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At least 19 recordsLinked to original sources
PubMed1994

[Acute ischemic spinal cord disease. Spinal cord infarction. A clinical study and MRI in 8 cases].

Acute spinal cord infarction (ASCI) occurs infrequently and may have diverse causes. The diagnosis of ASCI, and particularly of an anterior spinal artery syndrome (ASAS) can be confirmed nowadays by MRI, whereas in the past only necropsy confirmation was possible. Pathophysiology and long-term prognosis may be better known at present and treatments more consistent. We present the longitudinal study and clinical features of 8 patients suffering from ASCI. All of them were personally studied and had MRI examinations, often with sequential studies. three groups must be considered: one included 4 cases of ASAS at cervical level, the second 2 cases of ASAS at thoracic level and the third group with infarction of the conus medullaris (ICM), one of them developed during surgical repair of an infrarenal aortic aneurysm. Motor and sensory sequelae were assessed in each case together with possible etiological factors. In conclusion, recovery after ASAS tends to be dependent on the severity of the initial deficit. At cervical level, clinical and morphological findings argue in favour of an extrinsic selective compression of the C7 right radiculo-medullary artery as responsible for the ASA. At thoracic level, the artery preferentially occluded seems to be the sulco-commisural artery as a consequence of disc compression. Finally, an underlying peculiarity of the pattern of arterial supply is a probable predisposing factor for ICM. Generally, the long-term prognosis of ASCI is not necessarily bad.

Adult↗
PubMed1991

Medical complications of spinal cord disease.

Spinal cord injury increases the risk of many life-threatening medical problems, including respiratory failure, pulmonary embolism, and renal failure. Respiratory failure results from paralysis of muscles of inspiration (which impairs oxygen transport to alveoli) and of expiration (which impairs cough and predisposes to pneumonia and atelectasis). Respiratory failure in patients with spinal cord injury can be prevented by proper positioning of the patient, training of ventilatory muscles, pulmonary toilet, and aggressive use of antibiotics and bronchodilators. When respiratory failure occurs, it can be managed by administration of oxygen, intubation, and mechanical ventilation, and in instances of paralysis of the diaphragm, by diaphragmatic pacing. The risk of deep vein thrombosis and pulmonary embolism in acute spinal cord disease is increased by the immobilization of the patient and abnormalities in clotting factors. Thrombotic disease in spinal cord disease can be prevented by intermittent calf compression and heparinization. If pulmonary embolism develops, the patient should be started on a regimen of warfarin for at least 3 months. If anticoagulation is contraindicated, a Greenfield filter can be placed. However, concurrent use of quad cough places the patient at increased risk for complications from the Greenfield filter. Chronic pyelonephritis and systemic amyloidosis are the most common causes of renal failure in the patient with spinal cord disease. Renal failure can be prevented by maintaining a low postvoid residual volume, avoidance of indwelling catheters, use of medications that are not nephrotoxic, and rapid treatment of infection. Hemodialysis and peritoneal dialysis can extend the life of the patient with spinal cord disease in whom renal failure develops, and successful use of renal transplantation has recently been reported.

Humans↗
PubMed1991

Rehabilitation of patients with spinal cord disease.

Spinal cord injury and disease have multisystem consequences and many potential medical complications. This article addresses the various medical, psychosocial, and vocational issues associated with spinal cord injury and describes how the patient's lifestyle may be affected. The role of the physician and other rehabilitation professionals in the rehabilitation process is described. In addition, various medical concerns, complications, and available treatment modalities are discussed.

Humans↗
PubMed1996

Vertebrospinal angiography in the evaluation of vertebral and spinal cord disease.

Spinal angiography is an infrequently performed radiologic procedure requiring much skill and knowledge for its proper application. Most commonly, spinal angiography is used in the diagnosis of spinal arteriovenous malformations and in the delineation of vascular tumors of the spinal cord. Less usual indications may include preoperative evaluation of the spinal cord vasculature prior to surgeries involving the descending thoracic aorta or ventrolateral approaches to the spine, particularly in patients undergoing repeat operations. Spinal angiography should address three crucial considerations for the surgeon or neurointerventionalist: (1) the exact location and anatomic configuration of the lesion, (2) the vascularity of a lesion and identification of all feeding and draining vessels, and (3) depiction of the regional vascular anatomy of the spinal cord in relation to the lesion. Considering the relatively longer length of the procedure, larger contrast volumes, and increased complexity (as measured by catheter exchanges required) of spinal angiography, however, certain angiographic techniques (e.g., digital subtraction angiography, the use of general anesthesia, or placement of a groin sheath to facilitate catheter exchanges) and the use of low osmolality contrast agents should be considered to improve the quality of the examination while reducing risk.

Angiography↗
PubMed1987

Medical management of spinal cord disease.

In spinal cord disease of horses, a complete history, neurologic examination, and adjunctive diagnostic procedures are very helpful in establishing a tentative diagnosis; however, a definitive diagnosis may be difficult or impossible to establish antemortem. Medical management should be initiated with full consideration of possible etiologies and knowledge of the effects and consequences of medical therapies. This article discusses the drugs commonly used in the management of spinal cord disease and the rationale for their use.

Adrenal Cortex Hormones↗
PubMed1987

Spinal-evoked potentials in dogs with acute compressive thoracolumbar spinal cord disease.

Spinal evoked potentials (SpEP) were recorded on an electromyograph from electrodes placed percutaneously in the ligamentum flava at the lumbosacral junction and between the 10th and 11th thoracic vertebrae following tibial nerve stimulation in 31 anesthetized dogs with acute compressive spinal cord injuries. The neurologic status of each dog was determined by clinical examination before SpEP recordings, and the neurologic status was monitored for 2 months in dogs that had surgical or conservative treatment. Two months after spinal injury, the response to treatment (outcome) of each dog was evaluated and graded as favorable (ambulatory and urinary continent) or unfavorable (nonambulatory, urinary incontinent, or euthanatized with confirmation of myelomalacia). Onset latencies, conduction velocities, amplitudes and durations of the wave forms, and the ratio of conduction velocity to combined durations of the first positive (P1) and first negative (N1) waves (CV/DPN index) were determined and were compared with reference data from clinically normal (control) dogs. Single SpEP recordings were of value in determining the prognosis for recovery. Significant differences were not found in the L7-S1 recordings between the reference (control) and spinal injury groups. Analysis of data from the T10-11 recordings indicated significant differences between the reference and spinal injury groups and between the favorable and unfavorable outcome groups within the spinal injury group. A CV/DPN index was less than 30 in dogs with unfavorable outcomes and greater than 30 in dogs with favorable outcomes. Stepwise discriminant analysis of data from the spinal injury group predicted outcome correctly in all dogs.

Animals↗
PubMed1992

Repair and regeneration: experimental aspects of spinal cord disease.

Regeneration of spinal cord neurons after injury depends on first, the presence of trophic factor(s) which prevent death, induce growth and maintain the viability of the neurone and second, the regenerating neurites must overcome glial scars, extracellular matrices and white matter barriers to reinnervate their target. Attempts at promoting regeneration by using grafts of prosthetic material, Schwann cells and neural tissue have largely been unsuccessful. Although growth could be induced, penetration of regenerating neurites through damaged areas of the spinal cord has been limited. There is as yet very little beneficial functional recovery.

Animals↗
PubMed1986

Magnetic resonance imaging of spinal cord disease of childhood.

Correct diagnosis of spinal cord disease in childhood is often delayed, resulting in irreversible neurologic deficits. A major reason for this delay is the lack of a reliable means to noninvasively visualize the spinal cord. Magnetic resonance imaging (MRI) should be useful in the evaluation of diseases of the spinal cord. A 1.5 Tesla MRI unit with a surface coil was used to study 41 children, including eight patients with intrinsic spinal cord lesions, eight patients with masses compressing the cord, 12 patients with congenital anomalies of the cord or surrounding bony structures, three patients with syrinxes, and three patients with vertebral body abnormalities. Intrinsic lesions of the cord were well seen in all cases as intrinsic irregularly widened, abnormally intense cord regions. MRI was helpful in following the course of disease in patients with primary spinal cord tumors. Areas of tumor were separable from syrinx cavities. Extrinsic lesions compressing the cord and vertebral body disease were also well visualized. Congenital anomalies of the spinal cord, including tethering and lipomatous tissue, were better seen on MRI than by any other radiographic technique. MRI is an excellent noninvasive "screening" technique for children with suspected spinal cord disease and may be the only study needed in many patients with congenital spinal cord anomalies. It is also an excellent means to diagnose and follow patients with other forms of intra- and extraspinal pathology.

Adolescent↗
PubMed1985

Magnetic resonance imaging in the diagnosis of spinal cord diseases.

Experience with magnetic resonance imaging in 22 patients with diseases of the spinal cord is reported. Important additional diagnostic information as compared to conventional neuroradiological techniques (myelography, spinal CT) was gained especially in cases of hydrosyringomyelia, intraspinal tumour and multiple sclerosis. It is suggested that magnetic resonance imaging may become the method of choice in the diagnosis of structural spinal cord diseases.

Adult↗
PubMedDate not supplied

[Diagnosis of spinal cord diseases using myeloscintigraphy].

Ninety-eight patients with a suspected spinal volumetric process were examined and treated. In addition to the routine examinations, modified myeloscintigraphy was performed in 48 patients in order to make an accurate diagnosis and to define process sites. Filling defect was the most common myeloscintigraphic symptom. This symptom was detected in 31 patients with spinal tumors and in 10 patients with another abnormality of the vertebral canal. Myeloscintigraphy was found to be of particular value in the diagnosis of spinal tumors. The technique allows minimum-size formations to be diagnosed even when there are no evidence for subarachnoidal space block.

Diagnosis, Differential↗
PubMed2002

Electrophysiological evaluation of root and spinal cord disease.

The electrophysiological evaluation of root or spinal cord disease is complementary to neuroimaging studies, providing information about functional rather than anatomical integrity and information that is important for diagnostic and prognostic purposes. The electrophysiological findings help to localize a lesion but are not pathognomonic of specific diseases. The findings may also provide insight into underlying physiological mechanisms that have been disrupted. A number of different electrophysiological techniques are now in widespread use. Each of these techniques provides different information and thus has distinct utility and limitations. The optimal evaluation of patients with root or spinal cord disease requires an understanding of how these techniques complement each other and depends on the individual clinical problem for which electrophysiological assessment is requested.

Electromyography↗
PubMed1991

Paraparesis (paraplegia), tetraparesis (tetraplegia), urinary/fecal incontinence. Spinal cord diseases.

Paraparesis (paraplegia) refers to partial (-paresis) or complete (-plegia) loss of voluntary motor function in the pelvic limbs. Similar involvement of all four limbs is termed tetraparesis (tetraplegia). Paraparesis generally results from spinal cord lesions caudad to the second thoracic spinal cord segment, whereas tetraparesis occurs because of lesions craniad to this segment (see discussion of spinal cord lesion localization in The Neurologic Examination and Lesion Localization, on page 328). The limbs may be affected equally; however, asymmetric lesions cause greater clinical involvement on the ipsilateral side. Strictly unilateral lesions at C1-T2 result in clinical involvement on only the affected side of the body (hemiparesis, hemiplegia). Monoparesis (monoplegia) occurs subsequent to unilateral T2-S1 lesions. Trauma and neoplasia are the most common spinal cord diseases affecting cats. Urinary and fecal incontinence often occur concomitant with paresis. General concepts relating to disorders of micturition are discussed at the conclusion of this chapter.

Animals↗
PubMed1989

[Changes in bladder contractility in spinal cord diseases].

Changes in bladder contractility were studied by repeated cystomanometry in 147 patients suffering from central medullary lesions of sudden onset, including 93 cases of spinal shock. The morphology of contraction was always modified in the same fashion though intermediate stages were apparent, some being quite characteristic of neurological dysfunction. This process, which ends in a phasic contraction reproduces the stages of ontogenesis. When contractions are present, but do not produce complete bladder emptying, spontaneous improvement is unlikely in the presence of a complete lesion; sphincterotomy should therefore be considered at an early stage.

Adolescent↗