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 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We investigated the question as to whether transcranial magnetic stimulation of nerve structures can be used to obtain an objective description of motor impairment in humans with cervical nerve root compression or myelopathies. We were able to show that paresis is correlated with an increase in the latency of the evoked muscle potentials. Application of the method in the fields of orthopaedics and neurosurgery permits a description of motor deficits in cervical compression radiculopathy and myelopathy. Although the value of the method for orthopaedic and neurosurgical purposes is not yet completely clear, our experience does indicate interesting possibilities in the diagnostic evaluation of diseases of the cervical spine.
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PMID:[Diagnostic possibilities of transcranial magnetic stimulation in diseases of the cervical spine]. 139

An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.
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PMID:Diaphragm paralysis from cervical disc lesions. 326 22

Four patients aged 41 to 73 years, who had had rheumatoid arthritis for eight to 25 years, had signs and symptoms of cervical myelopathy and radiculopathy due to either atlantoaxial dislocation with herniation of the odontoid through the foramen magnum, or subluxation of the middle to lower cervical vertebrae. Spastic paraparesis or quadriparesis, severe nuchal immobility and pain, and flaccid paresis of the upper limbs necessitated anterior medullary decompression and posterior cervical fusion. Postmortem examination disclosed old ischemic necrosis, atrophy, and gliosis in the low medulla and cervical cord. Anterior and posterior gray horns and contiguous posterior and lateral funiculi bore the brunt of the damage. Ascending and descending wallerian degeneration and atrophy of the cervical nerve root were evident. In three cases, anterior spinal or radicular arteries demonstrated intimal fibrosis with moderate stenosis; two cases depicted chronic phlebitis or subarachnoid vessels. Previous reports have infrequently provided evidence of a vasculopathy.
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PMID:Cervical myelopathy due to atlantoaxial and subaxial subluxation in rheumatoid arthritis. 668 27

Achondroplasia is an autosomal dominant condition that occurs in approximately 1 of 25,000 births. It has long been associated with neurologic morbidity and mortality in adults, but more recently it has been increasingly identified in children. Neurological sequelae of achondroplasia includes spinal stenosis, spinal cord compression at the foramen magnum (which can result in fatal acute craniocervical junction compression), hydrocephalus, radiculopathy, paresis, and abnormal spinal curvature. We report the case of a 12-year-old achondroplastic patient who incurred an apparently nontraumatic cervical spinal cord infarction, with resultant quadriplegia, with no apparent cause, which was complicated by impaired tolerance of temperature changes and hypercalcemia of immobilization. Whereas persons with achondroplasia have many of the same physical and functional impairments from spinal cord injury as other SCI patients, they are more likely to experience certain types of neurologic deficits and are more subject to other problems because of their altered body habitus.
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PMID:Spinal cord injury rehabilitation in a pediatric achondroplastic patient: case report. 829 50

Magnetic stimulation of motor cortex and cervical spinal cord was used to assess motor impairment in patients with either cervical nerve root compression or myelopathy. Evoked potentials were recorded from biceps brachii and abductor pollicis brevis. Our interest centered on whether the paresis resulting from root compression is accompanied by an increased latency of magnetically evoked muscle potentials and whether latency is increased in cases of cervical root compression or myelopathy in which no paresis occurs. Latency increase does appear to be a moderately good indicator of disturbed nerve conduction. In particular, prolonged latencies in cases of "subclinical" paresis could be used as an important diagnostic tool for the early detection of motor deficits in cervical compression radiculopathy and myelopathy.
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PMID:Magnetic stimulation as a diagnostic tool in cervical nerve root compression and compression-induced neuropathy. 854 71

We were interested in the question, if transcranial magnetic stimulation of nerve structure can be used in the objective description of motor impairment in humans with cervical nerve root compression and myelopathies. We could demonstrate, that paresis is combined with an increase of the latency of the evoked muscle potentials. Applications of the method in Orthopaedics and Neurosurgery involve description of motor deficits in cervical compression radiculopathy and myelopathy. Although the value of the method for orthopaedic and neurosurgical purposes is not yet clear, our experiences indicate interesting diagnostic possibilities in cervical spine diagnostics.
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PMID:[Role of transcranial magnetic stimulation in the diagnosis of cervical root compression and cervical myelopathy]. 865 Oct 1

Segmental zoster paresis (SZP) is the focal, asymmetrical neurogenic weakness which may occur in a limb affected by cutaneous zoster. We have summarized the features of this syndrome, based on a retrospective review of 8 personal and 96 published cases. Limb SZP becomes apparent in at least 3-5% of patients with cutaneous zoster, who are usually over the age of sixty and weak proximally (C5,6,7 or L2,3,4 innervated muscles). Functional motor recovery occurs in about 75% of cases, generally by 1-2 years. Limb weakness is probably due to a lesion of the ventral nerve root, in close proximity to the initiating dorsal ganglionitis. The electrodiagnostic findings, scarce in the literature, typically consist of absent compound sensory nerve action potentials in the involved limb, with less frequent reduction or loss of compound muscle action potentials. Fibrillations and positive sharp waves become detectable within 1-4 months in limb and related paraspinal muscles, decreasing or disappearing later. In addition to this radiculopathy, peripheral nerves may also occasionally become involved, manifest as mononeuropathies of the median, ulnar, long thoracic, recurrent laryngeal, and phrenic nerves. The zoster infection or consequent inflammatory response appears able to affect motor axons distally as well as proximally.
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PMID:Segmental zoster paresis of limbs. 889 77

In a prospective series of 34 incident patients with primary cervical dystonia (CD), 6 showed clinical or radiological signs of cervical radiculopathy (RP) or myelopathy (MP) during the course of their movement disorder. Age at onset in these patients was in the range reported for pure spondylotic cervical RP without an accompanying movement disorder. Radiologically, spondylosis was mild in 1 case and absent in 2 cases. The intervals between onset of CD and RP were shorter than in literature reports of RP/MP in dystonic-athetotic patients of cerebral paresis. Clinically, RP/MP in patients with CD mostly appears at mid-cervical levels, whereas cases with cerebral paresis are more frequently affected at higher cervical segments. We propose that RP/MP does not occur more frequently in CD than in pure spondylotic cervical RP.
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PMID:Radiculopathy and myelopathy in patients with primary cervical dystonia. 1138 61

Monosegmental, degenerative, cervical discopathy may become symptomatic because of spinal instability or neurocompression and may present as cervicalgia, radiculopathy and myelopathy. Conservative therapy of these conditions is indicated only in case of minor symptoms. In patients with radiculopathy, this treatment may be used for a longer period of time than in individuals with myelopathy. However, the disorder may progress and lead to irreversible complaints, especially in case of myelopathy. Therefore, the surgical treatment is preferred: if conservative therapy does not improve symptoms within a short period of time and if the patient continues to suffer, surgery is clearly indicated. Only recently, novel surgical methods such as microtechniques and cage surgery were introduced. The results of these types of surgery in this indications are very favourable with respect to recovery from pain, paresis and sensory deficits, rates of fusion of the motion segment, morbidity and mortality.
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PMID:[Monosegmental , degenerative, cervical discopathy treated by surgery with insertion of an intervertebral cage]. 1221 92

Between 1993 and 1998, the surgical technique of posterior cervical foraminotomy as described by Frykholm, with individual cervical nerve root decompression had been applied at the Neurosurgical Department of the University of Vienna. We conducted a retrospective study to assess the functional and socio-economic outcome. Thirty-two patients were included in this study, 21 men and 11 women with a median age of 48 years (range 30 to 70 years). Prior to surgical management, median duration of symptoms had been 7 weeks (range 1-50 weeks), with cervicobrachialgia in 28 of the patients, 27 of the patients had sustained radicular sensory loss, and in 25 of the patients radicular paresis occurred. Measured by the Prolo Functional Economic Outcome Rating Scale, 64% of the patients were classified with a good outcome (scale 8-10), 18% of the patients were classified with a moderate outcome (scale 5-7), and 18% of the patients were classified with a poor outcome (scale < 5). Two of the patients required additional anterior cervical discectomy and one patient suffered a superficial wound infection which needed surgical drainage. This study confirms that posterior microforaminotomy is a useful technique for degenerative disease causing cervical radiculopathy with the advantage of avoiding fusion and immobilisation. Criteria for evaluating the results of treating cervical spinal disorders vary widely. Comparative analyses of outcome among different therapy protocols are compromised by the diversity among the groups studied, as well as by the varying methods of measuring success. We propose a scale based on the socio-economic and functional status of the patient before and after treatment This scale is easily applicable and can delineate pre- and postoperative conditions of patients. A more universal acceptance of common criteria for judging the outcome of spinal operations should facilitate comparisons among various methods of treatment.
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PMID:Social and economic outcome after posterior microforaminotomy for cervical spondylotic radiculopathy. 1223 9


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