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The neck
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
A plain lateral radiograph showing an anteroposterior diameter of the spinal canal of less than 11 mm strongly supports the diagnosis of cervical spinal stenosis. A better measure is the Pavlov ratio (the anteroposterior diameter of the canal divided by the diameter of the vertebral body at the same level) because this is not affected by magnification error. A ratio of less than 0.8 is abnormal.
Spinal Cord Injury in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Philippines G. Cabahug, Albert C. Recio, Jeffrey B. Palmer
Late neurologic change is not uncommon in SCI. Almost 20% of patients with chronic SCI report late-onset muscle weakness or sensory loss. Peripheral nerve dysfunction due to age-related anterior horn cell dropout, loss of myelinated tracts, median or ulnar nerve entrapment, cervical spinal stenosis, or radiculopathy can lead to progression of weakness.73
Extracorporeal shock wave therapy to treat neurogenic heterotopic ossification in a patient with spinal cord injury: A case report
Published in The Journal of Spinal Cord Medicine, 2021
Hyun Min Jeon, Won Jae Lee, Hee Sup Chung, You Gyoung Yi, Seoyon Yang, Dae Hyun Kim, Kyung Hee Do
A 55-year-old male diagnosed as having a complete C4 SCI[S(C5/C5)] according to American Spinal Injury Association (ASIA) Impairment Scale A visited the department of physical medicine and rehabilitation on September 20, 2017 due to severe right hip pain. The subject sustained tetraplegia in a fall while he was in the military in July 1983, for which a C5/6 vertebral body fusion was performed at that time. As time passed, the subject also developed cervical spinal stenosis at multiple levels with cervical myelopathy at the C3/4 level. Magnetic resonance imaging showed severe central stenosis and compressive myelopathy at C3/4 with vertebral body fusion at C5/6 and a cystic lesion in the spinal cord at this level. The results for manual muscle testing of both shoulder flexors and extensors were poor, and the others were all zero. Sensory examination revealed hypoesthesia in all extremities, and the modified Ashworth scales for all joints were grade 0. Moreover, no definite limitation of motion except plantar flexion of the left ankle was noted. The initial modified Barthel index and Spinal Cord Independence Measure score of the subject were 26 and 35, respectively.
Factors shaping expectations for complete relief from symptoms during rehabilitation for patients with spine pain
Published in Physiotherapy Theory and Practice, 2019
Mark D Bishop, Paul Mintken, Joel E Bialosky, Joshua A Cleland
The study of interventions for neck pain enrolled 140 patients with a primary report of neck pain seen in 1 of 5 physical therapy clinics located in four different states across the United States (New Hampshire, Wisconsin, Colorado, Massachusetts). Patients were eligible to participate in the primary study if they were between 18 and 60 years of age, had a primary report of neck pain with or without unilateral upper-extremity symptoms, and had a Neck Disability Index (NDI) score of at least 20%. Patients were excluded if they had any of the following: serious pathologies; diagnosis of cervical spinal stenosis; bilateral upper-extremity symptoms; evidence of central nervous system involvement; neurologic signs consistent with nerve root compression; or inability to adhere to the treatment and follow-up schedule. Interventions studied in this trial were a thoracic spine focused manipulation and range of motion exercises.
Central Sulcus Misfolding: Polarity Reversal of SSEP N20 Potential in “Layered” Polymicrogyria
Published in The Neurodiagnostic Journal, 2019
Tyson Hale, Aaron Knecht, Kristiana Barbarevech, Qing Yue
A 44-year-old female underwent anterior cervical discectomy and fusion (ACDF) for neck pain and arm weakness/numbness/pain. She had a normal cognitive function and no known history of seizure. Neurological examination revealed a mild weakness in the left arm (4/5) presumably secondary to cervical spinal stenosis. Her postural position, discriminative touch, pain perception, and thermal sensation were within normal ranges. The patient’s past medical history was significant for sub-occipital resection of 4th ventricle ependymoma about 4 years ago.