scholarly journals Pulmonary function test correlation with subclinical respiratory dysfunction in chronic cervical cord compression

2021 ◽  
Vol 12 (10) ◽  
pp. 64-68
Author(s):  
Manpreet Singh Banga ◽  
Sandeep BV ◽  
Anantha Kishan ◽  
Rajesh Babu Devabhakthuni ◽  
Arun MA ◽  
...  

Background: To assess respiratory function in cervical chronic compressive myelopathy (CCM) patients in pre-operative period, post-operative period and to compare pre-operative status with post-operative status. Aims and Objectives: 1. To assess respiratory function in cervical CCM patients in pre-operative period. 2. To assess respiratory function in cervical CCM patients in post-operative period, following relief of compression. 3. To compare, pre-operative status with post-operative status. Materials and Methods: A prospective study was done in 50 patients with cervical CCM due to either cervical disc disease or ossified posterior longitudinal ligament (OPLL) who were operated. None of the patients included in the study had any clinical signs & symptoms of respiratory dysfunction. Spirometry was performed in pre-operative and postoperative period after 3 months and results were analyzed. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), ratio of mean FEV1 to FVC (FEVI: FVC%) and peak expiratory flow rate (PEFR) were calculated. Results: Majority of the patients were in their fourth decade of life with male predominance. Thirty-six patients (72%) presented with prolapsed intervertebral disc and 14 patients (28%) had ossified posterior longitudinal ligament (OPLL). Patients were operated depending upon the pathology. The present study showed that there was significant reduction in preoperative FVC, FEV1, PEFR values as compared with predicted values and they showed significant improvement in post-operative period after surgical relief of compression. Conclusion: Significant yet occult respiratory dysfunction in form of impairment of various lung capacities exists in patients with cervical CCM. An objective evaluation of this occult respiratory dysfunction is essential to prognosticate, prevent respiratory complications and to improve post-operative respiratory rehabilitation. Institution of incentive spirometry as a routine in all cervical CCM cases will be of benefit in preventing respiratory complications.

2020 ◽  
Vol 13 (3) ◽  
pp. 317-327
Author(s):  
Joline E. Brandenburg ◽  
Matthew J. Fogarty ◽  
Gary C. Sieck

Respiratory dysfunction is a leading cause of morbidity and mortality in individuals with cerebral palsy (CP). In children and adults with CP, movement and physical function is always affected. Yet, many clinicians overlook potential for impaired movement and function of the diaphragm muscle (DIAm) in individuals with CP. Since individuals with pre-existing respiratory disorders are at greater risk for respiratory complications if they contract COVID-19, understanding potential risks to individuals with CP is important. In this review we present research on respiratory function and DIAm force generation in children with CP. We compare this clinical work to basic science research investigating phrenic motor neuron and DIAm motor unit dysfunction in an animal model with CP symptoms, the spa mouse. Finally, we integrate the clinical and basic science work in respiratory function in CP, discussing potential for individuals with CP to have severe respiratory symptoms from COVID-19.


2004 ◽  
Vol 77 (1) ◽  
pp. 260-265 ◽  
Author(s):  
Francesco Leo ◽  
Piergiorgio Solli ◽  
Lorenzo Spaggiari ◽  
Giulia Veronesi ◽  
Filippo de Braud ◽  
...  

1990 ◽  
Vol 72 (3) ◽  
pp. 370-377 ◽  
Author(s):  
Francois Aldrich

✓ The controversy over whether to use a posterior or anterior approach for surgical treatment of soft cervical discs is still largely unsettled. However, although the posterior approach may be underutilized, it has distinct advantages when there are specific indications. Out of a large pool of cases, 53 patients presented with acute monoradiculopathy caused by soft cervical disc herniation. In 36 of these, the disc was sequestered (nonconfined) and was posterolateral to the disc space as seen on computerized tomography-myelography. Distinct motor weakness was a common clinical finding in all 36 cases. These patients were treated by using a 2- to 3-cm skin incision for the posterolateral microsurgical approach. The extent of the lateral facetectomy depended upon the relationship between the nerve root and the disc. All fragments were lateral to the dural sac and were sequestered through the anulus fibrosus and the posterior longitudinal ligament. Sequestrations were removed under direct microscopic vision, but the disc space was not entered. Pain relief and motor-power improvement in the affected radicular distribution were immediate in all patients. Sensory deficit and residual motor loss improved dramatically with normalization at approximately 6 months. No complications occurred and the mean hospital stay was 2 days. The follow-up period varied from 4 to 42 months with a mean of 26 months. Thus far, there have been no recurrences or other associated complications. By using strict selection criteria and a microsurgical posterolateral approach with removal of the sequestered disc fragment, excellent results with normalization of the monoradiculopathy can be obtained. The ease of this technique, low risk, minimal complications, and excellent results make it an attractive alternative to the anterior approach. The clinical presentations, specific indications, surgical technique, and clinical results are discussed; and a prototype of a small cervical self-retaining retractor is described.


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