1E46 Construction of 3-D FEM model of Spinal cord and Stress Analysis for Nerve Root Area

2015 ◽  
Vol 2015.27 (0) ◽  
pp. 221-222
Author(s):  
Shusuke TOMIYAMA ◽  
Kazuhiko ICHIHARA ◽  
Junji OHGI ◽  
Xian CHEN ◽  
Itsuo SAKURAMOTO ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Stress Analysis ◽  
Nerve Root ◽  
Fem Model ◽  
Root Area

Microanatomy of the Origin of the Cervical Plexus at the Spinal Cord, Nerve Root Cuffs, and Dorsal Root Ganglia Levels

2022 ◽  
pp. 93-125
Author(s):  
Irene Riquelme ◽  
Miguel Angel Reina ◽  
André P. Boezaart ◽  
Francisco Reina ◽  
Virginia García-García ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglia ◽  
Nerve Root ◽  
Dorsal Root ◽  
Cervical Plexus

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

Spinal Intradural Juxtamedullary Cysts in the Adult: Surgical Management and Outcome

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1352-1360 ◽  
Author(s):  
Hischam Bassiouni ◽  
Anja Hunold ◽  
Siamak Asgari ◽  
Uwe Hübschen ◽  
Hermann-Josef König ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Management ◽  
Nerve Root ◽  
Pain Syndrome ◽  
Radicular Pain ◽  
Arachnoid Cysts ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Neuroepithelial Cysts

Abstract OBJECTIVE: Intradural nonneoplastic cysts compressing the spinal cord are rare lesions. We retrospectively analyzed a series of patients harboring this entity with regard to clinical and radiological features, surgical management, and follow-up results. METHODS: In a retrospective study, we reviewed the medical charts, radiological investigations, and follow-up data of 11 women and 10 men (mean age, 43.6 yr) with intradural juxtamedullary spinal cysts, which were consecutively treated microsurgically at our institutions between January 1995 and January 2003. All lesions were approached via a laminectomy, hemilaminectomy, or laminoplasty at the corresponding vertebral levels and histopathologically verified. The patients were routinely scheduled for clinical follow-up 2 and 6 months after surgery. Baseline postoperative magnetic resonance imaging (MRI) was ordered 6 months after surgery. Thereafter, follow-up was performed at 1-year intervals, with neurological examination and MRI. RESULTS: According to presenting symptomatology, two main patient groups could be differentiated: one group with a myelopathic syndrome (10 patients) and another group with a predominant radicular pain syndrome (8 patients). Histopathological examination revealed 16 arachnoid cysts, 4 neuroepithelial cysts, and 1 cervical nerve root cyst. Most arachnoid cysts (12 cases) were located on the dorsal aspect of the thoracic spinal cord. The mean craniocaudal extension of these cysts was 3.7 vertebral levels, and complete resection was performed. In four patients, the arachnoid cyst was situated ventral to the spinal cord and involved up to 17 vertebral levels. These patients had a history of major spinal trauma, and the cyst was generously fenestrated at its greatest circumference as depicted on preoperative MRI scans. The four neuroepithelial cysts and the cervical nerve root cyst were located on the ventral or ventrolateral aspect of the spinal cord, and their maximum sagittal extension was two spinal vertebral levels. Symptoms in all but two patients demonstrated major improvement; in particular, radiating pain disappeared immediately after surgery. There was no cyst recurrence on MRI after a mean follow-up period of 3.2 years. CONCLUSION: Intradural cysts should be considered in the differential diagnosis of lesions causing myelopathy and/or a radicular pain syndrome. Microsurgical resection or generous fenestration in cysts with large craniocaudal extensions effectively ameliorated patients' symptomatology. A description of the first documented case of a surgically treated intradural cervical nerve root cyst is provided.

Physiology of Spinal Cord, Nerve Root and Peripheral Nerve Compression

1956 ◽  
Vol 185 (1) ◽  
pp. 217-229 ◽  
Author(s):  
Samuel Gelfan ◽  
I. M. Tarlov
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Nerve Root ◽  
Peripheral Nerves ◽  
Compressive Force ◽  
Mechanical Deformation ◽  
Dorsal Column ◽  
Neuronal Structure ◽  
Mechanical Pressure ◽  
Wide Range

The reversible conduction block produced by maintained mechanical pressure around small segments of spinal cord, nerve root or peripheral nerve (dog) is due to mechanical deformation of the neuronal tissue and not to lack of O2. The compressed segment, although ischemic, is not anoxic; O2 from adjacent nonischemic tissue reaches it, presumably by diffusion. The entire pattern of modification of neuronal responses by compression and the postdecompression recovery pattern are distinctly different from the patterns observed during anoxia and recovery from the latter, indicating the difference in mechanisms by which mechanical deformation and O2 lack block conduction. The largest fibers in dorsal columns, roots and peripheral nerves are most susceptible to pressure and the smallest ones are relatively most resistant. Secondary neurons are less vulnerable than the primary afferent ones to light and moderate, but suprasystolic, circumferential spinal cord pressure. All components of the composite spinal cord potential are blocked at about the same time by larger compressive forces. Anoxia, on the other hand, always inactivates secondary neurons before dorsal column fibers and blocks smaller A fibers in peripheral nerves before the larger ones. The latency for complete blocking in each neuronal structure is specific and irreducible in the case of anoxia, whereas in compression it varies over a wide range, depending upon the magnitude of the compressive force.

scholarly journals Upper thoracic spinal cord herniation after traumatic nerve root avulsion

2004 ◽  
Vol 16 (5) ◽  
pp. 306-309
Author(s):  
Victor R. DaSilva ◽  
Mubarak Al-Gahtany ◽  
Rajiv Midha ◽  
Dipanka Sarma ◽  
Perry Cooper
Keyword(s):  
Spinal Cord ◽  
Nerve Root ◽  
Signs And Symptoms ◽  
Root Avulsion ◽  
Thoracic Spinal Cord ◽  
First Case ◽  
Thoracic Spinal ◽  
Spinal Cord Herniation ◽  
Nerve Root Avulsion ◽  
Upper Thoracic

✓ Transdural herniation of the spinal cord, a rare but well-documented entity, has been reported sporadically for more than 25 years as a possible cause for various neurological signs and symptoms ranging from isolated sensory or motor findings to myelopathy and Brown–Séquard syndrome. The authors report, to the best of their knowledge, the first case of upper thoracic spinal cord herniation occurring after traumatic nerve root avulsion.

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.

Microsurgical Resection of Cervical Intradural Juxtamedullary Solitary Fibrous Tumor: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (5) ◽  
pp. E532-E532
Author(s):  
Paolo Perrini ◽  
Davide Tiziano Di Carlo ◽  
Nicola Montemurro ◽  
Nicola Benedetto ◽  
Valerio Ortenzi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Nerve Root ◽  
Tumor Resection ◽  
Gross Total Resection ◽  
Total Resection ◽  
Neurophysiologic Monitoring ◽  
Intramedullary Lesion ◽  
Dural Attachment ◽  
Fibrous Tumor ◽  
Nerve Root Involvement

Abstract Solitary fibrous tumors (SFTs) are uncommon mesenchymal lesions originally described as pleura-based neoplasms. Intradural juxtamedullary SFTs are rare, hard, and scarcely vascularized and generally present a conspicuous extramedullary exophytic component without dural attachment and nerve root involvement. Gross-total resection is the mainstay of treatment, although the absence of an arachnoidal plane and the firm adherence to the spinal cord make resection challenging.  We describe the case of a 74-yr-old female patient presenting with a history of progressive spastic tetraparesis due to a cervical juxtamedullary SFT. The patient was not able to walk and magnetic resonance imaging (MRI) of the cervical spine demonstrated a possible intramedullary lesion at C2-C3 with homogeneous enhancement after gadolinium injection. Given the progressive nature of symptoms, the patient elected to have surgical resection of the tumor. The patient underwent C2-C3 laminoplasty and tumor resection under neurophysiologic monitoring. The tumor presented extremely hard without dural attachment or nerve root involvement and was progressively debulked using microsurgical techniques and ultrasonic aspirator. The identification of a plane between the mass and the spinal cord white matter allowed for a gross total resection. Permanent pathological analysis eventually demonstrated SFT. The patient's neurological condition was unchanged postoperatively. MRI performed 2 mo after the operation demonstrated gross total resection of the lesion. At the 6-mo follow-up visit, the patient was able to walk with assistance.  The patient signed the Institutional Consent Form to undergo the surgical procedure and to allow the use of her images and videos for any type of medical publications.

Nerve Injury Associated with Anesthesia 

1999 ◽  
Vol 90 (4) ◽  
pp. 1062-1069 ◽  
Author(s):  
Frederick W. Cheney ◽  
Karen B. Domino ◽  
Robert A. Caplan ◽  
Karen L. Posner
Keyword(s):  
Spinal Cord ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Root ◽  
Spinal Cord Injuries ◽  
Insurance Companies ◽  
Initial Report ◽  
Depth Analysis ◽  
American Society ◽  
Closed Claims

Background Nerve injury associated with anesthesia is a significant source of morbidity for patients and liability for anesthesiologists. To identify recurrent and emerging patterns of injury we analyzed the current American Society of Anesthesiologists (ASA) Closed Claims Project Database and performed an in-depth analysis of claims for nerve injury that were entered into the database since the authors' initial report of the subject. Methods The ASA Closed Claims Database is a standardized collection of case summaries derived from the closed claims files of professional liability insurance companies. Claims for nerve injury that were not included in the authors' 1990 report were reviewed in-depth. Results Six hundred seventy (16% of 4,183) claims were for anesthesia-related nerve injury. The most frequent sites of injury were the ulnar nerve (28%), brachial plexus (20%), lumbosacral nerve root (16%), and spinal cord (13%). Ulnar nerve (85%) injuries were more likely to have occurred in association with general anesthesia, whereas spinal cord (58%) and lumbosacral nerve root (92%) injuries were more likely to occur with regional techniques. Ulnar nerve injury occurred predominately in men (75%) and was also more apt to have a delayed onset of symptoms (62%) than other nerve injuries. Spinal cord injuries were the leading cause of claims for nerve injury that occurred in the 1990s. Conclusion New strategies for prevention of nerve damage cannot be recommended at this time because the mechanism for most injuries, particularly those of the ulnar nerve, is not apparent.

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