Search results for "Myelopathy"
showing 10 items of 23 documents
Abnormal subcortical somatosensory evoked potentials indicate high cervical myelopathy in achondroplasia
1999
Children with achondroplasia may have high cervical myelopathy due to stenosis of the cranio-cervical junction resulting in neurological disability and an increased rate of sudden death. To detect myelopathy we recorded somatosensory evoked potentials (SEPs) after median nerve stimulation in 30 patients with achondroplasia aged 13 months to 18 years (mean 6 years). In addition to the conventional technique of recording the cortical N20 and the central conduction time (CCT), we employed a noncephalic reference electrode recording the subcortical waveforms N13b and P13, generated near the cranio-cervical junction. The findings were related to the clinical status and MRI results. Eighteen pati…
Cervical spondylotic myelopathy: Changes of fractional anisotropy in the spinal cord and magnetic resonance spectroscopy of the primary motor cortex …
2019
Abstract Objective To determine the changes in fractional anisotropy (FA) at the proximal spinal cord and in magnetic resonance spectroscopy (MRS) of the precentral gyrus in patients with cervical spondylotic myelopathy (CSM) with respect to clinical symptoms and their duration. Material and Methods 20 patients with CSM (7 female; mean age 64.6 ± 10.5 years) and 18 age/sex matched healthy controls (9 female; mean age 63.5 ± 6.6 years) were prospectively included. Clinical data (modified Japanese Orthopaedic Association Score (mJOA) and Neck Disability Index (NDI)) and 3T MR measurements including DTI at the spinal cord (level C2/3) with FA and MRS of the left and right precentral gyrus were…
A cervical myelopathy with a Hirayama disease-like phenotype
2008
A 21-year-old man with a muscular atrophy of the left distal upper extremity is presented. The disorder had been progressive over a few years, showing an exacerbation of the hand's weakness when the patient worked in a chilled environment (i.e., in a cold room). The patient's diagnostic work-up was extensive and the MRI documented the presence of a cervical myelopathy, associated to an inversion of the physiological lordosis at the C5-C6 level, with a phenotype highly resembling Hirayama disease. This case indirectly supports the debated hypothesis that juvenile amyotrophy of the upper limb (Hirayama disease) is actually a type of cervical myelopathy, with a likely ischaemic pathogenesis of…
Use of Machine Learning and Artificial Intelligence to Drive Personalized Medicine Approaches for Spine Care
2020
Personalized medicine is a new paradigm of healthcare in which interventions are based on individual patient characteristics rather than on “one-size-fits-all” guidelines. As epidemiological datasets continue to burgeon in size and complexity, powerful methods such as statistical machine learning and artificial intelligence (AI) become necessary to interpret and develop prognostic models from underlying data. Through such analysis, machine learning can be used to facilitate personalized medicine via its precise predictions. Additionally, other AI tools, such as natural language processing and computer vision, can play an instrumental part in personalizing the care provided to patients with …
Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: a meta-analysis of mid- to long-term outcomes in prospe…
2019
Objectives: Cervical disc arthroplasty (CDA) has become an alternative treatment for cervical radiculopathy and myelopathy. This technique preserves appropriate motion at both the index and adjacent disc levels and consequently may prevent adjacent segment degeneration (ASD). The authors performed a meta-analysis to compare the safety and efficacy of CDA to those of the gold standard, anterior cervical discectomy and fusion (ACDF). Both surgical and clinical parameters were employed to verify the hypothesis that CDA can reduce the risk of ASD. Methods: The meta-analysis comprised high-quality randomized controlled trials that compared CDA and ACDF treatments of cervical degenerative disc di…
Association of long-term outcome of long cervical fusion with sagittal balance: the significance of T1 slope minus cervical lordosis
2022
Introduction. Retrospective study to assess correlation between the sagittal alignment of the cervical spine and the long-term outcomes of long cervical fusion due to cervical spondylotic myelopathy (CSM), with the emphasis on T1 slope minus cervical lordosis (T1S-CL).Summary of background data. Growing evidence shows that the sagittal profile can play a major role in the outcomes of treatment, but the role of its correction is yet to be established. Material and methods. We conducted a retrospective analysis of 54 patients treated for CSM from 2006 to 2012. The neck pain-related disability was measured using NDI, the myelopathy was measured with the mJOA and Nurick scales. Six years after …
Diagnostic potential of the diffusion tensor tractography with fractional anisotropy in the diagnosis and treatment of cervical spondylotic and postt…
2016
Background: Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI)-based methodology widely used for the evaluation of microstructural integrity of the central nervous system (CNS), particularly of brain white matter fibers and bundles. Methods: The most common parameters evaluated in a DTI study are the fractional anisotropy (FA) and mean diffusivity (MD). Combining FA and MD analyses is commonly used in the evaluation of various types of brain pathologies, such as brain tumors, where a combined analysis allows an accurate tumor characterization. Results: Recent studies have shown that FA and MD could be of value in non-oncologic spinal pathology. In this regard, it has been …
DEGENERATIVE CERVICAL MYELOPATHY: REVIEW OF SURGICAL OUTCOME PREDICTORS AND NEED FOR MULTIMODAL APPROACH
2020
Degenerative cervical myelopathy is the most common cause of spinal cord injury in the elderly population in the developed world, and it significantly affects the quality of life of patients and their caregivers. Surgery remains the only treatment option able to halt disease progression and provide neurological recovery for most patients. Although it has remained challenging to predict exactly who will experience improvement after surgery, increasingly it has been shown that clinical, imaging, and electrophysiological factors can predict, with relatively good capacity, those more likely to benefit. Clinically, the baseline neurological impairment appears to be strongly related to the outcom…
Waste not, want not: Report of a completely calcified C1-C2 juxtafacet cyst and literature review
2021
Background: Calcified juxtafacet cysts in the cervical spine are extremely rate. Such symptomatic cysts commonly cause neck pain, radiculopathy, or even myelopathy. MR and CT studies typically document cord/ root compression. On occasion, some of these cysts will spontaneously regress, while many others may warrant surgical removal. Case Description: A 70-year-old male presented with a 2-year history of a progressive tetraparesis. The preoperative MR/CT studies showed a C1-C2 left extradural mass occupying more than half of the spinal canal. On MR, it was homogeneously hypointense on both T1- and T2-weighted images, while the CT showed a calcified cyst. Intraoperative and histopathological…
Hirayama disease – Early MRI diagnosis of subacute medullary ischemia: A case report
2020
Background: Hirayama disease (HD) is a rare, benign, and self-limiting motor neuron disorder that results in selective motor impairment of the C7-T1 myotomes. It is characterized by progressive, unilateral, or bilateral asymmetric muscle atrophy of the distal upper extremities and myelopathy. Case Description: A 23-year-old male presented with bilateral atrophy of the thenar/hypothenar eminences/ interosseous muscles, plus left-hand weakness. The cervical MRI documented subacute ischemic damage of the distal cervical cord. To rule out a tumor and reduce questionable cord compression, the patient underwent a C5–C6 anterior cervical discectomy and fusion (ACDF) immediately followed by a lami…