Articles: spinal-stenosis-congenital.
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Randomized Controlled Trial
Congenital lumbar spinal stenosis: a prospective, control-matched, cohort radiographic analysis.
Degenerative lumbar spinal stenosis manifests primarily after the sixth decade of life as a result of facet hypertrophy and degenerative disc disease. Congenital stenosis, on the other hand, presents earlier in age with similar clinical findings but with multilevel involvement and fewer degenerative changes. These patients may have subtle anatomic variations of the lumbar spine that may increase the likelihood of thecal sac compression. However, to the authors' knowledge, no quantitative studies have addressed various radiographic parameters of symptomatic, congenitally stenotic individuals to normal subjects. ⋯ Congenital lumbar stenosis has not been clearly defined radiographically. Clinically, congenitally stenotic patients present at a younger age with fewer degenerative changes and multiple levels of involvement. Radiographically, these patients have a shorter pedicular length and as a result a smaller cross-sectional spinal canal area (mean critical values of 6.5 mm and 213 mm(2) were observed, respectively). The mean critical ratios were 0.43 (2:1 AP vertebral body: pedicle length) on the lateral lumbar radiograph and 0.36 on the sagittal MRI. The altered canal anatomy resulting from a decreased pedicle length may anatomically predispose these patients to earlier complaints of symptomatic neurogenic claudication. Identification of the presence of congenital stenosis should increase the treating surgeon's awareness of the potential need for multilevel treatment.
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Review Case Reports
Cervical myelopathy and congenital stenosis from hypoplasia of the atlas: report of three cases and literature review.
Case reports of patients with cervical myelopathy to hypoplasia of the atlas. ⋯ Congenital hypoplasia of the atlas is a rare cause of cervical myelopathy. This report should broaden the radiographic differential diagnosis when seeking an explanation for the signs and symptoms of cervical myelopathy.
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The outcome of a herniated disc in patients with cervical myelopathy treated by laminoplasty without discectomy and in those treated conservatively was studied by magnetic resonance imaging. ⋯ The size of the herniated disc in cervical lesions regressed as it does in the lumbar lesions. Laminoplasty for patients with narrowed spinal canals showed favorable surgical results. Therefore, the therapeutic method for cervical disc herniation should be chosen after taking the natural history of the disc herniation into consideration.