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1

Pachymeningitis cranialis hypertrophica.  

PubMed Central

A case of pachymeningitis cranialis hypertrophica is described and the CT appearances are presented. The likely cause was syphilis, though sarcoidosis and tuberculosis were not completely excluded. Images PMID:4045489

Moore, A P; Rolfe, E B; Jones, E L

1985-01-01

2

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. PMID:25285024

Stephenson, William; Kauflin, Matthew J

2014-01-01

3

Malignant spinal cord tumors: a review and case presentation.  

PubMed

Since malignant spinal cord tumors constitute such a small percentage of spinal cord lesions, nurses may be unaware of the challenging needs of this group of patients. Often young and previously healthy, these people face a rapidly progressive and dismal disease course. Presentation and complaints are related to the location and growth rate of the tumor. Treatment is geared to debulking the tumor mass and preventing its spread. This article discusses the pathophysiology, signs and symptoms, medical management and nursing implications for the patient diagnosed with a malignant spinal cord tumor. A case presentation including examples of nursing diagnosis and interventions follows. PMID:1849947

Raney, D J

1991-02-01

4

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. PMID:25396073

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

2014-01-01

5

Multiple myeloma presenting as spinal cord compression: a case report  

Microsoft Academic Search

INTRODUCTION: Spinal cord compression is a potentially devastating condition that demands immediate attention. Efforts must be divided between addressing the symptoms of cord compression and identifying the precise etiology of the condition. CASE PRESENTATION: A 76-year-old Peruvian man presented to our emergency department for evaluation of the gradual onset of lower extremity weakness over one month, resulting in falls and

Chayan Chakraborti; Kristen L Miller

2010-01-01

6

Cervical spinal abscess: an insidious presentation and unusual pathology.  

PubMed

Spinal abscess is a rare condition. Its presentation can often be subtle and insidious. This report describes the diagnosis and management of an 87-year-old man who presented to our orthopaedic clinic. We would like to emphasise the importance of rapid diagnosis and prompt treatment in such cases. PMID:22943315

Khoriati, A; Kitson, J; Deol, R S

2012-09-01

7

Cervical spinal abscess: an insidious presentation and unusual pathology  

PubMed Central

Spinal abscess is a rare condition. Its presentation can often be subtle and insidious. This report describes the diagnosis and management of an 87-year-old man who presented to our orthopaedic clinic. We would like to emphasise the importance of rapid diagnosis and prompt treatment in such cases. PMID:22943315

Khoriati, A; Kitson, J; Deol, RS

2012-01-01

8

Spinal dural arteriovenous fistula presenting with paraplegia following lumbar puncture.  

PubMed

Spinal dural arteriovenous fistulas are rare lesions with an annual incidence of 1 per 100,000 population. In patients with this disease, an abnormal vascular dural shunt exists between a dural branch of a segmental artery and a subdural radicular vein that drains the perimedullary venous system, leading to venous hypertension and secondary congestive myelopathy. Generally, patients present with progressive paraparesis, urinary disturbances, and gait ataxia. In this report the authors describe a 61-year-old woman with a spinal dural arteriovenous fistula who developed an acute paraplegia after a nontraumatic lumbar puncture. The possible underlying mechanisms and treatment options are discussed. PMID:23641674

Koerts, Guus; Vanthuyne, Vincent; Delavallee, Maxime; Rooijakkers, Herbert; Raftopoulos, Christian

2013-07-01

9

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

10

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

11

Posttraumatic intratumoural haemorrhage: an unusual presentation of spinal ependymoma  

PubMed Central

Ependymomas presenting with intratumoural and/or subarachnoid haemorrhages are seen rarely. These haemorrhages are mostly due to anticoagulation, epidural analgesia or pregnancy. A 62-year-old male farmer with cauda equina syndrome after a work-related trauma is presented. He was admitted to our hospital with paraparesis, faecal incontinance and sensory loss below the level of the lumbar-2 dermatome. Magnetic resonance imaging of the spine displayed an intradural mass lesion at the level of the first lumbar vertebrae. The lesion was excised totally via dorsal midline approach. Histopathologic examination revealed grade-3 ependymoma with intratumoural haemorrhage. The patient’s symptoms were relieved completely on postoperative day 7. The patient was given information about periodical examination for recurrence and discharged on the third postoperative week. Asymptomatic spinal lesions should be considered for operation whenever detected because of unpredicted complications. PMID:17235592

Calisaneller, Tarkan; Coven, Ilker; Altinors, Nur

2007-01-01

12

Spinal Stenosis Presenting with Scrotal and Perianal Claudication  

PubMed Central

A 63-year-old gentleman presented with a one-year duration of progressive neurogenic claudication. However, unlike most patients who presents with leg symptoms, his pain was felt in his scrotal and perianal region. This was exacerbated with walking and standing, but he had immediate relief with sitting. An magnetic resonance imaging (MRI) was performed which showed severe central canal stenosis. An L3/4 and L4/5 surgical decompression and a transforaminal lumbar interbody fusion was performed, and the patient made good recovery with immediate resolution of symptoms. Although rare, spinal stenosis should be considered a differential when approaching a patient with perianal and scrotal claudication, even in the absence of leg claudication. An MRI is useful to confirm the diagnosis. This rare symptom may be a sign of severe cauda equina compression and we recommend decompression with predictable good results. PMID:25705342

Tan, Jun-Hao; Teo, Timothy WW; Hee, Hwan-Tak

2015-01-01

13

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

14

Metastatic renal cell carcinoma initially presented with an intramedullary spinal cord lesion: a case report  

Microsoft Academic Search

INTRODUCTION: One of the rare manifestations of systemic neoplasia is intramedullary spinal cord metastasis that causes serious diagnostic and therapeutic dilemma. It has been very rarely reported as the initial manifestation of carcinoma. This is report of a metastatic renal cell carcinoma initially presented with intramedullary spinal cord lesion, to our knowledge there are few similar reports in literature. CASE

Mehrnaz Asadi; Hadi Rokni-Yazdi; Farahnaz Salehinia; Farshad S Allameh

2009-01-01

15

Spinal cord stimulation: principles of past, present and future practice: a review  

Microsoft Academic Search

Electric energy have been in use for the treatment of various ailments, including pain, since the time of Pharaohs. The theoretical\\u000a basis of electrotherapy of pain was provided by the Gate Control Theory of Melzak and Wall. In 1965, Shealey et al. first\\u000a introduced electrical stimulation of spinal cord for treating pain. At present spinal cord stimulation (SCS) is a

Sreekumar Kunnumpurath; Ravi Srinivasagopalan; Nalini Vadivelu

2009-01-01

16

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature  

PubMed Central

Approximately 10% of patients with AIDS present with some neurological deficit as their initial complaint, and up to 80% will have CNS involvement during the course of their disease. Toxoplasmosis is the most common cause of cerebral mass lesions in patients with AIDS, but appears to be an uncommon cause of spinal cord disease. The incidence of myelopathy may be as high as 20%, with 50% of the cases reported post-mortem. We present a unique case of spinal cord disease as the initial presentation of AIDS. We also present a comprehensive literature review of this topic, its diagnosis and treatment. This is a retrospective chart review case report. After a detailed case presentation, several diagnostic and therapeutic aspects of this unique case are thoroughly discussed. Although spinal cord toxoplasmosis is uncommon, it has been suggested that most patients with AIDS that present with evolving myelopathy, characterized by extremity weakness, sensory involvement, spinal cord enlargement, enhancing lesions in brain or spinal cord CT or MRI, have toxoplasmic myelitis. PMID:21373318

Fuentes, Carmen R.; Colon-Rolon, Lissandra; Masvidal, Daniel

2010-01-01

17

Toxoplasmosis of Spinal Cord in Acquired Immunodeficiency Syndrome Patient Presenting as Paraparesis: A Rare Entity  

PubMed Central

Although brain has been the most common site for toxoplasma infection in acquired immunodeficiency syndrome patients, involvement of spinal cord by toxoplasma has been rarely found. Spinal cord toxoplasmosis can present as acute onset weakness in both lower limbs associated with sensory and bladder dysfunction. A presumptive diagnosis can be made in patients with CD4 count <100/mm3 based on a positive serum Toxoplasma gondii IgG antibodies, no recent prophylaxis against toxoplasmosis, intramedullary ring enhancing lesion in spinal cord supported by similar lesions in brain parenchyma. Institutions of antitoxoplasma treatment in such patients result in prompt clinical response and therefore avoiding the need of unnecessary invasive diagnostic tests. Here, we report a case of toxoplasmic myelitis in immunocompromised patient presenting as myelopathy who showed significant clinical improvement after starting antitoxoplasma treatment. Hence toxoplasmic myelitis should be considered in toxoplasma seropositive immunocompromised patients presenting as myelopathy and imaging studies showing ring enhancing intramedullary lesion. PMID:25538456

Agrawal, Sachin R; Singh, Vinita; Ingale, Sheetal; Jain, Ajeet Prasad

2014-01-01

18

Malignant Nerve Sheath Tumor of the Spinal Accessory Nerve: A Unique Presentation of a Rare Tumor  

PubMed Central

Background Malignant peripheral nerve sheath tumors (MPNSTs), sarcomas originating from tissues of mesenchymal origin, are rare in patients without a history of neurofibromatosis. Case Report We report a case of an MPNST of the spinal accessory nerve, unassociated with neurofibromatosis, which metastasized to the brain. The tumor, originating in the intrasternomastoid segment of the spinal accessory nerve, was removed. Two years later, the patient presented with focal neurological deficits. Radiographic findings revealed a well-defined 2.2×2.2×2.2 cm, homogeneously enhancing mass in the left parieto-occipital region of the brain surrounded by significant vasogenic edema and mass effect, culminating in a 1-cm midline shift to the right. The mass was surgically removed. The patient had nearly complete recovery of vision, speech, and memory. Conclusions To our knowledge, this is the first documented case of an MPNST arising from an extracranial segment of the spinal accessory nerve and metastasizing to the brain. PMID:22523517

Sheikh, Omair A.; Reaves, Ann; Kralick, Francis A.; Brooks, Ari; Musial, Rachel E.

2012-01-01

19

Acute presentation of solitary spinal epidural cavernous angioma in a child.  

PubMed

Solitary spinal epidural cavernous angiomas are rare lesions, especially in paediatric age group. They are infrequently considered in the differential diagnosis of spinal epidural masses in children. We report a case of solitary epidural cavernous angioma of the thoracic spine in a child presenting with acute onset of back pain and myelopathy. Magnetic resonance imaging of the thoracic spine demonstrated a posterior epidural mass at T6-T8 levels with compression of the spinal cord. Using microsurgical technique and bipolar coagulation, total excision of the lesion was achieved. Histopathological examination confirmed the diagnosis of cavernous angioma. At the five-year follow-up, there was no recurrence of the tumour. PMID:23673181

Khalatbari, Mahmoud Reza; Hamidi, Mehrdokht; Moharamzad, Yashar

2013-05-01

20

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

21

Massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. Case report.  

PubMed

Charcot spinal disease is a destructive degenerative process involving the vertebrae and surrounding discs, resulting from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation. The typical presentation of the disease is back pain and progressive spinal instability and deformity. The authors report an unusual case of massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. PMID:20192662

Bishop, Frank S; Dailey, Andrew T; Schmidt, Meic H

2010-03-01

22

Spinal involvement in mucopolysaccharidosis IVA (Morquio-Brailsford or Morquio A syndrome): presentation, diagnosis and management.  

PubMed

Mucopolysaccharidosis IVA (MPS IVA), also known as Morquio-Brailsford or Morquio A syndrome, is a lysosomal storage disorder caused by a deficiency of the enzyme N-acetyl-galactosamine-6-sulphate sulphatase (GALNS). MPS IVA is multisystemic but manifests primarily as a progressive skeletal dysplasia. Spinal involvement is a major cause of morbidity and mortality in MPS IVA. Early diagnosis and timely treatment of problems involving the spine are critical in preventing or arresting neurological deterioration and loss of function. This review details the spinal manifestations of MPS IVA and describes the tools used to diagnose and monitor spinal involvement. The relative utility of radiography, computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of cervical spine instability, stenosis, and cord compression is discussed. Surgical interventions, anaesthetic considerations, and the use of neurophysiological monitoring during procedures performed under general anaesthesia are reviewed. Recommendations for regular radiological imaging and neurologic assessments are presented, and the need for a more standardized approach for evaluating and managing spinal involvement in MPS IVA is addressed. PMID:23385297

Solanki, Guirish A; Martin, Kenneth W; Theroux, Mary C; Lampe, Christina; White, Klane K; Shediac, Renée; Lampe, Christian G; Beck, Michael; Mackenzie, William G; Hendriksz, Christian J; Harmatz, Paul R

2013-03-01

23

Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders  

PubMed Central

Study Design Prospective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India. Purpose To show the efficacy of decompression in the late presentation of cervical spinal cord disorders. Overview of Literature Studies by various authors have shown that early spinal decompression results in better neurological outcomes. Methods From January 2003 to January 2005, 11 of the 41 patients with cervical spinal cord compression, meeting the inclusion criteria, underwent anterior decompression; interbody graft placement and stabilization by anterior cervical locking plate. The neurologic and functional outcomes were recorded. Results Five patients had spinal cord injury and 6 patients had compressive cervical myelopathy. Complications included 1 death and 1 plate loosening. No patient lost their preoperative neurological status. One patient had no improvement, 2 patients showed full recovery. The mean follow-up is 28.3 month. At the of rehabilitation, 6 were able to walk without support), 2 could walk with support, and 1 needed a wheelchair. The average American Spinal Injury Association motor score on admission to the hospital, 32.8 (standard deviation [SD], 30.5); admission to rehabilitation, 38.6 (SD, 32.4); discharge from rehabilitation, 46.2 (SD, 33.7). The most recent follow-up was 64.0 (SD, 35.3). Conclusions The anterior approach for cervical decompression allows for adequate decompression. This decompression is the best chance offered in even late reported cases, including posttraumatic cases where there is no evidence of cord transactions. The use of anterior cervical plates reduces the chances of graft loosening, extruding, or collapsing. PMID:24761201

Sakale, Harshal; Dulani, Rajesh; Singh, Pradeep K; Sanrakhia, Manoj

2014-01-01

24

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

25

Metastatic renal cell carcinoma initially presented with an intramedullary spinal cord lesion: a case report  

PubMed Central

Introduction One of the rare manifestations of systemic neoplasia is intramedullary spinal cord metastasis that causes serious diagnostic and therapeutic dilemma. It has been very rarely reported as the initial manifestation of carcinoma. This is report of a metastatic renal cell carcinoma initially presented with intramedullary spinal cord lesion, to our knowledge there are few similar reports in literature. Case presentation We report a 51-year-old Iranian woman who presented with back pain and paraparesis. MR imaging study of her spine showed an enhancing cystic lesion at the level of conus medullaris. Despite detailed investigation, no specific aetiology was found till a bone scan obtained to evaluate an agonizing pain on the dorsum of the left hand revealed photon deficient area within the left kidney in addition to oseoblastic bony lesions. After thorough imaging investigation she underwent radical nephrectomy which confirmed renal cell carcinoma. Conclusion Considering the prevalence of cancer, it is imperative that clinicians be mindful of occult carcinoma as the cause of suspicious intramedullary spinal cord lesion. PMID:19918485

Rokni-Yazdi, Hadi; Salehinia, Farahnaz; Allameh, Farshad S

2009-01-01

26

Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective  

PubMed Central

Multiple myeloma, a multicentric hematological malignancy, is the most common primary tumor of the spine. As epidural myeloma causing spinal cord compression is a rare condition, its therapeutic approach and clinical results have been reported to be diverse, and no clear guidelines for therapeutic decision have been established. Three patients presented with progressive paraplegia and sensory disturbance. Image and serological studies revealed multiple myeloma and spinal cord compression caused by epidural myeloma. Emergency radiotherapy and steroid therapy were performed in all three cases. However, their clinical courses and results were distinctly different. Following review of our cases and the related literature, we suggest a systematic therapeutic approach for these patients to achieve better clinical results. PMID:24175035

Ha, Kee-Yong; Kim, Hyun-Woo

2013-01-01

27

MRI features of spinal cord decompression sickness presenting as a Brown-Sequard syndrome.  

PubMed

Decompression sickness often manifests as central nervous system impairment. We report a 49-year-old woman who developed an unusual case of spinal cord decompression sickness presenting as complete Brown-Sequard syndrome. Initial MRI revealed increased signal intensity in the left side of the cervical cord at the level of C2-C3. A second MRI at 10 days post-injury showed signal abnormalities corresponding to an infarction in the posterior spinal artery territory. After two weeks of intensive treatment with various HBOT regimens, the clinical outcome was still poor, but at six months after the injury her neurological condition was greatly improved, with only slight impairment of proprioception on the left when walking remaining. PMID:22828817

Louge, Pierre; Gempp, Emmanuel; Hugon, Michel

2012-06-01

28

Intramedullary Sarcoidosis Presenting with Delayed Spinal Cord Swelling after Cervical Laminoplasty for Compressive Cervical Myelopathy  

PubMed Central

Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis. PMID:25535524

Kwon, Du Ho; Kim, Eun-Sang; Eoh, Whan

2014-01-01

29

Spinal cord compression due to primary intramedullary tuberculoma of the spinal cord presenting as paraplegia: A case report and literature review  

PubMed Central

Background: Spinal cord compression can be due to various causes but spinal intramedullary tuberculoma is a rare cause. We report a case that had an intramedullary spinal cord tuberculomas in which the diagnosis was made histologically, without evidence of symptoms of systemic tuberculosis. This lesion, located in the thoracic region, mimicked as an intramedullary tumor radiologically. Case Description: The patient was a 25-year-old male who presented with a history of progressive paraparesis. Initial diagnosis was made as an intramedullary tumor by magnetic resonance imaging (MRI). The treatment of the patient involved is complete surgical excision of intramedullary lesion followed by appropriate antituberculous therapy. Postoperatively, his neurological symptoms were dramatically improved. With combination of both surgical and medical treatments, excellent clinical outcome was obtained. Conclusion: This case illustrates the risk of misdiagnosis and the importance of histological confirmation of a pathological lesion as spinal cord tuberculoma prior to surgical therapy, which should be kept in mind as a differential diagnosis of the intramedullary spinal cord tumors.

Mishra, Sudhansu Sekhar; Das, Deepak; Das, Srikanta; Mohanta, Itibrata; Tripathy, Soubhagya Ranjan

2015-01-01

30

Bilateral carotid and vertebral rete mirabile presenting with subarachnoid hemorrhage caused by the rupture of spinal artery aneurysm.  

PubMed

Rete mirabile (or carotid rete) is a normal structure that plays physiological roles in the lower mammals. However, the rete does not exist in the normal carotid circulation of humans. Carotid rete mirabile (CRM) is a rare condition compensating for congenital dysplastic internal carotid artery. Arterial plexus at the cavernous region, which supplies intradural internal carotid artery instead of the aplastic cavernous portion of internal carotid artery, looks like the "rete mirabile" seen in the lower mammals, and is a characteristic angiographical finding of CRM. In addition to the CRM, existence of segmental occlusion and tortuous collaterals of vertebral artery, so-called carotid and vertebral rete mirabile (CVRM), is a very rare condition. We report a 70-year-old female patient with bilateral CVRM presenting with subarachnoid hemorrhage (SAH) caused by the rupture of a cervical spinal artery aneurysm. Our patient is the oldest, compared with the previously reported four patients with CVRM. Moreover, this is the first report of ruptured spinal artery aneurysm as a cause of SAH associated with CRM/CVRM. To avoid rebleeding in the patient, we successfully treated the patients by performing coil embolization of the remaining spinal aneurysms. In patients with CVRM, aneurysm formation of the cervical spinal artery may be a reasonable consequence because of the hemodynamic stress on the spinal artery as a collateral pathway. Detailed evaluation of the cervical spinal arteries should be performed to detect or to rule out ruptured aneurysm in patients with SAH associated with CVRM. PMID:23903351

Nagahata, Morio; Kondo, Rei; Mouri, Wataru; Sato, Atsushi; Ito, Miiko; Sato, Shinji; Itagaki, Hiroshi; Yamaki, Tetsu; Nagahata, Satoko; Saito, Shinjiro; Kayama, Takamasa

2013-01-01

31

Spinal Cord  

Microsoft Academic Search

The spinal cord is a relatively understudied target of diabetes. In this chapter an overview of the anatomy of the spinal\\u000a cord and its associated structures is presented before reviewing the published literature describing evidence for structural\\u000a damage to the spinal cord reported in both diabetic patients and animal models of diabetes. Spinal cord pathology is accompanied\\u000a by functional disorders

Andrew P. Mizisin; Corinne G. Jolivalt; Nigel A. Calcutt

32

Angiographically Occult Vascular Malformation of the Cauda Equina Presenting Massive Spinal Subdural and Subarachnoid Hematoma  

PubMed Central

We report a case of a non traumatic spinal subdural hematoma or subarachnoid hematoma manifesting as lumbago, leg pain and bladder dysfunction that showed angiographically occult vascular malformation (AOVM). Although the spinal angiogram did not reveal any vascular abnormality, the follow-up magnetic resonance image showed AOVM. Complete surgical removal was performed due to the aggravated bladder dysfunction. This case highlights the need to consider bleeding due to spinal AOVM, even when angiography is negative. PMID:21887399

Kim, Ji-Hyun; Kim, Eun-Sang; Eoh, Whan

2011-01-01

33

An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury  

PubMed Central

Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time. PMID:17587067

Omar, N.; Srinivasan, M. S.

2007-01-01

34

Patient with spinal muscular atrophy with respiratory distress type 1 presenting initially with hypertonia.  

PubMed

Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a rare autosomal recessive neuromuscular disorder caused by mutations in the IGHMBP2 gene and characterized by life-threatening respiratory distress due to irreversible diaphragmatic paralysis between 6weeks and 6months of age. In this study, we describe a two-month-old boy who presented with hypertonia at first and developed to hypotonia progressively, which was in contrast to the manifestations reported previously. Bone tissue compromise was also observed as one of the unique symptoms. Muscle biopsy indicated mild myogenic changes. He was misdiagnosed until genetic screening to be confirmed as SMARD1. SMARD1 is a clinical heterogeneous disease and this case broadens our perception of its phenotypes. PMID:25280635

Han, Chunxi; Mai, Jiahui; Tian, Tian; He, Yanxia; Liao, Jianxiang; Wen, Feiqiu; Yi, Xin; Yang, Yun

2015-05-01

35

Central and Extrapontine Myelinolysis Affecting the Brain and Spinal Cord. An Unusual Presentation of Pancreatic Encephalopathy  

PubMed Central

Pancreatic encephalopathy refers to a gamut of neuropsychiatric symptoms complicating acute pancreatitis. Osmotic myelinolysis is a known complication of pancreatic encephalopathy. We evaluated a 58-year-old woman with pancreatic encephalopathy associated to pontine and extrapontine myelinolysis involving the brain and spinal cord. To our knowledge, this is the first clinic pathological case report of pancreatic encephalopathy involving the spinal cord. PMID:23060853

Hornik, Alejandro; Rodriguez Porcel, Federico J.; Agha, Caroline; Flaster, Murray; Morales Vidal, Sarkis; Schneck, Michael J.; Lee, John; Biller, José

2012-01-01

36

Spinal meningiomas in dogs: Description of 8 cases including a novel radiological and histopathological presentation  

PubMed Central

Clinical, imaging, and histological features of 8 canine spinal meningiomas, including a cervical cystic meningioma with imaging and intraoperative features of an arachnoid cyst, are described. All meningiomas were histologically classified and graded following the international World Health Organization human classification for tumors. Six meningiomas were located in the cervical spinal cord. Myelography showed intradural/ extramedullary lesions in 3/4 cases. Magnetic resonance imaging revealed hyperintense intradural/extramedullary masses on pre-contrast T1-weighted and T2-weighted images with homogeneous contrast enhancement in 7/8 cases. One dog had a cerebrospinal fluid-filled subarachnoid cavity dorsal to the cervical spinal cord. A spinal arachnoid cyst was diagnosed on imaging, but the histopathological study of the resected tissue revealed a grade I meningothelial cystic meningioma. There were no differences in outcome associated with tumor grade and surgical treatment (6/8). Cystic meningioma should be considered in the differential diagnosis of intraspinal cystic lesions, and biopsy is necessary for definitive diagnosis. PMID:24155414

José-López, Roberto; de la Fuente, Cristian; Pumarola, Martí; Añor, Sonia

2013-01-01

37

Multipotent CNS Stem Cells Are Present in the Adult Mammalian Spinal Cord and Ventricular Neuroaxis  

Microsoft Academic Search

Neural stem cells in the lateral ventricles of the adult mouse CNS participate in repopulation of forebrain structures in vivo and are amenable to in vitro expansion by epidermal growth factor (EGF). There have been no reports of stem cells in more caudal brain regions or in the spinal cord of adult mammals. In this study we found that although

Samuel Weiss; Christine Dunne; Jennifer Hewson; Cheryl Wohl; Matt Wheatley; Alan C. Peterson; Brent A. Reynolds

38

Immune modulatory therapies for spinal cord injury--past, present and future.  

PubMed

Historically, the immune response after spinal cord injury was considered largely detrimental owing to the release of neurotoxic factors. While there is validity to this view, there is much greater heterogeneity of immune cells than was previously realized. Associated with this heterogeneity of immune cell subtypes, there is diversity of functions of immune cells that is still poorly understood after spinal cord injury. Modulating the immune system requires improved understanding of the major players: those immune cell subtypes that are more detrimental than beneficial and those that are important in repair. In this review we will discuss the early findings that supported the use of various anti-inflammatory medications as well as the evolving concept that not all immune subtypes are detrimental and some might even be beneficial. In the last section we will highlight the need to characterize better the role of immune cell subsets in the hopes of developing potential therapeutic targets for the future. PMID:25017890

Plemel, Jason R; Wee Yong, V; Stirling, David P

2014-08-01

39

Intradural spinal cord tumor presenting as a subarachnoid hemorrhage: magnetic resonance imaging diagnosis.  

PubMed

Negative findings on four-vessel angiography after a subarachnoid hemorrhage are seen in 5 to 30% of patients. A previously silent lesion in the spinal canal may be responsible for the ictus in a small percentage of this group. The etiological factors include tumors and arteriovenous malformations; however, investigations of such lesions have been limited to patients with signs and symptoms of spinal cord or nerve root pathological processes. This report describes the management of a 56-year-old woman with clinical findings typical of an aneurysmal subarachnoid hemorrhage and negative findings on cerebral angiography, in whom magnetic resonance imaging with gadolinium enhancement revealed an intradural extramedullary cervical schwannoma. For this reason, cervicothoracic magnetic resonance imaging with gadolinium enhancement should be considered as an adjunctive scanning examination in all patients with a subarachnoid hemorrhage and negative findings on angiography. PMID:2234370

Chalif, D J; Black, K; Rosenstein, D

1990-10-01

40

Spinal tumor  

MedlinePLUS

Tumor - spinal cord ... spinal tumors occur in the nerves of the spinal cord itself. Most often these are ependymomas and other ... genetic defects. Spinal tumors can occur: Inside the spinal cord (intramedullary) In the membranes (meninges) covering the spinal ...

41

Spinal extradural arachnoid cyst  

Microsoft Academic Search

Summary  Spinal extradural arachnoid cysts are rare expanding lesions in the spinal canal. They usually present with progressive signs\\u000a and symptoms caused by spinal cord compression if they enlarge. A comprehensive review about spinal extradural arachnoid cyst\\u000a is made including the author’s own case of a 59-year-old woman with a 6-month history of progressive back pain radiating to\\u000a both legs. Key

J. Y. Choi; S. H. Kim; W. S. Lee; K. H. Sung

2006-01-01

42

Spinal Stenosis  

MedlinePLUS

... common condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, ... image above shows the narrowing of the spinal canal. Some people are born with a small spinal ...

43

Upper thoracic intradural-extramedullary cavernous malformation presenting as subarachnoid hemorrhage without spinal dysfunction: a case report and review of the literature.  

PubMed

A 45-year-old man had subarachnoid hemorrhage (SAH) which was confirmed by lumbar puncture, since it was negative on head computed tomography. The result of neurological examination was normal. Following pan-cerebral angiography and cranial magnetic resonance imaging (MRI) failed to find out the cause of bleeding. The whole spinal MRI revealed an intradural-extramedullary mass lesion at the upper thoracic level which was consistent with cavernous malformation after surgery. When patients presented with SAH of no spinal symptoms, the diagnosis of an intradural-extramedullary cavernous malformation is challenging. A whole spinal workup should be considered in a patient with spontaneous SAH when bleeding from intracranial origin is carefully excluded. PMID:24878074

Tao, Chuan-Yuan; He, Min; Zhang, Yue-Kang; You, Chao

2014-12-01

44

Spinal Crawlers: Deformable Organisms for Spinal Cord Segmentation and Analysis  

E-print Network

Spinal Crawlers: Deformable Organisms for Spinal Cord Segmentation and Analysis Chris Mc, Canada {cmcintos, hamarneh}@cs.sfu.ca Abstract. Spinal cord analysis is an important problem relating to the study of various neurological diseases. We present a novel approach to spinal cord segmentation

Hamarneh, Ghassan

45

Extraskeletal Myxoid Chondrosarcoma Presenting as an Intradural Spinal Mass: Report of a Rare Clinical Presentation With an Emphasis on Differential Diagnostic Considerations  

PubMed Central

Extraskeletal myxoid chondrosarcoma is a rare soft tissue neoplasm that occurs predominantly in the soft tissues of the lower extremities. Herein we present a case of a 29 year old male who presented with bilateral femoral numbness believed to be the result of prior injury to his back. A magnetic resonance imaging revealed a mass in the T4-T5 epidural space compressing the spinal cord. Laminectomy was performed and the lesion removed piecemeal. The pathology specimen consisted of multiple fragments of dura involved by a myxoid neoplasm with a nodular growth pattern. The tumor cells were arranged in anastomosing cords and strands. Individual tumor cells were small, of uniform size and shape, with small hyperchromatic nuclei and scant eosinophilic cytoplasm. Immunohistochemical stains were performed which showed the tumor cells were diffusely positive for vimentin and focally positive for EMA, S-100 protein and cytokeratin, whereas they were negative for CD34 and CD99. Fluorescence in situ hybridization (FISH) studies showed a clonal population of cells with re-arrangement of the EWSR1 locus, confirming the histologic impression of extraskeletal myxoid chondrosarcoma. This is the first report of a case of an extraskeletal myxoid chondrosarcoma arising from the dura, confirmed to have rearrangement of the EWSR1 gene by FISH. There have only been two other cases of dural based extraskeletal myxoid chondrosarcoma reported prior to our case. We also briefly review the published literature and discuss differential diagnostic considerations for this rare tumor. PMID:25568751

Rao, Priya; Colen, Rivka R.; Bruner, Janet M.; Meis, Jeanne M.

2014-01-01

46

An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury  

Microsoft Academic Search

Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally\\u000a results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of\\u000a the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision,

N. Omar; F. Alvi; M. S. Srinivasan

2007-01-01

47

Rosai-Dorfman disease presenting with widespread intracranial and spinal cord involvement.  

PubMed

Rosai-Dorfman disease is associated with a histiocytic infiltration of lymphoid tissue, but may also involve the orbit, nasopharynx, respiratory pathways, gastrointestinal tract, endocrine glands (particularly the thyroid), bone, and skin. Neurologic manifestations are rare, occurring in 4% of one series, and the diagnosis is often not made until pathology is available. Using data from two cases, we present the clinical manifestations, pathology, and treatment, and review the literature regarding the ocular and neurologic manifestations. Finally, we discuss the optimum management of this disorder. PMID:17101885

Kidd, Desmond P; Revesz, Tamas; Miller, Neil R

2006-11-14

48

Mixed collecting duct and renal cell carcinoma presenting with spinal cord compression  

PubMed Central

Collecting duct carcinoma (CDC) is a rare renal malignancy thought to develop from the collecting duct epithelium of the kidney. CDC tends to have a more aggressive clinical course than conventional renal cell carcinoma (RCC), with early metastases. The occurrence of a mixed CDC and conventional RCC is infrequently reported in the literature. We report the first case of a metastatic mixed CDC and RCC presenting as back pain in a young adult. In addition we discuss the epidemiology of and current adjuvant therapies for CDC. PMID:23606388

Hennessey, Derek B; Thomas, Arun Z; Lynch, Thomas H

2013-01-01

49

Anterior spinal cord syndrome of unknown etiology  

PubMed Central

A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome. PMID:25552812

Klakeel, Merrine; Thompson, Justin; McDonald, Frank

2015-01-01

50

Superior mesenteric artery syndrome - A rare presentation and challenge in spinal cord injury rehabilitation: A case report and literature review.  

PubMed

Background Obstruction of the third part of the duodenum (D3) is a very rare cause of gastric outflow obstruction. Rapid weight loss is the biggest risk factor. Patients seen in acute rehabilitation settings, not uncommonly, have a period of rapid weight loss. We report two cases of superior mesenteric artery (SMA) syndrome and review the literature. Clinical details The patients presented differently, one with repeated, refractory autonomic dysreflexia and severe spasticity and one with nausea, abdominal discomfort, and vomiting. CT abdomen with contrast identified dynamic duodenal (D3) obstruction against the posterior structures by narrow angled SMA, gastric distension and, in one case, dilation of the left renal vein. Both patients responded well to optimizing nutrition in different ways. Surgery was successfully avoided. Discussion SMA syndrome is an atypical cause of high intestinal obstruction, frequently occurring in patients who have had rapid weight loss during spinal cord injury (SCI) rehabilitation. It may co-exist with left renal vein dilation "nutcracker phenomena". The associated neurogenic bowel dysfunction due to the nature of SCI could possibly contribute to delay in diagnosis. Conclusion Clinicians should consider the risk of SMA syndrome in patients with SCI with rapid weight loss. Early diagnosis is possible by doing a CT abdomen with contrast and angiography if there is a high index of suspicion. SMA syndrome can be successfully treated by aggressive nutritional management. This may include total parenteral nutrition or feeding by a nasojejunal tube. Duodenojejunostomy could be required in refractory cases. PMID:24976254

Desai, Manish H; Gall, Angela; Khoo, Michael

2014-06-29

51

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

52

Spinal stenosis  

MedlinePLUS

... claudication; Central spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis ... to bulge. The bones and ligaments of the spine thicken or grow larger. This is caused by ...

53

Spinal Tap  

MedlinePLUS

... Anger Spinal Tap KidsHealth > Teens > Cancer Center > Diagnostic Tests > Spinal Tap Print A A A Text Size What's in this article? What Is a Spinal Tap and Why Do You Need It? Preparation The Procedure Safety Results ... Need It? A spinal tap (also called a lumbar puncture) is a medical test that involves taking a small sample of cerebrospinal ...

54

Spinal Stenosis  

MedlinePLUS

... disk. Various devices may be used to enhance fusion and strengthen unstable segments of the spine following decompression surgery. Patients with spinal stenosis caused by spinal trauma or achondroplasia may ...

55

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

56

Brain and Spinal Tumors  

MedlinePLUS

NINDS Brain and Spinal Tumors Information Page Synonym(s): Spinal Cord Tumors Condensed from Brain and Spinal Tumors: Hope Through ... Trials Organizations Additional resources from MedlinePlus What are Brain and Spinal Tumors? Brain and spinal cord tumors ...

57

[Spinal claudication].  

PubMed

Spinal claudication refers to symptoms caused by nerve compression in the spinal canal brought on during strain. The symptoms are felt as lower limb pain, numbness or fatigue, but back pain that becomes worse under stress is also common. The symptoms are usually associated with the erect position and relieved when sitting or laying down. The underlying condition is most commonly narrowing of the spinal canal. While the diagnosis is often clear, MRI imaging is worth conducting if the symptoms are atypical or cause a clear-cut disability or functional limitation. Most patients are treated conservatively. PMID:24159715

Osterman, Heikki

2013-01-01

58

Spinal Stenosis  

MedlinePLUS

... with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis ... a physical exam and imaging tests. Treatments include medications, physical therapy, braces, and surgery. NIH: National Institute of Arthritis ...

59

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

60

Tethered Spinal Cord Syndrome  

MedlinePLUS

NINDS Tethered Spinal Cord Syndrome Information Page Table of Contents (click to jump to sections) What is Tethered Spinal Cord Syndrome? Is ... being done? Clinical Trials Organizations What is Tethered Spinal Cord Syndrome? Tethered spinal cord syndrome is a neurological ...

61

Spinal Cord Injury Map  

MedlinePLUS

Spinal Cord Injury Map Loss of function depends on what part of the spinal cord is damaged, as well ... control. Learn more about spinal cord injuries. A spinal cord injury affects the entire family FacingDisability is designed to ...

62

Spinal cord trauma  

MedlinePLUS

Spinal cord injury; Compression of spinal cord; SCI; Cord compression ... them more likely to fall may also have spinal cord injury. ... vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and ...

63

[Central necrosis of the lumbo-sacral segment of the spinal cord associated with multiple cholesterin emboli, clinically presenting as acute paraplegia].  

PubMed

A seventy-six-year-old man suddenly suffered from paraplegia and pain in both legs. He had been maintained on hemodialysis and committed a suicide attempt by cutting the shunt at the paraplegic attack. He was brought to the emergency ward for the treatment of hemorrhagic preshock. Neurological examination demonstrated flaccid paraplegia, loss of tendon reflex in the lower extremities, dissociated sensory loss below the fourth lumbar level; and incontinence in defecation. MRI showed T2 shortening in the ventral spinal cord caudal below the level of the eleventh thoracic cord. Postmortem examination confirmed ischemic infarct in the central area of the spinal cord, associated with disseminated cholesterin emboli in the small arteries. This case was the first MRI demonstration of central necrosis caused by cholesterin emboli, and may emphasize the significance of cholesterin emboli in the spinal arterial disorders in the aged. PMID:11296370

Yoshimura, M; Uchigata, M; Shimizu, S; Sakamoto, T; Murayama, S

2000-10-01

64

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

65

Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.  

PubMed

Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases. PMID:23276337

French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U

2013-01-01

66

Retraining the injured spinal cord  

NASA Technical Reports Server (NTRS)

The present review presents a series of concepts that may be useful in developing rehabilitative strategies to enhance recovery of posture and locomotion following spinal cord injury. First, the loss of supraspinal input results in a marked change in the functional efficacy of the remaining synapses and neurons of intraspinal and peripheral afferent (dorsal root ganglion) origin. Second, following a complete transection the lumbrosacral spinal cord can recover greater levels of motor performance if it has been exposed to the afferent and intraspinal activation patterns that are associated with standing and stepping. Third, the spinal cord can more readily reacquire the ability to stand and step following spinal cord transection with repetitive exposure to standing and stepping. Fourth, robotic assistive devices can be used to guide the kinematics of the limbs and thus expose the spinal cord to the new normal activity patterns associated with a particular motor task following spinal cord injury. In addition, such robotic assistive devices can provide immediate quantification of the limb kinematics. Fifth, the behavioural and physiological effects of spinal cord transection are reflected in adaptations in most, if not all, neurotransmitter systems in the lumbosacral spinal cord. Evidence is presented that both the GABAergic and glycinergic inhibitory systems are up-regulated following complete spinal cord transection and that step training results in some aspects of these transmitter systems being down-regulated towards control levels. These concepts and observations demonstrate that (a) the spinal cord can interpret complex afferent information and generate the appropriate motor task; and (b) motor ability can be defined to a large degree by training.

Edgerton, V. R.; Leon, R. D.; Harkema, S. J.; Hodgson, J. A.; London, N.; Reinkensmeyer, D. J.; Roy, R. R.; Talmadge, R. J.; Tillakaratne, N. J.; Timoszyk, W.; Tobin, A.

2001-01-01

67

Motorcycle-related spinal injury: crash characteristics.  

PubMed

This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury. PMID:23036400

Zulkipli, Zarir Hafiz; Abdul Rahmat, Abdul Manap; Mohd Faudzi, Siti Atiqah; Paiman, Noor Faradila; Wong, Shaw Voon; Hassan, Ahamedali

2012-11-01

68

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

69

Syringomyelia Associated with a Spinal Arachnoid Cyst  

PubMed Central

While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed the spinal cord anteriorly. Syringomyelia usually results from lesions that partially obstruct cerebrospinal fluid flow. Therefore, we concluded that the spinal arachnoid cyst was causing the syringomyelia. After simple excision of the arachnoid cyst, the symptoms were relieved. A follow-up MRI demonstrated that the syringomyelia had significantly decreased in size after removal of the arachnoid cyst. This report presents an unusual case of gait disturbance caused by syringomyelia associated with a spinal arachnoid cyst. PMID:19516954

Kim, Min-Su

2009-01-01

70

Spinal injury - resources  

MedlinePLUS

Resources - spinal injury ... The following organizations are a good resource for information on spinal injury : National Institute of Neurological Disorders and Stroke - www.ninds.nih.gov The National Spinal Cord Injury Association - ...

71

Spinal Cord Diseases  

MedlinePLUS

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back ... of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such ...

72

Spinal Muscular Atrophy (SMA)  

MedlinePLUS

... to spinal curvature is almost always spine-straightening surgery ( spinal fusion ), which can be done if the child’s respiratory status is good enough to withstand the surgery. Doctors generally like to wait until maximum spinal ...

73

Spinal Cord Injury  

MedlinePLUS

... Types of illnesses and disabilities Spinal cord injury Spinal cord injury Read advice from Dr. Jeffrey Rabin , a pediatric ... your health on a daily basis. Living with spinal cord injury — your questions answered top What are pediatric rehabilitation ...

74

Spinal Osteosarcoma  

PubMed Central

Although osteosarcoma represents the second most common primary bone tumor, spinal involvement is rare, accounting for 3%–5% of all osteosarcomas. The most frequent symptom of osteosarcoma is pain, which appears in almost all patients, whereas more than 70% exhibit neurologic deficit. At a molecular level, it is a tumor of great genetic complexity and several genetic disorders have been associated with its appearance. Early diagnosis and careful surgical staging are the most important factors in accomplishing sufficient management. Even though overall prognosis remains poor, en-block tumor removal combined with adjuvant radiotherapy and chemotherapy is currently the treatment of choice. This paper outlines histopathological classification, epidemiology, diagnostic procedures, and current concepts of management of spinal osteosarcoma. PMID:24179411

Katonis, P.; Datsis, G.; Karantanas, A.; Kampouroglou, A.; Lianoudakis, S.; Licoudis, S.; Papoutsopoulou, E.; Alpantaki, K.

2013-01-01

75

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

76

Spinal pain.  

PubMed

The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic pain, much more difficult to treat. The clinical assessment of pain source can be a challenge because of the complex anatomy and function of the spine; the advanced imaging methods are often not sufficient for a definitive diagnosis because similar findings could be present in either asymptomatic and symptomatic subjects: a clinical correlation is always mandatory and the therapy cannot rely uniquely upon any imaging abnormalities. Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. Special attention will be done to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. PMID:25824642

Izzo, R; Popolizio, T; D'Aprile, P; Muto, M

2015-05-01

77

Occult spinal dysraphism.  

PubMed

When spina bifida is associated with skin abnormalities such as dimples, sinus tracts hypertrichosis, or capillary hemangiomas, there is a high incidence of an occult intraspinal lesion such as epidermoid and dermoid tumours, lipomas, diastematomyelia, dural bands and tethered spinal cord. The present study consists of 50 patients with occult spinal dysraphism treated with the diagnosis of lipomeningomyelocoele (20), lumbosacral lipoma (15) and diastematomyelia (15). The clinical presentation varied from lipoma in the lumbosacral region, dermal sinus, cutaneous hemangioma and hypertrichosis. The age range varied from 2 months to 7 years with an average of 2 years. 40% patients had neurological deficit at the time of presentation which varied from lower limb weakness to bladder & bowel involvement. All patients underwent laminectomy of the lumbar and lumbo-sacral spine with excision of intraspinal lipoma, excision of bony or cartilaginous spur in diastematomyelia and detethering of the conus medullaris & cauda equina. No patient developed late neurological deficit. PMID:11129883

Bajpai, M; Kataria, R; Gupta, D K; Agarwala, S

1997-01-01

78

Metastatic spinal neurofibrosarcoma.  

PubMed

Neurofibrosarcomas are rare tumors usually arising in somatic soft tissues or peripheral nerves. Four cases of metastatic neurofibrosarcoma to the spine have been reported before. The current case is unusual because of the presence of two distinct, metachronous spinal metastasis and lung metastasis. A 30-year-old woman with neurofibromatosis and a history of previous neurofibrosarcoma resection presented with back pain. Radiologic evaluation revealed a lytic lesion of the eleventh thoracic vertebra. A transthoracal corpectomy, reconstruction by Harms' cage and posterior instrumentation, and fusion were carried out. After the completion of adjuvant chemotherapy, a solitary pulmonary nodule was detected. Shortly after resection of the metastatic pulmonary nodule, the patient complained of acute onset low-back pain. Radiologic assessment revealed another lytic lesion in the L5 vertebra after 6 months. Again, a corpectomy, anterior and posterior instrumentation, and fusion were carried out. Eight months after the second spinal resection, another solitary pulmonary metastasis was diagnosed and resected. The patient's health status suddenly deteriorated 26 months after the initial spinal metastatectomy, and she died. Though local control can be achieved in more than 80% of the patients with neurofibrosarcoma by wide surgical resection followed by adjuvant chemo- and radiotherapy, most patients die of systemic metastasis. The current patient survived 50 months after the initial resection of a forearm neurofibrosarcoma. Despite achieving local control, she died due to systemic recurrence. Prolonged survival with the help of chemo- and radiotherapy justifies our aggressive surgical strategy for the treatment of spinal metastasis in order to achieve neurologic cure and spinal stability. PMID:11880913

Sar, Cüneyt; Eralp, Levent

2002-03-01

79

Spinal epidural hemangioma related to pregnancy  

Microsoft Academic Search

We report the case of a 39-year-old woman with adolescent idiopathic scoliosis presenting with myelopathy secondary to a spinal\\u000a epidural hemangioma. MRI showed an epidural soft tissue mass within the spinal canal between T5 and T9 with severe spinal\\u000a cord compression. Symptoms had a temporal relationship to her pregnancy. Surgical removal of the epidural hemangioma rapidly\\u000a relieved her symptoms and

Gary S. Shapiro; Peter J. Millett; Edward F. DiCarlo; Douglas N. Mintz; Francis W Gamache; Bernard A. Rawlins

2001-01-01

80

Spinal crawlers: Deformable organisms for spinal cord segmentation and analysis  

E-print Network

Abstract. Spinal cord analysis is an important problem relating to the study of various neurological diseases. We present a novel approach to spinal cord segmentation in magnetic resonance images. Our method uses 3D “deformable organisms ” (DefOrg) an artificial life framework for medical image analysis that complements classical deformable models (snakes and deformable meshes) with high-level, anatomically-driven control mechanisms. The DefOrg framework allows us to model the organism’s body as a growing generalized tubular spring-mass system with an adaptive and predominantly elliptical cross section, and to equip them with spinal cord specific sensory modules, behavioral routines and decision making strategies. The result is a new breed of robust DefOrgs, “spinal crawlers”, that crawl along spinal cords in 3D images, accurately segmenting boundaries, and providing sophisticated, clinically-relevant structural analysis. We validate our method through the segmentation of spinal cords in clinical data and provide comparisons to other segmentation techniques. 1

2006-01-01

81

Spinal Cord Injury  

MedlinePLUS

NINDS Spinal Cord Injury Information Page Condensed from Spinal Cord Injury: Hope Through Research Table of Contents (click to jump to ... Trials Organizations Additional resources from MedlinePlus What is Spinal Cord Injury? A spinal cord injury usually begins with a ...

82

Neurotrophins and spinal circuit function  

PubMed Central

Work early in the last century emphasized the stereotyped activity of spinal circuits based on studies of reflexes. However, the last several decades have focused on the plasticity of these spinal circuits. These considerations began with studies of the effects of monoamines on descending and reflex circuits. In recent years new classes of compounds called growth factors that are found in peripheral nerves and the spinal cord have been shown to affect circuit behavior in the spinal cord. In this review we will focus on the effects of neurotrophins, particularly nerve growth factor (NGF), brain derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), on spinal circuits. We also discuss evidence that these molecules can modify functions including nociceptive behavior, motor reflexes and stepping behavior. Since these substances and their receptors are normally present in the spinal cord, they could potentially be useful in improving function in disease states and after injury. Here we review recent findings relevant to these translational issues. PMID:24926235

Boyce, Vanessa S.; Mendell, Lorne M.

2014-01-01

83

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

84

Magnetic resonance imaging of spinal dysraphism.  

PubMed

Spinal cord development occurs through three consecutive periods. Gastrulation (weeks 2-3) is characterized by conversion of the embryonic disk from a bilaminar to a trilaminar arrangement and establishment of a notochord. Primary neurulation (weeks 3-4) produces the uppermost nine tenths of the spinal cord. Secondary neurulation and retrogressive differentiation (weeks 5-6) result in formation of the conus tip and filum terminale. Defects in these early embryonic stages produce spinal dysraphisms, which are characterized by anomalous differentiation and fusion of dorsal midline structures. Spinal dysraphisms may be categorized clinically into two subsets. In open spinal dysraphisms, the placode (non-neurulated neural tissue) is exposed to the environment. These disorders include myelomeningocele, myeloschisis, hemimyelomeningocele, and hemimyelocele, and are always associated with a Chiari II malformation. Closed spinal dysraphisms are covered by intact skin, although cutaneous stigmata usually indicate their presence. Two subsets may be identified based on whether a subcutaneous mass is present in the low back. Closed spinal dysraphisms with mass comprise lipomyeloschisis, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise complex dysraphic states (ranging from complete dorsal enteric fistula to neurenteric cysts, split cord malformations, dermal sinuses, caudal regression, and spinal segmental dysgenesis), bony spina bifida, tight filum terminale, filar and intradural lipomas, and persistent terminal ventricle. Magnetic resonance imaging is the imaging method of choice for investigation of this complex group of disorders. PMID:11744877

Tortori-Donati, P; Rossi, A; Biancheri, R; Cama, A

2001-12-01

85

Spinal Cord Injury Reveals Multilineage Differentiation of Ependymal Cells  

Microsoft Academic Search

Spinal cord injury often results in permanent functional impairment. Neural stem cells present in the adult spinal cord can be expanded in vitro and improve recovery when transplanted to the injured spinal cord, demonstrating the presence of cells that can promote regeneration but that normally fail to do so efficiently. Using genetic fate mapping, we show that close to all

Konstantinos Meletis; Fanie Barnabé-Heider; Marie Carlén; Emma Evergren; Nikolay Tomilin; Oleg Shupliakov; Jonas Frisén

2008-01-01

86

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

87

LP: Spinal sympathetic interneurons: Their identification and roles after spinal cord injury  

E-print Network

Abstract: Primary afferent neurons rarely, if ever, synapse on the sympathetic preganglionic neurons that regulate the cardiovascular system, nor do sympathetic preganglionic neurons normally exhibit spontaneous activity in the absence of excitatory inputs. Therefore, after serious spinal cord injury ‘‘spinal sympathetic interneurons’ ’ provide the sole excitatory and inhibitory inputs to sympathetic preganglionic neurons. Few studies have addressed the anatomy and physiology of spinal sympathetic interneurons, to a great extent because they are difficult to identify. Therefore, this chapter begins with descriptions of both neurophysiological and neuroanatomical criteria for identifying spinal sympathetic interneurons, and it discusses the advantages and disadvantages of each. Spinal sympathetic interneurons also have been little studied because their importance in intact animals has been unknown, whereas the roles of direct projections from the brain to sympathetic preganglionic neurons are better known. This chapter presents evidence that spinal sympathetic interneurons play only a minor role in sympathetic regulation when the spinal cord is intact. However, they play an important role after spinal cord injury, both in generating ongoing activity in sympathetic nerves and in mediating segmental and intersegmental sympathetic reflexes. The spinal sympathetic interneurons that most directly influence the activity of sympathetic preganglionic neurons after spinal cord injury are located close to their associated sympathetic preganglionic neurons,

88

Spinal subdural abscess following epidural steroid injection.  

PubMed

The authors report the case of a 58-year-old man who presented with a cervicothoracolumbosacral spinal subdural abscess about a month after receiving an epidural steroid injection for management of low-back pain due to L5-S1 disc herniation. Although he presented with symptoms concerning for a spinal etiology, the subdural empyema was not evident on the initial MRI study and was observed on imaging 5 days later. This patient was successfully managed with surgical intervention and antibiotic treatment, and he is doing well more than 21 months after the operation. It is possible that a prior history of disc herniation or other spinal abnormality may increase a patient's risk of developing spinal subdural empyema. This case illustrates the risk of infection following spinal epidural steroid injections and the importance of early recognition and intervention to successfully treat an extensive subdural abscess. PMID:25343407

Kraeutler, Matthew J; Bozzay, Joseph D; Walker, Matthew P; John, Kuruvilla

2015-01-01

89

Spinal cord stimulation  

MedlinePLUS

Spinal cord stimulation is a treatment for pain that uses a mild electric current to block nerve impulses ... stretched into the space on top of your spinal cord. These wires will be connected to a small ...

90

Coherent Anti-Stokes Raman Scattering Imaging of Axonal Myelin in Live Spinal Tissues  

E-print Network

. The current work opens up a new approach to the study of spinal cord injury and demye- linating diseases (CARS) microscopy. We use spinal cord white matter strips that are isolated from guinea pigs and kept spinal cord white matter isolated from guinea pigs. Presently, the major tools used for spinal tissue

Cheng, Ji-Xin

91

Rehabilitation in spinal infection diseases  

PubMed Central

Spinal cord infections were the diseases defined by Hypocrite yet the absence of modern medicine and there was not a real protocol in rehabilitation although there were many aspects in surgical treatment options. The patients whether surgically or conservatively treated had a lot of neurological, motor, and sensory disturbances. Our clinic has quite experience from our previous researchs. Unfortunately, serious spinal cord infections are still present in our region. In these patients the basic rehabilitation approaches during early, pre-operation, post-operation period and in the home environment will provide significant contributions to improve the patients’ sensory and motor skills, develop the balance and proriocaption, increase the independence of patients in daily living activities and minimize the assistance of other people. There is limited information in the literature related with the nature of the rehabilitation programmes to be applied for patients with spinal infections. The aim of this review is to share our clinic experience and summarise the publications about spinal infection rehabilitation. There are very few studies about the rehabilitation of spinal infections. There are still not enough studies about planning and performing rehabilitation programs in these patients. Therefore, a comprehensive rehabilitation programme during the hospitalisation and home periods is emphasised in order to provide optimal management and prevent further disability. PMID:25621205

Nas, Kemal; Karakoç, Mehmet; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-01

92

Spinal Cord Injuries  

MedlinePLUS

... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

93

Spinal Cord Infarction  

MedlinePLUS

... 800-225-0292 Fax: 973-912-9433 National Spinal Cord Injury Association 75-20 Astoria Blvd Suite 120 East ... 785-4452 Related NINDS Publications and Information NINDS Spinal Cord Injury Information Page Spinal cord injury information sheet compiled ...

94

Spinal Muscular Atrophy Diagnostics  

Microsoft Academic Search

Spinal muscular atrophy is a common autosomal recessive neuromuscular disorder caused by mutations in the survival motor neuron gene (SMN), which exists in 2 nearly identical copies (SMN1 and SMN2). Exon 7 of SMN1 is homozygously absent in about 95% of spinal muscular atrophy patients, whereas the loss of SMN2 does not cause spinal muscular atrophy. Small mutations are found

Thomas W. Prior

2007-01-01

95

Spinal morphine anesthesia and urinary retention.  

PubMed

Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented. PMID:8258772

Mahan, K T; Wang, J

1993-11-01

96

Spinal Cord Ischemia Secondary to Hypovolemic Shock  

PubMed Central

A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable. PMID:25558328

Kapoor, Siddhant; Koh, Roy KM; Yang, Eugene WR; Hee, Hwan-Tak

2014-01-01

97

Spinal cord ischemia secondary to hypovolemic shock.  

PubMed

A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable. PMID:25558328

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

2014-12-01

98

[Spinal canal stenosis].  

PubMed

Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. PMID:25398571

Papanagiotou, P; Boutchakova, M

2014-11-01

99

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

100

Pediatric spinal tumors.  

PubMed

Although tumors of the central nervous system in children constitute the second most prevalent tumor type of childhood, spinal cord tumors account for less than 10% of pediatric central nervous system tumors. The most common are intramedullary, although they can be found in the extradural compartment or as intradural extramedullary masses. Extradural tumors can arise from bony elements, the meninges, or soft tissues. Neuroblastomas and sarcomas are frequently encountered along with bone tumors. Intradural extramedullary tumors can be meningeal or from distant sites and include meningiomas and schwannomas; most tend to be benign. Intradural intramedullary tumors, neuronal or glial, can be derived from neuroepithelial tissues. For the intramedullary tumors, astrocytomas represent around 60% of tumors, ependymomas 30%, and developmental tumors 4%. Such tumors require a multidisciplinary approach to ensure optimal patient outcomes. Spinal cord tumors most often present with pain followed by motor regression, gait disturbance, sphincter dysfunction or sensory loss, torticollis, and kyphoscoliosis. Treatment is based on tumor type, but surgical resection is the mainstay. Predictors of outcome include the histological grading, extent of resection, and neurological status at the time of surgery. PMID:23622304

Hsu, Wesley; Jallo, George I

2013-01-01

101

Subarachnoid Hemorrhage Following Posterior Spinal Artery Aneurysm  

PubMed Central

Summary Isolated posterior spinal artery aneurysms are rare vascular lesions. We describe the case of a 43-year-old man presenting with spinal subarachnoid hemorrhage after a minor trauma who was found to have a dissecting aneurysm of a posterior spinal artery originating from the right T4 level. Endovascular treatment was not contemplated because of the small size of the feeding artery, whereas surgical resection was deemed more appropriate because of the posterolateral perimedullary location that was well appreciated on CT angiography. After surgical resection of the aneurysm the patient had a complete neurological recovery. In comparison to anterior spinal artery aneurysms whose pathogenesis is diverse, posterior spinal aneurysms are most often secondary to a dissection and represent false or spurious aneurysms. Although the definite diagnosis still requires spinal angiography, MRI and CT may better delineate the relationship of the aneurysm to the spinal cord in order to determine the best treatment method. Prompt treatment is recommended as they have high rebleeding and mortality rates. PMID:20642894

Geibprasert, S.; Krings, T.; Apitzsch, J.; Reinges, M.H.T.; Nolte, K.W.; Hans, F.J.

2010-01-01

102

Lumbar spinal surgery - series (image)  

MedlinePLUS

... spinal column around the spinal cord. Symptoms of lumbar spine problems include: pain that extends (radiates) from the ... require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease ...

103

Three-Dimensional Spinal Morphology can Differentiate Between Progressive and Non-Progressive Patients With Adolescent Idiopathic Scoliosis at the Initial Presentation.  

PubMed

Study Design. This is a prospective case-control study.Objective. The objective of this study was to compare 3D morphologic parameters of the spine at the first visit between a non progressive (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 134 AIS was followed from skeletal immaturity to maturity (mean 37 months). The first group was made up of AIS patients with a minimum 6° progression of the major curve between the first and last follow up (P) (n=53) and the second group was composed of NP patients that reached maturity with less than 6° progression (n=81). Computerized measurements were undertaken on reconstructed 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, thoracolumbar junction), torsion and slenderness (height/width ratio). t tests were also undertaken.Results. There was no statistical difference between the two groups for age and initial Cobb angle. NP presented significant hypokyphosis, and parameters related to rotation presented significant statistical differences between NP and P (plane of maximal curvature, torsion, apical axial rotation). Depth slenderness also presented statistical differences.Conclusion. This study confirms that even at the initial visit, 3D morphologic 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. PMID:24583719

Nault, M-L; Mac-Thiong, J-M; Roy-Beaudry, M; Turgeon, I; de Guise, J; Labelle, H; Parent, S

2014-02-27

104

Isolated and silent spinal neurocysticercosis associated with pseudotumor cerebri  

PubMed Central

Incidence of spinal neurocysticercosis (NCC) is rare. Isolated spinal NCC is still rarer. We present here a case report where a young lady presented with all the clinical features of pseudotumor cerebri (PTC), where medical treatment for PTC failed and the presence of cysticercous in spinal canal was detected only on the operation table, while doing a lumbo- peritoneal shunt (LP shunt) to save her vision. Diagnosis could be confirmed only after the histopathology report was received. She did not have any direct evidence of spinal involvement, thereby eluding correct diagnosis. In English literature, we could not find any report of isolated and silent spinal NCC associated with PTC. In addition, we could not find any report of recovery of cysticercous larva through the Touhey?s needle injury, although this was an incidental finding. In endemic areas, isolated spinal NCC should be suspected in patients presenting with PTC. PMID:18417834

Pattanaik, Jaya K; Satpathy, Sanjoy K; Joshi, Sonia

2008-01-01

105

Restoring walking after spinal cord injury.  

PubMed

One of the most obvious deficits following a spinal cord injury is the difficulty in walking, forcing many patients to use wheelchairs for locomotion. Over the past decade considerable effort has been directed at promoting the recovery of walking and to find effective treatments for spinal cord injury. Advances in our knowledge of the neuronal control of walking have led to the development of a promising rehabilitative strategy in patients with partial spinal cord injury, namely treadmill training with partial weight support. The current focus is on developing more efficient training protocols and automating the training to reduce the physical demand for the therapists. Mechanisms underlying training-induced improvements in walking have been revealed to some extent in animal studies. Another strategy for improving the walking in spinal cord injured patients is the use of functional electric stimulation of nerves and muscles to assist stepping movements. This field has advanced significantly over the past decade as a result of developments in computer technology and the miniaturization of electronics. Finally, basic research on animals with damaged spinal cords has focused on enhancing walking and other motor functions by promoting growth and regeneration of damaged axons. Numerous important findings have been reported yielding optimism that techniques for repairing the injured spinal cord will be developed in the near future. However, at present no strategy involving direct treatment of the injured spinal cord has been established for routine use in spinal cord injured patients. It now seems likely that any successful protocol in humans will require a combination of a treatment to promote re-establishing functional connections to neuronal networks in the spinal cord and specialized rehabilitation training to shape the motor patterns generated by these networks for specific behavioral tasks. PMID:15201036

Fouad, Karim; Pearson, Keir

2004-06-01

106

Depression and Spinal Cord Injury  

MedlinePLUS

... Urinary Tract Infections: Indwelling (Foley) Catheter Depression and Spinal Cord Injury [ Download this pamphlet: “Depression and Spinal Cord Injury” (PDF - 477KB)] Depression is a common illness that ...

107

[Traumatic recurrence of idiopathic spinal cord herniation].  

PubMed

Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and its recurrence is even more infrequent. Cord herniation is through an anterior dural defect in thoracic spine with unknown causes. Symptomatic cases must be surgically treated to reduce the hernia and seal the defect to prevent recurrences. We report a patient presenting a Brown-Séquard syndrome secondary to a D5 spinal cord herniation treated successfully and its posterior traumatic recurrence. PMID:23453309

Lorente-Muñoz, Asís; Cortés-Franco, Severiano; Moles-Herbera, Jesús; Casado-Pellejero, Juan; Rivero-Celada, David; Alberdi-Viñas, Juan

2013-01-01

108

Multiple sclerosis of the spinal cord: Magnetic resonance appearance  

SciTech Connect

To determine the MR appearance of spinal cord multiple sclerosis (MS) plaques in patients presenting with myclopathy by using a high-field (1.5 T) imager. We studied 119 patients who underwent high-field (1.5 T) MR studies of the spinal cord for evaluation of myelopathy. All 119 patients were thought to have possible findings of spinal cord MS at the time of the MRI interpretation. Sixty-four plaques were studied in 47 patients with clinically definite MS and adequate quality MRI. Of these patients 68% had a single spinal cord plaque, 19% had two plaques, and 13% had three or more plaques. Sixty-two percent of the plaques occurred in the cervical spinal cord and most frequently involved the posterior (41%) and lateral (25%) aspects of the spinal cord. None of the 64 lesions involved the entire thickness of the spinal cord. The lesion length varied from 2 to 60 mm, with 84% of the lesions <15 mm in length. The spinal cord diameter was unchanged in 84% of plaques, enlarged at the level of the lesion in 14%, and atrophic in 2%. Just over half (55%) of the plaques enhanced with intravenously administered gadolinium. Of the patients who received synchronous head and spinal cord examinations on the same day, 24% had normal findings on the MR study of the head. Follow-up spinal cord studies were available in nine patients. New lesions developed in two patients, while previously described lesions resolved. In three patients only new lesions developed. In four patients no change occurred in the existing number of cord plaques. Spinal cord demyelinating plaques present as well-circumscribed foci of increased T2 signal that asymmetrically involve the spinal cord parenchyma. Knowledge of their usual appearance may prevent unnecessary biopsy. An MR examination of the head may confirm the imaging suggestion of spinal cord demyelinating disease, because up to 76% of patients have abnormal intracranial findings. 15 refs., 7 figs.

Thielen, K.R.; Miller, G.M. [Mayo Clinic, Rochester, MN (United States)] [Mayo Clinic, Rochester, MN (United States)

1996-05-01

109

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

110

Spinal tanycytic ependymomas  

Microsoft Academic Search

Three cases of spinal tanycytic ependymoma are reported, a man aged 45 years and two women aged 36 and 55 years. Each patient developed gradual paraparesis over a few months prior to admission. Magnetic resonance imaging showed an enhancing, well-circumscribed tumor in the spinal cord in each case. Histologically, the tumors consisted of monotonous proliferation of long spindle cells with

Nobuyuki Kawano; Saburo Yagishita; Hidehiro Oka; Satoshi Utsuki; Ikuo Kobayashi; Sachio Suzuki; Shigekuni Tachibana; Kiyotaka Fujii

2001-01-01

111

Erythropoietin in spinal cord injury  

PubMed Central

Spinal cord injury (SCI) is a devastating condition for individual patients and costly for health care systems requiring significant long-term expenditures. Cytokine erythropoietin (EPO) is a glycoprotein mediating cytoprotection in a variety of tissues, including spinal cord, through activation of multiple signaling pathways. It has been reported that EPO exerts its beneficial effects by apoptosis blockage, reduction of inflammation, and restoration of vascular integrity. Neuronal regeneration has been also suggested. In the present review, the pathophysiology of SCI and the properties of endogenous or exogenously administered EPO are briefly described. Moreover, an attempt to present the current traumatic, ischemic and inflammatory animal models that mimic SCI is made. Currently, a clearly effective pharmacological treatment is lacking. It is highlighted that administration of EPO or other recently generated EPO analogues such as asialo-EPO and carbamylated-EPO demonstrate exceptional preclinical characteristics, rendering the evaluation of these tissue-protective agents imperative in human clinical trials. PMID:19030901

Birbilis, Theodossios A.

2008-01-01

112

International bowel function basic spinal cord injury data set  

Microsoft Academic Search

Study design:International expert working group.Objective:To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A

K Krogh; I Perkash; S A Stiens; F Biering-Sørensen

2009-01-01

113

International bowel function extended spinal cord injury data set  

Microsoft Academic Search

Study design:International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A draft prepared by the working group

K Krogh; I Perkash; S A Stiens; F Biering-Sørensen

2009-01-01

114

Spinal gout tophus: a very rare cause of radiculopathy.  

PubMed

Gout is a common metabolic disease characterized by the development of arthritis and nephropathy related to the deposition of monosodium urate crystals within the joints, periarticular tissues, skin and kidneys. Tophus formation seen around the spinal column is very rare, while occurrences of spinal gout tophus without systemic gout disease are much more unique. In our study, we report a spinal gout case that presented with right sciatica without previous history of systemic gout disease. PMID:21594750

Hasturk, Askin Esen; Basmaci, Mehmet; Canbay, Suat; Vural, Cigdem; Erten, Fuat

2012-06-01

115

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

116

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

117

Spinal transection induces widespread proliferation of cells along the length of the spinal cord in a weakly electric fish  

PubMed Central

The ability to regenerate spinal cord tissue after tail amputation has been well studied in several species of teleost fish. The present study examined proliferation and survival of cells following complete spinal cord transection rather than tail amputation in the weakly electric fish Apteronotus leptorhynchus. To quantify cell proliferation along the length of the spinal cord, fish were given a single bromodeoxyuridine (BrdU) injection immediately after spinal transection or sham surgery. Spinal transection significantly increased the density of BrdU+ cells along the entire length of the spinal cord at 1 day post transection (dpt), and most newly generated cells survived up to 14 dpt. To examine longer term survival of the newly proliferated cells, BrdU was injected for 5 days after the surgery, and fish were sacrificed 14 or 30 dpt. Spinal transection significantly increased proliferation and/or survival, as indicated by an elevated density of BrdU+ cells in the spinal cords of spinally transected compared to sham-operated and intact fish. At 14 dpt, BrdU+ cells were abundant at all levels of the spinal cord. By 30 dpt, the density of BrdU+ cells decreased at all levels of the spinal cord except at the tip of the tail. Thus, newly generated cells in the caudal-most segment of the spinal cord survived longer than those in more rostral segments. Our findings indicate that spinal cord transection stimulates widespread cellular proliferation; however, there were regional differences in the survival of the newly generated cells. PMID:23147638

Allen, Antiño R.; Smith, G. Troy

2013-01-01

118

Retinoic acid signaling in spinal cord development.  

PubMed

Retinoic acid (RA) is an important signaling molecule mediating intercellular communication through vertebrate development. Here, we present and discuss recent information on the roles of the RA signaling pathway in spinal cord development. RA is an important player in the patterning and definition of the spinal cord territory from very early stages of development, even before the appearance of the neural plate and further serves a role in the patterning of the spinal cord both along the dorsoventral and anteroposterior axes, particularly in the promotion of neuronal differentiation. It is thus required to establish a variety of neuronal cell types at specific positions of the spinal cord. The main goal of this review is to gather information from vertebrate models, including fish, frogs, chicken and mice, and to put this information in a comparative context in an effort to visualize how the RA pathway was incorporated into the evolving vertebrate spinal cord and to identify mechanisms that are both common and different in the various vertebrate models. In doing so, we try to reconstruct how spinal cord development has been regulated by the RA signaling cascade through vertebrate diversification, highlighting areas which require further studies to obtain a better understanding of the evolutionary events that shaped this structure in the vertebrate lineage. PMID:23579094

Lara-Ramírez, Ricardo; Zieger, Elisabeth; Schubert, Michael

2013-07-01

119

Large spinal intraosseous arteriovenous fistula: case report.  

PubMed

Here the authors report the case of a fresh vertebral body fracture with a large spinal intraosseous arteriovenous fistula (AVF). A 74-year-old woman started to experience low-back pain following a rear-end car collision. Plain radiography showed diffuse idiopathic skeletal hyperostosis (DISH). Sagittal CT sections revealed a transverse fracture of the L-4 vertebral body with a bone defect. Sagittal fat-suppressed T2-weighted MRI revealed a flow void in the fractured vertebra. Spinal angiography revealed an intraosseous AVF with a feeder from the right L-4 segmental artery. A fresh fracture of the L-4 vertebral body with a spinal intraosseous AVF was diagnosed. Observation of a flow void in the vertebral body on fat-suppressed T2-weighted MRI was important for the diagnosis of the spinal intraosseous AVF. Because conservative treatment was ineffective, surgery was undertaken. The day before surgery, embolization through the right L-4 segmental artery was performed using 2 coils to achieve AVF closure. Posterolateral fusion with instrumentation at the T12-S2 vertebral levels was performed without L-4 vertebroplasty. The spinal intraosseous AVF had disappeared after 4 months. At 24 months after surgery, the bone defect was completely replaced by bone and the patient experienced no limitations in daily activities. Given their experience with the present case, the authors believe that performing vertebroplasty or anterior reconstruction may not be necessary in treating spinal intraosseous AVF. PMID:25635636

Imajo, Yasuaki; Kanchiku, Tsukasa; Yoshida, Yuichiro; Nishida, Norihiro; Taguchi, Toshihiko

2015-04-01

120

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:19084763

Boden, Barry P; Jarvis, Christopher G

2009-02-01

121

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:18295084

Boden, Barry P; Jarvis, Christopher G

2008-02-01

122

Spinal palpatory diagnostic procedures utilized by practitioners of spinal manipulation: annotated bibliography of content validity and reliability studies  

PubMed Central

The diagnosis of spinal neuro-musculoskeletal dysfunction is a pre-requisite for application of spinal manual therapy. Different disciplines rely on palpatory procedures to establish this diagnosis and design treatment plans. Over the past 30 years, the osteopathic, chiropractic, physical therapy and allopathic professions have investigated the validity and reliability of spinal palpatory procedures. We explored the literature from all four disciplines looking for scientific papers studying the content validity and reliability of spinal palpatory procedures. Thirteen databases were searched for relevant papers between January 1966 and October 2001. An annotated bibliography of these articles is presented and organized by the type of test used.

Seffinger, Michael; Adams, Alan; Najm, Wadie; Dickerson, Vivian; Mishra, Shiraz I; Reinsch, Sibylle; Murphy, Linda

2003-01-01

123

Neurologic recovery after traumatic spinal cord injury: data from the model spinal cord injury systems  

Microsoft Academic Search

Objective: To present data on neurologic recovery gathered by the Model Spinal Cord Injury (SCI) Systems over a 10-year period.Design: Case series.Setting: Twenty-one Model SCI Systems.Patients: A total of 3,585 individuals with traumatic SCI admitted between January 1, 1988 and December 31, 1997.Main Outcome Measures: Neurologic impairment category; Frankel grade; American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade; motor

Ralph J. Marino; John F. Ditunno; William H. Donovan; Frederick Maynard

1999-01-01

124

What Is Spinal Stenosis?  

MedlinePLUS

... bone spurs). Arthritis In some cases arthritis, a degenerative (gets worse over time) condition can cause spinal ... Tumors of the spine. ? Injuries. ? Paget's disease (a disease that affects the bones). ? Too much fluoride in the body. ? Calcium deposits ...

125

Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... is "Braingate" research? What is the status of stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell us? When can we ...

126

What Is Spinal Stenosis?  

MedlinePLUS

... publication. To order the Spinal Stenosis Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit ... NIAMS Site NIH… Turning Discovery Into Health ® Home | ...

127

Congenital spinal cord anomalies: a pictorial review.  

PubMed

Development of spinal canal and its contents occurs in a much regulated fashion. Aberration at any stage of development namely gastrulation, primary neurulation, secondary neurulation, and retrogressive differentiation can result in a specific abnormality. Spinal cord anomalies or spinal dysraphism is a heterogeneous group containing some entities that are obvious at birth and many that are discovered only after imaging for neurological symptoms or signs. Congenital spinal tumors are closely related and present either as an external mass or imaging abnormalities. Radiological imaging plays a crucial role in both diagnosis and postoperative evaluation of these patients. Magnetic resonance imaging is the modality of choice. Computed tomography is used in a limited fashion. Plain radiographs are the initial imaging in patients presenting with abnormal curvatures of spine. No other central nervous system abnormality requires as systematic an approach as spinal dysraphism. The authors present a review of both common and rare anomalies that they encountered for a 3-year period in their institute, a tertiary care level hospital. PMID:23332138

Gupta, Pankaj; Kumar, Atin; Kumar, Avneesh; Goel, Sandeep

2013-01-01

128

Walking after spinal cord injury: Evaluation, treatment, and functional recovery  

Microsoft Academic Search

Objective: To present some recent developments and concepts emerging from both animal and human studies aimed at enhancing recovery of walking after spinal cord injury (SCI).Data Sources: Researchers in the field of restoration of walking after SCI, as well as references extracted from searches in the Medline computerized database.Study Selection: Studies that reported outcome measures of walking for spinal cord

Hugues Barbeau; Michel Ladouceur; Kathleen E. Norman; André Pépin; Alain Leroux

1999-01-01

129

Spinal cord infarction secondary to nucleus pulposus embolization in pregnancy  

Microsoft Academic Search

Nucleus pulposus (NP) embolism is an extremely rare cause of spinal cord infarction. To our knowledge, it has not been reported in pregnancy in the English literature. A 41-year-old pregnant woman presented with clinical symptoms initially attributed to a transverse myelitis. After a complicated clinical course, she expired, and was found at autopsy to have NP embolism to the spinal

Shweta Uppal; Subasini Dash; Leroy Sharer; William Clark Lambert; Debra S Heller; Patrick Pullicino

2004-01-01

130

The Clinical Syndrome Associated with Lumbar Spinal Stenosis  

Microsoft Academic Search

Lumbar spinal stenosis is well defined in patho-anatomical terms but its clinical features are heterogeneous. We carried out a comprehensive retrospective review of the clinical features, radiological changes and outcome of 75 patients with radiologically diagnosed lumbar spinal stenosis in order to define its clinical spectrum. The presenting complaints were of weakness, numbness\\/tingling, radicular pain and neurogenic claudication in almost

Khean Jin Goh; Waël Khalifa; Philip Anslow; Tom Cadoux-Hudson; Michael Donaghy

2004-01-01

131

Intracranial metastasis of a spinal myxopapillary ependymoma. A case report.  

PubMed

A 37-year-old man exhibited a suprasellar tumor which histologically proved to be a myxopapillary ependymoma. Since these gliomas are virtually restricted to the cauda equina region, magnetic resonance imaging (MRI) was performed which revealed multiple spinal tumors. The present case seems to be the first report on spontaneous intracranial seeding of a spinal myxopapillary ependymoma. PMID:9584289

Woesler, B; Moskopp, D; Kuchelmeister, K; Schul, C; Wassmann, H

1998-01-01

132

Intracranial metastasis of a spinal myxopapillary ependymoma. A case report  

Microsoft Academic Search

A 37-year-old man exhibited a suprasellar tumor which histologically proved to be a myxopapillary ependymoma. Since these gliomas are virtually restricted to the cauda equina region, magnetic resonance imaging (MRI) was performed which revealed multiple spinal tumors. The present case seems to be the first report on spontaneous intracranial seeding of a spinal myxopapillary ependymoma.

Burkhard Woesler; Dag Moskopp; Klaus Kuchelmeister; Christoph Schul; Hansdetlef Wassmann

1998-01-01

133

Lumbar spinal angiolipoma: case report and review of the literature  

Microsoft Academic Search

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

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

2006-01-01

134

Evidence that descending serotonergic systems protect spinal cord plasticity against the disruptive effect of uncontrollable stimulation  

E-print Network

Evidence that descending serotonergic systems protect spinal cord plasticity against the disruptive Available online 31 August 2005 Abstract Prior work has demonstrated that spinal cord neurons, isolated from (e.g., intermittent tailshock). The present experiments examined whether spinal cord neurons are more

Grau, James

135

Flexible Microfabricated Parylene Multielectrode Arrays for Retinal Stimulation and Spinal Cord Field Modulation  

E-print Network

Flexible Microfabricated Parylene Multielectrode Arrays for Retinal Stimulation and Spinal Cord-arc neuromodulation in cases of spinal cord damage or transection, are presented. A single metal layer 16 ×16 retinal of these flexible electrode arrays in spinal cord stimulation experiments in animal models has proven their efficacy

Meng, Ellis

136

Intradural spinal cysts.  

PubMed

18 cases of benign intradural spinal cyst (9 arachnoidal, 2 neuroepithelial, 7 endodermal) are reported and compared with 94 cases (67 arachnoidal, 7 neuroepithelial, 20 endodermal) obtained from the literature. Arachnoidal intradural cysts (AIC) have no sex preference, occur at around the fourth-fifth decades of life and have characteristic intermittent root symptoms. They prefer the thoracic level and the posterior position. (Myelography images the cystic cavity (diverticular form). Surgical removal is usually easy. Neuroepithelial intradural cysts (NIC) are rare, have a 2:1 predilection for females and occur after the fourth decade. They have a serious clinical course similar to intramedullary or extramedullary tumours. They prefer the conus-cauda and the anterolateral positions. They often give rise to manometric block and to albuminocytological dissociation. There may be substantial adhesions to the cord and roots and the intramedullary variety presents no clear plane of cleavage. Endodermal intradural cysts (EIC) have a 2:1 predilection for males and prefer the second and third decades. They may have an intermittent or serious course with signs of root and cord impairment. They prefer the cervical segment (in the anterior position) and the conus-cauda (in the posterior position). As a rule they present manometric block and albuminocytological dissociation. Their frequent tough adhesions to the roots and cord demand special care during their removal. PMID:6880882

Fortuna, A; Mercuri, S

1983-01-01

137

Modeling spinal cord biomechanics  

NASA Astrophysics Data System (ADS)

Regeneration after spinal cord injury is a serious health issue and there is no treatment for ailing patients. To understand regeneration of the spinal cord we used a system where regeneration occurs naturally, such as the lamprey. In this work, we analyzed the stress response of the spinal cord to tensile loading and obtained the mechanical properties of the cord both in vitro and in vivo. Physiological measurements showed that the spinal cord is pre-stressed to a strain of 10%, and during sinusoidal swimming, there is a local strain of 5% concentrated evenly at the mid-body and caudal sections. We found that the mechanical properties are homogeneous along the body and independent of the meninges. The mechanical behavior of the spinal cord can be characterized by a non-linear viscoelastic model, described by a modulus of 20 KPa for strains up to 15% and a modulus of 0.5 MPa for strains above 15%, in agreement with experimental data. However, this model does not offer a full understanding of the behavior of the spinal cord fibers. Using polymer physics we developed a model that relates the stress response as a function of the number of fibers.

Luna, Carlos; Shah, Sameer; Cohen, Avis; Aranda-Espinoza, Helim

2012-02-01

138

Spinal cord and spinal nerve root involvement (myeloradiculopathy) in tuberculous meningitis.  

PubMed

Most of the information about spinal cord and nerve root involvement in tuberculous meningitis is available in the form of isolated case reports or case series. In this article, we evaluated the incidence, predictors, and prognostic impact of spinal cord and spinal nerve root involvement in tuberculous meningitis.In this prospective study, 71 consecutive patients of newly diagnosed tuberculous meningitis were enrolled. In addition to clinical evaluation, patients were subjected to magnetic resonance imaging (MRI) of brain and spine. Patients were followed up for at least 6 months.Out of 71 patients, 33 (46.4%) had symptoms/signs of spinal cord and spinal nerve root involvement, 22 (30.9%) of whom had symptoms/signs at enrolment. Eleven (15.4%) patients had paradoxical involvement. Paraparesis was present in 22 (31%) patients, which was of upper motor neuron type in 6 (8.4%) patients, lower motor neuron type in 10 (14%) patients, and mixed type in 6 (8.4%) patients. Quadriparesis was present in 3 (4.2%) patients. The most common finding on spinal MRI was meningeal enhancement, seen in 40 (56.3%) patients; in 22 (30.9%), enhancement was present in the lumbosacral region. Other MRI abnormalities included myelitis in 16 (22.5%), tuberculoma in 4 (5.6%), cerebrospinal fluid (CSF) loculations in 4 (5.6%), cord atrophy in 3 (4.2%), and syrinx in 2 (2.8%) patients. The significant predictor associated with myeloradiculopathy was raised CSF protein (>250?mg/dL). Myeloradiculopathy was significantly associated with poor outcome.In conclusion, spinal cord and spinal nerve root involvement in tuberculous meningitis is common. Markedly raised CSF protein is an important predictor. Patients with myeloradiculopathy have poor outcome. PMID:25621686

Gupta, Rahul; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Verma, Rajesh; Sharma, Praveen Kumar

2015-01-01

139

Isolated intramedullary spinal cord cysticercosis.  

PubMed

Neurocysticercosis is a major cause of epilepsy in developing countries. Cysticercal involvement of the spinal cord is rare even in endemic areas and accounts for 0.7 to 5.85% of all cases. We present a 19-year-old man who presented with weakness of both lower limbs and urinary complaints in the form of straining of micturition with increased frequency, in whom preoperative MRI revealed a well-defined cystic lesion in dorso-lumber cord extending from D11 to L1 level, which on pathological examination was found to be intramedullary cysticercosis. PMID:25540546

Qazi, Zeeshan; Ojha, Bal Krishna; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij; Patil, Tushar B

2014-11-01

140

Isolated intramedullary spinal cord cysticercosis  

PubMed Central

Neurocysticercosis is a major cause of epilepsy in developing countries. Cysticercal involvement of the spinal cord is rare even in endemic areas and accounts for 0.7 to 5.85% of all cases. We present a 19-year-old man who presented with weakness of both lower limbs and urinary complaints in the form of straining of micturition with increased frequency, in whom preoperative MRI revealed a well-defined cystic lesion in dorso-lumber cord extending from D11 to L1 level, which on pathological examination was found to be intramedullary cysticercosis. PMID:25540546

Qazi, Zeeshan; Ojha, Bal Krishna; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij; Patil, Tushar B.

2014-01-01

141

Multilevel Intramedullary Spinal Neurocysticercosis With Eosinophilic Meningitis  

PubMed Central

Background Cysticercal involvement of the spinal cord is a very rare form of neurocysticercosis. Intramedullary cysts are even less common. Objective To describe a novel presentation of multilevel intramedullary neurocysticercosis with eosinophilic meningitis. Design Case report. Patient A 35-year-old man with a history of cerebral neurocysticercosis who presented with both cauda equina and Brown-Sequard syndromes associated with cerebrospinal fluid findings of eosinophilic meningitis. Results Magnetic resonance imaging confirmed the multilevel intramedullary cord lesions. The patientwas treated medically with dexamethasone and albendazole and had a good recovery. Conclusion Intramedullary neurocysticercosis should be considered as a potentially treatable cause of multilevel spinal lesions with subacute meningitis. PMID:15148157

Torabi, Amir M.; Quiceno, Mary; Mendelsohn, Dianne B.; Powell, Craig M.

2014-01-01

142

Non-traumatic spontaneous spinal subdural haematoma.  

PubMed

We are presenting a case of non-traumatic spontaneous spinal subdural hematoma in a patient on warfarin and fluoxetine. This diagnosis should be considered early in patients who are on warfarin or fluoxetine or both presenting with acute neurological abnormalities of the limbs, and early decompression could result in good neurological outcome. PMID:23159904

Haji Mohd Yasin, Nur A B; Donato-Brown, Daniella; Taha, Ahmad

2012-10-12

143

Pediatric Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... Pressure Sores Transition from Hospital to Home Spasticity, Physical Therapy-Lokomat Sex and Fertility After Spinal Cord ... How do spinal cord injuries before puberty affect physical growth and development? Can scoliosis be slowed or ...

144

Living with Spinal Cord Injury  

MedlinePLUS

... techniques that may prevent injury and disease. A spinal cord injury (SCI) can result from trauma, such as a ... with daily living skills. What can persons with spinal cord injuries and their friends and families do? ? Get involved ...

145

What Is Spinal Cord Injury?  

MedlinePLUS

... NICHD Research Information Clinical Trials Resources and Publications Spinal Cord Injury (SCI): Condition Information Skip sharing on social media ... 3 National Institute of Neurological Disorders and Stroke. Spinal cord injury: Hope through research. Retrieved June 19 , 2013 , from ...

146

[Occult spinal dysraphia].  

PubMed

One of the most complex and most difficult congenital anomalies is spina bifida. Peter Van Forest was the first one who noticed this anomaly in 1587, and Recklinghausen, in 1886, classified spina bifida to types and suggested surgical procedures for its management. Earlier name, spina bifida, is currently more and more replacing with a term "defect of neural tube" (NTDs), or even more, "spinal dysraphia". Anomaly can appear at any level of spinal cord (cervical, thoracal, lumbar and sacral) and posterior localization is more often than the anterior one. Contrary to the open spinal dysraphism that can be perceived immediately, closed spinal dysraphism is very deceiving anomaly, and therefore, it must be treated properly as soon as it is diagnosed. Because of its seclusion, the term usually used is "occult spinal dysraphism (OSD)". The incidence of this anomaly is unknown, but it has been reported that it is more common among female children. Etiology of OSD is also unknown, but some of its risk factors are as follows: previous pregnancy with NTD, partner with NTD, type 1 diabetes mellitus, usage of anticonvulsives, a lack of folates in mother's nutrition. Prenatal diagnose of OSD is practically impossible. Skin changes, orthopedic, urological and neurological problems, suggest considering this complex anomaly. X-ray, ECHO, MRI, as well as neuropsychological examination corroborate diagnosis. At the same time, the diagnosis (once it is confirmed) represents the indication for neurosurgical treatment. PMID:15615481

Raicevi?, Mirjana; Abramovi?, Dusan; Mihajlovi?, Miljan; Petroni?, Ivana; Vidosavljevi?, Marko

2004-10-01

147

Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review.  

PubMed

Intramedullary spinal cord abscess (ISCA) without meningitis is an extremely rare entity in the central nervous system, and it is often difficult to diagnose immediately, and no definitive imaging findings have been established. We experienced the case of a 61-year-old male who presented with a sudden onset back pain without fever following rapidly worsening paraparesis for 3 days, who subsequently become unable to walk. According to the initial MRI and 3D-CTA, the presumptive diagnosis was spinal infarction due to spinal artery embolism. However, his symptoms did not improve, despite the gradual changes in MRI following antiplatelet therapy. He underwent a biopsy in an attempt to prevent the lesion from progressing toward the upper spinal cord. The pathological examination revealed an intramedullary abscess, so we performed a midline myelotomy and drained the pus from the abscess. After surgery, MRI showed improvement, but the patient's paraplegia persisted. To the best of our knowledge, this is the first case report of spinal cord abscess with the confirmation of spinal artery occlusion on angiography, which could have been caused by a bacterial embolism. We herein discuss its possible etiology and also review recent reports on ISCA. PMID:21308472

Iwasaki, Motoyuki; Yano, Shunsuke; Aoyama, Takeshi; Hida, Kazutoshi; Iwasaki, Yoshinobu

2011-07-01

148

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

149

Spinal dysraphism and cavovarus foot deformity: a case report  

PubMed Central

Neurological impairment secondary to spinal dysraphism most commonly presents as unilateral cavovarus foot in children. The deformity usually develops in the growing child around the age of five or six. The presence of a cavovarus foot of unknown origin in a child should lead to a complete neurological examination, including an assessment of the spine for spinal dysraphism. The early recognition of pathology may prevent severe neurological sequelae. A case of lipomyelomeningocele is presented to illustrate that cord damage in children with spinal dysraphism can present initially as a cavovarus foot. ImagesFigure 1 (a, b and c)Figure 2Figure 3Figure 4

Hains, François; Dzus, Ann K; Cassidy, J David

1992-01-01

150

Radiation-Induced Spinal Cord Hemorrhage (Hematomyelia)  

PubMed Central

Intraspinal hemorrhage is very rare and intramedullary hemorrhage, also called hematomyelia, is the rarest form of intraspinal hemorrhage, usually related to trauma. Spinal vascular malformations such intradural arteriovenous malformations are the most common cause of atraumatic hematomyelia. Other considerations include warfarin or heparin anticoagulation, bleeding disorders, spinal cord tumors. Radiation-induced hematomyelia of the cord is exceedingly rare with only one case in literature to date. We report the case of an 8 year old girl with Ewing’s sarcoma of the thoracic vertebra, under radiation therapy, presenting with hematomyelia. We describe the clinical course, the findings on imaging studies and the available information in the literature. Recognition of the clinical pattern of spinal cord injury should lead clinicians to perform imaging studies to evaluate for compressive etiologies. PMID:25568739

Agarwal, Amit; Kanekar, Sangam; Thamburaj, Krishnamurthy; Vijay, Kanupriya

2014-01-01

151

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

152

Spinal dural ossification causing neurological signs in a cat.  

PubMed

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

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

2013-01-01

153

Spinal Cord Injury  

NSDL National Science Digital Library

This patient education program discusses how spinal cord injuries are caused and their treatment options. It also includes tips on how to prevent spinal cord injuries. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

154

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

155

Gangliocytoma of the Cervicothoracic Spinal Cord  

Microsoft Academic Search

Summary: We present a case of an extensive cervicothoracic gangliocytoma in an asymptomatic 9-year-old boy with progres- sive scoliosis. MR findings were that of a moderately enhancing cervicothoracic intramedullary mass, which throughout most of its length could not be distinguished from the normal spinal cord.

Craig P. Russo; Douglas S. Katz; Robert J. Corona; Jeffrey A. Winfield

156

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

157

Spinal Muscular Atrophy  

MedlinePLUS

... a genetic disease that attacks nerve cells, called motor neurons, in the spinal cord. These cells communicate with ... like in your arms and legs. As the neurons die, the muscles weaken. This can affect walking, ... National Institute of Neurological Disorders and Stroke

158

Lumbar Spinal Canal Stenosis  

MedlinePLUS

... pain caused by a ruptured disk in the lumbar spine is usually easy to diagnose and is known ... the pressure off the nerves in your lower spine. This surgery works well for many people. Questions to Ask Your Doctor My father had lumbar spinal canal stenosis. Am I at risk of ...

159

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

160

Spinal Intradural Cerebellar Ectopia  

Microsoft Academic Search

Summary: An ectopic cerebellum, as in Chiari malforma- tions and ectopic cerebellar dysplastic tissue, is a common finding; however, the presence of an organized ectopic cer- ebellum is exceedingly rare. We describe the MR imaging, surgical, and histologic appearance of an intraspinal ec- topic cerebellum in an infant. Intradural spinal cerebellar ectopias are commonly seen in the Chiari malformations (1).

Charles J. Chung; Mauricio Castillo; Lynn Fordham; Suresh Mukherji; William Boydston; Roger Hudgins

161

Spinal tanycytic ependymomas.  

PubMed

Three cases of spinal tanycytic ependymoma are reported, a man aged 45 years and two women aged 36 and 55 years. Each patient developed gradual paraparesis over a few months prior to admission. Magnetic resonance imaging showed an enhancing, well-circumscribed tumor in the spinal cord in each case. Histologically, the tumors consisted of monotonous proliferation of long spindle cells with markedly eosinophilic cell processes; focally forming perivascular pseudorosettes. The tumor cells were strongly immunopositive for glial fibrillary acidic protein, S-100 protein and vimentin. Ultrastructurally, in addition to massive intermediate filaments, many tumor cells showed abundant microtubules. Well-developed desmosomes and microvilli/cilia-lined microlumina were occasionally observed. The tumors were grossly totally removed and the patients remain recurrence free at 9, 9, and 2 years postoperatively. Reviewing reported cases including our three cases, tanycytic ependymoma may occur frequently in spinal cord, especially in the cervical region of the spinal cord. Since histologically it resembles pilocytic astrocytoma and schwannoma, tanycytic ependymoma should be included in the differential diagnosis of benign spindle cell tumors of the central nervous system. PMID:11194940

Kawano, N; Yagishita, S; Oka, H; Utsuki, S; Kobayashi, I; Suzuki, S; Tachibana, S; Fujii, K

2001-01-01

162

Spinal intradural capillary hemangioma  

Microsoft Academic Search

BackgroundCapillary hemangiomas are typically superficial lesions found in the skin or mucosa of the head and neck, but intradural locations are rare. We report a case of the spinal intradural capillary hemangioma of the lumbar spine with a review of the pertinent literature.

Ki Joon Kim; Ji Young Lee; Sang-Ho Lee

2006-01-01

163

Anterior spinal artery syndrome after aortic surgery in a child  

Microsoft Academic Search

Anterior spinal artery syndrome is rare in children. In adults, where it is observed most frequently after resection of thoracoabdominal aortic aneurysms, spinal magnetic resonance imaging is considered the first-line investigation to confirm the clinical diagnosis. A 3-year-old male who presented with this syndrome after palliative cardiac surgery for a complex cardiac malformation associated with aortic coarctation is presented. Clinical

Laurent J Servais; Sarah K Rivelli; Bernard A Dachy; Catherine D Christophe; Bernard Dan

2001-01-01

164

Gangliocytoma of the spinal cord: a case report  

Microsoft Academic Search

We present a case of intramedullary spinal gangliocytoma in a 7-year-old girl who presented with scoliosis and progressive\\u000a weakness of both legs. The tumour involved the whole spinal cord and medulla oblongata and was composed of inner cystic and\\u000a outer solid components. On MRI, the solid portion of the lesion showed strong enhancement at the thoracolumbar level and mild\\u000a enhancement

Young Ho Choi; I.-O. Kim; Jung-Eun Cheon; W. S. Kim; Kyung Mo Yeon; Kyu-Chang Wang; Byung-Kyu Cho; Je Geun Chi

2001-01-01

165

Management of postoperative spinal infections.  

PubMed

Postoperative surgical site infection (SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention, diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories: (1) microbiological factors; (2) factors related to the patient and their spinal pathology; and (3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique, prophylactic antibiotics, avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinal instrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure. PMID:23330073

Hegde, Vishal; Meredith, Dennis S; Kepler, Christopher K; Huang, Russel C

2012-11-18

166

Spinal Arteriovenous Fistula with Progressive Paraplegia after Spinal Anaesthesia  

PubMed Central

A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed. PMID:24653807

Argyrakis, Nikolaos; Matis, Georgios K.; Mpata-Tshibemba, Stephanie

2014-01-01

167

Spinal somatosensory evoked potentials after epidural isoproterenol in awake sheep  

Microsoft Academic Search

Purpose  The use of 10–15 ?g epinephrine as an epidural test-dose is controversial. Isoproterenol would be a better alternative. However\\u000a before 5?g isoproterenol can be incorporated in an epidural test-dose, neurotoxicological studies have to be performed. The\\u000a present study was designed to assess spinal somatosensory evoked potentials (spinal SSEP) before and after epidural isoproteronol.\\u000a \\u000a \\u000a \\u000a Methods  Spinal SSEPs were recorded before, 30 min

Marco A. E. Marcus; Frans L. Bruyninckx; Jan D. Vertommcn; Patrick F. Wouters; Hugo Van Aken

1997-01-01

168

www.jneurovirol.com MRI of spinal cord in MS  

E-print Network

Over the last 10 ± 15 years, magnetic resonance imaging techniques have had a major impact in understanding and managing multiple sclerosis. The present review brie¯y summarises the current usefulness of spinal cord MRI in MS disease, examining the frequency, distribution and main characteristics of spine MS plaques; the differential diagnosis with other spinal cord disease was also described. Finally we considered how newer imaging sequences when added to semi-automated quantitative methods, may give us a putative tool to reliably quantify subtle changes which develop on the spinal cord of MS patients over time. Journal of NeuroVirology (2000) 6, S130 ± S133.

169

MR imaging of neonatal spinal dysraphia: what to consider?  

PubMed

The development of the spinal canal and its contents is highly complex and involves multiple programmed anatomic and functional developmental and maturational processes. Correct and detailed knowledge about spinal malformations is essential to understand and recognize these lesions early (preferably prenatally) to counsel parents during pregnancy, to plan possible intrauterine treatments, and to make decisions about the mode of delivery and the immediate postnatal treatment. This article discusses the imaging findings of the most frequently encountered neonatal spinal malformations and correlates these findings with the relevant embryologic processes. The presented classification is based on a correlation of clinical, neuroradiologic, and embryologic data. PMID:22118592

Huisman, Thierry A G M; Rossi, Andrea; Tortori-Donati, Paolo

2012-02-01

170

Brain-Derived Neurotrophic Factor Stimulates Hindlimb Stepping and Sprouting of Cholinergic Fibers after Spinal Cord Injury  

Microsoft Academic Search

Neurotrophic factors have been proposed as a therapeutic treatment for traumatic brain and spinal cord injury. The present study determined whether exogenous administration of one such factor, brain-derived neurotrophic factor (BDNF), could effect behavioral recovery and\\/or histopathological changes after spinal cord injury. Adult rats received a mild or moderate contusion injury or complete transection of the midthoracic spinal cord. Immediately

Lyn B. Jakeman; Ping Wei; Zhen Guan; Bradford T. Stokes

1998-01-01

171

Transection method for shortening the rat spine and spinal cord  

PubMed Central

Previous studies have presented evidence which indicates that the regeneration of axons in the spinal cord occurs following spinal cord transection in young rats. However, in a transection-regeneration model, the completeness of the transection is often a matter of dispute. We established a method for shortening the rat spine and spinal cord to provide a spinal cord injury (SCI) model in which there was no doubt about whether the axonal transection was complete. In the future, this model may be applied to the chronic period of complete paralysis following SCI. Adult, female Wistar rats (220–250g) were used in the study. The spinal cord was exposed and a 4-mm-long segment of the spinal cord was removed at Th8. Subsequently, the Th7/8 and Th8/9 discs were cut between the stumps of the spinal cord to remove the Th8 vertebra. The stitches which had been passed through the 7th and 9th ribs bilaterally were tied gradually to bring together the stumps of the spinal cord. Almost all the rats survived until the end of the experiment. Uncoordinated movements of the hind limbs in locomotion were observed at 4 weeks after surgery. However coordinated movements of the hind limbs in locomotion were not observed until the end of the experiment. After 12 weeks, an intracardiac perfusion was performed to remove the thoracic spine and the spinal cord. There were no signs of infection. The bone fusion of the Th7 and Th9 vertebrae was observed to be complete in all specimens and the alignment of the thoracic spine was maintained. The spinal canal was also correctly reconstituted. The stumps of the spinal cord were connected. Light microscopy of the cord showed that scar tissue intervened at the connection site. Cavitation inhibiting the axonal regeneration was also observed. This model was also made on the assumption that glial scar tissue inhibits axonal regeneration in chronic SCI. Axonal regeneration was not observed across the transected spinal cord in this model. Attempts should be made to minimize the damage to the spinal cord and the surgery time for successful axonal regeneration to occur. The model developed in this study may be useful in the study of axonal regeneration in SCI. PMID:23403404

YOSHIDA, YUICHIRO; KATAOKA, HIDEO; KANCHIKU, TSUKASA; SUZUKI, HIDENORI; IMAJYO, YASUAKI; KATO, HIDETOYO; TAGUCHI, TOSHIHIKO

2013-01-01

172

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

173

Spinal elastofibroma: a case report.  

PubMed

Elastofibroma is a benign fibroproliferative tumor of unknown origin and pathogenesis. It usually appears in the subscapular or infrascapular area. It is extremely rare in the spinal area, and it is most common in middle-aged women. In most cases, it is asymptomatic. Its diagnosis is based on nuclear MRI, where it presents a homogeneous lesion, similar to the skeletal muscle, hyperintense in T1-weighted sequences and hypointense in T2-weighted sequences. This finding is confirmed with anatomical pathology tests, where it appears as a nonencapsulated lesion made up of wide collagen bands from connective tissue mixed with fat and muscle tissue. The treatment of choice is surgical removal of the lesion. We present a clinical case of elastofibroma, a benign and rare pathology with few described cases in the literature, in a patient with a previous dorsal lesion. PMID:24993647

Miranda Zambrano, A David; Rivero-Garvía, Mónica; Galbarriatu, Lara; Ruíz-Martín, Laura; Márquez-Rivas, Javier

2013-01-01

174

Congenital segmental spinal muscular atrophy: a case report.  

PubMed

Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al (J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient's situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs. PMID:25300987

Sava?, Tülin; Erol, Ilknur; Özkale, Yasemin; Saygi, Semra

2015-03-01

175

The Quest to Repair the Damaged Spinal Cord  

E-print Network

Abstract: Spinal cord injuries devastate the lives of those affected. Normally, acute injury leads to chronic injury in the spinal cord, although this has a variable impact on normal sensory and motor functions. Currently the only drug used to treat acute spinal cord injury is methyl-prednisolone, administered in order to prevent secondary inflammatory neural damage. Thus, it is time that alternative and complementary pharmacological, cell and gene therapies be developed. In order to achieve this, several approaches to stimulate spinal cord repair must be considered. Indeed, the main lines of research that have been established in different animal models of spinal cord regeneration are now beginning to produce encouraging results. Several patents have been derived from these studies and hopefully, they will lead to the development of new treatments for human spinal cord injuries. Here is presented a review of the main patents that have been generated by this research, and that can be classified as:- Patents involving the use of different factors that promote axonal regeneration.- Patents aimed at overcoming the activity of glial scar inhibitory molecules that hinder axonal regeneration. These approaches can be further subdivided into those that block Nogo and other myelin components, and those that involve the use of chondroitinase against glial scar chondroitin sulphate proteoglycans.- Patents concerning glial cell therapy, in which glial cells are used to mediate axonal repair in the spinal cord (Schwann cells, olfactory ensheathing cells or astrocytes).

176

An Optimal Protocol to Analyze the Rat Spinal Cord Proteome  

PubMed Central

Since the function of the spinal cord depends on the proteins found there, better defing the normal Spinal Cord Proteome is an important and challenging task. Although brain and cerebrospinal fluid samples from patients with different central nervous system (CNS) disorders have been studied, a thorough examination of specific spinal cord proteins and the changes induced by injury or associated to conditions such as neurodegeneration, spasticity and neuropathies has yet to be performed. In the present study, we aimed to describe total protein content in the spinal cord of healthy rats, employing different proteomics tools. Accordingly, we have developed a fast, easy, and reproducible sequential protocol for protein extraction from rat spinal cords. We employed conventional two dimensional electrophoresis (2DE) in different pH ranges (eg. 4–7, 3–11 NL) combined with identification by mass spectrometry (MALDI-TOF/TOF), as well as first dimension protein separation combined with Liquid Chromatography Mass Spectrometry/Mass Spectrometry (LC-MS/MS) to maximise the benefits of this technology. The value of these techniques is demonstrated here by the identification of several proteins known to be associated with neuroglial structures, neurotransmission, cell survival and nerve growth in the central nervous system. Furthermore this study identified many spinal proteins that have not previously been described in the literature and which may play an important role as either sensitive biomarkers of dysfunction or of recovery after Spinal Cord Injury. PMID:20029654

Gil-Dones, F.; Alonso-Orgaz, S.; Avila, G.; Martin-Rojas, T.; Moral-Darde, V.; Barroso, G.; Vivanco, F.; Scott-Taylor, J.; Barderas, M.G.

2009-01-01

177

Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury  

PubMed Central

Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modification of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve fibers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our findings indicate that hyperbaric oxygen therapy reduces apoptosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury. PMID:25657740

Wang, Yang; Zhang, Shuquan; Luo, Min; Li, Yajun

2014-01-01

178

Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury.  

PubMed

Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modification of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve fibers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our findings indicate that hyperbaric oxygen therapy reduces apoptosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury. PMID:25657740

Wang, Yang; Zhang, Shuquan; Luo, Min; Li, Yajun

2014-12-15

179

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

180

Lumbar spinal epidural angiolipoma  

Microsoft Academic Search

Spinal angiolipomas are rare benign tumours most commonly found in the thoracic spine. A case of an extradural lumbar angiolipoma in a 47-year-old female is described. She had a recent history of lower back pain accompanied by sciatica. Lumbar MRI revealed a dorsal epidural mass at the L2–L3 level. The patient underwent a bilateral laminectomy, in which the tumour was

Kimon Nanassis; Parmenion Tsitsopoulos; Dimitrios Marinopoulos; Apostolos Mintelis; Philippos Tsitsopoulos

2008-01-01

181

Aspergillus spinal epidural abscess  

SciTech Connect

A spinal epidural abscess developed in a renal transplant recipient; results of a serum radioimmunoassay for Aspergillus antigen were positive. Laminectomy disclosed an abscess of the L4-5 interspace and L-5 vertebral body that contained hyphal forms and from which Aspergillus species was cultured. Serum Aspergillus antigen radioimmunoassay may be a valuable, specific early diagnostic test when systemic aspergillosis is a consideration in an immunosuppressed host.

Byrd, B.F. III (Vanderbilt Univ. School of Medicine, Nashville, TN); Weiner, M.H.; McGee, Z.A.

1982-12-17

182

Spinal muscular atrophy  

Microsoft Academic Search

Summary  Spinal muscular atrophy (SMA) is a potentially devastating and lethal neuromuscular disease frequently manifesting in infancy\\u000a and childhood. The discovery of the underlying mutation in the survival of motor neurons 1 (SMN1) gene has accelerated preclinical research, leading to treatment targets and transgenic mouse models, but there is still\\u000a no effective treatment. The clinical severity is inversely related to the

Maryam Oskoui; Petra Kaufmann

2008-01-01

183

Bridging spinal cord injuries  

E-print Network

] describe a particular type of immature astrocyte that seems to provide a very successful bridging material. The idea of using embryonic CNS tissue and embryonic astrocytes for repairing the spinal cord has a long history. Axons grow in the embryonic CNS, so... at various mechanisms, including neutrali- zation of inhibitory molecules, promotion of plasticity, direct stimulation of axon regeneration, bridging and control of inflammation. A combination of two or more of these approaches will be needed to achieve...

2008-10-15

184

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

185

Spinal intrathecal actinomycosis: a case report  

Microsoft Academic Search

BACKGROUND Actinomycosis of the central nervous system is a rare disease that most frequently forms cerebral abscesses. In the present report, we describe an extremely rare case of spinal intrathecal actinomycosis.CASE PRESENTATIONA 33-year-old man presented with high fever followed by back pain and paraparesis. Magnetic resonance imaging (MRI) with gadolinium-diethylene-triamine penta-acetic acid (Gd-DTPA) enhancement (Gd-MRI) displayed an irregularly enhanced mass

Satoshi Ushikoshi; Izumi Koyanagi; Kazutoshi Hida; Yoshinobu Iwasaki; Hiroshi Abe

1998-01-01

186

Herniation of the spinal cord 38 years after childhood trauma  

Microsoft Academic Search

We report an unusual post-traumatic spinal cord herniation, which became symptomatic 38 years after the trauma. A 44-year-old man presented with a 2-year history of increasing impotence, neuropathic bladder dysfunction and dissociated sensory loss below the level of T6. At the age of 6 years he had a severe blunt spinal injury with transient paraparesis. MRI revealed right lateral and

H. Urbach; B. Kaden; U. Pechstein; L. Solymosi

1996-01-01

187

Electrodiagnostic challenges in the evaluation of lumbar spinal stenosis.  

PubMed

Taken together, the most common electromyographic finding in lumbar spinal stenosis is bilateral multilevel radiculopathy. The sensitivity of electrodiagnostic testing for radiculopathy is difficult to quantify because there is no criterion standard. Differentiating peripheral neuropathy and lumbar spinal stenosis on electromyography and routine nerve-conduction studies can be clinically challenging, especially when the two entities may be present simultaneously in older patients. PMID:12622482

Plastaras, Christopher T

2003-02-01

188

Spinal tanycytic ependymoma with hematomyelia--case report--.  

PubMed

A 58-year-old man presented with an extremely rare case of "pure type" spinal tanycytic ependymoma associated with hematomyelia manifesting as sensory disturbance of the bilateral hands and weakness of the right arm. Magnetic resonance imaging demonstrated a tumor in the spinal cord from C-2 to C-4 levels. The soft gelatinous tumor was subtotally resected and the adjacent chronic liquid hematoma was aspirated. The immunohistochemical and ultrastructural findings indicated a diagnosis of tanycytic ependymoma. PMID:15782011

Sato, Kazufumi; Kubota, Toshihiko; Ishida, Masaki; Handa, Yuji

2005-03-01

189

Quantifying the Nonlinear, Anisotropic Material Response of Spinal Ligaments  

NASA Astrophysics Data System (ADS)

Spinal ligaments may be a significant source of chronic back pain, yet they are often disregarded by the clinical community due to a lack of information with regards to their material response, and innervation characteristics. The purpose of this dissertation was to characterize the material response of spinal ligaments and to review their innervation characteristics. Review of relevant literature revealed that all of the major spinal ligaments are innervated. They cause painful sensations when irritated and provide reflexive control of the deep spinal musculature. As such, including the neurologic implications of iatrogenic ligament damage in the evaluation of surgical procedures aimed at relieving back pain will likely result in more effective long-term solutions. The material response of spinal ligaments has not previously been fully quantified due to limitations associated with standard soft tissue testing techniques. The present work presents and validates a novel testing methodology capable of overcoming these limitations. In particular, the anisotropic, inhomogeneous material constitutive properties of the human supraspinous ligament are quantified and methods for determining the response of the other spinal ligaments are presented. In addition, a method for determining the anisotropic, inhomogeneous pre-strain distribution of the spinal ligaments is presented. The multi-axial pre-strain distributions of the human anterior longitudinal ligament, ligamentum flavum and supraspinous ligament were determined using this methodology. Results from this work clearly demonstrate that spinal ligaments are not uniaxial structures, and that finite element models which account for pre-strain and incorporate ligament's complex material properties may provide increased fidelity to the in vivo condition.

Robertson, Daniel J.

190

Estrogen receptor-like immunoreactivity in the medullary and spinal dorsal horn of the female rat  

Microsoft Academic Search

Using an immunohistochemical technique, we demonstrate that large numbers of neurons in the laminar spinal trigeminal nucleus and spinal gray matter of the female rat express estrogen receptors (ER). Densely packed ER-immunoreactive neurons were present in lamina II, but labeled neurons were also present in lamina I, the neck of the dorsal horn, and in lamina X. Labeling was present

Åsa Amandusson; Ola Hermanson; Anders Blomqvist

1995-01-01

191

Computed Tomography Fluoroscopic-guided Percutaneous Spinal Interventions in the Management of Spinal Pain  

Microsoft Academic Search

Local back pain and radiculopathy can be debilitating for sufferers of these conditions. There are a multitude of treatment modalities, ranging from conservative approaches such as bed rest, physical therapy and chiropractic manipulation, to more invasive options such as percutane- ous spinal intervention (PSI) and surgery. We present here the techniques employed in the use of minimally invasive, image-guided percutaneous

Lawrence HH Quek; Uei Pu; Gim Chuah Chu

2009-01-01

192

NORADRENERGIC INNERVATION OF THE RAT SPINAL CORD CAUDAL TO A COMPLETE SPINAL CORD TRANSECTION: EFFECTS OF OLFACTORY ENSHEATHING GLIA  

PubMed Central

Transplantation of olfactory bulb-derived olfactory ensheathing glia (OEG) combined with step training improves hindlimb locomotion in adult rats with a complete spinal cord transection. Spinal cord injury studies use the presence of noradrenergic (NA) axons caudal to the injury site as evidence of axonal regeneration and we previously found more NA axons just caudal to the transection in OEG- than media-injected spinal rats. We therefore hypothesized that OEG transplantation promotes descending coeruleospinal regeneration that contributes to the recovery of hindlimb locomotion. Now we report that NA axons are present throughout the caudal stump of both media- and OEG-injected spinal rats and they enter the spinal cord from the periphery via dorsal and ventral roots and along large penetrating blood vessels. These results indicate that the presence of NA fibers in the caudal spinal cord is not a reliable indicator of coeruleospinal regeneration. We then asked if NA axons appose cholinergic neurons associated with motor functions, i.e., central canal cluster and partition cells (active during fictive locomotion) and somatic motor neurons (SMNs). We found more NA varicosities adjacent to central canal cluster cells, partition cells, and SMNs in the lumbar enlargement of OEG- than media-injected rats. As non-synaptic release of NA is common in the spinal cord, more associations between NA varicosities and motor-associated cholinergic neurons in the lumbar spinal cord may contribute to the improved treadmill stepping observed in OEG-injected spinal rats. This effect could be mediated through direct association with SMNs and/or indirectly via cholinergic interneurons. PMID:20025875

Takeoka, Aya; Kubasak, Marc D.; Zhong, Hui; Kaplan, Jennifer; Roy, Roland R.; Phelps, Patricia E.

2010-01-01

193

The history of spinal biomechanics.  

PubMed

The history of spinal biomechanics has its origins in antiquity. The Edwin Smith surgical papyrus, an Egyptian document written in the 17th century BC, described the difference between cervical sprain, fracture, and fracture-dislocation. By the time of Hippocrates (4th century BC), physical means such as traction or local pressure were being used to correct spinal deformities but the treatments were based on only a rudimentary knowledge of spinal biomechanics. The Renaissance produced the first serious attempts at understanding spinal biomechanics. Leonardo da Vinci (1452-1519) accurately described the anatomy of the spine and was perhaps the first to investigate spinal stability. The first comprehensive treatise on biomechanics, De Motu Animalium, was published by Giovanni Borelli in 1680, and it contained the first analysis of weight bearing by the spine. In this regard, Borelli can be considered the "Father of Spinal Biomechanics." By the end of the 19th century, the basic biomechanical concepts of spinal alignment and immobilization were well entrenched as therapies for spinal cord injury. Further anatomic delineation of spinal stability was sparked by the anatomic analyses of judicial hangings by Wood-Jones in 1913. By the 1960s, a two-column model of the spine was proposed by Holdsworth. The modern concept of Denis' three-column model of the spine is supported by more sophisticated testing of cadaver spines in modern biomechanical laboratories. The modern explosion of spinal instrumentation stems from a deeper understanding of the load-bearing structures of the spinal column. PMID:8880756

Sanan, A; Rengachary, S S

1996-10-01

194

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

195

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

Microsoft Academic Search

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

Subramanian Vaidyanathan; Bakul M Soni; Paul Mansour; Peter L Hughes; Gurpreet Singh; Tun Oo

2009-01-01

196

Spinal amino acid release and repeated withdrawal in spinal morphine tolerant rats  

PubMed Central

We used spinal microdialysis in awake rats to investigate whether the repeated withdrawal with naloxone during continuous spinal infusion of morphine would lead to a progressively greater spinal glutamate release and a more pronounced intrathecal tolerance. Rats received lumbar intrathecal (IT) infusion of morphine (IT-M: 20 nmol ?l?1 h?1) or saline (IT-S: 1 ?l h?1) continuously for 3 days. Both groups were further subdivided to receive intraperitoneal (i.p.) injection of naloxone (IP-N: 0.6 mg kg?1) or saline (IP-S: 3 ml kg?1) every 24 h after the beginning of IT infusion. Daily thermal escape latencies, withdrawal signs, the resting basal release of spinal amino acids before IP injection and the release immediately after the injection (evoked) were measured. Rats receiving IT morphine showed a maximum increase in thermal escape latency on day 1, after which this value declined, with the fastest decline observed in IT morphine+IP naloxone group. On day 1, no significant difference was observed among groups in the resting basal release of amino acids. Rats in IT morphine+i.p. naloxone group displayed a progressive increase in this value. The release was not significantly altered in other groups. For the IT-M+IP-N group, basal resting dialysate concentrations of Glu, Asp and Tau rose steadily over the 3-day infusion interval. No change in basal resting release was noted for any other treatment. Evoked release (after i.p. naloxone) in IT-M animals displayed a progressive increase over the three repeated exposures. Evoked release did not change significantly in other treatment groups. The degree of precipitated withdrawal significantly correlated with the increase in glutamate acutely evoked by i.p. injection. The present results show that periodic transient withdrawal of spinal opiate agonist activity leads to a progressive increase in glutamate outflow and withdrawal signs, in a manner consistent with an enhanced development of spinal tolerance. PMID:12598423

Ibuki, Takae; Marsala, Martin; Masuyama, Takashi; Yaksh, Tony L

2003-01-01

197

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

198

Isolated spinal artery aneurysm: a rare culprit of subarachnoid haemorrhage.  

PubMed

Isolated spinal artery aneurysm is a rare lesion which could be accountable for spontaneous spinal subarachnoid haemorrhage. We describe the case of a 74-year-old man presenting with sudden onset of chest pain radiating to the neck and back, with subsequent headache and confusion. Initial computed tomography aortogram revealed incidental finding of subtle acute spinal subarachnoid haemorrhage. A set of computed tomography scans of the brain showed further acute intracranial subarachnoid haemorrhage with posterior predominance, small amount of intraventricular haemorrhage, and absence of intracranial vascular lesions. Subsequent magnetic resonance imaging demonstrated a thrombosed intradural spinal aneurysm with surrounding sentinel clot, which was trapped and excised during surgical exploration. High level of clinical alertness is required in order not to miss this rare but detrimental entity. Its relevant aetiopathological features and implications for clinical management are discussed. PMID:25904568

Sung, T Ht; Leung, W Kw; Lai, B Mh; Khoo, J Ls

2015-04-01

199

Spinal Cord Injury Prevention Tips  

MedlinePLUS

Spinal Cord Injury Prevention Tips Preventing SCI Biking prevention tips While many cycling injuries are head injuries, the proper ... NeurosurgeryToday.org Every year, an estimated 11,000 spinal cord injury (SCI) accidents occur in the United States. Motor ...

200

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

201

Hemorrhagic onset of spinal angiolipoma.  

PubMed

Spinal angiolipomas are rare benign tumors that generally induce slow progressive cord compression. Here, the authors describe a case of sudden-onset palsy of the lower extremities caused by hemorrhagic spinal angiolipoma. An emergent laminectomy was performed to achieve total lesion removal. Follow-up examinations indicated neurological improvement and the absence of recurrence. PMID:25303620

da Costa, Marcos Devanir Silva; Paz, Daniel de Araujo; Rodrigues, Thiago Pereira; Gandolfi, Ana Camila de Castro; Lamis, Fabricio Correa; Stavale, João Norberto; Suriano, Italo Capraro; Cetl, Luiz Daniel Marques Neves; Cavalheiro, Sergio

2014-12-01

202

Intraspinal Lipomas Without Associated Spinal Dysraphism  

PubMed Central

Introduction: The aim of this study was to report surgical strategies and clinical outcomes for thoraco-lumbar intradural lipomas. Intraspinal lipomas are rare congenital histologically benign neoplasms, which account for less than 1% of all spinal cord tumors. These tumors are most frequently found in the lumbosacral area as components of a dysraphic state, however, intramedullary lipomas are not associated with spina bifida or cutaneous malformations and have only been described as isolated cases among spinal lipomas, where the thoracolumbar region is rarely affected. Case Presentation: Three patients with thoracolumbar intradural lipomas were admitted to our clinic at different points of time. Partial resections and debulking of the tumors were achieved with the guidance of an operating microscope. We performed laminectomies or laminoplasties, for tumor resections. Discussion: Postoperatively, the patients demonstrated significant clinical improvements. In this manuscript we presented our surgical experiences for intraspinal lipomas. PMID:25031846

Arslan, Erhan; Kuzeyli, Kayhan; Acar Arslan, Elif

2014-01-01

203

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

204

Spinal cord avulsion in the pediatric population: case study and review.  

PubMed

Spinal cord injury without radiographic abnormality (SCIWORA) is a rare phenomenon, but with advances in imaging and improvements in magnetic resonance imaging more cases are being identified. Even more uncommon is the finding of spinal cord avulsion as a type of SCIWORA with only single case reports in the literature. We present the case reports of 2 patients both experiencing spinal cord avulsion as a type of SCIWORA, secondary to improper lap-belt restraint during a motor vehicle accident. PMID:24084611

Phillips, Blake C; Pinckard, Heather; Pownall, Ambre'; Ocal, Eylem

2013-10-01

205

Expression patterns of erythropoietin and its receptor in the developing spinal cord and dorsal root ganglia  

Microsoft Academic Search

Recombinant human erythropoietin (EPO) is neuroprotective in animal models of adult spinal cord injury, and reduces apoptosis\\u000a in adult dorsal root ganglia after spinal nerve crush. The present work demonstrates that spinal cord and dorsal root ganglia\\u000a share dynamic expression patterns of EPO and its receptor (EPOR) during development. C57Bl mice from embryonic days (E) 8\\u000a (E8) to E19 were

Wolfgang Knabe; Anna-Leena Sirén; Hannelore Ehrenreich; Hans-Jürg Kuhn

2005-01-01

206

Calcium handling proteins in isolated spinal motoneurons  

Microsoft Academic Search

Amyotrophic lateral sclerosis is characterized by motoneuron degeneration, in which glutamate-induced cell death is thought to play a pathogenic role. This excitotoxic process is mediated by cytosolic Ca2+ overload. The glutamatergic ionotropic channel molecules, which constitute a major route of Ca2+ entry, were present on cultured spinal motoneurons. Using ratio RT-PCR, the relative presence in isolated motoneurons of the GluR

Ludo Van Den Bosch; Kristof Verhoeven; Humbert De Smedt; Frank Wuytack; Ludwig Missiaen; Wim Robberecht

1999-01-01

207

[Closed spinal dysraphism].  

PubMed

This retrospective review included 133 patients with one or several of the following defects: diastematomyelia, neurenteric cyst, dermal sinus or cyst, meningeal malformation, sacral agenesis, tethering of the spinal cord, and lumbosacral lipoma. Physical evaluation readily identified most lumbosacral lipomas, as well as most cases of diastematomyelia since hypertrichosis over the defect was common. Some patients developed life-threatening clinical manifestations, e.g., meningitis due to a dermal sinus. On the basis of this retrospective review and a review of the literature, the clinical and therapeutic aspects of each defect are discussed. PMID:8323194

Bollini, G; Cottalorda, J; Jouve, J L; Labriet, C; Choux, M

1993-04-01

208

Pediatric Spinal Cord Tumors and Masses  

PubMed Central

Background/Objective: Spinal cord tumors are a relatively rare diagnosis, accounting for 1% to 10% of all pediatric central nervous system tumors. Understanding the etiology and clinical outcomes of these tumors is therefore very important. This study presents detailed information regarding clinical presentation, histological findings, outcomes, functional assessment, and management of a series of patients with this diagnosis. Method: Retrospective, descriptive study. Subjects: Thirty-five children with a final diagnosis of spinal cord tumor or mass, excluding dysraphism. Results: Neurodevelopmental tumors (dermoid tumors, epidermoid tumors, and teratomas) were the most common tumor type (31%), followed by astrocytomas (29%) and neuroblastomas (14%). Other types included schwannomas, meningiomas, giant cell tumors, extradural cystic masses, leukemic-related masses, and masses related to neurofibromatosis. Mean age at diagnosis was 6.6 years (SD = 5.5 y) and did not vary significantly by tumor type except for children with neuroblastoma (mean = 0.4 y, SD = 0.5 y). More boys (57%) were identified in the series than girls (43%); however, there was no association between tumor type and sex. Presenting complaints of pain were noted in 57% and were localized to the back, neck, or extremities. Extremity weakness was reported as an initial presenting symptom in 46%. Three children had scoliosis as a presenting issue and 14 had gait abnormalities. Regardless of treatment modality, mobility was retained in 83% of children with or without gait aids. Neurogenic bowel and/or bladder were present in 23% of the population. Conclusions: This study corroborates other studies indicating that intramedullary tumors are the predominant form of pediatric spinal cord tumor. This population, however, presented with an unusually large number of developmental tumors, contrary to several published studies. The disparity may be the result of this institution acting as a regional referral center, thus increasing the number of this type of patient. The population is too small to make any other conjecture. The predominance of astrocytomas and neuroblastomas among those patients with poor outcomes and the prevalence of developmental tumors suggest the need for broader investigation. Although, in general, spinal cord tumors are relatively rare, this preliminary study supports the need to further evaluate associations between tumor type, presenting symptoms, treatment, and functional outcome in children with spinal cord tumors. PMID:17874681

Wilson, Pamela E; Oleszek, Joyce L; Clayton, Gerald H

2007-01-01

209

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

210

Termination of vestibulospinal fibers arising from the spinal vestibular nucleus in the mouse spinal cord.  

PubMed

The present study investigated the vestibulospinal system which originates from the spinal vestibular nucleus (SpVe) with both retrograde and anterograde tracer injections. We found that fluoro-gold (FG) labeled neurons were found bilaterally with a contralateral predominance after FG injections into the upper lumbar cord. Anterogradely labeled fibers from the rostral SpVe traveled in the medial part of the ventral funiculus ipsilaterally and the dorsolateral funiculus bilaterally in the cervical cord. They mainly terminated in laminae 5-8, and 10 of the ipsilateral spinal cord. The contralateral side had fewer fibers and they were found in laminae 6-8, and 10. In the thoracic cord, fibers were also found to terminate in bilateral intermediolateral columns. In the lumbar and lower cord, fibers were mainly found in the dorsolateral funiculus bilaterally and they terminated predominantly in laminae 3-7 contralaterally. Anterogradely labeled fibers from the caudal SpVe did not travel in the medial part of the ventral funiculus but in the dorsolateral funiculus bilaterally. They mainly terminated in laminae 3-8 and 10 contralaterally. The present study is the first to describe the termination of vestibulospinal fibers arising from the SpVe in the spinal cord. It will lay the anatomical foundation for those who investigate the physiological role of vestibulospinal fibers and potentially target these fibers during rehabilitation after stroke, spinal cord injury, or vestibular organ injury. PMID:25791229

Liang, H; Bácskai, T; Paxinos, G

2015-05-21

211

Organotypic Spinal Cord Slice Culture to Study Neural Stem/Progenitor Cell Microenvironment in the Injured Spinal Cord  

E-print Network

The molecular microenvironment of the injured spinal cord does not support survival and differentiation of either grafted or endogenous NSCs, restricting the effectiveness of the NSC-based cell replacement strategy. Studying the biology of NSCs in in vivo usually requires a considerable amount of time and cost, and the complexity of the in vivo system makes it difficult to identify individual environmental factors. The present study sought to establish the organotypic spinal cord slice culture that closely mimics the in vivo environment. The cultured spinal cord slices preserved the cytoarchitecture consisting of neurons in the gray matter and interspersed glial cells. The majority of focally applied exogenous NSCs survived up to 4 weeks. Pre-exposure of the cultured slices to a hypoxic chamber markedly reduced the survival of seeded NSCs on the slices. Differentiation into mature neurons was severely limited in this co-culture system. Endogenous neural progenitor cells were marked by BrdU incorporation, and applying an inflammatory cytokine IL-1? significantly increased the extent of endogenous neural progenitors with the oligodendrocytic lineage. The present study shows that the organotypic spinal cord slice culture can be properly utilized to study molecular factors from the post-injury microenvironment affecting NSCs in the injured spinal cord. Key words: spinal cord injury, organotypic slice culture, neural stem cells, hypoxia, inflammatory cytokine

212

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

213

Spinal cord injury in the rat  

Microsoft Academic Search

Only limited therapeutic measures are currently available for the treatment of spinal cord injury. This review describes the pathologic mechanisms of trauma-induced spinal cord injury in rats, which will contribute to new understanding of the pathologic process leading to spinal cord injury and to further development of new therapeutic strategies. Spinal cord injury induced by trauma is a consequence of

Yuji Taoka; Kenji Okajima

1998-01-01

214

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

215

Chronic inflammatory demyelinating polyradiculoneuropathy: two cases with cervical spinal cord compression.  

PubMed

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a peripheral nerve disorder probably due to an immunological disturb. It evolves either in a steadily progressive or in a relapsing and fluctuating course. Weakness is mainly in the lower limbs proximally and distally. The electromyography is demyelinating. The cerebral spinal fluid protein is most of times elevated. Sometimes enlarged nerves are found. There are few cases described with spinal cord compression due to hypertrophic spinal nerve roots. Two patients (females, 66 and 67 years old) with diagnosis of a long standing CIDP are described. In the first one, the evolution was characterized by remission and relapsing course. The second patient had a chronic and progressive course. These patients presented after a long evolution a cervical spinal cord compression syndrome due to hypertrophic cervical roots. Neurologists must be aware of the possibility of development of spinal cord compression by enlarged spinal roots in patients with a long standing CIDP. PMID:16172720

Freitas, Marcos R G de; Nascimento, Osvaldo J M; Soares, Cristiane N; Brito, Adriana Rocha; Domingues, Romeu Cortes

2005-09-01

216

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

PubMed Central

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

2012-01-01

217

The rocky road to translation in spinal cord repair.  

PubMed

Over the past 2 decades, the biological understanding of the mechanisms underlying structural and functional repair of the injured central nervous system has strongly increased. This has resulted in the development of multiple experimental treatment strategies with the collective aim of enhancing and surpassing the limited spontaneous recovery occurring in animal models and ultimately humans suffering from spinal cord or brain injuries. Several of these experimental treatments have revealed beneficial effects in animal models of spinal cord injury. With the exception of neurorehabilitative therapies, however, therapeutic interventions that enhance recovery are currently absent within the clinical realm of spinal cord injury. The present review surveys the prospects and challenges in experimental and clinical spinal cord repair. Major shortcomings in experimental research center on the difficulty of closely modeling human traumatic spinal cord injury in animals, the small number of investigations done on cervical spinal injury and tetraplegia, and the differences in lesion models, species, and functional outcome parameters used between laboratories. The main challenges in the clinical field of spinal cord repair are associated with the standardization and sensitivity of functional outcome measures, the definition of the inclusion/exclusion criteria for patient recruitment in trials, and the accuracy and reliability of an early diagnosis to predict subsequent neurological outcome. Research and clinical networks were recently created with the goal of optimizing animal studies and human trials. Promising clinical trials are currently in progress. The time has come to translate the biologic-mechanistic knowledge from basic science into efficacious treatments able to improve the conditions of humans suffering from spinal cord injury. PMID:23109144

Filli, Linard; Schwab, Martin E

2012-10-01

218

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, Björn; Dierks, Thomas; Schachner, Melitta

2013-01-01

219

Neural plasticity after spinal cord injury?  

PubMed Central

Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.

Liu, Jian; Yang, Xiaoyu; Jiang, Lianying; Wang, Chunxin; Yang, Maoguang

2012-01-01

220

Spinal pleomorphic xanthoastrocytoma companied with periventricular tumor  

PubMed Central

Pleomorphic xanthoastrocytoma (PXA) is a low grade tumor that occurs in supratentorial area of children and young adult. In the previous reports, PXA of spinal cord or multicentre was extremely rare. A 60-year-old patient of spinal PXA and periventricular tumor presented with waist pain and weakness of double legs for one month. Neuroimaging showed that a lesion at the level of L2-L3 and periventricular tumor. Postoperative microscopy indicated that WHO grade II PXA. Photomicrograph of the lesion showed spindle cells, marked nuclear and cytoplasmic pleomorphism, with foamy cytoplasm. Immunohistochemical staining showed that GFAP and S-100 were positive. This is a rare case of synchronous multicentric PXA. Physicians should be realized multicentric dissemination by meninges or cerebrospinal fluid in PXA patients. It is important to describe the particular case in order to better understanding of clinical features. PMID:25755815

Zhao, Xintong; Jiang, Xiaochun; Wang, Xiangming

2015-01-01

221

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

222

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

223

The current state-of-the-art of spinal cord imaging: applications.  

PubMed

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small crosssectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research. PMID:23859923

Wheeler-Kingshott, C A; Stroman, P W; Schwab, J M; Bacon, M; Bosma, R; Brooks, J; Cadotte, D W; Carlstedt, T; Ciccarelli, O; Cohen-Adad, J; Curt, A; Evangelou, N; Fehlings, M G; Filippi, M; Kelley, B J; Kollias, S; Mackay, A; Porro, C A; Smith, S; Strittmatter, S M; Summers, P; Thompson, A J; Tracey, I

2014-01-01

224

The current state-of-the-art of spinal cord imaging: Applications  

PubMed Central

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small crosssectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of “critical mass” of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research. PMID:23859923

Wheeler-Kingshott, C.A.; Stroman, P.W.; Schwab, J.M.; Bacon, M.; Bosma, R.; Brooks, J.; Cadotte, D.W.; Carlstedt, T.; Ciccarelli, O.; Cohen-Adad, J.; Curt, A.; Evangelou, N.; Fehlings, M.G.; Filippi, M.; Kelley, B.J.; Kollias, S.; Mackay, A.; Porro, C.A.; Smith, S.; Strittmatter, S.M.; Summers, P.; Thompson, A.J.; Tracey, I.

2015-01-01

225

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; König, Matthias Alexander; Osterhoff, Georg; Wilzeck, Verena; Simmen, Hans-Peter; Jukema, Gerrolt Nico

2013-01-01

226

Intramedullary spinal cord cavernous malformations.  

PubMed

Although originally the subject of rare case reports, intramedullary spinal cord cavernous malformations (CMs) have recently surfaced in an increasing number of case series and natural history reports in the literature. The authors reviewed 27 publications with 352 patients to consolidate modern epidemiological, natural history, and clinical and surgical data to facilitate decision making when managing these challenging vascular malformations. The mean age at presentation was 42 years without a sex predilection. Thirty-eight percent of the cases were cervical, 57% thoracic, 4% lumbar, and 1% unspecified location. Nine percent of the patients had a family history of CNS CMs. Twenty-seven percent of the patients had an associated cranial CM. On presentation 63% of the patients had motor deficits, 65% had sensory deficits, 27% had pain, and 11% had bowel or bladder dysfunction. Presentation was acute in 30%, recurrent in 16%, and progressive in 54% of cases. An overall annual hemorrhage rate was calculated as 2.5% for 92 patients followed up for a total of 2571 patient-years. Across 24 reviewed surgical series, a 91% complete resection rate was found. Transient morbidity was seen in 36% of cases. Sixty-one percent of patients improved, 27% were unchanged, and 12% were worse at the long-term follow-up. Using this information, the authors review surgical nuances in treating these lesions and propose a management algorithm. PMID:20809755

Gross, Bradley A; Du, Rose; Popp, A John; Day, Arthur L

2010-09-01

227

Simulation in spinal diseases.  

PubMed

Simulation is frequent in spinal disease, resulting in problems for specialists like Orthopedic Surgeons, Neurosurgeons, Reumathologists, etc. Simulation requires demonstration of the intentional production of false or exaggerated symptoms following an external incentive. The clinician has difficulties in demonstrating these criteria, resulting in misdiagnosis of simulation or misinterpretation of the normal patient as a simulator, with the possibility of iatrogenic distress and litigation. We review simulation-related problems in spine, proposing a terminological, as well as a diagnostic strategy including clinical and complementary diagnosis, as a way to avoid misinterpretation and minimize the iatrogenic distress and liability Based on the clinical-Forensic author's expertise, the literature is analyzed and the terminology readdressed to develop new terms (inconsistences, incongruences, discrepancies and contradictions). Clinical semiology and complementary test are adapted to the new scenario. Diagnostic strategy relies on anamnesis, clinical and complementary tests, adapting them to a uniform terminology with clear meaning of signs and symptoms. PMID:24913963

Aso Escario, José; Martínez Quiñones, José Vicente; Aso Vizán, Alberto; Arregui Calvo, Ricardo; Bernal Lafuente, Marta; Alcázar Crevillén, Andrés

2014-01-01

228

MRI Features of Spinal Epidural Angiolipomas  

PubMed Central

Objective To describe the MRI findings in ten patients of spinal epidural angiolipoma for differentiated diagnosis presurgery. Materials and Methods Ten surgically proved cases of spinal epidural angiolipomas were retrospectively reviewed, and the lesion was classified according to the MR findings. Results Ten tumors were located in the superior (n = 4), middle (n = 2), or inferior (n = 4) thoracic level. The mass, with the spindle shape, was located in the posterior epidural space and extended parallel to the long axis of the spine. All lesions contained a fat and vascular element. The vascular content, correlating with the presence of hypointense regions on T1-weighted imaging (T1WI) and hyperintense signals on T2-weighted imaging, had marked enhancement. However, there were no flow void signs on MR images. All tumors were divided into two types based on the MR features. In type 1 (n = 3), the mass was predominantly composed of lipomatous tissue (> 50%) and contained only a few small angiomatous regions, which had a trabeculated or mottled appear. In type 2 (n = 7), the mass, however, was predominantly composed of vascular components (> 50%), which presented as large foci in the center of the mass. Conclusion Most spinal epidural angiolipomas exhibit hyperintensity on T1WI while the hypointense region on the noncontrast T1WI indicates to be vascular, which manifests an obvious enhancement with gadolinium administration. PMID:24043978

Hu, Su; Hu, Xiao-yun; Wang, Xi-ming; Dai, Hui; Fang, Xiang-ming; Cui, Lei

2013-01-01

229

Pacemaker neurons within newborn spinal pain circuits  

PubMed Central

Spontaneous activity driven by “pacemaker” neurons, defined by their intrinsic ability to generate rhythmic burst-firing, contributes to the development of sensory circuits in many regions of the immature CNS. However, it is unknown if pacemaker-like neurons are present within central pain pathways in the neonate. Here we provide evidence that a subpopulation of glutamatergic interneurons within lamina I of the rat spinal cord exhibits oscillatory burst-firing during early life, which occurs independently of fast synaptic transmission. Pacemaker neurons were distinguished by a higher ratio of persistent, voltage-gated Na+ conductance to leak membrane conductance (gNa,P / gleak) compared to adjacent, non-bursting lamina I neurons. The activation of high-threshold (N-type and L-type) voltage-gated Ca2+ channels also facilitated rhythmic burst-firing by triggering intracellular Ca2+ signaling. Bursting neurons received direct projections from high-threshold sensory afferents, but transmitted nociceptive signals with poor fidelity while in the bursting mode. The observation that pacemaker neurons send axon collaterals throughout the neonatal spinal cord raises the possibility that intrinsic burst-firing could provide an endogenous drive to the developing sensorimotor networks which mediate spinal pain reflexes. PMID:21677184

Li, Jie; Baccei, Mark L.

2011-01-01

230

Currarino syndrome and spinal dysraphism.  

PubMed

Currarino syndrome is a rare constellation of congenital anomalies characterized by the triad of sacral dysgenesis, presacral mass, and anorectal malformation. It is frequently associated with other congenital anomalies, often including occult spinal dysraphism. Mutations in the MNX1 gene are identified in the majority of cases. The authors report a rare case of Currarino syndrome in an infant with tethered cord syndrome and a dorsal lipomyelomeningocele continuous with a presacral intradural spinal lipoma, in addition to an imperforate anus and a scimitar sacrum. They review the literature to highlight patterns of occult spinal dysraphism in patients with Currarino syndrome and their relationship to tethered cord syndrome. Approximately 60% of the patients with Currarino syndrome reported in the literature have an occult spinal dysraphism. Published studies suggest that the risk of tethered cord syndrome may be higher among patients with a lipoma and lower among those with a teratoma or anterior meningocele. PMID:24745342

Kole, Matthew J; Fridley, Jared S; Jea, Andrew; Bollo, Robert J

2014-06-01

231

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 ...

232

Fictive motor activities in adult chronic spinal rats transplanted with embryonic brainstem neurons.  

PubMed

The present study was designed to examine the effects of an intraspinal transplantation of embryonic brainstem neurons on fictive motor patterns which can develop in hindlimb nerves of adult chronic spinal rats. Seventeen adult rats were spinalized at T8-9 level and, 8 days later, a suspension of embryonic cells obtained either from the raphe region (RR, n = 8) or from the locus coeruleus (LC, n = 9) was injected caudally (T12-13) to the cord transection. Eight control animals (control rats) were spinalized and injected with vehicle under the same conditions. One to three months later, the animals were decorticated and fictive motor patterns were recorded in representative hindlimb nerves. The data revealed that both control and grafted spinal rats could exhibit two distinctly different fictive motor patterns, one which could be associated with stepping and the other with hindlimb paw shaking. They further showed that following transplantation of embryonic RR or LC neurons the excitability of the spinal stepping generator was increased, whereas that of the spinal neural circuits which generate hindlimb paw shaking was not significantly affected. A histological analysis performed on the spinal cord segments below the transection revealed complete absence of serotonin and noradrenaline immunoreactivity in control spinal animals and, in both types of grafted rats, an extensive monoaminergic reinnervation with synaptic contacts between monoaminergic transplanted neurons and host interneurons and/or motoneurons. The possible mechanisms by which grafted monoaminergic neurons can influence the spinal motor networks are discussed. PMID:8542978

Yakovleff, A; Cabelguen, J M; Orsal, D; Gimenez y Ribotta, M; Rajaofetra, N; Drian, M J; Bussel, B; Privat, A

1995-01-01

233

Erythropoietin in spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a devastating condition for individual patients and costly for health care systems requiring significant\\u000a long-term expenditures. Cytokine erythropoietin (EPO) is a glycoprotein mediating cytoprotection in a variety of tissues,\\u000a including spinal cord, through activation of multiple signaling pathways. It has been reported that EPO exerts its beneficial\\u000a effects by apoptosis blockage, reduction of inflammation, and

Georgios K. Matis; Theodossios A. Birbilis

2009-01-01

234

Depletion of Hematogenous Macrophages Promotes Partial Hindlimb Recovery and Neuroanatomical Repair after Experimental Spinal Cord Injury  

Microsoft Academic Search

Traumatic injury to the spinal cord initiates a series of destructive cellular processes which accentuate tissue damage at and beyond the original site of trauma. The cellular inflammatory response has been implicated as one mechanism of secondary degeneration. Of the various leukocytes present in the spinal cord after injury, macrophages predominate. Through the release of chemicals and enzymes involved in

Phillip G. Popovich; Zhen Guan; Ping Wei; Inge Huitinga; Nico van Rooijen; Bradford T. Stokes

1999-01-01

235

Variation in the Weight of Spinal Cord in Different Age Group of Indian Human Foetuses  

E-print Network

the weight of foetal spinal cord is helpful in determining the age and sex of foetuses, which are of great medicolegal significance. The aim of present study is to obtain accurate measurements of weight of human foetal spinal cord in different age groups.

236

Spinal lymphoma and pulmonary filariasis in a pet domestic rabbit (Oryctolagus cuniculus domesticus).  

PubMed

Spinal lymphoma and concurrent pulmonary filariasis are reported in a pet rabbit. The rabbit presented for pelvic limb paralysis resulting from extradural spinal lymphoma, presumably rising from the body of the sixth lumbar vertebra. The neoplasm was subsequently immunophenotyped as a B-cell lymphoma. Pulmonary filariasis was an incidental finding at necropsy. PMID:19286509

Reed, Scott D; Shaw, Shannon; Evans, Dawn E

2009-03-01

237

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

238

Acute exacerbation of restless legs due to cervical spinal cord ischaemia  

PubMed Central

We present a 60-year-old male patient with an acute exacerbation of restless legs due to cervical spinal cord ischaemia. This case supports the hypothesis that interruption of spinal cord pathways are part of the aetiology of restless legs syndrome. PMID:23345489

Zwartbol, Rachel Theodora; Jellema, Korne; Boiten, Jelis; Rijsman, Roselyne

2013-01-01

239

AN AUTOMATIC SEGMENTATION METHOD OF THE SPINAL CANAL FROM CLINICAL MR IMAGES BASED ON AN ATTENTION MODEL AND AN ACTIVE CONTOUR MODEL  

E-print Network

AN AUTOMATIC SEGMENTATION METHOD OF THE SPINAL CANAL FROM CLINICAL MR IMAGES BASED ON AN ATTENTION present an unsupervised segmentation method that automatically extracts the spinal canal in the sagittal, as compared to the Dice's similarity index of 0.90 between two observers. Index Terms-- spinal canal

Chaudhary, Vipin

240

[Reaction of spinal epidural venous plexuses of the spinal canal in low back spinal discopathy].  

PubMed

Clinical ultrasonic investigations have shown dependence of blood-stream in spinal epidural venous plexuses on the character of low back spinal diskopathy. The leading starting factor of epiduritis is a disk protrusion or large size hernia. Epiduritis in disscopathy can run a chronic course, become a cause of (or complicate) development of vertebral neurological reflex or compression syndromes. One of acceptable diagnostic methods for local epiduritis is an ultrasonic technique which is a valuable adjunct to clinical studies. PMID:12669555

Gongal'ski?, V V; Prokopovich, E V

2002-01-01

241

Phlyctenular conjunctivitis: a rare association with spinal intramedullary tuberculoma.  

PubMed

We present a case of a 33-year-old woman who presented with phlyctenular conjunctivitis while on treatment for spinal intramedullary tuberculosis. She was treated with topical steroids along with continuation of antitubercular therapy, and improved on this treatment. PMID:24642174

Bhandari, Aveg; Bhandari, Heena; Shukla, Rakesh; Giri, Prithvi

2014-01-01

242

Spinal muscular atrophy  

PubMed Central

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by degeneration of alpha motor neurons in the spinal cord, resulting in progressive proximal muscle weakness and paralysis. Estimated incidence is 1 in 6,000 to 1 in 10,000 live births and carrier frequency of 1/40-1/60. This disease is characterized by generalized muscle weakness and atrophy predominating in proximal limb muscles, and phenotype is classified into four grades of severity (SMA I, SMAII, SMAIII, SMA IV) based on age of onset and motor function achieved. This disease is caused by homozygous mutations of the survival motor neuron 1 (SMN1) gene, and the diagnostic test demonstrates in most patients the homozygous deletion of the SMN1 gene, generally showing the absence of SMN1 exon 7. The test achieves up to 95% sensitivity and nearly 100% specificity. Differential diagnosis should be considered with other neuromuscular disorders which are not associated with increased CK manifesting as infantile hypotonia or as limb girdle weakness starting later in life. Considering the high carrier frequency, carrier testing is requested by siblings of patients or of parents of SMA children and are aimed at gaining information that may help with reproductive planning. Individuals at risk should be tested first and, in case of testing positive, the partner should be then analyzed. It is recommended that in case of a request on carrier testing on siblings of an affected SMA infant, a detailed neurological examination should be done and consideration given doing the direct test to exclude SMA. Prenatal diagnosis should be offered to couples who have previously had a child affected with SMA (recurrence risk 25%). The role of follow-up coordination has to be managed by an expert in neuromuscular disorders and in SMA who is able to plan a multidisciplinary intervention that includes pulmonary, gastroenterology/nutrition, and orthopedic care. Prognosis depends on the phenotypic severity going from high mortality within the first year for SMA type 1 to no mortality for the chronic and later onset forms. PMID:22047105

2011-01-01

243

Spinal cord repair in MS  

PubMed Central

Objective: To investigate the mechanisms of spinal cord repair and their relative contribution to clinical recovery in patients with multiple sclerosis (MS) after a cervical cord relapse, using spinal cord 1H-magnetic resonance spectroscopy (MRS) and volumetric imaging. Methods: Fourteen patients with MS and 13 controls underwent spinal cord imaging at baseline and at 1, 3, and 6 months. N-acetyl-aspartate (NAA) concentration, which reflects axonal count and metabolism in mitochondria, and the cord cross-sectional area, which indicates axonal count, were measured in the affected cervical region. Mixed effect linear regression models investigated the temporal evolution of these measures and their association with clinical changes. Ordinal logistic regressions identified predictors of recovery. Results: Patients who recovered showed a sustained increase in NAA after 1 month. In the whole patient group, a greater increase of NAA after 1 month was associated with greater recovery. Patients showed a significant decline in cord area during follow-up, which did not correlate with clinical changes. A worse recovery was predicted by a longer disease duration at study entry. Conclusions: The partial recovery of N-acetyl-aspartate levels after the acute event, which is concurrent with a decline in cord cross-sectional area, may be driven by increased axonal mitochondrial metabolism. This possible repair mechanism is associated with clinical recovery, and is less efficient in patients with longer disease duration. These insights into the mechanisms of spinal cord repair highlight the need to extend spinal cord magnetic resonance spectroscopy to other spinal cord disorders, and explore therapies that enhance recovery by modulating mitochondrial activity. GLOSSARY CI = confidence interval; EDSS = Expanded Disability Status Scale; FOV = field of view; MR = magnetic resonance; MRS = magnetic resonance spectroscopy; MS = multiple sclerosis; NAA = N-acetyl-aspartate; SC = spinal cord; TE = echo time; TI = inversion time; TR = repetition time. PMID:20107138

Ciccarelli, O.; Altmann, D. R.; McLean, M. A.; Wheeler-Kingshott, C. A.; Wimpey, K.; Miller, D. H.; Thompson, A. J.

2010-01-01

244

Synchronous and asynchronous electrically evoked motor activities during wind-up stimulation are differentially modulated following an acute spinal transection.  

PubMed

In this study, we used a novel technique to study reflex wind-up when the spinal cord is intact and following an acute spinal transection. Specifically, we evaluated reflex responses evoked by a series of 10 electrical pulses to the tibial or superficial peroneal nerves in 9 decerebrate adult cats, before and after an acute spinal transection. Electromyograms were recorded in four hindlimb muscles (lateral gastrocnemius, tibialis anterior, semitendinosus, and sartorius) to evaluate reflex amplitude, duration, and the temporal summation of reflex responses, so-called wind-up. We identified two distinct reflex responses evoked by electrical stimulation of the tibial or superficial peroneal nerves on the basis of their pattern of change following acute spinal transection, a short-latency (?10 ms) compound action potential (CAP) that was followed by a burst of sustained activity (SA). Wind-up of CAP and SA amplitudes was clearly present when the spinal cord was intact but was drastically reduced after acute spinalization in some muscles. Moreover, CAP and SA reflex responses were differentially modified by the acute spinalization. When the effects of acute spinal transection were significant, CAP responses were increased after acute spinalization, whereas SA responses were reduced, suggesting that the two signals are regulated by different neuronal mechanisms. The present results provide the first assessment of reflex wind-up before and after an acute spinal transection in the same animals and indicate that different reflex components must be considered separately when evaluating changes in neuronal excitability following SCI. PMID:22993264

Frigon, Alain; Hurteau, Marie-France; Johnson, Michael D; Heckman, C J; Telonio, Alessandro; Thibaudier, Yann

2012-12-01

245

Spinal Extradural Arachnoid Cyst  

PubMed Central

Spinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. The etiology remains still unclear. We experienced 2 cases of SEACs and reviewed the cases and previous literatures. A 59-year-old man complained of both leg radiating pain and paresthesia for 4 years. His MRI showed an extradural cyst from T12 to L3 and we performed cyst fenestration and repaired the dural defect with tailored laminectomy. Another 51-year-old female patient visited our clinical with left buttock pain and paresthesia for 3 years. A large extradural cyst was found at T1-L2 level on MRI and a communication between the cyst and subarachnoid space was illustrated by CT-myelography. We performed cyst fenestration with primary repair of dural defect. Both patients' symptoms gradually subsided and follow up images taken 1-2 months postoperatively showed nearly disappeared cysts. There has been no documented recurrence in these two cases so far. Tailored laminotomy with cyst fenestration can be a safe and effective alternative choice in treating SEACs compared to traditional complete resection of cyst wall with multi-level laminectomy. PMID:24294463

Choi, Seung Won; Seong, Han Yu

2013-01-01

246

Types of SMA (Spinal Muscular Atrophy)  

MedlinePLUS

... than the SMN1 gene. Spinal Muscular Atrophy Respiratory Distress (SMARD) SMARD is a very rare form of ... spinal cord. Babies with SMARD experience severe respiratory distress, and weakness in the arms and nearby muscles. ...

247

Ruptured Anterior Spinal Artery Aneurysm Associated with Coarctation of Aorta  

PubMed Central

Summary A 39-year-old man presented with acute headache and neck pain, followed by quadriparesis and quadriparesthesia, accompanied by urinary and bowel incontinence. Lumbar puncture showed subarachnoid haemorrhage. Angiogram via a right axillary approach revealed severe coarctation of the aorta, between the left common carotid artery and left subclavian artery. Multiple collateral circulation including an enlarged anterior spinal arterial axis bridging the stenosed arch provided collateral circulation to the abdominal aorta. A small lobulated aneurysm was seen at the radiculomedullary-anterior spinal artery junction from the right ascending cervical artery. This patient underwent successful surgical clipping of the aneurysm. Pathogenesis of the spinal arterial aneurysm associated with coarctation of the aorta is likely to result from the haemodynamic stress from collateral circulation through the anterior spinal axis rather than segmental arterial disease or angiodysplastic disease. Aneurysms of the spinal artery are rare but can be unusually found in association with SCAVMs, coarctation of aorta, Klippel-Trenaunay syndrome or more rarely with aortic arch interruption. PMID:20594486

Jiarakongmun, P.; Chewit, P.; Pongpech, S.

2002-01-01

248

BOLD responses to itch in the human spinal cord.  

PubMed

Itch is an independent sensory modality and a very common symptom with manifold causes. However, the neuronal representation of itch perception in the central nervous system is not entirely understood and there is hardly any knowledge about neuronal correlates of itch in the human spinal cord. In the present study we aimed to identify itch-related neural activity in the cervical spinal cord in healthy volunteers employing high-resolution functional magnetic resonance imaging (fMRI). We studied histamine-induced itch on the radial forearm and modulated itch intensity by non-noxious cooling. To control for effects of thermal stimulation (i.e., cooling), volunteers also underwent an identical session without histamine. We studied histamine-induced itch on the radial forearm, by using a block design with alternating blocks of non-noxious cooling separated by blocks of skin temperature. Non-noxious cooling of histamine-treated skin compared to cooling of non-treated skin led to a significant increase in itch perception. On the neural level, itch was paralleled by activation in the dorsal horn of the spinal cord at the transition between spinal segment C5 and C6, ipsilateral to the side of stimulation. These results suggest that itch-related neural activity can be assessed noninvasively in humans at the spinal cord. PMID:25497685

van de Sand, Missanga F; Sprenger, Christian; Büchel, Christian

2015-03-01

249

Innervation of sonic muscles in teleosts: occipital vs. spinal nerves.  

PubMed

The innervation of sonic muscles in teleosts has been categorized into three types: occipital nerve, spinal nerve, and a combination of occipital and spinal nerves. The innervation patterns of sonic muscles were examined (or re-examined) in seven sonic fish species (rockfish, pinecone fish, sweeper, tigerfish, piranha, dory, and pollack) that use the sonic muscles to vibrate the swimbladder. The peripheral nerves (occipital or spinal) were identified based on skeletal preparations. The sonic muscle innervation was of the occipital type in four species (rockfish, pinecone fish, sweeper, and tigerfish) and of the spinal type in three species (piranha, dory, and pollack); none of the seven species examined showed the combination type. Therefore, we hypothesized that innervation patterns could be divided simply into occipital and spinal types. Moreover, the present results revealed that previously reported innervation patterns are inaccurate for three species (tigerfish, piranha, and dory) re-examined in this study. Therefore, it is important to define the peripheral nerves precisely, by using skeletal preparations, in future investigations of sonic muscle innervation. PMID:17230021

Onuki, Atsushi; Somiya, Hiroaki

2007-01-01

250

Neuroprotection and its molecular mechanism following spinal cord injury?  

PubMed Central

Acute spinal cord injury initiates a complex cascade of molecular events termed ‘secondary injury’, which leads to progressive degeneration ranging from early neuronal apoptosis at the lesion site to delayed degeneration of intact white matter tracts, and, ultimately, expansion of the initial injury. These secondary injury processes include, but are not limited to, inflammation, free radical-induced cell death, glutamate excitotoxicity, phospholipase A2 activation, and induction of extrinsic and intrinsic apoptotic pathways, which are important targets in developing neuroprotective strategies for treatment of spinal cord injury. Recently, a number of studies have shown promising results on neuroprotection and recovery of function in rodent models of spinal cord injury using treatments that target secondary injury processes including inflammation, phospholipase A2 activation, and manipulation of the PTEN-Akt/mTOR signaling pathway. The present review outlines our ongoing research on the molecular mechanisms of neuroprotection in experimental spinal cord injury and briefly summarizes our earlier findings on the therapeutic potential of pharmacological treatments in spinal cord injury. PMID:25624837

Liu, Nai-Kui; Xu, Xiao-Ming

2012-01-01

251

Ultrasound-guided spinal fracture repositioning  

Microsoft Academic Search

.   The management of narrowing spinal fragments in the operative treatment of spinal fractures remains an open question, in\\u000a particular when the procedure is performed by a posterior approach. This article describes the use of intraoperative ultrasonography\\u000a during spinal surgery. From 1990 to 1997, 116 spinal fractures were treated operatively at our clinic. Stabilization of the\\u000a spine was achieved with

J. Degreif; K. Wenda

1998-01-01

252

Spinal axis irradiation with electrons: Measurements of attenuation by the spinal processes  

SciTech Connect

Electrons may be used beneficially for spinal axis irradiation in medulloblastoma children to avoid some of the long-term sequelae induced by megavoltage photons. However, the attenuation by the intervening bone ought to be considered. Three-dimensional computer treatment planning with inhomogeneity correction for electron beams is not yet generally available, and alternate methods are needed to evaluate the attenuation by the complex bony structure of the spine. Here, we present our experimental data showing the alteration in the electron isodoses due to the intervening spinous processes. Film dosimetric measurements were made in the vertebral columns obtained from autopsies of a goat, a dog, and a child. Our results show that electron beam therapy for the spinal axis is a viable option.

Muller-Runkel, R.; Vijayakumar, S.

1986-07-01

253

Natural Polyphenols and Spinal Cord Injury  

PubMed Central

Polyphenols have been shown to have some of the neuroprotective effects against neurodegenerative diseases. These effects are attributed to a variety of biological activities, including free radical scavenging/antioxidant and anti-inflammatory and anti-apoptotic activities. In this regard, many efforts have been made to study the effects of various well-known dietary polyphenols on spinal cord injury (SCI) and to explore the mechanisms behind the neuroprotective effects. The aim of this paper is to present the mechanisms of neuroprotection of natural polyphenols used in animal models of SCI. PMID:24842137

Khalatbary, Ali Reza

2014-01-01

254

[Spinal anaesthesia and Moya Moya disease].  

PubMed

Moya Moya is a rare disease of uncertain origin, characterised by stenosis of one or both of the internal carotid arteries and responsible of several neurological signs. We present the case of a boy with Moya Moya disease who was scheduled for an epiphisiodesis of the lateral malleola and had a spinal anaesthesia with hyperbaric bupivacaine 0.5% 10 mg without any perioperative complications. Any anaesthetic method could be used, provided special attention is given to avoid changes of capnea and blood pressure to preserve cerebral blood flow and palliate to cerebral flow steal. PMID:15158243

Jabbour, H; Jabbour, K; Ayoub, E N; Yazbeck, P; Antakly, M-C

2004-05-01

255

Classification of pain following spinal cord injury  

Microsoft Academic Search

Pain continues to be a significant management problem in people with spinal cord injuries. Despite this there is little consensus regarding the nature, terminology and definitions of the various types of pain that occur following spinal cord injury. This has led to large variations in the reported incidence and prevalence of pain following spinal cord injury. Treatment studies have been

P J Siddall; D A Taylor; M J Cousins

1997-01-01

256

Spinal Motor Control May 13 & 14, 2013  

E-print Network

"menage a trois" leading to spasticity after spinal cord injury Comments by Chair: Shawn Hochman, Emory and partial spinal cord injury in mammals Soheila Karimi, University of Manitoba (Pg 13) Reactivating endogenous mechanisms to optimize oligodendrocyte replacement and remyelination after spinal cord injury

Manitoba, University of

257

Evaluation of spinal cord injury animal models  

PubMed Central

Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies. PMID:25598784

Zhang, Ning; Fang, Marong; Chen, Haohao; Gou, Fangming; Ding, Mingxing

2014-01-01

258

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

259

Endovascular treatment of a spinal dural arteriovenous malformation (DAVF).  

PubMed

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine. The video can be found here: http://youtu.be/SDYNIGNQIW8 . PMID:24983729

Agarwal, Vijay; Zomorodi, Ali; Jabbour, Pascal; Chalouhi, Nohra; Tjoumakaris, Stavropoula; Babu, Ranjith; Back, Adam; Gonzalez, L Fernando

2014-07-01

260

No nonthermal effect observed under microwave irradiation of spinal cord  

SciTech Connect

The paper presents an in vivo experiment concerning cerebral evoked potentials in the presence and in the absence of microwaves irradiating the spinal cord. An electrical stimulus is applied on the peripheral nervous system of a rabbit while the impulse response (evoked potential) is measured by an electrode in the cortex. The spinal cord is irradiated at 4.2-GHz by an implanted micro-antenna. The purpose of the experiment is to distinguish between thermal and possible nonthermal effects. A statistical treatment of the recorded data shows that there is a microwave effect. Power deposition is calculated. The bioheat equation indicates that the microwave irradiation results in a temperature increase within the spinal cord. Nonthermal effects were not observed.

Teng, J.; Tournai, D.C. de; Duhamel, F.; Vander Vorst, A. [Microwaves UCL, Louvain-la-Neuve (Belgium)] [Microwaves UCL, Louvain-la-Neuve (Belgium)

1996-10-01

261

Spinal lobular capillary hemangioma with an intramedullary component.  

PubMed

Capillary hemangiomas are benign vascular neoplasms rarely involving the spinal cord, where their usual location is extramedullary. A 59-year-old man presented with a 7-month history of progressive numbness which began in the left lower extremity and progressed across the lower back, right flank, trunk and into the right lower extremity with associated pressure and pain in his lower back. On magnetic resonance imaging, there was an avidly-enhancing thoracic intradural lesion that contained an extramedullary intradural component posteriorly, with an apparent intramedullary component anteriorly. Laminectomy of T7 - 8 was performed, and intradural exploration revealed a highly vascular-appearing tumor below the arachnoid, which was not completely dissected because it was densely adherent to the spinal cord. The pathological diagnosis was lobular capillary hemangioma with extra- and intramedullary components. We suggest this lesion should be considered in the differential diagnosis of spinal cord tumors with an intramedullary component. PMID:23924752

Gonzalez, Ricardo; Spears, Julian; Bharatha, Aditya; Munoz, David G

2014-01-01

262

Melatonin treatment protects against acute spinal cord injury-induced disruption of blood spinal cord barrier in mice.  

PubMed

The spinal cord microcirculation plays a critically important role in maintaining the normal function of spinal cord neurons, glial cells, and axons. Previous researches were largely focused on improved neurological manifestations of spinal cord injury (SCI) while ignoring to improve spinal cord microcirculation disorder after melatonin treatment. Therefore, the mechanism of melatonin that affects blood spinal cord barrier (BSCB) integrity and microcirculation in SCI remains unclear. The present study was performed to investigate the effect of melatonin on the BSCB in a SCI mice model. Melatonin (5, 10, 25, 50, 100 mg/kg i.p.) was administered to mice immediately following SCI. Compared to the 48 h post-SCI group, mice treated with melatonin (50 mg/kg) exhibited significantly reduced BSCB permeability. Additionally, melatonin treatment restrained microvessel loss; attenuated edema; protected the tight junction proteins, endothelial cells, and pericytes; decreased the number of cell apoptosis; and reduced MMP3/AQP4/HIF-1?/VEGF/VEGFR2 expression after SCI. Above all, our results clearly demonstrated that melatonin could stabilize microvascular barrier function and microcirculation of SCI, whose mechanism was to promote the repair of the damaged BSCB. PMID:25303856

Wu, Qingbin; Jing, Yingli; Yuan, Xiaochen; Zhang, Xiaoyan; Li, Bingwei; Liu, Mingming; Wang, Bing; Li, Hongwei; Liu, Shuying; Xiu, Ruijuan

2014-12-01

263

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. PMID:25429237

Wolter, Tilman

2014-01-01

264

Intramedullary spinal neurocysticercosis treated successfully with medical therapy.  

PubMed

Neurocysticercosis caused by Taenia solium and is a common parasitic disease of the cental nervous system. It usually presents with seizures, headaches, progressively worsening focal neurologic symptoms, visual disturbances, loss of bladder control, etc. However, acute onset symptoms may also be seen. MRI scans can accurately diagnose spinal or cerebral lesions and is also helpful in monitoring progress while on treatment. Albendazole is currently the drug of choice along with steroids for medical management of neurocysticercosis. The case of intramedullary spinal neurocysticercosis was treated with praziquantel. PMID:25643507

Ahmed, Shameem; Paul, Siba Prosad

2014-12-01

265

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

266

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

267

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

268

Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects  

PubMed Central

Summary The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved. PMID:25505497

Szwedowski, Dawid; Walecki, Jerzy

2014-01-01

269

Test protocols for evaluation of spinal implants.  

PubMed

Prior to implantation, medical devices are subjected to rigorous testing to ensure safety and efficacy. A full battery of testing protocols for implantable spinal devices may include many steps. Testing for biocompatibility is a necessary first step. On selection of the material, evaluation protocols should address both the biomechanical and clinical performance of the device. Before and during mechanical testing, finite element modeling can be used to optimize the design, predict performance, and, to some extent, predict durability and efficacy of the device. Following bench-type evaluations, the biomechanical characteristics of the device (e.g., motion, load-sharing, and intradiscal pressure) can be evaluated with use of fresh human cadaveric spines. The information gained from cadaveric testing may be supplemented by the finite element model-based analyses. Upon the successful completion of these tests, studies that make use of an animal model are performed to assess the structure, function, histology, and biomechanics of the device in situ and as a final step before clinical investigations are initiated. The protocols that are presently being used for the testing of spinal devices reflect the basic and applied research experience of the last three decades in the field of orthopaedic biomechanics in general and the spine in particular. The innovation within the spinal implant industry (e.g., fusion devices in the past versus motion-preservation devices at present) suggests that test protocols represent a dynamic process that must keep pace with changing expectations. Apart from randomized clinical trials, no single test can fully evaluate all of the characteristics of a device. Due to the inherent limitations of each test, data must be viewed in a proper context. Finally, a case is made for the medical community to converge toward standardized test protocols that will enable us to compare the vast number of currently available devices, whether on the market or still under development, in a systematic, laboratory-independent manner. PMID:16595454

Goel, Vijay K; Panjabi, Manohar M; Patwardhan, Avinash G; Dooris, Andrew P; Serhan, Hassan

2006-04-01

270

Increased immunoreactivity of c?Fos in the spinal cord of the aged mouse and dog.  

PubMed

Expression of c?Fos in the spinal cord following nociceptive stimulation is considered to be a neurotoxic biomarker. In the present study, the immunoreactivity of c?Fos in the spinal cord was compared between young adult (2?3 years in dogs and 6 months in mice) and aged (10?12 years in dogs and 24 months in mice) Beagle dogs and C57BL/6J mice. In addition, changes to neuronal distribution and damage to the spinal cord were also investigated. There were no significant differences in neuronal loss or degeneration of the spinal neurons observed in either the aged dogs or mice. Weak c?Fos immunoreactivity was observed in the spinal neurons of the young adult animals; however, c?Fos immunoreactivity was markedly increased in the nuclei of spinal neurons in the aged dogs and mice, as compared with that of the young adults. In conclusion, c?Fos immunoreactivity was significantly increased without any accompanying neuronal loss in the aged spinal cord of mice and dogs, as compared with the spinal cords of the young adult animals. PMID:25351722

Ahn, Ji Hyeon; Shin, Myoung Chul; Park, Joon Ha; Kim, In Hye; Lee, Jae-Chul; Yan, Bing Chun; Hwang, In Koo; Moon, Seung Myung; Ahn, Ji Yun; Ohk, Taek Geun; Lee, Tae Hun; Cho, Jun Hwi; Shin, Hyung-Cheul; Won, Moo-Ho

2015-02-01

271

Novel alternative therapy for spinal tuberculosis during surgery: reconstructing with anti-tuberculosis bioactivity implants.  

PubMed

Accompanied with the worsening of the pulmonary tuberculosis bacterium (TB) epidemic, the incidence of spinal TB has increased in recent years. Spinal reconstruction and stabilisation, and bone defect repair play a crucial role in the surgical treatment of spinal TB. Unfortunately, the existing materials have not completely met the requirements for spinal TB reconstruction due to their diverse deficiencies. Therefore, there is an urgent need to develop novel reconstructing implants. Poly-DL-lactide (PDLLA) and nano-hydroxyapatite (nHA) are two promising drug delivery systems (DDS) and materials for bone repair, which could help us to overcome the difficulties in spinal TB reconstruction in the future. In this article, we discuss the properties of PDLLA and nHA, two potential drug delivering and bone repair materials for spinal TB reconstruction. We also presented two alternatives for spinal TB in future. Two strategies have the potential for treating spinal TB in the future. One such strategy consists of mixing anti-TB drugs, PDLLA with nHA to fabricate a novel three-dimensional (3D) porous scaffold via 3D printing (3DP) technology. Another is preparing a novel titanium mesh implant coated with drugs/PDLLA/nHA composites by solvent evaporation and low-temperature drying technology. These two hypotheses have recently been tested in a laboratory setting by our team. PMID:24328922

Dong, JunFeng; Zhang, ShengMin; Liu, HaoMing; Li, XinZhi; Liu, YongHui; Du, YingYing

2014-03-01

272

Geometric Structure of 3D Spinal Curves: Plane Regions and Connecting Zones  

PubMed Central

This paper presents a new study of the geometric structure of 3D spinal curves. The spine is considered as an heterogeneous beam, compound of vertebrae and intervertebral discs. The spine is modeled as a deformable wire along which vertebrae are beads rotating about the wire. 3D spinal curves are compound of plane regions connected together by zones of transition. The 3D spinal curve is uniquely flexed along the plane regions. The angular offsets between adjacent regions are concentrated at level of the middle zones of transition, so illustrating the heterogeneity of the spinal geometric structure. The plane regions along the 3D spinal curve must satisfy two criteria: (i) a criterion of minimum distance between the curve and the regional plane and (ii) a criterion controlling that the curve is continuously plane at the level of the region. The geometric structure of each 3D spinal curve is characterized by the sizes and orientations of regional planes, by the parameters representing flexed regions and by the sizes and functions of zones of transition. Spinal curves of asymptomatic subjects show three plane regions corresponding to spinal curvatures: lumbar, thoracic and cervical curvatures. In some scoliotic spines, four plane regions may be detected. PMID:25031873

Berthonnaud, E.; Hilmi, R.; Dimnet, J.

2012-01-01

273

Geometric Structure of 3D Spinal Curves: Plane Regions and Connecting Zones.  

PubMed

This paper presents a new study of the geometric structure of 3D spinal curves. The spine is considered as an heterogeneous beam, compound of vertebrae and intervertebral discs. The spine is modeled as a deformable wire along which vertebrae are beads rotating about the wire. 3D spinal curves are compound of plane regions connected together by zones of transition. The 3D spinal curve is uniquely flexed along the plane regions. The angular offsets between adjacent regions are concentrated at level of the middle zones of transition, so illustrating the heterogeneity of the spinal geometric structure. The plane regions along the 3D spinal curve must satisfy two criteria: (i) a criterion of minimum distance between the curve and the regional plane and (ii) a criterion controlling that the curve is continuously plane at the level of the region. The geometric structure of each 3D spinal curve is characterized by the sizes and orientations of regional planes, by the parameters representing flexed regions and by the sizes and functions of zones of transition. Spinal curves of asymptomatic subjects show three plane regions corresponding to spinal curvatures: lumbar, thoracic and cervical curvatures. In some scoliotic spines, four plane regions may be detected. PMID:25031873

Berthonnaud, E; Hilmi, R; Dimnet, J

2012-01-01

274

Ginsenoside Rb1 inhibits neuronal apoptosis and damage, enhances spinal aquaporin 4 expression and improves neurological deficits in rats with spinal cord ischemia?reperfusion injury.  

PubMed

Ginsenoside Rb1 is a potential therapeutic agent for the treatment of spinal cord ischemia?reperfusion injury (SCII), although it has not yet been investigated in depth. The aim of the present study was to investigate the effects of ginsenoside Rb1 treatment on SCII and aquaporin?4 (AQP4) expression in the rat spinal cord. Experimental animals were subjected to one of four conditions, including the blank control condition, sham procedure, spinal cord ischemia?reperfusion induced by abdominal aortic occlusion or spinal cord ischemia?reperfusion followed by ginsenoside Rb1 treatment. Locomotor activity was evaluated using the Basso Beattie Bresnahan scale. Spinal cord damage was assessed with hematoxylin and eosin and Nissl staining and the apoptotic rate was measured using terminal deoxynucleotidyl transferase dUTP nick end labeling. AQP4 expression was assessed by immunohistochemical analysis, western blotting and reverse transcription?quantitative polymerase chain reaction. Abdominal aortic occlusion resulted in the reduced expression of AQP4 in the spinal cord, which gradually recovered over time. Furthermore, ginsenoside Rb1 treatment significantly attenuated this decrease and protected the integrity of and reduced the apoptotic rate in spinal cord neurons. Treatment with ginsenoside Rb1 attenuated the initial downregulation and advanced the recovery of AQP4 expression levels, suggesting a possible mechanism for the therapeutic effects on SCII. PMID:25573543

Huang, Fei; Li, Ya-Nan; Yin, Fei; Wu, Yun-Tao; Zhao, Dong-Xu; Li, Ye; Zhang, Yun-Feng; Zhu, Qing-San

2015-05-01

275

Degenerative and regenerative mechanisms governing spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a major cause of disability, and at present, there is no universally accepted treatment. The functional decline following SCI is contributed to both direct mechanical injury and secondary pathophysiological mechanisms that are induced by the initial trauma. These mechanisms initially involve widespread haemorrhage at the site of injury and necrosis of central nervous system (CNS)

Christos Profyris; Surindar S Cheema; DaWei Zang; Michael F Azari; Kristy Boyle; Steven Petratos

2004-01-01

276

Adhesion Molecules and Wound Healing in Spinal Cord Injury  

Microsoft Academic Search

The purpose of this study was to design and test a model that could identify and define which cellular adhesion molecules (CAMs) present on peripheral blood leukocytes were depressed in spinal cord injury (SCI) patients. CAMs on peripheral blood cells of SCI patients with pressure ulcers were measured by flow cytometry and compared with those of age-matched healthy controls and

Julius M. Cruse; Robert E. Lewis; Reid Bishop; Jane A. Lampton; Malinda D. Mallory; Lamar Bryant; John C. Keith

1996-01-01

277

Late deterioration after decompression illness affecting the spinal cord.  

PubMed Central

A former amateur diver presented with a progressive paraparesis. Thirteen years previously he had developed acute spinal cord dysfunction immediately after dry hyperbaric exposure. He had completely recovered motor function in the intervening period. No alternative reason for the later decline emerged from detailed investigation. Images p363-a PMID:9015605

Dyer, J; Millac, P

1996-01-01

278

The clinical significance of spinal anomalies: A case report  

PubMed Central

A case with multiple block vertebrae is presented. The clinical significance of congenital anomalies is discussed with reference to spinal manipulative therapy. ImagesFigure 1a-1dFigure 2 (a) and (b)Figure 2 (c)Figure 3

Steiman, Igor

1983-01-01

279

Spinal Cord Calcification in an Early-Onset Progressive Leukoencephalopathy  

Microsoft Academic Search

Spinal cord calcifications are an unusual finding in pediatric neurology. We here describe a young child who presented severe psychomotor delay, tetraplegia, deafness, and anemia. Neuroradiological investigations revealed severe leukodystrophy and unusual calcifications in the cerebral white matter and all along the medullary pathways. Common infectious and metabolic diseases were ruled out. A mild reduction in the activity of several

Simona Orcesi; Roberta La Piana; Carla Uggetti; Davide Tonduti; Anna Pichiecchio; Moreno Pasin; Gisela Viselner; Giacomo P. Comi; Roberto Del Bo; Dario Ronchi; Stefano Bastianello; Umberto Balottin

2011-01-01

280

Computed tomography in spinal hemangioma with cord compression  

Microsoft Academic Search

Two teenagers with spinal cord compression due to a thoracic vertebral hemangioma are presented. Myelography showed a complete block in both patients. Selective intercostal arteriography was normal or non-conclusive. Only computed tomography (CT) gave precise information about the extent and nature of the compressive lesion. In the first case it showed angiomatous involvement of the body and all parts of

P. Schnyder; H. Fankhauser; B. Mansouri

1986-01-01

281

Acute spinal cord compression caused by vertebral hemangioma  

Microsoft Academic Search

Background contextThe reported incidence of vertebral hemangioma within the spinal column is common. Most often these benign vascular tumors are incidental radiographic findings and do not cause neurological sequelae. Rarely, vertebral hemangiomas will cause compressive neurological symptoms, such as radiculopathy, myelopathy and paralysis. In these cases the clinical presentation is usually the subacute or delayed onset of progressive neurological symptoms.

Cary R. Templin; Jeffrey B. Stambough; Jeffery L. Stambough

2004-01-01

282

Melatonin lowers edema after spinal cord injury  

PubMed Central

Melatonin has been shown to diminish edema in rats. Melatonin can be used to treat spinal cord injury. This study presumed that melatonin could relieve spinal cord edema and examined how it might act. Our experiments found that melatonin (100 mg/kg, i.p.) could reduce the water content of the spinal cord, and suppress the expression of aquaporin-4 and glial fibrillary acidic protein after spinal cord injury. This suggests that the mechanism by which melatonin alleviates the damage to the spinal cord by edema might be related to the expression of aquaporin-4 and glial fibrillary acidic protein. PMID:25657743

Li, Cheng; Chen, Xiao; Qiao, Suchi; Liu, Xinwei; Liu, Chang; Zhu, Degang; Su, Jiacan; Wang, Zhiwei

2014-01-01

283

Functional corticotropin-releasing factor receptors in neonatal rat spinal cord  

SciTech Connect

The present study localized corticotropin-releasing factor (CRF) receptors and studied the action of CRF in the neonatal rat spinal cord preparation. Lumbar CRF receptors were present in highest concentrations in laminae I and II with progressively lower concentrations in lamina IX and intermediate and central zones respectively. CRF directly and indirectly depolarized lumbar motoneurons in a concentration-related manner and the putative receptor antagonist, alpha helical oCRF(9-41), partially blocked the depolarizing response to CRF. The electrophysiological responses to CRF and the distribution of receptors within the spinal cord suggest that CRF may play a physiological role in regulating spinal cord reflex function.

Bell, J.A.; de Souza, E.B.

1988-11-01

284

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

285

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

Microsoft Academic Search

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

Per Flisberg; Owain Thomas; Bo Geijer; Ulf Schött

2009-01-01

286

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

287

Cerebellar, brainstem and spinal cord metastases from esophageal cancer following radiotherapy: A case report and literature review  

PubMed Central

Cerebellar, brainstem and spinal cord metastases from esophageal cancer following radiotherapy are extremely rare. The current study presents the case of a 74-year-old male who was admitted to the Zhejiang Cancer Hospital (Hangzhou, China) with a poorly-differentiated neuroendocrine carcinoma of the esophagus. Following radiotherapy, multiple abnormal signals in the brainstem and spinal cord were found on magnetic resonance imaging (MRI). Following palliative radiochemotherapy, the clinical symptoms and abnormal MRI signals in the brainstem and spinal cord were found to improve. This case revealed that brain metastasis from esophageal carcinoma may occur simultaneously with brainstem and spinal cord metastases. PMID:24959256

ZHANG, PENG; FENG, WEI; ZHENG, XIAO; WANG, YUE-ZHEN; SHAN, GUO-PING

2014-01-01

288

Pain following spinal cord injury  

Microsoft Academic Search

Chronic pain is an important problem following spinal cord injury (SCI) and is a major impediment to effective rehabilitation. The reported prevalence of chronic SCI pain is variable but averages 65% with around one third of these people rating their pain as severe. The mechanisms responsible for the presence of pain are poorly understood. However, evidence from clinical observations and

PJ Siddall; JD Loeser

2001-01-01

289

Vestibulo-spinal reflex mechanisms  

NASA Technical Reports Server (NTRS)

The specific objectives of experiments designed to investigate postural reflex behavior during sustained weightlessness are discussed. The first is to investigate, during prolonged weightlessness with Hoffmann response (H-reflex) measurement procedures, vestibulo-spinal reflexes associated with vestibular (otolith) responses evoked during an applied linear acceleration. This objective includes not only an evaluation of otolith-induced changes in a major postural muscle but also an investigation with this technique of the adaptive process of the vestibular system and spinal reflex mechanisms to this unique environment. The second objective is to relate space motion sickness to the results of this investigation. Finally, a return to the vestibulo-spinal and postural reflexes to normal values following the flight will be examined. The flight experiment involves activation of nerve tissue (tibial N) with electrical shock and the recording of resulting muscle activity (soleus) with surface electrodes. Soleus/spinal H-reflex testing procedures will be used in conjuction with linear acceleration through the subject's X-axis.

Reschke, M. F.

1981-01-01

290

Overview of Spinal Cord Disorders  

MedlinePLUS

... pair of coccygeal nerve roots, which supply a small area of the skin around the tailbone (coccyx). There are dermatomes for each of these nerve roots. Sensory information from a specific dermatome is carried by sensory nerve fibers to the spinal nerve root of a specific ...

291

SPINAL CORD INJURY (SCI) DATABASE  

EPA Science Inventory

The National Spinal Cord Injury Database has been in existence since 1973 and captures data from SCI cases in the United States. Since its inception, 24 federally funded Model SCI Care Systems have contributed data to the National SCI Database. Statistics are derived from this da...

292

Carrier materials for spinal fusion  

Microsoft Academic Search

Background contextThe rise in spinal fusion procedures has led to an increase in the available number and variety of bone graft substitutes. As our understanding of the biologic processes that influence bony fusion has improved, appreciation for the role of the carrier material involved in bone grafts has also increased.

Brian Kwon; Louis G. Jenis

2005-01-01

293

Intramedullary spinal cord metastasis from prostate carcinoma: a case report  

PubMed Central

Introduction Although vertebral and epidural metastases are common, intradural metastases and intramedullary spinal cord metastases are rare. The indications for the treatment of intramedullary spinal cord metastases remain controversial. We present the first biopsy-proven case of an intramedullary spinal cord metastasis from adenocarcinoma of the prostate. Case presentation Our patient was a 68-year-old right-handed Caucasian man with a Gleason grade 4?+?3 prostate adenocarcinoma who had previously undergone a prostatectomy, androgen blockade and transurethral debulking. He presented with new-onset saddle anesthesia and fecal incontinence. Magnetic resonance imaging demonstrated a spindle-shaped intramedullary lesion of the conus medullaris. Our patient underwent decompression and an excisional biopsy; the lesion’s pathology was consistent with metastatic adenocarcinoma of the prostate. Postoperatively, our patient received CyberKnife® radiosurgery to the resection cavity at a marginal dose of 27Gy to the 85% isodose line. At three months follow-up, our patient remains neurologically stable with no new deficits or lesions. Conclusions We review the literature and discuss the indications for surgery and radiosurgery for intramedullary spinal cord metastases. We also report the novel use of stereotactic radiosurgery to sterilize the resection cavity following an excisional biopsy of the metastasis. PMID:22657386

2012-01-01

294

Involvement of CX3CL1/CX3CR1 Signaling in Spinal Long Term Potentiation  

PubMed Central

The long-term potentiation (LTP) of spinal C-fiber-evoked field potentials is considered as a fundamental mechanism of central sensitization in the spinal cord. Accumulating evidence has showed the contribution of spinal microglia to spinal LTP and pathological pain. As a key signaling of neurons-microglia interactions, the involvement of CX3CL1/CX3CR1 signaling in pathological pain has also been investigated extensively. The present study examined whether CX3CL1/CX3CR1 signaling plays a role in spinal LTP. The results showed that 10-trains tetanic stimulation (100 Hz, 2s) of the sciatic nerve (TSS) produced a significant LTP of C-fiber-evoked field potentials lasting for over 3 h in the rat spinal dorsal horn. Blockade of CX3CL1/CX3CR1 signaling with an anti-CX3CR1 neutralizing antibody (CX3CR1 AB) markedly suppressed TSS-induced LTP. Exogenous CX3CL1 significantly potentiated 3-trains TSS-induced LTP in rats. Consistently, spinal LTP of C-fiber-evoked field potentials was also induced by TSS (100 Hz, 1s, 4 trains) in all C57BL/6 wild type (WT) mice. However, in CX3CR1-/- mice, TSS failed to induce LTP and behavioral hypersensitivity, confirming an essential role of CX3CR1 in spinal LTP induction. Furthermore, blockade of IL-18 or IL-23, the potential downstream factors of CX3CL1/CX3CR1 signaling, with IL-18 BP or anti-IL-23 neutralizing antibody (IL-23 AB), obviously suppressed spinal LTP in rats. These results suggest that CX3CL1/CX3CR1 signaling is involved in LTP of C-fiber-evoked field potentials in the rodent spinal dorsal horn. PMID:25768734

Bian, Chao; Zhao, Zhi-Qi; Zhang, Yu-Qiu; Lü, Ning

2015-01-01

295

Multimodal intraoperative monitoring during surgery of spinal deformities in 217 patients  

PubMed Central

A prospective study was performed on 217 patients who received MIOM during corrective surgery of spinal deformities between March 2000 and December 2005. Aim is to determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during corrective spine surgery. MIOM is becoming an increasingly used method of monitoring function during corrective spine surgery. The combination of monitoring of ascending and descending pathways may provide more sensitive and specific results giving immediate feedback information regarding any neurological deficits during the operation. Intraoperative somatosensory spinal and cerebral evoked potentials combined with continuous EMG and motor evoked potentials of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. A total of 217 consecutive patients with spinal deformities of different aetiologies were monitored by means of MIOM during the surgical procedure. Out of which 201 patients presented true negative findings while one patient presented false negative and three patients presented false positive findings. Twelve patients presented true positive findings where neurological deficit after the operation was predicted. All neurological deficits in those 12 patients recovered completely. The sensitivity of MIOM applied during surgery of spinal deformities has been calculated of 92.3% and the specificity 98.5%. Based upon the results of this study MIOM is an effective method of monitoring the spinal cord and nerve root function during corrective surgery of spinal deformities and consequently improves postoperative results. The Wake-up test for surgical procedure of spinal deformities became obsolete in our institution. PMID:17632737

Sutter, Martin A.; Grob, Dieter; Jeszenszky, Dezsö; Dvorak, Jiri

2007-01-01

296

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

297

Spinal epidural hematoma during anticoagulant therapy. A case report and review of the literature.  

PubMed

The authors present a case of spinal epidural hematoma during anticoagulant therapy. Clinical presentation is characterized by classic paravertebral back pain, followed by progressive neurological deficit due to spinal cord and radicular compression, with sensory deficits and bladder disturbance. From the literature, 37 cases are collected of spinal epidural hematoma during anticoagulant therapy, treated surgically. Pathogenesis, diagnosis, and differential diagnosis are discussed. Early surgical decompression of the spinal cord minimizes the degree of permanent neurological damage, because of the long-time compression of the spinal cord resulting in irreversible disturbance of circulation; therefore an early diagnosis is a better prognosis. The thoracic and cervical spine canal is smaller than the lumbar, therefore there is less space to reward the formation of hematomas, consequently the postoperative recovery is lower in patient with high spinal epidural hematomas with respect to lumbo-sacral spinal epidural hematomas; at this level the epidural hematoma may be insidious in its onset and tends to become chronic before definite treatment is undertaken. PMID:8568560

Rodriguez y Baena, R; Gaetani, P; Tancioni, F; Tartara, F

1995-03-01

298

Intramedullary spinal cord gangliocytoma: case report and a review of the literature  

Microsoft Academic Search

We present a case of intramedullary spinal gangliocytoma in a 19-year-old woman who presented with a long history of hyperhidrosis of the face and neck areas and intermittent pain of the hands. The tumor involved the cervico-thoracic region of the spinal cord from C7-T3. The patient underwent debulking of the lesion and remains neurologically stable at two years follow-up. A

Jeffrey T. Jacob; Aaron A. Cohen-Gadol; Bernd W. Scheithauer; William E. Krauss

2005-01-01

299

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 Fogaça; de Barros Filho, Tarcísio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

2012-01-01

300

Spinal cord injury medicine and rehabilitation.  

PubMed

The rehabilitation of spinal cord injury (SCI) is a complicated process, but one in which new research is developing novel and increasingly promising methods of restorative neurology. Spinal cord injury medicine addresses not only the neurologic injury, but all the secondary complications in other organ systems whose regulation is disrupted after SCI. To some degree, the rehabilitation of SCI is focused on return to the community and functional goals are paramount, regardless of whether they can be achieved through some mechanism of compensation or due to a growing effort at engendering neurologic plasticity and recovery. The authors present a typical case of cervical incomplete SCI and discuss the medical complications and considerations for care during acute rehabilitation. They also review current methods of planning and executing rehabilitation, along with emerging methods that are leading to, in varying degrees, greater neurologic recovery. Finally, new approaches in SCI rehabilitation, namely neuromodulation, are discussed as efforts are made to further augment neural plasticity and recovery in SCI. PMID:25520024

Stampas, Argyrios; Tansey, Keith E

2014-11-01

301

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

302

Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury.  

PubMed

This article was presented at the Premeeting Workshop on Outcome Measures at the American Spinal Injury Association (ASIA) Annual Scientific Meeting in Dallas, Texas, in May 2005. The article summarizes preliminary findings of three quantitative sensory tests that were evaluated as part of the International Spinal Research Trust Clinical Initiative study: perceptual thresholds to electrical, vibration, and thermal stimulation. The results gathered so far suggest that the three tests are simple, reproducible, and applicable in a clinical setting. The tests seem to add resolution and sensitivity to the standard clinical testing and could be useful adjuncts in longitudinal monitoring of spinal cord injury for research purposes. PMID:17551861

Savic, Gordana; Bergström, Ebba M K; Davey, Nick J; Ellaway, Peter H; Frankel, Hans L; Jamous, Ali; Nicotra, Alessia

2007-01-01

303

Successful staged surgical correction of congenital segmental spinal dysgenesis and complete rotary subluxation of the thoracolumbar spine in an infant  

Microsoft Academic Search

Congenital segmental spinal dysgenesis is a rare lesion that usually is associated with neurological deficits. Affected infants who are neurologically intact may suffer progressive kyphosis and subsequent neurological deterioration. Results of external casting, laminectomy with spinal fixation, or bone grafting of the defect have been disappointing. The authors present a successful staged surgical management scheme consisting of complete resection of

Edward G Ford; Bruce A Jaufmann; Sue C Kaste; Lawrence J Foody; Thomas E Kuivila

1996-01-01

304

Functional Recovery of Paraplegic Rats and Motor Axon Regeneration in Their Spinal Cords by Olfactory Ensheathing Glia  

Microsoft Academic Search

Axonal regeneration in the lesioned mammalian central nervous system is abortive, and this causes permanent disabilities in individuals with spinal cord injuries. In adult rats, olfactory ensheathing glia (OEG) transplants successfully led to functional and structural recovery after complete spinal cord transection. From 3 to 7 months post surgery, all OEG-transplanted animals recovered locomotor functions and sensorimotor reflexes. They presented

Almudena Ramón-Cueto; M. Isabel Cordero; Fernando F. Santos-Benito; Jesús Avila

2000-01-01

305

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

306

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

307

The current state-of-the-art of spinal cord imaging: methods.  

PubMed

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research. PMID:23685159

Stroman, P W; Wheeler-Kingshott, C; Bacon, M; Schwab, J M; Bosma, R; Brooks, J; Cadotte, D; Carlstedt, T; Ciccarelli, O; Cohen-Adad, J; Curt, A; Evangelou, N; Fehlings, M G; Filippi, M; Kelley, B J; Kollias, S; Mackay, A; Porro, C A; Smith, S; Strittmatter, S M; Summers, P; Tracey, I

2014-01-01

308

The current state-of-the-art of spinal cord imaging: Methods  

PubMed Central

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of “critical mass” of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research. PMID:23685159

Stroman, P.W.; Wheeler-Kingshott, C.; Bacon, M.; Schwab, J.M.; Bosma, R.; Brooks, J.; Cadotte, D.; Carlstedt, T.; Ciccarelli, O.; Cohen-Adad, J.; Curt, A.; Evangelou, N.; Fehlings, M.G.; Filippi, M.; Kelley, B.J.; Kollias, S.; Mackay, A.; Porro, C.A.; Smith, S.; Strittmatter, S.M.; Summers, P.; Tracey, I.

2015-01-01

309

Thoracic spinal cord intramedullary aspergillus invasion and abscess.  

PubMed

Invasive central nervous system aspergillosis is a rare form of fungal infection that presents most commonly in immunocompromised individuals. There have been multiple previous reports of aspergillus vertebral osteomyelitis and spinal epidural aspergillus abscess; however to our knowledge there are no reports of intramedullary aspergillus infection. We present a 19-year-old woman with active acute lymphoblastic leukemia who presented with several weeks of fevers and bilateral lower extremity weakness. She was found to have an intramedullary aspergillus abscess at T12-L1 resulting from adjacent vertebral osteomyelitis and underwent surgical debridement with ultra-sound guided aspiration and aggressive intravenous voriconazole therapy. To our knowledge this is the first reported case of spinal aspergillosis invading the intramedullary cavity. Though rare, this entity should be included in the differential for immunocompromised patients presenting with fevers and neurologic deficit. Early recognition with aggressive neurosurgical intervention and antifungal therapy may improve outcomes in future cases. PMID:25088481

McCaslin, Addason F; Lall, Rishi R; Wong, Albert P; Lall, Rohan R; Sugrue, Patrick A; Koski, Tyler R

2015-02-01

310

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

2015-03-11

311

How Are Brain and Spinal Cord Tumors in Children Diagnosed?  

MedlinePLUS

... spinal cord tumors in children staged? How are brain and spinal cord tumors diagnosed in children? Brain ... resonance angiography (MRA) or computerized tomographic angiography (CTA). Brain or spinal cord tumor biopsy Imaging tests such ...

312

21 CFR 880.2500 - Spinal fluid manometer.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 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...

2014-04-01

313

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

314

21 CFR 880.2500 - Spinal fluid manometer.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 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...

2011-04-01

315

21 CFR 880.2500 - Spinal fluid manometer.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 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...

2012-04-01

316

21 CFR 880.2500 - Spinal fluid manometer.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 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...

2013-04-01

317

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

318

Whole spontaneous spinal epidural hematoma.  

PubMed

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; Kim, Young-Jin

2014-06-01

319

Craniospinal Irradiation With Spinal IMRT to Improve Target Homogeneity  

SciTech Connect

Purpose: To report a new technique for the spinal component of craniospinal irradiation (CSI) in the supine position, to describe a verification procedure for this method, and to compare this technique with conventional plans. Methods and Materials: Twelve patients were treated between 1998 and 2006 with CSI using a novel technique. Sixteen children were treated with a conventional field arrangement. All patients were followed for outcomes and toxicity. CSI was delivered using a posteroanterior (PA) intensity-modulated radiation therapy (IMRT) spinal field matched to conventional, opposed lateral cranial fields. Treatment plans were generated for each patient using the IMRT technique and a standard PA field technique. The resulting dosimetry was compared to determine target homogeneity, maximum dose to normal tissues, and total monitor units delivered. Results: Evaluation of the spinal IMRT technique compared with a standard PA technique reveals a 7% reduction in the target volume receiving {>=}110% of the prescribed dose and an 8% increase in the target volume receiving {>=}95% of the prescribed dose. Although target homogeneity was improved, the maximum dose delivered in the paraspinal muscles was increased by approximately 8.5% with spinal IMRT compared to the PA technique. Follow-up evaluations revealed no unexpected toxicity associated with the IMRT technique. Conclusions: A new technique of spine IMRT is presented in combination with a quality assurance method. This method improves target dose uniformity compared to the conventional CSI technique. Longer follow-up will be required to determine any benefit with regard to toxicity and disease control.

Panandiker, Atmaram Pai [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Ning, Holly [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Likhacheva, Anna [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Ullman, Karen [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Arora, Barbara [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Ondos, John C. [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Karimpour, Shervin [Memorial Regional Cancer Center, Radiation Oncology, Hollywood, FL (United States); Packer, Roger [Division of Neurology and Pediatrics, Children's National Medical Center, Departments of Neurology and Pediatrics, George Washington University, Washington, D.C. (United States); Miller, Robert [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Citrin, Deborah [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States)]. E-mail: citrind@mail.nih.gov

2007-08-01

320

Use of demineralized bone matrix in spinal fusion  

PubMed Central

Spinal fusion remains the gold-standard treatment for several pathological spine conditions. Although, autologous Iliac Crest Bone Grafting is considered the gold-standard graft choice to promote spinal fusion; however, it is associated with significant donor site morbidity and a limited graft quantity. Therefore, several bone graft alternatives have been developed, to augment arthrodesis. The purpose of this review is to present the results of clinical studies concerning the use of demineralized bone matrix (DBM), alone or as a composite graft, in the spinal fusion. A critical review of the English-language literature was conducted on Pubmed, using key word “demineralized bone matrix”, “DBM”, “spinal fusion”, and “scoliosis”. Results had been restricted to clinical studies. The majority of clinical trials demonstrate satisfactory fusion rates when DBM is employed as a graft extender or a graft enhancer. Limited number of prospective randomized controlled trials (4 studies), have been performed comparing DBM to autologous iliac crest bone graft in spine fusion. The majority of the clinical trials demonstrate comparable efficacy of DBM when it used as a graft extender in combination with autograft, but there is no clinical evidence to support its use as a standalone graft material. Additionally, high level of evidence studies are required, in order to optimize and clarify the indications of its use and the appropriate patient population that will benefit from DBM in spine arthrodesis. PMID:24649412

Tilkeridis, Konstantinos; Touzopoulos, Panagiotis; Ververidis, Athanasios; Christodoulou, Sotirios; Kazakos, Konstantinos; Drosos, Georgios I

2014-01-01

321

Use of demineralized bone matrix in spinal fusion.  

PubMed

Spinal fusion remains the gold-standard treatment for several pathological spine conditions. Although, autologous Iliac Crest Bone Grafting is considered the gold-standard graft choice to promote spinal fusion; however, it is associated with significant donor site morbidity and a limited graft quantity. Therefore, several bone graft alternatives have been developed, to augment arthrodesis. The purpose of this review is to present the results of clinical studies concerning the use of demineralized bone matrix (DBM), alone or as a composite graft, in the spinal fusion. A critical review of the English-language literature was conducted on Pubmed, using key word "demineralized bone matrix", "DBM", "spinal fusion", and "scoliosis". Results had been restricted to clinical studies. The majority of clinical trials demonstrate satisfactory fusion rates when DBM is employed as a graft extender or a graft enhancer. Limited number of prospective randomized controlled trials (4 studies), have been performed comparing DBM to autologous iliac crest bone graft in spine fusion. The majority of the clinical trials demonstrate comparable efficacy of DBM when it used as a graft extender in combination with autograft, but there is no clinical evidence to support its use as a standalone graft material. Additionally, high level of evidence studies are required, in order to optimize and clarify the indications of its use and the appropriate patient population that will benefit from DBM in spine arthrodesis. PMID:24649412

Tilkeridis, Konstantinos; Touzopoulos, Panagiotis; Ververidis, Athanasios; Christodoulou, Sotirios; Kazakos, Konstantinos; Drosos, Georgios I

2014-01-18

322

Glycoconjugates Distribution during Developing Mouse Spinal Cord Motor Organizers  

PubMed Central

Background: The aim of this research was to study the distribution and changes of glycoconjugates particularly their terminal sugars by using lectin histochemistry during mouse spinal cord development. Methods: Formalin-fixed sections of mouse embryo (10-16 fetal days) were processed for lectin histochemical method. In this study, two groups of horseradish peroxidase-labeled specific lectins were used: N-acetylgalactosamine, including Dolichos biflorus, Wisteria floribunda agglutinin (WFA), Vicia villosa, Glycine max as well as focuse-binding lectins, including tetragonolobus, Ulex europaeus, and Orange peel fungus (OFA). All sections were counterstained with alcian blue (pH 2.5). Results: Our results showed that only WFA and OFA reacted strongly with the floor plate cells from early to late embryonic period of developing spinal cord. The strongest reactions were related to the 14, 15, and 16 days of tissue sections incubated with OFA and WFA lectins. Conclusion: The present study demonstrated that cellular and molecular differentiation of the spinal cord organizers is a wholly regulated process, and ?-L-fucose, ?-D-GalNAc, and ?/?-D-GalNAc terminal sugars play a significant role during the prenatal spinal cord development. PMID:25605492

Vojoudi, Elham; Ebrahimi, Vahid; Ebrahimzadeh-Bideskan, Alireza; Fazel, Alireza

2015-01-01

323

Characterization and spinal fusion effect of rabbit mesenchymal stem cells  

PubMed Central

Background The surface markers of mesenchymal stem cells (MSCs) of rabbits have been reported only sporadically. However, interest in the spinal fusion effect of MSCs has risen recently. The purpose of this research was to study the surface markers and spinal fusion effect of rabbit MSCs. Results Of our rabbit MSCs, 2% expressed CD14, CD29, and CD45, 1% expressed CD90 and 97% expressed CD44. These results implied the MSCs were negative for CD14, CD29, CD45, and CD90, but positive for CD44. The surgical results showed that satisfactory fusion occurred in 10 rabbits (83%) in the study group and unsatisfactory fusion in 2 (17%). In the control group, satisfactory fusion was found in 3 rabbits (25%) and unsatisfactory fusion in 9 (75%). Statistical analysis showed the study group had significantly better spinal fusion results than the control group. Conclusions The surface markers of human and rabbit MSCs are not exactly the same. Rabbit MSCs do not have positive reactivity for CD29 and CD90, which are invariably present on human MSCs. The allogeneic undifferentiated rabbit MSCs were able to promote spinal fusion and did not induce an adverse immune response. PMID:24325928

2013-01-01

324

Instrumented artificial spinal cord for human cervical pressure measurement.  

PubMed

Spinal cord injuries continue to generate large individual and societal costs. The study of spinal cord injury has been undertaken from the perspective of animal studies to understand cord functioning, and from the use of cadaver material to understand ligamentous column failure. The present study was conducted to develop a tool to link results from both these methods of research. An instrumented artificial spinal cord was designed, constructed, and evaluated under different testing scenarios. Properties of the in vivo animal cord were obtained using the dorsal impact method and reproduced in a collagen-encased gelatin physical model. The cord was instrumented in seven places using thin, non-invasive piezo-electric pressure sensors. The instrumented artificial cord was then evaluated in the canal of a human cadaver head-neck column under dynamic loading conditions. A C5 compression fracture correlated to high local pressure changes. These results demonstrate the feasibility of using this new tool to understand the mechanisms of spinal cord injury. PMID:8922266

Pintar, F A; Schlick, M B; Yoganandan, N; Maiman, D J

1996-01-01

325

Ectopic expression of Gcm1 induces congenital spinal cord abnormalities.  

PubMed

Brief ectopic expression of Gcm1 in mouse embryonic tail bud profoundly affects the development of the nervous system. All mice from 5 independently derived transgenic lines exhibited either one or both of two types of congenital spinal cord pathologies: failure of the neural tube to close (spina bifida) and multiple neural tubes (diastematomyelia). Because the transgene is expressed only in a restricted caudal region and only for a brief interval (E8.5 to E13.5), there was no evidence of embryonic lethality. The dysraphisms develop during the period and within the zone of transgene expression. We present evidence that these dysraphisms result from an inhibition of neuropore closure and a stimulation of secondary neurulation. After transgene expression ceases, the spinal dysraphisms are progressively resolved and the neonatal animals, while showing signs of scarring and tissue resorption, have a closed vertebral column. The multiple spinal cords remain but are enclosed in a single spinal column as in the human diastematomyelia. The animals live a normal life time, are fertile and do not exhibit any obvious weakness or motor disabilities. PMID:12135932

Nait-Oumesmar, Brahim; Stecca, Barbara; Fatterpekar, Girish; Naidich, Thomas; Corbin, Joshua; Lazzarini, Robert A

2002-08-01

326

Intensive care of patients with spinal trauma.  

PubMed

This article takes a systematic approach to intensive care unit management of acute spinal cord injury. Pathophysiology and current medical management of the neurologic injury are discussed. Anticipation, prevention, and treatment of sequelae of spinal cord injury are stressed in sections on respiratory, cardiovascular, venous thrombosis, and gastrointestinal issues, as well as in sections on nutritional, genitourinary, and skin problems associated with spinal cord injury. PMID:7827483

McBride, D Q; Rodts, G E

1994-10-01

327

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

328

Why Variability Facilitates Spinal Learning  

PubMed Central

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 mid-thoracic (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 to 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 co-activation of agonists 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

2010-01-01

329

Spinal cord tanycytic ependymoma associated with neurofibromatosis type 2  

Microsoft Academic Search

Tanycytic ependymoma is a rare subtype of ependymoma. Reports of this tumor in neurofibromatosis type 2 (NF-2) are rare. A 16-year-old girl presented with gait disturbance and a palpable neck mass, which had been present for 2years. MRI revealed an intramedullary lesion within the upper cervical spinal cord, which was removed surgically. Pathological investigation revealed an uncommon form of tanycytic

Bong-Suk Lim; Sukh Que Park; Ung Kyu Chang; Min Suk Kim

2010-01-01

330

Thermoelectric device for treatment of radiculitis and spinal massage  

NASA Astrophysics Data System (ADS)

Results of development of a thermoelectric device that enables controlled cyclic temperature impact on the damaged area of human organism are presented. Unlike the existing medical devices employing direct supply current for thermoelectric module, the present device controls supply current according to time dependence of temperature change assigned by doctor. It is established that such a device is an efficient means of therapy at herniation of intervertebral disks with marked radiculitis and tunicary syndromes, at meningitis, other spinal diseases and back traumas.

Anatychuk, L. I.; Kobylyansky, R. R.

2012-06-01

331

Multiple extradural spinal arachnoid cysts: a case report and review of the literature  

PubMed Central

Extradural spinal arachnoid cysts are rare lesions, which may become symptomatic due to mass effect. Multiple cysts are even rarer of which few are reported to date. A 17-year-old male with acute onset urinary retention and progressive paraparesis is presented. Magnetic resonance imaging of spine revealed multiple spinal extradural arachnoid cysts located dorsal to the spinal cord, causing mass effect. The patient underwent surgery for excision of the cyst and closure of dural defects. He gained urinary continence and near normal muscle strength of lower extremities over a period of two weeks following operation. Up to date, there have been only sixteen reported cases of multiple spinal extradural arachnoid cysts in the literature and the present case appears to be the second most extensive one reported so far. Appreciation of the rarity of such lesions as well as the importance of surgical planning (especially pre-operative localization of the dural defects) is highlighted. PMID:19829999

Bitaraf, Mohammad Ali; Zeinalizadeh, Mehdi; Meybodi, Keyvan Tayebi; Habibi, Zohreh

2009-01-01

332

[Spontaneous spinal epidural haematoma causing rapid flaccid paraplegia in a healthy 25-year-old patient].  

PubMed

Although clinical presentation of a spinal epidural compressive haematoma is well recognized, causing acute radicular pain shortly followed by cord compression syndrome, its aetiology may pose a quandary. Rare and most commonly seen after trauma, spinal surgery, epidural anaesthesia, anticoagulation therapy, vascular malformation or coagulopathy (haemophilia), spinal epidural haematoma (SHE) can be spontaneous. Surgical decompression remains the mainstay treatment especially when the prognosis depends on the interval to surgery and the severity of preoperative neurological deficit. We report the case of a healthy 25-year-old man who presented, three days after an acute back pain, a flaccid paraplegia with urinary retention. Magnetic resonance imaging of the spinal column identified a compressive SHE extending from T3 to T6, requiring an early laminectomy. After decompression, clinical outcome revealed a complete recovery excepted some mild sensibility trouble remains. PMID:17462853

Colsy, M; Argote, C; Raimbault, M; Touchard, P

2007-06-01

333

Sexuality for women with spinal cord injury.  

PubMed

The authors conducted a review of the literature on women's sexuality after spinal cord injury, including studies from 1990 to 2011 retrieved from PubMed. Several facets of a woman's sexuality are negatively affected by after spinal cord injury, and consequently, sexual satisfaction has been shown to decrease, which also negatively affects quality of life. Neurogenic bladder is common after spinal cord injury, and the resulting urinary incontinence is a top therapeutic priority of this population. To improve sexual satisfaction and quality of life for women with spinal cord injury, future research needs to explore the effects of urinary incontinence on various aspects of sexuality. PMID:24325679

Cramp, Jackie D; Courtois, Frédérique J; Ditor, David S

2015-01-01

334

Focused review: spinal anesthesia in severe preeclampsia.  

PubMed

Spinal anesthesia is widely regarded as a reasonable anesthetic option for cesarean delivery in severe preeclampsia, provided there is no indwelling epidural catheter or contraindication to neuraxial anesthesia. Compared with healthy parturients, those with severe preeclampsia experience less frequent, less severe spinal-induced hypotension. In severe preeclampsia, spinal anesthesia may cause a higher incidence of hypotension than epidural anesthesia; however, this hypotension is typically easily treated and short lived and has not been linked to clinically significant differences in outcomes. In this review, we describe the advantages and limitations of spinal anesthesia in the setting of severe preeclampsia and the evidence guiding intraoperative hemodynamic management. PMID:23868886

Henke, Vanessa G; Bateman, Brian T; Leffert, Lisa R

2013-09-01

335

Spinal NF-?B and Chemokine Ligand 5 Expression during Spinal Glial Cell Activation in a Neuropathic Pain Model  

PubMed Central

Background The NF-?B pathway and chemokine (C-C motif) ligand 5 (CCL5) are involved in pain modulation; however, the precise mechanisms of their interactions in chronic neuropathic pain have yet to be established. Methods The present study examined the roles of spinal NF-?B and CCL5 in a neuropathic pain model after chronic constriction injury (CCI) surgery. CCI-induced pain facilitation was evaluated using the Plantar and von Frey tests. The changes in NF-?B and CCL5 expression were analyzed by immunohistochemistry and Western blot analyses. Results Spinal NF-?B and CCL5 expression increased after CCI surgery. Repeated intrathecal infusions of pyrrolidine dithiocarbamate (PDTC, a NF-?B inhibitor) decreased CCL5 expression, inhibited the activation of microglia and astrocytes, and attenuated CCI-induced allodynia and hyperalgesia. Intrathecal injection of a CCL5-neutralizing antibody attenuated CCI-induced pain facilitation and also suppressed spinal glial cell activation after CCI surgery. However, the CCL5-neutralizing antibody did not affect NF-?B expression. Furthermore, selective glial inhibitors, minocycline and fluorocitrate, attenuated the hyperalgesia induced by intrathecal CCL5. Conclusions The inhibition of spinal CCL5 expression may provide a new method to prevent and treat nerve injury-induced neuropathic pain. PMID:25635831

Yin, Qin; Fan, Qin; Zhao, Yu; Cheng, Ming-Yue; Liu, He; Li, Jing; Lu, Fei-Fei; Jia, Jin-Tai; Cheng, Wei; Yan, Chang-Dong

2015-01-01

336

Activation of spinal locomotor circuits in the decerebrated cat by spinal epidural and/or intraspinal electrical stimulation.  

PubMed

The present study was designed to further compare the stepping-like movements generated via epidural (ES) and/or intraspinal (IS) stimulation. We examined the ability to generate stepping-like movements in response to ES and/or IS of spinal lumbar segments L1-L7 in decerebrate cats. ES (5-10Hz) of the dorsal surface of the spinal cord at L3-L7 induced hindlimb stepping-like movements on a moving treadmill belt, but with no rhythmic activity in the forelimbs. IS (60Hz) of the dorsolateral funiculus at L1-L3 (depth of 0.5-1.0mm from the dorsal surface of the spinal cord) induced quadrupedal stepping-like movements. Forelimb movements appeared first, followed by stepping-like movements in the hindlimbs. ES and IS simultaneously enhanced the rhythmic performance of the hindlimbs more robustly than ES or IS alone. The differences in the stimulation parameters, site of stimulation, and motor outputs observed during ES vs. IS suggest that different neural mechanisms were activated to induce stepping-like movements. The effects of ES may be mediated more via dorsal structures in the lumbosacral region of the spinal cord, whereas the effects of IS may be mediated via more ventral propriospinal networks and/or brainstem locomotor areas. Furthermore, the more effective facilitation of the motor output during simultaneous ES and IS may reflect some convergence of pathways on the same interneuronal populations involved in the regulation of locomotion. PMID:25446455

Lavrov, Igor; Musienko, Pavel E; Selionov, Victor A; Zdunowski, Sharon; Roy, Roland R; Reggie Edgerton, V; Gerasimenko, Yury

2015-03-10

337

21 CFR 888.3050 - Spinal interlaminal fixation orthosis.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3050 Spinal interlaminal fixation orthosis. (a) Identification. A spinal...

2014-04-01

338

21 CFR 888.3050 - Spinal interlaminal fixation orthosis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3050 Spinal interlaminal fixation orthosis. (a) Identification. A spinal...

2011-04-01

339

21 CFR 888.3050 - Spinal interlaminal fixation orthosis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3050 Spinal interlaminal fixation orthosis. (a) Identification. A spinal...

2012-04-01

340

Spinal primitive neuroectodermal tumor mimicking as chronic inflammatory demyelination polyneuropathy: a case report and review of literature.  

PubMed

We report a young boy who presented with progressive weakness of lower extremities associated with areflexia and abnormal electrophysiological findings initially suggestive of chronic inflammatory demyelinating polyneuropathy. Initial lumbosacral spinal magnetic resonance imaging (MRI) showed thickened descending spinal nerve roots only. Immunomodulating therapy was given but with limited clinical response. Repeated spine magnetic resonance imaging showed cauda equina and also new spinal cord extramedullary contrast enhancement. The initial extensive investigations including open biopsy did not point to any specific diagnosis. Only through pursuing a repeated biopsy, the diagnosis of the spinal peripheral primitive neuroectodermal tumor was confirmed. This case highlights the diagnostic challenges of the spinal peripheral primitive neuroectodermal tumor that could have an initial chronic inflammatory demyelinating polyneuropathy-like presentation. The literature review confirms that this is a rare condition and cauda equina origin has only been reported in adults and teenagers, and this is the first reported case in a young child. PMID:24659733

Chan, Sophelia H S; Tsang, Dickson S F; Wong, Virginia C N; Chan, Godfrey C F

2015-02-01

341

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

342

In vivo 1H-magnetic resonance spectroscopy of the spinal cord in humans.  

PubMed

Magnetic resonance spectroscopy (MRS) has been used in a variety of conditions affecting the central nervous system. Until now, only the brain has been studied, and spectroscopy of the spinal cord has not been previously reported. During the past 12 months, we have been experimenting with MRS of the cervical spinal cord of healthy volunteers. We present this technique, its current limitations, and possible future technological improvements and potential applications. PMID:10952184

Gómez-Ansón, B; MacManus, D G; Parker, G J; Davie, C A; Barker, G J; Moseley, I F; McDonald, W I; Miller, D H

2000-07-01

343

Spinal mechanism of standard analgesics: Evaluation using mouse models of allodynia  

Microsoft Academic Search

Spinal neurotransmission plays an important role in the perception of pain signaling. In the present study, we investigated the spinal anti-nociceptive mechanism of current standard analgesics in mouse models of tactile allodynia induced by intrathecal administration of N-methyl-d-aspartic acid (NMDA), prostaglandin E2 (PGE2), and bicuculline. NMDA-induced allodynia is induced by postsynaptic NMDA receptor activation, while PGE2-induced allodynia is triggered by

Mina Tsukamoto; Tetsuo Kiso; Yukinori Shimoshige; Toshiaki Aoki; Nobuya Matsuoka

2010-01-01

344

Electroacupuncture Induced Spinal Plasticity is Linked to Multiple Gene Expressions in Dorsal Root Deafferented Rats  

Microsoft Academic Search

The underlying mechanism for electroacupuncture (EA) associated functional improvement in patients suffering from spinal cord\\u000a injury (SCI) is largely unknown. Collateral sprouting is one plausible factor, where the cord microenvironment may contribute\\u000a greatly. The present study evaluated the effects of EA on collateral sprouting from spared dorsal root ganglion (DRG), sensory\\u000a functional restorations, and differential gene expressions in spinal cord

Xu-Yang Wang; Xiao-Li Li; Sun-Quan Hong; Yan-Bin Xi-Yang; Ting-Hua Wang

2009-01-01

345

Gliosarcoma metastatic to the cervical spinal cord: case report and review of the literature  

Microsoft Academic Search

BACKGROUNDWe describe a case of an intramedullary metastasis to the cervical spinal cord from a temporal gliosarcoma.CASE DESCRIPTIONA 48-year-old man with known temporal lobe gliosarcoma presented with a new onset of ipsilateral hemiparesis. A MRI scan revealed the presence of an intramedullary lesion in the spinal cord behind the body of C2. Despite repeated craniotomy, radiation, and chemotherapy, the patient

Brian P Witwer; M. Shahriar Salamat; Daniel K Resnick

2000-01-01

346

Non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, lumbar and sacral segments: a case report  

Microsoft Academic Search

Main problem: There are only a few cases reported with non-contiguous spinal tuberculosis in the literature. Most of these patients have only two non-contiguous lesions, and in almost all of these cases, surgical treatment is required. Methods: A 17-year-old girl with non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, thoracolumbar, lumbar and sacral segments is reported. The patient presented with systemic

Erhan Emel; Feyza Karagöz Güzey; Deniz Güzey; N. Serdar. Bas; Bar?s Sel; Ibrahim Alatas

2006-01-01

347

Traumatic spinal perimedullary arteriovenous fistula due to knife stabbing and subsequent kyphosis: case report.  

PubMed

Perimedullary arteriovenous fistula (AVF) is a relatively rare spinal vascular malformation. Although it has traditionally been considered to be a congenital lesion, some cases identified in adults have suggested that the lesion may be acquired. The etiology and exact mechanism of these lesions are unknown. The authors present a case of a perimedullary AVF caused by a direct stabbing injury of the spinal cord and induced by subsequent kyphosis, and they discuss the pathogenesis and treatment strategy. PMID:23725397

Bai, Yahui; Zhi, Xinglong; Jian, Fengzeng; Zhang, Hongqi; Ling, Feng

2013-08-01

348

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

PubMed Central

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.

2014-01-01

349

MOTOR NEURON DEVELOPMENT IN THE SPINAL CORD FOLLOWING REMOVAL OF THE ALAR PLATE AND SPINAL GANGLIA*  

E-print Network

The number of motor neurons ultimately present in the anterior horn of the spinal cord of chick embryos is regulated by the volume of the tissue innervated. That this relationship between the number of motor neurons and the peripheral field is a causal one has been repeatedly demonstrated.""' A reduction of the volume of periphery (i.e. by removal of wing or leg buds) results in a proportionally smaller number of motor neurons in the associated segments of the spinal cord. Furthermore, that intracentral factors (ascending and descending fibers) do not affect the number of motor neurons developed has been demonstrated by Danchaikoff and Agassiz ' who transplanted segments of the medullary tube and adjacent tissue to the allantoic membrane and observed relatively normal spinal cord development. Employing a variety of techniques, Hoadley,8 Bueker,' Levi-Montalcini,9 and Hamburger7 have confirmed this observation. To define more precisely the nature of the relationship of the volume of the peripheral field to the development of motor neurons, Barron studied the histogenesis of the spinal cord of the sheep ' and chick"8 under normal and experimental conditions. Neuroblasts in the motor area were observed to become bipolar at the time that their axons reached the un-innervated periphery, and at the time that these neuroblasts became bipolar, those indifferent cells in close association with the dendrites of the bipolar cells began to develop axons (became unipolar). This led Barron to the following hypothesis: "That the peripheral field-the somatopleur-regulates the number of unipolar neuroblasts which continue their differentiation through the bipolar stage and the development of dendrites; that the dendrites in turn exercise an inductive influence on the associated indifferent cells which determines their course of differentiation into motor neuroblasts " (pages 93, 94). More recently, additional evidence in support of this hypothesis was presented by Mottet,'0 who considered various mechanisms by which the periphery might regulate the ultimate number of motor neurons (i, the rate or duration of the production of the anlage-indifferent cells; ii, the differentiation of these cells; iii, the maintenance of neurons after differ-

350

Anterior Spinal Artery Syndrome in a Girl With Down Syndrome: Case Report and Literature Review  

PubMed Central

Background/Objective: Anterior spinal artery syndrome is an extremely rare cause of acute ischemic cord infarction in children. It is caused by hypoperfusion of the anterior spinal artery, leading to ischemia in the anterior two thirds of the spinal cord. The presentation is usually with an acute and painful myelopathy with impaired bladder and bowel control. Pain and temperature sensation below the lesion are lost, whereas vibration and position sense is intact because of the preservation of the posterior columns. Methods: Case report. Results: A 16-year-old girl with Down syndrome presented with urinary retention and acute complete flaccid paralysis of the legs with absent deep tendon and abdominal reflexes. Magnetic resonance imaging showed a signal abnormality in the anterior half of the thoracic cord from T5 to T12, consistent with anterior spinal artery infarction. Conclusions: Pediatricians should consider anterior spinal artery syndrome in the child who presents with acute, painful myelopathy. We summarize the etiology, neurological findings and outcomes of 19 children found in the literature with anterior spinal artery syndrome. PMID:19810637

Sohal, Aman Singh; Sundaram, Manu; Mallewa, Mac; Tawil, Mohamed; Kneen, Rachel

2009-01-01

351

Posterior approach to ventrally located spinal meningiomas  

PubMed Central

For the resection of anteriorly located meningiomas, various approaches have been used. Posterior approach is less invasive and demanding; however, it has been associated with increased risk of spinal cord injury. We evaluated ten consecutive patients that underwent surgery for spinal meningiomas. All patients were preoperative assessed by neurological examination, computed tomography and magnetic resonance imaging. All tumors were ventrally located and removed via a posterior approach. Transcranial motor-evoked potentials (TcMEPs), somatosensory-evoked potential (SSEP) and free running electromyography (EMG) were monitored intraoperative. Postoperative all patients had regular follow-up examinations. There were four males and six females. The mean age was 68.2 years (range 39–82 years). In nine out of ten cases, the tumor was located in the thoracic spine. A case of a lumbar meningioma was recorded. The most common presenting symptom was motor and sensory deficits and unsteady gait, whereas no patient presented with paraplegia. All meningiomas were operated using a microsurgical technique via a posterior approach. During the operation, free running EMG monitoring prompted a surgical alert in case of irritation, whereas TcMEP and SSEP amplitudes remained unchanged. Histopathology revealed the presence of typical (World Health Organisation grade I) meningiomas. The mean Ki-67/MIB-1 index was 2.75% (range 0.5–7). None of our patients sustained a transient or permanent motor deficit. After a mean follow-up period of 26 months (range 56–16 months), no tumor recurrence and no instability were found. Posterior approach for anteriorly located meningiomas is a safe procedure with the use of intraoperative monitoring, less invasive and well-tolerated especially in older patients. Complete tumor excision can be performed with satisfactory results. PMID:20127494

Voulgaris, Spyridon; Mihos, Evaggelos; Karagiorgiadis, Dimitrios; Zigouris, Andreas; Fotakopoulos, George; Drosos, Dimitrios; Pahaturidis, Dimitrios

2010-01-01

352

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

353

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

354

[Histological evaluation of ischemic injury to the spinal cord. Experimental study in the rabbit].  

PubMed

Sometimes in clinical practice the spinal cord is subjected to a more or less prolonged period of ischemia, after which cellular lesions may occur, causing paraplegia. The purpose of this paper is to quantify morphologically the damage of the spinal cord after an induced ischemia. Seventy male adult rabbits were used. They were divided into three groups: one group was used for evaluation of spinal cord ischemia at 3 hours, the second at 12 hours and the third at 24 hours. The recovery periods ranged from 3, to 12 and 24 hours. At the end of this period, the animals were anesthetized and killed. A clinical evaluation was made using the Tarlov method and criteria. The spinal cord was subjected to a histological evaluation. The results revealed different changes according to the multiple groups of study. The authors discuss the data of the present study and compare to the reports published in the bibliography on the subject. PMID:17308628

Vaquero, Carlos; Arce, Nuria; Agudo, Javier; Martinez, Rafael; Gutiérrez, Vicente; Diago, Maria Victoria

2006-01-01

355

Perfusion assessment in rat spinal cord tissue using photoplethysmography and laser Doppler flux measurements  

NASA Astrophysics Data System (ADS)

Animal models are widely used to investigate the pathological mechanisms of spinal cord injury (SCI), most commonly in rats. It is well known that compromised blood flow caused by mechanical disruption of the vasculature can produce irreversible damage and cell death in hypoperfused tissue regions and spinal cord tissue is particularly susceptible to such damage. A fiberoptic photoplethysmography (PPG) probe and instrumentation system were used to investigate the practical considerations of making measurements from rat spinal cord and to assess its suitability for use in SCI models. Experiments to assess the regional perfusion of exposed spinal cord in anesthetized adult rats using both PPG and laser Doppler flowmetry (LDF) were performed. It was found that signals could be obtained reliably from all subjects, although considerable intersite and intersubject variability was seen in the PPG signal amplitude compared to LDF. We present results from 30 measurements in five subjects, the two methods are compared, and practical application to SCI animal models is discussed.

Phillips, Justin P.; Cibert-Goton, Vincent; Langford, Richard M.; Shortland, Peter J.

2013-03-01

356

Cooling athletes with a spinal cord injury.  

PubMed

Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 °C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport. PMID:25119157

Griggs, Katy E; Price, Michael J; Goosey-Tolfrey, Victoria L

2015-01-01

357

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

358

Intramedullary Tuberculoma of the Spinal Cord  

PubMed Central

In the differential diagnosis of intramedullary masses or tumors of the spinal cord, tuberculoma is an often overlooked possibility. Although rare, this entity should be considered in the differential gamut of spinal cord lesions even in the presence of a normal chest x-ray. ImagesFigure 1Figure 2 PMID:439153

Norman, Calvin H.; Pacis, Andresito B.

1979-01-01

359

Vascular permeability of spinal nerve roots  

Microsoft Academic Search

The permeability of blood vessels in rat spinal nerve roots was investigated with Evans blue-albumin as an in vivo macromolecular tracer and lanthanum as tracers as an electron microscopic ionic marker added to a fixative. Rats injected intravenously with Evans blue, showed macroscopic distinct staining of dorsal root ganglia, whereas spinal nerve roots remained unstained. Fluorescence microscopy, however, revealed clear

C. Å. V. Pettersson; H. S. Sharma; Y. Olsson

1990-01-01

360

SPINAL INSTABILITY SECONDARY TO METASTATIC CANCER  

Microsoft Academic Search

Fifty-five patients with severe pain from spinal instability secondary to metastatic cancer were referred to Hope Hospital, none beingjudged to be in a terminal condition. One patient had too extensive disease for surgery so 54 were treated by 55 spinal stabilisations; 49 obtained complete relief of pain and two had partial relief. There were three failures. Twenty-eight of the patients

C. S. B. GALASKO; HEATHER E. NORRIS; STELLA CRANK

2000-01-01

361

Nutrition of People with Spinal Cord Injuries  

Technology Transfer Automated Retrieval System (TEKTRAN)

This conference proceeding summarizes current knowledge about the nutritional status and needs of the spinal cord injured patient. Topics covered include the aspects of spinal cord injury that influence nutrient intakes and status, and the nutrients most likely to be problematic in this diverse gro...

362

How Is Spinal Cord Injury (SCI) Diagnosed?  

MedlinePLUS

... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved June 26, 2012, from ... sci.htm [top] University Specialty Clinics. (n.d.). Spinal cord injury . Retrieved June 26, 2012, from http://neurosurgery.med. ...

363

Psychological Aspects of Spinal Cord Injury  

ERIC Educational Resources Information Center

Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)

Cook, Daniel W.

1976-01-01

364

Spinal cord herniation into pseudomeningocele after traumatic nerve root avulsion: case report and review of the literature  

PubMed Central

We present an extremely rare case of traumatic spinal cord herniation due to a brachial plexus avulsion injury and provide a review of the literature of spinal cord herniation. Spinal cord herniation is an uncommon condition that can occur spontaneously or as a result of surgery or trauma. This condition often presents with symptoms and signs as Brown-Séquard syndrome. Traumatic pseudomeningoceles after a brachial plexus avulsion injury have been reported. But transdural herniation of the spinal cord into this pseudomeningocele is an extremely rare and poorly documented condition. There is only two reports of this condition in a thoracic case. The authors report the case of a 22-year-old man presented with a 2-year history of quadriplegia. He was involved in a motorcycle accident, 3 years prior to his presentation. Four years after the initial right brachial plexus injury, he was not able to walk independently. Magnetic resonance imaging (MRI) and computerized tomography (CT) myelography revealed a lateral pseudomeningocele arising from the right C6–7 and C7–T1 intervetebral foramen and cervical spinal cord herniation into this pseudomeningocele. The patient underwent primary closure of pseudomeningocele to prevent spinal cord reherniation. He can walk with cane and use left arm unrestrictedly at the 2-year follow-up examination. Spinal cord herniation following traumatic nerve root avulsion is extremely rare but it should be considered in the differential diagnosis of patients presenting with delayed myelopathy or Brown-Séquard syndrome. PMID:17987326

Ikuma, Hisanori; Nakanishi, Kazuo; Sugimoto, Yoshihisa; Misawa, Haruo; Takigawa, Tomoaki; Ozaki, Toshifumi

2007-01-01

365

Bioengineered scaffolds for spinal cord repair.  

PubMed

Spinal cord injury can lead to devastating and permanent loss of neurological function, affecting all levels below the site of trauma. Unfortunately, the injured adult mammalian spinal cord displays little regenerative capacity and little functional recovery in large part due to a tissue environment that is nonpermissive for regenerative axon growth. Artificial tissue repair scaffolds may provide a physical guide to allow regenerative axon growth that bridges the lesion cavity and restores functional neural connectivity. By integrating different strategies, including the use of various biomaterials and microstructures as well as incorporation of bioactive molecules and living cells, combined or synergistic effects for spinal cord repair through regenerative axon growth may be achieved. This article briefly reviews the development of bioengineered scaffolds for spinal cord repair, focusing on spinal cord injury and the subsequent cellular response, scaffold materials, fabrication techniques, and current therapeutic strategies. Key issues and challenges are also identified and discussed along with recommendations for future research. PMID:21338266

Wang, Mindan; Zhai, Peng; Chen, Xiongbiao; Schreyer, David J; Sun, Xiaodan; Cui, Fuzhai

2011-06-01

366

Pure Spinal Epidural Cavernous Hemangioma with Intralesional Hemorrhage: A Rare Cause of Thoracic Myelopathy  

PubMed Central

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

2014-01-01

367

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

368

Descending brain neurons in larval lamprey: Spinal projection patterns and initiation of locomotion  

PubMed Central

In larval lamprey, partial lesions were made in the rostral spinal cord to determine which spinal tracts are important for descending activation of locomotion and to identify descending brain neurons that project in these tracts. In whole animals and in vitro brain/spinal cord preparations, brain-initiated spinal locomotor activity was present when the lateral or intermediate spinal tracts were spared but usually was abolished when the medial tracts were spared. We previously showed that descending brain neurons are located in eleven cell groups, including reticulospinal (RS) neurons in the mesenecephalic reticular nucleus (MRN) as well as the anterior (ARRN), middle (MRRN), and posterior (PRRN) rhombencephalic reticular nuclei. Other descending brain neurons are located in the diencephalic (Di) as well as the anterolateral (ALV), dorsolateral (DLV), and posterolateral (PLV) vagal groups. In the present study, the Mauthner and auxillary Mauthner cells, most neurons in the Di, ALV, DLV, and PLV cell groups, and some neurons in the ARRN and PRRN had crossed descending axons. The majority of neurons projecting in medial spinal tracts included large identified Müller cells and neurons in the Di, MRN, ALV, and DLV. Axons of individual descending brain neurons usually did not switch spinal tracts, have branches in multiple tracts, or cross the midline within the rostral cord. Most neurons that projected in the lateral/intermediate spinal tracts were in the ARRN, MRRN, and PRRN. Thus, output neurons of the locomotor command system are distributed in several reticular nuclei, whose neurons project in relatively wide areas of the cord. PMID:20510243

Shaw, Albert C.; Jackson, Adam W.; Holmes, Tamra; Thurman, Suzie; Davis, G.R.; McClellan, Andrew D.

2010-01-01

369

EGb761 Protects Hydrogen Peroxide-induced Death of Spinal Cord Neurons through Inhibition of Intracellular ROS Production and Modulation of Apoptotic Regulating Genes  

Microsoft Academic Search

The present study was conducted to investigate whether Ginkgo biloba extract (EGb) 761 could protect spinal cord neurons from H2O2-induced toxicity. In primary spinal cord neurons isolated from embryonic day 14 rats, H2O2 administration resulted in a significant decrease in the survival of spinal cord neurons. Terminal deoxynucleotidyl transferase-mediated\\u000a dUTP nick-end labeling (TUNEL) and Hoechst 33342 nuclear staining showed that

Xiaoyan Jiang; Baoming Nie; Saili Fu; Jianguo Hu; Lan Yin; Lin Lin; Xiaofei Wang; Peihua Lu; Xiao-Ming Xu

2009-01-01

370

Sexual Function Among Patients with Spinal Cord Injury  

Microsoft Academic Search

Summary Hundred and fifty spinal cord injury patients were interviewed concerning erections, coitus, ejaculation and orgasm. 123 (82%) were able to attain erections. 115 patients had upper motor neuron lesions (reflex activity present in the sacral segments). Seventy-five of the 115 patients had complete lesions; 9% had psychic erections, 95% had spontaneous erections, 92% had erections from penile stimulation. 44%

A. E. Comarr

1970-01-01

371

Candida albicans spinal epidural abscess secondary to prosthetic valve endocarditis  

Microsoft Academic Search

A 56-year-old woman, with underlying rheumatic heart disease status post mitral valve replacement, presented with fever, low back pain radiating to right leg, and congestive heart failure. Magnetic resonance imaging detected an L5-S1 spinal epidural abscess. A vegetation on prosthetic mitral valve was found by transesophageal echocardiography. Cultures of epidural aspirate, surgical specimen, and blood all grew Candida albicans. She

Ja-Der Liang; Chi-Tai Fang; Yee-Chun Chen; Shan-Chwen Chang; Kwen-Tay Luh

2001-01-01

372

A rare case of spinal dural arteriovenous fistula  

PubMed Central

Spinal dural arteriovenous fistula (SDAVF) is a rare vascular malformation of the spine. Only a limited number of cases of SDAVF have been reported in the current literature. We describe the case of a 74 year old male who presented with gradually progressive bilateral lower extremity weakness and bladder dysfunction and was subsequently diagnosed with SDAVF affecting both the thoracic and lumbar spine. The patient later underwent embolization with some improvement in his neurologic symptoms. PMID:23355932

Apostolova, Mariya; Nasser, Samer; Kodsi, Samir

2012-01-01

373

Pure intramedullary spinal cord metastasis secondary to gastric cancer  

Microsoft Academic Search

Pure intramedullary spinal-cord metastases (ISCM) are a rare manifestation of cancer. We report a case of ISCM from gastric\\u000a cancer. A 68-year-old man, treated with total gastrectomy for a gastric cancer, presented 9 months later with paresis of the\\u000a left arm, pain and dissociated sensory loss. Magnetic resonance imaging revealed a pure intramedullary lesion at the C3–C5\\u000a level. After surgical

Roberto Gazzeri; Marcelo Galarza; Andrea Faiola; Giovanni Gazzeri

2006-01-01

374

Expression of CAPON after Spinal Cord Injury in Rats  

Microsoft Academic Search

The adaptor protein, carboxy-terminal PDZ ligand of nNOS (CAPON), regulates the distribution of neuronal nitric oxide synthase\\u000a (nNOS) that increased after spinal cord injury (SCI) and produces the key signaling molecule nitric oxide (NO). But little\\u000a is known about the role of CAPON in the pathological process of SCI. The main objective of the present study was to investigate\\u000a expression

Chun Cheng; Xin Li; Shangfeng Gao; Shuqiong Niu; Mengling Chen; Jing Qin; Zhiqin Guo; Jian Zhao; Aiguo Shen

2008-01-01

375

Cerebral and spinal air embolism following percutaneous nephrolithotomy.  

PubMed

We present a case report of cerebral and spinal air embolism following percutaneous nephrolithotomy in a patient without evidence of intra-cardiac defects or prepulmonary A-V shunts. The position of the patient during the incidence determined the site of eventual lodgement of air emboli in the arterial circulation. We suspect that the time of onset of symptoms following the procedure may be the clue to the path followed by air emboli. PMID:21755765

Kachalia, Amit Girish; Savant, Charulata Sankhla; Patil, Suhas; Gupta, Santosh; Kapadia, Farhad N

2011-04-01

376

Thoracic vertebral hemangioma with extradural extension and spinal cord compression  

Microsoft Academic Search

A 45-year-old man presented with progressive numbness of lower extremities and unsteady gait. Magnetic resonance imaging of the dorsal spine demonstrated multiple hyperintense inactive vertebral hemangiomas on T-1 weighted images. There was an active hemangioma involving D7 vertebral body and neural arch with epidural extension and spinal cord compression. He underwent embolization of the main feeders of the lesion and

1998-01-01

377

Pneumomediastinum, Subcutaneous Emphysema, and Tracheal Tear in the Early Postoperative Period of Spinal Surgery in a Paraplegic Achondroplastic Dwarf  

PubMed Central

Achondroplasia was first described in 1878 and is the most common form of human skeletal dysplasia. Spinal manifestations include thoracolumbar kyphosis, foramen magnum, and spinal stenosis. Progressive kyphosis can result in spinal cord compression and paraplegia due to the reduced size of spinal canal. The deficits are typically progressive, presenting as an insidious onset of paresthesia, followed by the inability to walk and then by urinary incontinence. Paraplegia can be the result of direct pressure on the cord by bone or the injury to the anterior spinal vessels by a protruding bone. Surgical treatment consists of posterior instrumentation, fusion with total wide laminectomy at stenosis levels, and anterior interbody support. Pedicle screws are preferred for spinal instrumentation because wires and hooks may induce spinal cord injury due to the narrow spinal canal. Pedicle lengths are significantly shorter, and 20–25?mm long screws are appropriate for lower thoracic and lumbar pedicles in adult achondroplastic There is no information about the appropriate length of screws for the upper thoracic pedicles. Tracheal injury due to inappropriate pedicle screw length is a rare complication. We report an extremely rare case of tracheal tear due to posterior instrumentation and its management in the early postoperative period. PMID:24455372

Kahraman, Sinan; Enercan, Meriç; Demirhan, Özkan; ?engül, Türker; Hamzao?lu, Azmi

2013-01-01

378

Valproate prevents dysregulation of spinal glutamate and reduces the development of hypersensitivity in rats after peripheral nerve injury  

PubMed Central

The present study examined whether the histone deacetylase inhibitor valproate prevents down-regulation of glutamate transporters in the primary cultured astrocytes and in the spinal cord after L5-L6 spinal nerve ligation (SNL), and whether this action of valproate on spinal glutamate transporters prevents spinal glutamate dysregulation and development of hypersensitivity after SNL. In cultured astrocytes, valproate prevented down-regulation of glutamate transporter-1 (GLT-1) and glutamate-aspartate transporter (GLAST) in a concentration dependent manner. Repeated oral administration of valproate reduced the development of hypersensitivity and prevented the down-regulation of spinal GLT-1 and GLAST expression in rats after SNL, but did not affect mechanical nociception and expression of those transporters in normal rats. Valproate's effects on hypersensitivity and spinal GLT-1 expression in SNL rats were blocked by intrathecal administration of the selective GLT-1 blocker dihydrokainic acid or the GLT-1 selective small interfering RNA (siRNA). Extracellular glutamate concentration in the spinal cord, measured by microdialysis, was increased in animals with SNL or after GLT-1 selective siRNA treatment, and valproate prevented the SNL-induced glutamate increase. These results suggest that valproate reduces the development of chronic pain after nerve injury in part via preventing down-regulation of glutamate transporters, especially GLT-1, to maintain normal extracellular glutamate concentrations in the spinal cord. PMID:24021575

Yoshizumi, Masaru; Eisenach, James. C.; Hayashida, Ken-ichiro

2013-01-01

379

Dystrophic Spinal Deformities in a Neurofibromatosis Type 1 Murine Model  

PubMed Central

Despite the high prevalence and significant morbidity of spinal anomalies in neurofibromatosis type 1 (NF1), the pathogenesis of these defects remains largely unknown. Here, we present two murine models: Nf1flox/?;PeriCre and Nf1flox/?;Col.2.3Cre mice, which recapitulate spinal deformities seen in the human disease. Dynamic histomorphometry and microtomographic studies show recalcitrant bone remodeling and distorted bone microarchitecture within the vertebral spine of Nf1flox/?;PeriCre and Nf1flox/?;Col2.3Cre mice, with analogous histological features present in a human patient with dystrophic scoliosis. Intriguingly, 36–60% of Nf1flox/?;PeriCre and Nf1flox/?;Col2.3Cre mice exhibit segmental vertebral fusion anomalies with boney obliteration of the intervertebral disc (IVD). While analogous findings have not yet been reported in the NF1 patient population, we herein present two case reports of IVD defects and interarticular vertebral fusion in patients with NF1. Collectively, these data provide novel insights regarding the pathophysiology of dystrophic spinal anomalies in NF1, and provide impetus for future radiographic analyses of larger patient cohorts to determine whether IVD and vertebral fusion defects may have been previously overlooked or underreported in the NF1 patient population. PMID:25786243

Yang, Dalong; Yang, Hao; Chen, Shi; Wu, Xiaohua; Li, Xiaohong; Yang, Xianlin; Mohammad, Khalid S.; Guise, Theresa A.; Bergner, Amanda L.; Stevenson, David A.; Yang, Feng-Chun

2015-01-01

380

Instrumental Learning Within the Spinal Cord: Underlying Mechanisms  

E-print Network

the recovery of function after a contusion injury. Key Words: spinal cord, instrumental learning, recovery for the treatment of spinal cord injury. For example, consider the issue of spanning a spinal injury with a neural191 Instrumental Learning Within the Spinal Cord: Underlying Mechanisms and Implications

Grau, James

381

Rehabilitation of spinal cord injuries.  

PubMed

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-18

382

Spinal cord herniation as a complication of en bloc, multilevel, anterior thoracic vertebrectomy for a giant cell tumor: success of posterior cord reduction and dural repair.  

PubMed

Iatrogenic spinal cord herniation is a rare complication following spinal stabilization surgery. The authors present a case of circumferential thoracic tumor decompression and fixation by anterior instrumentation complicated by delayed anterior spinal cord herniation. This complication resulted in progressive paraparesis 5 years after the original procedure. The patient underwent reexploration and repair of the dural defect, resulting in the reduction of the spinal cord to its normal position. The patient's paraparesis improved significantly after dural repair. Although progression of neurological deficit can be very slow, repair of the dural defect can restore normal spinal cord alignment and improve neurological deficit. To the best of the authors' knowledge, this is the first reported case of spinal cord herniation following an anterior thoracic vertebrectomy. PMID:25237844

Kawsar, Khandkar A; Bhatia, Robin; Casey, Adrian C T H

2014-12-01

383

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

SciTech Connect

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

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

2010-11-15

384

Rapamycin ameliorates neuropathic pain by activating autophagy and inhibiting interleukin-1? in the rat spinal cord.  

PubMed

Autophagy acts as an important homoeostatic mechanism by degradation of cytosolic constituents and plays roles in many physiological processes. Recent studies demonstrated that autophagy can also regulate the production and secretion of the proinflammatory cytokine interleukin-1? (IL-1?), which plays a critical role in the development and maintenance of neuropathic pain. In the present study, the paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were significantly decreased after spinal nerve ligation (SNL), and the changes were accompanied by inhibited autophagy in the spinal microglia and increased mRNA and protein levels of IL-1? in the ipsilateral spinal cord. We then investigated the antinociceptive effect of rapamycin, a widely used autopahgy inducer, on SNL-induced neuropathic pain in rats and found that treatment with intrathecal rapamycin significantly attenuated the mechanical allodynia and thermal hyperalgesia. Moreover, rapamycin significantly enhanced autophagy in the spinal microglia, whereas it reduced the mRNA and protein levels of IL-1? in the ipsilateral spinal cord. Our results showed that rapamycin could ameliorate neuropathic pain by activating autophagy and inhibiting IL-1? in the spinal cord. PMID:25480578

Feng, Tao; Yin, Qin; Weng, Ze-Lin; Zhang, Jian-Cheng; Wang, Kun-Feng; Yuan, Shi-Ying; Cheng, Wei

2014-12-01

385

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

386

The Organotypic Longitudinal Spinal Cord Slice Culture for Stem Cell Study  

PubMed Central

The objective of this paper is to describe in detail the method of organotypic longitudinal spinal cord slice culture and the scientific basis for its potential utility. The technique is based on the interface method, which was described previously and thereafter was modified in our laboratory. The most important advantage of the presented model is the preservation of the intrinsic spinal cord fiber tract and the ventrodorsal polarity of the spinal cord. All the processes occurring during axonal growth, regeneration, synapse formation, and myelination could be visualized while being cultured in vitro for up to 4-5 weeks after the slices had been isolated. Both pups and adult animals can undergo the same, equally efficient procedures when going by the protocol in question. The urgent need for an appropriate in vitro model for spinal cord regeneration results from a greater number of clinical trials concerning regenerative medicine in the spinal cord injury and from still insufficient knowledge of the molecular mechanisms involved in the neuroreparative processes. The detailed method of organotypic longitudinal spinal cord slice culture is accompanied by examples of its application to studying biological processes to which both the CNS inhabiting and grafted cells are subjected. PMID:25802530

Sypecka, Joanna; Koniusz, Sylwia; Kawalec, Maria

2015-01-01

387

Robotic loading during treadmill training enhances locomotor recovery in rats spinally transected as neonates  

PubMed Central

Loading on the limbs has a powerful influence on locomotion. In the present study, we examined whether robotic-enhanced loading during treadmill training improved locomotor recovery in rats that were spinally transected as neonates. A robotic device applied a force on the ankle of the hindlimb while the rats performed bipedal stepping on a treadmill. The robotic force enhanced loading during the stance phase of the step cycle. One group of spinally transected rats received 4 wk of bipedal treadmill training with robotic loading while another group received 4 wk of bipedal treadmill training but without robotic loading. The two groups exhibited similar stepping performance during baseline tests of bipedal treadmill stepping. However, after 4 wk, the spinally transected rats that received bipedal treadmill training with robotic loading performed significantly more weight-bearing steps than the bipedal treadmill training only group. Bipedal treadmill training with robotic loading enhanced the ankle trajectory and ankle velocity during the step cycle. Based on immunohistochemical analyses, the expression of the presynaptic marker, synaptophysin, was significantly greater in the ventral horn of the lumbar spinal cord of the rats that received bipedal treadmill training with robotic loading. These findings suggested that robotic loading during bipedal treadmill training improved the ability of the lumbar spinal cord to generate stepping. The results have implications for the use of robotic-enhanced gait training therapies that encourage motor learning after spinal cord injury. PMID:23678012

See, Pamela Anne

2013-01-01

388

Spinal cord involvement in chronic inflammatory demyelinating polyradiculoneuropathy: a clinical and MRI study.  

PubMed

Concomitant central nervous system (CNS) involvement in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is rare. Although the spinal nerve roots may present MRI abnormalities in CIDP, hitherto, the spinal cord has been investigated in a single study. We retrospectively investigated clinically and with MRI a cohort of patients with definite CIDP diagnosis (EFNS/PNS criteria) for evidence of brain and spinal cord involvement, who were initially admitted in our department during the last 4 years. Among 12 patients with CIDP (men: 8, mean age: 59.3 years, mean disease duration: 3.8 years), nine patients had their MRI scan during a clinical relapse and three during remission. Brain MRI did not document typical multiple sclerosis lesions in any patient. We did not identify any MRI abnormalities in ten patients without clinical evidence of spinal cord involvement. Conversely, MRI disclosed extensive lesions of the thoracic cord in two patients with an overt spinal cord syndrome, whom we describe. This represents the biggest MRI study of CIDP patients who have been investigated for spinal cord involvement. Our data support earlier observations that a minority of CIDP patients may additionally develop CNS involvement of variable degree. PMID:24988899

Ioannidis, Panagiotis; Parissis, Dimitris; Karapanayiotides, Theodoros; Maiovis, Pantelis; Karacostas, Dimitris; Grigoriadis, Nikolaos

2014-07-01

389

Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity  

PubMed Central

The state of areflexia and muscle weakness that immediately follows a spinal cord injury (SCI) is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent animal and human studies that describe how motoneurons and their activation by sensory pathways become hyperexcitable to compensate for the reduction of functional activation of the spinal cord and the eventual impact on the muscle. Specifically, decreases in the inhibitory control of sensory transmission and increases in intrinsic motoneuron excitability are described. We present the idea that replacing lost patterned activation of the spinal cord by activating synaptic inputs via assisted movements, pharmacology or electrical stimulation may help to recover lost spinal inhibition. This may lead to a reduction of uncontrolled activation of the spinal cord and thus, improve its controlled activation by synaptic inputs to ultimately normalize circuit function. Increasing the excitation of the spinal cord with spared descending and/or peripheral inputs by facilitating movement, instead of suppressing it pharmacologically, may provide the best avenue to improve residual motor function and manage spasticity after SCI. PMID:24860447

D'Amico, Jessica M.; Condliffe, Elizabeth G.; Martins, Karen J. B.; Bennett, David J.; Gorassini, Monica A.

2014-01-01

390

Two-photon Imaging of Cellular Dynamics in the Mouse Spinal Cord.  

PubMed

Two-photon (2P) microscopy is utilized to reveal cellular dynamics and interactions deep within living, intact tissues. Here, we present a method for live-cell imaging in the murine spinal cord. This technique is uniquely suited to analyze neural precursor cell (NPC) dynamics following transplantation into spinal cords undergoing neuroinflammatory demyelinating disorders. NPCs migrate to sites of axonal damage, proliferate, differentiate into oligodendrocytes, and participate in direct remyelination. NPCs are thereby a promising therapeutic treatment to ameliorate chronic demyelinating diseases. Because transplanted NPCs migrate to the damaged areas on the ventral side of the spinal cord, traditional intravital 2P imaging is impossible, and only information on static interactions was previously available using histochemical staining approaches. Although this method was generated to image transplanted NPCs in the ventral spinal cord, it can be applied to numerous studies of transplanted and endogenous cells throughout the entire spinal cord. In this article, we demonstrate the preparation and imaging of a spinal cord with enhanced yellow fluorescent protein-expressing axons and enhanced green fluorescent protein-expressing transplanted NPCs. PMID:25742043

Weinger, Jason G; Greenberg, Milton L; Matheu, Melanie P; Parker, Ian; Walsh, Craig M; Lane, Thomas E; Cahalan, Michael D

2015-01-01

391

Stochastic resonance in the spinal cord and somatosensory cortex of the cat  

NASA Astrophysics Data System (ADS)

The aim of this study was to demonstrate the occurrence of stochastic resonance (SR) in spinal and cortical potentials elicited by periodic tactile stimuli in the anaesthetised cat. The periodic tactile stimuli were applied on the central pad of the hindpaw and the noisy tactile stimuli on the glabrous skin of the third hindpaw digit. This protocol allowed that the signal and noise were mixed not in the skin but in the somatosensory regions of the central nervous system. The results show that a particular level of tactile noise can increase the amplitude of the spinal and cortical potentials elicited by periodic tactile stimuli. The topographical distribution of evoked potentials indicates that the effects of noise were spatially restricted. All cats showed distinct SR behavior at the spinal and cortical stages of the sensory encoding. Such SR was abolished in the cortical but not in the spinal recording after the sectioning of the ascending pathways. This suggests that the spinal neurones may also contribute to the SR observed at the cortical level. The present study documents the first evidence that the SR phenomenon occurs in the spinal and cortical somatosensory system itself and not only in the peripheral sensory receptors.

Manjarrez, Elias; Rojas-Piloni, Gerardo; Perez, Hugo; Mendez, Ignacio; Hernandez-Paxtian, Zulma; Flores, Amira

2003-05-01

392

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

393

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. PMID:25187873

Hasankhani, Ebrahim Ghayem; Ashjazadeh, Amir

2014-01-01

394

Serotonin Affects Movement Gain Control in the Spinal Cord  

PubMed Central

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

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

2014-01-01

395

Spinal interneurones involved in presynaptic controls of supraspinal origin†  

PubMed Central

1. Interneurones presenting heterotopic and heterosensory convergence have been identified in laminae VI-VII of the lumbar dorsal horn in the cat. Stimulation of the hind limbs sometimes induced a bimodal response, but we considered only the late convergent discharge. 2. The fact that response latencies are longer to hind limb than to forelimb stimulation at this level suggests the intervention of a supraspinal loop in the activation of spinal convergent units. This hypothesis is supported by the relationship between the excitability of supraspinal structures and the discharge intensity of convergent cells as well as by the absence of long latency responses in the spinal preparation. 3. Electrophysiological and pharmacological evidence discloses a strong relationship between convergent unit discharges and the occurrence of dorsal root potentials to cortical, heterosegmental and heterosensory stimulation. 4. It is suggested that convergent units receive information of supraspinal origin and exert control over sensory input to the cord via primary afferent depolarization. PMID:4702428

Besson, J. M.; Rivot, J. P.

1973-01-01

396

Functional electrical stimulation for incomplete spinal cord injury  

PubMed Central

This case report describes the early use of functional electrical stimulation on an individual with an incomplete spinal cord injury to assist with motor recovery and a return to ambulation. A 32-year-old woman sustained a C7 burst fracture after a fall, requiring anterior cervical fixation from C6 to T1 prior to transfer to acute rehabilitation. She presented as a C8 AIS B spinal cord injury, meaning she had some sensory function spared below the level of injury but not motor function. At discharge from acute inpatient rehabilitation, she was able to ambulate household distances with supervision using a rolling walker and required a manual wheelchair for community mobility. Four months after discharge, she was ambulating in the community using a standard cane. PMID:25484510

2014-01-01

397

Herniated Lumbar Disc Combined with Spinal Intradural Extramedullary Cysticercosis  

PubMed Central

Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis. PMID:21430986

Choi, Kyeong Bo; Choi, Won Gyu; Lee, Sang-Ho

2010-01-01

398

Spinal Extradural Meningeal Cyst in Klippel-Trenaunay Syndrome  

PubMed Central

A case of a symptomatic spinal extradural meningeal cyst (SEMC) in Klippel-Trenaunay syndrome (KTS) is introduced. A 38-year-old woman presented with right L2 radiculopathy. She underwent operations for varicose veins in both her lower extremities. She had port-wine nevi on her trunk and extremities. The edematous change in both legs had waxed and waned. Magnetic resonance imaging showed an 11.8×13 mm extradural meningeal cyst growing through the intervertebral foramen in L2-3. Multiple meningeal cysts were located in the dorsal aspect of the spinal cord from T3 to T10. A 5.8×6.2 mm cyst was also found in left pleural cavity. The extradural meningeal cyst was completely excised and the preoperative symptom was improved. KTS is a congenital disorder due to a mesodermal abnormality, which may predispose the dura to weakness. The SEMC may occur through the dural defect or weakened point. PMID:21716629

Choi, Kyung-Chul; Shin, Yong Hawn; Lee, Sang-Ho

2011-01-01

399

Phantom limb pain from spinal sarcoma: a case report.  

PubMed

Phantom limb pain is a frequent sequela of amputation. A high prevalence of residual limb pain and back pain also exists among amputees. We present a case of a new-onset severe phantom limb pain resulting from a metastatic spinal mass in an 81-year-old patient with a history of malignant sarcoma and an old hip disarticulation amputation. The metastatic lesion, upon imaging, was found to involve the L3 vertebra and caused moderate compression of the thecal sac on the right and severe right lateral recess stenosis. After the mass was resected, the patient's phantom limb pain resolved. Our case report demonstrates that spinal metastatic pathologies may be a cause of phantom limb pain and should be included in the differential diagnosis of new-onset phantom limb pain or a change in phantom limb pain. PMID:23880049

Cruz, Ernesto; Dangaria, Harsh T

2013-07-01

400

Photoplethysmographic sensors for perfusion measurements in spinal cord tissue  

NASA Astrophysics Data System (ADS)

Sensors for recording photoplethysmographic signals from the nervous tissue of the spinal cord are described. The purpose of these sensors is to establish whether perfusion is compromised in various states of injury which occur in certain animal models of spinal cord injury, for example compression injury. Various measures of perfusion are applicable such as the amplitude of the photoplethysmograph signal and the oxygen saturation, measured using a dual wavelength configuration. Signals are usually compared to baseline measurements made in uninjured subjects. This paper describes two types of probe, one based on optical fibres, and one in which optotes are placed in direct contact with the tissue surface. Results from a study based on a compression model utilising a fibreoptic sensor are presented.

Phillips, J. P.; Kyriacou, P. A.

2011-08-01

401

Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy.  

PubMed

MRI was performed on the spinal roots, brachial and lumbar plexuses of 14 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Hypertrophy of cervical roots and brachial plexus was demonstrated in eight cases, six of whom also had hypertrophy of the lumbar plexus. Of 11 patients who received gadolinium, five of six cases with hypertrophy and one of five without hypertrophy demonstrated enhancement. All patients with hypertrophy had a relapsing-remitting course and a significantly longer disease duration. Gross onion-bulb formations were seen in a biopsy of nerve from the brachial plexus in one case with clinically evident nodular hypertrophy. We conclude that spinal root and plexus hypertrophy may be seen on MRI, particularly in cases of CIDP of long duration, and gadolinium enhancement may be present in active disease. PMID:10388803

Duggins, A J; McLeod, J G; Pollard, J D; Davies, L; Yang, F; Thompson, E O; Soper, J R

1999-07-01

402

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

403

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

404

Spinal stimulator peri-electrode masses: case report.  

PubMed

The authors describe a case of delayed spastic quadriparesis caused by a peri-electrode mass following the implantation of a minimally invasive percutaneous spinal cord stimulator (SCS). Prior reports with paddle-type electrodes are reviewed, and a detailed histological and pathophysiological comparison with the present case is made. The patient developed tolerance to a cervical percutaneous SCS 4 months after implantation, followed by the onset of spastic quadriparesis 9 months after implantation. The stimulator was removed, and contrast-enhanced MRI revealed an enhancing epidural mass where the system had been placed, with severe spinal cord compression. Decompression was carried out, and the patient experienced neurological improvement. Pathological examination revealed fibrotic tissue with granulomatous and multinucleated giant cell reactions. No evidence of infection or hemorrhage was found. Professionals treating patients with SCSs or contemplating their insertion should be aware of this delayed complication and associated risk factors. PMID:25380541

Scranton, Robert A; Skaribas, Ioannis M; Simpson, Richard K

2015-01-01

405

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

406

Transplants and neurotrophic factors increase regeneration and recovery of function after spinal cord injury.  

PubMed

Earlier studies suggested that while after spinal cord lesions and transplants at birth, the transplants serve both as a bridge and as a relay to restore supraspinal input caudal to the injury (Bregman, 1994), after injury in the adult the spinal cord transplants serve as a relay, but not as a bridge. We show here, that after complete spinal cord transection in adult rats, delayed spinal cord transplants and exogenous neurotrophic factors, the transplants can also serve as a bridge to restore supraspinal input (Fig. 9). We demonstrate here that when the delivery of transplants and neurotrophins are delayed until 2 weeks after spinal cord transection, the amount of axonal growth and the amount of recovery of function are dramatically increased. Under these conditions, both supraspinal and propriospinal projections to the host spinal cord caudal to the transection are reestablished. The growth of supraspinal axons across the transplant and back into the host spinal cord caudal to the lesion was dependent upon the presence of exogenous neurotrophic support. Without the neurotrophins, only propriospinal axons were able to re-establish connections across the transplant. Studies using peripheral nerve or Schwann cell grafts have shown that some anatomical connectivity can be restored across the injury site, particularly under the influence of neurotrophins (Xu et al., 1995a,b; Cheng et al., 1996; Ye and Houle, 1997). Without neurotrophin treatment, brainstem axons do not enter [figure: see text] the graft (Xu et al., 1995a,b; Cheng et al., 1996; Ye and Houle, 1997). Similarly, cells genetically modified to secrete neurotrophins and transplanted into the spinal cord influence the axonal growth of specific populations of spinally projecting neurons (Tuszynski et al., 1996, 1997; Grill et al., 1997; Blesch and Tuszynski, 1997). Taken together, these studies support a role for neurotrophic factors in the repair of the mature CNS. The regrowth of supraspinal and propriospinal input across the transection site was associated with consistent improvements in hindlimb locomotor function. Animals performed alternating and reciprocal hindlimb stepping with plantar foot contact to the treadmill or stair during ascension. Furthermore, they acquired hindlimb weight support and demonstrated appropriate postural control for balance and equilibrium of all four limbs. After spinal cord injury in the adult, the circuitry underlying rhythmic alternating stepping movements is still present within the spinal cord caudal to the lesion, but is now devoid of supraspinal control. We show here that restoring even relatively small amounts of input allows supraspinal neurons to access the spinal cord circuitry. Removing the re-established supraspinal input after recovery (by retransection rostral to the transplant) abolished the recovery and abolished the serotonergic fibers within the transplant and spinal cord caudal to the transplant. This suggests that at least some of the recovery observed is due to re-establishing supraspinal input across the transplant, rather than a diffuse influence of the transplant on motor recovery. It is unlikely, however, that the greater recovery of function in animals that received delayed transplant and neurotrophins is due solely to the restoration of supraspinal input. Recent work by Ribotta et al. (2000) suggests that segmental plasticity within the spinal cord contributes to weight support and bilateral foot placement after spinal cord transection. This recovery of function occurs after transplants of fetal raphe cells into the adult spinal cord transected at T11. Recovery of function appears to require innervation of the L1-L2 segments with serotonergic fibers, and importantly, animals require external stimulation (tail pinch) to elicit the behavior. In the current study, animals with transection only did not develop stepping overground or on the treadmill without tail pinch, although the transplant and neurotrophin-treated groups did so without external stimuli. Therefore both reorganization of the segmental circuit

Bregman, Barbara S; Coumans, Jean-Valery; Dai, Hai Ning; Kuhn, Penelope L; Lynskey, James; McAtee, Marietta; Sandhu, Faheem

2002-01-01

407

Lumbar spinal stenosis in the elderly: an overview.  

PubMed

Lumbar spinal stenosis is a common condition in elderly patients and also one of the most common reasons to perform spinal surgery at an advanced age. Disc degeneration, facet degeneration and hypertrophy, and ligamentum flavum hypertrophy and calcification usually participate in the genesis of a stenotic condition in the elderly. These changes can lead to symptoms by themselves or decompensate a preexisting narrow canal. Although some lesions are more central or more lateral, this classic dichotomy is less present in the elderly patient, in whom the degenerative process usually encroaches both central and lateral pathways. Some less common causes of lumbar spinal stenosis are found in the aging subject, such as Paget's disease. However, it must be stressed that so-called stenotic images (sometimes severe) are present on imaging studies in a great number of symptom-free individuals, and that the relationship between degenerative lesions, importance of abnormal images, and complaints is still unclear. Lumbar stenosis is a very common reason for decompressive surgery and/or fusion. Various conditions can lead to a narrowing of the neural pathways and differential diagnosis with vascular troubles, also common in the elderly, can be challenging. The investigation of stenotic symptoms should be extremely careful and thorough and include a choice of technical examinations including vascular investigations. This is of utmost importance, especially if a surgical sanction is considered to avoid disappointing results. PMID:13680315

Szpalski, Marek; Gunzburg, Robert

2003-10-01

408

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. PMID:25346770

Jeong, Seong Kyun; Seong, Han Yu

2014-01-01

409

Arterial peculiarities of the thoracolumbar spinal cord in rabbit.  

PubMed

The aim of this study was to investigate the arterial blood supply of the thoracolumbar spinal cord in rabbit. The study was carried out on twenty adult New Zealand white rabbits. Ten rabbits were used in the corrosion technique and ten rabbits in the dissection technique. After the killing, the vascular network was perfused with saline. Batson's corrosion casting kit no. 17 © was used as a casting medium. After polymerisation of the medium, in ten rabbits the maceration was carried out in KOH solution, and in ten other rabbits, formaldehyde was injected by the dissection technique into the vertebral canal. We found high variability of segmental arteries supplying blood to the spinal cord. There are 12 intercostal arteries and 1 costo-abdominal artery. Dorsal branches arising from the dorsal surface of the aorta thoracica were found as follows: in 70% of the cases, 9 pairs were present; in 20% of the cases 8 pairs; and in 10% of the cases 10 pairs. The paired arteriae lumbales were present in 6 pairs in 90% of the cases and in 5 pairs in 10% of the cases. On the dorsal surface of spinal cord, we found two irregular longitudinal arteries in 70% of the cases, no longitudinal arteries in 20% of the cases and three irregular longitudinal arteries in 10% of the cases receiving dorsal branches of rami spinales. Among the dorsal branches observed in the thoracic region, 60.5% were left-sided, 39.5% right-sided and in the lumbar region, 52.5% were left-sided and 47.5% right-sided. PMID:23952724

Mazensky, D; Danko, J; Petrovova, E; Mechirova, E; Prokes, M

2014-10-01

410

Expression Profile of Tumor Endothelial Marker 7 and a Putative Ligand in the Rat Spinal Cord and Dorsal Root Ganglion  

E-print Network

Study Design: To analyze the expression profile of tumor endothelial marker 7 (TEM7) in the spinal cord and dorsal root ganglion (DRG). Purpose: To investigate the expression profile of TEM7 in the spinal cord and DRG of adult and developing rats. Overview of Literature: Tumor endothelial marker 7 (TEM7) is a putative transmembrane protein that is highly expressed in the tumor endothelium and in cerebellar neurons. Methods: In the present study, the expression profile of TEM7 in the spinal cord and DRG of the rat was investigated using in situ hybridization and immunohistochemical analysis. In addition, the secreted recombinant ectodomain of TEM7 was employed to label the expression of a putative ligand of TEM7 in the spinal cord and DRG. Results: Specific TEM7 mRNA localization was observed in the motor neurons of the spinal cord and sensory neurons of the DRG. Glial cells and vascular endothelial cells did not show hybridization signals. Immunohistochemical analysis with a specific polyclonal antibody revealed a similar localization profile for TEM7 mRNA expression. In the spinal cord, weak labeling was observed in the gray matter. The TEM7 ectodomain localized the expression of a putative ligand of TEM7 in the neurilemmal structures and perineurium of the spinal nerve roots. In the DRG, ligand labeling was observed in the endoneurium and perineurium of the spinal nerves, and extracellular matrix around the sensory neurons. A developmental study has shown that TEM7 mRNA expression in the motor neurons of the spinal cord and DRG increased with age during postnatal development. Conclusion: These findings indicate that TEM7 plays a role as a transmembrane receptor in neuronal populations of the spinal cord and DRG.

411

[Microsurgical decompression of lumbar spinal stenosis].  

PubMed

Lumbar spinal stenosis in most cases is due to progressive degeneration of the spine, resulting in thickening of facet joints and flaval ligament. Thus the diameter of the lumbar spinal canal is reduced to less than 12 mm in the AP direction. Typically complaints consist in neurogenic claudication. Patients usually experience improvement of pain when bending their back or walking up a hill. Diagnosis of lumbar spinal stenosis is confirmed by MRI. CT myelography may help detect where compression is most pronounced. Surgical treatment should be based on the clinical symptoms of the mostly elderly people and should be performed as microsurgical decompression or in cases of clinical instability as TLIF. PMID:20480133

Drumm, J; Branea, I; Pitzen, T

2010-06-01

412

The changing pattern of spinal arachnoiditis.  

PubMed Central

Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. The majority had suffered a previous spinal condition, the most common being lumbar disc disease. There has been a change in the distribution of arahnoiditis with the lumbar region now most frequently involved. This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment. Images PMID:632824

Shaw, M D; Russell, J A; Grossart, K W

1978-01-01

413

Nanomedicine for Treating Spinal Cord Injury  

PubMed Central

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

2015-01-01

414

Nanomedicine for treating spinal cord injury  

NASA Astrophysics Data System (ADS)

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.

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

2013-09-01

415

Spinal Cord Injury Medicine. 3. Rehabilitation Phase After Acute Spinal Cord Injury  

Microsoft Academic Search

Kirshblum SC, Priebe MM, Ho CH, Scelza WM, Chiodo AE, Wuermser LA. Spinal cord injury medicine. 3. Rehabilitation phase after acute spinal cord injury.This self-directed learning module highlights the rehabilitation aspects of care for people with traumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees

Steven C. Kirshblum; Michael M. Priebe; Chester H. Ho; William M. Scelza; Anthony E. Chiodo; Lisa-Ann Wuermser

2007-01-01

416

Selective spinal anesthesia for outpatient laparoscopy. II: Epinephrine and spinal cord function  

Microsoft Academic Search

Purpose: To compare two small-dose solutions (with and without epinephrine) for spinal anesthesia during outpatient laparoscopy and\\u000a to determine spinal cord function with these low-dose solutions.\\u000a \\u000a \\u000a Method: Twenty outpatients undergoing gynecological laparoscopy were randomly assigned to receive spinal anesthesia with one of two\\u000a low dose solutions. Group LS- 10 mg lidocaine plus 10 µg sufentanil; Group LSE- 10 mg lidocaine

Himat Vaghadia; Michael A. Solylo; Cynthia L. Henderson; G. W. E. Mitchell

2001-01-01

417

[Primary amyloidosis of the spine presenting with acute paraplegia].  

PubMed

Primary amylosis is rarely located in bone, exceptionally in the spine. The radiographic presentation is polymorphous. Magnetic resonance imaging is currently the best imaging technique. Spinal amyloidosis can exceptionally lead to cord compression requiring rapid surgical release. PMID:18774025

Ajlani, H; Zaouia, K; Chtourou, A; Elleuch, M; Bellil, S; Sellami, S

2008-09-01

418

Targeting endothelin receptors A and B attenuates the inflammatory response and improves locomotor function following spinal cord injury in mice  

PubMed Central

After spinal cord injury (SCI), the disruption of blood-spinal cord barrier by activation of the endothelin (ET) system is a critical event leading to leukocyte infiltration, inflammatory response and oxidative stress, contributing to neurological disability. In the present study, we showed that blockade of ET receptor A (ETAR) and/or ET receptor B (ETBR) prevented early inflammatory responses directly via the inhibition of neutrophil and monocyte diapedesis and inflammatory mediator production following traumatic SCI in mice. Long-term neurological improvement, based on a series of tests of locomotor performance, occurred only in the spinal cord-injured mice following blockade of ETAR and ETBR. We also examined the post-traumatic changes of the microenvironment within the injured spinal cord of mice following blockade of ET receptors. Oxidative stress reflects an imbalance between malondialdehyde and superoxide dismutase in spinal cord-injured mice treated with vehicle, whereas blockade of ETAR and ETBR reversed the oxidation state imbalance. In addition, hemeoxygenase-1, a protective protease involved in early SCI, was increased in spinal cord-injured mice following the blockade of ETAR and ETBR, or only ETBR. Matrix metalloproteinase-9, a tissue-destructive protease involved in early damage, was decreased in the injured spinal cord of mice following blockade of ETAR, ETBR or a combination thereof. The findings of the present study therefore suggested an association between ETAR and ETBR in regulating early pathogenesis of SCI and determining the outcomes of long-term neurological recovery. PMID:24756152

GUO, JIAN; LI, YIQIAO; HE, ZHENNIAN; ZHANG, BIN; LI, YONGHUAN; HU, JIANGHUA; HAN, MINGYUAN; XU, YUANLIN; LI, YONGFU; GU, JIE; DAI, BO; CHEN, ZHONG

2014-01-01

419

In vivo two-photon imaging of structural dynamics in the spinal dorsal horn in an inflammatory pain model.  

PubMed

Two-photon microscopy imaging has recently been applied to the brain to clarify functional and structural synaptic plasticity in adult neural circuits. Whereas the pain system in the spinal cord is phylogenetically primitive and easily exhibits behavioral changes such as hyperalgesia in response to inflammation, the structural dynamics of dendrites has not been analysed in the spinal cord mainly due to tissue movements associated with breathing and heart beats. Here we present experimental procedures to prepare the spinal cord sufficiently to follow morphological changes of neuronal processes in vivo by using two-photon microscopy and transgenic mice expressing fluorescent protein specific to the nervous system. Structural changes such as the formation of spine-like structures and swelling of dendrites were observed in the spinal dorsal horn within 30 min after the multiple-site injections of complete Freund's adjuvant (a chemical irritant) to a leg, and these changes continued for 5 h. Both AMPA and N-methyl-D-aspartate receptor antagonists, and gabapentin, a presynaptic Ca(2+) channel blocker, completely suppressed the inflammation-induced structural changes in the dendrites in the spinal dorsal horn. The present study first demonstrated by in vivo two-photon microscopy imaging that structural synaptic plasticity occurred in the spinal dorsal horn immediately after the injection of complete Freund's adjuvant and may be involved in inflammatory pain. Furthermore, acute inflammation-associated structural changes in the spinal dorsal horn were shown to be mediated by glutamate receptor activation. PMID:25645012

Matsumura, Shinji; Taniguchi, Wataru; Nishida, Kazuhiko; Nakatsuka, Terumasa; Ito, Seiji

2015-04-01

420

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. PMID:25237435

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

2014-01-01

421

Spinal epidural lipomatosis in korean.  

PubMed

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. PMID:25237435

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

2014-06-01

422

Serotonergic pharmacotherapy promotes cortical reorganization after spinal cord injury.  

PubMed

Cortical reorganization plays a significant role in recovery of function after injury of the central nervous system. The neural mechanisms that underlie this reorganization may be the same as those normally responsible for skilled behaviors that accompany extended sensory experience and, if better understood, could provide a basis for further promoting recovery of function after injury. The work presented here extends studies of spontaneous cortical reorganization after spinal cord injury to the role of rehabilitative strategies on cortical reorganization. We use a complete spinal transection model to focus on cortical reorganization in response to serotonergic (5-HT) pharmacotherapy without any confounding effects from spared fibers left after partial lesions. 5-HT pharmacotherapy has previously been shown to improve behavioral outcome after SCI but the effect on cortical organization is unknown. After a complete spinal transection in the adult rat, 5-HT pharmacotherapy produced more reorganization in the sensorimotor cortex than would be expected by transection alone. This reorganization was dose dependent, extended into intact (forelimb) motor cortex, and, at least in the hindlimb sensorimotor cortex, followed a somatotopic arrangement. Animals with the greatest behavioral outcome showed the greatest extent of cortical reorganization suggesting that the reorganization is likely to be in response to both direct effects of 5-HT on cortical circuits and indirect effects in response to the behavioral improvement below the level of the lesion. PMID:23262119

Ganzer, Patrick D; Moxon, Karen A; Knudsen, Eric B; Shumsky, Jed S

2013-03-01

423

Complication with Removal of a Lumbar Spinal Locking Plate  

PubMed Central

Introduction. The use of locking plate technology for anterior lumbar spinal fusion has increased stability of the vertebral fusion mass over traditional nonconstrained screw and plate systems. This case report outlines a complication due to the use of this construct. Case. A patient with a history of L2 corpectomy and anterior spinal fusion presented with discitis at the L4/5 level and underwent an anterior lumbar interbody fusion (ALIF) supplemented with a locking plate placed anterolaterally for stability. Fifteen months after the ALIF procedure, he returned with a hardware infection. He underwent debridement of the infection site and removal of hardware. Results. Once hardware was exposed, removal of the locking plate screws was only successful in one out of four screws using a reverse thread screw removal device. Three of the reverse thread screw removal devices broke in attempt to remove the subsequent screws. A metal cutting drill was then used to break hoop stresses associated with the locking device and the plate was removed. Conclusion. Anterior locking plates add significant stability to an anterior spinal fusion mass. However, removal of this hardware can be complicated by the inherent properties of the design with significant risk of major vascular injury. PMID:25838956

Crawford, Brooke; Lenarz, Christopher; Watson, J. Tracy; Alander, Dirk

2015-01-01

424

Complication with removal of a lumbar spinal locking plate.  

PubMed

Introduction. The use of locking plate technology for anterior lumbar spinal fusion has increased stability of the vertebral fusion mass over traditional nonconstrained screw and plate systems. This case report outlines a complication due to the use of this construct. Case. A patient with a history of L2 corpectomy and anterior spinal fusion presented with discitis at the L4/5 level and underwent an anterior lumbar interbody fusion (ALIF) supplemented with a locking plate placed anterolaterally for stability. Fifteen months after the ALIF procedure, he returned with a hardware infection. He underwent debridement of the infection site and removal of hardware. Results. Once hardware was exposed, removal of the locking plate screws was only successful in one out of four screws using a reverse thread screw removal device. Three of the reverse thread screw removal devices broke in attempt to remove the subsequent screws. A metal cutting drill was then used to break hoop stresses associated with the locking device and the plate was removed. Conclusion. Anterior locking plates add significant stability to an anterior spinal fusion mass. However, removal of this hardware can be complicated by the inherent properties of the design with significant risk of major vascular injury. PMID:25838956

Crawford, Brooke; Lenarz, Christopher; Watson, J Tracy; Alander, Dirk

2015-01-01

425

Spinal cord damage in machado-joseph disease.  

PubMed

Machado-Joseph disease (SCA3) is the most frequent spinocerebellar ataxia worldwide and characterized by remarkable phenotypic heterogeneity. MRI-based studies in SCA3 focused in the cerebellum and connections, but little is known about cord damage in the disease and its clinical relevance. To evaluate the spinal cord damage in SCA3 through quantitative analysis of MRI scans. A group of 48 patients with SCA3 and 48 age and gender-matched healthy controls underwent MRI on a 3T scanner. We used T1-weighted 3D images to estimate the cervical spinal cord area (CA) and eccentricity (CE) at three C2/C3 levels based on a semi-automatic image segmentation protocol. The scale for assessment and rating of ataxia (SARA) was employed to quantify disease severity. The two groups-SCA3 and controls-were significantly different regarding CA (49.5?±?7.3 vs 67.2?±?6.3 mm(2), p?presented a significant correlation with SARA scores in the patient group (p?=?0.010). CE was not associated with SARA scores (p?=?0.857). In the multiple variable regression, we found that disease duration was the only variable associated with CA (coefficient?=?-0.629, p?=?0.025). SCA3 is characterized by cervical cord atrophy and antero-posterior flattening. In addition, the spinal cord areas did correlate with disease severity. This suggests that quantitative analyses of the spinal cord MRI might be a useful biomarker in SCA3. PMID:25370748

Fahl, Camila N; Branco, Lucas Melo T; Bergo, Felipe P G; D'Abreu, Anelyssa; Lopes-Cendes, Iscia; França, Marcondes C

2015-04-01

426

Dendritic spine dysgenesis contributes to hyperreflexia after spinal cord injury.  

PubMed

Hyperreflexia and spasticity are chronic complications in spinal cord injury (SCI), with limited options for safe and effective treatment. A central mechanism in spasticity is hyperexcitability of the spinal stretch reflex, which presents symptomatically as a velocity-dependent increase in tonic stretch reflexes and exaggerated tendon jerks. In this study we tested the hypothesis that dendritic spine remodeling within motor reflex pathways in the spinal cord contributes to H-reflex dysfunction indicative of spasticity after contusion SCI. Six weeks after SCI in adult Sprague-Dawley rats, we observed changes in dendritic spine morphology on ?-motor neurons below the level of injury, including increased density, altered spine shape, and redistribution along dendritic branches. These abnormal spine morphologies accompanied the loss of H-reflex rate-dependent depression (RDD) and increased ratio of H-reflex to M-wave responses (H/M ratio). Above the level of injury, spine density decreased compared with below-injury spine profiles and spine distributions were similar to those for uninjured controls. As expected, there was no H-reflex hyperexcitability above the level of injury in forelimb H-reflex testing. Treatment with NSC23766, a Rac1-specific inhibitor, decreased the presence of abnormal dendritic spine profiles below the level of injury, restored RDD of the H-reflex, and decreased H/M ratios in SCI animals. These findings provide evidence for a novel mechanistic relationship between abnormal dendritic spine remodeling in the spinal cord motor system and reflex dysfunction in SCI. PMID:25505110

Bandaru, Samira P; Liu, Shujun; Waxman, Stephen G; Tan, Andrew M

2015-03-01

427

Weight Management Following SCI (Spinal Cord Injury)  

MedlinePLUS

... changes, participation in physical activities, and long-term planning. As a person with spinal cord injury (SCI), you can benefit in many ways from a healthy weight management program. You may help... ... lower your risk for ...

428

Simulation and resident education in spinal neurosurgery  

PubMed Central

Background: A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. Methods: We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. Results: A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. Conclusion: The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education. PMID:25745588

Bohm, Parker E.; Arnold, Paul M.

2015-01-01

429

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

430

Brain and Spinal Cord Tumors in Adults  

MedlinePLUS

... saved articles window. My Saved Articles » My ACS » Brain and Spinal Cord Tumors in Adults Download Printable ... the topics below to get started. What Is Brain/CNS Tumors In Adults? What is cancer? What ...

431

Brain and Spinal Cord Tumors in Children  

MedlinePLUS

... saved articles window. My Saved Articles » My ACS » Brain and Spinal Cord Tumors in Children Download Printable ... the topics below to get started. What Is Brain/CNS Tumors In Children? What is cancer? What ...

432

Tracheostomy in Spinal Cord Injured Patients  

PubMed Central

Patients with cervical spinal cord injury frequently need prolonged mechanical ventilation as a result of worsening pulmonary vital capacity due to paralysis of respiratory muscles, severe impairment of tracheobronchial secretions clearance and high incidence of respiratory complications like pneumonia or atelectasis. Patients with thoracic spinal cord injury may need mechanical ventilation due to associate injuries. For these reasons, tracheostomy is frequently performed in these patients, more frequently when the spinal cord injury is at cervical level. Percutaneous technique, performed in the ICU, should be considered the preferred procedure for performing elective tracheostomies in spinal cord injured patients. Tracheostomy should be implemented as soon as possible in SCI patients they require prolonged mechanical ventilation. Tracheostomy can be performed just after anterolateral cervical spine fixation surgery. Tracheostomy can be removed when no longer needed without major complications. PMID:23905031

Ganuza, Javier-Romero; Oliviero, Antonio

2011-01-01

433

Genetics Home Reference: Spinal muscular atrophy  

MedlinePLUS

... children. Spinal muscular atrophy, lower extremity, dominant (SMA-LED) is characterized by leg muscle weakness that is ... to another. DYNC1H1 gene mutations that cause SMA-LED disrupt the function of the dynein complex. As ...

434

Three-dimensional distribution of sensory stimulation-evoked neuronal activity of spinal dorsal horn neurons analyzed by in vivo calcium imaging.  

PubMed

The spinal dorsal horn comprises heterogeneous populations of interneurons and projection neurons, which form neuronal circuits crucial for processing of primary sensory information. Although electrophysiological analyses have uncovered sensory stimulation-evoked neuronal activity of various spinal dorsal horn neurons, monitoring these activities from large ensembles of neurons is needed to obtain a comprehensive view of the spinal dorsal horn circuitry. In the present study, we established in vivo calcium imaging of multiple spinal dorsal horn neurons by using a two-photon microscope and extracted three-dimensional neuronal activity maps of these neurons in response to cutaneous sensory stimulation. For calcium imaging, a fluorescence resonance energy transfer (FRET)-based calcium indicator protein, Yellow Cameleon, which is insensitive to motion artifacts of living animals was introduced into spinal dorsal horn neurons by in utero electroporation. In vivo calcium imaging following pinch, brush, and heat stimulation suggests that laminar distribution of sensory stimulation-evoked neuronal activity in the spinal dorsal horn largely corresponds to that of primary afferent inputs. In addition, cutaneous pinch stimulation elicited activities of neurons in the spinal cord at least until 2 spinal segments away from the central projection field of primary sensory neurons responsible for the stimulated skin point. These results provide a clue to understand neuronal processing of sensory information in the spinal dorsal horn. PMID:25100083

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

2014-01-01

435

Bowel management in spinal cord injury patients.  

PubMed

Spinal cord injuries are common in the United States, affecting approximately 12,000 people per year. Most of these patients lack normal bowel function. The pattern of dysfunction varies with the spinal level involved. Most patients use a bowel management program, and elements of successful programs are discussed. Surgical treatment, when indicated, could include sacral nerve stimulation, Malone antegrade continence enema, and colostomy. PMID:25320571

Hughes, Matthew

2014-09-01

436

Metachronous spinal metastases from supratentorial anaplastic astrocytoma.  

PubMed

Leptomeningeal spinal metastases from supratentorial high-grade glioma are relatively rare. Authors report an unusual case of metachronous, symptomatic, dual spinal drop metastases in a 20-year-old male patient who was operated for right insular anaplastic astrocytoma 20 months earlier. Surgical decompression of the symptomatic D11-L2 drop metastasis was carried out. Histo-pathological examination revealed features suggestive of glioblastoma multiforme. Patient was advised postoperative radiotherapy. The pertinent literature is reviewed regarding this uncommon entity. PMID:25767596

Raheja, Amol; Borkar, Sachin Anil; Kumar, Rajinder; Suri, Vaishali; Sharma, Bhawani Shankar

2015-01-01

437

Metachronous spinal metastases from supratentorial anaplastic astrocytoma  

PubMed Central

Leptomeningeal spinal metastases from supratentorial high-grade glioma are relatively rare. Authors report an unusual case of metachronous, symptomatic, dual spinal drop metastases in a 20-year-old male patient who was operated for right insular anaplastic astrocytoma 20 months earlier. Surgical decompression of the symptomatic D11-L2 drop metastasis was carried out. Histo-pathological examination revealed features suggestive of glioblastoma multiforme. Patient was advised postoperative radiotherapy. The pertinent literature is reviewed regarding this uncommon entity.

Raheja, Amol; Borkar, Sachin Anil; Kumar, Rajinder; Suri, Vaishali; Sharma, Bhawani Shankar

2015-01-01

438

Uncommon Progression of an Extradural Spinal Meningioma  

PubMed Central

Extradural spinal meningiomas are rare. Our understanding of purely extradural spinal meningiomas is still incomplete and they may be easily confused with malignant neoplasms, much more common in this location. We report a rare case of a purely extradural thoracic spine meningioma in a 70-year-old man, with an unusual progression. In addition we discuss the pathogenesis of these tumors and the potential pitfalls in differential diagnosis and review the relevant literature concerning their treatment and outcome. PMID:25243091

Boughamoura, Mohamed; Mahmoudi, Houda; Kilani, Mohamed; Hattab, Nejib

2014-01-01

439

Spinal Cord and Nerve Root Decompression  

Microsoft Academic Search

Tumors of the vertebral column include both primary and metastatic lesions. These tumors can cause significant morbidity consisting\\u000a of lesional pain and pain from deformity. Compression of the spinal cord and spinal nerve roots can also cause radicular pain\\u000a as well as neurologial deterioration including sensory deficits, weakness, paralysis, and\\/or sexual\\/bowel\\/ bladder dysfunction.\\u000a In cases of metastatic lesions, the spine

Keith R. Lodhia; Paul Park; Gregory P. Graziano

440

Neuronal pathways for spinal reflexes activated by group I and group II muscle afferents in the spinal segment (Co1) innervating the tail in the low spinalized cat  

Microsoft Academic Search

We studied neuronal pathways for spinal reflexes activated by group-I and group-II muscle afferents in the spinal segments\\u000a innervating the tail in unanesthetized and spinalized (L1) cats. Experiments were performed on 25 adult cats of both sexes.\\u000a The effects of stimulating nerves innervating six tail muscles on both sides were recorded from tail motoneurons in the first\\u000a coccygeal spinal segment

N. Wada; N. Shikaki

1999-01-01

441

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

442

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. PMID:25309330

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

2014-01-01

443

Oligodendroglial apoptosis occurs along degenerating axons and is associated with FAS and p75 expression following spinal cord injury in the rat  

Microsoft Academic Search

Apoptosis or programmed cell death has been reported after CNS trauma. However, the significance of this mechanism in the pathophysiology of spinal cord injury, in particular at the cervical level, requires further investigation. In the present study, we used the extradural clip compression model in the rat to examine the cellular distribution of apoptosis following cervical spinal cord injury, the

S Casha; W. R Yu; M. G Fehlings

2001-01-01

444

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

445

Spinal cord ischemia after cardiac arrest.  

PubMed

Subsequent to cardiac arrest, a 58-year-old man with intractable dysrhythmia and severe arteriosclerosis developed flaccid paraplegia, depressed deep tendon reflexes, and showed no pain or temperature sensation caudal to Th-7 in spite of completely intact proprioception and vibration sensation. An echocardiogram showed no clots or vegetation on the prosthetic valve and no thrombus in the left atrium or left ventricle. The patient's paraplegia was permanent, at least through a follow-up period of 2 years. These findings suggest that the etiology was spinal cord ischemia due to blood supply in the area of the anterior spinal artery (ASA); however, magnetic resonance T2-weighted imaging demonstrated signal abnormalities throughout the gray matter and in the adjacent center white matter. Somatosensory-evoked potentials (SEP) measure neural transmission in the afferent spinal cord pathway, which is located in the lateral and posterior columns of the white matter; these showed a delay in latency between Th-6 and Th-7. The spinal cord is as vulnerable to transient ischemia as the brain. Spinal cord ischemia after cardiac arrest results from principal damage in the anterior horn of the gray matter, the so-called ASA syndrome; however, the pathways of SEP and pathogenesis of the spinal cord ischemia need further investigation. PMID:7884198

Imaizumi, H; Ujike, Y; Asai, Y; Kaneko, M; Chiba, S

1994-01-01

446

Cellular Scaling Rules for Primate Spinal Cords  

PubMed Central

The spinal cord can be considered a major sensorimotor interface between the body and the brain. How does the spinal cord scale with body and brain mass, and how are its numbers of neurons related to the number of neurons in the brain across species of different body and brain sizes? Here we determine the cellular composition of the spinal cord in eight primate species and find that its number of neurons varies as a linear function of cord length, and accompanies body mass raised to an exponent close to 1/3. This relationship suggests that the extension, mass and number of neurons that compose the spinal cord are related to body length, rather than to body mass or surface. Moreover, we show that although brain mass increases linearly with cord mass, the number of neurons in the brain increases with the number of neurons in the spinal cord raised to the power of 1.7. This faster addition of neurons to the brain than to the spinal cord is consistent with current views on how larger brains add complexity to the processing of environmental and somatic information. PMID:20926855

Burish, Mark J.; Peebles, J. Klint; Baldwin, Mary K.; Tavares, Luciano; Kaas, Jon H.; Herculano-Houzel, Suzana

2010-01-01

447

Recovery of control of posture and locomotion after a spinal cord injury: solutions staring us in the face  

PubMed Central

Over the past 20 years, tremendous advances have been made in the field of spinal cord injury research. Yet, consumed with individual pieces of the puzzle, we have failed as a community to grasp the magnitude of the sum of our findings. Our current knowledge should allow us to improve the lives of patients suffering from spinal cord injury. Advances in multiple areas have provided tools for pursuing effective combination of strategies for recovering stepping and standing after a severe spinal cord injury. Muscle physiology research has provided insight into how to maintain functional muscle properties after a spinal cord injury. Understanding the role of the spinal networks in processing sensory information that is important for the generation of motor functions has focused research on developing treatments that sharpen the sensitivity of the locomotor circuitry and that carefully manage the presentation of proprioceptive and cutaneous stimuli to favor recovery. Pharmacological facilitation or inhibition of neurotransmitter systems, spinal cord stimulation, and rehabilitative motor training, which all function by modulating the physiological state of the spinal circuitry, have emerged as promising approaches. Early technological developments, such as robotic training systems and high-density electrode arrays for stimulating the spinal cord, can significantly enhance the precision and minimize the invasiveness of treatment after an injury. Strategies that seek out the complementary effects of combination treatments and that efficiently integrate relevant technical advances in bioengineering represent an untapped potential and are likely to have an immediate impact. Herein, we review key findings in each of these areas of research and present a unified vision for moving forward. Much work remains, but we already have the capability, and more importantly, the responsibility, to help spinal cord injury patients now. PMID:19660669

Fong, Andy J.; Roy, Roland R.; Ichiyama, Ronaldo M.; Lavrov, Igor; Courtine, Grégoire; Gerasimenko, Yury; Tai, Y.C.; Burdick, Joel; Edgerton, V. Reggie

2010-01-01

448

The extracellular matrix glycoprotein tenascin-C promotes locomotor recovery after spinal cord injury in adult zebrafish.  

PubMed

Adult zebrafish, by virtue of exhibiting spontaneous recovery after spinal lesion, have evolved into a paradigmatic vertebrate model system to identify novel genes vital for successful regeneration after spinal cord injury. Due to a remarkable level of conservation between zebrafish and human genomes, such genes, once identified, could point to possibilities for addressing the multiple issues on how to deal with functional recovery after spinal cord injury in humans. In the current study, the extracellular matrix glycoprotein tenascin-C was studied in the zebrafish spinal cord injury model to assess the often disparate functions of this multidomain molecule under in vivo conditions. This in vivo study was deemed necessary since in vitro studies had shown discrepant functional effects on neurite outgrowth: tenascin-C inhibits neurite outgrowth when presented as a molecular barrier adjacent to a conducive substrate, but enhances neurite outgrowth when presented as a uniform substrate. Thus, our current study addresses the question as to which of these features prevails in vivo: whether tenascin-C reduces or enhances axonal regrowth after injury in a well accepted vertebrate model of spinal cord injury. We show upregulation of tenascin-C expression in regenerating neurons of the nucleus of median longitudinal fascicle (NMLF) in the brainstem and spinal motoneurons. Inhibition of tenascin-C expression by antisense oligonucleotide (morpholino) resulted in impaired locomotor recovery, reduced regrowth of axons from brainstem neurons and reduced synapse formation by the regrowing brainstem axons on spinal motoneurons, all vital indicators of regeneration. Our results thus point to an advantageous role of tenascin-C in promoting spinal cord regeneration, by promoting axonal regrowth and synapse formation in the spinal cord caudal to the lesion site after injury. PMID:21443931

Yu, Y-M; Cristofanilli, M; Valiveti, A; Ma, L; Yoo, M; Morellini, F; Schachner, M

2011-06-01

449

Human spinal locomotor control is based on flexibly organized burst generators.  

PubMed

Constant drive provided to the human lumbar spinal cord by epidural electrical stimulation can cause local neural circuits to generate rhythmic motor outputs to lower limb muscles in people paralysed by spinal cord injury. Epidural spinal cord stimulation thus allows the study of spinal rhythm and pattern generating circuits without their configuration by volitional motor tasks or task-specific peripheral feedback. To reveal spinal locomotor control principles, we studied the repertoire of rhythmic patterns that can be generated by the functionally isolated human lumbar spinal cord, detected as electromyographic activity from the legs, and investigated basic temporal components shared across these patterns. Ten subjects with chronic, motor-complete spinal cord injury were studied. Surface electromyographic responses to lumbar spinal cord stimulation were collected from quadriceps, hamstrings, tibialis anterior, and triceps surae in the supine position. From these data, 10-s segments of rhythmic activity present in the four muscle groups of one limb were extracted. Such samples were found in seven subjects. Physiologically adequate cycle durations and relative extension- and flexion-phase durations similar to those needed for locomotion were generated. The multi-muscle activation patterns exhibited a variety of coactivation, mixed-synergy and locomotor-like configurations. Statistical decomposition of the electromyographic data across subjects, muscles and samples of rhythmic patterns identified three common temporal components, i.e. basic or shared activation patterns. Two of these basic patterns controlled muscles to contract either synchronously or alternatingly during extension- and flexion-like phases. The third basic pattern contributed to the observed muscle activities independently from these extensor- and flexor-related basic patterns. Each bifunctional muscle group was able to express both extensor- and flexor-patterns, with variable ratios across the samples of rhythmic patterns. The basic activation patterns can be interpreted as central drives implemented by spinal burst generators that impose specific spatiotemporally organized activation on the lumbosacral motor neuron pools. Our data thus imply that the human lumbar spinal cord circuits can form burst-generating elements that flexibly combine to obtain a wide range of locomotor outputs from a constant, repetitive input. It may be possible to use this flexibility to incorporate specific adaptations to gait and stance to improve locomotor control, even after severe central nervous system damage. PMID:25582580

Danner, Simon M; Hofstoetter, Ursula S; Freundl, Brigitta; Binder, Heinrich; Mayr, Winfried; Rattay, Frank; Minassian, Karen

2015-03-01

450

Effect of a single dose of pamidronate administered at the time of surgery in a rabbit posterolateral spinal fusion model.  

PubMed

Spinal fusion is usually performed on patients who receive bisphosphonates (BP); however, limited data on their action on spinal fusion are available. Previous studies in animal models have shown that chronic administrations of BP reduced spinal fusion rates, and only one study has shown that a single dose administration of zolendronic acid increased fusion rate. The objective of the present study was to evaluate if pamidronate (PA), which was previously demonstrated to reduce spinal fusion rate when administered continuously for 8 weeks, would increase the spinal fusion rate if administered in a single dose at the time of surgery in a rabbit model. Thirty-two New Zealand rabbits underwent an L5-L6 posterolateral intertransverse fusion with iliac crest autograft. Animals were randomized to receive either PA 3 mg/kg in a single dose immediately after surgery, or normal saline. Animals were killed 8 weeks after surgery and fusion was determined by manual palpation and radiographic analysis. Fusion healing was obtained in eight rabbits (50%) in the PA group and in four animals (25%) in the control group, p = 0.137. In a rabbit model, a single dose of PA did not decrease lumbar spinal arthrodesis consolidation rates, but it obtained a nonsignificant higher spinal fusion rate. PMID:20127496

Urrutia, Julio; Briceno, Jorge; Carmona, Maximiliano; Olavarria, Fernando; Hodgson, Felipe

2010-06-01

451

Regenerating motor bridge axons refine connections and synapse on lumbar motoneurons to bypass chronic spinal cord injury.  

PubMed

To restore motor control after spinal cord injury requires reconnecting the brain with spinal motor circuits below the lesion. A bridge around the injury is an important alternative to promoting axon regeneration through the injury. Previously, we reported a novel motor bridge in rats. The thirteenth thoracic nerve was detached from the muscle it innervates and the cut end implanted caudally into the lumbar gray matter where motor bridge axons regenerate. In this study, we first determined that regenerating bridge axons project to spinal motor circuits. Stable projections were present in ventral motor laminae of the cord, including putative synapses directly on motoneurons, 2 months after insertion in the intact cord. At this time, earlier-forming dorsal horn projections were mostly eliminated. Regenerating axons were effective in evoking leg motor activity as early as 2 weeks. We next determined that bridge axons could regenerate caudal to a chronic injury. We hemisected the spinal cord at L2 and inserted the bridge nerve 1 month later at L5 and found ventral laminae projections similar to those in intact animals, including onto motoneurons directly. Finally, we determined that the bridge circuit could be activated by neural pathways rostral to its origin. For spinally hemisected animals, we electrically stimulated the rostral spinal cord and recorded evoked potentials from the bridge and, in turn, motor responses in the sciatic nerve. Our findings suggests that bridge motoneurons could be used by descending motor pathways as premotor interneurons to transmit neural signals to bypass a chronic spinal injury. PMID:18076081

Campos, Lucas W; Chakrabarty, Samit; Haque, Raqeeb; Martin, John H

2008-02-10

452

Spinal cord tanycytic ependymoma associated with neurofibromatosis type 2.  

PubMed

Tanycytic ependymoma is a rare subtype of ependymoma. Reports of this tumor in neurofibromatosis type 2 (NF-2) are rare. A 16-year-old girl presented with gait disturbance and a palpable neck mass, which had been present for 2 years. MRI revealed an intramedullary lesion within the upper cervical spinal cord, which was removed surgically. Pathological investigation revealed an uncommon form of tanycytic ependymoma associated with NF-2. This rare morphology of tanycytic ependymoma could be misinterpreted as pilocytic astrocytoma or other tumor types that exhibit elongated cells. Increased awareness of this transitional form of intramedullary ependymoma among neurosurgeons and pathologists might avoid incorrect surgical approaches and postoperative treatments. PMID:20403699

Lim, Bong-Suk; Park, Sukh Que; Chang, Ung Kyu; Kim, Min Suk

2010-07-01

453

A simple technique for localizing consecutive fields for disector pairs in light microscopy: application to neuron counting in rabbit spinal cord following spinal cord injury.  

PubMed

Locating the same microscopic fields in consecutive sections is important in stereological analysis. The tools for achieving this requirement have limited number in practice. This paper presents a simple and inexpensive technique for localizing the same fields on disector pairs in conventional light microscopes equipped with widely available dial indicators. It is partly a modification of equipment previously described. The presented procedure requires two light microscopes equipped with dial indicators and modified slide clips. An application of the present system was shown in a model of spinal cord injury (SCI). A midthoracic laminectomy was performed leaving the dura intact. A contusion was done at the level of midthoracic spinal cord segments (T7-T8) by dropping a 10-g mass from a height of 30 cm. The subjects were randomly divided into three groups (10 animals in each): hypothermia group, methylprednisolone group, and traumatic spinal cord injury alone group. Present results show that treatment with hypothermia after spinal cord trauma has a neuroprotective effect on cell damage but not in the methylprednisolone treatment group. PMID:15922043

Kaplan, Süleyman; Gökyar, Ahmet; Unal, Bünyami; Tunç, Ayten Türkkani; Bahadir, Ay?e; Aslan, Hüseyin

2005-06-30

454

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 model