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At least 829 records · Page 46Linked to original sources
PubMed1991

[Neurosurgery in old age. I: Significance of the problem--herniated disk, spinal canal stenosis--craniocerebral injuries--chronic subdural hematoma--resorptive hydrocephalus].

The relative percentage of patients over 60 years who underwent operations in our clinic has greatly increased from 18% in 1874 to 27% in 1989. Postoperatively, difficulties may also result from additional medical problems, which may be cardiovascular, pulmonary, metabolic (especially diabetes mellitus), increased thromboembolism in origin as well as from the reduced tendency to neurological recovery in elderly patients. On the other hand, advances in diagnostics and surgical treatment often make it possible to help even these patients effectively today. The clinical pictures which are especially frequent in our hospital are specified below. Disc herniations: Soft nucleus-pulposus herniations occur in every age group. In elderly patients, the osseous constriction of the lumbar canal (especially by spondylarthrosis) often leads to spinal claudication. Functional myelography with myelograms taken in the sitting and the standing position is important for preoperative appraisal. On the basis of the clinical/neuroradiological findings, it may be decided whether a selective or an extended decompression is necessary. Larger-scale decompressions are mostly possible in this age group without postoperative instability, with good results in more than 80% of the cases. In our clinic, anterior microsurgical decompression without graft is the most frequently used procedure in cervical disc herniations/spondylosis, a method which is well tolerated by spinal cord and nerve roots: 75% simple anterior discectomies/spondylectomies compared to only 25% classical Cloward operations with bone grafts. We use intervertebral bone grafts only in severe spondylosis and/or instabilities, if necessary in combination with metal plates (e.g. in the context of cervical myelopathy). Craniocerebral injuries: Epidural hematomas and CSF fistulae, but also circumscribed space-occupying contusions have a relatively favorable prognosis in every age group. The older the patient, the more serious is the acute subdural hematoma, which is often associated with extensive contusions, although surprisingly good recoveries are occasionally possible postoperatively even here. Detailed scrutiny of all prognostically relevant factors is important. In borderline situations we give the patient a chance in order to take later action, depending on the course. Chronic subdural hematomas are especially frequent and readily dealt with surgically in patients over 60 years. The simple borehole drainage to the outside is often sufficient. In extensive excreting membranes, which are especially frequent in elderly patients, we prefer today a subdural-peritoneal drainage for six to eight weeks to the very much more burdensome craniotomy: The relatively simple operation allows an early mobilization and almost always a prompt healing. Hydrocephalus male resorptivus is also very much more frequent in this age group.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed2005

A special case on the use of ultrasonography for evaluation of the spinal canal and its contents in adults.

In this article we present a 70-year-old man with a history of severe trauma in the upper thoracic spine. This patient presented at our emergency department with a leaking wound in the lower neck after removal of osteosynthetic material. He had undergone a laminectomy of the third thoracic vertebra in the past. As an incidental finding, while examining the region of the lower neck by transcutaneous ultrasonography, we diagnosed a post-traumatic syrinx of the spinal medulla at this level.

Aged↗
PubMed1980

[An experimental study on the computed tomography of the cervical spinal canal (author's transl)].

A study was carried out to investigate how accurately CT could delineate the vertebral canal, vertebral body, lamina, intervertebral foramen and transverse process, and which factor influences the size of the vertebral canal, using cervical vertebrae obtained from four cadavers and one skeleton. EMI CT 5005 scanner was used. CT picture depicted accurate shapes of the vertebral canal, body and transverse process. The sagittal diameter of the vertebral canal of CT picture varied by various conditions, such as difference of scanning chance, scanning angle, window width and level, but variations due to different absorption coefficients of the bone surrounding the vertebral canal were negligible. It was most significantly changed by scanning angle. Permissible scanning angle was within 5 degrees, and morphological findings were not influenced up to 15 degrees. In repeated scan to measure diameter at window width 400 and level 100, difference was observed from 0.8 mm to 0 mm with a mean of 0.3 mmn. Window width and level also gave influence to the outline of the vertebral canal. The size of the vertebral canal was most accurately measured under the condition of 400 in width and 250 in level. The optimal condition for delineation of the spine seemed to be 400 in width and 100--200 in level. Under the condition at width 400 and level 100, the vertebral canal was delineated narrower by an average 0.6 mm and 0.2 mm in the sagittal and transverse diameter respectively. In CT picture of the imitational ossified posterior longitudinal ligament made of plastic and alginate, the average narrowing rate of the vertebral canal was 4.4% greater than the one obtained by lateral view of radiograph, but both correlated well with each other. The narrowing rate of the vertebral canal by CT tended to increase in proportion to the increase in scanning angle. Further, the narrowing rate was not significantly different at window level from 0--300 as long as width was maintained at 400.

Aged↗
PubMed1982

Constitutional narrowness of the lumbar spinal canal and cheiro-lumbar dysostosis.

The author reports a further case of cheirolumbar dysostosis (associated of Verbiest's constitutional narrowness of the lumbar canal and short and broad phalanges and metacarpals) and a case with multiple malformations including both the narrow lumbar canal and brachycheiry and also several other malformations of the bones. The author discusses the nosography of Verbiest's syndrome with regard to cheirolumbar dysostosis and to more complex and diffuse malformations.

Adult↗
PubMed1989

[The spinal periosteal layer and the fibrous sheath of the cervical spinal canal].

At the cervical level, in the foramen, the rachidian nerve is surrounded by two mantles: a dural one and a fibrous one continuing the epidural periosteal sheet of which it is a thickening. We can wonder whether this fibrous sheath is at the origin of some cervical radiculalgias in which one cannot detect any radiological lesion of the skeleton or disk.

Cervical Vertebrae↗
PubMedDate not supplied

[Some aspects of microsurgical decompression of neurovascular formations of the spinal canal in lumbar osteochondrosis].

Microsurgical techniques have been developed for decompression of neurovascular formations of the vertebral canal in lumbar osteochondrosis. Surgical policy has been proposed in relation to the site of hernial prolapse by the disk diameter. The use of this policy provides the minimal traumatism of surgical interventions in posterolateral hernias in particular.

Humans↗
PubMed2002

A case of multiple schwannomas of the trigeminal nerves, acoustic nerves, lower cranial nerves, brachial plexuses and spinal canal: schwannomatosis or neurofibromatosis?

In most cases, while schwannoma is sporadically manifested as a single benign neoplasm, the presence of multiple schwannomas in one patient is usually indicative of neurofibromatosis 2. However, several recent reports have suggested that schwannomatosis itself may also be a distinct clinical entity. This study examines an extremely rare case of probable schwannomatosis associated with intracranial, intraspinal and peripheral involvements. A 63-year-old woman presented with a seven-year history of palpable lumps on both sides of the supraclavicular area and hearing impairment in both ears. On physical examination, no skin manifestations were evident. Facial sensory change, deafness in the left ear and decreased gag reflex were revealed by neurological examination. Magnetic resonance imaging revealed multiple lesions of the trigeminal nerves, acoustic nerves, lower cranial nerves, spinal accessory nerve, brachial plexuses, and spinal nerves. Pathological examination of tumors from the bilateral brachial plexuses, the spinal nerve in the T8 spinal position and the neck mass revealed benign schwannomas. Following is this patient case report of multiple schwannomas presenting with no skin manifestations of neurofibromatosis.

Brachial Plexus Neuropathies↗
PubMed2000

A foreign body in the spinal canal. A case report.

An 18-year-old man who presented with weakness in his lower limbs, had an upper motor neurone lesion at the D12-L1 level. At laminectomy two stone-like objects were found which proved to be bundles of tiny pieces of wood. They are thought to have entered the cord through an abdominal penetrating injury sustained six years previously.

Abdominal Injuries↗
PubMed1989

[The effect of x-ray contrast media on magnetic resonance tomography of the spinal canal].

The effects of x-ray contrast media on signal intensities were studied. Relaxation times of myelographic contrast media were measured. Whereas relaxation times of Amipaque were longer, compared to CSF, the relaxation times of Duroliopaque, Omnipaque und Solutrast were significantly shorter than that of CSF. Therefore, the qualitative and quantitative effects of different contrast media on signal intensities varied. Most notable was the increase of signal intensity on T1-weighted images due to oily contrast media.

Contrast Media↗
PubMed2003

[Neurenteric cyst: an unusual congenital malformation of the spinal canal].

Neurenteric cyst is a rare congenital anomaly, which is included in the split notochord syndrome. The cyst arises from abnormal persistence of the neurenteric canal at about three weeks of gestation. The most common locations are extramedullary intradural. They can extend anywhere along the neuraxis. The intermittent, polymorphic and misleading clinical symptoms may result in a delay in diagnosis. Magnetic resonance imaging is the gold standard in the diagnosis of this anomaly. Surgical treatment allows total recovery in most cases.

Abnormalities, Multiple↗
PubMed1982

Spontaneous migration of an intracranial bullet to the cervical spinal canal causing Lhermitte's sign. Case report.

A case is presented of a woman who was shot in the left occipital area with a .32 caliber automatic pistol. She was neurologically intact on admission, and skull x-ray films revealed the bullet in the right suboccipital area. On the 2nd day of the admission she developed Lhermitte's sign. Repeat films showed that the bullet had migrated to the C-4 vertebral level. The bullet was subsequently removed via a total laminectomy at C3-4.

Adult↗
PubMed1990

Measurements of the normal lumbar spinal canal by computed tomography. Segmental study of L3-L4 and L4-L5 related to the height of the subject.

Computed tomography measurements of the main diameters and cross section areas of the lumbar vertebral canal and the lower end of the dural sac at the L3-L4 and L4-L5 levels were made in 34 young male adults who were free of symptoms. This study shows a statistically significant correlation between the height of the subject and the cross sectional area of the canal and the dural sac, and the interpedicular diameter. The determination of regression coefficients enabled an estimate to be made of the mean values of these parameters in relation to height, the actual values having a normal distribution around these means. This study suggest that the areas, when narrowing is suspected, should be interpreted as a function of the height of the subject.

Adolescent↗
PubMed1996

[Ultrasound anatomy of the spinal canal of the lumbar spine. Results ofan experimental study and report of initial clinical applications of intraoperative ultrasound in nucleotomies].

UNLABELLED: Results of an Experimental Study and Report of Intraoperative Application: AIM: Intraoperative sonography has been used in neurosurgery (especially in tumors) and in traumatology (assess reduction of dorsal vertebral body fragments). This study was performed to determine the value of sonography in detecting vertebral disc tissue. RESULTS: We examined 6 specimens of the Lumbar spine using the extended flavectomy approach. We found that sono-anatomy was reproducible and that the assessable area was large enough to make sonography useful for detection of sequesters. Dislocated vertebral disc tissue could be differentiated clearly from original disc tissue and from other intraspinal structures. In 6 of 8 cases of intraoperative sonography in nucleotomies we were able to evaluate intraspinal and intraforaminal structures. The complete removal of the detected prolapses could be documented. In 2 cases the examination failed because the probe had a too large diameter and could not be pushed down between the spinous processus and the wound distractor to the extended flavectomy. CONCLUSIONS: Sonography allows one to document complete resection of disc herniations. Limitations of the method are due to technical problems.

Adult↗