To objectively determine the incidence of dysphagia associated with unilateral vocal cord immobility (UVCI) and to evaluate the potential for response to vocal cord medialization, we made videofluoroscopic swallowing (VFS) recordings of patients with newly diagnosed UVCI and prospectively analyzed them in a blinded fashion using the Penetration-Aspiration Scale (PAS) ...

Release of tethered spinal cord by sectioning of the filum terminale carries a risk of injuring neighboring motor and sensory nerve roots involved in bowel and bladder control. Therefore, intraoperative neurophysiological monitoring techniques have been developed to prevent neurological complications postoperatively. We performed a retrospective chart review of 63 patients ...

OBJECTIVES: To evaluate the efficacy and clinical usefulness of laryngeal electromyography (EMG) in the evaluation and management of vocal cord mobility problems in children; and to determine the ability of laryngeal EMG to differentiate vocal fold fixation versus paralysis. STUDY DESIGN: Case-series review of 8 children with vocal cord immobility ...

A 54-year-old patient with myelofibrosis developed paresis of the legs, and bladder dysfunction due to extramedullary haematopoiesis in the spinal channel. He was given palliative radiotherapy but died shortly afterwards. Although rare, the possibility of extramedullary haematopoiesis in the central nervous system should be considered when neurological symptoms appear in ...

A postpartum patient with a history of epilepsy and lack of compliance with anticonvulsant medication presented with seizures following removal of the placenta under spinal anaesthesia. An acute posterior fossa extradural haematoma was diagnosed and evacuated uneventfully. The aetiology of the seizures and possible association of the haematoma with spinal ...

We describe the clinical, radiologic, and postmortem findings of a 42-year-old man with intravascular lymphomatosis. The patient presented with a conus medullaris syndrome followed by progressive, disseminated spinal and cerebral symptoms. Disseminated encephalomyelitis was suspected due to the clinical, radiologic, and cerebrospinal fluid findings and the results of a stereotactic ...

OBJECT: The authors report their experience in the treatment of 12 symptomatic patients with intradural spinal neurocysticercosis. METHODS: The mean age of the 12 patients was 33 years. There were eight female and four male patients. Cysticercosis was present in association with hydrocephalus in nine cases. In nine of 12 ...

Twenty-three patients with Marfan syndrome who had a posterior spinal arthrodesis, with or without instrumentation, autogenous iliac crest bone graft, and postoperative immobilization were retrospectively reviewed to formulate guidelines for the treatment of scoliosis. Patients in group 1 (7 patients) had both the primary and secondary curves arthrodesed, whereas patients ...

OBJECTIVE: The purpose of this study was to describe the natural history of tethered cord in patients who have undergone meningomyelocele repair. METHODS: We performed a retrospective review of 45 patients with a history of neonatal meningomyelocele repair who subsequently developed symptoms of tethered cord. Symptoms of tethered cord in ...

PURPOSE: Most patients with spinal cord injuries suffer from constipation or fecal incontinence. This study was designed to observe rectal wall properties and the rectoanal inhibitory reflex in patients with acute and chronic spinal cord injury. METHODS: Rectal wall properties were studied by rectal impedance planimetry, a method for simultaneous ...

OBJECT: The goal of this study was to clarify the pathogenesis of myelopathy in patients with ossification of the posterior longitudinal ligament (OPLL) based on the relationship between static compression factors and dynamic factors. METHODS: There was a total of 247 patients, including 167 patients who were conservatively followed for ...

OBJECTIVES: This paper compares the diagnostic sensitivity of two tests in lumbar spinal stenosis (LSS): lumbosacral root stimulation with needle electrodes and needle electromyograph (EMG). MATERIAL AND METHODS: Twenty patients with LSS were assigned to two groups: Patients with 'neurogenic intermittent claudication' (NIC) only (n=11), and patients with 'neurological signs' ...

Previous studies have suggested that spinal cord compression by the vertebral bodies and intervertebral discs during neck flexion cause cervical flexion myelopathy (CFM). However, the exact pathophysiology of CFM is still unknown, and surgical treatment for CFM remains controversial. We examined retrospectively patients with CFM based on studies of the ...

OBJECTIVE: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric Bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects. METHODOLOGY: In this study 40 ASA III and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. All patients received unilateral spinal ...

OBJECTIVE: To evaluate long-term results of chronic intrathecal Baclofen infusion on the spasticity, on the spasms and to evaluate the side-effects of the intrathecal Baclofen in patients with supraspinal spasticity. CLINICAL MATERIALS AND METHODS: Fourteen patients with severe progressive refractory to medical therapy spasticity were evaluated after chronic intrathecal Baclofen ...

OBJECTIVES: Previous studies on reciprocal Ia inhibition in spinal spasticity were contradictory, probably due to differences in the etiology, severity, and the course of recovery from the disease. The purpose of the present study was to establish a correlation between Ia inhibition and clinical abnormalities in spasticity following a spinal ...

STUDY DESIGN: Study of magnetic resonance imaging (MRI) of tuberculosis of spine to determine the incidence and features of isolated tuberculous involvement of the posterior spinal elements. OBJECTIVE: To describe the MRI findings in patients with isolated tuberculous involvement of the posterior spinal elements. SUMMARY OF BACKGROUND DATA: Spinal tuberculosis ...

OBJECTIVE: Käpylä Rehabilitation Centre is in Finland the only unit taking care of the subacute rehabilitation activities of patients with spinal cord injury (SCI). The annual incidence of new patients with SCI is 55 (1.1 per 100,000 inhabitants). The ankylosed spine (AS) is reported to be at greater risk for ...

OBJECT: Dural arteriovenous fistulas (AVFs) are a well-known pathoanatomical and clinical entity. Excluding bilateral involvement of the cavernous sinus, multiple dural AVFs are rare, with isolated reports in the literature. The additional risk associated with multiplicity is unknown, although it has been claimed that there is a greater risk of ...

BACKGROUND AND PURPOSE: It is generally accepted that the gray matter in the watershed area of the midthoracic level of the spinal cord is the ischemic watershed zone of the spinal cord. We performed a retrospective study to reevaluate the frequency and distribution of spinal cord injury after a global ...

The aim of this study is to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS because progression of spinal curvature in patients with idiopathic scoliosis (IS) is of paramount concern in treatment strategies. Follow-up of the outcome of two prospective studies using the ...

For the follow-up of patients with sagittal spinal deformities and postural disorders, we do not have well validated measuring systems at our disposal. All clinical measuring parameters are liable to a high margin of error. With a growing number of patients suffering from postural disorders and kyphoses, we have to ...

We describe a 64-year-old woman with biphenotypic leukemia involving the meninges who received 2 doses of intrathecal methotrexate. Soon after treatment, the patient developed postural rigidity and a marked decline in mental status. The patient died of respiratory failure 1 month after methotrexate treatment was initiated. At autopsy, the brain ...

Lesions situated ventrally and ventrolaterally to the lower brainstem and upper cervical spinal cord test the skills of neurosurgeons. We present our experience with eight such patients who underwent the extreme lateral craniocervical approach. The pathologies encountered include three distal vertebral aneurysms, one prepontine epidermoid, one anterior foramen magnum meningioma, ...

Although intramedullary spinal cord cysticercosis (IMC) is uncommon, its presence is being increasingly recognised by magnetic resonance imaging. We studied six patients from an endemic region and present the MRI features and clinical correlation of IMC. Six patients who presented with para- or quadriplegia were studied by contrast enhanced spinal ...

The importance of spinal cord monitoring during corrective scoliosis surgery is widely acknowledged. However, for patients with preoperative neurologic deficits, its use is technically difficult. In this article, we describe intraoperative transcranial electrical motor evoked potential (TCE-MEP) monitoring in nine patients with neuromuscular weakness who underwent corrective scoliosis surgery. In ...

Retrospective chart review. To identify factors in addition to level of injury (LOI) that may predict ejaculation by penile vibratory stimulation (PVS) in spinal cord injured males. Major urban medical school and teaching hospital. Presence of a bulbocavernosus response (BCR) and a hip flexor response (HR) before PVS (n=123 patients), ...

We studied the spectrum of septic discitis presenting to two busy district general hospitals over 2.5 years (November 1996 to April 1999), surveying the case notes of all patients attending Royal Bournemouth and Poole Hospitals with probable septic discitis on magnetic resonance imaging (MRI). Twenty-two cases of septic discitis were ...

BACKGROUND: In 1995, we reported the use of lateral thoracic expansion in a patient with symptomatic Jeune's asphyxiating thoracic dystrophy. We have subsequently used lateral thoracic expansion 16 times on 10 patients during 7 years. This article reports our outcomes and provides surgical details. METHODS: Charts of all patients undergoing ...

A young asymptomatic patient, with moderate haemophilia due to factor IX deficiency, developed symptoms of upper cord compression caused by a haemorrhage 12 hours after riding a motorcycle on a poorly maintained road. This led to quadriparesis with respiratory paralysis. In spite of neurosurgical intervention and intensive management with respirator ...

The occurrence of motor neuron disease after electrical injury in six patients is reported and compared with patients from the literature. The patients were five men with spinal onset and one woman with bulbar motor neuron disease after electric shock. Two patients were struck by lightning and four by industrial ...

Spinal anaesthesia is a safe, routinely performed procedure. However, in patients with lumbar cutaneous abnormities or deformities of the lower extremities, a previously undetected spinal anomaly may be present. In such patients, it may be prudent to avoid central neuraxial block to prevent neural damage. This instructive case presents such ...

OBJECTIVE: Blepharoclonus (BLC) denotes a large amplitude, involuntary tremors of the orbicularis oculi muscles, observed during gentle closure of the eyelids. BLC may follow major head trauma. Four patients with Arnold-Chiari malformation (ACM) and BLC are described. MATERIALS AND METHODS: The first patient had facial numbness for 5 months; the ...

BACKGROUND: The objective of this study was to identify clinical parameters that predict occult subarachnoid space or spinal cord (SAS/SC) compression, as determined by magnetic resonance imaging (MRI), in patients with metastatic prostate carcinoma. METHODS: A prospective study was performed in which 68 patients with bone metastases from prostate carcinoma ...

SUMMARY: The incidence of intraspinal abnormalities associated with congenital spinal anomalies as detected by magnetic resonance imaging (MRI) is becoming better defined. In this study, 41 nonrandomized children with congenital spinal deformities (excluding myelomeningocele) who underwent complete MR evaluation were reviewed. Of the 41 congenital spinal deformities, 37 demonstrated congenital ...

OBJECT: This study was conducted to review the presentation and management of patients with coccidioidomycosis involving the spine. METHODS: The authors reviewed 23 cases of spinal coccidioidomycosis treated at their institutions. There were 20 males and three females who ranged in age from 9 to 62 years. Non-Caucasian individuals were ...

BACKGROUND: Patients with spinal cord injury (SCI) have always posed difficulties for the diagnosis of an acute abdomen. The aim of the present study was to define this problem retrospectively at Princess Alexandra Hospital and to assess the results of treatment for these patients. METHODS: A retrospective review was conducted ...

The difficulties in diagnosing spinal cord lesions due to the cervical spondylosis is well-known in clinical neurology. In order to investigate the contribution of various neurophysiological examinations in the diagnosis in cervical spondylosis, we examined 70 patients suffering from cervical spondylosis, with peripheral nerve conduction studies, F-wave from the upper ...

To clarify clinical and laboratory findings that may be related to the pathomechanism of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we analyzed these findings in 239 patients with HAM/TSP, including 64 patients followed up for 10 years after their first examinations, with special interest in the HTLV-I proviral load in peripheral ...

Back injuries are a serious problem for nursing personnel who perform frequent patient-handling activities. Common prevention strategies include body mechanics education, technique training, and ergonomic interventions such as the introduction of assistive equipment. This investigation assessed and compared the effectiveness of two patient-handling approaches to reducing injury risk. One strategy ...

INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder affecting motor neuron cells in the cerebral cortex, brain stem and spinal cord. Autonomic nervous system involvement is not a recognized feature of the disease; nonetheless, autonomic dysfunction has been reported in severely affected patients. The aim of this study ...

The possibility of using learned physiological responses in control of progressive adolescent idiopathic scoliosis (AIS) was investigated. Sixteen (16) AIS patients with progressing or high-risk curves (Cobb's angle between 25 degrees and 35 degrees at start and reducible by lateral bending) were fitted with a device with tone alarm for ...

Syringomyelia is a rare degenerative disorder of the spinal cord that causes progressive neurological dysfunction. Patients with syringomyelia have a variety of gastrointestinal symptoms although there are limited data on the frequency or the severity of these complaints. In this case report we describe a 65-yr-old man with syringomyelia and ...

The objective of this study was to identify acute spinal and three-dimensional postural adaptations induced by a shoe lift in a population of idiopathic scoliosis (IS) patients. Forty-six IS patients (mean age: 12 +/- 2 years) were evaluated radiologically and with a stereovideographic system for pelvic obliquity. Based on the ...

Atrophy of the spinal cord is known to occur in multiple sclerosis but the cause and the timing of its onset are not clear. Recent evidence suggests that atrophy may start to occur early in the disease. The aim was to determine whether atrophy of the spinal cord could be ...

A wide variety of disorders of diverse pathogenic mechanisms can trigger spinal cord dysfunction in HIV-1-infected patients. The most common such condition is HIV-1-associated myelopathy (HM) which characteristically complicates advanced HIV-1 disease in patients with low CD4 cell counts and previous AIDS-defining diagnoses. We describe an unusual presentation of HM ...

The acro-osteolyses are a heterogeneous group of disorders characterized by bone resorption. The disorder may occur as familial, idiopathic, or secondary to vascular, inflammatory, or neurologic conditions. Acro-osteolysis is rare in association with spinal dysraphism. It is even rarer for it to be the presenting symptom in spinal dysraphism. We ...

OBJECTIVE: To evaluate lemniscal pathways in patients with central pain (CP) by use of a novel tactile illusion (TI)-producing technique. PATIENTS AND METHODS: Somatosensory (SS) and TI testing was performed on the unaffected and affected wrists of 27 patients with unilateral central nervous system injury and unilateral CP. Data on ...

The medical records of 52 consecutive patients diagnosed with postinfectious encephalitis/encephalomyelitis during the period from 1980 to 1998, including 29 males and 23 females, were reviewed. These patients were divided into three groups according to their clinical and neurodiagnostic characteristics: (1) group I: postinfectious encephalitis, 38 patients; (2) group II: ...

Patients with spinal cord lesion suffer from complex disorders of bladder and anorectal function. We assessed the value of urodynamics and anorectal manometry as prognostic and diagnostic tools in these patients and evaluated the usefulness of these techniques for the differentiation between complete and incomplete spinal cord lesions. Thirty patients ...