Origin of somatosensory evoked responses recorded from the cervical skin surface

1978 ◽  
Vol 48 (6) ◽  
pp. 980-984 ◽  
Author(s):  
Koki Shimoji ◽  
Hiroyuki Shimizu ◽  
Yoichi Maruyama
Keyword(s):  
Cauda Equina ◽  
Skin Surface ◽  
Peak Latency ◽  
Spinal Root ◽  
Negative Wave ◽  
Content Type ◽  
Segmental Nerve ◽  
Strong Stimulation ◽  
Somatosensory Evoked Response ◽  
Two Peaks

✓ Somatosensory evoked response from the cervical skin surface over the spine (the cervical SER) was recorded, and compared with the cord dorsum potential (CDP) simultaneously recorded from the posterior epidural space at the same segment. The cervical SER evoked by segmental nerve stimulation consisted of an initially positive spike (P1), the peak latency being the same as that of the P1 of the CDP, followed by a smaller negative wave with two peaks. The latency of the second peak of the negative wave (N1) coincided with that of the N1 of the CDP. Subsequent to this negative wave, a slow positive wave (P2) with peak latency similar to that of the P2 of the CDP, could be noticed in some subjects. The cervical SER could not be evoked even by strong stimulation of the cauda equina. Thus, the cervical SER might reflect a segmental phenomenon rather than the conducted potential along the cord, and originate from the spinal root and cord in the same way as the segmentally evoked CDP.

Surgical treatment of lumbosacral plexus injuries

2004 ◽  
Vol 1 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Eva Maria Lang ◽  
Jörg Borges ◽  
Thomas Carlstedt
Keyword(s):  
Cauda Equina ◽  
Femoral Nerve ◽  
Severe Trauma ◽  
Lumbosacral Plexus ◽  
Spinal Root ◽  
Content Type ◽  
Spinal Nerves ◽  
Nerve Grafts ◽  
Nerve Transfers ◽  
Fine Print

Object. The purpose of this study was to analyze therapeutic possibilities and clinical outcomes in patients with lumbosacral plexus injuries to develop surgical concepts of treatment. Methods. In a retrospective investigation 10 patients with injuries to the lumbosacral plexus were evaluated after surgery. The patients were assessed clinically, electrophysiologically, and based on the results of magnetic resonance imaging and computerized tomography myelography. In most patients a traction injury had occurred due to severe trauma that also caused pelvic fractures. In most cases the roots of the cauda equina of the lumbosacral plexus had ruptured. In cases of spinal root ruptures repair with nerve grafts were performed. In cases in which proximal stumps of the plexus could not be retrieved palliative nerve transfers by using lower intercostals nerves or fascicles from the femoral nerve were performed. Conclusions. Lesions of the proximal spinal nerves and cauda equina occur in the most serious lumbosacral plexus injuries. Patients with such injuries subjected to reconstruction of spinal nerves, repair of ventral roots in the cauda equina, and nerve transfers recovered basic lower-extremity functions such as unsupported standing and walking.

Posterior epidural migration of sequestered lumbar disc fragments

1999 ◽  
Vol 90 (2) ◽  
pp. 264-266 ◽  
Author(s):  
Pierre Robe ◽  
Didier Martin ◽  
Jacques Lenelle ◽  
Achille Stevenaert
Keyword(s):  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Contrast Material ◽  
Cauda Equina ◽  
Radicular Pain ◽  
Content Type ◽  
Diagnostic Pitfalls ◽  
Fine Print

✓ The posterior epidural migration of sequestered lumbar disc fragments is an uncommon event. The authors report two such cases in which patients presented with either intense radicular pain or cauda equina syndrome. The radiological characteristics were the posterior epidural location and the ring enhancement of the mass after injection of contrast material. The major diagnostic pitfalls are discussed.

Dermoid tumors of the spinal cord

1970 ◽  
Vol 33 (6) ◽  
pp. 676-681 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Complete Removal ◽  
Cord Compression ◽  
Conus Medullaris ◽  
Low Back ◽  
Content Type ◽  
Fine Print

✓ This is an analysis of 10 cases of dermoid tumor occurring in the spinal canal (8 lumbar and 2 thoracic). Low-back pain was the commonest presenting symptom, especially if the tumor was adherent to the conus medullaris. Other complaints included urinary dysfunction and motor and sensory disturbances of the legs. Clinical and radiological evidence of spina bifida was found in about half of the cases and suggested the diagnosis of a developmental type of tumor when patients presented with progressive spinal cord compression. At operation, the tumors were often found embedded in the conus medullaris or firmly adherent to the cauda equina, thus precluding complete removal. Evacuation of the cystic contents, however, gave lasting relief of the low-back pain and did not cause any deterioration in neurological function. In a follow-up study, ranging from 1 to 15 years, virtually no improvement in the neurological signs was observed. On the other hand, only one case has deteriorated due to recurrence of tumor growth.

Paragangliomas of the lumbar region

2005 ◽  
Vol 2 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Miguel Gelabert-González
Keyword(s):  
Cauda Equina ◽  
Lumbar Region ◽  
Rare Tumor ◽  
Content Type ◽  
Fine Print

✓ The author reports two cases of cauda equina paraganglioma (CEP) and provides a review of all previously published cases. The current radiological, neurosurgical, and pathological literature on this rare tumor is also reviewed.

Ankylosing spondylitis: cauda equina syndrome with multiple spinal arachnoid cysts

1971 ◽  
Vol 34 (2) ◽  
pp. 241-243 ◽  
Author(s):  
Wolf Rosenkranz
Keyword(s):  
Ankylosing Spondylitis ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Arachnoid Cysts ◽  
Content Type ◽  
Neural Canal ◽  
Fine Print

✓ A case of ankylosing spondylitis in a patient with a cauda equina syndrome is reported. A lumbar myelogram revealed erosions of the bones of the neural canal with enclosed multiple intraspinal cysts.

Impaction fracture of the lumbar vertebrae with dural tear

1980 ◽  
Vol 53 (6) ◽  
pp. 765-771 ◽  
Author(s):  
Carole A. Miller ◽  
Richard C. Dewey ◽  
William E. Hunt
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina ◽  
Lumbar Vertebrae ◽  
Dural Tear ◽  
Mechanism Of Injury ◽  
Content Type ◽  
X Ray ◽  
Jefferson Fracture ◽  
Vertical Impaction ◽  
Fine Print

✓ The authors describe a lumbar spine fracture that is characterized on anteroposterior x-ray views by separation of the pedicular shadows. It is almost invariably associated with posterior interlaminar herniation of the cauda equina through a dorsal dural split, and anterolateral entrapment or amputation of the nerve root. The fracture is unstable and requires internal fixation and fusion at the time of neurolysis. Fractures meeting these criteria should be explored as soon as the patient's condition permits. Myelography is usually unnecessary and may be contraindicated in some cases. The postulated mechanism of injury is hyperextension with vertical impaction and rupture of the ring made up of the lamina, pedicle, and vertebral body. The ring is fractured in several places in a manner similar to that seen in “Jefferson fracture” of C-1. The special anatomical relationships of the thoracolumbar junction and the plane of the lumbar facets are also discussed.

Acute cauda equina syndrome from a ruptured aneurysm in the sacral canal

1992 ◽  
Vol 77 (6) ◽  
pp. 945-948 ◽  
Author(s):  
Richard H. Schmidt ◽  
M. Sean Grady ◽  
Wendy Cohen ◽  
Sanford Wright ◽  
H. Richard Winn
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Signs And Symptoms ◽  
Vascular Supply ◽  
Ruptured Aneurysm ◽  
Collateral Flow ◽  
Content Type ◽  
Internal Iliac ◽  
The Right ◽  
Sacral Canal

✓ The case is presented of a young woman with acute cauda equina syndrome from a ruptured aneurysm in the sacral canal. The lesion was associated with pathological enlargement of the lateral sacral arteries bilaterally, which presumably occurred to provide cross-pelvic collateral flow in response to the diversion of the right internal iliac artery for renal transplantation. The patient presented with signs and symptoms of spontaneous spinal epidural hemorrhage. The radiographic features of this lesion are described. In addition to angiography and partial embolization of the vascular supply, contrast-enhanced high-resolution computerized tomography was essential in the diagnosis and treatment of this unique aneurysm.

Spinal cord disorders

2011 ◽  
Author(s):  
David Bates
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Cardiac Pacing ◽  
X Rays ◽  
Spinal Disease ◽  
Metabolic Disturbances ◽  
Spinal Root ◽  
Spinal Cord Disorders ◽  
Specific Disorders ◽  
Speed Of Onset

Non-traumatic spinal cord disease may be caused by compression due to tumour, infection or haematoma, inflammation, infection or post-infection, metabolic disturbances, infarction, and degeneration. The diagnosis is often made easier by the clinical assessment: the patient’s age, the speed of onset of the disease, severity of the deficits, the pattern of motor and sensory involvement, and presence of pain and sphincter symptoms are all important in making an assessment of the site and likely nature of the spinal disease.Investigations are obligatory to confirm a diagnosis and to direct therapy. MRI is the most useful investigation. It has largely replaced myelography which should now only be considered in patients with indwelling cardiac pacing wires. Additional investigations including examination of the cerebrospinal fluid, evoked potentials, and specific blood tests may be required and the value of plain X-rays, CT scan, and, in some instances, angiography should not be overlooked.The remainder of this chapter will consider specific disorders, identifying pathology, clinical presentation, investigation, and management. Acute and chronic conditions are considered separately and those affecting the cauda equina, spinal root, and sphincters are considered in Chapter 29.

scholarly journals Transcriptional Regulation oficaADBCby both IcaR and TcaR inStaphylococcus epidermidis

2019 ◽  
Vol 201 (6) ◽  
Author(s):  
Tra-My Hoang ◽  
C. Zhou ◽  
J. K. Lindgren ◽  
M. R. Galac ◽  
B. Corey ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Constitutive Expression ◽  
Skin Surface ◽  
Fine Tuning ◽  
Transcriptional Repressors ◽  
Content Type ◽  
Expression Levels ◽  
Dnase I Footprinting ◽  
Genetic Mechanisms ◽  
Operon Expression

ABSTRACTS. epidermidisis a primary cause of biofilm-mediated infections in humans due to adherence to foreign bodies. A major staphylococcal biofilm accumulation molecule is polysaccharide intracellular adhesin (PIA), which is synthesized by enzymes encoded by theicaADBCoperon. Expression of PIA is highly variable among clinical isolates, suggesting that PIA expression levels are selected in certain niches of the host. However, the mechanisms that govern enhancedicaADBCtranscription and PIA synthesis in these isolates are not known. We hypothesized that enhanced PIA synthesis in these isolates was due to function of IcaR and/or TcaR. Thus, twoS. epidermidisisolates (1457 and CSF41498) with differenticaADBCtranscription and PIA expression levels were studied. Constitutive expression of bothicaRandtcaRdemonstrated that both repressors are functional and can completely repressicaADBCtranscription in both 1457 and CSF41498. However, it was found that IcaR was the primary repressor for CSF41498 and TcaR was the primary repressor for 1457. Further analysis demonstrated thaticaRtranscription was repressed in 1457 in comparison to CSF41498, suggesting that TcaR functions as a repressor only in the absence of IcaR. Indeed, DNase I footprinting suggests IcaR and TcaR may bind to the same site within theicaR-icaAintergenic region. Lastly, we found mutants expressing variable amounts of PIA could rapidly be selected from both 1457 and CSF41498. Collectively, we propose that strains producing enhanced PIA synthesis are selected within certain niches of the host through several genetic mechanisms that function to repressicaRtranscription, thus increasing PIA synthesis.IMPORTANCEStaphylococcus epidermidisis a commensal bacterium that resides on our skin. As a commensal, it protects humans from bacterial pathogens through a variety of mechanisms. However, it is also a significant cause of biofilm infections due to its ability to bind to plastic. Polysaccharide intercellular adhesin is a significant component of biofilm, and we propose that the expression of this polysaccharide is beneficial in certain host niches, such as providing extra strength when the bacterium is colonizing the lumen of a catheter, and detrimental in others, such as colonization of the skin surface. We show here that fine-tuning oficaADBCtranscription, and thus PIA synthesis, is mediated via two transcriptional repressors, IcaR and TcaR.

Clinical recording of pressure on the spinal cord and cauda equina

1982 ◽  
Vol 57 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Bjørn Magnaes
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Endotracheal Intubation ◽  
Cervical Spondylosis ◽  
Cauda Equina ◽  
Upper Cervical Spine ◽  
Lower Cervical Spine ◽  
Skeletal Traction ◽  
Neck Extension ◽  
Content Type

✓ Pressure on the spinal cord with the neck in the extended position for endotracheal intubation was recorded in eight patients with a narrow spinal canal due to cervical spondylosis. Pressures up to about 1400 mm H2O were recorded. Longitudinal skeletal traction with the tong placed frontally reduced the pressure on the spinal cord in all patients. When longitudinal skeletal traction was applied, the stress of the neck extension was probably in part transferred from the lower cervical spine where the canal was narrow to the upper cervical spine with the more spacious canal. Placing the tong for longitudinal skeletal traction frontally when performing endotracheal intubation is advocated in patients with cervical spondylosis and probably also in patients with injuries of the lower cervical spine.

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