Database : MEDLINE
Search on : spinal and cord and compression [Words]
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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 / 16385 MEDLINE  
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[PMID]: 29515730
[Au] Autor:Okyere I; Lamina A; Owusu B
[Ad] Address:Cardiothoracic and Vascular Surgeon, Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital,Kumasi, Ghana.
[Ti] Title:Full median sternotomy approach for treatment of upper thoracic vertebral tuberculosis in a developing country: case report and short literature review.
[So] Source:Pan Afr Med J;28:112, 2017.
[Is] ISSN:1937-8688
[Cp] Country of publication:Uganda
[La] Language:eng
[Ab] Abstract:Direct anterior approach to the cervicothoracic spine (C7-T4) poses a technical challenge in neurosurgery, due to the presence of important neurovascular structures anterior to the cervicothoracic junction (CTJ). Median Sternotomy approach is a surgical option that allows for direct anterior exposure of the lower cervical and upper thoracic vertebrae. We report the first case from Ghana, West Africa of a young man who developed post-tuberculosis osteomyelitis of upper thoracic (T1-2) vertebrae with cord compression after spinal tuberculosis in childhood. He underwent a full median Sternotomy for Anterior Decompression and Fusion of C7-T2 with autologous iliac crest bone graft. We detail our operative procedure and review the relevant literature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.11604/pamj.2017.28.112.12948

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[PMID]: 29506496
[Au] Autor:Yon DK; Ahn TK; Shin DE; Kim GI; Kim MK
[Ad] Address:Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
[Ti] Title:Extragonadal germ cell tumor of the posterior mediastinum in a child complicated with spinal cord compression: a case report.
[So] Source:BMC Pediatr;18(1):97, 2018 Mar 05.
[Is] ISSN:1471-2431
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Germ cell tumors (GCTs) in children are rare neoplasms with diverse pathological findings according to the site and age of presentation. The most common symptoms in children with mediastinal GCTs, which are nonspecific, are dyspnea, chest pain, cough, hemoptysis, vena cava occlusion syndrome, and fatigue/weakness. Because of these nonspecific symptoms, it is difficult to suspect a mediastinal mass. A posterior mediastinal tumor causing spinal cord compression is an important example of an oncologic emergency arising from a neurogenic tumor. CASE PRESENTATION: Children with posterior mediastinum GCTs can be easily mistaken as having a neurogenic tumor because of site of tumor origin. We treated our 7-year-old patient with emergency decompression surgery and high-dose steroid pulse therapy to prevent secondary injury to the spinal cord. Primary injury was a result of spinal cord compression due to the initial manifestation of GCT in the posterior mediastinum. Cisplatin-based chemotherapy was also administered. The patient was followed up regularly for 3 years and is undergoing rehabilitation without any signs of recurrence. CONCLUSIONS: We present an extremely rare case of a child with paraparesis caused by extradural spinal cord compression as the initial manifestation of GCT in the posterior mediastinum. The child was treated with emergency decompression surgery and high-dose pulse steroid therapy to prevent secondary injury to the spinal cord.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1186/s12887-018-1070-6

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[PMID]: 29517765
[Au] Autor:Eisengart JB; Rudser KD; Xue Y; Orchard P; Miller W; Lund T; Van der Ploeg A; Mercer J; Jones S; Mengel KE; Gökce S; Guffon N; Giugliani R; de Souza CFM; Shapiro EG; Whitley CB
[Ad] Address:Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
[Ti] Title:Long-term outcomes of systemic therapies for Hurler syndrome: an international multicenter comparison.
[So] Source:Genet Med;, 2018 Mar 08.
[Is] ISSN:1530-0366
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PurposeEarly treatment is critical for mucopolysaccharidosis type I (MPS I), justifying its incorporation into newborn screening. Enzyme replacement therapy (ERT) treats MPS I, yet presumptions that ERT cannot penetrate the blood-brain barrier (BBB) support recommendations that hematopoietic cell transplantation (HCT) treat the severe, neurodegenerative form (Hurler syndrome). Ethics precludes randomized comparison of ERT with HCT, but insight into this comparison is presented with an international cohort of patients with Hurler syndrome who received long-term ERT from a young age.MethodsLong-term survival and neurologic outcomes were compared among three groups of patients with Hurler syndrome: 18 treated with ERT monotherapy (ERT group), 54 who underwent HCT (HCT group), and 23 who received no therapy (Untreated). All were followed starting before age 5 years. A sensitivity analysis restricted age of treatment below 3 years.ResultsSurvival was worse when comparing ERT versus HCT, and Untreated versus ERT. The cumulative incidences of hydrocephalus and cervical spinal cord compression were greater in ERT versus HCT. Findings persisted in the sensitivity analysis.ConclusionAs newborn screening widens treatment opportunity for Hurler syndrome, this examination of early treatment quantifies some ERT benefit, supports presumptions about BBB impenetrability, and aligns with current guidelines to treat with HCT.GENETICS in MEDICINE advance online publication, 8 March 2018; doi:10.1038/gim.2018.29.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1038/gim.2018.29

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[PMID]: 29517672
[Au] Autor:Amano E; Ozaki K; Egawa S; Suzuki M; Hirai T; Ishibashi S; Ohkubo T; Yoshii T; Okawa A; Yokota T
[Ad] Address:Department of Neurology and Neurological Science.
[Ti] Title:Dynamic spinal compression revealed by computed tomography myelography in overshunting-associated myelopathy: A case report.
[So] Source:Medicine (Baltimore);97(10):e0082, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: OSAM is a rare ventriculoperitoneal (VP) shunt complication where cervical spinal cord compression by epidural venous plexus engorgement is caused by cerebrospinal fluid (CSF) overdrainage. Symmetrically indented deformity of the upper cervical spinal cord and surrounding epidural venous engorgement are characteristic radiological findings. Both of them are typically detected on magnetic resonance imaging (MRI) and enhanced computed tomography (CT). PATIENT CONCERNS: The 77-year-old man who underwent the placement of a VP shunt without an antisiphon device to treat post-subarachnoid hemorrhage (SAH) hydrocephalus presented with progressive quadriplegia 10 years postoperatively. DIAGNOSIS: MRI revealed a symmetrically indented spinal cord from the craniocervical junction (CCJ) to the C2 level and enhanced CT showed the epidural venous engorgement, which were characteristic radiological findings of overshunting-associated myelopathy (OSAM). However, MRI atypically failed to detect the engorged epidural vein and showed no compressive lesion around the spinal cord. INTERVENTION: In order to reveal how the cervical spinal cord was deformed and compressed by engorged epidural vein, CT myelography was performed. OUTCOMES: CT myelography proved that the epidural vein dynamically engorged and compressed the cervical spinal cord immediately after rotation and extension of the neck. LESSONS: CT myelography combined with neck rotation and extension revealed the dynamic change of the epidural venous engorgement, and is useful for evaluation and diagnosis of OSAM especially when epidural venous engorgement was not detectable on MRI.
[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.0000000000010082

  6 / 16385 MEDLINE  
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[PMID]: 29517670
[Au] Autor:Li X; Qi S; Jiao Y; Gao J; Du H
[Ad] Address:Department of Gastroenterology.
[Ti] Title:A case report of primary central nervous system lymphoma with intestinal obstruction as the initial symptom.
[So] Source:Medicine (Baltimore);97(10):e0080, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Primary central nervous system lymphoma (PCNSL) with initial manifestations of constipation and intestinal obstruction (IO) is rare. PATIENT CONCERNS: A 50-year-old Chinese male patient was admitted to the gastroenterology department due to constipation and abdominal distention for 8 days. He had experienced intermittent back pain for 3 years prior to admission. Based on abdominal radiography, he was initially diagnosed with IO and treated with meal restriction and enemas. However, his symptoms worsened, and progressive lower limb weakness was observed. DIAGNOSES: A colonoscopy was inconclusive due to the IO. Computed tomography and magnetic resonance imaging revealed space-occupying lesions near centrums 9-11 of the thoracic vertebrae. The patient underwent spinal decompression surgery, and pathologic examination led to a diagnosis of PCNSL (diffuse large B cell lymphoma). OUTCOMES: The symptoms of the IO improved postoperatively, and the patient partially recovered his lower limb muscle strength. He returned to his homeland for chemotherapy. LESSONS: IO can be an initial, unspecific symptom of spinal cord compression in patients with PCNSL.
[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.0000000000010080

  7 / 16385 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

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[PMID]: 29514154
[Au] Autor:Bouty A; Dobremez E; Harper L; Harambat J; Bouteiller C; Zaghet B; Wolkenstein P; Ducassou S; Lefevre Y
[Ad] Address:Department of Paediatric Urology, Royal Children's Hospital, Melbourne, Victoria, Australia.
[Ti] Title:Bladder Dysfunction in Children with Neurofibromatosis Type I: Report of Four Cases and Review of the Literature.
[So] Source:Urol Int;, 2018 Mar 07.
[Is] ISSN:1423-0399
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:AIM: Neurofibromatosis type 1 (NF1) is a rare autosomal dominant disorder. Malignant transformation into malignant peripheral nerve sheath tumors (MPNST) can occur. However, urinary tract involvement is rare. We report 4 cases of NF1 with bladder dysfunction. METHODS: A retrospective single center analysis of 4 patients was conducted over a 17-year period, focusing on urinary tract involvement. RESULTS: NF1 was diagnosed at a median of 16.5 months (4-36) and urinary involvement occurred at a median of 5.25 years (4-9) after diagnosis. Bladder dysfunction was due to spinal cord compression in 2 cases, bladder invasion in 1 case, and cerebral lesions in 1 case. Malignant transformation of neurofibromas into MPNST occurred in 2 patients. Mechanisms of urinary involvement in NF1 are diverse and no pre-established protocol of management and follow-up exists. CONCLUSION: Although rare, dysfunction of the bladder can arise in NF1 and innovative strategies then need to be considered. This is best achieved with the help of a multidisciplinary team and a national reference center when available.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1159/000487193

  9 / 16385 MEDLINE  
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[PMID]: 29505753
[Au] Autor:Lee SF; Wong FCS; Tung SY
[Ad] Address:Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong. Electronic address: leesfm@ha.org.hk.
[Ti] Title:No Ordinary Back Pain: Malignant Spinal Cord Compression.
[So] Source:Am J Med;, 2018 Mar 02.
[Is] ISSN:1555-7162
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  10 / 16385 MEDLINE  
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[PMID]: 29429912
[Au] Autor:Raje N; Terpos E; Willenbacher W; Shimizu K; García-Sanz R; Durie B; Legiec W; Krejcí M; Laribi K; Zhu L; Cheng P; Warner D; Roodman GD
[Ad] Address:Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Boston, MA, USA. Electronic address: NRAJE@mgh.harvard.edu.
[Ti] Title:Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study.
[So] Source:Lancet Oncol;19(3):370-381, 2018 Mar.
[Is] ISSN:1474-5488
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Multiple myeloma is characterised by monoclonal paraprotein production and osteolytic lesions, commonly leading to skeletal-related events (spinal cord compression, pathological fracture, or surgery or radiotherapy to affected bone). Denosumab, a monoclonal antibody targeting RANKL, reduces skeletal-related events associated with bone lesions or metastases in patients with advanced solid tumours. This study aimed to assess the efficacy and safety of denosumab compared with zoledronic acid for the prevention of skeletal-related events in patients with newly diagnosed multiple myeloma. METHODS: In this international, double-blind, double-dummy, randomised, active-controlled, phase 3 study, patients in 259 centres and 29 countries aged 18 years or older with symptomatic newly diagnosed multiple myeloma who had at least one documented lytic bone lesion were randomly assigned (1:1; centrally, by interactive voice response system using a fixed stratified permuted block randomisation list with a block size of four) to subcutaneous denosumab 120 mg plus intravenous placebo every 4 weeks or intravenous zoledronic acid 4 mg plus subcutaneous placebo every 4 weeks (both groups also received investigators' choice of first-line antimyeloma therapy). Stratification was by intent to undergo autologous transplantation, antimyeloma therapy, International Staging System stage, previous skeletal-related events, and region. The clinical study team and patients were masked to treatment assignments. The primary endpoint was non-inferiority of denosumab to zoledronic acid with respect to time to first skeletal-related event in the full analysis set (all randomly assigned patients). All safety endpoints were analysed in the safety analysis set, which includes all randomly assigned patients who received at least one dose of active study drug. This study is registered with ClinicalTrials.gov, number NCT01345019. FINDINGS: From May 17, 2012, to March 29, 2016, we enrolled 1718 patients and randomly assigned 859 to each treatment group. The study met the primary endpoint; denosumab was non-inferior to zoledronic acid for time to first skeletal-related event (hazard ratio 0·98, 95% CI 0·85-1·14; p =0·010). 1702 patients received at least one dose of the investigational drug and were included in the safety analysis (850 patients receiving denosumab and 852 receiving zoledronic acid). The most common grade 3 or worse treatment-emergent adverse events for denosumab and zoledronic acid were neutropenia (126 [15%] vs 125 [15%]), thrombocytopenia (120 [14%] vs 103 [12%]), anaemia (100 [12%] vs 85 [10%]), febrile neutropenia (96 [11%] vs 87 [10%]), and pneumonia (65 [8%] vs 70 [8%]). Renal toxicity was reported in 85 (10%) patients in the denosumab group versus 146 (17%) in the zoledronic acid group; hypocalcaemia adverse events were reported in 144 (17%) versus 106 (12%). Incidence of osteonecrosis of the jaw was not significantly different between the denosumab and zoledronic acid groups (35 [4%] vs 24 [3%]; p=0·147). The most common serious adverse event for both treatment groups was pneumonia (71 [8%] vs 69 [8%]). One patient in the zoledronic acid group died of cardiac arrest that was deemed treatment-related. INTERPRETATION: In patients with newly diagnosed multiple myeloma, denosumab was non-inferior to zoledronic acid for time to skeletal-related events. The results from this study suggest denosumab could be an additional option for the standard of care for patients with multiple myeloma with bone disease. FUNDING: Amgen.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review


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