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PubMedDate not supplied

[Congenital kyphosis with neurological disorders].

The paper outlines the results of examination and surgical treatment of a large group of patients with congenital sternolumbar kyphoses complicated by development of neurological symptoms. The results of radioopaque investigations showed there was a relationship of the magnitude of intracanal changes to the size of kyphotic deformity. The comparative study of the outcomes of surgical management of patients with congenital kyphoses demonstrated the high efficiency of interventions, whose complex included central spondylosis. This operation decreases spinal deformity, yields decompression of intracanal nervous structures and ensures further stability of the vertebral column.

Adolescent↗
PubMed1994

[Cervical myelopathy from an aspect of a neurological surgeon].

More than 65 per cent of intramedurally tumors and intradural extramedurally tumors were located in cervical region. They enact a cause of cervical myelopathy. A special attention should be paid to solitaly intramedurally vascular malformations, when the patients show an acute progressive myelopathy. In very rare cases of syringomyelia, intramedurally tumors such as hemangioblastoma or ependymoma could be found, so that enhanced MRI or angiography should be done if necessary. In cases of a herniated disc, cervical spondylosis and OPLL, the distance between articulo-pillar line and spinolaminal line must be measured. If the distance of both lines is near or the same, that means narrow cervical canal. In rare cases the form of the vertebral body is round. This is a rare cause of a type of narrow canal.

Humans↗
PubMedDate not supplied

A short communication on occurrence of rheumatic diseases attending hospital.

A total of 4800 patients suffering from rheumatic diseases, attending Department of Physical Medicine, Burdwan Medical College Hospital, West Bengal, during the period from January 1991 to June 1991, were studied. Out of these 4800 cases, soft tissue rheumatism cases were maximum (57%), followed by osteo-arthrosis cases (36%), rheumatoid arthritis (5.2%), rheumatic arthritis (0.4%), ankylosing spondylitis (0.6%), osteo-chondrosis (0.7%) and gouty arthritis (0.1). Soft tissue rheumatism cases were common (62.8) in age group 20-40 years, mainly (58.4%) in female and maximum (37%) of lumbosacral strain. Osteo-arthrosis cases were highest (53.9%) in 40-60 years of age with female preponderance (57.2%) and mainly (49%) of cervical spondylosis.

Adolescent↗
PubMed1995

Myelopathies in Ethiopia.

From December 1990 to December 1993, 130 patients who had a lesion localized to the spinal cord were admitted to the Tikur Anbessa Hospital, Department of Internal Medicine, Addis Ababa. These patients accounted for 18.0% of all neurological admission to this department. The male/male female ratio was 1:8:1; the mean age was 40 years for these patients; 52% were from Addis Ababa City and 48% of them were coming from the rest of the country. Paraparesis or paraplegia (77%) and quadriparesis or quadriplegia (23%) were the commonest presenting complaints. Sensory level, sphincter dysfunction and bedsores were found in 70%, 54% and 14% of the cases respectively. Tuberculous spondylitis was found to be the leading cause accounting for 35 (26.9%), and HIV-1 myelopathies was the second common type accounting for 22 (16.9%) of spinal cord disease. Metastatic cord compression, tropical spastic paraparesis, (progressive non compressive myelopathy), cervical spondylosis, primary cord tumours and transverse myelitis were also not uncommon. Death related to sepsis or other causes were documented in 14 (10.8%). Follow-up was arranged on discharge, and only 45 (38.8%) patients were able to attend at least once the neurology referral clinic. Myelopathy is an important neurological disease and currently HIV-1 associated myelopathy has become the second important presumed cause.

Adolescent↗
PubMed1995

Treatment of drop attacks with nifedipine: a case report.

Drop attacks are sudden, unexpected, nonsyncopal falls, which are not preceded or accompanied by loss of consciousness, dizziness, lightheadedness, or loss of balance. They can be a manifestation of epilepsy, brain stem tumors, and a variety of other conditions. In the elderly, they have been associated with vertebrobasilar insufficiency, cervical spondylosis, or both. However, the specificity and etiology of drop attacks have come under some scrutiny in recent years. The patient described in this case report experienced frequent drop attacks that were effectively prevented with nifedipine. Possible pathophysiologic mechanisms are discussed and the relevant literature is reviewed.

Accidental Falls↗
PubMedDate not supplied

[Pathogenesis of osteochondrosis].

Osteochondrosis may present as a separate disease or be one of the stages of a dystrophic process coursing in the presence of cartilagenous nodes of deforming spondylosis. Primary or secondary dystrophic involvement of the nucleus pulposus may eventuate in the disk fibrosis.

Diagnosis, Differential↗
PubMed1994

Cervical spondylotic myelopathy: a cause of gait disturbance and falls in the elderly.

Cervical spondylosis is a very common disorder in the elderly that leads to osteophyte formation and degenerative disc disease. Compression of the cervical cord and nerve roots can occur in a small number of patients, often dependent upon a congenitally narrow canal. Cord compression produces progressive spastic paraparesis, frequently asymmetric, and often accompanied by paresthesias and sensory loss in the feet and hands. The course is quite variable. Often, symptoms are mild and do not progress. Such cases are best treated conservatively with a cervical collar and physical therapy. Elderly patients often experience progression of symptoms and more serious neurologic impairment. Surgery should be recommended to arrest progression of myelopathic symptoms in patients whose general condition is satisfactory.

Accidental Falls↗
PubMed1994

An aetiological survey of paraplegia in Accra.

Sixty-four cases of non-traumatic paraplegia in Accra, Ghana, were investigated. The commonest cause of paraplegia was tuberculosis (29.69%). Next were transverse myelitis and the Guillain-Barré syndrome, each accounting for 10.94% of cases. Parasitic causes were not seen in this study. The other important causes are neoplastic conditions (14.07%) and degenerative conditions namely, cervical spondylosis with myelopathy (12.5%), and motor neurone disease (6.25%). It is concluded that the major causes of non-traumatic paraplegia in Accra are related to non-parasitic microbial infections (51.57%).

Adolescent↗
PubMedDate not supplied

[Osteopenic syndrome in liquidators of the aftereffects of the accident at the Chernobyl power plant].

Bone system was examined in 112 liquidators; in 71 of these osseous tissue density was studied by osseous densitometer using bienergetic x-ray absorptiometry and in 45 x-ray examinations, analyses of biochemical and hormonal parameters were carried out. Spinal painful syndrome was detected in 61 to 82% of the examinees. For analysis of densitometric and x-ray parameters the liquidators were divided into 2 groups: group 1 included those who worked at the power plant in 1986 (55%) and group 2 were those who worked there in 1987-1989. Radiation doses in group 1 reliably surpassed those in group 2 (p < 0.001). Bone mineral density in the lumbar vertebrae was significantly lower in group 1 as against group 2 and lower in both groups vs. controls. More than 5% osseous mineral loss was revealed in 73% of group 1 liquidators and in 43% of group 2 ones. Analysis of spinal roentgenograms in 45 liquidators showed a high incidence of negligible and moderately expressed osteoporosis without compression fractures of vertebral bodies: osteopenia signs were found in 87% of group 1 examinees complaining of pain in the spine and in 73% of group 2 examinees; signs of osteochondrosis and spondylosis were detected in 40% of group 1 and in 47% of group 2 subjects. Hence, a higher incidence of osteopenia in liquidators, more manifest condition and its higher detection rate in subjects exposed to higher radiation doses indicate a certain contribution of radiation factor to the development of the osteopenia syndrome in liquidators.

Adult↗
PubMed1994

Evaluation of cervical radiculopathy by cervical root stimulation.

For precise evaluation of cervical radiculopathy, cervical root stimulation (CRS), conventional electromyographic (EMG) studies, nerve conduction velocity (NCV) studies and F responses were done in 32 patients with clinical symptoms and signs of cervical radiculopathy. While performing CRS, a monopolar needle was inserted into the paraspinal muscles, and the compound muscle action potentials (CMAPs) in the biceps, triceps and abductor digiti minimi muscles were recorded. Conventional EMG was abnormal in 18 (56.2%), whereas CRS was abnormal in 25 (78.1%). Among the 25 patients with positive CRS tests, 13 received surgical decompression for cervical root compression caused either by a cervical disc or by foramen narrowing due to spondylosis. Only 10 out of 13 (76.9%) had abnormal conventional EMG findings. CRS provides a sensitive method for making a direct evaluation of proximal root conduction and is a good aid for pre-surgical evaluation of cervical radiculopathy.

Action Potentials↗
PubMed1994

MR imaging evaluation of bone marrow signal change in post-irradiation patients with nasopharyngeal carcinoma.

BACKGROUND: The normal distribution of red and yellow marrow can be altered by therapeutic irradiation, which causes a well-documented sequence of bone marrow changes. This study measured the T1 signal intensity of the clivus and cervical vertebral bodies of NPC patients who had received a complete course of radiation therapy. METHODS: There were 3 categories of patients: Group I: NPC patients who had radiation myelitis; 14 persons which a total 20 times of MRI. Group II: NPC patients, without radiation myelitis; 6 patients, which a total 6 times of MRI. Group III (control group): patients who received MRI of the cervical spine because of cervical spondylosis or HIVD, were total of 45 patients. In the sagittal section of T1WI, the signal intensity of the bone marrow of clivus and C2 to T1 vertebral bodies was measured. RESULTS: 1). There were homogeneous increases of signal intensity of the bone marrow of clivus and C2 to T1 in Groups I and II. 2). There was no statistical difference between Groups I and II. 3). The increased signal intensity of bone marrow after radiation showed no difference in short and long duration between radiation therapy and MR examinations, indicating that bone marrow signal intensities were increased in NPC patients whether or not they had radiation myelitis. CONCLUSIONS: Signal change in bone marrow may have occurred soon after radiation therapy, and may have persisted for several years. The radiation myelitis always involved the low medulla oblongata to C5 level; however, the bone marrow signal change always extended downward to the T1 level, so bone marrow is more sensitive than the spinal cord and is prone to be affected by irradiation.

Adult↗
PubMed1994

A case of alkaptonuria with root canal stenosis.

Spinal involvement in alkaptonuria is common. Patients usually present in the third or fourth decade with spondylosis or acute intervertebral disc prolapse. Alkaptonuria with root canal stenosis has however hitherto not been reported. We wish to report one such patient.

Adult↗
PubMed1994

Preoperative and postoperative neuroradiologic evaluation of cervical disk disease.

For over five years, a 2.0 Tesla superconductive magnetic resonance imager (Elscint) has been available in Rockland County for neuroradiologic evaluation of cervical disk herniation, stenosis, and spondylosis. Refinement in surface coil design, software, and scanning technique seems to have overcome the problems of providing thin, artifact-free sections with high signal to noise and contrast to noise in a short amount of time. Noninvasive magnetic resonance imaging has been used routinely to preoperatively screen and to postoperatively diagnose patients with cervical radiculopathy and myelopathy. The only patients who underwent conventional myelography or computerized-tomographic myelography were extremely claustrophobic or had a contraindication to MRI such as an aneurysm clip or pacemaker.

Adult↗
PubMed1994

[Surgical treatment of atlanto-axial dislocation in a patient of athetoid cerebral palsy].

The authors report a case of successful surgical treatment of atlanto-axial dislocation (AAD) secondary to athetoid cerebral palsy. A 61-year-old woman was admitted to our hospital in July 1993 complaining of progressive weakness in the right upper extremity and gait disturbance. She had been suffering from athetoid movements of her face, neck and arms due to cerebral palsy. Neurological examinations on admission revealed down-beat nystagmus on downward gazing, motor weakness of extremities, pallhypesthesia, hyperreflexia exaggerated in the right side and bilateral positive pathological reflexes. Lateral tomogram of the upper cervical spine demonstrated instability of the atlanto-axial joint, increased atlanto-dental interval (ADI) by 5.5 mm (in flexion), and narrowed canal at C1 level. Myelogram showed narrowed dural sac and angulation of the spinal cord at C1 level. A halo vest was applied two days before operation for reduction of the atlanto-axial junction and external fixation. She underwent posterior internal fixation using a Hartshill Ransford Loop combined with posterior decompression. This loop was secured to the occiput, C1, C2 and C3 by sublaminar wiring, and foramen magnum decompression and laminectomy of C1 were performed. Postoperative course was uneventful. Postoperative plain X-ray film, tomogram and computed tomography demonstrated good fixation (ADI was 2.5 mm) and excellent stability. There has been no problem during 6 months since the operation. It is known that involuntary movements in patients with athetoid cerebral palsy sometimes cause cervical spondylosis (especially at C3/4 and C4/5 level). Recently, AAD due to athetoid cerebral palsy has been reported. Almost every case of AAD secondary to athetoid cerebral palsy is combined with incompetence of the odontoid process.(ABSTRACT TRUNCATED AT 250 WORDS)

Athetosis↗
PubMed1994

[The former place of execution of the Lucerne herd in Emmen (1562-1798)(1562-1798) and slaughter yard belonging to it (1562-1866): pathologico-anatomic findings in excavated animal bones].

During archaeological excavations of the former knackers yard in Emmen (Canton Lucerne) skeletons and individual bones of more than 700 animals were recovered. 110 bone samples had lesions and were examined macroscopically and radiologically, 100 were from horses, 9 from dogs and only one from cattle. According to morphological and etiopathogenetical criteria, lesions are presented in the following groups: tooth irregularities (10), degenerative changes in bones and joints due to overload and aging (80), trauma and infection (10), other lesions (10). Over 80% of pathological bone samples presented degenerative changes: spondylosis and spondylarthrosis, arthropathies (mainly spavin and ringbone in horses) and ossifying periostitis due to mechanical stress (Periostitis of phalanx I and periostitis of the dorsal cortex of the third metacarpal bone).

Abattoirs↗
PubMed1994

Treatment of non-rheumatoid occipitocervical instability. Internal fixation with the Hartshill-Ransford loop.

We performed posterior fixation with a Hartshill-Ransford contoured loop in 43 patients with instability at the craniocervical junction. No external bracing was used. Fifteen patients had congenital malformations, ten had tumours, seven had 'bone-softening' conditions (such as osteogenesis imperfecta), five had suffered complicated fractures, three had occipito-C1-C2 hypermobility due to lax ligaments and three had severe degenerative spondylosis with pseudotumours of the transverse ligament. Twenty-nine patients had transoral decompression of the cord before fixation. In most cases, cancellous bone grafts taken from the iliac crest were used to induce fusion; in nine very ill patients, no bone graft was used. In the whole series there was no instance of construct failure, broken wire or laminar fracture. The best results were achieved in patients with tumours or bone-softening conditions. No patient with normal neurology deteriorated after surgery but seven had worse neurological deficits after operation than before. Neck stiffness caused half the patients to change their lifestyle.

Adolescent↗
PubMedDate not supplied

[Pathogenesis of thyroalgia].

The authors analyze thyroalgias occurring in various thyroid diseases and diseases of the adjacent organs and tissues. They come to a conclusion that as far as thyroid diseases are concerned, true thyroalgias are the most incident in various thyroiditis forms, thyroid tumors, postoperative cicatrices, and are explained by the pathologic process impact on glandular capsule (stretching, intergrowth, pressure, etc.). Of diseases not directly related to thyroid but causing thyroalgias (pseudothyroalgias) laryngitis, pharyngitis, and osseous conditions are the most incident, which indirectly influence pain development. Pseudothyroalgias should be differentiated from such osseous changes in the neck as deforming spondylosis, spondylarthrosis, extra cervical ribs (a developmental abnormality), and structural specificities of temporal bone styloid processes.

Adolescent↗
PubMed1993

Patterns of rheumatic diseases and antirheumatic drug usage in 11931 Indian patients.

Patterns of rheumatic diseases and antirheumatic drug usage in different regions of India were analysed. The data was collected from a post-marketing surveillance of diclofenac sodium (Voveran) in 11931 patients. The common conditions were-rheumatoid arthritis (RA) 28.1%, osteoarthrosis (OA) 24.8%, soft-tissue rheumatism 12.4%, cervical spondylosis 6%, ankylosing spondylitis (AS) 3.5%, gout 2%. East zone had a significantly lower proportion of osteoarthritis (20.9%). The age distribution and sex ratios of RA, OA and AS were in line with literature reports. The severity of illness was moderate in 62% and duration was more than 6 months in 50.2%. Data on NSAID usage showed a preponderance of combinations and ibuprofen. There were no significant differences in NSAID usage across diseases or regions.

Adolescent↗