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Day: July 28, 2017

Surfer’s myelopathy: a radiologic study of 23 cases.

By London Spine
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Surfer’s myelopathy: a radiologic study of 23 cases.

AJNR Am J Neuroradiol. 2013 Dec;34(12):2393-8

Authors: Nakamoto BK, Siu AM, Hashiba KA, Sinclair BT, Baker BJ, Gerber MS, McMurtray AM, Pearce AM, Pearce JW

Abstract
BACKGROUND AND PURPOSE: Surfing is an uncommon cause of an acute nontraumatic myelopathy. This study describes the MR imaging characteristics and clinical correlates in 23 subjects with surfer’s myelopathy.
MATERIALS AND METHODS: This was a retrospective review of 23 cases of surfer’s myelopathy from 2003-2012. Spinal cord MR imaging characteristics and neurologic examinations with the use of the American Spinal Injury Association scale were reviewed. Logistic regression was used to determine associations between MR imaging characteristics, American Spinal Injury Association scale, and clinical improvement.
RESULTS: All subjects (19 male, 4 female; mean age, 26.3 ± 7.4 years) demonstrated “pencil-like,” central T2-hyperintense signal abnormalities in the spinal cord extending from the midthoracic region to the conus with associated cord expansion and varying degrees of conus enlargement on spinal cord MR imaging within 24 hours of symptom onset. T1 signal was normal. Faint gadolinium enhancement was present in a minority. Although there was a strong correlation between initial American Spinal Injury Association score and clinical improvement (P = .0032), MR imaging characteristics were not associated with American Spinal Injury Association score or clinical improvement.
CONCLUSIONS: Surfer’s myelopathy should be considered in the radiographic differential diagnosis of a longitudinally extensive T2-hyperintense spinal cord lesion. MR imaging characteristics do not appear to be associated with severity on examination or clinical improvement.

PMID: 23828111 [PubMed – indexed for MEDLINE]

Comparison of three ultrasound guided approaches to the lumbar plexus in dogs: a cadaveric study.

By London Spine
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Comparison of three ultrasound guided approaches to the lumbar plexus in dogs: a cadaveric study.

Vet Anaesth Analg. 2014 Sep 4;

Authors: Graff SM, Wilson DV, Guiot LP, Nelson NC

Abstract
OBJECTIVE: To assess the accuracy of contrast material injection and the dispersion of injectate following ultrasound guided injections at the level of L6 and L7, in canine cadavers.
STUDY DESIGN: Prospective, randomized, experimental study.
ANIMALS: Twenty nine mixed breed canine cadavers (28.9 ± 6.0 kg).
METHODS: Three ultrasound-guided approaches to the lumbar plexus (LP) were compared: 1) a dorsal pre-iliac approach at the level of L6; 2) a lateral paravertebral approach at mid-L6; and 3) a lateral paravertebral approach at mid-L7. An isovolumic mixture of iodine-based contrast with new methylene blue (0.1 mL kg(-1) ) was injected bilaterally in the juxta-foraminal region along the L6 or L7 nerve root. Computed tomography was performed followed by segmentation and 3D reconstruction of the lumbar spine and contrast material volumes using dedicated software. Distances between contrast material and the fifth through seventh lumbar foraminae, and length of femoral (FN) and obturator (ON) nerve staining were measured and compared between approaches (p < 0.05).
RESULTS: Injectate moved cranial and caudal to the site of injection, and dispersed into an ovoid shape between the quadratus lumborum, iliopsoas and psoas minor muscles. Injections at L7 resulted in significantly closer contrast proximity to the L6 and L7 foraminae (p < 0.001). Femoral nerve staining was similar for all approaches, ON staining was more consistent after L7 injections (p < 0.001).
CONCLUSION AND CLINICAL RELEVANCE: An ultrasound-guided lateral paravertebral approach to the LP proved very practical and accurate, with easy visualization of the plexus and associated nerves. To ensure that the ON is covered by injectate, an approach at the level of L7 is recommended. Further studies are necessary to determine if this correlates with clinically effective local anesthesia.

PMID: 25185566 [PubMed – as supplied by publisher]

Mesenchymal Stem Cells from Nucleus Pulposus and Neural Differentiation Potential: a Continuous Challenge.

By London Spine

Related Articles Mesenchymal Stem Cells from Nucleus Pulposus and Neural Differentiation Potential: a Continuous Challenge. J Mol Neurosci. 2019 Jan;67(1):111-124 Authors: Lazzarini R, Guarnieri S, Fulgenzi G, Mariggiò MA, Graciotti L, Martiniani M, Orciani M, Specchia N, Di Primio R Abstract Mesenchymal stem cells (MSCs) are well-characterized adult stem cells, recently isolated from human nucleus…