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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Laminectomy is a procedure necessary to gain surgical access to the spinal canal. Whether just one lamina is removed or both lamina and the spinous process are to be excised depends on the location and nature of the spinous pathology (Figure 10.69). Spinal tumor removal or correction of spinal stenosis generally require a bilateral laminectomy. Decompression of a herniated disk pressing on a nerve root may require only a unilateral procedure. Whichever operation is performed, the bone is not replaced afterward, leaving a “window” of thermal conduction from the circulating cerebrospinal fluid to the skin above. This postoperative increased warmth over the spine will appear in the midline in the case of bilateral laminectomy, and just lateral to the midline when a unilateral laminectomy has been performed (Figure 10.70).
Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Cauda equina syndromes usually occur as a result of compression of the nerve roots in the lumbosacral spine distal to the conus medullaris, such as tumors of the lumbosacral spine. The symptoms associated with a lumbosacral spinal tumor typically include urinary incontinence. Pain worsens with recumbency and is relieved by walking; pain is usually more intense at night and may awaken the patient from sleep (Alvarez and Russell 1998). Most patients have severe pain in the lower back and buttocks, which may travel down the posterior thigh, passing the knee, to the calf and foot, as well as numbness and tingling in the “saddle area” (the rectal and genital areas and the inner thighs).
Pediatric Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Rajiv R. Iyer, Nir Shimony, Mohammad Hassan A. Noureldine, Eric Bouffet, George I. Jallo
Like in other clinical scenarios, a thorough history and physical examination should be performed to establish a clear sense of the behavior and clinical consequences of a spinal tumor. IMSCTs most commonly arise in the cervical and thoracic spine, resulting in associated clinical symptoms. Approximately 60% of astrocytomas in children will develop in the cervical and cervicothoracic junction. For unclear reasons, thoracic, lumbosacral, conus, and filum lesions are rarer. Different IMSCTs have variable locations within the spinal cord; astrocytomas tend to be more eccentric, involving the white matter of the spinal cord, while ependymomas tend to arise from the central canal.
Biomechanical effect of posterior ligament repair in lamina repair surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Kaixiang Jin, Yuanjun Zhu, Nan Li, Yinghui Li, Yan Yao, Zhongjun Mo, Yubo Fan
Spinal tumours including primary and secondary tumours occurs in various tissues such as nerve root, blood vessel, spinal cord, and so on. There was about 9.7 patient with spinal tumour in every one million (Duetzmann et al. 2015). Cervical laminectomy has usually been applied in treating cervical spinal cord tumour (Hirabayashi et al. 1983). However, the incidence rate of spinal instability following laminectomy was reportedly 20% in adults (Katsumi et al. 1989) and up to 45% in children (Yeh et al. 2001), since the posterior structures, including interspinous ligament, supraspinous ligament, flaval ligament and spinous process, was excised in laminectomy (Haddadi and Ganjeh Qazvini 2016). Excision of posterior structures increased the range of motion of anterior vertebrae, which induced declination and torsion of vertebrae, resulting in spinal instability (Kotani et al. 1994; McGirt et al. 2010; Wang et al. 2021). The previous studies reported the increase in ROM in laminectomies, which was likely to result in developing spinal kyphosis or other deformity (Goel et al. 1988; Saito et al. 1991; Hong-Wan et al. 2004; Ogden et al. 2009; Tadepalli et al. 2011; Xie et al. 2013; Ahmed et al. 2014; Kode et al. 2014). Spinal deformity following laminectomy would compress spinal cord or nerve root, subsequently result neurological symptoms as back pain and radiculopathy.
The impact of body mass index and height on risk for primary tumours of the spinal cord, spinal meninges, spinal and peripheral nerves in 1.7 million norwegian women and men: a prospective cohort study
Published in Acta Oncologica, 2022
Anamaria Gheorghiu, Cathrine Brunborg, Tom B. Johannesen, Eirik Helseth, John A. Zwart, Markus K. H. Wiedmann
Mechanisms underlying the association between body height and CNS tumour risk are still unclear. The insulin-like growth factor (IGF) system is an important determinant for body height and has been linked to the development of different cancers (e.g., melanoma, breast, lymphoma, thyroid) [17,18]. Circulating levels of IGFs are consistently higher in taller adults, although highest during puberty [18,19]. IGF binding proteins are involved in neuronal development, but are also overexpressed in high grade glioma and a biomarker for aggressive behaviour [20–22]. It has further been shown that IGF-II is overexpressed in ependymoma and that the production of high amounts of IGF-II may promote tumour progression [23,24]. Further assessment of the IGF system in spinal tumour subtypes may help to elucidate the hypothesis of causality between height, increased tumour risk and IGF pathways and should be considered in future studies [22].
Safety and efficacy of tranexamic acid in spinal canal tumors: a retrospective cohort study
Published in British Journal of Neurosurgery, 2020
Heng Zhu Zhang, Lun Dong, Huan Ming Wang, Fei Hu, Qiang Shao, Xu Chen, Lang Chen
All operations were performed by the same surgical team. Spinal tumor resection was performed in all cases with the patient under general anesthesia. Patients were in prone position. After routine disinfection, a C-arm X-ray machine was positioned over the lesional segment. A median, longitudinal, straight, skin incision was performed at the lesional segment and extending one segment just higher and one just lower than the lesional segment. The skin and subcutaneous tissue were then separated to locate the spinous process. Muscles along the side of the spinous process were separated using monopolar electrical cautery and were held on both sides with retractors to expose the vertebral lamina where the tumor was located. After careful hemostasis, a milling cutter was used to remove the vertebral lamina. The tumor was then separated and removed under microscopic guidance. Hemostasis was again ensured, and the endorachis was sutured, covering the artificial meninges and patching any residual leakage. The spinal lamina was fixed with titanium nails and a titanium connector, and a drainage tube was placed outside the endorachis. Each layer of tissue was sutured. Intraoperative blood loss was measured according to the amount of fluid pumped in minus the amount of fluid that was flushed.