Surgical treatment of laterally ruptured cervical disc

1973 ◽  
Vol 38 (6) ◽  
pp. 679-683 ◽  
Author(s):  
Francis Murphey ◽  
James C. H. Simmons ◽  
Bruce Brunson
Keyword(s):  
Nerve Root ◽  
Cervical Disc ◽  
Root Pressure ◽  
Content Type ◽  
Arm Pain ◽  
Follow Up Study ◽  
History Of ◽  
Neurosurgical Operation ◽  
Better Than

✓ From the analysis of 648 patients operated on for ruptured cervical discs between 1939 and March of 1972 and a follow-up study of 380 of these patients, the following conclusions seem justified. Osteophytes or hypertrophic spurs rarely produced the classical clinical picture or deficits. Ninety per cent of the patients awakened in the morning with pain in the neck and rhomboid region. Ten per cent had a history of injury, but there was no characteristic pattern as in lumbar discs. Only one patient had a typical hyperextension injury. Anterior chest pain occurred in one-fifth of the cases. Pain in the neck, rhomboid region, and anterior chest was referred from the discs, while the arm pain was usually the result of nerve root compression; however, in a few cases the degenerating disc caused referred pain to the arm without any nerve root pressure. Since accurate diagnosis can be made on clinical grounds, myelography is not necessary in most cases. In our experience conservative treatment was usually unsuccessful while the surgical results were better than in almost any other neurosurgical operation. The nerve root syndromes associated with extruded lateral cervical discs are outlined and the indications and contraindications for myelography discussed.

Complete asymptomatic thrombosis and resorption of a congenital giant intracranial aneurysm

2002 ◽  
Vol 97 (1) ◽  
pp. 184-189 ◽  
Author(s):  
Hilmar Krapf ◽  
Martin Schöning ◽  
Dirk Petersen ◽  
Wilhelm Küker
Keyword(s):  
Intracranial Aneurysms ◽  
Giant Aneurysm ◽  
Resonance Imaging ◽  
Initial Finding ◽  
Content Type ◽  
Risk Of Rupture ◽  
History Of ◽  
Superselective Angiography ◽  
Better Than

✓ Intracranial aneurysms in infants are rare, but are associated with a high risk of rupture and subarachnoid hemorrhage. The authors report a case of an incidentally diagnosed, probably congenital, asymptomatic giant aneurysm of the posterior communicating artery in a 9-month-old girl, which completely thrombosed following a diagnostic superselective angiography without any neuropathological incident. Follow-up magnetic resonance imaging revealed that the aneurysm decreased further in size and was largely resorbed within 3 years after the initial finding. In single cases the natural history of congenital giant aneurysms may be better than previously assumed.

Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results

2005 ◽  
Vol 3 (6) ◽  
pp. 424-428 ◽  
Author(s):  
Robert J. Hacker
Keyword(s):  
Randomized Study ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Cervical Fusion ◽  
Systemic Complications ◽  
Disc Arthroplasty ◽  
Content Type ◽  
Arm Pain ◽  
Fine Print

Object. The authors of studies of anterior cervical fusion for disc-related disease have documented satisfying clinical results and infrequent complications. Recently, cervical disc arthroplasty has entered clinical trials as an alternative to fusion. Although the results of anecdotal reports and prospective studies support this procedure, these studies have not conferred the validity of a controlled randomized study. In the present study, the author presents data obtained in such a study. Methods. After symptoms failed to respond to conservative therapy, 46 patients with one-level discogenic cervical radiculopathy and/or myelopathy were randomized to undergo arthroplasty or fusion as part of a US Food and Drug Administration medical device study. In all patients there was a minimum follow-up duration of 1 year. Equivalent results for the relief of arm pain and neck pain were noted in both treatment groups. Treatment parameters other than operative time were similar. No neurological or serious systemic complications occurred. Conclusions. Although extended follow-up data and larger patient populations are needed, the results of this study indicate that arthroplasty is a viable alternative to cervical fusion.

scholarly journals Natural history of unruptured intracranial aneurysms: a long-term follow-up study

1993 ◽  
Vol 79 (2) ◽  
pp. 174-182 ◽  
Author(s):  
Seppo Juvela ◽  
Matti Porras ◽  
Olli Heiskanen
Keyword(s):  
Natural History ◽  
Unruptured Aneurysm ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Multiple Aneurysms ◽  
Follow Up Study ◽  
Risk Of Rupture ◽  
History Of ◽  
Fine Print

✓ To investigate the natural history of unruptured aneurysms and predictive risk factors determining subsequent rupture, the authors followed 142 patients with 181 unruptured aneurysms until death or subarachnoid hemorrhage intervened, or for at least 10 years after the unruptured aneurysm was diagnosed. Six patients had a symptomatic aneurysm, five had an incidentally discovered aneurysm, and 131 had multiple aneurysms, of which the ruptured lesion was clipped at the beginning of the follow-up study. The median follow-up time was 13.9 years (range 0.8 to 30.0 years). During 1944 patient-years of follow-up study there were 27 first episodes of hemorrhage from a previously unruptured aneurysm, giving an average annual rupture incidence of 1.4%. Fourteen of these bleeding episodes were fatal. The cumulative rate of bleeding was 10% at 10 years, 26% at 20 years, and 32% at 30 years after the diagnosis. The only predictor for the rupture was the size of the aneurysm (p = 0.036). However, in patients with multiple aneurysms (the main subgroup) the only variable that tended to predict rupture was the age of the patient: risk of rupture was inversely associated with age (p = 0.080). The median diameter of the aneurysms was 4 mm at the beginning of the follow-up period, both in those with and those without a later hemorrhage. During the angiographic monitoring period, a ruptured aneurysm significantly (p < 0.001) increased in size in 17 patients with hemorrhage but aneurysms did not increase significantly in 14 patients without hemorrhage. In addition, a new aneurysm was found in six of 31 patients. The authors conclude that an unruptured aneurysm should be operated on, irrespective of its size, if it is technically possible and the patient's age and concurrent diseases are not contraindications to surgery.

Bilateral aneurysm formation developing from junctional dilatation (infundibulum) of the posterior communicating arteries

1983 ◽  
Vol 58 (1) ◽  
pp. 117-119 ◽  
Author(s):  
Toru Itakura ◽  
Fuminori Ozaki ◽  
Ekini Nakai ◽  
Toru Fujii ◽  
Seiji Hayashi ◽  
...  
Keyword(s):  
Young Women ◽  
True Aneurysm ◽  
Content Type ◽  
Aneurysmal Rupture ◽  
Follow Up Study ◽  
Aneurysm Formation ◽  
History Of ◽  
Fine Print

✓ The authors report a case in which bilateral aneurysms developed from junctional dilatations of the posterior communicating arteries. A 7-year follow-up study of this case strongly suggested that an infundibulum can develop into a true aneurysm. After reviewing seven cases in the literature, the authors conclude that junctional dilatations, especially in young women with a history of aneurysmal rupture, should be carefully followed by angiography.

Spontaneous regression of a herniated cervical disc in a patient with myelopathy

1999 ◽  
Vol 90 (1) ◽  
pp. 138-140 ◽  
Author(s):  
Jun-Hyeok Song ◽  
Hyang-Kwon Park ◽  
Kyu-Man Shin
Keyword(s):  
Mr Imaging ◽  
Disc Herniation ◽  
Spontaneous Regression ◽  
Specific Treatment ◽  
Cervical Disc ◽  
Content Type ◽  
First Case ◽  
History Of ◽  
Herniated Cervical Disc

✓ The authors present a case of spontaneous regression of a herniated cervical nucleus pulposus in a patient with myelopathy. This 37-year-old woman developed sudden quadriparesis; she had reported no history of trauma. Magnetic resonance (MR) imaging revealed a large disc herniation and increased signal intensity of the cord at the C5–6 level. The extruded disc fragment was found to have resolved on follow-up MR imaging after 28 months, despite the fact that the patient had undergone no specific treatment. The patient's symptoms had subsided almost totally. This is the first case of MR-documented regression of a cervical disc herniation in a patient with myelopathy.

The natural history of pituitary apoplexy: long term follow-up study

2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  
Keyword(s):  
Natural History ◽  
Pituitary Apoplexy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of

A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis

2003 ◽  
Vol 98 (3) ◽  
pp. 290-293 ◽  
Author(s):  
Koichi Sairyo ◽  
Shinsuke Katoh ◽  
Tadanori Sakamaki ◽  
Shinji Komatsubara ◽  
Natsuo Yasui
Keyword(s):  
Clinical Outcome ◽  
Nerve Root ◽  
Clinical Results ◽  
Skin Incision ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Nerve Roots ◽  
Content Type ◽  
Proximal Stump

✓ The authors describe a new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42–70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the decompression of nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.

scholarly journals Cardiovascular risk estimation in women with a history of hypertensive pregnancy disorders at term: a longitudinal follow-up study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Wietske Hermes ◽  
Jouke T Tamsma ◽  
Diana C Grootendorst ◽  
Arie Franx ◽  
Joris van der Post ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Risk Estimation ◽  
Follow Up Study ◽  
Hypertensive Pregnancy ◽  
History Of ◽  
Cardiovascular Risk Estimation ◽  
Pregnancy Disorders

scholarly journals Adjacent-level arthroplasty following cervical fusion

2017 ◽  
Vol 42 (2) ◽  
pp. E5 ◽  
Author(s):  
Deshpande V. Rajakumar ◽  
Akshay Hari ◽  
Murali Krishna ◽  
Subhas Konar ◽  
Ankit Sharma
Keyword(s):  
Cobb Angle ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Fusion ◽  
Adjacent Level ◽  
Cervical Disc Disease ◽  
Disc Disease ◽  
Cervical Arthroplasty ◽  
Arm Pain

OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1–3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2–7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow-up period. CONCLUSIONS Artificial cervical disc replacement in patients who have previously undergone cervical fusion surgery appears to be safe, with encouraging early clinical results based on this small case series, but more data from larger numbers of patients with long-term follow-up are needed. Arthroplasty may provide an additional tool for the management of post-fusion adjacent-level cervical disc disease in carefully selected patients.

scholarly journals OC21.03: Natural history of asymptomatic endometrial polyps in postmenopausal women: a 10-year follow-up study

2010 ◽  
Vol 36 (S1) ◽  
pp. 39-39
Author(s):  
F. Leone ◽  
C. Marciante ◽  
C. Lanzani ◽  
E. Ferrazzi
Keyword(s):  
Natural History ◽  
Postmenopausal Women ◽  
Endometrial Polyps ◽  
Follow Up Study ◽  
History Of
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