes at 4–9 months after injury. Adult Gottingen-Minnesota minipigs were anesthetized and placed in a spine immobilization frame. The exposed T12 spinal segment was compressed in a dorso-ventral direction using a 5-mm-diameter circular bar with a progressively increasing peak force (1.5, 2.0, or 2.5?kg) at a velocity of 3?cm/sec. During recovery, motor and sensory function were periodically monitored. After survival, the animals were perfusion fixed and the extent of local SCI was analyzed by (1) post-mortem MRI analysis of dissected spinal cords, (2) qualitative and quantitative analysis of axonal survival at the epicenter of injury, and (3) defining the presence of local inflammatory changes, astrocytosis, and schwannosis. Following 2.5-kg spinal cord compression the animals demonstrated a near complete loss of motor and sensory function with no recovery over the next 4–9 months. Those that underwent spinal cord compression with 2?kg force developed an incomplete injury with progressive partial neurological recovery characterized by a restricted ability to stand and walk. Animals injured with a spinal compression force of 1.5?kg showed near normal ambulation 10 days after injury. In fully paralyzed animals (2.5?kg), MRI analysis demonstrated a loss of spinal white matter integrity and extensive septal cavitations. A significant correlation between the magnitude of loss of small and medium-sized myelinated axons in the ventral funiculus and neurological deficits was identified. These data, demonstrating stable neurological deficits in severely injured animals, similarities of spinal pathology to humans, and relatively good post-injury tolerance of this strain of minipigs to spinal trauma, suggest that this model can successfully be used to study therapeutic interventions targeting both acute and chronic stages of SCI. PMID:22029501

Navarro, Roman; Juhas, Stefan; Keshavarzi, Sassan; Juhasova, Jana; Motlik, Jan; Johe, Karl; Marsala, Silvia; Scadeng, Miriam; Lazar, Peter; Tomori, Zoltan; Schulteis, Gery; Beattie, Michael; Ciacci, Joseph D.

2012-01-01

389

[11C]PK11195 PET imaging of spinal glial activation after nerve injury in rats.  

PubMed

The role of glial activation has been implicated in the development and persistence of neuropathic pain after nerve injury by recent studies. PK11195 binding to the translocator protein 18kDa (TSPO) has been shown to be enhanced in activated microglia. This study was designed to assess PK11195 imaging in spinal microglia during activation after nerve injury. The development of neuropathic pain was induced by partial sciatic nerve ligation (PSL). PSL rats on days 7 and 14 after nerve injury were subjected to imaging with a small-animal positron emission tomography/computed tomography (PET/CT) scanner using [(11)C]PK11195 to detect spinal microglial activation by means of noninvasive in vivo imaging. Spinal [(3)H]PK11195 autoradiography was performed to confirm the results of [(11)C]PK11195 PET in PSL rats. Quantitative RT-PCR of CD11b and GFAP mRNA, and the immunohistochemistry of Iba1 and GFAP were investigated to detect activated microglia and astrocytes. Mechanical allodynia was observed in the ipsilateral paw of PSL rats from day 3 after nerve injury and stably persisted from days 7 to 14. PET/CT fusion images clearly showed large amounts of accumulation of [(11)C]PK11195 in the lumbar spinal cord on days 7 and 14 after nerve injury. [(11)C]PK11195 enhanced images were restricted to the L3-L6 area of the spinal cord. The standardized uptake value (SUV) of [(11)C]PK11195 was significantly increased in the lumbar spinal cord compared to that of the thoracic region. Increased specific binding of [(11)C]PK11195 to TSPO in the spinal cord of PSL rats was confirmed by competition studies using unlabeled (R, S)-PK11195. Increased [(3)H]PK11195 binding was also observed in the ipsilateral dorsal horn of the L3-L6 spinal cord on days 7 and 14 after nerve injury. CD11b mRNA and Iba1 immunoreactive cells increased significantly on days 7 and 14 after nerve injury by PSL. However, changes in GFAP mRNA and immunoreactivity were slight in the ipsilateral side of PSL rats. In the present study, we showed that glial activation could be quantitatively imaged in the spinal cord of neuropathic pain rats using [(11)C]PK11195 PET, suggesting that high resolution PET using TSPO-specific radioligands might be useful for imaging to assess the role of glial activation, including neuroinflammatory processes, in neuropathic pain patients. PMID:23611861

Imamoto, Natsumi; Momosaki, Sotaro; Fujita, Masahide; Omachi, Shigeki; Yamato, Hiroko; Kimura, Mika; Kanegawa, Naoki; Shinohara, Shunji; Abe, Kohji

2013-10-01

390

Cardiac myxosarcoma with thoracic spinal metastasis.  

PubMed

Echocardiography revealed a left atrial tumor in a 59-year-old man with back pain that concurrently worsened with left foot drop and loss of the left ankle reflex soon after admission to our hospital. Magnetic resonance imaging of the spine revealed an epidural tumor extending from Th5 with spinal cord compression. The patient was immediately treated by emergency Th4-5 laminectomy and epidural decompression. One month later, a cardiac tumor excised via the left atrial approach was histopathologically diagnosed as myxosarcoma, and the Th5 tumor was consistent with this finding. This is the first report to describe spinal metastasis of cardiac myxosarcoma. PMID:23677508

Kimura, Mitsuhiro; Kikuchi, Chizuo; Takahashi, Yoshiki; Kanazawa, Hiroshi; Nakazawa, Satoshi

2014-07-01

391

Vulnerable Groups Living with Spinal Cord Injury  

PubMed Central

There is considerable variation in rehabilitation outcomes within the population of spinal cord–injured individuals across racial and socioeconomic groups. This suggests that the long-term health following spinal cord injury (SCI) is determined, at least in part, by group differences in exposure to advantages and disadvantages among persons living in the community. This article conceptualizes the nature of vulnerability and how increased vulnerability leads to disparities in SCI outcomes. Demographic, socioeconomic, and geographic determinants of adverse outcomes among vulnerable groups are discussed. Finally, a research model that outlines potential processes that elicit vulnerability following SCI and clinical implications is reviewed. PMID:23966760

Fyffe, Denise C.; Botticello, Amanda L.; Myaskovsky, Larissa

2013-01-01

392

Delayed acute spinal cord injury following intracranial gunshot trauma: case report.  

PubMed

The authors report the case of a patient who presented with a hoarse voice and left hemiparesis following a gunshot injury with trajectory entering the left scapula, traversing the suboccipital bone, and coming to rest in the right lateral medullary cistern. Following recovery from the hemiparesis, abrupt quadriparesis occurred coincident with fall of the bullet into the anterior spinal canal. The bullet was retrieved following a C-2 and C-3 laminectomy, and postoperative MR imaging confirmed signal change in the cord at the level where the bullet had lodged. The patient then made a good neurological recovery. Bullets can fall from the posterior fossa with sufficient momentum to cause an acute spinal cord injury. Consideration for craniotomy and bullet retrieval should be given to large bullets lying in the CSF spaces of the posterior fossa as they pose risk for acute spinal cord injury. PMID:22242667

Cheng, Jason S; Richardson, R Mark; Gean, Alisa D; Stiver, Shirley I

2012-04-01

393

Spinal and pelvic corrections in a patient with spondylocostal dysplasia syndrome and hemimyelomeningocele.  

PubMed

Congenital malformation complex of the spine and the spinal cord can be a syndromic entity rather than a symptom complex. The spinal cord lesion is usually bilaterally symmetrical, but, there are occasional cases with one or more hemivertebrae, often associated with a central bony spur splitting the cord (diastematomyelia), in which one leg is virtually normal while the other is severely paralysed. Hemimyelomeningocele over the lumbar area may be associated with extensive spine malsegmentation compatible with the diagnosis of spondylocostal dysplasia syndrome. In this report, we present a 3-year-old girl who underwent neurological evaluation and spinal imaging studies for extensive spine malsegmentation compatible with spondylocostal dysostosis syndrome associated with hemimyelomeningocele. She had a series of corrective orthopaedic interventions to reconstruct her pelvic girdle and spine deformities, with a satisfactory outcome. PMID:25323186

Al Kaissi, Ali; Stuecker, Ralf; Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

2014-01-01

394

Spinal Surgery in Patients with Parkinson's Disease: Unsatisfactory Results, Failure and Disappointment  

PubMed Central

Previous studies on spinal surgery in PD patients report an exceptionally high rate of complications. Failure and re -operation are frequent outcomes. This is a retrospective case series with the aim of establishing the rate of complications in patients with concomitant Parkinson’s disease. Ten patients were subjected to spinal surgery from 2005 to 2009. The indications and type of operation varied. Cases of Failed Back Surgery and re-operation were sought. Follow – up was between 6 – 42 months. All 10 patients presented some clinical or radiological complication. The most common complications were screw pull – out and progressive spinal deformity. Re – operations were performed in 5 patients, while clinical and radiological results were poor in the majority of cases. Patients with Parkinson’s disease have a very high complication rate and often have to undergo revision surgery. This particular group of patients should be informed of the increased risk of failure and be closely followed – up on a regular basis.

Sapkas, G.; Lykomitros, V.; Soultanis, K.; Papadopoulos, E.C.; Papadakis, M.

2014-01-01

395

Totally extradural spinal en plaque meningiomas - Diagnostic dilemmas and treatment strategies  

PubMed Central

Background: Meningiomas are the second most common intraspinal tumors, constituting ~25% of all intraspinal tumors; however, in the context of extradural spinal lesions, the diagnosis of meningioma is an uncommon one. Purely extradural spinal meningiomas, especially of the en plaque variety, frequently mimic metastatic disease and may result in inadequate therapy. Case Description: We report two cases of totally extradural en-plaque meningiomas of the spine, one each in the cervical and dorsal spine. We present the significant diagnostic dilemmas posed by these cases and discuss the pathogenesis, treatment strategies, and long-term behavior of these uncommon lesions. Conclusion: Attention needs to be drawn to this dangerous preoperative and intraoperative misinterpretation. Intraoperative histopathology support for correct identification, gross total resection at surgery, inclusion of a durotomy to rule out intradural extension, and long-term follow-up are cornerstones for successful management of totally extradural en plaque spinal meningiomas.

Savardekar, Amey; Chatterjee, Debarshi; Chatterjee, Debajyoti; Dhandapani, Sivashanmugam; Mohindra, Sandeep; Salunke, Pravin

2014-01-01

396

Dynamic lumbar spinal stenosis : the usefulness of axial loaded MRI in preoperative evaluation.  

PubMed

Two cases of dynamic lumbar spinal stenosis were identified by the authors using axial loaded magnetic resonance image (MRI). In both cases, the patients presented with neurogenic claudication but MRI in decumbency showed no definite pathologic condition associated with their symptoms. In contrast, axial loaded MRI demonstrated constrictive spinal stenosis and a significantly decreased dural sac caused by epidural fat buckling and thickening of the ligamentum flavum in both cases. In the second case, a more prominent disc protrusion was also demonstrated compared with decumbent MRI. After decompressive surgery, both patients had satisfactory outcomes. Axial loaded MRI can therefore give decisive information in dynamic spinal disorders by allowing simulation of an upright position. PMID:19844630

Choi, Kyung-Chul; Kim, Jin-Sung; Jung, Byungjoo; Lee, Sang-Ho

2009-09-01

397

Localizing the spinal cord in oblique off-cord lung boosts  

SciTech Connect

We present a method to accurately localize the spinal cord in oblique projections on plain radiographs. Utilizing a CT scan done with the patient in the treatment position, a template is generated to localize the spinal cord. The technique involves analyzing successive axial CT slices and locating cord position relative to the beam central axis. The template is then placed on the simulator fiducial plate at the time of verification simulation. Cord position is documented in the beam's eye view on the radiograph. Utilizing this technique, our radiation oncologists are more comfortable defining the medial field border in oblique setups. In most cases, this technique will minimize the perceived need to add superfluous spinal cord blocks that compromise tumor dose.

McCune, K.; Amundsen, J.; Travaglini, J. (Virginia Mason Clinic, Seattle, WA (USA))

1989-09-01

398

Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review.  

PubMed

Magnetic resonance imaging (MRI) is the modality of choice for the investigation of intramedullary lesions of the spinal cord. A wide variety of conditions may result in similar imaging findings on MRI, and it is essential that the reporting radiologist have a detailed understanding of spinal cord anatomy, the pertinent imaging features of specific intramedullary lesions and the typical clinical presentation of those conditions to aid clinicians to make a prompt diagnosis. This pictorial essay discusses the clinical features and MRI appearance of a number of intramedullary conditions, which can be broadly categorised as congenital, demyelinating, vascular, neoplastic or infectious, and highlights their differentiating features. PMID:24986469

Watts, Jane; Box, Georgia Alexandra; Galvin, Angela; Van Tonder, Frans; Trost, Nicholas; Sutherland, Thomas

2014-10-01

399

Apnea following spinal anaesthesia in two former pre-term infants  

Microsoft Academic Search

Purpose  To report the occurrence of apnea and bradycardia in two former pre-term infants who received spinal anaesthesia without inhalational\\u000a or intravenous anaesthetic agents during inguinal hemiorrhaphy.\\u000a \\u000a \\u000a \\u000a Clinical features  Two former pre-term infants who had no recent history of apnea or bradycardia and who had been discharged from the hospital\\u000a presented for anaesthetic care during inguinal hemiorrhaphy. Spinal anaesthesia using 1 mg·kg?1

Joseph D. Tobias; Randall S. Burd; Mary Alice Helikson

1998-01-01

400

The Effect of Safflower Yellow on Spinal Cord Ischemia Reperfusion Injury in Rabbits  

PubMed Central

Safflower yellow (SY) is the safflower extract and is the one of traditional Chinese medicine. The aim of the present work was to investigate the effect of SY on spinal cord ischemia reperfusion injury (SCIRI) in rabbits. The models of spinal cord ischemia reperfusion (SI/R) were constructed, and the degree of the post-ischemic injury was assessed by means of the neurological deficit scores and plasma levels of lipid peroxidation reactioin and neuronal morphologic changes. SCIRI remarkably affected the functional activities of the hind limbs and activated lipid peroxidation reaction. SY could attenuate apoptosis and SCIRI by enhancing Bcl-2 expression and inhibiting Bax and caspase-3 activation. PMID:24381717

Zhou, Daiwei; Liu, Bingbing; Xiao, Xiaoshan; Dai, Peng; Ma, Songmei; Huang, Weihua

2013-01-01

401

The effect of safflower yellow on spinal cord ischemia reperfusion injury in rabbits.  

PubMed

Safflower yellow (SY) is the safflower extract and is the one of traditional Chinese medicine. The aim of the present work was to investigate the effect of SY on spinal cord ischemia reperfusion injury (SCIRI) in rabbits. The models of spinal cord ischemia reperfusion (SI/R) were constructed, and the degree of the post-ischemic injury was assessed by means of the neurological deficit scores and plasma levels of lipid peroxidation reactioin and neuronal morphologic changes. SCIRI remarkably affected the functional activities of the hind limbs and activated lipid peroxidation reaction. SY could attenuate apoptosis and SCIRI by enhancing Bcl-2 expression and inhibiting Bax and caspase-3 activation. PMID:24381717

Zhou, Daiwei; Liu, Bingbing; Xiao, Xiaoshan; Dai, Peng; Ma, Songmei; Huang, Weihua

2013-01-01

402

Radiofrequency ablation for non-spinal osteoid osteomas in 557 patients  

Microsoft Academic Search

Objectives  To present the results of biopsy and computed tomography (CT) guided radiofrequency ablation (RFA) for non-spinal osteoid\\u000a osteomas, and compare the results before and after procedural modifications.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We retrospectively studied 557 patients with non-spinal osteoid osteomas treated with biopsy and CT-guided RFA. In 68 patients\\u000a we used 3-mm CT at 2-mm intervals, 19 G\\/5-mm active tip electrodes, and one 4-minute ablation

Eugenio Rimondi; Andreas F. Mavrogenis; Giuseppe Rossi; Rosanna Ciminari; Cristina Malaguti; Cristina Tranfaglia; Daniel Vanel; Pietro Ruggieri

403

Ultrasound-guided facet joint injection to treat a spinal cyst.  

PubMed

Lumbar spinal cysts often present with backache and may be accompanied by lower extremity weakness as well as radiation pain if root compression occurs. The treatment regimens include anti-inflammatory drugs, physical therapy, procedures guided by fluoroscopy or computed tomography, and surgery. We report the case of a patient with a symptomatic lumbar spinal cyst at the L4-L5 facet joint. The symptoms immediately remitted after ultrasound-guided steroid-lidocaine injection into the L4-L5 facet joint. Magnetic resonance imaging follow up 4 months after injection showed complete resolution of the cyst. PMID:24631041

Lin, Tung-Liang; Chung, Chin-Teng; Lan, Howard Haw-Chang; Sheen, Huey-Min

2014-04-01

404

Coronary slow flow and acute coronary syndrome in a patient with spinal cord injury.  

PubMed

We report the case of a 55-year-old man who presented with acute coronary syndrome due to coronary slow flow after spinal cord injury. Data regarding the causes and clinical manifestations of coronary slow flow are inconclusive, but the autonomic nervous system is believed to be at least a contributing factor. The predominant vagal activity causes vasodilation and hemostasis, which can lead to acute coronary syndrome. We hereby call attention to hyperactive parasympathetic tonicity, which can lead to coronary slow flow and acute coronary syndrome in acute spinal cord injury patients. PMID:21841878

Aktoz, Meryem; Tatli, Ersan; Barutcu, Ahmet; Ozkalayci, Flora; Umit, Elif; Altun, Armagan

2011-01-01

405

Hydrocephalic dementia and spinal cord tumor. Report of a case and review of the literature.  

PubMed

A 68-year-old woman presented with an 18-month history of low back pain followed by leg weakness, dementia, and incontinence. Myelography revealed an intradural, extramedullary block from L-2 to L-4, and cranial computed tomography demonstrated ventriculomegaly. Excision of a benign schwannoma resulted in rapid relief of back pain and more gradual normalization of mental function and hydrocephalus. Five similar cases of dementia and hydrocephalus complicating spinal cord tumor have been reported. A variety of mechanisms have been proposed to explain the association but the pathophysiology is still unclear. Spinal tumor should be considered in the differential diagnosis of dementia and of communicating hydrocephalus. PMID:3729751

Feldmann, E; Bromfield, E; Navia, B; Pasternak, G W; Posner, J B

1986-07-01

406

[Spinal marrow development in Japanese quail embryos and chicklings in the spaceflight environment].  

PubMed

Results of studying spinal marrow histogenesis in age varying Japanese quail embryos and chicklings whose embryonic development took place in microgravity are presented. Histological comparison of spinal cords showed retardation of morphogenetic development, lumber spine especially, in the group of flight embryos manifested as incomplete proliferative activity during migration processes and nervous cell differentiation. Like on earth, in space microgravity chicklings also hatched on day 17 of embryogenesis. Multiform marrow changes in space chicklings were a nervous cells reaction to the functional state of organism in the micro-g environment. PMID:24490278

Dadasheva, O A; Gur'eva, T S; Sychev, V N; Mednikova, E I; Filatova, A V; Komissarova, D V

2013-01-01

407

Fetal Spinal Cord Transplants Support Growth of Supraspinal and Segmental Projections after Cervical Spinal Cord Hemisection in the Neonatal Rat  

Microsoft Academic Search

Cervical spinal cord injury at birth permanently disrupts fore- limb function in goal-directed reaching. Transplants of fetal spinal cord tissue permit the development of skilled forelimb use and associated postural adjustments (Diener and Bregman, 1998, companion article). The aim of this study was to deter- mine whether transplants of fetal spinal cord tissue support the remodeling of supraspinal and segmental

Pamela S. Diener; Barbara S. Bregman

1998-01-01

408

Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery: A review focus on the corticospinal tracts  

Microsoft Academic Search

Recent advances in technology and the refinement of neurophysiological methodologies are significantly changing intraoperative neurophysiological monitoring (IOM) of the spinal cord. This review will summarize the latest achievements in the monitoring of the spinal cord during spine and spinal cord surgeries. This overview is based on an extensive review of the literature and the authors’ personal experience. Landmark articles and

Vedran Deletis; Francesco Sala

2008-01-01

409

A Modified Sagittal Spine Postural Classification and Its Relationship to Deformities and Spinal Mobility in a Chinese Osteoporotic Population  

PubMed Central

Background Abnormal posture and spinal mobility have been demonstrated to cause functional impairment in the quality of life, especially in the postmenopausal osteoporotic population. Most of the literature studies focus on either thoracic kyphosis or lumbar lordosis, but not on the change of the entire spinal alignment. Very few articles reported the spinal alignment of Chinese people. The purpose of this study was threefold: to classify the spinal curvature based on the classification system defined by Satoh consisting of the entire spine alignment; to identify the change of trunk mobility; and to relate spinal curvature to balance disorder in a Chinese population. Methodology/Principal Findings 450 osteoporotic volunteers were recruited for this study. Spinal range of motion and global curvature were evaluated noninvasively using the Spinal-Mouse® system and sagittal postural deformities were characterized. Results We found a new spine postural alignment consisting of an increased thoracic kyphosis and decreased lumbar lordosis which we classified as our modified round back. We did not find any of Satoh’s type 5 classification in our population. Type 2 sagittal alignment was the most common spinal deformity (38.44%). In standing, thoracic kyphosis angles in types 2 (58.34°) and 3 (58.03°) were the largest and lumbar lordosis angles in types 4 (13.95°) and 5 (?8.61°) were the smallest. The range of flexion (ROF) and range of flexion-extension (ROFE) of types 2 and 3 were usually greater than types 4 and 5, with type 1 being the largest. Conclusions/Significance The present study classified and compared for the first time the mobility, curvature and balance in a Chinese population based on the entire spine alignment and found types 4 and 5 to present the worst balance and mobility. This study included a new spine postural alignment classification that should be considered in future population studies. PMID:22693647

Wang, Hua-Jun; Giambini, Hugo; Zhang, Wen-Jun; Ye, Gan-Hu; Zhao, Chunfeng; An, Kai-Nan; Li, Yi-Kai; Lan, Wen-Rui; Li, Jian-You; Jiang, Xue-Sheng; Zou, Qiu-Lan; Zhang, Xiao-Ying; Chen, Chao

2012-01-01

410

Ionotropic Glutamate Receptors and Voltage-Gated Ca2+ Channels in Long-Term Potentiation of Spinal Dorsal Horn Synapses and Pain Hypersensitivity  

PubMed Central

Over the last twenty years of research on cellular mechanisms of pain hypersensitivity, long-term potentiation (LTP) of synaptic transmission in the spinal cord dorsal horn (DH) has emerged as an important contributor to pain pathology. Mechanisms that underlie LTP of spinal DH neurons include changes in the numbers, activity, and properties of ionotropic glutamate receptors (AMPA and NMDA receptors) and of voltage-gated Ca2+ channels. Here, we review the roles and mechanisms of these channels in the induction and expression of spinal DH LTP, and we present this within the framework of the anatomical organization and synaptic circuitry of the spinal DH. Moreover, we compare synaptic plasticity in the spinal DH with classical LTP described for hippocampal synapses. PMID:24224102

Youn, Dong-ho; Gerber, Gabor; Sather, William A.

2013-01-01

411

Effective Presentations  

PubMed Central

Where the purpose of presentations is to inform, effective delivery is important to ensure that audiences receive the educational message. We offer six suggestions: introduce the topic in an interesting way; speak loudly enough; do not read; involve the audience actively; respect the attention span of the audience; and limit the amount of content. We conclude that the skills of live public presentation can be learned, but that the art of presentation is innate. Imagesp2063-ap2064-a PMID:21233951

Spooner, H. James; Swanson, Richard W.

1990-01-01

412

Activation of Descending Pain Facilitatory Pathways from the Rostral Ventromedial Medulla by Cholecystokinin Elicits Release of PGE2 in the Spinal Cord  

PubMed Central

Cholecystokinin (CCK) has been suggested to be both pro-nociceptive and anti-opioid by actions on pain modulatory cells within the RVM. One consequence of activation of RVM CCK2 receptors may be enhanced spinal nociceptive transmission but how this might occur, especially in states of pathological pain is unknown. Here, in vivo microdialysis was used to demonstrate that levels of RVM CCK increased by approximately 2-fold following ligation of L5/L6 spinal nerves (SNL). Microinjection of CCK into the RVM of naïve rats elicited hypersensitivity to tactile stimulation of the hindpaw. Additionally, RVM CCK elicited a time-related increase in PGE2 measured in cerebrospinal fluid from the lumbar spinal cord. The peak increase in spinal PGE2 was approximately 5-fold and was observed at approximately 80-min post-RVM CCK, a time coincident with maximal RVM CCK-induced mechanical hypersensitivity. Spinal administration of naproxen, a non-selective COX-inhibitor, significantly attenuated RVM CCK-induced hindpaw tactile hypersensitivity. RVM-CCK also resulted in a 2-fold increase in spinal 5-HIAA, a 5-HT metabolite, as compared to controls, and mechanical hypersensitivity that was attenuated by spinal application of ondansetron, a 5-HT3 antagonist. The present studies suggest that chronic nerve injury can result in activation of descending facilitatory mechanisms that may promote hyperalgesia via ultimate release of PGE2 and 5-HT in the spinal cord. PMID:22030324

Marshall, Timothy M.; Herman, David S.; Largent-Milnes, Tally M.; Badghisi, Hamid; Zuber, Konstantina; Holt, Shannon C.; Lai, Josephine; Porreca, Frank; Vanderah, Todd W.

2011-01-01

413

Poster Presentation  

NSDL National Science Digital Library

To prepare their presentations students do background reading on a topic of their choosing. They are required to prepare a visual poster presentation of their topic that incorporates graphic elements and a short written summary of their topic. In class students are required to give a five minute oral presentation using their poster to illustrate their talk. They must then answer questions from their classmate and instructor. The final element of this assignment requires students to evaluate the work of their classmates and to ask questions about the topics other students present.

Hoppe, Kathryn

414

Spinal Dysraphism: A Neurosurgical Review for the Urologist  

PubMed Central

Spinal neural tube defects are congenital malformations of the spine and spinal cord (eg, myelomeningocele) and are frequently seen in pediatric urology practice. These neurologic problems have many consequences in a child’s life and affect different parts of the body, such as the brain, spinal cord, limbs, bladder, and bowels. Because of the complexity and neurologic aspects of spinal dysraphism, many related terms and aspects of the disease are unfamiliar to the urologist. This review addresses some of the most commonly used neurosurgical terms and concepts related to spinal dysraphism. PMID:19680528

Netto, Jose Murillo B; Bastos, Andre N; Figueiredo, Andre A; Perez, Luis M

2009-01-01

415

Presenters University  

NSDL National Science Digital Library

Everyone has to give presentations at some point in their career, whether they are in the field of criminal justice or animal husbandry. Fortunately for all such persons who might be experiencing presentation anxiety, there is the Presenters University website. While this âÂÂuniversityâ does not grant any honorary doctorates, they have assembled a fine selection of articles on presentation âÂÂdoâÂÂs and donâÂÂtsâÂÂ, along with a section where visitors can âÂÂAsk The Professorâ about their most vexing presentation quandaries. The most useful material on this site is contained in the âÂÂCoursesâ area. Here, visitors can read such timely pieces as âÂÂStorytelling-A Leadership Development ToolâÂÂ, âÂÂThemes in PowerPoint 2007âÂÂ, and âÂÂHow to Write and Deliver a Dynamite SpeechâÂÂ.

416

Treadmill step training promotes spinal cord neural plasticity after incomplete spinal cord injury.  

PubMed

A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spinal cord transection. However, after incomplete lesions, the effect of treadmill training has been debated, which is likely because of the difficulty of separating spontaneous stepping from specific training-induced effects. In this study, rats with moderate spinal cord contusion were jected to either step training on a treadmill or used in the model (control) group. The treadmill training began at day 7 post-injury and lasted 20 ± 10 minutes per day, 5 days per week for 10 weeks. The speed of the treadmill was set to 3 m/min and was increased on a daily basis according to the tolerance of each rat. After 3 weeks of step training, the step training group exhibited a sig-nificantly greater improvement in the Basso, Beattie and Bresnahan score than the model group. The expression of growth-associated protein-43 in the spinal cord lesion site and the number of tyrosine hydroxylase-positive ventral neurons in the second lumbar spinal segment were greater in the step training group than in the model group at 11 weeks post-injury, while the levels of brain-derived neurotrophic factor protein in the spinal cord lesion site showed no difference between the two groups. These results suggest that treadmill training significantly improves functional re-covery and neural plasticity after incomplete spinal cord injury. PMID:25206564

Sun, Tiansheng; Ye, Chaoqun; Wu, Jun; Zhang, Zhicheng; Cai, Yanhua; Yue, Feng

2013-09-25

417

Effects of hip joint angle changes on intersegmental spinal coupling in human spinal cord injury  

Microsoft Academic Search

Pathological expression of movement and muscle tone in human upper motor neuron disorders has been partly associated with\\u000a impaired modulation of spinal inhibitory mechanisms, such as reciprocal or presynaptic inhibition. In addition, input from\\u000a specific afferent systems contributes significantly to spinal reflex circuits coupled with posture or locomotion. Accordingly,\\u000a the objectives of this study were to identify the involved afferents

Maria Knikou

2005-01-01

418

New evidence for the involvement of spinal fractalkine receptor in pain facilitation and spinal glial activation in rat model of monoarthritis.  

PubMed

Fractalkine, a chemokine binding to only one known receptor CX3CR1, has recently been proposed to be a neuron-to-glia signal in the spinal cord leading to microglial activation and glially dependent pain facilitation. The previous studies explored that blockade of endogenous fractalkine, using anti-CX3CR1 neutralizing antibody, dose-dependently attenuated neuropathic pain. The present study examined the role of endogenous fractalkine in inflammatory pain. Intra-articular injection of complete Freund's adjuvant (CFA)-induced rat ankle joint monoarthritis (MA) model was used. Western blot analysis revealed that CX3CR1 expression in the spinal cord was significantly increased following CFA-induced MA. Intrathecal injection of anti-CX3CR1 neutralizing antibody both delayed the development of mechanical allodynia and thermal hyperalgesia, and reversed established pain facilitation. Furthermore, blockade of CX3CR1 significantly suppressed activation of spinal glia, especially microglia, evoked by MA. These data provided new evidence for the contribution of endogenous fractalkine to the initiation and early maintenance of inflammatory pain facilitation via activating spinal microglia. PMID:17123734

Sun, Shan; Cao, Hong; Han, Mei; Li, Ting-Ting; Pan, Hai-Li; Zhao, Zhi-Qi; Zhang, Yu-Qiu

2007-05-01

419

Outcome predictors and complications in the management of intradural spinal tumours  

Microsoft Academic Search

The results of the management of 115 patients with intradural spinal tumours are presented. Data was collected retrospectively from the case notes. Tumours were categorized as intramedullary or extramedullary for statistical analysis. Meningioma, schwannoma and ependymoma accounted for 70% of tumours. Complete macroscopic excision was achieved in 84% of extramedullary and 54% of intramedullary tumours. There were two post-operative deaths,

M. D. Jenkinson; C. Simpson; R. S. Nicholas; J. Miles; G. F. G. Findlay; T. J. D. Pigott

2006-01-01

420

Coping Effectiveness Training During Acute Rehabilitation of Spinal Cord Injury\\/Dysfunction: A Randomized Clinical Trial  

Microsoft Academic Search

Purpose: To compare coping effectiveness training (CET) with supportive group therapy (SGT) for anxiety, depression, and adjustment to injury in an acute spinal cord injury\\/dysfunction (SCI\\/D) rehabilitation population. CET was shown to result in decreased anxiety and depression symptoms when compared to historical no-treatment control groups (Kennedy, Duff, Evans, & Beedie, 2003; King & Kennedy, 1999). The present study sought

Jennifer J. Duchnick; Elizabeth A. Letsch; Glenn Curtiss

2009-01-01

421

Fungal Spinal Osteomyelitis in the Immunocompromised Patient: MR Findings in Three Cases  

Microsoft Academic Search

Summary: The MR imaging findings of fungal spinal os- teomyelitis in three recipients of organ transplants showed hypointensity of the vertebral bodies on T1-weighted se- quences in all cases. Signal changes and enhancement ex- tended into the posterior elements in two cases. Multiple- level disease was present in two cases (with a total of five intervertebral disks involved in three

Robert L. Williams; Melanie B. Fukui; Carolyn Cidis Meltzer; Amar Swarnkar; David W. Johnson; William Welch

422

Lumbar spinal ganglia enhancement after Gadolinium chelate administration: a radio-histological correlation  

Microsoft Academic Search

: The aim of the present study was to assess the frequency of enhancement of lumbar spinal ganglia after Gadolinium chelate injection in patients without radiculopathy, and to correlate the enhancement with histology. This study is based on the analysis of MR lumbar examinations conducted on 18 patients without radicular symptoms, or previous surgery of the lumbar spine, or disease

X. Demondion; X. Leroy; F. Lapègue; A. Drizenko; J.-P. Francke; A. Cotten

2002-01-01

423

Neonatal Hind-Paw Injury Disrupts Acquisition of an Instrumental Response in Adult Spinal Rats  

Microsoft Academic Search

The present study was designed to evaluate the impact of neonatal injury on adult spinal plasticity in rats. Subjects were randomly assigned to 1 of 4 experimental conditions: (a) hind-paw injury at Postnatal Day (PD) 2, (b) hind-paw injury at PD 5, (c) anesthesia exposure only on PD 2, or (d) anesthesia exposure only on PD 5. Subjects receiving a

Erin E. Young; Kyle M. Baumbauer; Audrea Elliot; Robin L. Joynes

2007-01-01

424

Rib displacement threatening the spinal cord in a scoliotic child with neurofibromatosis  

Microsoft Academic Search

About 30% of children with neurofibromatosis are affected by scoliosis usually due to bony dysplasia and\\/or neurogenic tumors. We report the case of a scoliotic girl with type 1 neurofibromatosis presenting with a costovertebral dislocation at the apex of the spinal curvature.

J. N. Dacher; S. Zakine; M. Monroc; D. Eurin; J. Lechevallier; P. Le Dosseur

1995-01-01

425

Psychological, Sexual, Social and Vocational Aspects of Spinal Cord Injury. A Selected Bibliography.  

ERIC Educational Resources Information Center

Presented is a bibliography with approximately 700 citations referring to research in the area of spinal cord injury. Entries are listed alphabetically by author under the following sections: psychological aspects (236 entries), sexual aspects (170 entries), social aspects (152 entries), and vocational aspects (134 entries). Information for each…

Scarlett, Sharon, Comp.; And Others

426

Simplified spinal cord phantom for evaluation of SQUID magnetospinography  

NASA Astrophysics Data System (ADS)

Spinal cord functional imaging by magnetospinography (MSG) is a noninvasive diagnostic method for spinal cord diseases. However, the accuracy and spatial resolution of lesion localization by MSG have barely been evaluated in detail so far. We developed a simplified spinal cord phantom for MSG evaluation. The spinal cord phantom is composed of a cylindrical vessel filled with saline water, which acts as a model of a neck. A set of modeled vertebrae is arranged in the cylindrical vessel, which has a neural current model made from catheter electrodes. The neural current model emulates the current distribution around the activated site along the axon of the spinal cord nerve. Our MSG system was used to observe the magnetic field from the phantom; a quadrupole-like pattern of the magnetic field distribution, which is a typical distribution pattern for spinal cord magnetic fields, was successfully reproduced by the phantom. Hence, the developed spinal cord phantom can be used to evaluate MSG source analysis methods.

Adachi, Y.; Oyama, D.; Somchai, N.; Kawabata, S.; Uehara, G.

2014-05-01

427

Information Presentation  

NASA Technical Reports Server (NTRS)

The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew on flight vehicles, surface landers and habitats, and during extra-vehicular activities (EVA). Designers of displays and controls for exploration missions must be prepared to select the text formats, label styles, alarms, electronic procedure designs, and cursor control devices that provide for optimal crew performance on exploration tasks. The major areas of work, or subtasks, within the Information Presentation DRP are: 1) Controls, 2) Displays, 3) Procedures, and 4) EVA Operations.

Holden, Kritina; Sandor, A.; Thompson, S. G.; McCann, R. S.; Kaiser, M. K.; Begault, D. R.; Adelstein, B. D.; Beutter, B. R.; Stone, L. S.

2008-01-01

428

Chiari II Malformation and Occult Spinal Dysraphism  

Microsoft Academic Search

We report two cases of children with occult spinal dysraphism who were also found to have many associated brain anomalies seen in the Chiari II malformation. No previous report has commented on the possible association between the Chiari II malformation and the ‘closed’ form of neural tube defect. One child had symptoms referable to pathology at the craniocervical junction. Neither

R. Shane Tubbs; John C. Wellons III; Paul A. Grabb; W. Jerry Oakes

2003-01-01

429

Vocational outcome following spinal cord injury  

Microsoft Academic Search

Study Design: Non-experimental (ex post facto) survey research design involving the use of a fixed alternative format questionnaire. Objectives: To investigate variables influencing vocational outcome, to identify barriers to gaining and sustaining employment and to identify the effects of variables on the type of work engaged in following spinal cord injury. The two sets of independent variables considered were, individual

L Conroy; K McKenna

1999-01-01

430

Surgery of intramedullary spinal cord tumors  

Microsoft Academic Search

The diagnosis and management of intramedullary spinal cord tumors have been significantly influenced by new diagnostic and surgical tools such as MRI, ultrasonic aspiration, intraoperative ultrasound, and evoked potential monitoring. In this study we compared the surgical results of our earlier cases using conventional methods with more recent cases using these new methods. We report our experience based on 44

M. Zileli; E. Co?kun; N. Özdamar; I. Övül; E. Tunçbay; K. Öner; N. Oktar

1996-01-01

431

Pediatric Intramedullary Spinal Cord Tumors: Special Considerations  

Microsoft Academic Search

Intramedullary spinal cord tumors (IMSCTs) of the pediatric population are rare and comprise thirty-five percent of intraspinal neoplasms. Low-grade astrocytomas predominate; ependymomas increase in frequency with ascending age and become the most frequent IMSCT in adults. Gangliogliomas are very rare in adults but comprise nearly thirty percent of tumors in children under three years of age. The cervical spine is

John K. Houten; Howard L. Weiner

2000-01-01

432

Pain in Children with Spinal Cord Tumors  

Microsoft Academic Search

Pain in children is generally not accorded the same significance by allied health professionals as pain in adults. To some extent this relative neglect may be the result of a general belief that pain is less of a problem in the pediatric age-group. However, it is the authors’ experience that the management of pain in children with spinal cord tumors

Yoon Sun Hahn; David G. McLone

1984-01-01

433

Spinal metastases from pituitary hemangiopericytic meningioma  

SciTech Connect

A rare, previously irradiated, recurrent malignant angioblastic meningioma of the pituitary, hemangiopericytic type, was locally controlled by a new endocurietherapy technique that allows delivery of very high (10,000 cGy), sharply localized irradiation. Rather than succumbing to the local tumor recurrence, as would otherwise be expected, the patient developed distant spinal metastases several years later.

Kumar, P.P.; Good, R.R.; Skultety, F.M.; Masih, A.S.; McComb, R.D.

1987-10-01

434

Endovascular treatment in spinal perimedullary arteriovenous fistula.  

PubMed

This study includes 20 patients with 21 spinal perimedullary fistulae. There were nine Type IVa (42.8%) lesions, ten Type IVb (47.6%) and two Type IVc (9.5%) lesions. The dominant arterial supply was from the anterior spinal artery (47.6%), posterior spinal artery (19%) and directly from the radiculomedullary artery (28.5%). Sixteen lesions in 15 patients were treated by endovascular route using n-butyl-2-cyanoacrylate. Endovascular treatment was not feasible in five patients. Of the ten patients with microfistulae, catheterization failed/was not attempted in 40%, complete obliteration of the lesion was seen in 60% but clinical improvement was seen in 40% of patients. Catheterization was feasible in all ten patients with macrofistulae (nine type IVb and two type IVc lesions). Complete obliteration of the lesions was seen in 60% and residue in 30%. Clinical improvement was seen in 80% and clinical deterioration in 10%. In conclusion, endovascular glue embolization is safe and efficacious in type IVb and IVc spinal perimedullary fistulae and should be considered the first option of treatment. It is also feasible in many of the type IVa lesions. PMID:24976100

Phadke, Rajendra V; Bhattacharyya, Avik; Handique, Akash; Jain, Krishan; Kumar, Alok; Singh, Vivek; Baruah, Deb; Kumar, Tushant; Patwari, Sriram; Mohan, B Madan

2014-01-01

435

Spinal Cord Stimulation Revisited: Psychological Effects  

Microsoft Academic Search

97 patients undergoing spinal cord stimulation (SCS) were studied for a median of 24 days after initiation of treatment. SCS was associated with significant improvement in memory, visuo-spatial integration, activation, cognitive efficiency, attention and overall psychological status. Significant emotional improvement in self-image, anxiety and depression was also confirmed following SCS. Diagnosis did not differentially affect psychological outcome except for relief

Eric Levita; Bruce A. Sorkin; Joseph M. Waltz

1986-01-01

436

Radiology of intervertebral cages in spinal surgery  

Microsoft Academic Search

This pictorial essay reviews the normal appearances and the post-operative complications of intervertebral cages. These are implants which are being more widely used in spinal surgery. The text outlines the background leading to their development, the clinical indications and surgical techniques for insertion of the cages. The normal post-operative appearance of fusion and the complications that can occur are emphasized.

S. D. Hanley; M. T. Gun; O. Osti; E. M. Shanahan

1999-01-01

437

AN ELECTRON MICROSCOPE STUDY OF CULTURED RAT SPINAL CORD  

PubMed Central

Explants prepared from 17- to 18-day fetal rat spinal cord were allowed to mature in culture; such preparations have been shown to differentiate and myelinate in vitro (61) and to be capable of complex bioelectric activity (14–16). At 23, 35, or 76 days, the cultures were fixed (without removal from the coverslip) in buffered OsO4, embedded in Epon, sectioned, and stained for light and electron microscopy. These mature explants generally are composed of several strata of neurons with an overlying zone of neuropil. The remarkable cytological similarity between in vivo and in vitro nervous tissues is established by the following observations. Cells and processes in the central culture mass are generally closely packed together with little intervening space. Neurons exhibit well developed Nissl bodies, elaborate Golgi regions, and subsurface cisternae. Axosomatic and axodendritic synapses, including synaptic junctions between axons and dendritic spines, are present. Typical synaptic vesicles and increased membrane densities are seen at the terminals. Variations in synaptic fine structure (Type 1 and Type 2 synapses of Gray) are visible. Some characteristics of the cultured spinal cord resemble infrequently observed specializations of in vivo central nervous tissue. Neuronal somas may display minute synapse-bearing projections. Occasionally, synaptic vesicles are grouped in a crystal-like array. A variety of glial cells, many apparently at intermediate stages of differentiation, are found throughout the otherwise mature explant. There is ultrastructural evidence of extensive glycogen deposits in some glial processes and scattered glycogen particles in neuronal terminals. This is the first description of the ultrastructure of cultured spinal cord. Where possible, correlation is made between the ultrastructural data and the known physiological properties of these cultures. PMID:14326105

Bunge, Richard P.; Bunge, Mary Bartlett; Peterson, Edith R.

1965-01-01

438

Information Presentation  

NASA Technical Reports Server (NTRS)

The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. The major areas of work, or subtasks, within this DRP are: 1) Displays, 2) Controls, 3) Electronic Procedures and Fault Management, and 4) Human Performance M