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At least 775 records · Page 43Linked to original sources
PubMed1987

[Propofol versus methohexital in the surgery of the spinal canal].

The aim of this study was to compare the quality of postanaesthetic recovery after anaesthesia with methohexitone (M) or with propofol (P). Thirty patients undergoing spinal surgery were randomly assigned to either group. The induction dose was 2 mg . kg-1 for both M and P. Anaesthesia was maintained by continuous infusion. The rate was 0.15 mg . kg-1 . min-1 for P and 0.07 mg . kg-1 . min-1 for M. Analgesia was obtained with fentanyl with the same doses in both groups. The maintenance doses were subsequently decreased by 50 and 75% of the initial values. This work compared the quality induction and the criteria of recovery (Aldrete score, Newman test). In two patients in each group, sensory evoked potentials (SEP) were recorded to monitor neurological integrity. The quality of induction was similar in both groups. Awakening was significantly more rapid in group P. The SEP were much decreased in group P, whilst there were few changes in group M. Monitoring of medullar integrity is mandatory in spinal surgery, requiring a rapid recovery. This objective was obtained with shorter delays in patients anaesthetized with propofol than in those who had received methohexitone. However, the former, at the doses used, seemed to depress the SEP.

Adult↗
PubMed1994

[Clinical value of the posterolateral approach, supplemented with pedicle excision of the arch, to the anterior wall of the spinal canal within the thoracolumbar (Th11-L1) and lumbar spine].

UNLABELLED: The author validates clinically his own lateral approach to the lumbosacral (Th11-L1) and lumbar spine. In this approach an enlargement of the intervertebral foramen is achieved by the partial excision of adjacent pedicles or excision of one or several pedicles. The access to the anterior canal wall is gained in this manner. This surgical approach has been used in 48 patients with neurological injury (spinal cord, conus medullaris, cauda equina or the roots). An active tuberculosis was the causative factor in 12 cases, the sequelae of tuberculous infection in 10 cases, infection in one case, degenerative disc disease in 12 cases, osteochondrosis in 2 cases, nucleus pulposus prolapse into the root canal in 3 cases, developmental defect of the vertebrae in 2 cases, primary or metastatic tumors in 6 cases. These conditions resulted in plegia (3 cases), spastic paresis (3 cases), caudal paresis (5 cases), root paresis (12 cases) and root syndrome (24 cases). This approach provided possibility to recognize the pathology accurately and decompress the roots. Neurological results achieved were most advantageous since in 41 cases neurological symptoms subsided entirely, in 2 cases an improvement was noted, in 2 cases partial improvement and no improvement occurred in 3 cases only. IN CONCLUSION: this approach offers good visualization of the anterior part of the spinal canal and allows for efficient decompression rendering good clinical results.

Adolescent↗
PubMed1998

The effect of translation of the C1-C2 on the spinal canal.

The stability of the atlantoaxial articulation depends fundamentally on the integrity of the odontoid process and the ligaments. Ligament stability mostly is maintained by two ligaments: the transverse ligament and the alar, apical ligaments. Failure of the transverse ligament can result in anterior translation of the atlas on the axis. The anteroposterior diameter of the ring of the atlas is approximately 3 cm. The spinal cord and the odontoid process are each approximately 1 cm in diameter, approximately 1/3 the diameter of the ring. According to Steel's rule of thirds, the remaining centimeter of free space allows for some degree of pathologic displacement. The current anatomic study showed that the space available for the spinal cord was limited. The sagittal diameter C1-C2 canal is 18.71 +/- 2.88 mm (excluding 10 mm thickness of the dens and 2.91 +/- 0.69 mm thickness of transverse ligament), with the spinal cord occupying 7.73 +/- 0.87 mm of the available space. Space available for spinal cord at the level of the atlas is 3.44 +/- 1.19 mm plus 1.01 +/- 0.20 mm space anterior to the cord (anterior epidural space) and 5.64 +/- 2.22 mm space posterior to the cord (posterior epidural space), which is approximately in agreement with the normal diameter by Steel's rule of thirds.

Aged↗
PubMed2005

Spinal canal narrowing during simulated frontal impact.

Between 23 and 70% of occupants involved in frontal impacts sustain cervical spine injuries, many with neurological involvement. It has been hypothesized that cervical spinal cord compression and injury may explain the variable neurological profile described by frontal impact victims. The goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to quantify canal pinch diameter (CPD) narrowing during frontal impact and to evaluate the potential for cord compression. The biofidelic model and a sled apparatus were used to simulate frontal impacts at 4, 6, 8, and 10 g horizontal accelerations of the T1 vertebra. The CPD was measured in the intact specimen in the neutral posture (neutral posture CPD), under static sagittal pure moments of 1.5 Nm (pre-impact CPD), during dynamic frontal impact (dynamic impact CPD), and again under static pure moments following each impact (post-impact CPD). Frontal impact caused significant (P<0.05) dynamic CPD narrowing at C0-dens, C2-C3, and C6-C7. The narrowest dynamic CPD was observed at C0-dens during the 10 g impact and was 25.9% narrower than the corresponding neutral posture CPD. Interpretation of the present results indicate that the neurological symptomatology reported by frontal impact victims is most likely not due to cervical spinal cord compression. Cord compression due to residual spinal instability is also not likely.

Acceleration↗
PubMed1988

Enterogenous cyst in the cervical spinal canal. Case report.

The case of an 11-year-old Japanese girl with an intradural and extramedullary enterogenous cyst is presented. A mass giving a low-intensity signal in comparison with the spinal cord was demonstrated on magnetic resonance imaging. Histologically, the diagnosis was confirmed on specimens stained with periodic acid-Schiff, alcian blue, mucicarmine, and immunohistochemical staining of carcinoembryonic antigen, and by electron microscopy.

Carcinoembryonic Antigen↗
PubMed2005

Primitive neuroectodermal tumours (PNETs) located in the spinal canal; the relevance of classification as central or peripheral PNET : case report of a primary spinal PNET occurrence with a critical literature review.

Intraspinal location of central PNET (cPNET) is very rare. We present a case, critically review all publications of primary intraspinal cPNET occurrence and discuss tendencies in clinical presentation. In several previous attempts to summarise, authors often confused cPNET with peripheral PNET (pPNET). cPNET and pPNET are different entities with different immunohistochemical profiles and genetic backgrounds. Clinically, they are both aggressive tumours, but exhibit different characteristics in their local manifestation and metastatic spread. Survival rates are quite similar provided that treatment is applied according to the established protocols. Protocols in cPNET treatment differ from those for pPNET as regards the order of the treatment sub-modalities, specific chemotherapeutic regimen and intensity, radiation dose and its extent and consequently, the side effects. Therefore, failure to distinguish cPNET from pPNET leads to clinical guidance and treatment proposals based on false assumptions, which might effect outcomes. Often, distinguishing between cPNET and pPNET is easy, because they occur in different location. In the case of intraspinal tumour location, however, the differentiation is crucial because both primary cPNET and pPNET can occur intraspinally, even though this is rare. Nowadays, demonstrating the expression of MIC2 glycoprotein by immunocytochemical staining (CD99) showing the specific EWS-FLI1 chimeric gene presence in pPNET, offers an easy way of making a differential diagnosis between cPNET and pPNET.

12E7 Antigen↗