Calcified cervical intervertebral discs in children

1977 ◽  
Vol 46 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Richard A. Smith ◽  
M. Darius Vohman ◽  
Joseph H. Dimon ◽  
James E. Averett ◽  
James H. Milsap
Keyword(s):  
Spontaneous Recovery ◽  
Neurological Complications ◽  
Intervertebral Discs ◽  
Pathological Findings ◽  
Content Type ◽  
Distinct Disease ◽  
Benign Course ◽  
Fine Print

✓ Calcified cervical intervertebral discs in children are manifestations of an uncommon, distinct disease of unknown cause. Acute symptoms are usually followed by a benign course of spontaneous recovery, frequently culminating in resorption of the calcium. Rarely herniation of the disc may cause neurological complications. Two cases are presented as examples of the typical syndrome. A third case was operated on because of herniation with radiculopathy; the clinical, radiographic, and pathological findings are reported in detail.

A proposed grading system for arteriovenous malformations

1986 ◽  
Vol 65 (4) ◽  
pp. 476-483 ◽  
Author(s):  
Robert F. Spetzler ◽  
Neil A. Martin
Keyword(s):  
Venous Drainage ◽  
Neurological Complications ◽  
Management Decision ◽  
Grading System ◽  
Content Type ◽  
Treatment Techniques ◽  
Clinical Series ◽  
Management Decision Making ◽  
Eloquent Cortex ◽  
Fine Print

✓ An important factor in making a recommendation for treatment of a patient with arteriovenous malformation (AVM) is to estimate the risk of surgery for that patient. A simple, broadly applicable grading system that is designed to predict the risk of morbidity and mortality attending the operative treatment of specific AVM's is proposed. The lesion is graded on the basis of size, pattern of venous drainage, and neurological eloquence of adjacent brain. All AVM's fall into one of six grades. Grade I malformations are small, superficial, and located in non-eloquent cortex; Grade V lesions are large, deep, and situated in neurologically critical areas; and Grade VI lesions are essentially inoperable AVM's. Retrospective application of this grading scheme to a series of surgically excised AVM's has demonstrated its correlation with the incidence of postoperative neurological complications. The application of a standardized grading scheme will enable a comparison of results between various clinical series and between different treatment techniques, and will assist in the process of management decision-making.

Treatment of protruded lumbar intervertebral discs with chymopapain (Discase)

1973 ◽  
Vol 39 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Dwight Parkinson ◽  
Christopher Shields
Keyword(s):  
Intervertebral Disc ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Intervertebral Discs ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Chemical Action ◽  
Content Type ◽  
Fine Print

✓ Thirty-three intervertebral disc patients who otherwise would have been subjected to surgery were treated by injection with chymopapain. The pharmacology, toxicology, physiology, immunology, and chemical action of this enzyme, which specifically reacts with chondromucoproteins, are discussed. Results indicate that this method, although still experimental and unapproved by the U. S. Food and Drug Administration, may become a useful addition to the surgeon's armamentarium in the treatment of intervertebral disc disease.

Intracranial extension of an eccrine porocarcinoma

1999 ◽  
Vol 90 (1) ◽  
pp. 138-140 ◽  
Author(s):  
Ann M. Ritter ◽  
R. Scott Graham ◽  
Barbara Amaker ◽  
William C. Broaddus ◽  
Harold F. Young
Keyword(s):  
Soft Tissue ◽  
Malignant Tumor ◽  
Clinical Presentation ◽  
Intracranial Extension ◽  
Pathological Findings ◽  
Review Of The Literature ◽  
Radiographic Evidence ◽  
Content Type ◽  
Eccrine Porocarcinoma ◽  
Fine Print

✓ Eccrine porocarcinoma is a rare malignant tumor of the true sweat gland. It commonly presents in the lower extremities with lymphatic metastasis. The authors describe the clinical presentation, radiographic evidence, operative discoveries, and pathological findings in a patient with an eccrine porocarcinoma involving the soft tissue of the occiput, which had eroded through the cranium. A review of the literature failed to reveal any other such case. The discussion includes the epidemiology, pathogenesis, treatment, and outcome of eccrine porocarcinomas. The six reported cases of scalp eccrine tumors are reviewed.

Acute meningeal reaction following Pantopaque myelography

1971 ◽  
Vol 34 (3) ◽  
pp. 396-404 ◽  
Author(s):  
William E. Mayher ◽  
Ernest F. Daniel ◽  
Marshall B. Allen
Keyword(s):  
Hypersensitivity Reaction ◽  
Contrast Material ◽  
Neurological Complications ◽  
Content Type ◽  
Incomplete Removal ◽  
Fine Print

✓ Severe neurological complications including one death followed Pantopaque myelography in three cases in a series of 6000 myelograms over a 10-year period. In each of the three cases there was incomplete removal of the contrast material at the end of the procedure. The literature is reviewed and similar cases cited. The possibility that the acute meningeal reaction may be due to a hypersensitivity reaction is discussed.

Percutaneous radiofrequency denervation of spinal facets

1975 ◽  
Vol 43 (4) ◽  
pp. 448-451 ◽  
Author(s):  
C. Norman Shealy
Keyword(s):  
Neurological Complications ◽  
Content Type ◽  
Radiofrequency Denervation ◽  
Fine Print

✓ A technique for radiofrequency localization and coagulation of articular nerves supplying the spinal facets is described and results are reported from a series of 207 patients followed 6 to 21 months (mean 13 months). Relief of pain was achieved in 79% of previously unoperated patients, in 41% of those with laminectomy but no fusion, and in 27% of those with an earlier fusion. No neurological complications were encountered.

Management and results of sciatic nerve injuries: a 24-year experience

1998 ◽  
Vol 89 (1) ◽  
pp. 13-23 ◽  
Author(s):  
David G. Kline ◽  
Daniel Kim ◽  
Rajiv Midha ◽  
Carter Harsh ◽  
Robert Tiel
Keyword(s):  
Sciatic Nerve ◽  
Spontaneous Recovery ◽  
Nerve Injuries ◽  
Management Guidelines ◽  
Content Type ◽  
Surgical Exploration ◽  
Excellent Outcome ◽  
Retrospective Clinical Study ◽  
Late Referral ◽  
Fine Print

Object. The purpose of this retrospective clinical study was to present results and provide management guidelines for various types of sciatic injuries. Methods. Over a 24-year period, 380 patients with sciatic nerve injuries were managed. In 230 patients (60%), the injury was at the buttock level, with injection injuries comprising more than half of these cases. Thigh-level sciatic injury was evaluated in 150 cases (40%) and was usually secondary to one of four main causes: 1) gunshot wound; 2) femur fracture; 3) laceration; or 4) contusion. Patients with partial deficits uncomplicated by severe pain or with significant spontaneous recovery or late referral were managed medically. Surgical exploration was not indicated in 23% of injuries at the thigh level and almost 50% of those at the buttock level. Most of these patients achieved partial but good spontaneous recovery, especially in the tibial division distribution. Surgical intervention was required for more complete and persistent deficits in either the tibial or peroneal distribution. Divisions of the sciatic nerve were split apart and evaluated independently. Management was guided by nerve action potential (NAP) recordings, which indicated whether neurolysis or resection of the lesion was required. Repair was then made by using sutures or more frequently by graft placement. In most cases in which neurolysis was performed because a positive NAP was recorded distal to the lesion, useful function was found in the peroneal distribution. Unfortunately, significant recovery occurred in only 36% of patients who received suture or graft repairs of the peroneal division. Good-to-excellent outcome was common for the tibial division, even in cases in which repair was proximal and required lengthy grafts. The relatively favorable recovery of tibial as opposed to peroneal divisions of the sciatic nerve occurred regardless of the level or mechanism of injury. Conclusions. Surgical exploration and, when necessary, repair of sciatic nerve injuries is worthwhile in selected cases.

Fourth ventriculoceles with extracranial extension

1984 ◽  
Vol 61 (2) ◽  
pp. 348-350 ◽  
Author(s):  
Robert A. Fenstermaker ◽  
Uros Roessmann ◽  
Harold L. Rekate
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Outcome ◽  
Fourth Ventricle ◽  
Pathological Findings ◽  
Direct Communication ◽  
Content Type ◽  
Cyst Excision ◽  
Occipital Encephalocele ◽  
Fine Print

✓ The radiographic features and long-term clinical outcome in three patients who presented at birth with a cystic suboccipital mass in direct communication with the fourth ventricle are reviewed. The pathological findings in a fourth infant who died are also discussed. All surviving infants were treated with cyst excision and diversion of cerebrospinal fluid. The prognosis in these children, followed from 6 to 20 years, surpasses that of the more common occipital encephalocele, for which this entity could be mistaken. The morphogenetic implications relative to more common congenital lesions in this location are discussed.

Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease

2002 ◽  
Vol 96 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Crispin Wigfield ◽  
Steven Gill ◽  
Richard Nelson ◽  
Ilana Langdon ◽  
Newton Metcalf ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Sagittal Plane ◽  
Autologous Bone Graft ◽  
Intervertebral Discs ◽  
Cervical Disc ◽  
Adjacent Level ◽  
Disc Disease ◽  
Content Type ◽  
Flexion Extension ◽  
Fine Print

Object. The authors report the preservation of motion at surgically treated and adjacent spinal segments after placing an artificial cervical joint (ACJ) and they describe the influence of interbody fusion on changes in angulation occurring in the sagittal plane at adjacent levels in the treatment of cervical spondylosis. Methods. The authors conducted a prospective nonrandomized study of patients in whom an ACJ was placed or autologous bone graft interbody fusion was performed. Angular measurements at levels adjacent to that surgically treated were calculated using plain flexion—extension radiographs obtained at 6-month intervals. Analyses of qualitative data, such as increase or decrease in adjacent-level motion, and the degree of disc degeneration were performed. Quantitative data were also analyzed. In the fusion group a significant increase in adjacent-level movement was demonstrated at the 12-month follow-up visit compared with the group of patients in whom ACJs were placed (p < 0.001). The increase in movement occurred predominantly at intervertebral discs that were preoperatively regarded as normal (p < 0.02). An overall reduction in adjacent-level movement was observed in patients who underwent joint replacement, although this was compensated for by the movement provided by the ACJ itself. Conclusions. Fusion results in increased motion at adjacent levels. The increase in adjacent-level motion derives from those discs that appear radiologically normal prior to surgery. It remains unknown whether ACJs have a protective influence on adjacent intervertebral discs.

Pathological findings in acute experimental spinal cord trauma

1971 ◽  
Vol 35 (6) ◽  
pp. 700-708 ◽  
Author(s):  
Thomas B. Ducker ◽  
Glenn W. Kindt ◽  
Ludwig G. Kempe
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
Clinical Improvement ◽  
Spinal Cord Trauma ◽  
Pathological Findings ◽  
Pathological Changes ◽  
Content Type ◽  
Acute Trauma ◽  
Central Gray ◽  
Fine Print

✓ This study shows that spinal cord pathology secondary to acute trauma in monkeys evolves with stepwise sequential changes. The acute damage is more central than peripheral. Depending on the amount of trauma, the subacute damage may be limited to central gray necrosis or may progress or evolve to include the neighboring white matter. These pathological changes may be taking place even in the presence of clinical improvement.

scholarly journals Two-year observation of artificial intervertebral disc replacement: results after supplemental ultra—high strength bioresorbable spinal stabilization

2004 ◽  
Vol 100 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Yoshihisa Kotani ◽  
Kuniyoshi Abumi ◽  
Yasuo Shikinami ◽  
Masahiko Takahata ◽  
Ken Kadoya ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Bone Ingrowth ◽  
Intervertebral Discs ◽  
Disc Replacement ◽  
Segmental Mobility ◽  
Content Type ◽  
Spinal Stabilization ◽  
Titanium Screws ◽  
Flexion Extension ◽  
Fine Print

Object. This 2-year experimental study was conducted to investigate the efficacy of a bioactive three-dimensional (3D) fabric disc for lumbar intervertebral disc replacement. The authors used a bioresorbable spinal fixation rod consisting of a forged composite of particulate unsintered hydroxyapatite/poly-l-lactide acid (HA/PLLA) for stability augmentation. The biomechanical and histological alterations as well as possible device-related loosening were examined at 2 years postoperatively. Methods. Two lumbar intervertebral discs (L2–3 and L4–5) were replaced with the 3D fabric discs, which were augmented by two titanium screws and a spanning bioresorbable rod (HA/PLLA). The segmental biomechanics and interface bone ingrowth were investigated at 6, 15, and 24 months postoperatively, and results were compared with the other two surgical groups (3D fabric disc alone; 3D fabric disc with additional anterior instrumentation stabilization). The 3D fabric disc and HA/PLLA—spinal segments demonstrated segmental mobility at 15 and 24 months; however, the range of motion (ROM) in flexion—extension decreased to 49 and 40%, respectively, despite statistically equivalent preserved torsional ROM. Histologically there was excellent osseous fusion at the 3D fabric disc surface—vertebral body interface. At 2 years posttreatment, no adverse tissue reaction nor aseptic loosening of the device was observed. Conclusions. Intervertebral disc replacement with the 3D fabric disc was viable and when used in conjunction with the bioresorbable HA/PLLA spinal augmentation. Further refinements of device design to create a stand-alone type are necessary to obviate the need for additional spinal stabilization.

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