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Clinical Evaluation
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Clinicians should also inquire about symptoms of myelopathy. These may occasionally be subtle (e.g., diffuse hand numbness and clumsiness, which are often attributed to peripheral neuropathy or carpal tunnel syndrome, difficulty with balance and sphincter disturbances presenting initially as urinary urgency or frequency rather than as retention or incontinence) (Table 2.5).
Treatment of postlaminectomy kyphosis
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Christopher T. Martin, John M. Rhee
With increasing muscle fatigue and segmental translation, it becomes more difficult to maintain an upright posture, and the cervical spine falls into kyphosis. This mechanism that produces kyphosis tends to be a self-perpetuating cycle: As the head moves farther anteriorly, additional tensile loads are placed onto the posterior elements and musculature, leading to worsening decompensation (Figure 13.2). With worsening malalignment, the spinal cord can become draped over the vertebral bodies, leading to myelopathy. In addition, postlaminectomy membranes can form, which may lead to compression of the dura in extension.3 In severe cases, the patient may develop a chin-on-chest deformity, which interferes with the normal forward gaze during gait and poses difficulties in hygiene, swallowing, and feeding.
Anterior cervical surgery
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Álvaro Martín Gallego, Chelsie McCarthy, Roger Härtl
Myelopathy: This term refers to any damage or functional disturbance, acute or chronic, in the spinal cord. Compression of the cervical spinal cord may yield symptoms of spinal cord dysfunction known as cervical spondylotic myelopathy. The normal transmission of the neural signals to the upper and lower limbs is disrupted. This syndrome occurs in 5%–10% of patients with symptomatic cervical spondylosis and may be exhibited as Arm and hand weaknessLeg stiffnessHyperreflexiaLoss of balance with falling episodesPoor coordination or lack of fine motor dexterityBowel or bladder changes
The factors affecting the outcomes of conservative and surgical treatment of chiari i adult patients: a comparative retrospective study
Published in Neurological Research, 2022
Anas Abdallah, İrfan Çınar, Meliha Gündağ Papaker, Betül Güler Abdallah, Özden Erhan Sofuoğlu, Erhan Emel
Etiological factors that lead to abnormal CSF hydrodynamics can cause clinical symptoms as typical occipital Valsalva-type headaches, changes in neuropsychological and cognitive functions, the lower cranial nerve involvements, and myelopathy [1,11,16]. The association of CM1 with myelopathy is not a common phenomenon[22]. In our studied patients, five of them were presented with myelopathy and other advanced symptoms. After requesting an MRI, all of these patients were operated on to reduce irreversible neurological deficits. Obstruction of the 4th ventricular level can result in changes in craniospinal pressure that have been advocated in the genesis of syringomyelia. However, the exact relationship between syringomyelia and arachnoid veils is not yet completely identified [1,16]. Several studies suggested that the selection criteria for surgery should depend mainly on the degree of CSF flow obstruction rather than herniation degree and mild presenting symptoms. These studies supposed that CSF flow is an effective and better alternative parameter to assess treatment outcome [8,9,11]. In our clinical practice, we noticed that invariably symptomatic patients generally presented with ASV<15 µl. To obtain an acceptable outcome, we directly recommend surgical treatment for such cases.
Surfer’s myelopathy: A review of etiology, pathogenesis, evaluation, and management
Published in The Journal of Spinal Cord Medicine, 2021
Jason Gandhi, Min Yea Lee, Gunjan Joshi, Sardar Ali Khan
Myelopathy is generally defined as any neurological deficit related to spinal cord dysfunction. While SM cases have often involved first-time surfers, activities such as gymnastics, cheerleading, acrobatics, ballet, yoga, Pilates, or any sports where the back is hyperextended may cause SM. Currently, the youngest reported case of SM was documented in 2015 when a 7-year-old girl presented with back pain, urinary retention, and lower extremity weakness after performing a backbend during cheerleading practice. This case places greater importance in recognizing SM by emergency medicine physicians as more children become involved in competitive sports and experience possible trauma and consequent SM.4 Golfers are also at risk of myelopathic syndromes such as neck-tongue syndrome and cervical arterial dissections. The injury is rare but may affect a diverse range of athletes in various sports and may occur in non-athletes such as demolition workers.5,6
Treatment of spinal cord compression caused by C2 osteochondroma with reconstruction and fusion after total resection: Case report and literature review
Published in The Journal of Spinal Cord Medicine, 2021
Qian Guo, Zhong Fang, Yong Li, Yong Xu, Hanfeng Guan, Feng Li
In 2017, Payman Vahedi et al.9 found 99 reported cases of cervical osteochondroma by performing a thorough review of the English-language literature using PubMed and Google search engines. Because lesion location in the case we reported was C2 lamina, we performed a thorough review of the English-language literature using PubMed search engine and found 19 reported cases of osteochondroma located in C2 in addition to our case (Table 1). The average age of 19 patients reviewed was 35.5 years and most were male (57.9%). Most of the reported tumors were diagnosed within C2 posterior element (78.9%). Neurological symptoms including myelopathy and radiculopathy were seen in less than a half of all the cases (42.1%). Total resection was performed in nearly all the cases (89.5%). Most of the patients were treated with total resection with laminectomy (68.4%). No reconstruction was performed in all 19 cases. Only one case of recurrence was reported, in which the patient underwent subtotal resection.10