Cervical myeloradiculopathy caused by arthrotic hypertrophy of the posterior facets and laminae

1978 ◽  
Vol 49 (3) ◽  
pp. 387-392 ◽  
Author(s):  
Joseph A. Epstein ◽  
Bernard S. Epstein ◽  
Leroy S. Lavine ◽  
Robert Carras ◽  
Alan D. Rosenthal
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Anatomical Studies ◽  
Content Type ◽  
Significant Pathology ◽  
Cervical Spinal Stenosis ◽  
Fine Print

✓ Five patients with typical cervical myeloradiculopathy caused by focal cervical spinal stenosis are presented. Dorsal intrusions into the spinal canal by hypertrophied apophyseal joints and thickened laminae resulted in cord and nerve root compression. Minor spondylotic changes were present in the floor of the spinal canal. Laminar decompression with foraminotomy and facetectomy relieved the patients of their symptoms. An anterior approach should not be considered in the management of this disorder. Our findings of severe apophyseal arthrosis with lesser degrees of associated spondylosis are similar to those described in anatomical studies by other authors. While uncommon, myelopathy caused by dorsal compression of the spinal cord and nerve roots deserves specific mention so that therapy can be directed to the proper quadrants of the spinal canal wherein the significant pathology is located.

Lipoma with dumb-bell extradural extension through the intervertebral foramen into the spinal canal

2005 ◽  
Vol 2 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Jin Soo Park ◽  
Isao Shirachi ◽  
Kimiaki Sato ◽  
Noriyuki Ando ◽  
Kensei Nagata
Keyword(s):  
Vertebral Artery ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Content Type ◽  
First Report ◽  
Fine Print

✓ The authors present the case of a 60-year-old woman with a neck lipoma that developed dumb-bell extradural extension, causing radiculopathy. To the best of the authors' knowledge, this is the first report of a lipoma originating in the neck with dumb-bell extradural extension through the intervertebral foramen and into the spinal canal. The lipoma was first excised from the foramen via a posterior approach to allow decompression of the nerve roots. The remaining lipomatous tissue was then resected via an anterior approach to avoid the region around the vertebral artery.

The denticulate ligament: anatomy and functional significance

2001 ◽  
Vol 94 (2) ◽  
pp. 271-275 ◽  
Author(s):  
R. Shane Tubbs ◽  
George Salter ◽  
Paul A. Grabb ◽  
W. Jerry Oakes
Keyword(s):  
Spinal Cord ◽  
Functional Significance ◽  
Spinal Canal ◽  
Cervical Region ◽  
Content Type ◽  
Functional Studies ◽  
Applied Tension ◽  
Limited Degree ◽  
Formalin Fixed ◽  
Fine Print

Object. The authors conducted a study to examine the detailed anatomy of the denticulate ligaments and to assess their classic role in spinal cord stability within the spinal canal. Methods. Detailed observation of the denticulate ligaments in 12 adult cadavers was performed. Stress was applied in all major planes to discern when the ligaments would become taut, and at the same time, gross motion of the cord was observed at sites distal to the stresses applied. Tension necessary for avulsion of the ligaments in various areas of the spinal cord was also measured. Conclusions. These results show that the denticulate ligaments do not inhibit cord motion to such discrete areas of the cord as was once thought. The authors have determined that the ligaments are stronger in the cervical region and that they decrease in strength as the spinal cord descends. These findings are demonstrative of the denticulate ligaments being more resistant to caudal compared with cephalad stresses in the cord. Anterior and posterior motion is constrained by these ligaments but to a limited degree, especially as one descends inferiorly along the cord. Further embryological and functional studies of these ligaments is needed in non—formalin fixed tissues.

Lumbar nerve root compression by synovial cysts of the ligamentum flavum

1984 ◽  
Vol 60 (3) ◽  
pp. 617-620 ◽  
Author(s):  
Adel F. Abdullah ◽  
Robert W. Chambers ◽  
Dennis P. Daut
Keyword(s):  
Nerve Root ◽  
Ligamentum Flavum ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Synovial Cysts ◽  
Fine Print

✓ Synovial cysts of the ligamentum flavum, measuring 1 cm in diameter, caused compression of the lumbar nerve roots in four patients. The authors discuss the association of these cysts with advanced focal spondylosis, and speculate on their etiology.

Effect of sacral nerve blocks on the function of the urinary bladder in humans

1974 ◽  
Vol 40 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Gaylan L. Rockswold ◽  
William E. Bradley ◽  
Shelley N. Chou
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Urinary Bladder ◽  
Nerve Roots ◽  
Nerve Blocks ◽  
Content Type ◽  
Sacral Nerve ◽  
Spinal Cord Involvement ◽  
Fine Print

✓ The authors report over 100 sacral root blocks performed in 50 patients with detrusor activation by air cystometry. The detrusor reflex was abolished with unilateral sacral blocks in over 50% of the patients. The nerve roots most frequently innervating the bladder were S-3 and S-4. Most of these patients suffered from multiple sclerosis and had spinal cord involvement. The possible pathophysiology and its significance regarding urinary bladder innervation is discussed.

Lateral interscalenic multilevel oblique corpectomies to repair ventral root avulsions after brachial plexus injury in humans: anatomical study and first clinical experience

2001 ◽  
Vol 95 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Henri-Dominique Fournier ◽  
Philippe Mercier ◽  
Philippe Menei
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
Anterior Approach ◽  
Cervical Spinal Cord ◽  
Anatomical Study ◽  
Ventral Root ◽  
Anterolateral Approach ◽  
Content Type ◽  
Anterior Aspect ◽  
Fine Print

Object. Because central nervous system white matter exerts a powerful inhibitory effect on axonal growth, implantation of nerve grafts or rootlets into the cervical spinal cord following ventral root avulsion injury should, ideally, be performed directly through the ventral root exit zone (VRExZ), which is located near the anteromedial aspect of the anterior horn; the grafts/rootlets should not be implanted into the white matter of the lateral cord. This is not possible when using a conservative posterior approach. Therefore, the authors have studied the anatomy encountered when using the anterolateral approach and evaluated the technique in the particular case of avulsed ventral nerve roots. They also present a case illustration of the procedure, which is used currently in their department. Methods. Anterior access to the rootlets is obtained using a lateral interscalenic approach; the vertebral artery is exposed and mobilized, and oblique drilling of the vertebral bodies (VBs) is performed. Because the articular processes and half of the VBs are preserved, fusion is not required. The approach allows the surgeon to expose the anterior aspect of the cervical dura and the entire length of the emerging spinal nerves. The anterior aspect of the dura is opened at the desired levels for VRExZ exposure, and the position is ideal for implantation of the graft/rootlets. The interscalenic dissection is mandatory so that the lesions of the supraclavicular plexus can be evaluated and repaired. If necessary, the anterior approach allows for exploration of the infraclavicular plexus during the same procedure. Conclusions. The use of a true anterior approach to the ventral rootlets appears to be a valuable and appropriate approach that avoids extensive laminectomy/facetectomy while reimplantation is performed through the anterolateral sulcus itself. In this approach, however, reimplantation of dorsal roots into the spinal cord remains impossible.

Intradural neurotropic spread of malignant mesothelioma

1998 ◽  
Vol 88 (1) ◽  
pp. 122-125 ◽  
Author(s):  
Timothy R. Steel ◽  
James Allibone ◽  
Tamas Revesz ◽  
Corrado D'Arrigo ◽  
H. Alan Crockard
Keyword(s):  
Spinal Cord ◽  
Brachial Plexus ◽  
Malignant Mesothelioma ◽  
Nerve Root ◽  
Spinal Canal ◽  
Content Type ◽  
Lower Trunk ◽  
Local Spread ◽  
History Of ◽  
Fine Print

✓ This 54-year-old man with a history of right-sided malignant mesothelioma presented with signs of a partial spinal cord syndrome. The tumor had invaded the lower trunk of the brachial plexus and spread along the T-1 nerve root beneath the arachnoid onto the spinal cord itself. Mesothelioma, despite its known predilection for local spread, is rarely encountered within the spinal canal. Neurotropism is commonly encountered in facial malignancies; however, it has never been reported to affect the brachial plexus and spinal cord.

Surgical treatment of irreducible atlanto-axial dislocation with spinal cord compression

1973 ◽  
Vol 38 (3) ◽  
pp. 374-378 ◽  
Author(s):  
Chikao Nagashima
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Spinal Cord Compression ◽  
Spinal Canal ◽  
Cord Compression ◽  
Foramen Magnum ◽  
Posterior Decompression ◽  
Content Type ◽  
Arthritic Changes ◽  
Fine Print

✓ The author reports the successful treatment of a case of irreducile atlantoaxial dislocation due to separation of the dens and secondary arthritic changes causing sagittal narrowing of the atlanto-axial spinal canal to 3 mm. Complete myelography obstruction was present. A one-stage posterior decompression of the foramen magnum and atlas was performed and occipito-cervical fixation accomplished by wire encased in acrylic plastic.

Elasticity of the spinal cord dura in the dog

1977 ◽  
Vol 47 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Archie R. Tunturi
Keyword(s):  
Spinal Cord ◽  
Elastic Modulus ◽  
Connective Tissue ◽  
Elastic Fibers ◽  
Filum Terminale ◽  
Nerve Roots ◽  
Content Type ◽  
Collagenous Fibers ◽  
Fine Print

✓ The elasticity of the spinal cord dura in the dog has been investigated histologically, in situ, and by measurement. The dura was composed of collagenous and elastic connective tissue fibers. The collagenous fibers were arranged in longitudinal bundles, straight when stretched and wavy when unstretched, with a delicate network of fine elastic fibers coursing in all directions. Transecting the cord and dura at T-5 caused a separation of 25 to 30 mm of the dura and a 15- to 20-mm gap in the cord. By means of an appropriate sequence of transections of nerve roots and denticulate ligaments within the dura, and transections of the dural sheaths and nerves outside the dura, the strain on the dura was found to be imposed by the attachments of the dural nerve sheaths from T-6 to S-7. The filum terminale was not appreciably strained. By adding weights to a suspended dura, two components of elasticity were found. For loads of 0 to 50 gm, the incremental displacements in the length were large. The elastic modulus was about 4 × 106 dynes/sq cm, which was comparable to that of elastic fibers. For loads of 50 to 150 gm the displacements in length were small. The elastic modulus was about 5 × 108 dynes/sq cm, which was comparable to that of collagenous fibers.

Comparison of anterior and posterior surgical approaches in the treatment of ventral spinal hemangioblastomas in patients with von Hippel—Lindau disease

2003 ◽  
Vol 98 (1) ◽  
pp. 117-124 ◽  
Author(s):  
Ryszard M. Pluta ◽  
Brian Iuliano ◽  
Hetty L. Devroom ◽  
Tung Nguyen ◽  
Edward H. Oldfield
Keyword(s):  
Spinal Cord ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Content Type ◽  
Von Hippel Lindau ◽  
Vhl Disease ◽  
Ventral Spinal Cord ◽  
Fine Print

Object. Von Hippel—Lindau (VHL) disease is an autosomal-dominant neoplastic syndrome with manifestations in multiple organs, which is evoked by the deletion or mutation of a tumor suppressor gene on chromosome 3p25. Spinal hemangioblastomas (40% of VHL disease—associated lesions of the central nervous system) arise predominantly in the posterior aspect of the spinal cord and are often associated with an intraspinal cyst. Rarely, the tumor develops in the anterior aspect of the spinal cord. Ventral spinal hemangioblastomas are a surgical challenge because of difficult access and because vessels feeding the tumor originate from the anterior spinal artery. The goal of this study was to clarify whether an anterior or posterior surgical approach is better for management of hemangioblastomas of the ventral spinal cord. Methods. The authors performed a retrospective analysis of clinical outcomes and findings on magnetic resonance (MR) imaging studies in eight patients (two women and six men with a mean age of 34 ± 15 years) who underwent resection of ventral spinal hemangioblastomas (nine tumors: five cervical and four thoracic). Two surgical approaches were used to resect these tumors. A posterior approach was selected to treat five patients (laminectomy and posterior myelotomy in four patients and the posterolateral approach in one patient); an anterior approach (corpectomy and arthrodesis) was selected to treat the remaining three patients. Immediately after surgery, the ability to ambulate remained unchanged in patients in whom an anterior approach had been performed, but deteriorated significantly in patients in whom a posterior approach had been used, because of motor weakness (four of five patients) and/or proprioceptive sensory loss (three of five patients). This difference in ambulation, despite significant improvements over time among patients in the posterior access group, remained significant 6 months after surgery. In all cases, MR images revealed complete resection of the tumor and in five patients significant or complete resolution of the intramedullary cyst was demonstrated (present in six of eight patients). Conclusions. The outcomes of these eight patients with hemangioblastomas of the ventral spinal cord indicate that both immediate and long-term results are better when an anterior approach is selected for resection.

Percutaneous treatment of gas-containing lumbar disc herniation

1999 ◽  
Vol 91 (1) ◽  
pp. 133-136 ◽  
Author(s):  
Andrea Righini ◽  
Silvia Lucchi ◽  
Paolo Reganati ◽  
Mario Zavanone ◽  
Agostino Bettinelli
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Percutaneous Treatment ◽  
Needle Aspiration ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Content Type ◽  
Tomography Scanning ◽  
Fine Print

✓ A limited number of cases have been reported in which gas-containing lumbar disc herniation caused compression of nerve roots. The authors describe two patients in whom computerized tomography scanning revealed a large intraspinal gas collection that appeared to be causing nerve root compression and that was successfully evacuated by percutaneous needle aspiration.

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