Thoracic dorsal ramus entrapment

1989 ◽  
Vol 70 (1) ◽  
pp. 124-125 ◽  
Author(s):  
José M. González-Darder
Keyword(s):  
Back Pain ◽  
Chronic Back Pain ◽  
Transverse Process ◽  
Spinal Nerve ◽  
Sensory Disturbance ◽  
Content Type ◽  
Thoracic Spinal ◽  
Dorsal Rami ◽  
Fine Print

✓ Entrapment of the dorsal ramus of a thoracic spinal nerve is described in a patient with chronic back pain and sensory disturbance in the cutaneous territory served by the T3–5 dorsal rami. The dorsal ramus of the T-4 nerve was found to be compressed by a bone spur involving the inferior T-4 apophyseal facet. The point of entrapment was a tunnel bounded by the transverse process, apophyseal joint, rib, and superior costotransverse ligament.

Monostotic fibrous dysplasia of the thoracic spine: clinopathological description and follow up

2004 ◽  
Vol 100 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Mehmet Arazi ◽  
Onder Guney ◽  
Mustafa Ozdemir ◽  
Omer Uluoglu ◽  
Nuket Uzum
Keyword(s):  
Fibrous Dysplasia ◽  
Thoracic Spine ◽  
Histopathological Examination ◽  
En Bloc Resection ◽  
Spinal Tumors ◽  
En Bloc ◽  
Content Type ◽  
Thoracic Spinal ◽  
Fine Print

✓ The authors report the case of a 53-year-old woman with monostotic fibrous dysplasia of the thoracic spine. The patient presented with a 1-month history of pain in the thoracic spinal region. En bloc resection of the lesion was successfully performed via a transthoracic approach, and a histopathological examination confirmed the diagnosis of fibrous dysplasia. At 24-month follow-up examination, pain and vertebral instability were absent. The findings in this case illustrate that, although very rare, monostotic fibrous dysplasia of the thoracic spine should be considered in the differential diagnosis of spinal tumors. Although a consensus for management of this disease has not been achieved, the authors recommend radical removal of all involved bone as well as internal fixation or bone graft—assisted fusion to achieve long-term stabilization.

Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine

1990 ◽  
Vol 72 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Joseph C. Maroon ◽  
Thomas A. Kopitnik ◽  
Larry A. Schulhof ◽  
Adnan Abla ◽  
James E. Wilberger
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Spinal Nerve ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Enhanced Ct ◽  
Disc Herniations ◽  
Microsurgical Approach ◽  
Far Lateral ◽  
Fine Print

✓ Lumbar-disc herniations that occur beneath or far lateral to the intervertebral facet joint are increasingly recognized as a cause of spinal nerve root compression syndromes at the upper lumbar levels. Failure to diagnose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the incorrect interspace. If these herniations are diagnosed, they often cannot be adequately exposed through the typical midline hemilaminectomy approach. Many authors have advocated a partial or complete unilateral facetectomy to expose these herniations, which can lead to vertebral instability or contribute to continued postoperative back pain. The authors present a series of 25 patients who were diagnosed as having far lateral lumbar disc herniations and underwent paramedian microsurgical lumbar-disc excision. Twelve of these were at the L4–5 level, six at the L5–S1 level, and seven at the L3–4 level. In these cases, myelography is uniformly normal and high-quality magnetic resonance images may not be helpful. High-resolution computerized tomography (CT) appears to be the best study, but even this may be negative unless enhanced by performing CT-discography. Discography with enhanced CT is ideally suited to precisely diagnose and localize these far-lateral herniations. The paramedian muscle splitting microsurgical approach was found to be the most direct and favorable anatomical route to herniations lateral to the neural foramen. With this approach, there is no facet destruction and postoperative pain is minimal. Patients were typically discharged on the 3rd or 4th postoperative day. The clinical and radiographic characteristics of far-lateral lumbar-disc herniations are reviewed and the paramedian microsurgical approach is 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.

Ligamentum flavum hematoma in the rigid thoracic spinal segments

2005 ◽  
Vol 2 (4) ◽  
pp. 495-497 ◽  
Author(s):  
Naohisa Miyakoshi ◽  
Yoichi Shimada ◽  
Kyoji Okada ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Ligamentum Flavum ◽  
Facet Joint ◽  
Axial Stress ◽  
Spinal Nerve ◽  
Content Type ◽  
First Case ◽  
Thoracic Spinal ◽  
Thoracolumbar Region ◽  
Spinal Segments

✓ Ligamentum flavum hematoma, a rare cause of spinal nerve root and canal compression, typically occurs in the mobile lumbar spine segments. A thoracic ligamentum flavum hematoma is extremely rare—only one such case of a thoracolumbar (T11–12) lesion has been reported. The thoracolumbar region with its floating ribs, however, is structurally and biomechanically similar to the lumbar spine and its mobility is greater than the higher thoracic levels. To the best of their knowledge, the authors report the first case of a ligamentum flavum hematoma in the region of the rigid thoracic spinal segments with the contiguous rib cage. A symptomatic T9–10 ligamentum flavum hematoma is described in the case of a 66-year-old woman with compensatory thoracic lordosis secondary to the lumbar degenerative kyphosis. The hematoma was removed and the diagnosis was histologically confirmed. The authors speculate that thoracic lordosis might have contributed to the development of the hematoma because the ligamentum flavum and the facet joint were subjected to greater axial stress than in individuals with normal spinal alignment.

The “open book” technique for preparation of the lumbar transverse process for posterolateral fusion

2000 ◽  
Vol 93 (2) ◽  
pp. 332-334
Author(s):  
H. Gordon Deen
Keyword(s):  
Lumbar Spine ◽  
Cancellous Bone ◽  
Dorsal Surface ◽  
Transverse Process ◽  
Open Book ◽  
Content Type ◽  
Dorsal Aspect ◽  
Technical Details ◽  
A New Technique ◽  
Fine Print

✓ A new technique is reported for preparation of the recipient graft bed for posterolateral intertransverse process fusion of the lumbar spine. The dorsal surface of each transverse process is reflected open like the pages of a book. This increases the surface area of cancellous bone in the recipient bed, thereby promoting better contact with the grafted bone. This maneuver also preserves much of the periosteal blood supply to the dorsal aspect of the transverse process and much of the cortical bone that would normally be drilled away during decortication. The technical details are described.

Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study

2000 ◽  
Vol 93 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Shunji Matsunaga ◽  
Kosei Ijiri ◽  
Kyoji Hayashi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Symptoms ◽  
Degenerative Spondylolisthesis ◽  
Low Back ◽  
Indications For Surgery ◽  
Initial Examination ◽  
Content Type ◽  
Fine Print

Object. Controversy exists concerning the indications for surgery and choice of surgical procedure for patients with degenerative spondylolisthesis. The goals of this study were to determine the clinical course of nonsurgically managed patients with degenerative spondylolisthesis as well as the indications for surgery. Methods. A total of 145 nonsurgically managed patients with degenerative spondylolisthesis were examined annually for a minimum of 10 years follow-up evaluation. Radiographic changes, changes in clinical symptoms, and functional prognosis were surveyed. Progressive spondylolisthesis was observed in 49 patients (34%). There was no correlation between changes in clinical symptoms and progression of spondylolisthesis. The intervertebral spaces of the slipped segments were decreased significantly in size during follow-up examination in patients in whom no progression was found. Low-back pain improved following a decrease in the total intervertebral space size. A total of 84 (76%) of 110 patients who had no neurological deficits at initial examination remained without neurological deficit after 10 years of follow up. Twenty-nine (83%) of the 35 patients who had neurological symptoms, such as intermittent claudication or vesicorectal disorder, at initial examination and refused surgery experienced neurological deterioration. The final prognosis for these patients was very poor. Conclusions. Low-back pain was improved by restabilization. Conservative treatment is useful for patients who have low-back pain with or without pain in the lower extremities. Surgical intervention is indicated for patients with neurological symptoms including intermittent claudication or vesicorectal disorder, provided that a good functional outcome can be achieved.

Neurological and pathological effects of second lumbar spondylectomy and spinal column shortening in the dog

1975 ◽  
Vol 42 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Daniel J. Yturraspe ◽  
William V. Lumb ◽  
Stuart Young ◽  
Harry A. Gorman
Keyword(s):  
Vertebral Column ◽  
Axonal Degeneration ◽  
Spinal Column ◽  
Lumbar Vertebra ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Loss Of Function ◽  
Nerve Roots ◽  
Content Type ◽  
Fine Print

✓ The second lumbar vertebra was surgically removed from 10 dogs, and the shortened vertebral column was stabilized by internal fixation with two types of plastic plates. Shortening of the spinal column was usually not associated with detectable loss of function or neurological deficit. Histological lesions, however, included widely disseminated axonal degeneration, gliosis, and atrophy of spinal nerve roots in the surgical area. The spinal cord adapted to shortening of the vertebral column by becoming intrinsically shorter, rather than by being displaced within the spinal canal.

Microangioarchitecture of the feline spinal cord

1987 ◽  
Vol 66 (3) ◽  
pp. 447-452 ◽  
Author(s):  
Yutaka Naka ◽  
Toru Itakura ◽  
Kunio Nakai ◽  
Kazuo Nakakita ◽  
Harumichi Imai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Surface ◽  
Ventral Surface ◽  
Anterior Spinal Artery ◽  
Corrosion Casts ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal ◽  
Fine Print ◽  
Anterior Median

✓ The microangioarchitecture of corrosion casts of the cat spinal cord was studied by scanning electron microscopy. On the ventral surface of the spinal cord, the anterior spinal artery and the anterior spinal vein ran parallel along the anterior median fissure. Many central arteries branching from the anterior spinal artery coursed in a wavelike manner in the anterior median fissure. The number of central arteries was lowest in the thoracic spinal cord. Central arteries at some spinal cord levels revealed well-developed anastomoses with other central arteries in the anterior median fissure. These well-developed anastomotic central arteries were frequently observed in the thoracic spinal cord, in which the number of central arteries was lowest. On the dorsal surface of the spinal cord, the posterior spinal vein ran longitudinally at the midline and was drained by circumferential veins and posterior central veins. This vein formed a characteristic anastomotic plexus. Small arterioles (20 µm in diameter) in the spinal parenchyma revealed a ring-like compression at the branching site.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

Evoked potentials from direct cerebellar stimulation for monitoring of the rodent spinal cord

1992 ◽  
Vol 76 (2) ◽  
pp. 280-291 ◽  
Author(s):  
R. John Hurlbert ◽  
Charles H. Tator ◽  
Michael G. Fehlings ◽  
Greg Niznik ◽  
R. Dean Linden
Keyword(s):  
Spinal Cord ◽  
Evoked Potentials ◽  
Posterior Fossa ◽  
Evoked Potential ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal ◽  
Ventral Funiculus ◽  
Fine Print ◽  
Cerebellar Stimulation

✓ Although the assessment of spinal cord function by electrophysiological techniques has become important in both clinical and research environments, current monitoring methods do not completely evaluate all tracts in the spinal cord. Somatosensory and motor evoked potentials primarily reflect dorsal column and pyramidal tract integrity, respectively, but do not directly assess the status of the ventral funiculus. The present study was undertaken to evaluate the use of evoked potentials, elicited by direct cerebellar stimulation, in monitoring the ventral component of the rodent spinal cord. Twenty-nine rats underwent epidural anodal stimulation directly over the cerebellar cortex, with recording of evoked responses from the lower thoracic spinal cord, both sciatic nerves, and/or both gastrocnemius muscles. Stimulation parameters were varied to establish normative characteristics. The pathways conducting these “posterior fossa evoked potentials” were determined after creation of various lesions of the cervical spinal cord. The evoked potential recorded from the thoracic spinal cord consisted of five positive (P1 to P5) and five negative (N1 to N5) peaks. The average conduction velocity (± standard deviation) of the earliest wave (P1) was 53 ± 4 m/sec, with a latency of 1.24 ± 0.10 msec. The other components followed within 4 msec from stimulus onset. Unilateral cerebellar stimulation resulted in bilateral sciatic nerve and gastrocnemius muscle responses; there were no significant differences (p > 0.05) in the thresholds, amplitudes, or latencies of these responses elicited by right- versus left-sided stimulation. Recordings performed following creation of selective lesions of the cervical cord indicated that the thoracic response was carried primarily in the ventral funiculus while the sciatic and gastrocnemius responses were mediated through the dorsal half of the spinal cord. It is concluded that the posterior fossa evoked potential has research value as a method of monitoring pathways within the ventral spinal cord of the rat, and should be useful in the study of spinal cord injury.

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