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Spinal manipulation and neurology

Patricia M Herman, Eric L Hurwitz, Paul G Shekelle, Margaret D Whitley, Ian D Coulter
BACKGROUND: Spinal mobilization and manipulation are 2 therapies found to be generally safe and effective for chronic low back pain (CLBP). However, the question remains whether they are appropriate for all CLBP patients. RESEARCH DESIGN: An expert panel used a well-validated approach, including an evidence synthesis and clinical acumen, to develop and then rate the appropriateness of the use of spinal mobilization and manipulation across an exhaustive list of clinical scenarios which could present for CLBP...
March 12, 2019: Medical Care
Atul Goel, Ravikiran Vutha, Abhidha Shah, Pralhad Dharurkar, Neha Jadhav, Dikpal Jadhav
OBJECTIVE: Immediate postoperative and early clinical outcome of treatment of spinal kyphoscoliosis associated with Chiari formation and syringomyelia and treated by atlantoaxial fixation is described. MATERIAL AND METHODS: During the period April 2016 to March 2018, 11patients having spinal kyphosciolosis (SKS) as a major presenting symptom in association with Chiari formation and syringomyelia were surgically treated and are analysed retrospectively. There were 6 males and 5 females and their ages ranged from 11 to 17 years (average 14 years)...
February 11, 2019: World Neurosurgery
Julia Bandura, Zhong-Ping Feng
Neuronal calcium sensor 1 (NCS-1) is a high-affinity calcium-binding protein and its ubiquitous expression in the nervous system implies a wide range of functions. To date, it has been implicated in regulation of calcium channels in both axonal growth cones and presynaptic terminals, pre- and postsynaptic plasticity mechanisms, learning and memory behaviors, dopaminergic signaling, and axonal regeneration. This review summarizes these functions and relates them to several diseases in which NCS-1 plays a role, such as schizophrenia and bipolar disorder, X-linked mental retardation and fragile X syndrome, and spinal cord injury...
February 4, 2019: Molecular Neurobiology
Ann Ali Abdelkader, Ahmed Zohdi, Amira M El Gohary, Reem Atef El-Hadidy, Rania Ahmed Almahdy
PURPOSE: Monitoring of somatosensory evoked potentials (SSEPs) serves as an early warning system to detect spinal cord injury and is correlated with postoperative sensory findings. It is an indirect indicator of motor function. This study aimed to evaluate the usefulness of intraoperative SSEPs monitoring as a stand-alone tool during spinal surgeries when motor evoked potentials are not available, to prevent and predict new postoperative neurologic deficits. Motor evoked potentials were not used as the equipment needed to record them was not available at the time of this study...
January 28, 2019: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Alissara Vanichkulbodee, Suwara Issaragrisil, Pholaphat Charles Inboriboon
BACKGROUND: Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury. OBJECTIVE: We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia. CASE REPORT: A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. 3 days prior he was given a layperson Thai massage by a friend...
January 15, 2019: American Journal of Emergency Medicine
Su Jiang, Wei Chen, Yun-Dong Shen, Yan-Qun Qiu, Ai-Ping Yu, Wen-Dong Xu
OBJECTIVE: Contralateral C7 nerve root transfer surgery has been successfully applied to rescue motor function of a hemiplegic upper extremity in patients with central neurological injury. This surgical technique is challenging, and limited anatomical space makes it difficult to manipulate tissues and may lead to higher complication rates. The authors hypothesis a new surgical route in which cervical nerve roots of both donor and recipient sides are exposed from a posterior intradural approach and neurorrhaphy is performed easily and clearly...
January 25, 2019: British Journal of Neurosurgery
Joanna Elizabeth Gernsback, John Paul G Kolcun, Glen Manzano
The catheter tip "granuloma" is a rare inflammatory mass that forms in about 3% of patients with an intradural catheter, most commonly from a morphine pump. It has also been seen with other narcotic pumps, narcotic-non-narcotic combinations, and baclofen pumps. Mass formation is associated with increased opioid dose and concentration. It typically presents with increasing pain requiring increasing doses of medication, with minimal improvement, although it may present with neurologic deficits or be asymptomatic...
December 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Mostafa Osman, Ahmed Diraz
Arachnoid cyst can be defined as cerebral-spinal fluid entrapment within the central nervous system. It may occur primarily as a congenital malformation or secondary as a complication following trauma, infection, bleeding, or surgical manipulation. Congenital arachnoid cyst usually asymptomatic and cause no pressure symptoms. No treatment is needed unless size increase and cause pressure symptoms and increased intracranial pressure. We report a case presented to the hospital with neurological signs of increased intracranial pressure, 3 years Post aborted craniotomy for meningioma resection...
October 2018: Asian Journal of Neurosurgery
Charlie Bouthors, Ahmed Benzakour, Charles Court
BACKGROUND: Surgical treatment of thoracic disc herniation (TDH) is technically demanding due to its proximity to the spinal cord. METHODS: Literature review. RESULTS: Symptomatic TDH is a rare condition predominantly localized between T8 and L1. Surgical indications include intractable back or radicular pain, neurological deficits, and myelopathy signs. Giant calcified TDH (> 40% spinal canal occupation) are frequently associated with myelopathy, intradural extension, and post-operative complications...
November 8, 2018: International Orthopaedics
Matthew E R Butchbach
Systems biology uses a combination of experimental and mathematical approaches to investigate the complex and dynamic interactions with a given system or biological process. Systems biology integrates genetics, signal transduction, biochemistry and cell biology with mathematical modeling. It can be used to identify novel pathways implicated in diseases as well as to understand the mechanisms by which a specific gene is regulated. This review describes the development of mathematical models for the regulation of an endogenous modifier gene, SMN2, in spinal muscular atrophy-an early-onset motor neuron disease that is a leading genetic cause of infant mortality worldwide-by cAMP signaling...
2018: Advances in Neurobiology
Joshua Scott Will, David C Bury, John A Miller
Low back pain is usually nonspecific or mechanical. Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. Clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or imaging. Red flags include progressive motor or sensory loss, new urinary retention or overflow incontinence, history of cancer, recent invasive spinal procedure, and significant trauma relative to age. Imaging on initial presentation should be reserved for when there is suspicion for cauda equina syndrome, malignancy, fracture, or infection...
October 1, 2018: American Family Physician
Jeffrey P Leri
Objective: The purpose of this case study is to describe the presentation of a patient with persistent back pain and a history of carcinoma. Clinical Features: A 50-year-old female runner presented to a chiropractic office with persistent moderate low back and mid-back pain. She had a history of breast carcinoma. She had no positive neurologic signs or symptoms suggestive of radiculopathy. She denied any other health symptoms and received mild relief with only 1 office visit consisting of spinal manipulation, moist heat, and electrical stimulation...
June 2018: Journal of Chiropractic Medicine
Randall J Hlubek, David S Xu, Celene B Mulholland, Jourdan Gilson, Nicholas Theodore, Jay D Turner, U Kumar Kakarla
BACKGROUND: Idiopathic spinal cord herniation (ISCH) is a rare pathology of the spine defined by herniation of the spinal cord through a dural defect. OBJECTIVE: To highlight the operative management of ISCH and the surgical nuances of ISCH repairs conducted at our institution. METHODS: This retrospective review examines consecutive patients with ISCH who were treated surgically between January 1, 2010, and July 31, 2017, at Barrow Neurological Institute, Phoenix, Arizona...
July 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
Simonas Jesmanas, Kristina Norvainytė, Rymantė Gleiznienė, Algirdas Mačionis
A 50-year-old male presented with a one-day history of right leg weakness, numbness, and urinary retention. Weakness was present for two weeks but worsened significantly during the last 24 hours. On the right there was sensory loss in the leg and below the Th8 dermatome. On the left there was sensory loss below the Th10 dermatome and distal loss of temperature sensation. Past medical history revealed a cervical trauma 30 years ago when a glass chip lodged into the left side of the neck. The patient did not seek medical attention after removing it himself...
2018: Case Reports in Neurological Medicine
Robert D Vining, Stacie A Salsbury, W Carl Cooley, Donna Gosselin, Lance Corber, Christine M Goertz
Objectives: Individuals rehabilitating from complex neurological injury require a multidisciplinary approach, which typically does not include chiropractic care. This study describes inpatients receiving multidisciplinary rehabilitation including chiropractic care for brain injury, spinal cord injury (SCI), stroke, and other complex neurological conditions. Design: Chiropractic services were integrated into Crotched Mountain Specialty Hospital (CMSH) through this project...
2018: Journal of Multidisciplinary Healthcare
Zong-Ming Gong, Zhen-Yu Tang, Xiao-Liang Sun
OBJECTIVE: To explore the role of miR-411/FasL in acute spinal cord injury (ASCI). METHODS: The ASCI rat model was established, and expression of miR-411 and Fas ligand (FasL) was examined. Basso, Beattie and Bresnahan (BBB) score was used to evaluate the rats' neurological function. PC12 oxygen-glucose deprivation (OGD) model was also established. Gene manipulation (including miR-411 mimic or inhibitor) was used to modulate gene expression. Luciferase reporter assay was conducted to confirm the targeting relationship between miR-411 and FasL...
June 22, 2018: Biochemical and Biophysical Research Communications
Jonathan A Forbes, Nathan Teschan, Samuel Hayden Jones, Phillip Parry, Luke Simonet, Narayana K Swamy
There is limited evidence to suggest that anterior approaches for the resection of ventral intramedullary lesions of the cervical spinal cord may result in superior neurological outcomes compared with those following more traditional posterior approaches. To the authors' knowledge, no report of an anterior approach to resect a ventral intramedullary capillary hemangioma exists in the literature. In the following paper, the case of a 75-year-old male who presented with progressive neck and left shoulder pain, weakness of the left hand, myelopathy, and gait imbalance is reported...
August 2018: Journal of Neurosurgery. Spine
Marisa Silva, Ana Ferro
INTRODUCTION: Spinal cord injury after thoracoabdominal aortic aneurysm surgery is a devastating and unpredictable complication (1). With surgical manipulation, particularly with aortic clamping, cerebrospinal fluid (CSF) pressure may rise, and its pressure exceeds the spinal arterial pressure, spinal perfusion may be reduced, leading to neurological dysfunction. METHODS AND RESULTS: This clinical case reports to a 70-year-old male patient with an early onset of post-operative paraesthesia of the lower limbs in the immediate post-operative period of thoracoabdominal aortic aneurysm repair...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
July 2018: Clinical Spine Surgery
Tong Yu, Yao Wang, Xi-Wen Zhang, Zhen-De Jiang, Xiu-Jie Zhu, Qi-Yao Jiang, Jian-Wu Zhao
This study aims to evaluate the application of multimodal intraoperative monitoring (MIOM) in surgical treatment for spine burst fracture and dislocation (SBFD) patients.Eleven patients who underwent posterior reduction and instrumentation (PRI) for SBFD from June 2014 to July 2016 were included into the study. The function of the spinal cord was monitored by MIOM. The muscle strength of the lower extremities and American Spinal Injury Association (ASIA) scores were, respectively, evaluated (before surgery, and at 1, 3, 6, and 12 months after surgery)...
March 2018: Medicine (Baltimore)
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