scholarly journals Spinal shortening and monosegmental posterior spondylodesis in the management of dorsal and lumbar unstable injuries

2011 ◽  
Vol 02 (01) ◽  
pp. 017-022 ◽  
Author(s):  
Tarek A Aly
Keyword(s):  
Spinal Cord ◽  
Interbody Fusion ◽  
Cauda Equina ◽  
Fracture Dislocation ◽  
Primary Indication ◽  
Cauda Equina Compression ◽  
Solid Fusion ◽  
Bone Fragments ◽  
Local Kyphosis ◽  
Sagittal Index

ABSTRACT Introduction: Patients with spinal injuries have been treated in the past by laminectomy in an attempt to decompress the spinal cord. The results have shown insignificant improvement or even a worsening of neurologic function and decreased stability without effectively removing the anterior bone and disc fragments compressing the spinal cord. The primary indication for anterior decompression and grafting is narrowing of the spinal canal with neurologic deficits that cannot be resolved by any other approach. One must think of subsequent surgical intervention for increased stability and compressive posterior fusion with short-armed internal fi xators. Aim: To analyze the results and efficacy of spinal shortening combined with interbody fusion technique for the management of dorsal and lumbar unstable injuries. Materials and Methods: Twenty-three patients with traumatic fractures and or fracture-dislocation of dorsolumbar spine with neurologic deficit are presented. All had radiologic evidence of spinal cord or cauda equina compression, with either paraplegia or paraparesis. Patients underwent recapping laminoplasty in the thoracic or lumbar spine for decompression of spinal cord. The T-saw was used for division of the posterior elements. After decompression of the cord and removal of the extruded bone fragments and disc material, the excised laminae were replaced exactly in situ to their original anatomic position. Then application of a compression force via monosegmental transpedicular fixation was done, allowing vertebral end-plate compression and interbody fusion. Results: Lateral Cobb angle (T10–L2) was reduced from 26 to 4 degrees after surgery. The shortened vertebral body united and no or minimal loss of correction was seen. The preoperative vertebral kyphosis averaged +17 degrees and was corrected to +7 degrees at follow-up with the sagittal index improving from 0.59 to 0.86. The segmental local kyphosis was reduced from +15 degrees to −3 degrees. Radiography demonstrated anatomically correct reconstruction in all patients, as well as solid fusion. Conclusion: This technique permits circumferential decompression of the spinal cord through a posterior approach and posterior interbody fusion.

scholarly journals Alteration of the lysophosphatidic acid and its precursor lysophosphatidylcholine levels in spinal cord stenosis: A study using a rat cauda equina compression model

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Baasanjav Uranbileg ◽  
Nobuko Ito ◽  
Makoto Kurano ◽  
Daisuke Saigusa ◽  
Ritsumi Saito ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Lysophosphatidic Acid ◽  
Mass Spectrometry Imaging ◽  
Cauda Equina ◽  
Motor Dysfunction ◽  
Lipid Mediator ◽  
Neurogenic Claudication ◽  
Imaging Analysis ◽  
Cauda Equina Compression ◽  
Tissue Damages

Abstract Cauda equina compression (CEC) is a major cause of neurogenic claudication and progresses to neuropathic pain (NP). A lipid mediator, lysophosphatidic acid (LPA), is known to induce NP via the LPA1 receptor. To know a possible mechanism of LPA production in neurogenic claudication, we determined the levels of LPA, lysophosphatidylcholine (LPC) and LPA-producing enzyme autotaxin (ATX), in the cerebrospinal fluid (CSF) and spinal cord (SC) using a CEC as a possible model of neurogenic claudication. Using silicon blocks within the lumbar epidural space, we developed a CEC model in rats with motor dysfunction. LPC and LPA levels in the CSF were significantly increased from day 1. Importantly, specific LPA species (16:0, 18:2, 20:4) were upregulated, which have been shown to produce by ATX detected in the CSF, without changes on its level. In SC, the LPC and LPA levels did not change, but mass spectrometry imaging analysis revealed that LPC was present in a region where the silicon blocks were inserted. These results propose a model for LPA production in SC and CSF upon neurogenic claudication that LPC produced locally by tissue damages is converted to LPA by ATX, which then leak out into the CSF.

Spinal arterial malformation in a child with hereditary hemorrhagic telangiectasia

1976 ◽  
Vol 44 (5) ◽  
pp. 613-616 ◽  
Author(s):  
Glen S. Merry ◽  
D. Barry Appleton
Keyword(s):  
Spinal Cord ◽  
Family History ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Cauda Equina ◽  
Content Type ◽  
Cauda Equina Compression ◽  
History Of ◽  
Spinal Aneurysm ◽  
Arterial Malformation ◽  
Fine Print

✓ A case is reported of spinal aneurysm in a child with a family history of hereditary hemorrhagic telangiectasia causing spinal cord and cauda equina compression. The operative approach is discussed.

scholarly journals The use of carbon fiber cages in anterior cervical interbody fusion

2002 ◽  
Vol 12 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Khalil Salame ◽  
Georges E. R. Ouaknine ◽  
Nissim Razon ◽  
Semion Rochkind
Keyword(s):  
Carbon Fiber ◽  
Interbody Fusion ◽  
Good Alternative ◽  
Cervical Lordosis ◽  
Short Term ◽  
Alternative Material ◽  
Solid Fusion ◽  
Bone Fragments ◽  
The Mean

Object Cage devices were introduced in spinal fusion to overcome the shortcomings of autograft, allograft, and biocompatible implants. The aim of this study was to assess the short-term results of anterior cervical discectomy and fusion (ACDF) in which an interbody carbon fiber cage (CFC) and local osteophyte–derived bone graft were implanted. Methods A retrospective review was conducted of 100 consecutive patients treated by ACDF in which a CFC was packed with bone fragments obtained from osteophytes at the surgical site. Plain radiographs with dynamic lateral views obtained 1 year postoperatively were used to assess bone fusion, alignment of the cervical spine, and stability. Dynamic radiographs were also obtained at last follow up to determine whether loss of cervical alignment or collapse at the fused disc had occurred. The mean follow-up period was 25 months. In all cases the cervical lordosis was maintained or corrected to different extents and disc height was restored. Solid fusion was achieved in 98% of the cases. There were no cage-related complications and no cases of cage failure. Conclusions The authors conclude that application of the CFC for ACDF is safe, effective, and technically feasible. Osteophytes resected during surgery may be a good alternative material for bone grafting in cage-assisted cervical interbody fusion.

scholarly journals P3.13-025 Spinal Cord and Cauda Equina Compression in Lung Cancer

2017 ◽  
Vol 12 (11) ◽  
pp. S2325
Author(s):  
H. Neji ◽  
M.A. Haouari ◽  
M. Attia ◽  
M. Affes ◽  
I. Baccouche ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Cauda Equina ◽  
Cauda Equina Compression

Operative Stabilization of the Posttraumatic Thoracic and Lumbar Spine: A Comparative Analysis of the Harrington Distraction Rod and the Modified Weiss Spring

Neurosurgery ◽  
1986 ◽  
Vol 19 (3) ◽  
pp. 378-385 ◽  
Author(s):  
Edward C. Benzel ◽  
Sanford J. Larson
Keyword(s):  
Interbody Fusion ◽  
Dynamic Compression ◽  
Cauda Equina ◽  
Bed Rest ◽  
Neurological Injury ◽  
Spine Stabilization ◽  
Operative Stabilization ◽  
Cauda Equina Compression ◽  
Thoracic And Lumbar Spine ◽  
Neurological Injuries

Abstract To assess the efficacy of operative stabilization techniques, a retrospective study of Harrington distraction rod (HDR) and modified Weiss spring instrumentation was performed in 90 patients. An operation was performed for one or both of two indications: persistent spine instability or the presence of a neurological deficit in patients with incomplete neurological injuries and myelographic evidence of spinal cord or cauda equina compression. The lateral extracavitary operative approach to the spine for decompression and anterior interbody fusion was performed with an accompanying HDR (47 patients) or modified Weiss spring placement (43 patients). Eight HDRs failed, resulting in gross instability (17 per cent) that either resulted in further neurological injury (1 patient), further surgery (2 patients), or increased morbidity secondary to prolonged bed rest (5 patients). One Weiss spring failed, requiring further surgery (2.3 per cent). Nonsurgical complications were similar in both groups and appeared to be unrelated to the type of instrumentation utilized. The modified Weiss spring instrumentation technique, which offers a dynamic compression fixation of the spine, was clearly superior to the HDR technique, which offers a rigid distraction fixation. The biomechanics of distraction versus compression and rigid versus nonrigid spine stabilization are discussed.

scholarly journals Dorsal migration of lumbar disc fragments causing cauda equina syndromes: A three case series and literature review

2020 ◽  
Vol 11 ◽  
pp. 175
Author(s):  
Shawn Singh Rai ◽  
Carlos Rodrigo Goulart ◽  
Sepehr Lalezari ◽  
Michael Anthony Galgano ◽  
Satish Krishnamurthy
Keyword(s):  
Spinal Cord ◽  
Literature Review ◽  
Current Literature ◽  
Lumbar Disc ◽  
Correct Diagnosis ◽  
Cauda Equina ◽  
Case Series ◽  
Surgical Decompression ◽  
Case Description ◽  
Cauda Equina Compression

Background: Dorsal migration of an intervertebral lumbar disc fragment is exceedingly rare and may result in spinal cord or cauda equina compression. Radiologically, these lesions may be misdiagnosed as extradural masses or epidural hematomas. Case Description: We present three cases involving dorsal migration of sequestered lumbar disc fragments resulting in cauda equina syndromes. A 31-year-old male, 79-year-old female, and 47-year-old female presented with cauda equina syndromes attributed to the migration of dorsal sequestered lumbar disc fragments. Prompt surgical decompression resulted in adequate outcomes. Here, we review the three cases and the current literature for such lesions. Conclusion: Dorsal migration of sequestered lumbar disc fragments is exceedingly rare, and these lesions are frequently misdiagnosed as extradural masses of other origin or epidural hematomas. Here and in the literature, prompt epidural decompression both confirmed the correct diagnosis and resulted in excellent outcomes.

Thoracolumbar spinal deformity in achondroplasia

2003 ◽  
Vol 14 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Sanjay N. Misra ◽  
Howard W. Morgan
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Spinal Canal Stenosis ◽  
Kyphotic Deformity ◽  
Thoracolumbar Kyphosis ◽  
Neurological Damage ◽  
Management Options ◽  
Canal Stenosis ◽  
Cauda Equina Compression ◽  
Biomechanical Factors

The authors review the management of thoracolumbar kyphotic deformity in cases of achondroplasia. The presence of angular thoracolumbar kyphosis in achondroplasia is well recognized. In children this is initially a nonfixed deformity that persists, however, in more than 10% of individuals and becomes a fixed thoracolumbar kyphotic deformity. Additionally, with the coexistent spinal canal stenosis, neurological damage can occur and manifest as spinal cord or cauda equina compression. The nature of this condition, the natural history, and management options are discussed. Anatomical and biomechanical factors relevant to the condition are specifically highlighted. Avoidance of pitfalls in the management of these patients is discussed for both pediatric and adult patients.

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