2 Anatomy of the Spinal Cord and Nerve Roots

2022 ◽  
Keyword(s):  
Spinal Cord ◽  
Nerve Roots

Anterior Cervical Discectomy With Fusion and Plating for Correction of Degenerative Cervical Kyphosis: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Jeremy M V Guinn ◽  
Brenton Pennicooke ◽  
Joshua Rivera ◽  
Praveen V Mummaneni ◽  
Dean Chou
Keyword(s):  
Spinal Cord ◽  
Informed Consent ◽  
Bone Density ◽  
Surgical Intervention ◽  
Anterior Cervical Discectomy ◽  
Cervical Kyphosis ◽  
Nerve Roots ◽  
Cervical Discectomy ◽  
Cervical Plate ◽  
Sequential Induction

Abstract This surgical video demonstrates the technique for correcting degenerative cervical kyphosis using an anterior cervical discectomy and fusion (ACDF). Degenerative cervical kyphosis can cause radiculopathy, myelopathy, and difficulty holding up one's head. The goal of surgical intervention is to alleviate pain, improve the ability for upright gaze, and decompress the spinal cord or nerve roots. Posterior-only approaches and anterior corpectomies are alternative treatments to address cervical kyphosis. However, an ACDF allows for sequential induction of lordosis via distraction over multiple segments and for further lordosis induction by sequential screw tightening, pulling the spine towards a lordotic cervical plate.1 This video shows 2 cases demonstrating a technique of correcting severe cervical degenerative kyphosis. The video illustrates our initial kyphotic Caspar pin placement coupled with sequential anterior distraction to correct kyphosis. The technique is most useful in patients who have good bone density, nonankylosed facets, and degenerative cervical kyphosis. We have received informed consent of this patient to submit this video.

scholarly journals Targeted axonal import (TAxI) peptide delivers functional proteins into spinal cord motor neurons after peripheral administration

2016 ◽  
Vol 113 (9) ◽  
pp. 2514-2519 ◽  
Author(s):  
Drew L. Sellers ◽  
Jamie M. Bergen ◽  
Russell N. Johnson ◽  
Heidi Back ◽  
John M. Ravits ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Motor Neurons ◽  
Unmet Need ◽  
Nerve Roots ◽  
Biologic Drugs ◽  
Administration Routes ◽  
Macromolecular Drugs ◽  
The Central Nervous System ◽  
Clinical Potential

A significant unmet need in treating neurodegenerative disease is effective methods for delivery of biologic drugs, such as peptides, proteins, or nucleic acids into the central nervous system (CNS). To date, there are no operative technologies for the delivery of macromolecular drugs to the CNS via peripheral administration routes. Using an in vivo phage-display screen, we identify a peptide, targeted axonal import (TAxI), that enriched recombinant bacteriophage accumulation and delivered protein cargo into spinal cord motor neurons after intramuscular injection. In animals with transected peripheral nerve roots, TAxI delivery into motor neurons after peripheral administration was inhibited, suggesting a retrograde axonal transport mechanism for delivery into the CNS. Notably, TAxI-Cre recombinase fusion proteins induced selective recombination and tdTomato-reporter expression in motor neurons after intramuscular injections. Furthermore, TAxI peptide was shown to label motor neurons in the human tissue. The demonstration of a nonviral-mediated delivery of functional proteins into the spinal cord establishes the clinical potential of this technology for minimally invasive administration of CNS-targeted therapeutics.

Unknown fatal encephalomyelopolyradiculoneuritis in a child. A case report

2021 ◽  
Vol 2 (2) ◽  
pp. 100-106
Author(s):  
Aleksandra I. Pavlyuchkova ◽  
Aleksey S. Kotov
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Genetic Diseases ◽  
Cranial Nerves ◽  
Unknown Etiology ◽  
Active Therapy ◽  
Nerve Roots ◽  
Child Patient ◽  
Brain And Spinal Cord ◽  
The Brain

In childhood, various infectious, autoimmune, genetic diseases can manifest. We present a case of fatal encephalomyelopolyradiculoneuritis of unknown etiology in a 9-year-old child. Patient N.K. in February 2019, noted an increase in temperature to subfebrile values, received symptomatic and antibiotic therapy without effect. An increase in protein and lymphocytes was found in the cerebrospinal fluid. According to MRI data, the emergence of more and more foci of the pathological signal in the brain and spinal cord, cranial nerves and nerve roots of the lumbar plexus was noted. Known infectious and autoimmune diseases were excluded. Despite active therapy with glucocorticoids, antibiotics, antiviral drugs, immunoglobulin, the disease continued to progress, and the patient died in April 2020.

INTRADURAL LIPOMAS IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 911-926
Author(s):  
Homer S. Swanson ◽  
Joseph C. Barnett
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Congenital Defects ◽  
Surgical Removal ◽  
Nerve Roots ◽  
Adult Type ◽  
Neurological Condition ◽  
History Of ◽  
Intradural Lipoma ◽  
Subtotal Removal

A series of nine cases of intradural spinal lipomas presenting in childhood or infancy are discussed. In all instances, associated congenital defects and a history of insidious neurological deficit were characteristic findings. In seven of the nine cases a subtotal removal of the intradural lipoma was accomplished, with resulting improvement in the neurological condition. In all instances the pathological interpretation of the lesion was that of an adult type of lipoma. Despite the benign connotations of lipoma, total surgical removal of these lipomas occurring intradurally has often been found not feasible and is probably not necessary. The inclusion of lipoma tissue within the substance of the spinal cord and nerve roots renders manipulation and excision extremely hazardous in terms of retaining the integrity of the nervous structures involved. In these instances subtotal surgical removal and decompression have proven beneficial in all instances in this series. Although exaggeration of neurological deficit may occur postoperatively, if the above surgical principles are adhered to, this deficit is not necessarily of a permanent nature.

scholarly journals Reducing Neuron Apoptosis in the Pontine Micturition Center by Nerve Root Transfer for Restoration of Micturition Function after Spinal Cord Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ronghua Yu ◽  
Gang Yin ◽  
Jianguo Zhao ◽  
Huihao Chen ◽  
Depeng Meng ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Nerve Root ◽  
Neuronal Apoptosis ◽  
Nerve Transfer ◽  
Tunel Staining ◽  
Nerve Roots ◽  
Cord Injury ◽  
Group A ◽  
Group B

Objective. The rate of neuronal apoptosis increases after spinal cord injury (SCI). Anastomosing the normal nerve roots above the SCI level to the injured sacral nerve roots can enhance the functional recovery of neurons. Therefore, we evaluated the effect of sacral nerve root transfer after SCI on pontine neuronal survival. Methods. Sprague–Dawley rats were randomly divided into three groups: Group A, reconstruction of afferent and efferent nerve pathways of the bladder after SCI; Group B, SCI only; and Group C, control group. We examined pontine neuronal morphology using hematoxylin and eosin (H&E) staining after SCI and nerve transfer. Bcl-2 and Bax protein expression changes in the pontine micturition center were quantified by immunohistochemistry. The number of apoptotic neurons was determined by TUNEL staining. We examined pontine neuronal apoptosis by transmission electron microscopy (TEM) at different time points. Results. H&E staining demonstrated that the number of neurons had increased in Group A, but more cells in Group B displayed nuclear pyknosis, with the disappearance of the nucleus. Compared with Group B, Group A had significantly higher Bcl-2 expression, significantly lower Bax expression, and a significantly higher Bcl-2/Bax ratio. The number of apoptotic neurons and neuron bodies in Group A was significantly lower than that in Group B, as indicated by TUNEL staining and TEM. Conclusions. These findings demonstrate that lumbosacral nerve transfer can reduce neuronal apoptosis in the pontine micturition center and enhance functional recovery of neurons. This result further suggests that lumbosacral nerve transfer can be used as a new approach for reconstructing bladder function after spinal cord injury.

Syringomyelia as a delayed complication of lumbar–sacral adhesive arachnoiditis in Pott’s disease

2020 ◽  
Vol 13 (5) ◽  
pp. e234032
Author(s):  
Gautam Jesrani ◽  
Jaspreet Kaur ◽  
Monica Gupta ◽  
Nishit Sawal
Keyword(s):  
Spinal Cord ◽  
Rare Case ◽  
Nerve Roots ◽  
Pott’S Disease ◽  
Delayed Complication ◽  
Over Time

Syringomyelia is the development of a fluid-filled cyst (syrinx) within the spinal cord and is an extremely rare chronic manifestation of tuberculosis. The syrinx so formed may expand over time, causing compression or destruction of spinal tracts and surrounding nerve roots. Development of syringomyelia in a patient of Pott’s disease is particularly infrequent. We report this rare case of a 31-year-old man with syringomyelia as a prolonged complication of Pott’s disease.

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