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[PMID]: 29524700
[Au] Autor:Tykocki T; du Plessis J; Wynne-Jones G
[Ad] Address:Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary,Newcastle upon Tyne, UK. Electronic address: ttykocki@gmail.com.
[Ti] Title:Analysis of morphometric parameters in cervical canal stenosis on neutral and dynamic magnetic resonance imaging.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: A dynamic compression injury of the cervical spinal cord is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension MRI provides information on the dynamic cervical injury. To compare morphometric parameters on neutral, flexion/extension MRI in cervical spondylotic myelopathy METHODS: Patients with cervical canal stenosis who had MRI in neutral, flexion and extension positions were retrospectively reviewed. A morphometric comparison of following parameters at compression level was performed: Spinal cord (SC) area, cerebrospinal fluid (CSF) area, CSF reserve ratio (CSF/CSF plus SC). Patients were classified according to the presence of high signal (HS) in SC and predictors of HS were calculated using logistic regression analysis. RESULTS: 55 patients, 26 men; with mean age of 57±13 were analysed. Significant difference was found in mean CSF reserve ratio between flexion and extension (0.47±0.18 vs. 0.41±0,21 p<0.05). SC area was significantly smaller in flexion (58.8±13.3 mm2) than in both neutral (66.9±22.3mm2) and extension (68.3±19.1 mm2). HS was found in 22 cases and predictors of HS were smaller SC area on extension (OR 1,46; 95%CI 1,07-1,84) and smaller CSF plus SC area on flexion (OR 1,32; 95%CI 1,06-1,45). Cut off values on ROC curve were 55mm2 for SC and 99mm2 for CSF plus SC area. CONCLUSIONS: Application of dynamic MRI in cervical stenosis reveals significant differences of both SC and CSF reserve ratio in flexion/extension and neutral positions. Patients with smaller SC area in extension and smaller CSF plus SC area in flexion have higher risk of HS on MRI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 15233 MEDLINE  
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[PMID]: 28467418
[Au] Autor:Khare S; Nick JA; Zhang Y; Galeano K; Butler B; Khoshbouei H; Rayaprolu S; Hathorn T; Ranum LPW; Smithson L; Golde TE; Paucar M; Morse R; Raff M; Simon J; Nordenskjöld M; Wirdefeldt K; Rincon-Limas DE; Lewis J; Kaczmarek LK; Fernandez-Funez P; Nick HS; Waters MF
[Ad] Address:Department of Neurology, University of Florida, Gainesville, FL, United States of America.
[Ti] Title:A KCNC3 mutation causes a neurodevelopmental, non-progressive SCA13 subtype associated with dominant negative effects and aberrant EGFR trafficking.
[So] Source:PLoS One;12(5):e0173565, 2017.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The autosomal dominant spinocerebellar ataxias (SCAs) are a diverse group of neurological disorders anchored by the phenotypes of motor incoordination and cerebellar atrophy. Disease heterogeneity is appreciated through varying comorbidities: dysarthria, dysphagia, oculomotor and/or retinal abnormalities, motor neuron pathology, epilepsy, cognitive impairment, autonomic dysfunction, and psychiatric manifestations. Our study focuses on SCA13, which is caused by several allelic variants in the voltage-gated potassium channel KCNC3 (Kv3.3). We detail the clinical phenotype of four SCA13 kindreds that confirm causation of the KCNC3R423H allele. The heralding features demonstrate congenital onset with non-progressive, neurodevelopmental cerebellar hypoplasia and lifetime improvement in motor and cognitive function that implicate compensatory neural mechanisms. Targeted expression of human KCNC3R423H in Drosophila triggers aberrant wing veins, maldeveloped eyes, and fused ommatidia consistent with the neurodevelopmental presentation of patients. Furthermore, human KCNC3R423H expression in mammalian cells results in altered glycosylation and aberrant retention of the channel in anterograde and/or endosomal vesicles. Confirmation of the absence of plasma membrane targeting was based on the loss of current conductance in cells expressing the mutant channel. Mechanistically, genetic studies in Drosophila, along with cellular and biophysical studies in mammalian systems, demonstrate the dominant negative effect exerted by the mutant on the wild-type (WT) protein, which explains dominant inheritance. We demonstrate that ocular co-expression of KCNC3R423H with Drosophila epidermal growth factor receptor (dEgfr) results in striking rescue of the eye phenotype, whereas KCNC3R423H expression in mammalian cells results in aberrant intracellular retention of human epidermal growth factor receptor (EGFR). Together, these results indicate that the neurodevelopmental consequences of KCNC3R423H may be mediated through indirect effects on EGFR signaling in the developing cerebellum. Our results therefore confirm the KCNC3R423H allele as causative for SCA13, through a dominant negative effect on KCNC3WT and links with EGFR that account for dominant inheritance, congenital onset, and disease pathology.
[Mh] MeSH terms primary: Receptor, Epidermal Growth Factor/metabolism
Shaw Potassium Channels/genetics
Spinocerebellar Degenerations/genetics
[Mh] MeSH terms secundary: Animals
CHO Cells
Cricetinae
Cricetulus
Drosophila melanogaster
Female
Humans
Male
Pedigree
Protein Transport
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (KCNC3 protein, human); 0 (Shaw Potassium Channels); EC 2.7.10.1 (Receptor, Epidermal Growth Factor)
[Em] Entry month:1709
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:IM
[Da] Date of entry for processing:170504
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0173565

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[PMID]: 28452710
[Au] Autor:Loftus PA; Wise SK; Daraei P; Baugnon K; DelGaudio JM
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.
[Ti] Title:Excavating meningoencephaloceles: A newly recognized entity.
[So] Source:Am J Rhinol Allergy;31(2):127-134, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner. OBJECTIVE: To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence. METHODS: A retrospective review was performed at a tertiary care rhinology practice to identify a subset of CSF leak patients with an excavating/canal-like skull base defect visualized radiographically on computed tomography (CT) scan or magnetic resonance imaging and/or endoscopically in the operating room. RESULTS: The cohort of patients consisted of 7 females and 1 male with an average age of 53.6 years and a self-reported race of 4:3:1 African-American:Caucasian:Indian. All patients presented with CSF rhinorrhea. The most common leak site was the cribriform and upper septum. Six of the 8 patients had multiple defects and/or progression of their skull base defects, and 5 patients required multiple and/or repeat repairs in the operating room. Seven of the 8 patients underwent a cisternogram because the excavating nature of the leaks made it difficult to identify the specific leak site on high-resolution CT scan alone. CONCLUSION: In spontaneous CSF leaks that are difficult to identify or recur soon after a proper repair, an excavating pattern should be considered. Failure to recognize this type of leak and all of its tributaries, to fully unroof the excavated bone to completely resect the meningocele, and to visualize and close the site of origin will likely result in failure and recurrence of CSF leak.
[Mh] MeSH terms primary: Cerebrospinal Fluid Leak/diagnosis
Encephalocele/diagnosis
Meningocele/diagnostic imaging
Skull Base/diagnostic imaging
Skull Base/pathology
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Cerebrospinal Fluid Leak/surgery
Encephalocele/surgery
Endoscopy
Female
Humans
Magnetic Resonance Imaging
Male
Meningocele/surgery
Middle Aged
Skull Base/surgery
Tomography, X-Ray Computed
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4413

  4 / 15233 MEDLINE  
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[PMID]: 29521698
[Au] Autor:Cho SK; Kim JS; Overley SC; Merrill RK
[Ad] Address:From the Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY.
[Ti] Title:Cervical Laminoplasty: Indications, Surgical Considerations, and Clinical Outcomes.
[So] Source:J Am Acad Orthop Surg;, 2018 Mar 07.
[Is] ISSN:1940-5480
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cervical laminoplasty was initially described for the management of cervical myelopathy resulting from multilevel stenosis secondary to ossification of the posterior longitudinal ligament. The general concepts are preservation of the dorsal elements, preservation of segmental motion, and expansion of the spinal canal via laminar manipulation. No clear evidence suggests that laminoplasty is superior to either posterior laminectomy or anterior cervical diskectomy and fusion. However, laminoplasty has its own advantages, indications, and complications. Surgeons have refined the technique to decrease complication rates and improve efficacy. Recent efforts have highlighted less invasive approaches that are muscle sparing and associated with less postoperative morbidity. Although the long-term outcomes suggest that cervical laminoplasty is safe and effective, continued research on the development of novel modifications that decrease common complications, such as C5 nerve palsy, axial neck pain, and loss of lordosis, is required.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.5435/JAAOS-D-16-00242

  5 / 15233 MEDLINE  
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[PMID]: 29520416
[Au] Autor:Yoong S; Kothari R; Brooks A
[Ad] Address:Queen's Medical Centre, Derby Rd, Nottingham, NG7 2UH, UK. susanyoong@hotmail.com.
[Ti] Title:Assessment of sensitivity of whole body CT for major trauma.
[So] Source:Eur J Trauma Emerg Surg;, 2018 Mar 08.
[Is] ISSN:1863-9941
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014. Injuries were classified as per ISS score-1 = head and neck 2 = face 3 = chest 4 = abdomen. The authors reviewed patient's electronic charts, radiological results; interventional procedure records, discharge letters and outpatient follow up documentation and referenced this with Trauma Audit and Research Network data. RESULTS: 407 patients with ISS > 15 presented to the Trauma centre during May 2012 and April 2014. Of these, 337 (82.8%) had a whole body CT scan. 246 pts were male, 91 were female. 74 (21.9%) were due to a fall from > 2 m, 41 (12.2%) due to a fall from < 2 m, 208 (61.7%) were due to motor vehicle crashes, 1 (0.3%) due to a blast injury, 5 (1.5%) due to blows, and 8 (2.4%) due to crush injuries. Sensitivity for Region 1 was 0.98, Region 2 = 0.98, Region 3 = 0.98 and Region 4 was 0.95. Overall sensitivity was 0.98. 15 injuries (2.4%) were not identified on initial CT (false -ve). These injuries were: colonic perforation = 1, splenic contusion = 1, pneumothorax = 1, liver laceration = 1, intracranial haemorrhage = 1, cerebral contusions = 1, spinal injuries = 7, canal haemorrhage = 1, maxilla fracture = 1. CONCLUSION: These results show that whole body CT in trauma has a high sensitivity and a low rate of missed injuries (2.4%). However, our study only evaluated a subgroup of patients with ISS > 15 and further work is required to assess the use of this investigation for all major trauma patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1007/s00068-018-0926-7

  6 / 15233 MEDLINE  
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[PMID]: 29519994
[Au] Autor:Ozturk S; Cakin H; Karabulut K; Pasahan R; Kaplan M
[Ad] Address:Department of Neurosurgery, School of Medicine, Firat University, Elazig, Turkey.
[Ti] Title:Laparoscopy in the management of lumboperitoneal shunt catheter in obese patients with pseudotumor cerebri.
[So] Source:Niger J Clin Pract;21(3):397-400, 2018 Mar.
[Is] ISSN:1119-3077
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Lumboperitoneal shunts are widely used for the treatment of patients diagnosed with pseudotumor cerebri (PTC). Obesity is a risk factor for PTC. In particular, catheter migration out of the abdominal cavity is more commonly observed in morbidly obese patients. The aim of this study was to discuss the underlying mechanisms of catheter migration and treatment modalities in morbidly obese patients with PTC. The present study included four morbidly obese patients. All cases had undergone the previous laparotomy for insertion of a distal catheter into the abdominal cavity. In three cases, migration of the distal catheter out of the abdominal cavity was observed. Migration of the proximal tip of the catheter out of the spinal canal was observed in the fourth case. In all cases, laparoscopic revision surgeries were performed. During revision surgery, a catheter tunnel was prepared immediately over the external oblique fascia to obtain the shortest and deepest tunnel, and a distal catheter was inserted by laparoscopic guidance posterolaterally, i.e., through the postaxillary line. None of the patients developed any complications during the follow-up period of 4 years. We recommend laparoscopic insertion of distal catheters through the postaxillary line into the abdominal cavity using as short a catheter route as possible. Thus, tension and traction on the catheter due to abdominal movements can be decreased in morbidly obese patients to prevent catheter migration.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.4103/njcp.njcp_50_17

  7 / 15233 MEDLINE  
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[PMID]: 29517667
[Au] Autor:Meng Y; Wang X; Wang B; Wu T; Liu H
[Ad] Address:Department of Orthopedic Surgery, West China Hospital, Sichuan University, China.
[Ti] Title:Aggravation and subsequent disappearance of cervical disc herniation after cervical open-door laminoplasty: A case report.
[So] Source:Medicine (Baltimore);97(10):e0068, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Cervical open-door laminoplasty can enlarge the volume of the cervical vertebral canal and thus has become an effective and safe treatment for multilevel cervical disc herniation and cervical stenosis. Some post-surgery complications exist, such as reduction of cervical alignment and local kyphosis. However, aggravation of cervical disc herniation at the surgical level during short-term follow-up has not been discussed. Additionally, spontaneous disappearance of herniated disc pulposus is a common phenomenon in the lumbar region but is relatively rare in the cervical region. PATIENT CONCERNS: A 42-year-old female presented with a 7-year history of neck pain and a 2-year history of paresthesia and weakness in the upper and lower limbs. The sensations and muscle strength of both upper and lower limbs were decreased. The radiological findings showed that the Pavlov ratios from C3-7 were decreased obviously. Osteophytes as well as spinal cord compression were observed at C4/5, C5/6, and C6/7. DIAGNOSES: Considering the symptoms and clinical examinations, the patient was diagnosed with cervical stenosis. INTERVENTIONS: We performed cervical open-door laminoplasty at C3-7 to enlarge the space of the cervical vertebral canal. OUTCOMES: At the 6-month post-surgery follow-up, the patient showed obvious improvement in paresthesia and weakness in the upper limbs. The cervical disc herniation at C3/4 was aggravated. However, at the 18-month follow-up, the symptoms were relieved, and the herniated cervical disc at C3/4 spontaneously disappeared without any special treatment. LESSONS: We suggest that the attachment points of deep muscles in the neck region should be carefully protected during this surgery. Patients who undergo cervical open-door laminoplasty should pay attention to their cervical position and perform neck exercises to train their neck muscles. MRI is an important imaging method to observe dynamic changes in herniated discs for patients with cervical disc herniation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000010068

  8 / 15233 MEDLINE  
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[PMID]: 29517657
[Au] Autor:Kim JK; Moon BJ; Kim SD; Lee JK
[Ad] Address:Department of Neurosurgery, Chonnam National University Hospital and Medical School Gwangju, Republic of Korea.
[Ti] Title:Minimal invasive nonfusion technique for the treatment of noncontiguous lumbar burst fractures in young age patient: A case report.
[So] Source:Medicine (Baltimore);97(10):e0009, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: In the treatment of noncontiguous lumbar burst fractures, there still remains controversy over proper surgical procedures. PATIENT CONCERNS: A 19-year-old female patient visited our hospital after fall down from 3 m high. DIAGNOSES: Initial neurologic examination revealed an incomplete spinal cord injury characterized by hypoesthesia and motor grade of 2 below the L2 segment. Lumbar computed tomography and magnetic resonance imaging demonstrated L2 and L5 burst fractures severely obliterating the spinal canal. INTERVENTIONS: She underwent emergent PSSPSF at L1-2-3 and L4-5-S1 following bilateral L1 and L4 laminotomy with reduction of bony fragments by tapping method. OUTCOMES: She was gradually recovered and able to walk with assistance two weeks after surgery. Removal of implants was performed at 12 months after surgery. Follow-up radiography showed well-preserved segmental motion and adequate decompressed spinal canal with fused fractured bony fragment. She returned to her normal daily activities without any neurologic deficits and pain. LESSONS: Noncontiguous burst fracture of the lumbar spine is an unusual injury. For the adequate management in patient with neurologic deficit, reduction of the fractured body and stabilization of vertebral column is necessary. It is also important to preserve the segmental motion in young age patients. From that point of view, temporary PSSPSF with spinal canal decompression is considered as minimal invasive surgery with significant low morbidity, providing stability with motion saving and good clinical outcome.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000010009

  9 / 15233 MEDLINE  
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[PMID]: 29516348
[Au] Autor:Kamogawa J; Kato O; Morizane T
[Ad] Address:Spine Center, Shiraishi Hospital, Matsumoto Town 1-5-9, Imabari, Ehime, 794-0041, Japan. Kamogawa58@mb.pikara.ne.jp.
[Ti] Title:Three-dimensional visualization of internal vertebral venous plexuses relative to dural sac and spinal nerve root of spinal canal stenosis using MRI.
[So] Source:Jpn J Radiol;, 2018 Mar 07.
[Is] ISSN:1867-108X
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection. Three patients with degenerative lumbar spine disease and one with cervical ossification of the posterior longitudinal ligament (OPLL) were studied with and without contrast media. As three patients underwent operations, we investigated intraoperative microscopic findings, and compared VVP images. RESULTS: Abundant components of internal VVPs were identified on MRI in correlation with neural tissues such as dura and nerve roots. CONCLUSIONS: Using 3D MRI without and with gadoteridol, we can evaluate morphological changes in VVP under degenerative spinal conditions. The MR anatomy of VVPs of the spine is important, as it has been implicated in many pathophysiological mechanisms and may also cause pitfalls in MRI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1007/s11604-018-0725-4

  10 / 15233 MEDLINE  
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[PMID]: 29425362
[Au] Autor:Kaiser R; Nasto LA; Venkatesan M; Waldauf P; Perez B; Stokes OM; Haddad S; Mehdian H; Tsegaye M
[Ad] Address:The Centre for Spinal Studies and Surgery, QMC, Nottingham University Hospitals NHS Trust, Nottingham, UK.
[Ti] Title:Time Factor and Disc Herniation Size: Are They Really Predictive for Outcome of Urinary Dysfunction in Patients With Cauda Equina Syndrome?
[So] Source:Neurosurgery;, 2018 Feb 06.
[Is] ISSN:1524-4040
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Timing of surgery and the importance of the size of disc prolapse in cauda equina syndrome (CES) remain controversial. OBJECTIVE: To investigate whether there is a relationship between postoperative urinary function, preoperative duration of neurogenic lower urinary tract dysfunction (NLUTD), and the level of canal compromise. METHODS: Seventy-one patients operated for CES were prospectively identified between 2010 and 2013. Fifty-two cases with preoperative NLUTD were included. The "Prolapse: Canal ratio" (PCR) was calculated as a proportion of cross-sectional area of disc prolapse on total cross-sectional area of spinal canal. RESULTS: Median of preoperative duration of NLUTD was 72 h (48; 132) and period from first assessment to surgery 10.5 h (7; 18.5). Urinary incontinence was seen in 46.2% of patients, 38.4% had painless retention and 15.4% had painful retention. In 38.5% of cases, urinary symptoms persisted for more than 20 mo postoperatively. There was no correlation between duration of preoperative NLUTD and urinary dysfunction persistence (P = .921). The outcome was not significantly influenced by having surgery more than the 48 h after presentation (P = .135). Preoperative incontinence persisted in 58% and painless retention in 30% of cases. The mean PCR was 0.6 ± 0.18. There was no correlation between PCR and outcome (P = .537) even after adjusting for duration of preoperative NLUTD (P = .7264). CONCLUSION: No significant correlation was demonstrated between the preoperative duration of urinary dysfunction, the size of disc herniation relative to size of spinal canal, and postoperative urinary function in a large consecutive series of patients with CES.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/neuros/nyx607


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