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The diagnostic value of MRI fistulogram and MRI distal colostogram in patients with anorectal malformations.

Contrast fistulogram (FG) and distal pressure colostogram (DPCG) are standard diagnostic methods for the assessment of anorectal malformations. Pelvic magnetic resonance imaging (MRI) earned a place among essential diagnostic methods in preoperative investigations after the Currarino syndrome and a high incidence of associated spinal dysraphism were described. The aim of our study was to evaluate the possibility of substituting FG and DPCG by a modified pelvic MRI, e.g. MRI fistulogram (MRI-FG) and MRI colostogram (MRI-DPCG). The prospective study involved 29 patients with anorectal malformati

Separation of pyopagus conjoined twins: a New Zealand neurosurgical experience.

Conjoined twins represent a rare form of incomplete embryonic separation. They are classified into eight different subtypes, with 18% representing pyopagus conjoints. History is scattered with accounts of the various types of conjoints and it is only recently that strategies have been devised to enable surgical separation of such twins. It is estimated that approximately 20 cases of separation of pyopagus twins have been performed. We provide a historical look at pyopagus conjoint twins and report our neurosurgical experience of Australasia's first separation of pyopagus twin girls.

[Unilateral pedicle screw fixation versus its combination with contralateral translaminar facet screw fixation for the treatment of single segmental lower lumbar vertebra diseases].

OBJECTIVE: To compare the advantages and disadvantages of unilateral pedicle screw fixation plus lumbar interbody fusion and unilateral pedi … intervertebral disc protrusion in 13 patients, lumbar intervertebral disc protrusion accompany with spinal canal stenosis in 12 patients, massive lumbar intervertebral disc protrusion in 5 patients and lumbar degenerative spondylolisthesis with degree I in 10 patients. The lesions occurred at L3,4 segment in 5 patients, at L4,5 segment in 42 patients, and at L …

Development of a comprehensive treatment algorithm for tandem spinal stenosis: decision making and surgical strategy.

BACKGROUND CONTEXT: Tandem spinal stenosis (TSS) can present with a constellation of myriad neurological symptoms and signs. Whole spine MRI has improved the diagnosis but does not aid therapeutic decision-making. While most studies have focused on cervico-lumbar TSS, there is inadequate literature on TSS of other regions. Further, there are no guidelines on the optimal surgical strategy for patients with TSS. STUDY DESIGN: Retrospective evaluation of prospectively collected data. PURPOSE: To develop a clinico-radiological treatment algorithm for TSS involving all the regions of the spine.

Cochlear implant and inner ear malformation. Proposal for an hyperosmolar therapy at surgery.

The objective of this retrospective study is to evaluate the efficiency of hyperosmolar therapy for cerebrum spinal fluid (CSF) leakage in cochlear implant (CI) surgery in children with inner ear malformations. Between 1991 and 2006, 490 cochlear implantations were performed in Armand Trousseau Children's Hospital. Thirty-seven patients (7.5%) had inner ear malformation. They were classified as isolated enlargement of the vestibular aqueduct (EVA) (18 cases), incomplete partition (IP) (11 cases), common cavity (CC) (1 case) and variable canal and vestibular malformations (VSCC) (7 cases). A hy

[Two different fixation methods combined with lumbar interbody fusion for the treatment of two-level lumbar vertebra diseases: a clinical comparison study].

OBJECTIVE: To investigate the advantages and disadvantages of unilateral pedicle screw fixation combined with contralateral translaminar fac … 29 to 68 years old. Among these patients, lumbar intervertebral disc herniation accompanied by the spinal canal stenosis was found in 29 patients, degenerative lumbar disc diseases in 17 patients and lumbar degenerative spondylolisthesis (degree I) in 3 patients. The lesions occurred at L2,3 and L3,4 segments in 1 patient, at L3,4 and L4,5 segments in 30 pati …

Trans-iliosacral plating for vertically unstable fractures of sacral spine associated with spinopelvic dissociation: A cadaveric study.

BACKGROUND: The treatment algorithm for sacral fracture associated with vertical shear pelvic fracture has not emerged. Our aim was to study a new approach of fixation for comminuted and vertically unstable fracture pattern with spinopelvic dissociation to overcome inconsistent outcome and avoid complications associated with fixations. We propose fixation with well-contoured thick reconstruction plate spreading across sacrum from one iliac bone to another with fixation points in iliac wing, sacral ala and sacral pedicle on either side. Present biomechanical study tests the four fixation patter

Oral Presentations

Introduction: As robotic-guidance and minimally invasive approaches become more prevalent in spine surgery, there is a growing interest in h … ves in an educational environment that is difficult to create in real life, such as the inside of a spinal canal. The visualizations included color-coded anatomy, animations, and interactive movement based on real patient information. Patients not only improved their understanding of the pathology, but the technology enabled patients to feel more confident ove …

Endoscopic Posterior Cervical Foraminotomy and Discectomy.

BACKGROUND: Open posterior cervical foraminotomy has been shown to be comparable with anterior cervical discectomy and fusion (ACDF) in the treatment of cervical radiculopathy1,2. More recently, posterior endoscopic cervical foraminotomy was described as an ultra-minimally invasive technique that allows for neural decompression in cervical radiculopathy. This technique has been shown to have excellent clinical outcomes with a short length of hospital stay and low postoperative pain levels3. DESCRIPTION: The procedure is performed with the patient in the prone position under general anesthesia

E-Posters

Introduction: Cervical disc replacement (cTDR) is a popular treatment for cervical degenerative disc disease. While some devices have shown … hesis & increase in segmental lordosis were measured on radiographs and increase in overall area of spinal canal was evaluated on MRI scans. Results: Out of 34 patients 11 were male and 23 were female. Average age was 63 years. Single segment fusion was done in 24, 2 segment fusion in 9 and 3 segment fusion was done in 1 patient. Average follow up was 5 months …

Transpedicular Corpectomy in Minimally Invasive Surgery for Metastatic Spinal Cord Compression: A Single-Center Series.

Introduction The role of separation surgery in managing symptomatic spinal metastases has been increasing in recent years, and it represents a crucial part of the definitive management of this condition. Methods We report on a series of seven patients treated at the National Cancer Institute in Mexico using minimally invasive approaches to perform transpedicular corpectomy. The goal was to obtain a margin of tumor-free tissue, enabling the completion of oncological treatment with radiotherapy. Results We collected data from six cases. The mean age was 61.2 years. Surgical outcomes were good in

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… Figure 1 (A) Computed tomography (CT) scan of the spine shows a T11 pathological compression fracture with displacement of the posterior wall and invasion of the spinal canal. (B) MRI scan of the spine shows compression of the spinal canal due to a metastatic lesion. … Figure 2 (A) CT scan of the spine shows vertebral augmentation of T11 with methylmethacrylate, preservation of sagittal balance, and decompression of the spinal canal. …

The Use of Imaging in Management of Patients with Low Back Pain.

Lower back pain (LBP) is one of the most common chief complaints encountered in primary care. Advanced imaging studies, including computerized tomography (CT) and magnetic resonance imaging (MRI), are frequently ordered in the setting of LBP. Structural abnormalities are commonly identified by CT and MRI in patients complaining of low back pain, however, these findings are also found in asymptomatic patients. In the past decade, multiple guidelines have been published to help providers identify patients in whom the use of advanced imaging is appropriate. In this article, we review common condi

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… canal size on radiological imaging have not been shown to correlate with clinical symptoms of spinal canal stenosis. … EDH can be suspected if epidural fat is displaced, and if there is displacement of the dura toward the spinal canal. …

Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures.

BackgroundPercutaneous kyphoplasty (PKP), percutaneous mesh-container-plasty (PMCP), and pedicle screw fixation plus vertebroplasty (PSFV) were three methods for osteoporotic vertebral burst fractures (OVBF). The purpose of the current study was to evaluate the clinical safety and efficacy of PKP, PMCP, and PSFV for OVBFs.MethodsThis retrospective study included 338 consecutive patients with thoracolumbar OVBFs who underwent PKP (n = 111), PMCP (n = 109), or PSFV (n = 118) and compared their epidemiological data, surgical outcomes, and clinical and radiological features. Clinical evaluations o

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… B , C Preoperative CT-scan (plain and sagittal reconstruction image) showing the burst fracture with spinal canal compromise. D Preoperative MRI (T2-weighted sequences) showing the burst fracture with spinal canal compromise. … spinal canal via the basivertebral vein, respectively( P > 0.05) (Table 2 ). …

Recent topics in diagnosis and treatment of malignant spinal tumors.

The diagnosis and treatment of malignant spinal tumors are complex and require an integrated approach known as Jaffe's triangle. This review discusses recent topics in the diagnosis and treatment of primary and metastatic malignant spinal tumors. Integrated diagnostic methods, including the development of a dumbbell scoring system for benign-malignant differentiation and the use of positron emission tomography and magnetic resonance imaging (PET-MRI), have improved diagnostic accuracy. Curative resection techniques such as vertebrectomy, sagittal resection, and posterior resection are crucial

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… However, tumor-related vertebral fractures often show more severe vertebral destruction than osteoporotic vertebral fractures, and the risk of leakage into or out of the spinal canal during cement injection is high. … (d) Axial CT image showing intact posterior wall of the spinal canal. (e) Post-BKP lateral X-ray image. …

Oncological and functional results of the surgical treatment of vertebral metastases in patients with multiple myeloma".

BACKGROUND: In nearly 30% of patients with myeloma, pathological fractures are found to occur in the spine. If the patients are not treated promptly and satisfactorily, the quality of their lives diminishes. Currently, the standard treatment for metastatic lesions of the spine is radiotherapy, but surgical intervention is becoming more frequent. It is very important to quickly identify metastases and implement surgical treatment before any fracture/s occur. METHODS: Over the period of 2010-2014 in our department, a total of 129 patients were treated for metastatic spinal myeloma. 73 patients

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… Contraindications to vertebroplasty are symptoms of spinal canal stenosis, neurological deficits and haemorrhagic difficulties [ 2 , 10 – 13 ]. … It was assessed whether there were no losses in the anterior wall of the spinal canal. Patients with vertebral compression (over 50% of the initial group) and patients with recently experienced neurological symptoms or spinal canal stenosis were not scheduled for a vertebroplasty. …

A Rare Occurrence of Primarily Extranodal Spinal Epidural Lymphoma With Spinal Cord Compression and Invasion to the Thoracic Cavity.

A 41-year-old man suffered from progressive radiculomyelopathy caused by spinal epidural mass primarily encasing the spinal cord at the cervicothoracic vertebrae that extended into the thoracic cavity through the neural foramen. An urgent decompressive laminectomy and epidural tumor resection were performed to prevent neurological deterioration and effective spinal cord decompression. The histopathologic diagnosis was diffuse large B-cell lymphoma. As first-line treatment for stage II extranodal lymphoma, he received 6 cycles of R-CHOP (rituximab/cyclophosphamide, hydroxydaunorubicin, Oncovin,

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… MRI images demonstrated a contrast-enhancing lesion in the epidural space which compressed and encased the spinal cord in the spinal canal from C4 to T5. … In MRI findings, extranodal and PSEL show a low signal at T1-weighted imaging (WI) and low to high signal intensity at T2WI and are characterized by no bony invasion in the spinal canal. …

The Correspondence Between Magnetic Resonance Images and the Clinical and Intraoperative Status of Patients with Spinal Tumors.

ABSTRACT INTRODUCTION: Surgical treatment of tumors, particularly metastases to the spine, has become increasingly common owing to the progress in anesthesiology and spinal surgery and greater detectability. The patients qualified for surgeries are those with mechanical pain, fracture or at risk of vertebral fracture or neurological complications. The basis for qualification for different types of surgeries is clinical and imaging examination, particularly MRI and CT. Qualification should always be multidisciplinary and requires understanding and knowledge of its most essential aspects. When c

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… The tumor could be easily dissected from the spinal canal structures that were not neoplastically tarnsformed (Fig. 2 ). The actual infiltration into both the dura mater and the spinal canal was found intraoperatively in two patients. … In some patients, despite the visible on imaging significant stenosis of the spinal canal, no clinical signs of nervous structure compression were observed. …

Magnetic Resonance Imaging in 50 Captive Non-domestic Felids - Technique and Imaging Diagnoses.

Magnetic resonance imaging (MRI) is the recognized gold standard for diagnostic imaging of the central nervous system in human and veterinary patients. Information on the use of this modality and possible imaging abnormalities in captive non-domestic felids is currently limited to individual case reports or small case series. This retrospective study provides information on technique and imaging findings in a cohort of cases undergoing MRI at an academic Veterinary Medical Center. The University of Tennessee College of Veterinary Medicine MRI database was searched for non-domestic felids under

Informed appropriate imaging for low back pain management: A narrative review.

Most patients with acute low back pain (LBP), with or without radiculopathy, have substantial improvements in pain and function in the first 4 weeks, and they do not require routine imaging. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their LBP. It is also considered for those patients presenting with suspicion for serious underlying conditions, such as cauda equina syndrome, malignancy, fracture and infection. In western country primary care settings, the prevalence has been suggeste

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… Antero-posterior spinal canal diameter less than 12 mm in size is considered strongly suggestive of stenosis [96] ; however, the cross-sectional area of the thecal dural sac is considered more suited in the diagnosis of spinal canal stenosis. … In patients who cannot undergo MRI, CT with myelography can be performed to assess the patency of the spinal canal and thecal sac and patency of the neural foramen ( Fig 7 ). …

Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with 125I particle implantation in the treatment of metastatic spinal cord compression: A retrospective study.

BACKGROUND CONTEXT: Metastatic spinal cord compression (MSCC) seriously affects the survival rate. OBJECTIVE: The therapeutic effects of two treatment strategies for MSCC: percutaneous vertebroplasty (PVP) combined with radiofrequency ablation (RFA) and PVP combined with 125I particle implantation, were compared. STUDY DESIGN: Retrospective study. PATIENT SAMPLE: 40 patients with MSCC were divided into two groups: 19 cases in the RFA group and 21 cases in the 125I group. METHOD: All patients were accessed to determine the differences in pain, which was evaluated using the visual analog sca

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… The stenosis rate of the spinal canal was determined by measuring the diameter of the spinal canal and the actual extent of the spinal canal at the site with the most severe compression. … The SSR was calculated using the following formula: SSR = (maximum diameter of the spinal canal at the narrowest level - actual diameter at the narrowest level)/maximum diameter of the spinal canal at the narrowest level. The SSR was measured by two experienced associate chief radiologists. …