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PubMed2006

[A case of the myelitis due to Toxocara canis infection complicated with cervical spondylosis].

A 59-year-old male had suffered from numbness of the hands for 7 months. With a diagnosis of cervical spondylosis, he had been treated conservatively at a nearby clinic. After he fell off his bicycle, the numbness intensified and limb weakness developed. Cervical MRI revealed spinal cord compression at the C4/5 and C5/6 levels due to cervical spondylosis with prominent edema in the spinal cord spreading from the C4 to C6 level. The edema was very serious. Therefore, we suspected that the traumatic spinal injury underlying the cervical spondylosis was complicated by another disease. Cervical spinal angiography revealed no apparent vascular disorder. Contrast enhanced MRI showed a small enhanced area in the spinal cord at the C5 level. Because of the rapid progression of gait disturbance, expansive laminoplasty was performed without further examination. Although remarkable amelioration of the symptoms was seen just after the surgery, the symptoms worsened again about 1 month later. The patient's clinical history was reconsidered, revealing that he likes raw bovine liver. Serological examination, because of suspicion of parasitic infection showed elevated titers of anti-Toxocara canis antibody in the serum and cerebrospinal fluid. Administration of albendazole improved the clinical symptoms, and normalized the serological and MRI findings. Myelitis due to T canis infection is a rare disease. For an early and accurate diagnosis, it is important to be fully aware of this disease and to include detailed information on food preferences and pet-keeping in the process of compiling a clinical history.

Animals↗
PubMedDate not supplied

[Characterization of biomechanical behavior of the lumbosacral spine in dogs. Characteristics related to spondylosis and disk degeneration].

The in vitro and static biomechanical behaviour of vertebrae with spondylosis were compared with that of healthy vertebrae. In the dog, spondylosis predominates in the lombo-sacral spine which was chosen as an animal model for spontaneous spondylosis. Fourteen surgical specimens were take from German shepherd dogs which had been submitted to right and left lateral flexion, saggital flexion and dorsal flexion. Angular displacements were recorded with an analyser of spinal movement. Our results demonstrated diseased vertebrae have more flexibility than healthy vertebrae in the sagittal and frontal planes than but less so for dorsal flexion. In Addition, diseased vertebrae tend to move upward during lateral flexion. Exeresis of ligament and capsular structures has allowed us to demonstrate the importance of these structures in maintaining spine stability in the sagittal plane and in joint coaptation. Exeresis of the facet joints led to the demonstration of the role of these structures in the maintenance of spine stability in the transverse plane in cases of disc degeneration.

Animals↗
PubMed1977

Myelopathy associated with cervical spondylosis: a frequently unrecognized disease.

Cervical spondylosis or chronic diskogenic disease of the cervical spine is a relatively common cause of myelopathy, but it is often not recognized or is incorrectly diagnosed. The clinical presentation may mimic several types of neurological disease including multiple sclerosis and amyotrophic lateral sclerosis. Even more frequently, and especially early in the course of the disease, neurologic impairment is not recognized and the symptoms are thought to be due to osteoarthritis. Early recognition of this condition is important since adequate treatment can prevent slowly progressive neurologic impairment. Knowledge of the pathophysiology of myelopathy due to cervical spondylosis and adequate radiographic evaluation will often lead to treatment that can prevent progressive spinal cord damage. Cervical spondylosis with myelopathy is one of the most frequently unrecognized and misdiagnosed, yet treatable, conditions affecting the nervous system.

Cervical Vertebrae↗
PubMed1996

Increased cerebrospinal fluid nitrite and nitrate levels in patients with lumbar spondylosis.

Nitric oxide is thought to mediate the cytotoxic effects of certain neurologic diseases. To investigate whether overproduction of nitric oxide may play a role in lumber spondylosis, we compared the levels of nitrite and nitrate in the cerebrospinal fluid (CSF) from patients with lumbar spondylosis with those from a control group by automated flow injection analysis. CSF levels of nitric oxide metabolites were significantly higher in patients with lumbar spondylosis compared with the control (p < 0.01). Nitric oxide may play a role in lumbar pain or nerve damage in sciatic and the CSF nitrite/nitrate may be used as a diagnostic parameter of spinal diseases.

Aged↗
PubMed2005

[Randomized controlled study on picking therapy for treatment of cervical spondylosis].

OBJECTIVE: To use randomized controlled clinical research method to assess therapeutic effect of picking therapy on cervical spondylosis. METHODS: One hundred and fifty-eight cases were randomly divided into a picking therapy group (n=56), a routine acupuncture group (n=55) and a local anesthesia group (n=47). They were treated respectively with picking therapy, routine acupuncture and local anesthesia at Jing bailao (EX HN 15), Dazhui (GV 14), Jianjing (GB 21), etc. Brief McGill Pain Questionaire was used for score, which was combined with clinical symptoms and signs to analyze the therapeutic effect. RESULTS: The cured rate was 57.1% in the picking therapy group, better than 23.6% in the acupuncture group and 14.9% in the local anesthesia group (P < 0.01), and adverse reaction was basically not found in the picking therapy group. CONCLUSION: Picking therapy is a highly effective and safe therapy for cervical spondylosis.

Acupuncture Points↗
PubMed2006

[Effects of a combined regime of auricular-plaster and body acupuncture in treatment of cervical spondylosis of vertebral artery type].

OBJECTIVE: To study effects of a combined regime of auricular-plaster and body acupuncture in treatment of cervical spondylosis of vertebral artery type and make a preliminary revelation of the mechanism. METHODS: Ninety-two patients were randomly divided into 2 groups, the treatment group (n = 56) received the combined regime of auricular-plaster and body acupuncture, and the control group (n = 36) received treatment with body acupuncture. Clinical symptoms and signs, therapeutic effect and some indexes about vertebrobasilar hema-kinetics and hema-rheology were investigated before and after treatment. RESULTS: The treatment group was better than the control group in the clinical overall effective rate (89.29%) and the clinically control rate (17. 85%), and in improving the following indexes, including dizziness and headache, the vertebrobasilar volume and rate of blood flow etab and IR (P < 0.05). CONCLUSIONS: A combined regime of auricular-plaster and body acupuncture ameliorates not only main signs but also some indexes about vertebrobasilar hema-kinetics and hema-rheology. This treatment is an effective therapy for cervical spondylosis of vertebral artery type both in Malaysia and in China.

Acupuncture Points↗
PubMed2006

[The clinical study of cervical arthroplasty in management of cervical spondylosis].

OBJECTIVE: To investigate the clinical effects of cervical disc prosthesis in patients of cervical spondylosis early, compared with the anterior cervical interbody fusion. METHODS: Bryan disc prosthesis replacement applied in 21 case (22 levels) of cervical spondylosis, 27 patients (32 levels) were treated by the anterior interbody fusion. Clinic (JOA grade) and radiological (X-ray of bending, extending; left and right bending position) follow-up of 48 patients was performed preoperatively and postoperatively. Systemic radiographic study about stability and rang of movement (ROM) of replaced levels postoperatively was measured; meantime the ROM of adjacent levels of all cases was observed. CT or MRI scan were applied in 21 patients postoperatively to find out the pressure of the spine and heterotopic ossification in the replaced level. RESULTS: There was no complication. Improvement in all case increased obviously, JOA score increased and stabilized postoperatively in all cases (P < 0.01). Replaced segment achieved stability and restored partial of ROM. There was no prosthesis subsidence or excursion. The adjacent ROM of the case treated by the anterior interbody fusion increased obviously (P < 0.01). No heterotopic ossification was found in the replaced level, but the deteriorated adjacent level of 1 case applied by the anterior interbody fusion occurred. CONCLUSIONS: Bryan cervical disc prosthesis restore stability and partial motion to the level of the intact segment in flexion-extension and lateral bending in postoperational images; The adjacent ROM has not increased obviously. At the same time, it can achieve good short-term clinic effect in replaced level, compared with the anterior interbody fusion.

Adult↗
PubMed2003

Unilateral drop finger due to cervical spondylosis at the C6/7 intervertebral level.

A 64-year-old man who presented right drop fingers without pyramidal signs due to cervical spondylosis is reported. Magnetic resonance imaging showed a high signal intensity change on T2-weighted scans of the spinal cord at the C6/7 intervertebral level. Evoked spinal cord potentials following ulnar nerve stimulation were attenuated at the C6/7 intervertebral level. Compound muscle action potentials (CMAPs) following right cervical nerve root stimulation were recorded from the extensor digitorum communis. CMAPs following right C8 nerve root stimulation were evoked with small amplitudes. Small polyphasic CMAPs with prolonged onset latency were recorded following right C7 nerve root stimulation. Simultaneous C7 radiculopathy and C8 segmental spinal cord lesion due to cervical spondylosis at the C6/7 intervertebral level were the causes of drop fingers in the present case. Unilateral drop finger is a clinical symptom commonly associated with posterior interosseus nerve palsy, but mention should be made about cervical lesions causing drop finger. Electromyographic abnormalities of the triceps and first dorsal interosseus muscle were the key findings for differentiating the cause from paralysis of the posterior interosseous nerve.

Cervical Vertebrae↗
PubMed2005

Examination of the effects of degeneration on vertebral artery by using neural network in cases with cervical spondylosis.

The scope of this study is to diagnose vertebral arterial inefficiency by using Doppler measurements from both right and left vertebral arterials. Total of 96 patients' Doppler measurements, consisting of 42 of healthy, 30 of spondylosis, and 24 of clinically proven vertebrobasillary insufficiency (VBI), were examined. Patients' age and sex information as well as RPSN, RPSVN, LPSN, LPSVN, and TOTALVOL medical parameters obtained from vertebral arterials were classified by neural networks, and the performance of said classification reached up to 93.75% in healthy, 83.33% in spondylosis, and 97.22% in VBI cases. The area under ROC curve, which is a direct indication of repeating success ratio, is calculated as 92.3%, and the correlation coefficient of the classification groups is 0.9234. It is also demonstrated that those medical parameters of age and systolic velocity, which were applied into the neural networks, were more effective in developing vertebral deficiency.

Adult↗
PubMed1981

Somatosensory evoked potentials in diagnostics of cervical spondylosis and herniated disc.

Somatosensory evoked potentials (SEPs) were recorded in 16 healthy controls and 12 patients suffering symptoms typical of cervical spondylosis and/or herniated disc and showing abnormal findings both in clinical and myelographic examinations. SEP recordings were performed at 3 different levels of the nervous system, at Erb's point, over the 7th cervical spine and at the inion, by stimulating the median nerve separately at both wrists. Nine of the 12 patients were chosen for surgical treatment, while 3 patients received physiotherapy. Six out of the 12 patients showed abnormal findings in SEP recordings, while the 3 patients chosen for the physiotherapy group showed normal SEP recordings. In the present study the amplitudes of the responses may seem to reflect nerve lesions caused by spondylotic deformities more than the latencies of responses. The results suggest that the SEP recordings may have value as a diagnostic aid in cervical spondylosis and spinal stenosis, which finding is in agreement with those of some other authors.

Adult↗
PubMed1984

"Numb, clumsy hands" and high cervical spondylosis.

Thirteen patients with cervical spondylosis and high compressive myelopathy between C-3 and C-5 presented with a distinctive clinical syndrome of "numb, clumsy hands" and stereoanesthesia of the hands. Loss of position and vibration sense was much more severe in the hands than in the legs. Relative sparing of primary sensory modalities and motor and bladder functions were other features. Most patients were incorrectly diagnosed at first and cervical myelography was the critical diagnostic test. Pathology was confirmed surgically or at autopsy. Early recognition and treatment resulted in lessened disability. The syndrome is a distinctive and unusual manifestation of high cervical myelopathy, and it has seldom been reported associated with cervical spondylosis.

Adult↗
PubMed2005

Cage containing a biphasic calcium phosphate ceramic (Triosite) for the treatment of cervical spondylosis.

BACKGROUND: We evaluated the fusion efficacy and clinical outcomes of a cage containing a biphasic calcium phosphate ceramic (Triosite) in treating cervical spondylosis. METHODS: We randomly divided 100 patients with cervical spondylosis undergoing anterior discectomy with interbody polyetheretherketone (PEEK) fusion into 2 groups in the past 2 years: group A (n = 50), PEEK cage containing a biphasic calcium phosphate ceramic (Triosite), and group B (n = 50), PEEK cage containing an autogenous iliac bone graft. We compared the fusion rate, fusion time, spinal curvature, and neuroforamen size between the 2 groups. We also compared excess operation time, excess blood loss, hospital stay, complications, and neurological recovery status between the groups. RESULTS: The fusion rates were 57%, 67%, 77%, 82%, 92%, and 100% in group A and 81%, 86%, 95%, 95% 100%, and 100% in group B in the first 6 postoperative months. The fusion rate in group A was significantly lower than that in group B in the first 5 months after the procedure (P < .05 and P < .01, respectively), but the fusion rate reached 100% in both groups by the sixth month. Within the first 6 months, as the fusion level increased, the fusion rates reduced and time to fusion was delayed in both groups. There were no donor site complications in group A. However, 3 patients (6%) from group B experienced complications (1, wound infection; 1, numbness of thigh; and 1, subcutaneous hematoma) (P < .001). The hospital stay was shorter in group A (4.43 +/- 2.36 days) than in group B (7.00 +/- 3.77 days) (P = .001). The mean excessive blood loss and excessive operative time for an iliac bone graft in group B were 15 +/- 5 mL and 10 +/- 6 minutes. There was no statistical significance in spinal curve correction, neuroforamen enlargement, and neurological recovery. CONCLUSIONS: A cage containing a biphasic calcium phosphate ceramic resulted in complete fusion by the sixth postoperative month, although the fusion rate was lower than that in a cage containing an autograft during the first 5 months after the operation and the time to fusion was delayed. Using a cage containing a biphasic calcium phosphate ceramic leads to a shorter hospital stay, less blood loss, shorter operative time, and no donor site complications. It seemed to be a good substitute for cervical spondylotic fusion.

Absorbable Implants↗
PubMed1981

Cervical spondylosis and dysphagia.

Spondylosis can lead to dysphagia in the elderly. In these patients pressure of solid food on the osteophytes very probably induces pain and cricopharyngeal spasm, and a transient sharp cut-off is seen in the barium column at fluoroscopy. Three cases are presented and it is suggested that this triad should be looked for in all elderly patients with cervical spondylosis.

Aged↗
PubMed1986

Spinal cord injury in forty-four patients with cervical spondylosis.

Within a 12-year period, 44 (9.4%) of 466 patients had spinal cord injury complicating cervical spondylosis. A history of alcoholic use preceding the accident was obtained in 12 (54.5%) of 22 patients whose cord injury was due to a minor fall. The initial myelopathy was complete in 10 patients and incomplete in 34. Although neurological recovery was seen in the majority of the patients with incomplete cord lesion, complete recovery was unusual and most of the patients were partly or completely wheelchair dependent. No patient developed acute neurological deterioration after injury but seven expired. The mortality rate was much higher in the patients whose initial cord lesion was complete (50% or 5/10) than in those with incomplete myelopathy (5.9% or 2/34). There was no delayed neurological deterioration due to progressive spondylosis of the spine but three patients developed post-traumatic syringomyelia several months to several years after the injury.

Accidents↗
PubMed1985

Somatosensory evoked potentials in cervical spondylosis. Correlation of median, ulnar and posterior tibial nerve responses with clinical and radiological findings.

Somatosensory evoked potentials (SEPs) following median, ulnar and tibial nerve stimulation were recorded from sites over the shoulders, neck and scalp in 34 patients with cervical spondylosis. Twenty control subjects were matched for sex and age. Detailed clinical and radiological data were assembled, with particular attention to the sensory modalities impaired and the locus and severity of cord compression. The patients were divided clinically into 4 groups: combined myelopathy and radiculopathy (6 cases), myelopathy alone (15), radiculopathy (6) and neck pain (7). Four cases are described in detail. SEP abnormalities were strongly correlated with clinical myelopathy, but not with radiculopathy. Median and ulnar nerve responses were less often affected than tibial, even with myelopathy above C6 level. Tibial nerve SEP abnormalities were strongly correlated with posterior column signs on the same side of the body, but not with anterolateral column sensory signs. In myelopathy cases, the SEP examination appeared to be more sensitive to sensory pathway involvement than clinical sensory testing. SEP abnormalities were infrequent in cases of radiculopathy and neck pain, bearing no relation to the clinical locus of root lesions. Abnormal SEPs consistent with subclinical posterior column involvement, however, were recorded in 1 patient with radiculopathy and 2 with neck pain. Follow-up recordings made postoperatively in 7 myelopathy cases reflected the clinical course (improvement, deterioration or no change) in 4, but failed to reflect improvement in 3. The correlation of SEP findings with radiological data was generally poor. SEP abnormalities were detected in 6 out of 8 patients with clinical myelopathy but no radiological evidence of posterior cord compression, suggesting that impairment of the blood supply may be an important factor contributing to cord damage. An application for SEPs in the clinical management of cervical spondylosis may lie in the detection of posterior column involvement and the differential diagnosis from disorders such as multiple sclerosis and amyotrophic lateral sclerosis.

Adult↗
PubMed1977

Posterior decompression for myelopathy due to cervical spondylosis: laminectomy alone versus laminectomy with dentate ligament section.

In summary we have reviewed some of the studies and theories regarding the role of the dentate ligaments in cervical spondylosis and myelopathy and the logic which has been proposed either for or against their transection in the surgical treatment of this disease. A review of our own series of patients shows no significant increased morbidity in patients undergoing decompressive laminectomy, dentate ligament section, and dural graft as compared to laminectomy alone for treatment of myelopathy due to cervical spondylosis. Of equal importance is the fact that we could demonstrate no superiority in terms of neurological benefit between these two types of operative therapy. However, intradural inspection carried out as a matter of routine did reveal unexpected midline disk protrusions in two cases, the removal of which allowed the patients to do better than might have been expected from laminectomy alone. These findings lead us to conclude that intradural exploration is always indicated if there exists any doubt as to the nature of the basic pathological process. Also there has been presented some experimental evidence to support division of the dentate ligaments if an unresectable anterior lying mass is found.

Cervical Vertebrae↗
PubMed1999

Quantitative analysis of cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance imaging.

OBJECTIVE: To investigate changes in the cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance (MR) imaging. METHODS: The participants included 44 healthy volunteers, 11 asymptomatic patients with evidence of degenerative changes of the cervical spine revealed by MR imaging but no neurological symptoms referable to those abnormalities, and 23 symptomatic patients with myelopathy who underwent surgery. Cervical spondylotic myelopathy was evaluated using the Japanese Orthopedic Association scores, and the percentage reduction of the transverse cord area at the level of maximum cord compression was measured on T1-weighted magnetic resonance images. A cine phase-contrast MR pulse sequence with peripheral gating was used to measure the cerebrospinal fluid flow direction and velocity in the ventral subarachnoid spaces at the C1 and T1 levels. RESULTS: The velocity waveforms produced by plotting flow velocity at 16 intervals during one cardiac cycle significantly differed among the healthy volunteers, asymptomatic patients, and preoperative symptomatic patients. However, velocity waveforms did not differ between the healthy volunteers and the postoperative patients at the C1 level. Decreases of flow velocity were significantly correlated with the severity of myelopathy and the percentage reduction of cord area. Patients with severe myelopathy (Japanese Orthopedic Association score of 0-9 points) or greater than 30% reduction of cord area showed significantly decreased flow velocity compared with those with mild myelopathy (Japanese Orthopedic Association score of 10-17 points) or less than 30% reduction of cord area. Changes in flow velocity were not correlated with multiplicity of the lesion or the level of maximum cord compression. Postoperative improvement of flow velocity was not correlated with neurological recovery. CONCLUSION: Cine phase-contrast MR imaging allows quantitative and noninvasive assessment of changes in cerebrospinal fluid flow in patients with cervical spondylosis.

Adult↗