Gait abnormality due to spinal instability after lumbar facetectomy in the rat

2014 ◽  
Vol 24 (9) ◽  
pp. 2085-2094 ◽  
Author(s):  
Daisuke Fukui ◽  
Mamoru Kawakami ◽  
Munehito Yoshida ◽  
Shin-ichi Nakao ◽  
Toshiko Matsuoka ◽  
...  
Keyword(s):  
Spinal Instability ◽  
Gait Abnormality ◽  
Lumbar Facetectomy

Three-dimensional micro-computed tomography analysis for spinal instability after lumbar facetectomy in the rat

2016 ◽  
Vol 26 (8) ◽  
pp. 2014-2020 ◽  
Author(s):  
Daisuke Fukui ◽  
Mamoru Kawakami ◽  
Kevin Cheng ◽  
Koichiro Murata ◽  
Keianne Yamada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Spinal Instability ◽  
Micro Computed Tomography ◽  
Lumbar Facetectomy ◽  
Tomography Analysis

scholarly journals Secondary Normal-Pressure Hydrocephalus in Rheumatoid Meningitis

2021 ◽  
pp. 434-440
Author(s):  
Micaela Owens ◽  
Na Tosha Gatson ◽  
Gino Mongelluzzo ◽  
Oded Goren ◽  
Eric Newman ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Normal Pressure Hydrocephalus ◽  
Immune Suppression ◽  
Normal Pressure ◽  
The Elderly ◽  
Common Cause ◽  
Gait Abnormality ◽  
Ventriculoperitoneal Shunting ◽  
Patient Reported ◽  
Rheumatoid Meningitis

Normal-pressure hydrocephalus (NPH) is a common cause of gait apraxia, cognitive impairment, and urinary incontinence in the elderly. It is usually a primary idiopathic disorder but can be secondary. We present a case of secondary NPH due to biopsy-confirmed rheumatoid meningitis initially refractory to intravenous (IV) immunotherapy. Our patient reported an excellent response right after shunting. Her gait remains normal one and a half years later. We searched PubMed for similar cases of rheumatoid meningitis with gait abnormality for additional clinicopathologic discussion. The patient’s movement disorder initially improved with steroid taper. However, she developed progressive symptoms, later on, refractory to IV solumedrol and rituximab. She underwent ventriculoperitoneal shunting (VPS) and reported an outstanding outcome. This is the first reported biopsy-confirmed case of rheumatoid meningitis causing NPH to undergo shunting for immediate improvement. Previous cases of rheumatoid meningitis-associated Parkinsonism have improved with steroid induction. Although our patient’s rheumatoid arthritis is now controlled, her case illustrates that NPH in autoinflammatory conditions may not recover with immune suppression alone. VPS is an option for a faster response in secondary NPH due to rheumatoid meningitis or other inflammatory disorders with progressive symptoms despite standard induction therapy.

scholarly journals 413 Posterior Stabilisation Without Formal Debridement for The Treatment of Non-Tuberculous Pyogenic Spinal Infection in A Frail and Debilitated Population – A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Elmajee ◽  
C Munasinghe ◽  
A Aljawadi ◽  
K Elawady ◽  
F Shuweihde ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Meta Analysis ◽  
Spinal Infection ◽  
Spinal Instability ◽  
Surgical Interventions ◽  
Spine Tango ◽  
Neurological Outcomes ◽  
Neurological Improvement ◽  
Posterior Stabilisation ◽  
Successful Infection

Abstract Background Non-tuberculous pyogenic spinal infection (PSI) incorporates a variety of different clinical conditions. Surgical interventions may be necessary for severe cases where there is evidence of spinal instability or neurological compromise. The primary surgical procedure focuses on the anterior approach with aggressive debridement of the infected tissue regions. We aim to evaluate the effectiveness of the posterior approach without debridement. Method Several databases including MEDLINE, NHS evidence and the Cochrane database were searched. The main clinical outcomes evaluated include pain, neurological recovery (Frankel Grading System, FGS) post-operative complications and functional outcomes (Kirkaldy-Willis Criteria and Spine Tango Combined Outcome Measure Index, COMI). Results From the four papers included in the meta-analysis, post-operative pain levels were found to be lower at a statistically significant level when a random effects model was applied, with the effect size found to be at 0.872 (p < 0.001, 95% CI: 0.7137 to 1.0308). Post-surgical neurological improvement was also demonstrated with a mean FGS improvement of 1.12 in 64 patients over the included articles. Conclusions Posterior approach with posterior stabilisation without formal debridement can results in successful infection resolution, improved pain scores and neurological outcomes. However, Larger series with longer follow-up duration are strongly recommended.

scholarly journals Corticobasal Degeneration Misdiagnosed As Musculoskeletal Disease: A Challenging Diagnosis of Higher-Level Gait Disease

2020 ◽  
Vol 11 (04) ◽  
pp. 640-642
Author(s):  
Halil Onder
Keyword(s):  
Corticobasal Degeneration ◽  
The Elderly ◽  
Gait Disorders ◽  
Physiological Changes ◽  
Gait Abnormality ◽  
Age Related ◽  
Musculoskeletal Problems ◽  
Neurological Exam ◽  
Long Time ◽  
High Level

AbstractGait disorders are common in the elderly as there are various causes of neurological and non-neurological conditions. On the other hand, most of the gait parameters do change with advancing age which is identified as age-related physiological changes in gait. At this point, the discrimination between age-related physiological changes and gait disorders may be strictly challenging. After identifying gait as an abnormal pattern, classification of it and making the responsible pathophysiology also require high-level expertise in this regard. Herein, we present a rare patient with corticobasal degeneration (CBD) who had admitted initially due to complaints of gait problems. Over a long time, the patient had received the misdiagnosis of gait abnormality due to musculoskeletal problems by multiple physicians. However, the detailed neurological exam showed a higher level gait disorder (HLGD). Further investigations at this point yielded the diagnosis of CBD.

Vertebral fractures and luxations in dogs and cats part 2: treatment and surgery options

2021 ◽  
Vol 26 (3) ◽  
pp. 15-19
Author(s):  
Ivona Orgonikova ◽  
Josep Brocal ◽  
Giunio Bruto Cherubini ◽  
Viktor Palus
Keyword(s):  
Spinal Cord ◽  
Vertebral Fractures ◽  
Vertebral Column ◽  
Compartment Model ◽  
Spinal Instability ◽  
Decompression Surgery ◽  
Implant Loosening ◽  
Bone Fragment ◽  
Three Compartment Model ◽  
Disc Extrusion

Assessing the presence of vertebral column instability is essential in animals with vertebral fractures or luxations. Spinal instability is most commonly assessed using a three-compartment model and unstable vertebral fractures and luxations require surgical stabilisation. In cases of compression of the spinal cord (by haematoma, traumatic intervertebral disc extrusion or bone fragment), decompression surgery is necessary. Prompt surgery prevents additional spinal cord damage, but the overall condition of the patient, including any concurrent injuries, needs to be continually kept in mind. The vertebral column can be stabilised using multiple techniques, such as screws, pins, polymethylmetacrylate and plating techniques, as well as external stabilisation and spinal stapling. Complications of spinal surgeries include haemorrhage, infection, neurological deterioration, particularly in cases of spinal stabilisations, implant loosening and failure.

Vertebral compression fracture rate following stereotactic ablative body radiotherapy for spine oligometastases: a UK experience

2021 ◽  
pp. 1-5
Author(s):  
Sameed Hussain ◽  
Anjali Zarkar ◽  
Ahmed Elmodir ◽  
Daniel Ford ◽  
Sundus Yahya ◽  
...  
Keyword(s):  
Vertebral Compression Fracture ◽  
Demographic Data ◽  
Spinal Metastases ◽  
Compression Fracture ◽  
Spinal Instability ◽  
Fracture Rate ◽  
Strict Adherence ◽  
Stereotactic Ablative Body Radiotherapy ◽  
Vertebral Bodies ◽  
Pre Treatment

Abstract Aim: Stereotactic ablative body radiotherapy (SABR) for spine metastases is associated with a risk of vertebral compression fracture (VCF). The aim of this study was to determine the rate of VCF at one UK institution and evaluate the use of the Spinal Instability Neoplastic Score (SINS) to predict these. Materials and methods: A retrospective analysis of all patients who underwent SABR for spinal metastases between 2014 and 2018 at one UK institution was performed. Basic demographic data were collected, and SINS prior to SABR was calculated. The primary outcome was VCF rate. Secondary outcomes included time to VCF and need for surgical intervention following VCF. Results: A total of 48 oligometastases were treated with a median follow-up of 20·5 months. A maximum of two vertebral bodies were treated. The median baseline SINS was calculated as 3. The median dose was 26 Gy in three fractions. Two patients were reported to have VCF and both were successfully conservatively managed. Findings: SABR for spine oligometastases is being performed safely with low VCF rates which are comparable with those in international publications. This may be as a result of strict adherence to criteria for delivery of SABR with low pre-treatment SINS.

A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis

2003 ◽  
Vol 98 (3) ◽  
pp. 290-293 ◽  
Author(s):  
Koichi Sairyo ◽  
Shinsuke Katoh ◽  
Tadanori Sakamaki ◽  
Shinji Komatsubara ◽  
Natsuo Yasui
Keyword(s):  
Clinical Outcome ◽  
Nerve Root ◽  
Clinical Results ◽  
Skin Incision ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Nerve Roots ◽  
Content Type ◽  
Proximal Stump

✓ The authors describe a new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42–70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the decompression of nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.

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