Stress Distribution of the Spinal Cord and Clinical Relevance in Cervical Spondylotic Myelopathy

2014 ◽  
pp. 311-321
Author(s):  
Kohei Takahashi ◽  
Hiroshi Ozawa ◽  
Naoya Sakamoto ◽  
Yuka Minegishi ◽  
Masaaki Sato ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Stress Distribution ◽  
Clinical Relevance ◽  
Cervical Spondylotic Myelopathy

scholarly journals Assessing structure and function of myelin in cervical spondylotic myelopathy

Neurology ◽  
2017 ◽  
Vol 89 (6) ◽  
pp. 602-610 ◽  
Author(s):  
Hanwen Liu ◽  
Erin L. MacMillian ◽  
Catherine R. Jutzeler ◽  
Emil Ljungberg ◽  
Alex L. MacKay ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Compression Ratio ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Cord Compression ◽  
Whole Body ◽  
Healthy Controls ◽  
Conventional Mri ◽  
Intensity Compression

Purpose:To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques.Methods:Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC).Results:Group analysis showed marked differences in T2 signal intensity, compression ratio, MSCC, and MCC between healthy controls and patients with CSM. There were no group differences in MWF and SSEP latencies. However, patients with CSM with pathologic SSEPs exhibited reduction in MWF (p < 0.05). MWF was also correlated with SSEP latencies.Conclusion:Our findings provide evidence of decreased myelin content in the spinal cord associated with impaired spinal cord conduction in patients with CSM. While conventional MRI are of great value to define the extent of cord compression, they show a limited correlation with functional deficits (i.e., delayed SSEPs). MWI provides independent and complementary readouts to spinal cord compression, with a high specificity to detect impaired conduction.

Clinical Study of Cervical Spondylotic Myelopathy Using Evoked Spinal Cord Potentials

1985 ◽  
pp. 290-301 ◽  
Author(s):  
K.-I. Shinomiya ◽  
K. Furuya ◽  
I. Yamaura ◽  
H. Sato ◽  
A. Kaneda ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Study ◽  
Cervical Spondylotic Myelopathy

scholarly journals MR diffusion tensor imaging of the spinal cord: can it help in early detection of cervical spondylotic myelopathy and assessment of its severity?

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Talaat Ahmed Abd El Hameed Hassan ◽  
Ramy Edward Assad ◽  
Shaimaa Atef Belal
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Early Detection ◽  
Cervical Spondylotic Myelopathy ◽  
Diffusion Tensor ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Mr Diffusion ◽  
Compressive Myelopathy ◽  
Mr Diffusion Tensor Imaging

Abstract Background The aim of this study is to evaluate the potential application of MR diffusion tensor imaging (with calculation of fractional anisotropy (FA) values) in assessment of the spondylotic cervical spinal canal compromise and comparison with the information issued from conventional MR sequences for early detection of cervical spondylotic myelopathy (CSM). Thirty patients (11 males and 19 females) were included in this study; age ranged from 22 to 70 years (mean age = 44). All patients had conventional and diffusion tensor imaging (DTI) examinations of the cervical spine for detection and assessment of degree of cervical cord myelopathy. FA values of the whole cord circumference and at 3, 6, 9, 12 o’clock positions of the normal cord (opposite to C2), opposite to the most affected disc, and below the level of the most affected disc were measured. Results High statistically significant P values were obtained when comparing the FA values of the normal cord with the cord opposite to the most affected disc, the normal cord with the cord below the affected disc and the cord at the level of the most affected disc with the cord below the level of the most affected disc. Conclusions DTI of the cervical spinal cord with FA measurement in patients with cervical spondylosis helps in early detection of cervical cord compressive myelopathy prior to appearance of changes in conventional MRI, which can improve the clinical outcome and help in treatment plans.

scholarly journals Isolated Spinal Cord Arteritis

1975 ◽  
Vol 2 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Thomas E. Feasby ◽  
Gary G. Ferguson ◽  
J.C.E. Kaufmann
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Erythrocyte Sedimentation Rate ◽  
Laboratory Study ◽  
Sedimentation Rate ◽  
Polyarteritis Nodosa ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Vascular Lesions ◽  
Erythrocyte Sedimentation

SUMMARY:This patient presented as a subacute progressive cervical myelopathy and the differential diagnosis included cervical spondylotic myelopathy and intramedullary mass. Microscopically, vascular lesions plus a patchy myelomalacia indicated a vasculitis. However, there was no suggestion of a generalized vasculitis at autopsy and the only supporting laboratory study was a raised erythrocyte sedimentation rate. It would seem that a vasculitis similar to polyarteritis nodosa or other collagen disease may be confined to the spinal cord.

scholarly journals Reliability of pre-operative diffusion tensor imaging parameter measurements of the cervical spine in patients with cervical spondylotic myelopathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eugene Lee ◽  
Joon Woo Lee ◽  
Yun Jung Bae ◽  
Hyo Jin Kim ◽  
Yusuhn Kang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Cervical Spondylotic Myelopathy ◽  
Diffusion Tensor ◽  
Intraclass Correlation ◽  
Measurement Methods ◽  
Retest Reliability ◽  
Observer Reliability ◽  
Spinal Cord Level ◽  
Test Retest Reliability

Abstract The present study assessed test–retest and inter-observer reliability of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy (CSM), as well as the agreement among measurement methods. A total 34 patients (12 men, 22 women; mean age, 58.7 [range 45–79] years) who underwent surgical decompression for CSM, with pre-operative DTI scans available, were retrospectively enrolled. Four observers independently measured fractional anisotropy (FA) values twice, using three different measurement methods. Test–retest and inter-observer reliability was assessed using intraclass correlation coefficients (ICCs). Overall, inter-observer agreements varied according to spinal cord level and the measurement methods used, and ranged from poor to excellent agreement (ICC = 0.374–0.821), with relatively less agreement for the sagittal region of interest (ROI) method. The radiology resident and neuro-radiologist group showed excellent test–retest reliability at almost every spinal cord level (ICC = 0.887–0.997), but inter-observer agreements varied from fair to good (ICC = 0.404–0.747). Despite excellent test–retest reliability of the ROI measurements, FA measurements in patients with CSM varied widely in terms of inter-observer reliability. Therefore, DTI parameter data should be interpreted carefully when applied clinically.

Influence of Prefabricated Post Material on Restored Teeth: Fracture Strength and Stress Distribution

2006 ◽  
Vol 31 (1) ◽  
pp. 47-54 ◽  
Author(s):  
A. Barjau-Escribano ◽  
J. L. Sancho-Bru ◽  
L. Forner-Navarro ◽  
P. J. Rodríguez-Cervantes ◽  
A. Pérez-González ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Stress Distribution ◽  
Glass Fiber ◽  
Success Rate ◽  
Failure Mode ◽  
Fracture Strength ◽  
Clinical Relevance ◽  
Fiber Posts ◽  
Glass Fiber Posts

Clinical Relevance When restoring teeth, a higher restoring success rate can be achieved by using posts with an elastic modulus similar to that of dentin and a core, with equal or higher strength, such as glass fiber posts. Moreover, the failure mode for these post systems will allow for further repair.

Effective lordosis: analysis of sagittal spinal canal alignment in cervical spondylotic myelopathy

2009 ◽  
Vol 11 (6) ◽  
pp. 667-672 ◽  
Author(s):  
David E. Gwinn ◽  
Christopher A. Iannotti ◽  
Edward C. Benzel ◽  
Michael P. Steinmetz
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Planning ◽  
Interobserver Reliability ◽  
Straight Line ◽  
Angular Measurements ◽  
Sagittal Deformity ◽  
Straight Line Method

Object Analysis of cervical sagittal deformity in patients with cervical spondylotic myelopathy (CSM) requires a thorough clinical and radiographic evaluation to select the most appropriate surgical approach. Angular radiographic measurements, which are commonly used to define sagittal deformity, may not be the most appropriate to use for surgical planning. The authors present a simple straight-line method to measure effective spinal canal lordosis and analyze its reliability. Furthermore, comparisons of this measurement to traditional angular measurements of sagittal cervical alignment are made in regards to surgical planning in patients with CSM. Methods Twenty preoperative lateral cervical digital radiographs of patients with CSM were analyzed by 3 independent observers on 3 separate occasions using a software measurement program. Sagittal measurements included C2–7 angles utilizing the Cobb and posterior tangent methods, as well as a straight-line method to measure effective spinal canal lordosis from the dorsal-caudal aspect of the C2–7 vertebral bodies. Analysis of variance for repeated measures or Cohen 3-way (kappa) correlation coefficient analysis was performed as appropriate to calculate the intra- and interobserver reliability for each parameter. Discrepancies in angular and effective lordosis measurements were analyzed. Results Intra- and interobserver reliability was excellent (intraclass coefficient > 0.75, kappa > 0.90) utilizing all 3 techniques. Four discrepancies between angular and effective lordotic measurements occurred in which images with a lordotic angular measurement did not have lordosis within the ventral spinal canal. These discrepancies were caused by either spondylolisthesis or dorsally projecting osteophytes in all cases. Conclusions Although they are reliable, traditional methods used to make angular measurements of sagittal cervical spine alignment do not take into account ventral obstructions to the spinal cord. The effective lordosis measurement method provides a simple and reliable means of determining clinically significant lordosis because it accounts for both overall alignment of the cervical spine as well as impinging structures ventral to the spinal cord. This method should be considered for use in the treatment of patients with CSM.

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