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Day: July 26, 2016

Infectious myelopathies.

By wp_zaman

Related Articles
Infectious myelopathies.
Continuum (Minneap Minn). 2011 Aug;17(4):761-75
Authors: Berger JR
Abstract
Every genus of microorganism, as well as prions, has been associated with disease of the …

Clinical and Radiographic Results of Indirect Decompression and Posterior Cervical Fusion for Single-Level Cervical Radiculopathy Using an Expandable Implant with 2-Year Follow-Up.

By wp_zaman

Clinical and Radiographic Results of Indirect Decompression and Posterior Cervical Fusion for Single-Level Cervical Radiculopathy Using an Expandable Implant with 2-Year Follow-Up.

J Neurol Surg A Cent Eur Neurosurg. 2016 Jun 8;

Authors: Siemionow K, Janusz P, Phillips FM, Youssef JA, Isaacs R, Tyrakowski M, McCormack B

Abstract
Background Indirect posterior cervical nerve root decompression and fusion performed by placing bilateral posterior cervical cages in the facet joints from a posterior approach has been proposed as an option to treat select patients with cervical radiculopathy. The purpose of this study was to report 2-year clinical and radiologic results of this treatment method. Methods Patients who failed nonsurgical management for single-level cervical radiculopathy were recruited. Surgical treatment involved a posterior approach with decortication of the lateral mass and facet joint at the treated level followed by placement of the DTRAX Expandable Cage (Providence Medical Technology, Lafayette, California, United States) into both facet joints. Iliac crest bone autograft was mixed with demineralized bone matrix and used in all cases. The Neck Disability Index (NDI), visual analog scale (VAS) for neck and arm pain, and SF-12 v.2 questionnaire were evaluated preoperatively and 2 years postoperatively. Segmental (treated level) and overall C2-C7 cervical lordosis, disk height, adjacent segment degeneration, and fusion were assessed on computed tomography scans and radiographs acquired preoperatively and 2 years postoperatively. Results Overall, 53 of 60 enrolled patients were available at 2-year follow-up. There were 35 females and 18 males with a mean age of 53 years (range: 40-75 years). The operated level was C3-C4 (N = 3), C4-C5 (N = 6), C5-C6 (N = 36), and C6-C7 (N = 8). The mean preoperative and 2-year scores were NDI: 32.3 versus 9.1 (p < 0.0001); VAS Neck Pain: 7.4 versus 2.6 (p < 0.0001); VAS Arm Pain: 7.4 versus 2.6 (p < 0.0001); SF-12 Physical Component Summary: 34.6 versus 43.6 (p < 0.0001), and SF-12 Mental Component Summary: 40.8 versus 51.4 (p < 0.0001). No significant changes in overall or segmental lordosis were noted after surgery. Radiographic fusion rate was 98.1%. There was no device failure, implant lucency, or surgical reinterventions. Conclusions Indirect decompression and posterior cervical fusion using an expandable intervertebral cage may be an effective tissue-sparing option in select patients with single-level cervical radiculopathy.

PMID: 27276119 [PubMed – as supplied by publisher]

[Metastatic malignant melanoma with spinal cord compression and resulting recumbency ante partum in a mare. A case report].

By wp_zaman

[Metastatic malignant melanoma with spinal cord compression and resulting recumbency ante partum in a mare. A case report].

Tierarztl Prax Ausg G Grosstiere Nutztiere. 2013 Jun 14;41(3):190-4

Authors: Hildebrandt L, Jäger K, Snyder A, Sobiraj A

Abstract
The case report describes a narrowing of the spinal canal in the lumbar and sacroiliac regions with entailing acute recumbency in a nearterm 17-year-old Welsh B Pony mare. The reason for recumbency was metastases of a malignant melanoma in the spinal canal of the lumbo-sacral region, where the tumour had invaded the dura mater and applied severe pression on the spinal cord over a length of 10 cm. Clinical findings, laboratory diagnostics, pathological-anatomical and histopathological findings are presented.

PMID: 23765322 [PubMed – in process]

Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level.

By wp_zaman
Related Articles

Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level.

J Clin Neurosci. 2013 Jan 10;

Authors: Liu FJ, Chai Y, Shen Y, Xu JX, Du W, Zhang P

Abstract
Our objective was to evaluate the clinical efficacy and feasibility of posterior decompression with transforaminal thoracic interbody fusion (PTTIF) for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) and ossification of the posterior longitudinal ligament (OPLL) at the same level. Between March 2004 and December 2008, 13 patients (five men and eight women, average age: 56years, range: 39-72years) who underwent PTTIF for concurrent OLF and OPLL were studied retrospectively. The clinical efficacy, operative time, blood loss, sagittal alignment and complications were investigated. Cerebrospinal fluid leakage occurred in three patients, all of whom healed well after repair. One patient developed a urinary tract infection and one developed a wound infection, but both were cured with appropriate antibiotic therapy. Neurological symptom deterioration occurred in one patient, but she returned to her preoperative baseline after completing methylprednisolone therapy. After an average 36.8months follow up, the mean Japanese Orthopaedic Association (JOA) score significantly increased from 4.3±1.3 preoperatively to 7.2±1.8 at 3months after the operation and 8.5±1.7 at the final follow-up (P<0.01), with an overall recovery rate of 63.2±21.8%. Postoperative imaging demonstrated an improvement in the local kyphosis (P<0.01), and as of the final follow up no cases of spinal instability or instrument loosening had occurred. We conclude that PTTIF provides satisfactory neurological recovery and stabilises the thoracic fusion through a single posterior approach. However, this procedure is not complication free and demands advanced technical expertise on the part of practitioners, particularly to avoid catastrophic spinal cord injuries.

PMID: 23313526 [PubMed – as supplied by publisher]