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Cervical Radiculopathy
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Cervical radiculopathy can be defined as pain, weakness and sensory disturbance in a radicular pattern in one or both upper extremities related to compression and/or irritation of one or more cervical nerve roots. Risk factors include cigarette smoking and prior lumbar radiculopathy.
Head injury in the child
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Helen Whitwell, Christopher Milroy
Gleckman et al. (1999) published a series of 10 cases of NAI in infants and diagnosed DAI in 5 cases of ‘shaken baby syndrome’. However, much of the APP staining appears to indicate the vascular type. In 2001, Geddes and colleagues (2001a) published the largest series to that date of 53 infants and children with inflicted head injury. This series also had defined diagnostic criteria for inclusion. In the 37 infants, only two of the cases showed DAI; both of these had evidence of significant impact with skull fractures. The authors concluded that DAI was uncommon and that the most common pathology related to widespread hypoxic-ischaemic damage and swelling. In the eight cases where there was no impact (no bruising or skull fracture), no DAI was present. In 13 of 37, there was evidence of either macroscopic or microscopic cervical cord damage, including epidural haemorrhage, APP positivity of cervical nerve roots, and corticospinal axonal damage in the lower pons and medulla (Figure 15.13). This last has been reported in adult hyperextension injury (Lindenberg and Freytag 1970) but not previously in NAI. There was no difference between cases with and those without impact (Geddes et al. 2001a).
The patient with acute neurological problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Spinal nerves are arranged as follows: 8 pairs of cervical nerves (C1–C8).12 pairs of thoracic nerves (T1–T12).5 pairs of lumbar nerves (L1–L5).5 pairs of sacral nerves (S1–S5).1 pair of coccygeal nerves (Co1).
Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial
Published in Annals of Medicine, 2023
Jianfeng Pu, Wenping Cao, Yetin Chen, Yunwu Fan, Ye Cao
Because there are no unified diagnostic criteria for CSR, we developed diagnostic criteria based on the published literature [15–18]. These criteria were: (1) Have suffered neck strain or a sprained or stiff neck; (2) Have radiation numbness, pain, or paresthesia in the neck and areas innervated by the root of the cervical nerve, which might be aggravated when the neck posture is improper; (3) Symptoms might be accompanied by the reduced muscle strength of the upper limbs, as well as inflexible finger movement, and hand muscle atrophy might occur in the elderly over the course of the disease; (4) There may be tenderness or muscle tension spasms in the neck during physical examination; (5) The neck extension test, brachial plexus traction test (Eaten test), intervertebral foramen extrusion test (Spurling test), head percussion test, and Hoffman sign might be positive; (6) X-ray and CT might show changes to the physiological curvature of the cervical spine, as well as vertebral joint instability, bone spur formation, and intervertebral foramen stenosis; and (7) MRI might show changes to cervical disc degeneration, nucleus pulposus, nerve root compression, and cervical spinal canal stenosis. Electromyography is useful for identifying responsible neural segments. CSR can be diagnosed if any one of (1)+(2)+(5)+other four items is met.
Effects of rTMS combined with rPMS on stroke patients with arm paralysis after contralateral seventh cervical nerve transfer: a case-series
Published in International Journal of Neuroscience, 2023
Ting Yang, Xueping Li, Peng Xia, Xiaoju Wang, Jianqiang Lu, Lin Wang
The process of pain relief and strength improvement obtained by rTMS is assumed that the stimuli act locally within M1 can modulate the remote, deep brain structures through the subcortical fibers. The four patients had more or less neuropathic pain and different degree of muscle strength decrease due to severance of the contralateral seventh cervical nerve. Additionally, some of the patients took medications, for instance, celebrex, parecoxib sodium injection and flurbiprofen axetil injection after surgery. Although, NRS after treatment was significantly lower compared to the pre-treatment score. And the Cohen’s d effect size (d = 1.38) indicated a high level of practical significance of the treatment, and the mean change indicated that the treatment was clinically effective. The result of (S-W) test for difference in NRS is 0.73 of W score and 0.02 of p value which means the data didn’t conform to a normal distribution. The improvement of pain treated by rTMS should be interpreted with caution. After rehabilitation, there was some improvement in grip strength and pinch strength found by the ELINK assessment. The Cohen’s d effect size indicated a high level of practical significance of the treatment. Furthermore, the mean change indicated that the treatment was clinically effective. Therefore, this treatment may have some effect in improving the loss of muscle strength as a result of surgery.
Open biopsy with posterior instrumentation followed by anterolateral approach for removal of an uncommon tumor in the cervical spine
Published in Baylor University Medical Center Proceedings, 2021
Jian-Cheng Liao, Mao-Ying Zhang, Yu-Sang Liu, Wei-Long Ding, Xiang-Yu Wang, Buqing Liang, Jason H. Huang
When the vertebral bodies, VAs, and cervical nerves are all invaded by a spinal tumor, surgical resection can be difficult, necessitating multidisciplinary collaboration.5 In our case, preoperative imaging suggested multilevel vertebral body erosion and destruction, leading to instability of the spinal column. Therefore, a posterior C2–C5 instrumented fusion was first performed for spinal stabilization. With paravertebral tumor invading the nerve roots and encasing the VA, a conventional anterior cervical spine approach is inadequate for tumor exposure.6 Jules-Elysee suggested that anterior surgery could cause respiratory complications and esophageal injury.7 Posterior resection of paravertebral tumors requires an exposure of sufficient surgical field, and total resection would be impossible to complete as the tumor blocks the view. Although the combined anterior and posterior approach increases the chance of total tumor resection, its morbidity and the possibility of tumor spread need to be considered as well.8,9 The anterolateral approach can be used to remove tumors from the intervertebral foramina, laminas, and transverse processes. However, this approach may injure the ipsilateral VA and adjacent cervical nerves. Therefore, it is crucial to evaluate the vasculatures prior to the operation and protect the cervical nerves during the operation.