scholarly journals Recent advances in the management of cervical spondylotic myelopathy: bibliometric analysis and surgical perspectives

2019 ◽  
Vol 31 (3) ◽  
pp. 299-309 ◽  
Author(s):  
Yu-Chun Chen ◽  
Chao-Hung Kuo ◽  
Chieh-Ming Cheng ◽  
Jau-Ching Wu
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Diagnosis And Treatment ◽  
Optimal Timing ◽  
Asian Countries ◽  
The Past ◽  
Recent Advances ◽  
Number Of Patients ◽  
Pubmed Database ◽  
Cord Injury

OBJECTIVECervical spondylotic myelopathy (CSM) has become a prevalent cause of spinal cord dysfunction among the aging population worldwide. Although great strides have been made in spine surgery in past decades, the optimal timing and surgical strategy to treat CSM have remained controversial. In this article the authors aimed to analyze the current trends in studies of CSM and to summarize the recent advances of surgical techniques in its treatment.METHODSThe PubMed database was searched using the keywords pertaining to CSM in human studies that were published between 1975 and 2018. Analyses of both the bibliometrics and contents, including the types of papers, authors, affiliations and countries, number of patients, and the surgical approaches were conducted. A systematic review of the literature was also performed with emphasis on the diagnosis and treatment of mild CSM.RESULTSA total of 1008 papers published during the span of 44 years were analyzed. These CSM studies mainly focused on the natural history, diagnosis, and treatment, and only a few prospective randomized trials were reported. For the authors and affiliations, there was a shift of clustering of papers toward Asian countries in the past decades. Regarding the treatment for CSM, there was an exponential growth of surgical series published, and there was a trend toward slightly more anterior than posterior approaches through the past decade. Patients with CSM had increased risks of neurological deterioration or spinal cord injury with nonoperative management. Because surgery might reduce the risks, and early surgery was likely to be correlated with better outcomes, there was a trend toward attention to mildly symptomatic CSM.CONCLUSIONSThere is emerging enthusiasm for research on CSM worldwide, with more publications originating in Asian countries over the past few decades. The surgical management of CSM is evolving continuously toward early and anterior approaches. More prospective investigations on the optimal timing and choices of surgery are therefore needed.

scholarly journals Development of priorities for a Canadian strategy to advance activity-based therapies after spinal cord injury

Spinal Cord ◽  
2021 ◽  
Author(s):  
Kristin E. Musselman ◽  
Kristen Walden ◽  
Vanessa K. Noonan ◽  
Hope Jervis-Rademeyer ◽  
Nancy Thorogood ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Stroke Rehabilitation ◽  
Participatory Design ◽  
Best Practice ◽  
Optimal Timing ◽  
Activity Levels ◽  
Cord Injury ◽  
Healthcare Administrators ◽  
Psychosocial Benefits

Abstract Study Design Participatory design. Objectives Activity-based therapies (ABT) have physical and psychosocial benefits for individuals with spinal cord injury (SCI). A Canadian ABT summit was held to: (1) identify methods used in stroke rehabilitation that may be appropriate for SCI; (2) understand the current state of ABT activities in Canada; and (3) identify priorities for ABT research and care for the next five years. Setting Stakeholder-engaged meeting at a tertiary rehabilitation hospital. Methods Thirty-nine stakeholders, including individuals with SCI, frontline clinicians, healthcare administrators, researchers, funders and health policy experts, attended. Two participants were note-takers. Priority identification occurred through input from stakeholder groups, followed by individual voting. Conventional content analysis was used to synthesize the information in the meeting notes. Results The strengths of ABT in stroke rehabilitation included clear and clinically feasible definitions, measurements and interventions, and recognized requirements for implementation (e.g. behavior change, partnerships). Knowledge gaps concerning ABT activities in Canada were identified for acute and community settings, non-traumatic populations, and the interventions, equipment and standardized measures (i.e. upper limb, activity levels) used. Five priorities for ABT across the continuum of care were identified: (1) Identify current ABT activities; (2) Create a network to facilitate dialog; (3) Track engagement in ABT activities; (4) Develop and implement best practice recommendations; and (5) Study optimal timing, methods, and dose of ABT. Working groups were formed to address priorities 1–3. Conclusions The priorities will guide SCI research and care activities in Canada over the next five years. Sponsorship Praxis Spinal Cord Institute.

scholarly journals Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

2020 ◽  
Vol 27 (4) ◽  
pp. 276-288 ◽  
Author(s):  
Noritoshi Sekido ◽  
Yasuhiko Igawa ◽  
Hidehiro Kakizaki ◽  
Takeya Kitta ◽  
Atsushi Sengoku ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract ◽  
Clinical Guidelines ◽  
Lower Urinary Tract ◽  
Diagnosis And Treatment ◽  
Lower Urinary Tract Dysfunction ◽  
Cord Injury ◽  
Lower Urinary

Recent Advances in the Regenerative Approaches for Traumatic Spinal Cord Injury: Materials Perspective

2020 ◽  
Vol 6 (12) ◽  
pp. 6490-6509
Author(s):  
Walaa A. Abbas ◽  
Maha E. Ibrahim ◽  
Manar El-Naggar ◽  
Wessam A. Abass ◽  
Ibrahim H. Abdullah ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traumatic Spinal Cord Injury ◽  
Recent Advances ◽  
Cord Injury

scholarly journals Decompression via microsurgical anterior foraminotomy for cervical spondylotic myelopathy

1996 ◽  
Vol 1 (6) ◽  
pp. E6 ◽  
Author(s):  
Hae-Dong Jho
Keyword(s):  
Spinal Cord ◽  
Surgical Technique ◽  
Nerve Root ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Fast Recovery ◽  
The Past ◽  
Spinal Cord Decompression ◽  
New Surgical Technique ◽  
Uncovertebral Joint

Over the past few years, a microsurgical anterior foraminotomy technique has been developed by the author and used to achieve spinal cord decompression for the treatment of cervical spondylotic myelopathy. A 5 X 8-mm unilateral anterior foraminotomy is accomplished by resecting the uncovertebral joint via an anterior approach. Through the foraminotomy hole, the posterior osteophytes at the spinal cord canal are removed diagonally up to the beginning of the contralateral nerve root. To treat multilevel disease, a tunnel is made among the foraminotomy holes. This technique accomplishes widening of the spinal cord canal in the transverse and longitudinal axes by direct resection of the compressive lesions through the holes of unilateral anterior foraminotomies; however, it does not require bone fusion or postoperative immobilization. Postoperatively patients remain in the hospital overnight, and do not need to wear cervical braces. This new surgical technique has shown excellent clinical outcomes with fast recovery and adequate anatomical decompression in patients with cervical spondylotic myelopathy. The surgical technique is reported and illustrated by two of the author's cases.

Experimental spinal cord trauma: a review of mechanically induced spinal cord injury in rat models

2017 ◽  
Vol 28 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Dauda Abdullahi ◽  
Azlina Ahmad Annuar ◽  
Masro Mohamad ◽  
Izzuddin Aziz ◽  
Junedah Sanusi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cord Compression ◽  
Acute Injury ◽  
Optimal Timing ◽  
Spinal Cord Trauma ◽  
Rat Models ◽  
Human Spinal Cord ◽  
Cord Injury ◽  
Transient Force

AbstractIt has been shown that animal spinal cord compression (using methods such as clips, balloons, spinal cord strapping, or calibrated forceps) mimics the persistent spinal canal occlusion that is common in human spinal cord injury (SCI). These methods can be used to investigate the effects of compression or to know the optimal timing of decompression (as duration of compression can affect the outcome of pathology) in acute SCI. Compression models involve prolonged cord compression and are distinct from contusion models, which apply only transient force to inflict an acute injury to the spinal cord. While the use of forceps to compress the spinal cord is a common choice due to it being inexpensive, it has not been critically assessed against the other methods to determine whether it is the best method to use. To date, there is no available review specifically focused on the current compression methods of inducing SCI in rats; thus, we performed a systematic and comprehensive publication search to identify studies on experimental spinalization in rat models, and this review discusses the advantages and limitations of each method.

scholarly journals Functional cortical reorganization in cases of cervical spondylotic myelopathy and changes associated with surgery

2016 ◽  
Vol 40 (6) ◽  
pp. E2 ◽  
Author(s):  
Indira Devi Bhagavatula ◽  
Dhaval Shukla ◽  
Nishanth Sadashiva ◽  
Praveen Saligoudar ◽  
Chandrajit Prasad ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Patient Group ◽  
Cervical Spondylotic Myelopathy ◽  
Cortical Reorganization ◽  
Control Group ◽  
Study Cohort ◽  
Precentral Gyrus ◽  
Technical Problems ◽  
Cord Injury ◽  
Preoperative Patient

OBJECTIVE The physiological mechanisms underlying the recovery of motor function after cervical spondylotic myelopathy (CSM) surgery are poorly understood. Neuronal plasticity allows neurons to compensate for injury and disease and to adjust their activities in response to new situations or changes in their environment. Cortical reorganization as well as improvement in corticospinal conduction happens during motor recovery after stroke and spinal cord injury. In this study the authors aimed to understand the cortical changes that occur due to CSM and following CSM surgery and to correlate these changes with functional recovery by using blood oxygen level–dependent (BOLD) functional MRI (fMRI). METHODS Twenty-two patients having symptoms related to cervical cord compression due to spondylotic changes along with 12 age- and sex-matched healthy controls were included in this study. Patients underwent cervical spine MRI and BOLD fMRI at 1 month before surgery (baseline) and 6 months after surgery. RESULTS Five patients were excluded from analysis because of technical problems; thus, 17 patients made up the study cohort. The mean overall modified Japanese Orthopaedic Association score improved in patients following surgery. Mean upper-extremity, lower-extremity, and sensory scores improved significantly. In the preoperative patient group the volume of activation (VOA) was significantly higher than that in controls. The VOA after surgery was reduced as compared with that before surgery, although it remained higher than that in the control group. In the preoperative patient group, activations were noted only in the left precentral gyrus (PrCG). In the postoperative group, activations were seen in the left postcentral gyrus (PoCG), as well as the PrCG and premotor and supplementary motor cortices. In postoperative group, the VOA was higher in both the PrCG and PoCG as compared with those in the control group. CONCLUSIONS There is over-recruitment of sensorimotor cortices during nondexterous relative to dexterous movements before surgery. After surgery, there was recruitment of other cortical areas such as the PoCG and premotor and supplementary motor cortices, which correlated with improvement in dexterity, but activation in these areas was greater than that found in controls. The results show that improvement in dexterity and finer movements of the upper limbs is associated with recruitment areas other than the premotor cortex to compensate for the damage in the cervical spinal cord.

scholarly journals Abnormal Anterior Pretectal Nucleus Activity Contributes to Central Pain Syndrome

2010 ◽  
Vol 103 (6) ◽  
pp. 3044-3053 ◽  
Author(s):  
Peter D. Murray ◽  
Radi Masri ◽  
Asaf Keller
Keyword(s):  
Spinal Cord ◽  
Pain Syndrome ◽  
Zona Incerta ◽  
Central Pain ◽  
Number Of Patients ◽  
Cord Injury ◽  
Pretectal Nucleus ◽  
Evoked Activity ◽  
Selective Increase ◽  
Central Pain Syndrome

Central pain syndrome (CPS) is a debilitating condition that affects a large number of patients with a primary lesion or dysfunction in the CNS, most commonly due to spinal cord injury, stroke, and multiple sclerosis lesions. The pathophysiological processes underlying the development and maintenance of CPS are poorly understood. We have recently shown, in an animal model of CPS, that neurons in the posterior thalamic nucleus (PO) have increased spontaneous and evoked activity. We also demonstrated that these changes are due to suppressed inhibitory inputs from the zona incerta (ZI). The anterior pretectal nucleus (APT) is a diencephalic nucleus that projects on both the PO and ZI, suggesting that it might be involved in the pathophysiology of CPS. Here we test the hypothesis that CPS is associated with abnormal APT activity by recording single units from APT in anesthetized rats with CPS resulting from spinal cord lesions. The firing rate of APT neurons was increased in spinal-lesioned animals, compared with sham-operated controls. This increase was due to a selective increase in firing of tonic neurons that project to and inhibit ZI and an increase in bursts in fast bursting and slow rhythmic neurons. We also show that, in normal animals, suppressing APT results in increased PO spontaneous activity and evoked responses in a subpopulation of PO neurons. Taken together, these findings suggest that APT regulates ZI inputs to PO and that enhanced APT activity during CPS contributes to the abnormally high activity of PO neurons in CPS.

Decompression via microsurgical anterior foraminotomy for cervical spondylotic myelopathy

1997 ◽  
Vol 86 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Hae-Dong Jho
Keyword(s):  
Spinal Cord ◽  
Surgical Technique ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Fast Recovery ◽  
Content Type ◽  
The Past ◽  
Spinal Cord Decompression ◽  
New Surgical Technique ◽  
Uncovertebral Joint

✓ Over the past few years, a microsurgical anterior foraminotomy technique has been developed by the author and used to achieve spinal cord decompression for the treatment of cervical spondylotic myelopathy. A 5 × 8—mm unilateral anterior foraminotomy is accomplished by resecting the uncovertebral joint via an anterior approach. Through the foraminotomy hole, the posterior osteophytes at the spinal cord canal are removed diagonally up to the beginning of the contralateral nerve root. To treat multilevel disease, a tunnel is made among the foraminotomy holes. This technique accomplishes widening of the spinal cord canal in the transverse and longitudinal axes by direct resection of the compressive lesions through the holes of unilateral anterior foraminotomies; however, it does not require bone fusion or postoperative immobilization. Postoperatively patients remain in the hospital overnight, and do not need to wear cervical braces. This new surgical technique has shown excellent clinical outcomes with fast recovery and adequate anatomical decompression in patients with cervical spondylotic myelopathy. The surgical technique is reported and illustrated by two of the author's cases.

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