scholarly journals Segment-specific orientation of the dorsal and ventral roots for precise therapeutic targeting of human spinal cord

2020 ◽  
Author(s):  
Alan Mendez ◽  
Riazul Islam ◽  
Timur Latypov ◽  
Prathima Basa ◽  
Ogeneitsega J. Joseph ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spatial Orientation ◽  
Vertebral Column ◽  
Anatomical Landmarks ◽  
X Rays ◽  
Functional Neuroanatomy ◽  
Vertebral Bone ◽  
Cord Injury ◽  
Spinal Roots ◽  
Ventral Roots

AbstractAn understanding of spinal cord functional neuroanatomy is essential for diagnosis and treatment of multiple disorders including, chronic pain, movement disorders, and spinal cord injury. Till now, no information is available on segment-specific spinal roots orientation in humans. In this study we collected neuroanatomical measurements of the dorsal and ventral roots from C2-L5, as well as spinal cord and vertebral bone measurements from adult cadavers. Spatial orientation of dorsal and ventral roots were measured and correlated to the anatomical landmarks of the spinal cord and vertebral column. The results show less variability in rostral root angles compared to the caudal angles across all segments. Dorsal and ventral rootlets were oriented mostly perpendicular to the spinal cord at the cervical level and demonstrate more parallel orientation at the thoracic and lumbar segments. The number of rootlets was the highest in dorsal cervical and lumbar segments. Spinal cord transverse diameter and size of the dorsal columns were largest at cervical and lumbar segments. The strongest correlation was found between the length of intervertebral foramen to rostral rootlet and vertebral bone length. These results could be used to locate spinal roots and spinal cord landmarks based on bone marks on CT or X-rays. These results also provide background for future correlations between anatomy of spinal cord and spinal column structures that could improve stereotactic surgical procedures and electrode positioning for spinal cord neuromodulation.One Sentence SummaryThis is the first detailed analysis of the segment-specific dorsal and ventral spinal roots spatial orientation measured and correlated to the anatomical landmarks of the spinal cord and vertebral column for human.

scholarly journals Spinal Cord Injuries in Dogs Part II: Standards of Care, Prognosis and New Perspectives

2018 ◽  
Vol 62 (2) ◽  
pp. 45-58
Author(s):  
I. Šulla ◽  
V. Balik ◽  
S. Horňák ◽  
V. Ledecký
Keyword(s):  
Spinal Cord ◽  
Contrast Medium ◽  
Vertebral Column ◽  
Spinal Cord Injuries ◽  
Water Soluble ◽  
Standards Of Care ◽  
Epidural Administration ◽  
Science Literature ◽  
X Rays ◽  
Cord Injury

Abstract Severe spinal cord injuries (SCI), causing physical handicaps and accompanied by many serious complications, remains one of the most challenging problems in both, human and veterinary health care practices. The central nervous system in mammals does not regenerate, so the neurological deficits in a dog following SCI persists for the rest of its life and the affected animals display an image of permanent suffering. Diagnostics are based on: neurological examination, plain x-rays of vertebral column, x-rays of the vertebral column following intrathecal administration of a water-soluble contrast medium (myelography), x-rays of the vertebral column following epidural administration of a contrast medium (epidurography), computed tomography (CT) and/or magnetic resonance imaging (MRI). Currently, only limited therapeutic measures are available for the dogs with SCIs. They include: the administration of methylprednisolone sodium succinate (MPSS) during the acute stage; early spinal cord decompression; stabilisation of vertebral fractures or luxations; prevention and treatment of complications, and expert rehabilitation. Together with the progress in the understanding of pathophysiologic events occurring after SCI, different therapeutic strategies have been instituted, including the local delivery of MPSS, the utilisation of novel pharmacological agents, hypothermia, and stem/precursor cell transplantation have all been tested in the experimental models and preclinical trials with promising results. The aim of this review is the presentation of the generally accepted methods of diagnostics and management of dogs with SCIs, as well as to discuss new therapeutic modalities. The research strategy involved a PubMed, Medline (Ovid), Embase (Ovid) and ISI Web of Science literature search from January 2001 to December 2017 using the term “spinal cord injury”, in the English language literature; also references from selected papers were scanned and relevant articles included.

Fractures of the spine in children

2011 ◽  
Author(s):  
James Wilson-MacDonald ◽  
Colin Nnadi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injuries ◽  
Healthy Children ◽  
X Rays ◽  
Radiographic Abnormality ◽  
Cord Injury ◽  
High Incidence ◽  
Fractures Of The Spine ◽  
Epiphyseal Plates

♦ Spinal injuries in children are rare♦ Pseudosubluxation above C4 is common in healthy children so the sign needs careful interpretation♦ Epiphyseal plates and a high incidence of skeletal variability make the interpretation of spinal x-rays in children difficult. Anterior wedging is also normal as is interpedicular widening♦ Spinal cord injury without radiographic abnormality (SCIWORA) may occur for up to one-third of spinal injuries in children♦ Deformity secondary to trauma tends to deteriorate with growth.

The Impact of Hospital Teaching Status on Timing of Intervention, Inpatient Morbidity, and Mortality After Surgery for Vertebral Column Fractures with Spinal Cord Injury

2017 ◽  
Vol 99 ◽  
pp. 140-144 ◽  
Author(s):  
Rafael De la Garza Ramos ◽  
Jonathan Nakhla ◽  
Rani Nasser ◽  
Ajit Jada ◽  
Daniel M. Sciubba ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Column ◽  
Morbidity And Mortality ◽  
Cord Injury ◽  
Teaching Status ◽  
The Impact

Atlantoaxial Instability in Individuals with Down’s Syndrome

1984 ◽  
Vol 1 (3) ◽  
pp. 194-196 ◽  
Author(s):  
Robert E. Cooke
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Atlantoaxial Instability ◽  
X Rays ◽  
Neurological Damage ◽  
Cord Injury

Atlantoaxial Instability occurs in approximately 17% of all persons with Down’s syndrome. Such persons are susceptible to serious spinal cord injury if marked flexion of the neck occurs. Every person with Down’s syndrome should have cervical spine x-rays before performing in certain sports even though the frequency of sports-induced neurological damage is low.

scholarly journals LOWER CERVICAL FRACTURE AND DISLOCATIONS

2018 ◽  
Vol 25 (02) ◽  
pp. 185-190
Author(s):  
Faisal Abdul Jabbar ◽  
Abdul Ali Khan ◽  
Rehana Ali Shah
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Burst Fracture ◽  
Tertiary Care ◽  
Insertion Site ◽  
Fracture Dislocation ◽  
X Rays ◽  
Cord Injury ◽  
Screw Breakage ◽  
Set Up

Objectives: The aim of our study is to determine the outcome of cervical pediclescrew fixation for fractures/dislocations of the cervical spine at our set up in Karachi, Pakistan.Study Design: A prospective case series. Period: 04 years duration from January 2013 toDecember 2016. Setting: Tertiary Care Centre in Karachi, Pakistan. Method: All the patientswho were included in the study signed a full informed consent. The inclusion criterion was allthe patients who cervical spine fracture/dislocation, presented to us within 24 hours of injuryand were operated at our set up. Data was collected in a predesigned proforma which includeda complete history and physical examination, age, gender, cause of injury, co morbidities, preoperativeradiological findings, past medical and surgical history. Serial X rays, MRI and CTscans were taken at 3, 6, 12 and 24 months post operatively for evaluation of stability, fusion andany complication such as deformity. The American Spinal Cord Injury Association impairmentscale was utilized in all the patients at follow ups to determine the sensory and motor functionimprovement post operatively. Data was analyzed using IBM SPSS for windows version 21.Results: The study population consisted of n= 40 patients of which n= 28 were male andn= 12 were female with a mean age of 45.2 years. The various types of injuries sustained bythe patients were as follows, n= 6 (15%) cases of cases had compression fractures (vertical),n=15 (37.5%) had flexion rotation injury and n=19 (47.5%) had flexion compression fracturesrespectively. While the division of bony injuries in the patient was as follows, n=5 (12.5%) hadcervical spinal burst fracture with dislocation, n= 15 (37.5%) patients had joint facet fracturewith dislocation bilaterally along with compression fracture of the vertebral body, n= 14 (35%)patients had facet joint fracture with dislocation bilaterally and n= 6 (15%) had unilateral fracturedislocation of joint facet. Complications such as injury to the vertebral artery, spinal cord, nerveroot were not observed in any of the patients in this series, all the patients achieved full bonyfusion at the 6 month follow up as observed on radiographic images. We also did not find anyincidence of screw penetration into the pedicle, similarly no incidence of screw breakage orloosening was observed. N=24 patients with incomplete injury of the spinal cord showedimprovements in their ASIA impairment scale, the patients n= 15 who had a complete spinalcord injury failed to show any improvement post operatively, but reported some decrease in painand numbness post operatively. Conclusion: For fractures/dislocations of the cervical spine thecervical pedicle screw is a reliable and effective method and provides good stability and bonyfusion. However the technique is dependent on surgeons experience and the extensive use ofpre-operative imaging to select the best insertion site of the screws as individualized for everypatient accordingly.

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