scholarly journals Magneticresonance imaging in the diagnosis of vertebral haemangiomas

1998 ◽  
Vol 4 (1) ◽  
pp. 149-155
Author(s):  
Asem Hiari ◽  
Bassam Nawaiseh ◽  
Hesham Jaber
Keyword(s):  
Retrospective Analysis ◽  
Vertebral Body ◽  
Cervical Region ◽  
Lumbar Region ◽  
Thoracic Region ◽  
Vertebral Haemangioma ◽  
Frequent Site

A retrospective analysis of 600 [238 females, 362 males] spine examinations was carried out. Vertebral haemangioma was observed in 160 patients [27%], 74 females [31%] and 86 males [24%]. The majority were over 35 years. The most frequent site was the lumbar region, 64 patients [40%], then the thoracic region, 32 patients [20%], cervical region, 26 patients [16%], predominantly in the dense complex of the axis, and 38 patients [24%] were found to have multiple haemangiomas. Characteristically all vertebral haemangiomas abutted or included the basivertebral veins in the vertebral body

Treatment of neoplastic epidural cord compression by vertebral body resection and stabilization

1985 ◽  
Vol 63 (5) ◽  
pp. 676-684 ◽  
Author(s):  
Narayan Sundaresan ◽  
Joseph H. Galicich ◽  
Joseph M. Lane ◽  
Manjit S. Bains ◽  
Patricia McCormack
Keyword(s):  
Vertebral Body ◽  
De Novo ◽  
Cord Compression ◽  
Cervical Region ◽  
Lumbar Region ◽  
Content Type ◽  
Prior Therapy ◽  
Results Of Treatment ◽  
Experienced Pain

✓ The results of treatment of neoplastic spinal cord compression by vertebral body resection and immediate stabilization in 101 consecutive patients over a 5-year period have been analyzed. Sites of primary cancer included the lung (25 patients), kidney (15 patients), breast (14 patients), connective tissue (12 patients), and a variety of others (35 patients). Of the 101 patients, 23 received surgery de novo; the remaining 78 patients had undergone previous therapy. Sites of involvement included the cervical region in 13 patients, the thoracic region in 68 patients, and the lumbar region in 20 patients. Prior to surgery, severe pain was noted in 90% of the patients, and 45% were non-ambulatory. Using an anterolateral surgical exposure, the vertebral body was resected along with all epidural tumor. Immediate stabilization was achieved with methyl methacrylate and Steinmann pins. Following surgery, the overall ambulation rate was 78%, and 85% of patients experienced pain relief. Of the 23 patients who had received no prior therapy, 90% continued to be ambulatory at their last follow-up examination or until death. The authors believe that surgery prior to irradiation is indicated in selected patients with neoplastic cord compression. In patients with solitary osseous metastasis to the spine, potentially curative resection can be undertaken if surgery is performed when the tumor is still confined to the vertebral body.

scholarly journals Complications of Fluoroscopically Directed Facet Joint Nerve Blocks: A Prospective Evaluation of 7,500 Episodes with 43,000 Nerve Blocks

2012 ◽  
Vol 2;15 (2;3) ◽  
pp. E143-E150 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Ambulatory Surgery ◽  
Facet Joint ◽  
Spinal Pain ◽  
Cervical Region ◽  
Medial Branch ◽  
Lumbar Region ◽  
Thoracic Region ◽  
Nerve Blocks ◽  
Surgery Center ◽  
Chronic Spinal Pain

Background: Chronic spinal pain is common along with numerous modalities of diagnostic and therapeutic interventions utilized, creating a health care crisis. Facet joint injections and epidural injections are the 2 most commonly utilized interventions in managing chronic spinal pain. While the literature addressing the effectiveness of facet joint nerve blocks is variable and emerging, there is paucity of literature on adverse effects of facet joint nerve blocks. Study Design: A prospective, non-randomized study of patients undergoing interventional techniques from May 2008 to December 2009. Setting: A private interventional pain management practice, a specialty referral center in the United States. Objectives: Investigation of the incidence in characteristics of adverse effects and complications of facet joint nerve blocks. The study was carried out over a period of 20 months including almost 7,500 episodes of 43,000 facet joint nerve blocks with 3,370 episodes in the cervical region, 3,162 in the lumbar region, and 950 in the thoracic region. All facet joint nerve blocks were performed under fluoroscopic guidance in an ambulatory surgery center by 3 physicians. The complications encountered during the procedure and postoperatively were evaluated prospectively. Methods: This study was carried out over a period of 20 months and included over 7,500 episodes or 43,000 facet joint nerve blocks. All of the interventions were performed under fluoroscopic guidance in an ambulatory surgery center by one of 3 physicians. The complications encountered during the procedure and postoperatively were prospectively evaluated. Outcomes Assessment: Measurable outcomes employed were intravascular entry of the needle, profuse bleeding, local hematoma, dural puncture and headache, nerve root or spinal cord irritation with resultant injury, and infectious complications. Results: There were no major complications. Multiple side effects and complications observed included overall intravascular penetration in 11.4% of episodes with 20% in cervical region, 4% in lumbar region, and 6% in thoracic region; local bleeding in 76.3% of episodes with highest in thoracic region and lowest in cervical region; oozing with 19.6% encounters with highest in cervical region and lowest in lumbar region; with local hematoma seen only in 1.2% of the patients with profuse bleeding, bruising, soreness, nerve root irritation, and all other effects such as vasovagal reactions observed in 1% or less of the episodes. Limitations: Limitations of this study include lack of contrast injection, use of intermittent fluoroscopy and also an observational nature of the study. Conclusion: This study illustrate that major complications are extremely rare and minor side effects are common. Key words: Spinal pain, facet joint nerve blocks, cervical medial branch or facet joint nerve blocks, thoracic medial branch or facet joint nerve blocks, lumbar facet joint nerve blocks, L5 dorsal ramus block complications

scholarly journals Demographic Characteristics and Anatomical Location of Primary Spinal Cord Tumour Patients operated at a Referral Neuroscience Hospital in Dhaka City

2020 ◽  
Vol 6 (1) ◽  
pp. 15-18
Author(s):  
Md Shafiul Alam ◽  
Kaisar Haroon ◽  
Md Abdullah Alamgir ◽  
Muhammad Tanvir Ashraf ◽  
Monsur Ahmed ◽  
...  
Keyword(s):  
Spinal Tumor ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Cervical Region ◽  
Anatomical Location ◽  
Lumbar Region ◽  
Thoracic Region ◽  
Cross Sectional ◽  
Female Ratio ◽  
Study Population

Background: Spinal tumor can occur in different anatomical location. Objective: The purpose of the present study was to see the demographic characteristics and anatomical location of spinal tumour. Methodology: This descriptive cross sectional study was conducted in the Department of Neurosurgery at National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from January 2016 to December 2019 for a period of around 04 (four) years. Patients presented with spinal tumor were selected as study population. The demographics characteristics were evaluated among all the patients. Patients were examined by MRI for the detection of anatomical location of the tumor. Result: A total number of 57 spinal tumor cases were recruited for this study. The mean age with SD of the study population was 38.7±13.24 years. The male and female ratio was 1.34:1 Most of the spinal tumor were found in the thoracic region which was 29(50.9%) cases followed by lumbar region which was 20(35.1%) cases. Spinal tumor in cervical region was found in only 5(8.8%) cases. Conclusion: In conclusion adult middle age male patients are the most commonly suffering from spinal tumor which are mostly located in the thoracic region. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 15-18

Rôle du mésoderme somitique dans le développement du plumage dorsal chez l'embryon de Poulet

Development ◽  
1972 ◽  
Vol 28 (2) ◽  
pp. 343-366
Author(s):  
Par Annick Mauger
Keyword(s):  
Early Stage ◽  
Cervical Region ◽  
Lumbar Region ◽  
Chick Embryos ◽  
A Chain ◽  
Normal Differentiation ◽  
Time Of Operation ◽  
Somitic Mesoderm ◽  
Axial Organs

The role of somitic mesoderm in the development of dorsal plumage in chick embryos. II. Regionalisation. Transplantation and inversion experiments were performed on the somitic mesoderm of 2- to 2·5-day chick embryos in order to study the role of regional and axial determinations in the development of the dorsal plumage. The transposition of a piece of somitic mesoderm from the posterior cervical region (where the spinal pteryla is narrow) to the thoraco-lumbar region (where it is wide) leads to a local and unilateral narrowing of the spinal pteryla at the operation site. Conversely, the transposition of somitic mesoderm from the thoraco-lumbar region to the posterior cervical region results in a local and unilateral widening of the spinal pteryla. Consequently at the time of operation the segmented or not yet segmented somitic mesoderm is already determined to give rise to a definite transverse level of the spinal pteryla. The inversion of the cephalo-caudal polarity of a piece of somitic mesoderm without the ectodermal covering, or of a portion of the axial organs deprived of the overlying ectoderm has no effect on the orientation of feather filaments and feather rows. In contrast, the inversion of the cephalo-caudal polarity of a portion of the axial organs together with the overlying ectoderm results in the development of feathers growing in a cephalad direction and feather chevrons opening towards the head of the embryo. The inversion of the dorso-ventral polarity of a piece of somitic mesoderm does not prevent the normal differentiation of feathers in the operated region. The inversion of the medio-lateral polarity of a piece of unsegmented somitic mesoderm has little effect on the development of the spinal pteryla. On the contrary, the medio-lateral inversion of a chain of somites precludes the formation of the feathers at the level of operation. The somitic mesoderm, even when segmented, is endowed with extensive regulative capacity of its axes, except for the medio-lateral polarity, which is fixed irreversibly at the time of segmentation. The regional determination of the feather-forming somitic mesoderm is acquired at an early stage, at any rate before segmentation. However, at a given transverse level of the cephalo-caudal axis, the somitic cells remain totipotent as concerns their histo-genetic destiny (dermatome, myotome, or sclerotome) until after the onset of segmentation.

Vertebral body integrity: a review of various anatomical factors involved in the lumbar region

2007 ◽  
Vol 18 (7) ◽  
pp. 891-903 ◽  
Author(s):  
Prakash ◽  
L. V. Prabhu ◽  
V. V. Saralaya ◽  
M. M. Pai ◽  
A. V. Ranade ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Lumbar Region

scholarly journals Use of fat-suppressed T2 -weighted sagittal images after infusion of excess saline into the subarachnoid space as a new diagnostic modality for cerebrospinal fluid hypovolemia: technical note

2016 ◽  
Vol 124 (2) ◽  
pp. 580-583 ◽  
Author(s):  
Eiichi Nakai ◽  
Mitsuhiro Takemura ◽  
Motonobu Nonaka ◽  
Yu Kawanishi ◽  
Noritaka Masahira ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Subarachnoid Space ◽  
Epidural Blood Patch ◽  
Fluid Pressure ◽  
Cervical Region ◽  
Lumbar Region ◽  
Diagnostic Modality ◽  
Ct Myelography ◽  
Blood Patch ◽  
Leakage Site

The diagnosis of CSF hypovolemia remains controversial. The primary diagnostic factor relies on confirmation of leakage of the CSF based on reduced spinal fluid pressure. Determining the specific leakage site is the most important issue for effective treatment but remains a difficult task. Although CT myelography, radioisotope cisternography, and MRI are commonly performed in the diagnosis of CSF hypovolemia, these techniques can rarely identify the precise leakage site. Therefore, an epidural blood patch is performed in the lumbar spine in many cases. This study reports a new diagnostic modality that can help to confirm the leakage site. Fat-suppressed T2-weighted sagittal images were compared before and after the infusion of 20 ml of saline into the subarachnoid space of the lumbar region to detect the specific leakage site with high probability. Three patients were successfully treated by the epidural blood patch based on data obtained with the new diagnostic modality. Two patients were treated in the cervical region and 1 in the lumbar region. The use of fat-suppressed T2-weighted sagittal images after saline infusion could be a relevant diagnostic modality compared with images obtained by CT myelography, radioisotope cisternography, and ordinary MRI to achieve accurate diagnosis and effective treatment of patients with CSF hypovolemia.

scholarly journals Intraspinal Neurenteric Cysts in Children

2008 ◽  
Vol 35 (5) ◽  
pp. 609-615 ◽  
Author(s):  
Chunquan Cai ◽  
Changhong Shen ◽  
Weidong Yang ◽  
Qingjiang Zhang ◽  
Xiaoli Hu
Keyword(s):  
Spinal Cord ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Clinical Manifestations ◽  
The Other ◽  
Cervical Region ◽  
Neurological Involvement ◽  
Neurenteric Cyst ◽  
Lumbar Region ◽  
Magnetic Resonance Imaging Mri

Background:Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.Materials and Methods:Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.Results:All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.Conclusions:Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

scholarly journals Incidence of Accessory Phrenic Nerve and its Clinical Significance: A Cadaveric Study

2008 ◽  
Vol 51 (3) ◽  
pp. 181-184 ◽  
Author(s):  
Soubhagya R. Nayak ◽  
Ashwin Krishnamurthy ◽  
Latha V. Prabhu ◽  
Lakshmi Ramanathan ◽  
Mangala M. Pai ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Phrenic Nerve ◽  
Subclavian Vein ◽  
Indian Population ◽  
Internal Thoracic Artery ◽  
Gross Anatomy ◽  
Neck Surgery ◽  
Cervical Region ◽  
Thoracic Region ◽  
Formalin Fixed

The description of accessory phrenic nerve (APN) in the standard textbooks and available literature is vague and sometimes limited to few lines. The incidence of APN varies a great deal from 17.6 % to 80.9 % in the available literature. The aim of the present study was to calculate the incidence and variation of APN in Indian population. Material and methods: Forty five adult formalin-fixed cadavers (35 male, 10 female; 90 sides) used for gross anatomy dissection for undergraduates; during the 2 year period 2006–2007 were considered. Findings were recorded at different stages of the dissection. Results: Out of 90 body sides studied, the APN was present in 48 sides (53.3 %). In 17 of the above sides the APN was confined to the cervical region (Cervical type) and in 31 sides the APN entered the thorax (Thoracic type), all anterior to the subclavian vein (SV). In eleven specimens the APN was found bilaterally. Conclusion: The incidence of APN, with its course and relation to the various structures in cervical and thoracic region will help the surgeons while performing internal thoracic artery (ITA) grafting and other radical neck surgery.

scholarly journals Clinical heterogeneity of low flow spinal arteriovenous fistulas; a case series

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
D. Krishnan ◽  
S. Viswanathan ◽  
N. Rose ◽  
H. S. N. Benjamin ◽  
A. M. Ong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Immune Therapy ◽  
False Negative ◽  
Spastic Paraparesis ◽  
Cauda Equina ◽  
Case Series ◽  
Low Flow ◽  
Cervical Region ◽  
Lumbar Region ◽  
Post Surgery

Abstract Background Spinal AVF (SAVF), a potentially treatable cause of myelopathy, remains a challenging diagnosis. Its rarity and non-specific imaging findings often result in misdiagnosis despite a high index of clinical suspicion. The classically described high T2 signal in the spinal cord or prominent vascular flow voids in the intradural space were not infrequently missed on initial imaging, only to be picked up at follow-up imaging after progression of symptoms. Additionally, small sized fistulas(< 1 mm) and SAVF involving less frequent locations like the craniocervical junction in a patient presenting with paraplegia further complicates the diagnosis. On rare occasions, acute atypical presentation following a surgery adds to the conundrum. Definite diagnosis with spinal angiography, the gold-standard modality requires the expertise of highly skilled interventionists which may otherwise lead to false negative findings. We describe four SAVF patients with unconventional presentations, highlighting less described clinical findings. Case presentation First was a 50-year-old man presented with spastic paraparesis and was found to have an AVF at the cervical region arising from the vertebral artery. Second, a 45-year-old man with acute paraplegia post-operatively, initially treated for a transverse myelitis before lumbar region AVF was detected. Thirdly, a 27-year-old man presented with subacute lower thoracic myelopathy and deteriorated after corticosteroid treatment. The last patient, who initially appeared to have conus medullaris/cauda equina syndrome had a SAVF at the mid thoracic level. Presentation varied with some exhibiting acute deterioration mimicking other spinal cord pathology such as inflammatory disorders. All patients eventually underwent endovascular treatment with successful embolization of SDAVF. None of them exhibited further neurological deterioration after embolization. Conclusion Successful treatment of SAVF is possible provided the diagnosis is made early, allowing timely intervention. Certain clues may aid the diagnosis. Firstly, arteriovenous fistula can be located distant to the clinical localization of myelopathy resulting in the unexpected longitudinally extensive spinal cord signal change. This clinical-radiological discrepancy can be a useful clue in diagnosing SAVF. Secondly, an acute myelopathic presentation immediately post-surgery may be related to SAVF. Other SAVF feature of note includes progressive myelopathy mimicking immune-mediated myelitis among young adults below 30 years of age refractory to immune therapy.

scholarly journals Effect of mobilization time by maitland method in nonspecific low back pain and neck pain.

2014 ◽  
Vol 12 ◽  
pp. 211
Author(s):  
Luís Eugênio Silva De Aguiar ◽  
Mafra Raiele Torres Oliveira ◽  
Rafael Rêgo Caldas ◽  
Mariana Cavalcanti Correia ◽  
Sérgio Rocha ◽  
...  
Keyword(s):  
Electrical Activity ◽  
Spinal Manipulation ◽  
Cervical Region ◽  
Lumbar Region ◽  
Low Back ◽  
Application Time ◽  
Joint Mobilization ◽  
Knowledge And Practice ◽  
Positive Results ◽  
Reduced Time

Introduction: Maitland method is a technique of manipulation and joint mobilization to reduce pain, recovery of mobility and joint alignment. Objective: Analyze effects of spinal manipulation in Maitland pains of cervical and lumbar spine, considering reducing the exposure time of each maneuver on pain, range of motion and muscle function. Method: 11 patients randomly assigned to two groups: (i) Experimental Conventional (GEC; 06): conventional technical indications, (ii) Experimental Modified (GEM; 05): protocol with the same maneuvers, but reduced application time. All evaluated before (t0) and after (t1) the period of therapeutic sessions with Visual Analogue Scale (VAS) for pain, Flexibility Test Bank with Wells and Surface Electromyography (EMG) for muscle electrical activity of the cervical and lumbar regions . The data were statistically analyzed; p <0.05. Results: In GEM pain decreased significantly (p = 0.047), muscle electrical activity in the cervical region showed a significant trend (p = 0.068). Flexibility in GEC was improved, but not significantly. tended Root Mean Square in the cervical region of the GEM (p = 0.068) to achieve significant value, but this trend was not observed in GEC. In the lumbar region there were no differences in both groups. Conclusion: Volunteers in both groups had positive results even though not statistically significant. The effects of reduced time and time recommended by Maitland (1 minute) the sessions were effective in decreasing symptoms, pain and restricted joint mobility, but we consider important to continue further studies in this knowledge and practice of physical therapy area. 

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