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This page shows you the latest news and research items in this category.

Long-term outcome of laminectomy for cervical ossification of the posterior longitudinal ligament.
Conclusions The long-term outcome of laminectomy for cervical OPLL is satisfactory in terms of the clinical and radiological aspects. The risk of postlaminectomy kyphosis was not high, raising the possibility that the OPLL itself may serve as a support for the spinal column. PMID: 23452249 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - May 1, 2013 Category: Neurosurgery Authors: Lee SE, Chung CK, Jahng TA, Kim HJ Tags: J Neurosurg Spine Source Type: research

Isolated cervical spinal canal stenosis at C-1 in the pediatric population and in Williams syndrome.
Conclusions Isolated cervical spinal canal stenosis at the level of the atlas is a rare cause of cervical myelopathy. The authors hope that this report will prompt clinicians to consider it when searching for the origin of signs and symptoms of cervical myelopathy, especially in children. PMID: 23540732 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - March 29, 2013 Category: Neurosurgery Authors: Desai SK, Vadivelu S, Patel AJ, Brayton A, Jea A Tags: J Neurosurg Spine Source Type: research

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament.
Conclusions The modified laminoplasty technique used in this study ensured very good neurological status and ROM after 2 years and was associated with low incidences of axial neck pain and serious complications. This simple and easy operative method could benefit future laminoplasty protocols. PMID: 23540735 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - March 29, 2013 Category: Neurosurgery Authors: Umeda M, Sasai K, Kushida T, Wakabayashi E, Maruyama T, Ikeura A, Iida H Tags: J Neurosurg Spine Source Type: research

The enigma of dorsal cord migration after cervical laminectomy: A radiological entity or something else?
Sridhara Narayana, Ashish Kumar, Rajesh AlugoluNeurology India 2013 61(1):97-99 (Source: Neurology India)
Source: Neurology India - March 4, 2013 Category: Neurology Authors: Sridhara NarayanaAshish KumarRajesh Alugolu Source Type: research

[Retro-odontoid pseudotumor in diffuse idiopathic skeletal hyperostosis.]
Abstract Retro-odontoid pseudotumors are lesions caused by inflammatory granulation or reactive soft tissue hypertrophy from chronic atlantoaxial subluxation. However, one-third of the cases reported in the medical literature did not show atlantoaxial instability clearly. The authors present the case of a 76-year-old man previously diagnosed with diffuse idiopathic skeletal hyperostosis who presented with severe progressive myelopathy. A magnetic resonance imaging of his cervical spine revealed a retro-odontoid predural mass, which caused a severe compression of the cervical spinal cord. The patient underwent a pos...
Source: Neurocirugia - March 1, 2013 Category: Neurosurgery Authors: Castro-Castro J, Castro-Bouzas D, Pinzón-Millán A, Pastor-Zapata A Tags: Neurocirugia (Astur) Source Type: research

Modified Plate-only Open-door Laminoplasty Versus Laminectomy and Fusion for the Treatment of Cervical Stenotic Myelopathy.
Abstract The purpose of this study was to compare modified plate-only laminoplasty and laminectomy and fusion to confirm which of the 2 surgical modalities could achieve a better decompression outcome and whether a significant difference was found in postoperative complications. Clinical data were retrospectively reviewed for 141 patients with cervical stenotic myelopathy who underwent plate-only laminoplasty and laminectomy and fusion between November 2007 and June 2010. The extent of decompression was assessed by measuring the cross-sectional area of the dural sac and the distance of spinal cord drift at the 3 mo...
Source: Orthopedics - January 1, 2013 Category: Orthopaedics Authors: Yang L, Gu Y, Shi J, Gao R, Liu Y, Li J, Yuan W Tags: Orthopedics Source Type: research

Intramedullary space occupying lesion of the cervical cord: when magnetic resonance imaging is not possible
A 71-year-old white man had an L1–L5 laminectomy and a successful removal of intradural extramedullary schwannoma in 2009. He returned after 2 years with a complaint of slow onset of neck pain. This was followed by weakness in his left arm and, subsequently, weakness in his left leg. He also had some loss of temperature sensation in the right hand. Manual testing of the motor groups of the upper and lower extremities revealed diffuse weakness of the left arm and leg, particularly the left deltoid, biceps, and intrinsic muscles. Sensation to light touch and pinprick was slightly decreased diffusely throughout the left arm...
Source: The Spine Journal - December 26, 2012 Category: Orthopaedics Authors: David A. Cavanaugh, Phillip A. Utter, Ajay Jawahar, James A. Harper, Pierce D. Nunley Tags: Images of Spine Care Source Type: research

Cervical myelopathy resulting from combined ossification of the ligamentum flavum and posterior longitudinal ligament: report of two cases and literature review
Conclusions: We experienced two cases of cervical myelopathy resulting from the combination of OLF and OPLL in the cervical spine. The symptoms of myelopathy were treated successfully by laminectomy and laminoplasty with OLF resection in both cases. The literature review including the present two cases revealed that cervical OLF tended to occur adjacent or close to the margin of cervical OPLL, suggesting that the increased mechanical stress at the junction of OPLL may be a causative factor. (Source: The Spine Journal)
Source: The Spine Journal - December 20, 2012 Category: Orthopaedics Authors: Yoshihisa Kotani, Masahiko Takahata, Kuniyoshi Abumi, Manabu Ito, Hideki Sudo, Akio Minami Tags: Case Reports Source Type: research

Intraosseous ganglion cyst within the L4 lamina causing spinal stenosis
Conclusions: This is the first report to describe an intraosseous ganglion cyst occurring in the lumbar spine. Although spinal stenosis is commonly a result of degenerative joint or disc disease, it occasionally may result from more obscure causes. This case illustrates a patient with an intraosseous ganglion cyst within the spinal lamina resulting in spinal stenosis, treated successfully with a laminectomy and resection. (Source: The Spine Journal)
Source: The Spine Journal - November 16, 2012 Category: Orthopaedics Authors: James D. Lin, Steven M. Koehler, Roberto A. Garcia, Sheeraz A. Qureshi, Andrew C. Hecht Tags: Case Reports Source Type: research

Multiple-level ossification of the ligamentum flavum in the cervical spine combined with calcification of the cervical ligamentum flavum and posterior atlanto-axial membrane
Conclusions Simultaneous development of cervical OLF and CLF in this case seems unlikely to have occurred coincidentally and suggests that the pathogenesis of OLF and CLF may share a common initiation factor. Content Type Journal ArticleCategory Case ReportPages 1-5DOI 10.1007/s00586-012-2521-7Authors Hirokazu Inoue, Department of Orthopaedic Surgery, Faculty of Medicine, Jichi Medical University, 3311-1 Yakushiji, Tochigi, Shimotsuke 329-0498, JapanAtsushi Seichi, Department of Orthopaedic Surgery, Faculty of Medicine, Jichi Medical University, 3311-1 Yakushiji, Tochigi, Shimotsuke 329-0498, JapanAt...
Source: European Spine Journal - October 6, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Cervical Vertebral Stenosis Associated with a Vertebral Arch Anomaly in the Basset Hound
Conclusions and Clinical ImportanceDorsal lamina and spinous process hypertrophy leading to ligamentum flavum hypertrophy should be included in the differential diagnosis of Basset Hounds with cervical hyperesthesia or myelopathy. Prognosis after decompressive surgery is favorable. Although a genetic component is suspected, additional studies are needed to determine the specific etiology of this disorder. (Source: Journal of Veterinary Internal Medicine)
Source: Journal of Veterinary Internal Medicine - September 14, 2012 Category: Veterinary Research Authors: S. Decker, L. Risio, M. Lowrie, D. Mauler, E. Beltran, A. Giedja, P.J. Kenny, I. Gielen, L. Garosi, H. Volk Tags: Standard Article Source Type: research

Long-term surgical outcomes of cervical dumbbell neurinomas
Conclusion Total resection should be attempted for cervical dumbbell tumors. In cases where total resection was potentially of high risk, however, subtotal resection (within the capsule) was found to be a practical choice yielding favorable long-term outcome when the tumor growth rate (MIB-1 index) was low. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00776-012-0300-2Authors Masaya Nakamura, Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582 JapanAkio Iwanami, Department of Orthopaedic Surgery, School of Me...
Source: Journal of Orthopaedic Science - September 4, 2012 Category: Orthopaedics Tags: Journal of Orthopaedic Science Source Type: research

Surgical treatment of Klippel–Feil syndrome with basilar invagination
Conclusion Reduction and internal fixation using instrumentation are effective techniques for KFS with BI; however, caution should be exercised because of the possibility of paralysis caused by intraoperative reduction. Content Type Journal ArticleCategory Case ReportPages 1-8DOI 10.1007/s00586-012-2489-3Authors Nobuhide Ogihara, Department of Orthopaedic Surgery, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto-city, Nagano 390-8621, JapanJun Takahashi, Department of Orthopaedic Surgery, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto-city, Nagano 390-8621, JapanHiroki H...
Source: European Spine Journal - August 28, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

[Minimally invasive approach of extramedullary intradural spinal tumours. Review of 30 cases.]
CONCLUSIONS: We consider that the microsurgical unilateral approach is a safe and effective technique for the resection of most extramedullary, intradural spinal tumours. PMID: 22871355 [PubMed - as supplied by publisher] (Source: Neurocirugia)
Source: Neurocirugia - August 4, 2012 Category: Neurosurgery Authors: González Martínez EL, García-Cosamalón PJ, Fernández Fernández JJ, Ibáñez-Plágaro FJ, Alvarez B Tags: Neurocirugia (Astur) Source Type: research

Surgical strategy for ossification of the posterior longitudinal ligament in the cervical spine.
Abstract Ossification of the posterior longitudinal ligament is a common cause of cervical myelopathy, and controversy remains regarding surgical options. Between January 2004 and December 2007, a total of 164 patients with ossification of the posterior longitudinal ligament in the cervical spine who underwent surgical treatment at the authors' institution were included in this study. The choice of surgical option was based on pathological extent and cervical alignment. Short-segment pathology was treated via the anterior approach and long-segment pathology via the posterior approach. When the posterior approach wa...
Source: Orthopedics - August 1, 2012 Category: Orthopaedics Authors: Chen Y, Liu X, Chen D, Wang X, Yuan W Tags: Orthopedics Source Type: research

The sinuvertebral nerves at the craniovertebral junction: A microdissection study
AbstractBogduk et al. (1988, Spine 13:2–8) noted that the joints and ligaments at the cervico‐occipital region are susceptible to whiplash injury. The upper three cervical sinuvertebral nerves (SVNs) at the craniovertebral junction (CVJ) are thought to be responsible for mediating pain from the ligaments, dura mater, and soft tissues of the posterior cranial fossa and upper cervical column. The purpose of this study was to describe in detail the origin and course of the SVNs at C0–C1, C1–C2, and C2–C3 intervertebral levels and their anterior intraspinal distribution. A sample comprising 10 adult, 12 fetal (crown ...
Source: Clinical Anatomy - July 17, 2012 Category: Anatomy Authors: C. Rennie, M.R. Haffajee, M.A.A. Ebrahim Tags: Original Communication Source Type: research

Neisseria gonorrhoeae paravertebral abscess.
In this report, the authors present their therapeutic decisions and review the relevant literature on disseminated gonococcal infection in a patient presenting with an epidural abscess. A 42-year-old Indonesian man was admitted with symptoms of neck and upper back pain and bilateral lower-limb weakness. Clinical examination was unremarkable apart from tenderness over the lower cervical spine. Postgadolinium T1-weighted MRI of the cervical and thoracic spine demonstrated an enhancing lesion in the right paraspinal and epidural soft tissue at C-6 to T1-2, in keeping with a spinal epidural abscess. The patient underwent lami...
Source: Journal of Neurosurgery.Spine - July 1, 2012 Category: Neurosurgery Authors: Low SY, Ong CW, Hsueh PR, Tambyah PA, Yeo TT Tags: J Neurosurg Spine Source Type: research

Spinal Cord Stimulation for Intractable Pain Following Limb Amputation
Conclusions: Successful SCS in some patients with amputation‐related pain otherwise resistant to treatment indicates that the procedure merits continued use with further efforts to refine technique. (Source: Neuromodulation)
Source: Neuromodulation - July 1, 2012 Category: Neurology Authors: John McAuley, Richard van Gröningen, Christopher Green Source Type: research

Management of cervical myelopathy due to ossification of posterior longitudinal ligament in a patient with Alström syndrome
Abstract Introduction Alström syndrome (AS) is a rare autosomal recessive genetic disorder with multisystemic involvement characterised by early blindness, hearing loss, obesity, insulin resistance, diabetes mellitus, dilated cardiomyopathy, and progressive hepatic and renal dysfunction. The clinical features, time of onset and severity can vary greatly among different patients. Many of the phenotypes are often not present in infancy but develop throughout childhood and adolescence. Recessively inherited mutations in ALMS1 gene are considered to be responsible for the causation of AS. Musculoskeletal manif...
Source: European Spine Journal - May 11, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Intraoperative Pontine Infarction: A Hidden Challenge
We describe the airway management of a patient with an acute, occult pontine infarct status post craniectomy and cervical laminectomy for decompression of known Chiari malformation in the postanesthesia care unit (PACU). (Source: International Journal of Telemedicine and Applications)
Source: International Journal of Telemedicine and Applications - April 5, 2012 Category: Information Technology Source Type: research

Quadriplegia secondary to cervical spondylotic myelopathy—A rare complication of head and neck surgery
ConclusionCervical spondylotic myelopathy is a rare but disastrous complication of head and neck surgery. We hypothesize that it is potentially avoidable with heightened awareness of this disease entity, preoperative identification of patients at risk, and prophylactic interventions © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)
Source: Head and Neck - March 17, 2012 Category: ENT & OMF Authors: Wei‐Fan ChenChung‐Jan KangSai‐Cheung LeeChung‐Kan Tsao Tags: Case Report Source Type: research

Cervical pseudarthrosis and lumbar fusion mass
At his request, a 59-year-old man’s body was donated to a local medical school after he died of suspected myocardial infarction. On evaluation in a medical student human anatomy suite, an incompletely healed posterior midline thoracolumbar surgical incision was evident. Dissection revealed a laminectomy defect and solid intertransverse fusion at L2 and L3; segmental pedicle screw-based instrumentation had evidently been removed (). During neck dissection, interbody pseudarthrosis because of incomplete bridging between C3 and C4 was uncovered (). There was coincident robust uncinate hypertrophy, perhaps secondary to the f...
Source: The Spine Journal - February 27, 2012 Category: Orthopaedics Authors: Geoffrey E. Stoker Tags: Images of Spine Care Source Type: research

A bilateral myocutaneous trapezius advancement flap to cover a cervical laminectomy defect
Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s00238-012-0689-zAuthors Anouk Tan, Department of Plastic, Reconstructive and Hand surgery, Medisch Spectrum Twente, Postbus 50000, 7500 KA Enschede, The NetherlandsOliver T. Zöphel, Department of Plastic, Reconstructive and Hand surgery, Medisch Spectrum Twente, Postbus 50000, 7500 KA Enschede, The Netherlands Journal European Journal of Plastic SurgeryOnline ISSN 1435-0130Print ISSN 0930-343X (Source: European Journal of Plastic Surgery)
Source: European Journal of Plastic Surgery - February 16, 2012 Category: Cosmetic Surgery Tags: European Journal of Plastic Surgery Source Type: research

106 Reversible dystonia induced by cervical myelopathy: a case report
We present the case of a young male who developed sustained, patterned, involuntary movements of his upper limbs following cervical myelopathy induced by a whiplash injury. The movements were not altered after eye closure, therefore were dystonic rather than pseudoathetoid in nature. The dystonia was associated with markedly impaired upper limb proprioception secondary to the myelopathy. Both the dystonia and proprioception improved following a C3-C6 cervical laminectomy and lateral mass fusion surgical procedure. Our case is very rare and only one similar case has previously been reported. We propose that this gentleman d...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 9, 2012 Category: Neurosurgery Authors: Bray, K., Chhetri, S., Varma, A., Silverdale, M. Tags: Spinal cord, Trauma, Injury ABN abstracts Source Type: research

Increased atypical PKC expression and activity in the phrenic motor nucleus following cervical spinal injury.
Abstract Atypical protein kinase C (aPKC) isoforms are expressed in phrenic motor neurons, a group of motor neurons critical for breathing. Following C2 cervical hemisection (C2HS), spontaneous plasticity occurs in crossed-spinal synaptic pathways to phrenic motor neurons, at least partially restoring inspiratory phrenic activity below the injury. Since aPKCs are necessary for synaptic plasticity in other systems, we tested the hypothesis that C2HS increases aPKC expression and activity in spinal regions associated with the phrenic motor nucleus. C2 laminectomy (sham) or C2HS was performed on adult, male Lewis rats...
Source: Experimental Neurology - February 6, 2012 Category: Neurology Authors: Guenther CH, Windelborn JA, Tubon TC, Yin JC, Mitchell GS Tags: Exp Neurol Source Type: research

Central Brown–Sequard syndrome caused by hyperextension: An unexpected complication of cervical pedicle screw fixation
This report describes a case of atypical Brown–Sequard syndrome, following cervical pedicle screw fixation and laminectomy. In our opinion, this complication was related to hyperextension rather than direct trauma or penetration. (Source: Clinical Neurology and Neurosurgery)
Source: Clinical Neurology and Neurosurgery - February 3, 2012 Category: Neurosurgery Authors: Hasan Kamil Sucu, İsmail Ertan Sevin, Murat Yıldırım Tags: Case Reports Source Type: research

Comparison between anterior and posterior decompression for cervical spondylotic myelopathy: subjective evaluation and cost analysis
Conclusions: Both anterior and posterior decompressions (with instrumentation) are effective procedures for improving the neurological outcomes of patients with CSM. However, although the two approaches have similar health care costs, anterior cervical corpectomy (with instrumentation) seems to be subjectively assessed by patients as better. (Source: Orthopaedic Surgery)
Source: Orthopaedic Surgery - February 1, 2012 Category: Orthopaedics Authors: Bin LiuWei MaFeng ZhuChi‐hua GuoWen‐long Yang Source Type: research

Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study
Conclusion Anatomic and morphologic study of the cervical nerve roots and their relationships to the lateral mass and the intervertebral disc are useful landmarks to reduce the operative complications of the posterior foraminotomy. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00586-012-2158-6Authors Mohamed Barakat, Neurosurgery Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptYoussef Hussein, Anatomy Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source...
Source: European Spine Journal - January 24, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Drug overdose resulting in quadriplegia
Conclusion Our patient suffered a spinal cord injury likely due to existing cervical stenosis, and in addition to an overdose of sedating medications, he likely sat in flexed neck position for prolonged period of time with the inability to modify his position. This likely resulted in cervical spine vascular and/or neurological compromise producing an irreversible spinal cord injury. Spinal cord injury is a rare finding in patients presenting with drug overdose. The lack of physical exam findings suggestive of trauma may delay prompt diagnosis and treatment, and thus clinicians must have a high index of suspi...
Source: European Spine Journal - January 11, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach
Conclusions: The posterior indirect decompression and fixation has now been adopted as the primary treatment for cervical OPLL involving multiple levels with the canal occupancy by OPLL <50% at our institution because this approach leads to significantly less implant failures. Those patients with the occupancy ≥50% managed with anterior approach surgeries had better outcomes, but approach was more difficult and associated with higher risk and complications. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))
Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) - January 10, 2012 Category: Orthopaedics Authors: Dasheng LinZhenqi DingKejian LianJiayuan HongWenliang Zhai Source Type: research

C2 lamina reconstruction using locking miniplate for the intradural tumor of the craniocervical junction (two case reports)
Conclusions This procedure results in rigid fixation of the reimplanted C2 lamina and helps to restore the paraspinous muscles. For these reasons, it appears to be a useful surgical procedure for spinal tumors requiring C2 laminectomy and does not cause postoperative kyphosis of the cervical spine. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00586-011-2138-2Authors Hisanori Ikuma, Department of Orthopaedic Surgery, Kagawa Rosai Hospital, 3-3-1 Joto-cho, Marugame, Kagawa 763-8502, JapanKensuke Shinohara, Department of Orthopaedic Surgery, Kagawa Rosai Hospital, 3-3-1 Joto-ch...
Source: European Spine Journal - January 7, 2012 Category: Orthopaedics Tags: European Spine Journal Source Type: research

A rare case of life-threatening giant plexiform schwannoma
A 28-year-old woman with idiopathic scoliosis presented with a cervical mass and progressive gait disturbance over the course of 2 years. Examination demonstrated mild spastic paraplegia, hypoesthesia with upper level at T5 and severe respiratory failure requiring assisted ventilation. Magnetic resonance imaging showed multiple thoracic masses compressing left lung, trachea, and spinal cord (). Surgical resection was performed. Through C5–T1 laminectomy, the intradural part of the neoplasia was completely removed, and the extradural part was enucleated as much as possible. After surgery, the respiratory function improved...
Source: The Spine Journal - January 3, 2012 Category: Orthopaedics Authors: Fioravante Capone, Emanuele Pravatà, Mariangela Novello, Stefania Moncelsi, Tommaso Pirronti, Mario Meglio, Serenella Servidei Tags: Images of Spine Care Source Type: research

Laparoscopic Sleeve Gastrectomy: a First Step for Rapid Weight Loss in Morbidly Obese Patients Requiring a Second Non-Bariatric Procedure
Conclusions In this small group, laparoscopic sleeve gastrectomy appears to be an effective and safe first surgical approach for rapid weight loss in high-risk patients that require a second non-bariatric procedure. Content Type Journal ArticleCategory Clinical ResearchPages 1-5DOI 10.1007/s11695-011-0574-zAuthors Jesus E. Hidalgo, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USAMayank Roy, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USAAlexander Ramirez, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USASamuel Szomste...
Source: Obesity Surgery - December 30, 2011 Category: Surgery Tags: Obesity Surgery Source Type: research

Neurosurgery at Queen Square
This article has been peer reviewed. Article Submitted on: 9th October 2011 Article Accepted on: 28th November 2011 Funding sources: None declared Correspondence to:Hamza Tariq Medical student Address:King Edward Medical University, Lahore, Pakistan. Email: hamxatariq@yahoo.com Download PDF Elective Report The day I finished studying the anatomy of brain, I knew that I wanted to pursue neurosurgery as a career speciality. A medical student getting fascinated by the mysterious workings of the human brain is not something unusual. Here, in a mere 3 pounds of living tissue, lies the complexity suffici...
Source: Journal of Pakistan Medical Students - December 29, 2011 Category: Universities & Medical Training Authors: JPMS Source Type: research

Less invasive approaches for the treatment of cervical schwannomas: our experience
Conclusions Minimal access procedures are increasingly gaining popularity but their use is poorly described in the treatment of cervical tumors. Less invasive approaches may effectively be used instead of traditional laminectomy in the treatment of cervical tumors, especially schwannomas, providing less iatrogenic traumatism and preventing postsurgical spinal instability. Modern neuroimaging allows adequate preoperative planning and microsurgical techniques provide adequate execution of the surgical act. The procedure has to be tailored case by case considering the specific lesional features and the individu...
Source: European Spine Journal - December 16, 2011 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Unusual spine anatomy contributing to wrong level spine surgery: a case report and recommendations for decreasing the risk of preventable 'never events'
CONCLUSION: This case highlights the importance of strict adherence to a preoperative method of vertebral labeling that focuses on the landmarks used to label a pathologic disc space, rather than simply relying on the reference to a particular level. That is, by designating the pathological level as the disc space associated with the fourth rib up from the last rib-bearing vertebrae, rather than calling it "T7-8," then the correct level can be found intraoperatively even in the case of abnormal segmentation. We recommend working closely with radiology during preoperative planning to identify unusual anatomy that may have b...
Source: Patient Safety in Surgery - December 14, 2011 Category: Surgery Authors: Lindley EM, Botolin S, Burger EL, Patel VV Tags: Patient Saf Surg Source Type: research

Spinal posterior movement after posterior cervical decompression surgery: clinical findings and factors affecting postoperative functional recovery.
This study investigated the posterior movement of the spinal cord after posterior decompression surgery and evaluated factors affecting postoperative functional recovery in patients with cervical spondylotic myelopathy (CSM). Thirty-two patients with CSM underwent posterior decompression from C3 to C7 through laminectomy (n=12) and single, open-door laminoplasty (n=20). There were no significant differences between laminectomy and laminoplasty in degree of spinal posterior movement, recovery rate, and curvature index. Japanese Orthopedic Association (JOA) scores improved from preoperative (10.63±1.77; range, 7-14) to 3-mo...
Source: Orthopedics - December 8, 2011 Category: Orthopaedics Authors: Xia G, Tian R, Xu T, Li H, Zhang X Tags: Orthopedics Source Type: research

Spinal cord bypass surgery with intercostal and spinal accessory nerves: an anatomical feasibility study in human cadavers.
Conclusions Both spinal accessory and intercostal nerves, accessible from a posterior approach in the prone position, can be successfully harvested and transferred to their respective targets in the cervical spinal cord and conus medullaris. As expected, the number of axons available to grow into the spinal cord diminishes distally along each nerve. To maximize axon "bandwidth" in nerve bypass procedures, the most proximal section of the nerve that can be transferred in a tension-free manner to a spinal level caudal to the level of injury should be implanted. This study supports the feasibility of SAN and intercostal nerv...
Source: Journal of Neurosurgery.Spine - December 2, 2011 Category: Neurosurgery Authors: Haque RM, Malone HR, Bauknight MW, Kellner MA, Ogden AT, Martin JH, Tanji K, Winfree CJ Tags: J Neurosurg Spine Source Type: research

Isolated extradural tuberculous granuloma of the cervical spine: a case report
Conclusions The isolated IETG, although a rare entity, should be considered in the differential diagnosis of the intraspinal mass, especially in patients with spinal cord compression and a history of tuberculosis. If there is a progressing neurological deficit, a combination of surgical and anti-tuberculous treatment should be the optimal choice. Content Type Journal ArticleCategory Chinese sectionPages 1-4DOI 10.1007/s00586-011-2095-9Authors Qi Ding, Department of Spine Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Zhongshan Road No.321, Nanjing, 210008 ChinaZhen L...
Source: European Spine Journal - December 1, 2011 Category: Orthopaedics Tags: European Spine Journal Source Type: research

Cervical transpedicular fixation aided by biplanar flouroscopy.
CONCLUSION. Cervical transpedicular fixation provides strong stabilisation. With the aid of biplanar fluoroscopy, the risk of pedicle perforation was about 8%, but no neurovascular injury was ensued. PMID: 22184164 [PubMed - in process] (Source: Journal of Orthopaedic Surgery)
Source: Journal of Orthopaedic Surgery - December 1, 2011 Category: Orthopaedics Authors: Kotil K, Sengoz A, Savas Y Tags: J Orthop Surg (Hong Kong) Source Type: research

Extensive laminectomy for the treatment of ossification of the posterior longitudinal ligament in the cervical spine
Conclusion Extensive laminectomy is effective in treating cervical OPLL, with mild cervical/shoulder pain, low rate of C5 nerve root palsy, and no recurrence of spinal cord compression symptoms. Content Type Journal ArticleCategory Orthopaedic SurgeryPages 1-7DOI 10.1007/s00402-011-1420-4Authors Xiaotao Zhao, Department of Orthopedic Surgery, Tianjin Medical University General Hospital, Tianjin, 300052 ChinaYuan Xue, Department of Orthopedic Surgery, Tianjin Medical University General Hospital, Tianjin, 300052 ChinaFeilong Pan, Department of Orthopedic Surgery, Tianjin Medical University General Hosp...
Source: Archives of Orthopaedic and Trauma Surgery - November 25, 2011 Category: Orthopaedics Tags: Archives of Orthopaedic and Trauma Surgery Source Type: research

Posterior surgery for cervical myelopathy: indications, techniques, and outcomes.
This article details the controversies associated with the different treatment strategies in patients with cervical spondylotic myelopathy. The natural history, incidence, pathophysiology, physical examination, and imaging findings are discussed followed by the indications, techniques, and outcomes of patients treated with posterior cervical decompression via decompressive laminectomy, laminectomy and instrumented fusion, and laminoplasty. PMID: 22082627 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - November 22, 2011 Category: Orthopaedics Authors: Lawrence BD, Brodke DS Tags: Orthop Clin North Am Source Type: research

Posterior Surgery for Cervical Myelopathy: Indications, Techniques, and Outcomes
This article details the controversies associated with the different treatment strategies in patients with cervical spondylotic myelopathy. The natural history, incidence, pathophysiology, physical examination, and imaging findings are discussed followed by the indications, techniques, and outcomes of patients treated with posterior cervical decompression via decompressive laminectomy, laminectomy and instrumented fusion, and laminoplasty. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 17, 2011 Category: Orthopaedics Authors: Brandon D. Lawrence, Darrel S. Brodke Source Type: research

Laminectomy, durotomy, and piotomy effects on spinal cord intramedullary pressure in severe cervical and thoracic kyphotic deformity: a cadaveric study.
Conclusions In this cadaveric study, laminar decompression reduced ?IMP by approximately 15%?25%, while correction of the kyphotic deformity returned ?IMP to zero. This study helps explain the pathophysiology of myelopathy in kyphotic deformity and the failure of laminectomy alone for cervical and thoracic kyphotic deformities with myelopathy. In addition, the study emphasizes the need for correction of deformity during operative treatment of kyphotic deformity, the need for maintaining adequate intraoperative blood pressure during operative treatment, and the higher risk of spinal cord injury associated with operative tr...
Source: Journal of Neurosurgery.Spine - November 11, 2011 Category: Neurosurgery Authors: Winestone JS, Farley CW, Curt BA, Chavanne A, Dollin N, Pettigrew DB, Kuntz C Tags: J Neurosurg Spine Source Type: research

Cervical chondroid chordoma in a standard dachshund: a case report
A ten-year-old male standard dachshund was presented with a history of neck pain and progressive gait disturbances. Following a neurological examination and diagnostic imaging, including CT, a neoplastic lesion involving the third and fourth cervical vertebrae was suspected. The lesion included an extradural mass on the right side of the spinal canal causing a local compression of the cervical cord. Surgery, using a modified dorsal laminectomy procedure, was performed in order to decompress the cervical spinal cord. Histopathological examination of the extradural mass indicated that the tumour was a chondroid chordoma. Fol...
Source: Acta Veterinaria Scandinavica - October 21, 2011 Category: Veterinary Research Authors: Oyvind StigenNina OttesenHans GamlemCaroline Akesson Source Type: research

Cervical Laminoplasty for Multilevel Cervical Myelopathy
Cervical spondylotic myelopathy can result from degenerative cervical spondylosis, herniated disk material, osteophytes, redundant ligamentum flavum, or ossification of the posterior longitudinal ligament. Surgical intervention for multi-level myelopathy aims to decompress the spinal cord and maintain stability of the cervical spine. Laminoplasty was major surgical advancement as laminectomy resulted in kyphosis and unsatisfactory outcomes. Hirabayashi popularised the expansive open door laminoplasty which was later modified several surgeons. Laminoplasty has changed the way surgeons approach multilevel cervical spondyloti...
Source: Clinical and Developmental Immunology - October 2, 2011 Category: Allergy & Immunology Source Type: research

Lumbosacral sensory neuronal activity is enhanced by activation of urothelial purinergic receptors.
Abstract Urothelial purinergic receptors are important for the regulation of afferent sensory pathways in bladder pain and overactivity. Using in vivo electrophysiological recordings we evaluated the activity of spinal dorsal horn neurons in female rats at the L6/S1 level when urinary bladder pressure was abruptly increased. Intravesical infusion of ATP and systemic application of suramin allowed us to evaluate the contribution of urothelial purinergic receptors. Rats were anesthetized with isofluorane. Suprapubic, venous and tracheal catheters were implanted. Laminectomy was performed at the L6-S1 spinal levels. T...
Source: Brain Research Bulletin - September 8, 2011 Category: Neurology Authors: Munoz A, Somogyi GT, Boone TB, Smith CP Tags: Brain Res Bull Source Type: research