Journal of neurosurgery
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It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of acute cervical cord injury in which fracture or dislocation of the cervical spine has not occurred. ⋯ Degenerative changes of the cervical spine and developmental narrowing of the spinal canal are important preexisting factors. In the acute stage MR imaging is useful to understand the level and mechanisms of spinal cord injury. The fact that a significant number of the patients were found to have spinal cord compression despite the absence of bone injuries of the spinal column indicates that future investigations into surgical treatment of this type of injury are necessary.
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Journal of neurosurgery · Apr 2001
Clinical analysis and prognostic study of ossified ligamentum flavum of the thoracic spine.
A variety of factors may affect surgery-related outcome in patients with ossification of the ligamentum flavum (OLF) of the thoracic spine. The aim of this study was to determine these factors on the basis of preoperative clinical and radiological findings. ⋯ Thoracic OLF frequently develops in the lower-thoracic spine in middle-aged men, and it is complicated by various spinal lesions in many cases. Early diagnosis and treatment are important for understanding the clinical symptoms and imaging diagnosis because the present findings suggest that a delay in diagnosis and treatment correlates with the functional prognosis postoperatively.
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Journal of neurosurgery · Apr 2001
Surgical and endovascular treatment of spinal dural arteriovenous fistulas: long-term disability assessment and prognostic factors.
The authors assessed clinical outcomes of patients with treated spinal dural arteriovenous fistulas (DAVFs) and investigated prognostic factors. ⋯ Spinal DAVF treatment significantly improved patients' mean gait disability score by almost one grade at last follow up. The mean micturition disability score was not significantly improved, unless treatment was performed within 13 months of symptom onset. Longer and more uniform follow-up study is needed to determine if improved and stabilized clinical outcomes are sustained.
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Journal of neurosurgery · Apr 2001
Case ReportsSubarachnoid-pleural fistula treated with noninvasive positive-pressure ventilation. Case report.
The authors describe the case of a 24-year-old man who underwent an L-1 corpectomy for spinal decompression and stabilization following an injury that caused an L-1 burst fracture. Postoperatively, an accumulation of spinal fluid developed in the pleural space, which was refractory to 1 week of thoracostomy tube drainage and lumbar cerebrospinal fluid (CSF) diversion. ⋯ After 5 days, the CSF collection in the pleural space resolved. Use of a bi-level PAP mask represents a safe, noninvasive method of reducing the negative intrathoracic pressure that promotes CSF leakage into the pleural cavity and may be a useful adjunct in the treatment of subarachnoid-pleural fistula.
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Journal of neurosurgery · Apr 2001
Long-lasting analgesic effect of radiofrequency treatment of the lumbosacral dorsal root ganglion.
The authors conducted a study to establish the benefit of radiofrequency (RF) treatment of the lumbosacral dorsal root ganglion (DRG) as a therapy to reduce symptomatic pain in patients with chronic spinal pain radiating to the leg. ⋯ The use of RF in the treatment of DRG appears to be a useful and safe therapy in patients with chronic spinal pain that radiates to the leg. The initial success rate is approximately 60%. It seems to lead to a time-limited effect on the target structure, and the mean duration of pain reduction is approximately 3.7 years. The mechanism of action remains unclear.