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Results for “LUMBOSACRAL REGION”

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PubMed1980

Acute modification of embryonic spinal cord activity induced by hypoxia.

The effects of acute environmental hypoxia on spinal cord polyneuronal activity throughout the later stages (14, 16 or 19 days) of chick incubation were studied. Bioelectrical activity was recorded in ovo from lumbosacral regions of the spinal cord, and frequency histograms were computed from multiunit (burst) activity during a 5-min control, an altered environment (10% O2) period, and a recovery period following hypoxic episodes. An hypoxic environment inhibited burst activity at 14 and 19 but not at 16 days. An age-dependent ability to recover from an acute hypoxic depression of neural activity was apparent, but multiple episodes of hypoxia depressed burst frequency to the same level independent of age. Hypoxia may inhibit the functional expression of specific neuron pools. The different responses to and recovery from hypoxia observed in this embryonic series may be dependent on the relative development of different components of the neuroaxis in the chick. Metabolic processes with age-related capabilities may also influence the different responses which were observed.

Animals↗

PubMedDate not supplied

Magnetic resonance evaluation of pediatric spinal dysraphism.

Magnetic resonance (MR) scans of 22 children with spinal dysraphism were reviewed. MR scans of the cervicothoracic spine in 12 cases revealed 10 Chiari II malformations, 1 Chiari III malformations, and 4 syringohydromyelias. Twelve MR scans of the lumbosacral region were performed demonstrating 11 tethered cords, 6 myelomeningoceles, 4 lipomyeloschises, 2 diastematomyelias, 2 syringohydromyelias, and 2 dermal sinus tracts. MR is effective in defining the relationship of the cerebellar tonsils and brainstem to the upper cervical spinal canal and in evaluating the extent of syringohydromyelia and the degree of cord expansion. The ability to image the spinal cord and associated paraspinal lesions directly in the sagittal and coronal planes with excellent tissue characterization allows MR to accurately diagnose and define the myriad abnormalities associated with pediatric dysraphism.

Adolescent↗

PubMedDate not supplied

Nuclear grooves in ependymoma. Cytologic study of 21 cases.

OBJECTIVE: To study the efficacy of crush preparation smears in the diagnosis of ependymomas. STUDY DESIGN: The study group consisted of 21 patients aged 7-61 years. All were admitted to Shiraz University hospitals (Nemazi and Beheshti) with intramedullary tumors. Fourteen were ventricular (fourth ventricle), 1 was in the parietal lobe, 5 were in the lumbosacral region and 1 was in the cauda equina. Intraoperative crush preparation smears were obtained from tissue, which was sent for frozen section and diagnosed cytologically. The control group consisted of 123 intracranial tumors (meningiomas, schwannomas, astrocytomas, oligodendrogliomas, medulloblastomas, pituitary adenomas, choroid plexus papilloma, craniopharyngioma and metastatic tumors). RESULTS: The smears in 11 cases revealed perivascular pseudorosettes, and the smears in 21 cases revealed ependymal rosettes. Papillary clusters, calcification and intranuclear inclusions were seen in two cases. Acinar structures were seen in seven cases. Myxomatous material was seen in one case. Nuclear grooves were seen in 15 cases. All cases were diagnosed as ependymomas. Biopsy specimens confirmed the cytologic diagnosis. The tumors in the control group showed no evidence of nuclear grooves. CONCLUSION: Fifteen cases of ependymoma showed a substantial number of nuclear grooves. Intraoperative crush preparation smears were very useful in the diagnosis of ependymomas and helped with the rapid interpretation of frozen sections.

Adolescent↗

PubMed2003

Celiac neuropathy.

BACKGROUND: Celiac disease (CD) is a chronic inflammatory enteropathy resulting from sensitivity to ingested gluten. Neurologic complications are estimated to occur in 10% of affected patients, with ataxia and peripheral neuropathy being the most common problems. The incidence and clinical presentation of patients with CD-associated peripheral neuropathy have not previously been investigated. OBJECTIVE: To determine the incidence of CD in patients with neuropathy and to characterize the clinical presentation. METHODS: The records of 20 patients with neuropathy and biopsy-confirmed CD were reviewed. RESULTS: Six of the 20 patients had neuropathic symptoms alone without gastrointestinal involvement, and neuropathic symptoms preceded other CD symptoms in another 3 patients. All patients had burning, tingling, and numbness in their hands and feet, with distal sensory loss, and nine had diffuse paresthesias involving the face, trunk, or lumbosacral region. Only two had weakness. Results of electrophysiologic studies were normal or mildly abnormal in 18 (90%) of the patients. Sural nerve biopsies, obtained from three patients, revealed mild to severe axonopathy. Using the agglutination assay, 13 (65%) of the patients were positive for ganglioside antibodies. Excluding patients who were referred with the diagnosis of celiac neuropathy, CD was seen in approximately 2.5% of all neuropathy patients and in 8% of patients with neuropathy and normal electrophysiologic studies seen at our center. CONCLUSION: CD is commonly associated with sensory neuropathy and should be considered even in the absence of gastrointestinal symptoms.

Adult↗

PubMed1977

Diffuse "anoxic" myelopathy.

Pathologic changes and distribution of lesions of the spinal cord were studied in 16 patients who suffered from "anoxic" episodes. The lesions were symmetrical and limited to the gray matter. The vulnerability of the spinal cord was most marked in the lumbosacral region, although almost every nucleus throughout the spinal cord was subject to damage.

Adolescent↗

PubMed1998

Continuing organizer function during chick tail development.

Development of the posterior body (lumbosacral region and tail) in vertebrates is delayed relative to gastrulation. In amniotes, it proceeds with the replacement of the regressed node and primitive streak by a caudal blastema-like mass of mesenchyme known as the tail bud. Despite apparent morphological dissimilarities, recent results suggest that tail development in amniotes is in essence a continuation of gastrulation, as is the case in Xenopus. However, this has been inferred primarily from the outcome of fate mapping studies demonstrating discrete, regionalized cell populations in the tail bud, like those present at gastrulation. Our analysis of the tail bud distribution of several molecular markers that are expressed in specific spatial domains during chick gastrulation confirms these results. Furthermore, we present evidence that gastrulation-like ingression movements from the surface continue in the early chick tail bud and that the established tail bud retains organizer activity. This 'tail organizer' has the expected properties of being able to recruit uncommitted host cells into a new embryonic axis and induce host neural tissue with posteriorly regionalized gene expression when grafted to competent host cells that are otherwise destined to form only extra-embryonic tissue. Together, these results indicate that chick tail development is mechanistically continuous with gastrulation and that the developing tail in chick may serve as a useful experimental adjunct to investigate the molecular basis of inductive interactions operating during gastrulation, considering that residual tail organizing activity is still present at a surprisingly late stage.

Animals↗

PubMed1998

The advantage of magnetic resonance imaging in diagnosis of cauda equina syndrome in dogs.

Three dogs were evaluated in our study using magnetic resonance imaging (MRI) to reveal the anatomical deformity and the degree of the lesion of cauda equina. In all dogs, MRI revealed soft tissue, such as cauda equina, epidural fat, and intervertebral disc, at the lumbosacral region clearly without contrast medium. Our results suggest that MRI has some advantages in evaluating cauda equina syndrome in dogs.

Animals↗

PubMed2005

Injuries to the lumbar spine: identification and management.

Fifteen percent of spinal injuries occur in the lumbosacral region. Damage to the spinal cord or cauda equina is a possible complication. Thorough assessment of all trauma patients for such injuries will result in early diagnosis and optimal outcome can be achieved. This article looks at the identification and management of injuries to the lumbar spine.

Humans↗

PubMed1991

Coccydynia. Aetiology and treatment.

A five-year prospective trial involving 120 patients was undertaken to investigate the aetiology and treatment of coccydynia. The cause lies in some localised musculoskeletal abnormality in the coccygeal region. Lumbosacral disc prolapse is not a significant factor. The condition is genuine and distressing and we found no evidence of neurosis in our patients. Physiotherapy was of little help in treatment but 60% of patients responded to local injections of corticosteroid and local anaesthesia. Manipulation and injection was even more successful and cured about 85%. Coccygectomy was required in almost 20% and had a success rate of over 90%.

Adolescent↗

PubMed2005

Mouse-chick neural chimeras.

Embryonic chimera production was used to study the developmental processes of the mouse nervous system. The difficulty of performing in situ transplantation experiments of neural primordium of mouse embryo was overcome by isotopic and isochronic grafting of mouse neural tube fragments into chick embryo. Mouse neural tube cells differentiated perfectly in ovo and neural crest cells associated with the grafted neural tube were able to migrate and reach the normal arrest sites of host neural crests. Cranial neural crest cells penetrated into chick facial areas and entered into the development of dental bud structures, participating in vibrissa formation. Depending on graft level, in ovo implanted mouse neural crest cells formed different components of the peripheral nervous system. At trunk level, they located in spinal ganglia and orthosympathetic chains and gave rise to Schwann cells lining the nerves. When implanted into the lumbosacral region, they penetrated into the enteric nervous system. At the precise 18-24 somite level, they colonized host adrenal gland. Mouse neural tube was involved in the mechanisms required to maintain myogenesis in host somites. Furthermore in ovo grafts of mouse cells from genetically modified embryos, in which many mutations induce early death, are particularly useful to investigate cellular events involved in the development of the nervous system and to identify molecular events of embryogenesis.

Animals↗

PubMed2003

[Hopkins' syndrome in the differential diagnosis of flaccid paralysis in children: clinical and neurophysiological features. Case report].

INTRODUCTION: Hopkins syndrome is a motor neuron disease which leads to a flaccid paralysis affecting one or more limbs resembling poliomyelites. It follows an asthmatic attack and the prognosis is poor. All the 34 related cases occured after 13 months of age and there is no report in South America. Our objective is to describe a case of Hopkins Syndrome in Brazil affecting a patient younger than 1 year. CASE: Male 4 months-old infant, started presenting wheezing that turned into respiratory failure which required mecanical ventilation. Three days later he initiated with loss of strength in the lower limbs (LL). The patient was dismissed from hospital better of his respiratory complains but still paraparetic. Five months later, the patient returned with another episode of severe bronchospasm. At that time, he presented with flaccid paralysis, arreflexia and atrophy of the LL. There were no upper limbs and sensory abnormalities. The patient undergone to lumbar puncture, spinal MRI and SEPs which were all normal. MUSCLE BIOPSY: type grouping. EMG and NCS were in keeping with motor neuron disease affecting just the lumbosacral region. CONCLUSION: Hopkins syndrome should be included in the differential diagnosis of any flaccid paralysis when it is associated with an asthma attack.

Acute Disease↗

PubMed2002

Hydromyelia in a Reeves' muntjac (Muntiacus reevesi).

A 24-day-old, 2.2-kg, female Reeves' muntjac (Muntiacus reevesi) acutely developed left hind limb lameness that resolved with rest and anti-inflammatory drugs but recurred at 8 mo of age. Magnetic resonance imaging (MRI) of the lumbar, sacral, and coccygeal spine revealed a fluid-filled dilatation of the central canal of the spinal cord, which was interpreted as a hydromyelic cyst. Surgical exploration and drainage of the cyst were attempted. Despite initially improved mobility, severe plantar ulceration of both hocks developed. The animal was euthanatized. Gross necropsy of the central nervous system revealed a 1.5-cm-long, mild depression with associated yellowing of the dorsal spinal cord in the lumbosacral region, dilatation of the central spinal canal that extended from the cranial thoracic spinal cord with diameter increasing caudally, and mild herniation of the brainstem at the foramen magnum. Histopathologic lesions of the central nervous system were restricted to the spinal cord, with equivocal enlargement of the fourth ventricle. Pathologic changes included irregular dilatation of the central canal, flattening to the absence of the ependymal cells, spongiosis of the gray matter neuropil, and dystrophic calcification. The gross and histologic findings confirmed the diagnosis of hydromyelia.

Animals↗

PubMed2003

Effects of the treatment of acute lumbar painful syndrome (ALPS) by "PRAXIS METHOD" during the period from 1996 to 2000.

Acute lumbar syndrome occurs suddenly and is accompanied with strong pain in the lower part of the back. The most frequent APLS causes are vertebral (herniation of intervertebral disc, subluxation of intervertebral disc, subluxation of intervertebral joint, fracture of vertebra--traumatic or pathological), or extravertebral (subluxation of sacroiliac joint, acute bursitis of iliolumbar segment, muscle injuries or injuries of tendo-ligamentous apparatus of lumbosacral region). The treatment of acute lumbar painful syndrome is classified as medical, alternatively medical, surgical and combined. On the basis of durable experience, "Praxis method" as a treatment of lumbar pain (general and acute) is being applied in the Centre for Physical Medicine and Rehabilitation "Praxis" in Sarajevo. During the period from 1996 to 2000, the total number of 5.663 patients were examined in the centre "Praxis". Out of that number, 17.7% (1.003) of patients had acute lumbar painful syndrome (ALPS). Immediately after the therapeutic manipulation, which included "Praxis method, 31.5% (317) patients experienced the cessation of pains followed by ending of the treatment. The length of treatment for the rest of patients lasted: 1-7 days in 412 or 41.07 % of patients, 8-21 days in 195 or 19.48% of patients, and more than 21 days in 79 or 7.88% of patients. For all patients (1.003) the average treatment duration was 6.6 days. The recidivation occurred in 127 patients (12.66%). Throughout the treatment successfulness estimation according to clinical results scaled from 0 to 5, it was confirmed that out of the total number of 831 patients (82.85%) results were excellent in 459 patients (45.76%) or very good in 372 patients (35.09%). The average age of patients was ranging between 35 and 45 years (621 patients or 61.9%). The male/female distribution was 2:1.

Journal Article↗

PubMed1999

Dandy-Walker syndrome associated with occipital meningocele and spinal lipoma--case report.

A neonate presented with Dandy-Walker syndrome associated with occipital meningocele and spinal lipoma, manifesting as soft masses on the skull and lumbosacral regions. Magnetic resonance imaging demonstrated a large posterior fossa cyst between the fourth ventricle and occipital meningocele, but the aqueduct was patent and there was no sign of hydrocephalus. A cyst-peritoneal shunt was emplaced at the age of 8 days followed by partial removal of the spinal lipoma and untethering of the cord at the 3 months. Follow-up examination of age 3 years found almost normal development, although the cyst still persisted.

Adult↗

PubMed1983

Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders.

The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

Adipose Tissue↗

PubMed1985

Intraspinal seeding from intracranial tumors in children.

Cerebrospinal fluid-borne metastases were demonstrated by metrizamide myelography in 20 children with primary intracranial tumors, posterior fossa medulloblastomas being the most common. The lumbosacral region was affected most often, with nerve root thickening, nodularity, and irregularity of the thecal sac. Cord cloaking, nodularity, and meningeal disease were common in the cervical and thoracic areas. Intraspinal spread from primary intracranial tumors signals a poor prognosis. However, the early detection of intraspinal spread afforded by metrizamide myelography can alter therapy and thereby improve prognosis.

Brain Neoplasms↗

PubMed1985

Morphometry of lower lumbar vertebrae as seen on CT scans: newly recognized characteristics.

Transaxial computed tomographic (CT) sections represent a new approach to vertebral morphometry, allowing certain measurements to be made in vivo for the first time. The cross-sectional morphology of the bodies and pedicles of L3, L4, and L5 was studied in a series of 213 vertebrae. This revealed that the pedicles of L5 arise more laterally from the body of L5 than from L3. Further, the lateral surfaces of the L5 body are inclined obliquely, unlike those of L3. L4 is transitional in form between L3 and L5, more closely resembling the former. This morphology explains the fact, hitherto unnoticed, that the lateral outlines of the pedicles and the lateral borders of the body of L5 are not normally imaged on plain anteroposterior radiographs. It is evident that pathologic changes of the lateral borders of the body of L5 may be invisible also. In cases of transitional vertebrae in the lumbosacral region the presence or absence of the lateral outlines of the pedicles and of the lateral borders of the vertebral body may be of help in identifying the vertebrae on conventional projections.

Adolescent↗

PubMedDate not supplied

[Balneotherapy in the treatment of subjective symptoms of lumbar syndrome].

INTRODUCTION: Chronic low back pain is a degenerative rheumatic disease and is characterized by various symptoms and clinical signs. BALNEOTHERAPY: Balneotherapy represents a therapy by various hot or warm baths in natural mineral waters of specific physical and chemical characteristics. When used externally, they have mechanical, chemical and thermic effects. Balneotherapy of lumbar syndrome includes: individual baths, swimming in the pool, hydrokinesitherapy, underwater massage, underwater extension, mud therapy, mud baths. The therapy should be closely monitored for optimal efficacy and it is necessary to examine: functional status of the lumbosacral region, general functional status (level of activity), lower extremities, pain measurement, use of non-steroid antirheumatic and analgesic agents. In order to follow-up the effects of therapy and establish the prognosis it is important to perform: detailed anamnesis, anthropometric measurements, socio-epidemiological research, clinical examinations. CONCLUSION: Lumbar syndrome is usually caused by a degenerative disease of the spinal column. More than 25% of people under 45 years of age are unable to work due to chronic low back pain. That is why preventive measures, prompt diagnosis and adequate therapy are of utmost importance.

Balneology↗