European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Patients with neurosarcoidosis are usually initially treated with steroid administration even when they have concomitant cord compression on magnetic resonance imaging (MRI). Operative intervention may be indicated in patients with spinal cord sarcoidosis requiring either tissue biopsy for diagnosis or associated with progressive neurologic symptoms. However, there have been no previous reports describing clinical outcomes of laminoplasty for spinal cord sarcoidosis. ⋯ The possibility of spinal cord sarcoidosis should be included in the differential diagnosis, when a distinct high signal intensity area is observed within the spinal cord on T2-weighted MR images in patients with spondylotic changes. Laminoplasty is not an effective intervention for the treatment of spinal cord sarcoidosis even when patients have spondylotic changes and/or a constitutionally narrowing cervical spinal canal. Patients with neurosarcoidosis should be treated first with steroid administration even when they have concomitant cord compression on MRI.
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Existing predictive signs as available in current literature may miss potential proximal thoracic (PT) curve deterioration and shoulder imbalance, following selective main thoracic (MT) curve correction in adolescent idiopathic scoliosis (AIS). The present study is an attempt to evaluate and complement these signs, through a retrospective study of 56 AIS patients who underwent correction and fusion from 1986 till 2003 with follow-up 4-16 years. Forty-nine had fusion of MT curve, 7 of MT and PT. ⋯ Seven of these expressed dissatisfaction. Statistically FRI proved valuable predictive factor always in combination with previously described signs. We concluded that a postoperative left shoulder elevation >/=2 cm is a potential cause of dissatisfaction and may be prevented with thorough validation of all predictive signs, principally the FRI.
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Here we investigated the biomechanical properties of spinal segments in patients with degenerative lumbar spondylolisthesis (DLS) using a novel intraoperative measurement system. The measurement system comprised spinous process holders, a motion generator, a load cell, an optical displacement transducer, and a computer. Cyclic displacement of the holders produced flexion-extension of the segment with all ligamentous structures intact. ⋯ The NZ, however, was significantly greater in Group D than in Group N. Thus, compared to normal segments, spinal segments with DLS had a lower flexion stiffness and a higher NZ. NZs in Group D were, however, widely distributed compared to those in Group N that showed NZ <2 mm/N in all cases, suggesting that the segment with DLS is not always unstable and that the segments with NZ >2 mm/N can be considered as unstable.
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Since the dorsal root ganglia represent the first structure of pain modulation, they are the target of the newest therapies of neuropathic pain. Between these, pulsed radiofrequency (PRF) has been described among the promising non-invasive methods. Although the results encourage the clinical use of this procedure, their mechanism of action is still unclear. ⋯ Instead, unmyelinated axons appeared normal in shape and dimension and the Schwann cells surrounding it had intact plasmamembrane. Our results, obtained at acute stage, reveal that the PRF procedure should destroy the myelin envelope of nervous fibres. Further future studies, at chronic stage, should give other information on the prognosis of the myelinic damage.