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Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
On the one hand, axial pain is a marker of ligamentous, osseous, muscular, joint, and annular pathologies. Radicular pain, on the other hand, is usually caused by irritation of neurological tissue due to compression because of an etiology like disc fragment, canal stenosis, and foraminal stenosis. Patients with nerve root symptoms usually present with paresthesia, hyperalgesia, tingling, numbness, and burning pain. Patients with cervical radiculopathy usually obtain relief on abduction of the ipsilateral shoulder, while a patient with shoulder pathology usually has painful abduction of the shoulder. The pelvic cause of low back pain must be considered in differential diagnosis, particularly sacroiliitis. Pathology in retroperitoneal structures like the kidney, ureter, pancreas, etc. can present as back pain.
Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Prognosis depends on the underlying cause and duration and degree of spinal cord and nerve root compression/infiltration. In contrast to brain tumors, many spinal tumors are benign and produce their effects mainly by compression of the spinal cord rather than by invasion.
Intervertebral Disc Whole Organ Cultures
Published in Raquel M. Gonçalves, Mário Adolfo Barbosa, Gene and Cell Delivery for Intervertebral Disc Degeneration, 2018
Sebastian Wangler, Zhen Li, Sibylle Grad, Marianna Peroglio
While the physical examination describes the functional loss, e.g., missing reflexes, changes in muscle tonus, or sensory loss, imaging (especially the MRI) provides information about the morphological changes of the investigated structure. The physical examination of this case can typically be described as follows: “Palpable muscle spasm in lower back. Positive straight leg raising test and femoral stretch test right. Sensory loss in the right lateral sole and the right calf according to the S1 dermatome. Power plantar flexion: right grade III, left grade IV with diminished ankle jerk reflex right.” This status leads to the working diagnosis of nerve root compression, to be confirmed by the result of an MRI. The MRI uses the content of water to describe the grade of degeneration in intervertebral discs (IVDs). The most popular classification to characterize the phenotype of degenerated IVDs based on routine T2-weighted MRI images has been introduced by Pfirrmann et al. (2001). The classification uses four different criteria such as disc structure (homogenous/inhomogeneous, white and black signal), distinction between annulus fibrosus (AF) and nucleus pulposus (NP) (clear/lost), signal intensity of the disc (hyperintense/hypointense) and disc height (normal/collapsed) to describe the degenerative grade of a human IVD. Figure 3.1 shows the MRI of the earlier described clinical case.
Requirements for implementing online information material for patients with low back pain in general practice: an interview study
Published in Scandinavian Journal of Primary Health Care, 2019
Ditte Meulengracht Hjelmager, Line Dausel Vinther, Søren Herold Poulsen, Lone Stub Petersen, Martin Bach Jensen, Allan Riis
Low back pain (LBP) is a common condition that most people will experience at some point in their life [1]. Furthermore, LBP is the leading cause of activity loss and work absence, making it an economic burden worldwide [2]. In 2015, the Danish Health Authority estimated the annual cost of LBP to be DKK 1,820 million in Danish general practice [3]. LBP is a symptom and the specific cause of the pain is usually not identified. In a minority of cases, there are signs of specific causes such as compression of a nerve root (sciatica) or underlying serious diseases like cancers, fractures, or inflammation (red flags) [4]. However, in most cases, the cause of the pain remains unknown and it is classified as unspecific LBP [4]. LBP thus constitutes an umbrella term for a range of underlying, often unknown causes; some patients will develop persistent pain, others will be pain-free after weeks, and some will experience recurrent symptoms with periods without pain [5]. Only a minority of patients with LBP will have recovered after the first three months, with an estimated 65% of patients still experiencing pain a year after their first incident [6], thereby resulting in many general practice consultations [3]. The global burden is projected to increase; therefore, research is needed to support patients in coping with LBP in the future [7].
Multiple retrograde tracing methods compatible with 3DISCO clearing
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Shuai Han, Dongdong Li, Yuhui Kou, Zhongguo Fu, Xiaofeng Yin
After the intramuscular injections, the mice were kept for 7 days to allow for optimal retrograde transport of neuronal tracers. Then, mice were deeply anaesthetized and perfused with 37 °C saline followed by 4 °C 4% paraformaldehyde (PFA; Sigma-Aldrich, St. Louis, MO, USA dissolved by 1× PBS). After perfusion, intact spinal cord was removed between T12 and S2 region to ensure the entire motor neuron pool was covered. Spinal nerve roots were remained so as to recognize the specific segments of spinal cord (Figure 2). Then, the spinal cord was fixed with the post-fixation solution (4% PFA) over night. The sample was immobilized with microsutures on a piece of flat folded aluminium foil during the fixation and optical clearing procedure in order to prevent the deformation.
Biomechanical evaluation of subaxial lateral mass prothesis: a finite element analysis study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Qiang Jian, Zhenlei Liu, Wanru Duan, Fengzeng Jian, Xuefeng Bo, Zan Chen
The cervical nerve roots originate from the cervical cord and exit the spinal canal through the intervertebral foramina in front of the lateral masses. Therefore, to expose a dumbbell tumor originating from the nerve root during surgery, it is necessary to resect the whole or part of the lateral mass (Huang et al. 2017). In addition, primary spinal tumors often directly involve the lateral mass, and their treatment even requires total en bloc spondylectomy (including the vertebral body, lateral mass, lamina, transverse process, and other structures). Moreover, infection and trauma may lead to bone destruction of lateral masses. After lateral mass destruction of >50%, cervical stability decreases significantly (Cusick et al. 1988; Zdeblick et al. 1992; Voo et al. 1997).