• Title/Summary/Keyword: Cervical Spinal Cord

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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography

  • Oichi, Yuki;Hanakita, Junya;Takahashi, Toshiyuki;Minami, Manabu;Kawaoka, Taigo;Funakoshi, Yusuke;Kawauchi, Takeshi;Ohtake, Yasufumi
    • Neurospine
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    • v.15 no.4
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    • pp.388-393
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    • 2018
  • Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

Using the PNF Approach to Improve Respiratory Function in Patients with Cervical Spinal Cord Injuries (고유수용성촉진법을 이용한 호흡운동이 경수 손상환자의 호흡기능에 미치는 영향 : 증례보고)

  • Song, Gui-Bin;Kim, Jung-Bin
    • PNF and Movement
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    • v.12 no.2
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    • pp.115-121
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    • 2014
  • Purpose: The study aimed to examine the influence of PNF direct and indirect breathing treatments for patients with cervical spinal cord injuries who had breathing problems. Methods: For each cervical spinal cord patient, force vital capacity (FVC), peak expiratory flow, maximum phonation time (MPT), rib cage width, and VAS were measured pre-intervention and four weeks after post-intervention. The indirect method and the direct method were used for interventions. We treated patients with the indirect method using scapular anterior depression pattern, bilateral extensor pattern with rhythmic initiation, and a combination of isotonic. We treated patients with the direct method, applying pressure on the sternum and using rhythmic initiation (hold relax and stretch reflex) for the rib cage. Training occurred for 50 minutes a day and three days per week for four weeks. Results: FVC, MPT, peak expiratory flow, and rib cage width were increased and decreased at the VAS point for rolling after treatment. Conclusion: Patients with cervical spinal cord injuries who had breathing problems felt uncomfortable when they had conversations on a couch. We found that PNF direct and indirect treatments improved rib cage width and breathing functions of patients with cervical spinal cord injuries.

Distribution of Neurons in the Lateral Reticular Nucleus Projecting to Cervical, Thoracic, and Lumbar Segments , of the Spinal Cord in the Rat

  • Lee, Hyun Sook
    • Animal cells and systems
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    • v.4 no.4
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    • pp.353-359
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    • 2000
  • Location of the neurons in the lateral reticular nucleus projecting to dorsal horn of the cervical, thoracic, or lumbar spinal cord was investigated in the rat using the technique of retrograde transport of horseradish peroxidase. The projection was bilateral with ipsilateral predominance. Neurons projecting to the cervical spinal cord were located near the medial, dorsal, and lateral perimeter of the magnocellular division of the lateral reticular nucleus, whereas cells projecting to the thoracic and lumbar spinal cord were localized in the medial and dorsal boundaries of the magnocellular division. The labeled neurons were distinctly multipolar in shape and measured approximately 10-15 $\mu m$ in their greatest transverse diameter. A few neurons were also observed in the subtrigeminal nucleus, whereas few cells were in the parbocellular division. These observations provide an anatomical substrate for the functional implication of the lateral reticular nucleus in the regulation of spinal nociceptive transmission and vascular hemodynamics via the descending pathway into the spinal cord.

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High-Level Cervical Spinal Cord Stimulation Used to Treat Intractable Pain Arising from Transverse Myelitis Caused by Schistosomiasis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.151-154
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    • 2010
  • The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.

Finite Element Modeling of the Rat Cervical Spine and Adjacent Tissues from MRI Data (MRI 데이터를 이용한 쥐의 경추와 인접한 조직의 유한요소 모델화)

  • Chung, Tae-Eun
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.6
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    • pp.436-442
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    • 2012
  • Traumatic loading during car accidents or sports activities can lead to cervical spinal cord injury. Experiments in spinal cord injury research are mainly carried out on rabbit or rat. Finite element models that include the rat cervical spinal cord and adjacent soft tissues should be developed for efficient studies of mechanisms of spinal cord injury. Images of a rat were obtained from high resolution MRI scanner. Polygonal surfaces were extracted structure by structure from the MRI data using the ITK-SNAP volume segmentation software. These surfaces were converted to Non-uniform Rational B-spline surfaces by the INUS Rapidform rapid prototyping software. Rapidform was also used to generate a thin shell surface model for the dura mater which sheathes the spinal cord. Altair's Hypermesh pre-processor was used to generate finite element meshes for each structure. These processes in this study can be utilized in modeling of other biomedical tissues and can be one of examples for reverse engineering on biomechanics.

Evaluation of computed tomographic and radiographic myelography in normal miniature pigs

  • Choi, Mihyun;Lee, Hyeyeon;Kim, Mieun;Kim, Junyoung;Lee, Namsoon;Chang, Jinhwa;Jung, Joohyun;Choi, Mincheol
    • Korean Journal of Veterinary Research
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    • v.50 no.1
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    • pp.37-42
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    • 2010
  • Evaluation of the myelography was studied in miniature pigs. Radiographs and computed tomographic (CT) images of the whole spine were obtained at clinically healthy twelve miniature pigs of 4 (8.7-10 kg) and 12 (26-31 kg) months. The assessments of the spinal cord were made in accordance with the Pavlov's method and compared area ratio [at spinal cord (SC), vertebral canal (VC) and vertebral body (VB)]. The Pavlov's ratio in the cervical spine was significant larger than that of thoracolumbar in radiographic myelography. On CT myelography, the area of the spinal cord had a significant difference between the cervical and thoracolumbar spine. Among the cervical spine, the ratios of spinal cord and vertebral body (SC : VB), vertebral canal and vertebral body (VC : VB) were minimum at the level of 4th cervical spine in both ages, while maximum at the level of 6th cervical spine in both months. In case of lumbar spine, the ratios of spinal cord and vertebral body (SC : VB) were the largest at the level of 4th lumbar spine in 4 months and at the level of 3rd lumbar spine in 12 months. In addition, the ratio of spinal cord and vertebral body (SC : VB) of the cervical spinal cord was significant lower at 4 months but the lumbar spinal cord showed lower pattern at 12 months old miniature pigs.

Acute Hydrocephalus Following Cervical Spinal Cord Injury

  • Son, Seong;Lee, Sang Gu;Park, Chan Woo;Kim, Woo Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.145-147
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    • 2013
  • We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.

Anterior Surgical Approach in Recurrent Cervical Neurenteric Cyst - Case Report - (재발한 경추 신경장성 낭종의 전방경유 치험 - 증 례 보 고 -)

  • Bae, Kwang Ju;Kim, Il-Man
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1258-1261
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    • 2000
  • Intraspinal neurenteric cyst is rare congenital lesion derived from disorder of notochord formation. Most of these are located ventral to the spinal cord and conventional posterior approach is considered to be effective method as initial treatment modality. This cyst can recur, but the risk of reccurence after partial removal through long term follow-up has not been determined. We experienced one case of cervical neurenteric cyst which recurred after partial removal through laminectomy. The magnetic resonance imaging and postmyelography computerized tomography revealed an intradural extramedullary cystic lesion anterior to the cervical cord at the fifth cervical vertebra level. We performed anterior cervical corpectomy and cyst was totally removed. The patient's neurological symptom was improved postoperatively. Neurenteric cyst located ventrally to the cervical spinal cord should be removed through anterior route for direct visualization of the relationship between the cyst wall and the spinal cord.

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Intramedullary Sarcoidosis Presenting with Delayed Spinal Cord Swelling after Cervical Laminoplasty for Compressive Cervical Myelopathy

  • Kwon, Du Ho;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.436-440
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    • 2014
  • Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis.