Spine
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Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord in the cervical or thoracic region. Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. In particular, cervical disc herniation has been rarely reported as a cause of this syndrome, and including the first article of Stookey in 1928, 9 only 22 cases have been reported. ⋯ A critical review of the pertinent literature is proposed, and the neuroradiologic, therapeutic, and prognostic implications are discussed. Brown-Sequard syndrome produced by a cervical disc herniation is presumably often underdiagnosed, and early surgical intervention is always recommended.
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An in vivo model was used to investigate the response of degenerated discs to various exogenous growth factors. ⋯ Anular fibrochondrocytes in degenerated discs are responsive to some growth factors in vivo. The results have implications in the early intervention of disc degeneration to arrest or slow the degenerative process.
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Spinal somatosensory-evoked potentials (SSEPs), elicited by mixed nerve and dermatomal stimulation, and compound evoked muscle potentials (CMAPs), elicited by lower thoracic interspinous space stimulation, were recorded in rats that underwent single nerve root transection. ⋯ Injury to a single lumbosacral nerve root is diagnosed more easily with M-SSEP. With D-SSEP and CMAP, it was possible to differentiate the lesioned nerve root by stimulating the primary dermatome or recording from the innervated muscle. M-SSEP is an easy-sampling and appropriate tool for screening nerve root injury; its poor specificity may be overcome by using D-SSEP and CMAP in addition. Optimal monitoring of the lumbosacral nerve roots during lumbar spinal surgery requires the administration of M-SSEP, D-SSEP, and CMAP to provide independent verification of lumbosacral nerve root integrity and to allow detection of the occasional injuries that selectively affect either the sensory or motor system.
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Randomized Controlled Trial Comparative Study Clinical Trial
Trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain randomized to lumbar fusion or cognitive intervention and exercises.
A randomized study. ⋯ Patients with chronic low back pain who followed cognitive intervention and exercise programs improved significantly in muscle strength compared with patients who underwent lumbar fusion. In the lumbar fusion group, density decreased significantly at L3-L4 compared with the exercise group.
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Case Reports
Congenital formation of an intraspinal osseous vertebral ring causing spinal cord compression.
A unique case of the congenital formation of an intraspinal osseous vertebral ring causing spinal cord compression is reported. ⋯ An intraspinal osseous vertebral ring is a unique anomaly that, to our knowledge, has not been reported to date. The authors discuss the pathology, imaging, and treatment of this unique condition.