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At least 19 recordsLinked to original sources
PubMed1993

[Spinal diseases].

Spinal diseases belong to the most frequently occurring disease groups. Accordingly diagnostic spinal imaging is probably the most common imaging procedure after chest X-ray. Since more than 30 years plain X-ray films are unchanged the first standard procedures. Discrepancies in size and localization of pain and the X-ray results are very often, because pain is in many cases soft-tissue dependent, abnormalities on X-rays images mostly bonybased, however. Therefore in many cases additional examinations like "functional" and oblique views are necessary. Of great help are also CT and MRI. With both modalities soft tissues abnormalities are very well demonstrated. For a lot of questions both modalities are already the "gold standard" of imaging. However, bone scintigraphy is the method of choice in screening of bone metastasis and follow up of inflammatory and malignant abnormalities.

Diagnosis, Differential↗
PubMed1987

Use of magnetic resonance imaging in the evaluation of metastatic spinal disease.

Spinal metastases are present in up to 10% of all cancer patients at some time during the course of their disease. Pain is the most common presenting symptom, and neurological function is usually normal at this early stage. The clinical challenge is to detect and treat the spinal disease before the onset of neurological compromise. Myelography has been the standard test for identification of epidural metastases, but the invasive nature of myelography carries inherent risk and produces patient discomfort. Magnetic resonance imaging (MRI) has been useful in the evaluation of other spinal diseases, is noninvasive, and is tolerated well by patients. We evaluated and compared MRI (64 studies in 58 patients) to conventional studies (myelography, computed tomography, bone scanning, plain films) and determined its accuracy in diagnosis and efficacy in clinical decision making. MRI proved superior in detecting bone and epidural involvement by tumor and was valuable in clinical decision making. In addition, MRI provided better visualization of paravertebral soft tissue involvement by tumor. MRI is recommended as the initial study in patients with suspected metastatic spinal disease.

Adolescent↗
PubMed1994

[Acute ischemic spinal cord disease. Spinal cord infarction. A clinical study and MRI in 8 cases].

Acute spinal cord infarction (ASCI) occurs infrequently and may have diverse causes. The diagnosis of ASCI, and particularly of an anterior spinal artery syndrome (ASAS) can be confirmed nowadays by MRI, whereas in the past only necropsy confirmation was possible. Pathophysiology and long-term prognosis may be better known at present and treatments more consistent. We present the longitudinal study and clinical features of 8 patients suffering from ASCI. All of them were personally studied and had MRI examinations, often with sequential studies. three groups must be considered: one included 4 cases of ASAS at cervical level, the second 2 cases of ASAS at thoracic level and the third group with infarction of the conus medullaris (ICM), one of them developed during surgical repair of an infrarenal aortic aneurysm. Motor and sensory sequelae were assessed in each case together with possible etiological factors. In conclusion, recovery after ASAS tends to be dependent on the severity of the initial deficit. At cervical level, clinical and morphological findings argue in favour of an extrinsic selective compression of the C7 right radiculo-medullary artery as responsible for the ASA. At thoracic level, the artery preferentially occluded seems to be the sulco-commisural artery as a consequence of disc compression. Finally, an underlying peculiarity of the pattern of arterial supply is a probable predisposing factor for ICM. Generally, the long-term prognosis of ASCI is not necessarily bad.

Adult↗
PubMed1992

[Degenerative spinal disease in an outpatient clinic in Lomé (Togo)].

A survey was conducted to determine the frequency and semiological characteristics of degenerative spinal disease in patients attending a hospital rheumatology outpatient clinic in Lomé, Togo. Seven hundred and one of the 1,821 patients seen over a two-year period had degenerative spinal disease. Spinal disease included lower back pain (n = 385), lumbar and radicular pain suggestive of disk protrusion (n = 137), lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal (n = 42), dorsal pain (n = 24), cervical pain (n = 68) and cervical and brachial pain (n = 45). Clinical patterns were similar to those seen in Western countries. However, lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal occurred at a younger age and mainly affected females. These data are in contrast with previous studies suggesting that lumbar and radicular pain due to disk protrusion and stenosis of the spinal canal are uncommon in Black Africa.

Adult↗
PubMed2001

The intervertebral disk: a landmark for spinal diseases in children.

The aim of this paper is to describe the diagnostic value of the different radiological modifications of the intervertebral disk in children. Usual disk modifications include: disk-space narrowing; disk space enlargement; intervertebral disk calcifications; intervertebral disc prolapse; and signal modification in MRI. The gamuts (which are provided in the paper) of these different images must take into account the association with bone changes and the possibility of several disks' involvement. Calcifications are usually related to benign disorders.

Child↗
PubMed2001

Imaging of fungal, viral, and parasitic musculoskeletal and spinal diseases.

There are many nonbacterial infections that have musculoskeletal manifestations and radiologic findings. These infections produce a limited range of tissue responses, depending on the organism, the tissue compartment affected, and the immune competence of the host. Diagnosis is dependent on obtaining an appropriate travel or geographic history, the clinical and laboratory features, and on occasion the specific radiologic findings.

Humans↗
PubMed1990

[Epidemiological aspects of spinal diseases in the GDR in 1979 to 1988].

The socio-economic impact of disorders of the spine and the back has obtained an increasing importance in all industrial countries. Considering indicators of public health and national economy, namely temporary sickness incapacity for work, invalidity (insured persons in the GDR), utilization of hospital services (total population of the GDR), of rheumatological dispensaries as well as of the general practitioner, frequencies have been studied and trends pursued by means of serial analyses in a 10-year period. Diseases of the spine and the back within diagnostic class XIII/ICD, 9th revision, 1975 (diseases of the musculoskeletal system and connective tissue) have caused--nearly 2/3 of all cases of sickness incapacity for work--1/3 of the incidence of disability pensions--about 1/3 of the utilization of hospital services--about 1/5 of the utilization of rheumatological dispensaries--more than 50% of all cases consulting the general practitioner. As to the indicators sickness incapacity for work, incidence of disability pensions and discharges from the hospital, the serial analyses of the period from 1979 to 1988 have shown that the diseases of the spine and the back have the highest increase within the group of class XIII.

Adult↗
PubMed1993

Aortic pathology revealed by MRI in patients with clinical suspicion of spinal disease.

In five patients with clinical suspicion of spinal disease, MRI of the spine revealed unexpected aortic pathology explaining the symptoms. No significant intraspinal pathology was found on MRI. However, in one patient with clinical suspicion of spinal stenosis, an aortic occlusion was detected on MR images of the spine. The lower extremity ischaemia, caused by the occlusion, was responsible for the symptoms. In another patient a paravertebral haematoma from a ruptured aortic aneurysm resulted in spinal nerve compression, thought before MRI to be caused by a spinal tumour. In three patients aortic aneurysm or dissection resulted in spinal cord ischaemia with symptoms mimicking those of compressive spinal disease. Thus, if MRI of the spine does not provide an explanation for the patient's symptoms, examination of the aorta is recommended.

Aged↗
PubMed2001

Concentration of nitric oxide (NO) in spinal fluid of chronic spinal disease.

We studied total nitric oxide (nitrite + nitrate) (NO) levels in cerebrospinal fluid (CSF) of chronic spinal diseases in nonsmokers (133 patients: 76 men and 57 women; mean age, 63 years; range, 15-92 years) by the Griess method to clarify the role of NO in different spinal diseases. The extent of compression in terms of numbers of disc level at the compressed spinal nerve and neurological evaluation were also assessed according to the Japanese Orthopaedic Association scores. The spinal diseases included cervical myelopathy and radiculopathy (cervical disease group), ossification of yellow ligament (thoracic disease group), and lumbar disc herniation, lumbar canal stenosis and lumbar spondylolisthesis (lumbar disease group). NO levels in the spinal disease groups (4.98+/-2.28 micromol/l: mean +/- SD) were significantly higher than that in the control group (2.53+/-0.94 micromol/l). An inverse correlation was detected between the elevated levels of NO and the grade of clinical symptoms in the cervical disorders. The number of disc level at the compressed spinal nerve was positively correlated with elevated NO levels in CSF in the cervical and lumbar disorder groups. These results indicate that nerve compression may elevate NO levels in CSF, and that NO concentration in the CSF might be a useful marker of damage to nervous system in spinal disorders.

Adolescent↗
PubMed2001

Analysis of cartilage-derived retinoic acid-sensitive protein in cerebrospinal fluid From patients With spinal diseases.

STUDY DESIGN: The expression of cartilage-derived retinoic acid-sensitive protein (CD-RAP) was measured in cerebrospinal fluid from patients with spinal diseases. OBJECTIVES: To quantify the levels of CD-RAP in human cerebrospinal fluid and to clarify its character. SUMMARY OF BACKGROUND DATA: Cartilage-derived retinoic acid-sensitive protein is a newly discovered, secreted molecule that is expressed during the chondrogenesis phase of endochondral bone formation and in articular cartilage. In recent studies CD-RAP has been detected in the serum of patients with melanoma and breast cancer, and it has been used to monitor tumor activity. However, the function of CD-RAP is unknown, and the expression of CD-RAP in human cerebrospinal fluid has never been reported. METHODS: The concentration of CD-RAP in human cerebrospinal fluid was measured by enzyme-linked immunosorbent assay with antihuman CD-RAP antibodies. Cerebrospinal fluid samples were collected from two groups of patients. Group 1, the control group, consisted of 40 patients: 22 with trauma and 18 with gynecologic diseases. Group 2 consisted of 172 patients with spinal diseases: 5 with meningioma, 5 with neurinoma, 5 with arachnoid cyst, 30 with cervical spondylotic myelopathy, 35 with lumbar disc herniation, 56 with lumbar canal stenosis, and 36 with scoliosis. RESULTS: The concentration of CD-RAP in the control group was 16.5 +/- 8.3 ng/mL. The concentrations of CD-RAP in Group 2 were: 35.3 +/- 14.7 ng/mL in meningioma, 23.5 +/- 7.41 ng/mL in neurinoma, 26.0 +/- 22.2 ng/mL in arachnoid cyst, 41.7 +/- 22.3 ng/mL in cervical myelopathy, 27.8 +/- 14.7 ng/mL in lumbar disc herniation, 36.5 +/- 18.4 ng/mL in lumbar canal stenosis, and 13.4 +/- 7.48 ng/mL in scoliosis. The concentrations of CD-RAP in cervical myelopathy, lumbar canal stenosis, and lumbar disc herniation were significantly higher than in the control group (P < 0.001). CONCLUSIONS: The CD-RAP concentration was low in the control group, whereas it was significantly higher in spinal diseases that cause spinal stenosis. CD-RAP is expressed in cerebrospinal fluid as a result of damage to or stressing of neural structures and could be a marker for spinal diseases.

Adolescent↗
PubMed1981

[Diagnosis of focal spinal diseases - a critical review].

The article offers a critical review of the diagnosis of focal diseases of the vertebral column, based on 200 histological vertebral column examinations. The findings obtained by means of the roentgenological, histological and bacteriological examinations can be subdivided into 6 groups: 1. Non-specific and specific cases of spondylitis (59 patients); 2. Systemic malignant diseases and primarily malignant tumours (23 patients); 3. Metastases (71 patients); 4. Benign tumours (11 patients); 5. Miscellaneous cases (28 patients) and 6. Unclarified cases (8 patients). The authors comment on the following points with specific reference to the results obtained by them: a) Possibilities and limitations of roentgenological diagnosis: roentgenologically, the inflammatory diseases are most easy to identify, but is not always possible to differentiate safely between non-specific, specific and plasmacellular spondylitis. There are clear limitations to the diagnosis of the type of focal diseases of the spinal column; this applies particularly to the benign and malignant types of tumours. b) Necessity of arriving at an accurate diagnosis: it is imperative to aim at an accurate diagnosis before any meaningful therapy can be initiated. The mandatory need for this is explained via examples covered by the present study. c) Closed or open biopsy: it is shown by means of a review of the literature that open biopsy yields more representative material for the histological examination than closed needle biopsy. It goes without saying that this is a true prerequisite for an accurate histological diagnosis. In this connection, the authors go into the details of the difficulties governing any histological examination. d) informative value of further additional examinations: Scintigraphy, tomography and computer tomography may be valuable aids in the discovery and better visualisation of a vertebral focus, but they are not helpful in arriving at a diagnosis regarding the type of focus involved. Laboratory examinations are not very helpful, either. e) Accuracy of the authors' own diagnostic measures: in spite of open biopsy, 177 cases only out of 200 (88%) could be diagnosed on a purely histological basis. In 12 further cases, diagnosis was established after correlation of the histological finding with the x-ray film. 8 cases (4%) could not be clarified. In 7 patients (3.5%) it must be assumed that the focus was not located despite open biopsy.

Adolescent↗
PubMed2000

Degenerative spinal disease in large felids.

Degenerative spinal disorders, including intervertebral disc disease and spondylosis, seldom occur in domestic cats. In contrast, a retrospective study of 13 lions (Panthera leo), 16 tigers (Panthera tigris), 4 leopards (Panthera pardis), 1 snow leopard (Panthera uncia), and 3 jaguars (Panthera onca) from the Knoxville Zoo that died or were euthanatized from 1976 to 1996 indicated that degenerative spinal disease is an important problem in large nondomestic felids. The medical record, radiographic data, and the necropsy report of each animal were examined for evidence of intervertebral disc disease or spondylosis. Eight (three lions, four tigers, and one leopard) animals were diagnosed with degenerative spinal disease. Clinical signs included progressively decreased activity, moderate to severe rear limb muscle atrophy, chronic intermittent rear limb paresis, and ataxia. The age at onset of clinical signs was 10-19 yr (median = 18 yr). Radiographic evaluation of the spinal column was useful in assessing the severity of spinal lesions, and results were correlated with necropsy findings. Lesions were frequently multifocal, included intervertebral disc mineralization or herniation with collapsed intervertebral disc spaces, and were most common in the lumbar area but also involved cervical and thoracic vertebrae. Marked spondylosis was present in the cats with intervertebral disc disease, presumably subsequent to vertebral instability. Six of the animals' spinal cords were examined histologically, and five had acute or chronic damage to the spinal cord secondary to disc protrusion. Spinal disease should be suspected in geriatric large felids with decreased appetite or activity. Radiographic evaluation of the spinal column is the most useful method to assess the type and severity of spinal lesions.

Age Factors↗