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PubMed2001

[A case of chronic bromvalerylurea intoxication due to habitual use of commercially available nonsteroidal anti-inflammatory drugs presenting an indefinite hyperchloremia].

A 75-year-old man was admitted to our hospital with disorientation and progression of speech disturbance and gait disturbance. He had been given a diagnosis of cervical spondylosis about four years previously, and gait disturbance and numbness in his extremities have been gradually increasing. Hyperchloremia and a careful history taking, which led to the discovery of habitual use of an analgesic containing bromvalerylurea, suggested bromism. A high level of bromide in serum yielded a diagnosis of bromism. Disorientation and speech disturbance were treated and improved by infusion diuresis. Gait disturbance only partly improved. There is a possibility that not only cervical spondylosis, but also chronic bromvalerylurea intoxication, may have contributed to the neurological disturbance resulting in gait disturbance and numbness. Bromvalerylurea, which is contained in many commercially available analgesics, should be noted as a possible cause of neurological disturbance.

Aged↗
PubMed2001

Anterior cervical interbody fusion with hydroxyapatite graft and plate system.

OBJECT: In cases of spondylosis or spine trauma, cervical interbody grafts are sometimes required after anterior discectomy. To avoid morbidity related to the harvesting of iliac crest bone, numerous materials have been developed such as allografts, methylmethacrylate, biocompatible osteoconductive polymer, and coralline grafts or cages. Some of these materials, however, are inefficient for fusion or are associated with specific complications. Conversely, hydroxyapatite (HA) grafts have numerous advantages. For example, their mechanical properties provide adequate load resistance and their porosity allows infiltration by newly formed bone, leading to complete fusion. The authors studied the results of using HA grafts combined with plating in patients who underwent anterior cervical discectomy. METHODS: Fifty-four patients underwent 68 cervical interbody fusion procedures in which an HA graft and plating were used. Indications for surgery were radiculopathy (caused by soft-disc herniation or spondylosis) in 46 cases, spondylotic myelopathy in two cases, and spinal trauma in six cases. Postoperatively the patients were followed for a mean of 24.6 months. Patients underwent radiography to evaluate fusion, intervertebral disc height, and the degree of lordosis. Clinically, excellent or good results (based on the Odon classification) were demonstrated in 91% of patients who presented with radiculopathy. Complete interbody fusion was achieved in 99% of all cases. Preoperative kyphotic deformities were corrected in all cases after surgery. Intervertebral disc height was maintained throughout follow up. Surgery-related morbidity was low; only one patient suffered from a permanent dysphagia. Graft deterioration was observed in 13 cases and two graft fractures occurred but without adversely affecting fusion. There were no cases of graft extrusion. CONCLUSIONS: Hydroxyapatite grafts are very efficient in achieving cervical fusion, maintaining intervertebral disc height, and restoring lordosis. When combined with the placement of a cervical plate, immediate stability is achieved and graft displacement is prevented.

Adult↗
PubMed1976

Anterior cervical discectomy with and without interbody bone graft.

Fifty-one patients with symptomatic cervical disc disease refractory to conservative management were allocated at random to one of two treatment groups. The standard anterior approach devised by Cloward was used for 25 patients, and radical discectomy and foraminotomy for the other 26. All patients were followed for 6 months or longer with interview, physical examination, and radiographic evaluation. There was no difference in the success rate between the two groups. The large majority (92%) of patients in both groups were pleased with results of their operation. Because of technical factors related to operative exposure of the spinal canal and nerve roots, we prefer the Cloward procedure for patients symptomatic from advanced spondylosis and reserve discectomy without bone graft insertion for those with minimal spondylosis or soft disc herniations.

Adult↗
PubMed1984

Cervical spondylotic myelopathy treated by single-stage multilevel anterior decompression. A prospective study.

Fifty patients suffering from advanced cervical spondylotic myelopathy were surgically treated to eliminate compression of the cord. All disc protrusions demonstrated by positive-contrast myelography that measured larger than 1.5 mm were excised. Each patient was operated on in a single-stage procedure by anterior discectomy, without bone fusion, for protrusions between 2 and 4 mm, and by vertebral trephination and intercorporeal iliac bone-graft fusion for protrusions larger than 4 mm. There were no serious complications. Improvement by one clear disability grade (as defined by the authors) was observed in 36% of the cases, by two grades in 56%, and by three grades in 8%. No patient showed an improvement of four grades. During a follow-up period varying from 2 to 5 years, none of the patients showed clinical evidence of progression of myelopathy; however, 44% of patients showed definite radiological evidence of progression of cervical spondylosis. This indicates that myelopathy may be arrested and may regress, but the process of cervical spondylosis continues unabated in almost half of the cases.

Adult↗
PubMed1988

Spinal arteriovenous malformations and neurogenic claudication. Report of two cases.

Spinal arteriovenous malformations (AVM's) can present with symptoms of neurogenic claudication indistinguishable from those of lumbar spondylosis. Spinal AVM's occur most frequently in males of middle age or older; lumbar spondylosis is often also present in these patients. The myelographic appearance of the abnormal vessels may resemble that of the dilated veins or redundant nerve roots sometimes seen adjacent to regions of spinal block, obscuring the diagnosis. Two patients are described who presented with clinical histories and myelographic findings that led to laminectomies for presumed spinal stenosis; ultimately, both were found to have an AVM. Treatment of the AVM arrested the neurological decline in one patient, and resulted in dramatic improvement in the other. A hypothesis related to hemodynamic consequences of venous hypertension is presented in an attempt to link the pathophysiology of the two conditions.

Aged↗
PubMed2002

Traumatic central cord syndrome: results of surgical management.

OBJECT: The authors compare clinical outcomes demonstrated in patients with traumatic central cord syndrome (CCS) who underwent early (< or = 24 hours after injury) or late (> 24 hours after injury) surgery. METHODS: The clinical characteristics, radiographic findings, surgery-related results, length of hospital stay (LOS), and clinical outcomes obtained in 50 patients with surgically treated traumatic CCS were reviewed retrospectively. Shorter intensive care unit (ICU) stay and LOS were observed in all patients who underwent early surgery compared with those who underwent late surgery. In patients with CCS secondary to acute disc herniation or fracture/dislocation who underwent early surgery significantly greater overall motor improvement was observed than in those who underwent late surgery (p = 0.04). Overall motor outcome in patients with CCS secondary to spinal stenosis or spondylosis who underwent early surgery was not significantly different from that in those who underwent late surgery (p = 0.51). Worse motor outcomes were found in patients who were older than 60 years of age and in whom initial bladder dysfunction was present (p = 0.03 and 0.02, respectively) compared with younger patients without bladder dysfunction. CONCLUSIONS: Early surgery is safe and more cost effective than late surgery for the treatment of traumatic CCS, based on ICU stay and LOS and improved overall motor recovery, in patients whose CCS was related to acute disc herniation or fracture. In the setting of spinal stenosis or spondylosis, early surgery was safe but did not improve motor outcome compared with late surgery.

Adolescent↗
PubMed1999

Posterior cervical arthrodesis and stabilization: an early report using a novel lateral mass screw and rod technique

OBJECTIVE: Posterior cervical arthrodesis and stabilization with lateral mass plates is a biomechanically sound construct in multiple planes of motion. It is reproducible and especially useful when the posterior elements are missing or fractured. Unfortunately, it is difficult to use in patients with severe degenerative spondylosis because the plate is malleable only in the sagittal plane and the screw positions are dictated by the plate's entry holes. METHODS: A novel system of lateral mass screws that can be positioned before placement of a lateral construct was used in nine patients. Their outcomes as well as the technical applications of this system were reviewed. RESULTS: A total of 52 screws were placed in nine patients who underwent posterior cervical arthrodesis with the Cervifix system (Synthes USA, Paoli, PA). Diagnoses included trauma in four patients, degenerative spondylosis in three, and tumor in two. Rods were molded individually according to the patient's anatomy. Compression, distraction, and lateral rotation, if indicated, were performed. Follow-up averaged 36 weeks. Lateral and anteroposterior radiographs, obtained at progressive intervals, revealed excellent fixation and screw purchase without pull-out. There were no cases of spinal cord, nerve root, or vertebral artery injury. CONCLUSION: The Cervifix system accommodates variation in anatomic size and spacing of the lateral masses, potentiating precise screw placement. The rods can be molded in multiple planes, and selective application of compressive, distractive, or lateral rotatory forces is allowed. The system is very straightforward and simple to use, and we have had good success without pseudarthrosis or complications from screw placement in our series.

Journal Article↗
PubMedDate not supplied

Late whiplash syndrome: a clinical and magnetic resonance imaging study.

Cervical hyperextension injuries are common and are associated with significant morbidity. Clinically two syndromes are described: "acute" whiplash syndrome and "late" whiplash syndrome (in which the patients are still symptomatic after six months despite normal physical and radiological examination). In order to clarify the pathology of the persistent pain in late whiplash syndrome we performed a cervical spine magnetic resonance imaging (MRI) in 33 consecutive patients suffering from this condition. Twenty-six patients (78.8%) showed MRI abnormalities, the most common MRI finding (57.6%) was pre-existent spondylosis. Indeed, the group of patients with spondylosis and other MRI changes had higher clinical scores than those without MRI abnormalities as measured by a three-point grading system based upon the symptoms and signs shown. Several MRI changes, most of them already demonstrable by standard X-ray were seen among 33 patients suffering from late whiplash syndrome. Although no one of these findings appears to be specific and certainly related to the previous neck injury, they could represent a risk factor for a longer pain duration.

Adult↗
PubMed2000

Thoracic cord compression due to gout: a case report and literature review.

An 82-year-old man developed progressive weakness of both legs 1 month prior to admission. He reported no previous history of trauma. Spine radiography revealed marked thoracic and lumbar spondylosis. Magnetic resonance imaging of the spine disclosed segmental stenosis with cord compression at T10-11 due to an extradural soft tissue lesion. Based on a diagnosis of thoracic spondylosis with cord compression, decompression laminectomy was performed. During the operation, fragile chalky-white material was noted over the epidural space, compressing the thoracic cord. The granular lesion was meticulously removed until the dura was identified and the cord was decompressed. Histologic examination of the surgical specimen revealed deposits of needle-like crystals that were consistent with monosodium urate, demonstrating that a gouty lesion of the thoracic spine had caused the cord compression. The patient had previously experienced several attacks of gouty arthritis of his feet. The postoperative serum uric acid concentration was 8.5 mg/dL. After surgery, he was treated with benzbromarone 100 mg per day. He was able to walk 3 months after the operation. A high index of suspicion of gouty involvement of the spine is necessary in patients with gout. Surgical decompression followed by regular administration of antigout drugs can provide satisfactory results.

Aged↗
PubMed2000

Design and clinical application of cervical hollow threaded fixator.

OBJECTIVE: Cervical hollow threaded fixator (CHTF) was designed and applied to stabilize the cervical spine following anterior decompression due to cervical spondylosis or acute cervical disc herniation. METHODS: Medical use titanium alloy with no magnetism was made into a hollow threaded structure with holes on the wall of the fixator. Forty-two patients with cervical spondylosis and acute cervical disc herniation were stabilized using the CHTF technique after anterior decompression. X-ray films and CT scans were taken after the operation to observe the stability and fusion rate of the segments. RESULTS: Patients were allowed to walk one day after the operation and were followed up for 6 to 36 months. The operated segments were stable and solid fusion was observed 3-6 months after surgery. CONCLUSIONS: Immediate stability of the operated segments can be obtained using the CHTF technique. Patients were easy to manage after the operation and returned to their jobs in a short time. The CHTF technique is safe and simple to perform and eliminates the complications of an autograft. It may be an alternative to traditional cervical interbody fusion with bone graft.

Adolescent↗
PubMed2003

Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome.

OBJECTIVE: Multilevel anterior decompressive procedures for cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament may be associated with a high incidence of neurological morbidity, construct failure, and pseudoarthrosis. We theorized that laminectomy and stabilization of the cervical spine with lateral mass plates would obviate the disadvantages of anterior decompression, prevent the development of kyphotic deformity frequently seen after uninstrumented laminectomy, decompress the spinal cord, and produce neurological results equal or superior to those achieved by multilevel anterior procedures. METHODS: We retrospectively reviewed the records of 38 patients who underwent laminectomy and lateral mass plating for cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament between January 1994 and November 2001. Seventy-six percent of patients had spondylosis, 18% had ossification of the posterior longitudinal ligament, and 5% had both. Clinical presentation included upper extremity sensory complaints (89%), gait difficulty (70%), and hand use deterioration (67%). Spasticity was present in 83%, and weakness of one or more muscle groups was seen in 79%. Spinal cord signal abnormality on sagittal T2-weighted magnetic resonance imaging (MRI) was seen in 68%. Neurological evaluation was performed using a modification of the Japanese Orthopedic Association Scale for functional assessment of myelopathy, the Cooper Scale for separate evaluation of upper and lower extremity motor function, and a five-point scale for evaluation of strength in individual muscle groups. Lateral cervical spine x-rays were analyzed using a curvature index to determine maintenance of alignment. Each surgically decompressed level was graded on a four-point scale using axial MRI to assess the adequacy of decompression. Late follow-up was conducted by telephone interview. RESULTS: Laminectomy was performed at a mean 4.6 levels. Follow-up was obtained at a mean of 30.2 months after the procedure. The score on the modified Japanese Orthopedic Association scale improved in 97% of patients from a mean of 12.9 preoperatively to 15.58 postoperatively (P < 0.0001). In the upper extremities, function measured by the Cooper Scale improved from 1.8 to 0.7 (P < 0.0001), and in the lower extremities, function improved from 1.0 to 0.4 (P < 0.0002). There was a statistically significant improvement in strength in the triceps (P < 0.0001), iliopsoas (P < 0.0002), and hand intrinsic muscles (P < 0.0001). X-rays obtained at a mean of 5.9 months after surgery revealed no change in spinal alignment as measured by the curvature index. There was a decrease in the mean preoperative compression grade from 2.46 preoperatively to 0.16 postoperatively (P < 0.0001). There was no correlation between neurological outcome and the presence of spinal cord signal change on T2-weighted MRI scans, patient age, duration of symptoms, or preoperative medical comorbidity. CONCLUSION: Multilevel laminectomy and instrumentation with lateral mass plates is associated with minimal morbidity, provides excellent decompression of the spinal cord (as visualized on MRI), produces immediate stability of the cervical spine, prevents kyphotic deformity, and precludes further development of spondylosis at fused levels. Neurological outcome is equal or superior to multilevel anterior procedures and prevents spinal deformity associated with laminoplasty or noninstrumented laminectomy.

Adult↗
PubMedDate not supplied

Lateral mass screw-rod fixation of the cervical spine: a prospective clinical series with 1-year follow-up.

BACKGROUND CONTEXT: Lateral mass plating has become the technique of choice for posterior cervical fixation. Although these systems are safe and reliable, they can be difficult to use in patients with abnormal cervical anatomy; screw placement can be compromised by the fixed hole spacing of the plate; screw back-out and other forms of implant failure can occur; and extension across the cervicothoracic junction can be problematic. PURPOSE: To report a series of patients undergoing posterior cervical stabilization with a polyaxial screw-rod construct and to investigate whether this new system offers any advantages over existing methods of fixation. STUDY DESIGN: A prospective study evaluating clinical and radiographic parameters in a consecutive series of patients treated with this technique. PATIENT SAMPLE: There were 21 patients in the study group. The surgical indication was cervical spondylosis in 14, trauma in 2, postsurgical kyphosis in 2 and 1 case each of congenital cervicothoracic stenosis, C7-T1 pseudarthrosis and basilar invagination with brainstem compression. OUTCOME MEASURES: Clinical indicators included age, gender, neurologic status, surgical indication and number of levels stabilized. Note was made of whether laminectomy and concomitant anterior reconstructive surgery were performed. Radiographic indicators included early postoperative computed tomography (CT) scan to check for screw placement and plain radiographs at subsequent visits. METHODS: The participants in this study underwent posterior cervical stabilization using lateral mass screw-rod fixation. Clinical and radiographic assessment was carried out immediately after surgery, and 3, 6 and 12 months after surgery. One-year follow-up was obtained in all cases. RESULTS: A total of 212 screws were implanted in 21 patients. Fixation was carried out over an average of 5.5 spinal segments (range, 2 to 11). The system was successfully implanted in all patients despite the presence of coronal and sagittal plane deformities and/or lateral mass abnormalities in the majority of cases. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-C7 lateral masses and upper thoracic pedicles. Early postoperative CT scanning confirmed satisfactory screw placement in all cases. Three patients experienced transient single-level radiculopathy, for an incidence of 1.4% per screw placed. Two patients developed wound seromas requiring evacuation. There were no infections or other wound healing problems. There were no examples of cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, loss of alignment or implant failure. When compared with plating techniques, screw-rod fixation appeared to offer several advantages. First, unlike plates, rods proved to be amenable to multiplanar contouring, which is often needed for deformities associated with cervical spondylosis. Second, lateral mass screw placement was more precise because it was not constrained by the hole spacing of the plate. Third, screw back-out and other types of implant failure were not seen. Fourth, the screw-rod system was more easily extended to the occiput and across the cervicothoracic junction. Fifth, the screw-rod system permitted the application of compression, distraction and reduction forces within the construct, to a greater extent than plate systems. The incidence of postoperative radiculopathy was similar to that seen with plate systems. CONCLUSIONS: These data indicate that posterior cervical stabilization with polyaxial screw-rod fixation is a safe, straightforward technique that appears to offer some advantages over existing methods of fixation. Results appear to be durable at 1-year follow-up. Benefits are more significant with longer constructs, especially those extending to the occiput or crossing the cervicothoracic junction.

Adult↗
PubMed2003

[Comparison of three-dimensional gradient echo, turbo spin echo and steady-state gradient echo sequences in axial MRI examination of the cervical spine].

PURPOSE: The aim of this study was to assess the detectability of the structures that are affected by cervical spondylosis by different 3D MRI sequences and compare the image quality of those sequences. MATERIALS AND METHODS: Twenty healthy volunteers were examined using a 1.5 T MR unit. T2* weighted 3D-gradient echo sequence with magnetization transfer saturation pulse (3D-FFE-MTC), T2 weighted 3D turbo spin echo (TSE) sequence with and without spectral presaturation inversion recovery pulse (T2-3D-TSE/SPIR+ and T2-3D-TSE/SPIR-) and balanced-FFE (b-FFE) sequences were compared. Spinal cord signal-to-noise ratio (SNR), cerebrospinal fluid (CSF) SNR, and CSF-spinal cord contrast-to-noise ratio (CNR) were calculated quantitatively. The detectability of neural foramina, spinal nerve roots, uncinate process and ligamentum flava were graded on a 5-point scale (0: minimum, 4: maximum) qualitatively. The presence of the artifacts and overall image quality were graded on a 4-point scale (0: minimum, 3: maximum). RESULTS: Balanced-FFE sequence yielded the best results for each of three quantitative evaluation. In terms of qualitative evaluation, for the uncinate process T2-3D-TSE/SPIR- sequence was superior to the other three sequences (p < 0.01). For the ligamentum flava T2-3D-TSE/SPIR- and b-FFE sequences were superior to the other two (p < 0.01). For the neural foramina b-FFE yielded the lowest score (3), however the other three sequences were not significantly different (3.2-3.5) (p > 0.05). Artifacts were most commonly seen using 3D-FFE-MTC. In terms of overall image quality T2-3D-TSE/SPIR- yielded the highest score, followed by b-FFE. CONCLUSION: 3D-FFE-MTC sequence is frequently preferred for cervical spinal MRI studies. However our study yielded best scores for T2-3D-TSE/SPIR, followed by b-FFE in the quantitative and qualitative evaluation of the structures affected by cervical spondylosis.

Adolescent↗
PubMed2004

Anterior cervical spinal surgery for multilevel cervical myelopathy.

BACKGROUND: In multilevel spinal cord compression caused by cervical spondylosis, surgeons face the choice of performing a posterior route as a laminectomy or laminoplasty, or an anterior route as multiple adjacent interbody decompressions or corpectomies. The anterior cervical operation is not considered by some clinicians because of concerns about complications and the complexity of multilevel anterior cervical surgery. METHODS: In this retrospective study, 14 patients with multilevel cervical spondylosis who were operated on via an anterior route were enrolled to evaluate the complexity, safety, and clinical results. The collected parameters were operation time, blood loss, hospital days, and early and late complications for evaluating the operative complexity, radiographic follow-up for evaluating fusion, graft problems, implants problems, and the recovery rate using the Japanese Orthopaedic Association score (JOA score) for evaluating the operative results. RESULTS: The mean operation time was 363.4 min, and blood loss was 431.4 ml. An early complication was noted in 1 patient with combined deep vein thrombosis and a pulmonary embolism. Late complications were screw breakage in 1 patient and screw loosening in 5 patients. The mean duration of follow-up was 21.9 months. The mean recovery rate of the JOA score was 38.8% postoperatively and 51.9% at the final follow-up. The fusion rate was 100% in this series. CONCLUSIONS: Anterior cervical decompression and fusion for multilevel stenosis requires a longer operation time than posterior procedures; however, the clinical results are satisfactory.

Adult↗
PubMed2004

[Active range of cervical motion in healthy subjects and in spinal disorders. DBC equipment validity in complex cervical motion evaluation].

UNLABELLED: Active Range of motion (AROM) is one of the crucial parameters assessed in the cervical spine evaluation. Repeated standardized AROM evaluation enables objectified monitoring of disease progress or therapy related improvement. Active spine therapy according to DBC (Documentation Based Care) requirement is a contemporary therapeutic system with proven efficacy in spinal disorders. The therapeutic concept f DBC is mechanotherapy based and introduces special devices designed for active exercises in strictly defined range, rate and load. DBC-3CR device is constructed for active motion (composed of rotation, anteflexion and lateral flexion) exercise of the cervical spine with repeated dynamic load. Technical properties allow to avail the machine for diagnostic purposes as far complex range of motion is concerned. PURPOSE: Comparison of AROM between healthy volunteers and patients with cervical disorders. Evaluation of DBC-3CR validity in complex AROM measurement Patients: A--99 healthy volunteers; B--106 patients with chronic neck pain resulting from cervical spondylosis; C--36 patients with acute neck pain related to cervical disc disease or whiplash injury. METHODS: Complex AROM detection with DBC-3CR was compared with reference measurements (goniometric and inclinometric simple AROM detection). Age and sex dependence of AROM among healthy subjects was observed. AROM was compared between B, C and reference groups. DISCUSSION: AROM was significantly decreased in patients with chronic and acute neck pain. Motion limitation pattern was symmetric in both groups. The presence of linear dependency between complex AROM acquired with DBC-3CE and rotation acquired with goniometer was observed (Pearson coefficient 0.81 at p < 0.0001). CONCLUSIONS: I. DBC-3CR device is useful in AROM evaluation. 2. AROM in healthy subjects decreases with age, but is sex--independent parameter. 3. In cervical spondylosis AROM is symmetrically reduced as far as rotation and lateral flexion are concerned. 4. Acute cervical pain results in symmetric AROM limitation.

Adult↗
PubMed2004

[Anterior cervical diskectomy and fusion with allograft and internal fixation].

OBJECTIVE: To evaluate the effect of cylindrical titanium mesh packing cancellous allograft in the anterior cervical fusion for the cervical spondylosis with anterior titanium plate. METHODS: Ninety-eight patients with cervical spondylosis underwent diskectomy and cancellous allograft contained in cylindrical titanium mesh enhanced by anterior titanium plate system. Sixty-four patients were followed up clinically and radiographically. The mean follow-up time was (15.2 +/- 1.7) months. JOA scores and Nurick myelopathy grading system were used for clinical assessment. Roentgenograms were analyzed to identify the stability of fused levels. RESULTS: In all patients of 98 cases, the wounds were normally healed without acute or chronic infection. In statistical analysis of 64 patients followed up, the mean JOA scores was (11.6 +/- 1.8) preoperatively and improved to (16.0 +/- 1.2) at final follow-up (P < 0.05). And the mean Nurick grades were (2.7 +/- 0.7) and (0.7 +/- 0.8) before and after surgery respectively (P < 0.05). The X-ray films demonstrated that no meshes were found displacing or subsiding. New bone formation occurred in the back of meshes at 5 months after surgery. The final follow-up fusion rate was 95%. CONCLUSION: The cancellous allograft impacted into titanium meshes for cervical fusion has gained excellent or good results clinically and radiographically in short term follow-up.

Bone Transplantation↗
PubMed2005

[Correlations between clinical course and investigation results of central conduction time of somatosensory potentials evoked from tibial nerves in patients with cervical myelopathy treated by surgery].

OBJECTIVE: The aim of study was to determine if abnormal somatosensory evoked potentials (SSEPs), specifically central conduction time (CCT) correlated with the degree of cervical myelopathy surgically treated or with clinical improvement following surgery. MATERIAL AND METHODS: Thirty patients (women, n=12 and men, n=18) with cervical myelopathy with neurological signs of cervical pyramidal tracts lesion and gait difficulties treated in 7-th Navy Hospital were studied. In our group in MR investigation we observed 26% discopathy, 56% cervical spondylosis and 43% cervical discopathy and spondylosis. Patients were treated surgically in cervical region. SSEP from tibial nerves data especially N22 to P40 interlatency (CCT) and basic everyday motional ability (by Dudek and Michno) were collected pre-operatively and 6-month after surgical treatment. RESULTS: Preoperatively, 43% (n=13) patients had normal values of CCT No patients had worsened CCT value after surgery. Six months after surgical treatment we observed abnormal in 13% (n=4) and normal values of CCT in 86% (n=26). In the second group we observed summary 60% (n=18) decrease of basic everyday motional ability. CONCLUSION: In 56% patients with cervical myelopathy abnormal SEP's from tibial nerve's abnormal CCT we observed. There is significant reduction of abnormalities SEP's from tibial nerve's after surgery. Abnormal SSEPs before the surgery correlates with the severity of myelopathy and improvement in SSEPs following surgery correlates strongly with clinical improvement.

Aged↗
PubMed2005

Effects of Ge Gen Decoction on PGE2 content and COX activity in the degenarated cervical intervertebral discs of rats.

After the rat model of cervical spondylosis was developed for 6 months, the PGE2 content and COX activity in the cervical intervertebral discs were determined respectively by radioimmunoassay and catalytic activity assay. The results indicated that the PGE2 content and COX activity in the model rat increased significantly, and that Ge Gen Decoction could down-regulate the PGE2 content and inhibit COX activity. This is possibly one of the mechanisms of Ge Gen Decoction for treating cervical spondylosis.

Animals↗