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The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
Cervical spondylosis results from the degeneration of intervertebral discs in the cervical region. The disc spaces are narrowed, osteophytes form, and, in addition to compression of nerve roots, there may be interference with the blood supply to the spinal cord where the vertebral canal is narrowest. The importance of cervical spondylosis is uncertain because it can be demonstrated radiologically in some 50% of adults aged >50 and in some 75% > 65. It may therefore be that secondary ischaemic damage in the spinal cord – cervical myelopathy – occurs only in individuals with congenital narrowing of the vertebral canal.
Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Patients are positioned supine and imaged using a spine phased array coil to provide high-resolution imaging of the spine. The patient is positioned so that the cervical region is in the isocentre of the magnetic field. Imaging begins over the cervico-thoracic region and proceeds to the thoraco-lumbar region. Pads and straps may be used to support and immobilise the head and neck to improve patient comfort and prevent motion artefact.
Developmental and Acquired Disorders of The Spine
Published in Milosh Perovitch, Radiological Evaluation of the Spinal Cord, 2019
Spondylolisthesis is marked by a forward displacement of the vertebral body affected by congenital or acquired disorders. The displacement occurs mostly in the lower lumbar region at the level of Ls to S1, and less often in the cervical area. In the cervical region, spondylolisthesis occurs predominently in males and may be the cause of the spinal cord compression. Retrolisthesis or reverse spondylolisthesis is a posterior displacement, usually of the fourth or fifth lumbar vertebral body. It happens much less frequently than the anterior spondylolisthesis. Its appearance may be related either to developmental abnormalities of the spine, or to trauma, laxity of the ligaments, herniated disk, arthritis, and infections (earlier, usually in tuberculous spondylitis).25, 27
Classification of cervicogenic dizziness
Published in Hearing, Balance and Communication, 2023
Sympathetic nerve postganglionic fibres are distributed in the capsules of the uncovertebral joint, posterior longitudinal ligament, rear of the annulus, and dural sac in humans [7]. Numerous sympathetic postganglionic fibres have been shown to be distributed in the cervical posterior longitudinal ligament of every segment in rabbits [8]. Therefore, compression of the cervical roots or degenerative changes in the cervical spine can cause irritation to the postganglionic sympathetic system and induce reflexive vasoconstriction and inner ear ischaemia, resulting in disequilibrium, vertigo, tinnitus, headache, blurred vision, dilated pupils, nausea, and vomiting [1,4,9]. This condition is called posterior cervical sympathetic syndrome or Barré-Lieou syndrome. The symptoms of Barré-Liéou syndrome have been reported to be associated with cervical instability [10]. Patients experience symptoms after a cervical injury, especially in the mid-cervical region. This region is more unstable than other spinal segments [11]. Hackett et al. [10] documented that various interventions produced successful outcomes in patients with sympathetic symptoms of Barré-Liéou syndrome. Hong and Kawaguchi [12] reported that sympathetic symptoms are relieved after anterior cervical discectomy and fusion in patients with cervical spondylosis. In addition, Wang et al. [7] suggested that removal of the posterior longitudinal ligament or stabilisation of the segment might decrease sympathetic symptoms.
An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy
Published in Annals of Medicine, 2022
Xiaohong Cui, Di Zhang, Yongming Zhao, Yongsheng Song, Liangliang He, Jian Zhang
Consistent with the previous study, identification of critical vessels surrounding the intervertebral foramen was allowed using colour Doppler model with in-plane technique to reduce the risk of advertent VP and IVI [35]. Our results showed that under the real-time US guidance unintended VP was nearly half as frequent in 3.8% of injections in the US group (13.8% in the FL group, p = .010), which illustrated that the US is not 100% accurate in preventing intravascular puncture or injection. This may be related to the limitations in visualisation of bone structure and small vessels adjacent to intervertebral foramen by the US-guided method. Therefore, when choosing this technique, the proceduralist should familiarise themself with the anatomic structures in the cervical spine and be precisely experienced with the scanning and injection technique of intervention in the cervical region. However, there was no sign of major complications. Besides, the mean puncture time in the US group was significantly shorter than that in the FL group.
Resolution of chronic lower back pain symptoms through high-intensity therapeutic exercise and motor imagery program: a case-report
Published in Physiotherapy Theory and Practice, 2022
Jorge Ribas, Maria Armanda Gomes, António Mesquita Montes, Cláudia Ribas, José Alberto Duarte
The patient presented with continuous lumbar pain that was ongoing for more than 6 months, with irradiation to both lower limbs. She assumed an antalgic fetal posture, with anterior trunk flexion and neck extension and a bent trunk position induced by pain with hip flexion at approximately 90º and a slight inclination of the trunk to the left. She had great difficulty with ambulation and an inability to assume the orthostatic position. She also had intense pain irradiation to the lower limbs, especially the right limb; spasms in her back muscles; and gait disturbance with atypical claudication, a predominance of right limb external rotation, and trunk and lateral flexion. Muscle strength and the range of motion in the trunk were seemingly symmetrical but limited due to pain. The patient showed symmetrical slight weakness in the lower limb muscles with a range of motion also limited due to pain. The patient had a normal range of motion and muscle mass in the upper limbs. The mobility of the cervical region was preserved with some limitation in flexion and extension due to pain, which impacted the dorsal kyphosis to a lesser degree. Likewise, the patient had a horizontal sacrum as well as postural instability at the lumbosacral level and a discreet dextroscoliosis in the lumbar spine. No abdominal masses or organomegalies were detected on painless palpation, and her breath sounds and cardiopulmonary auscultation were normal.