Spinal cord
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Clinical Trial
Diagnostic and prognostic value of compound motor action potential of lower limbs in acute paraplegic patients.
To evaluate the diagnostic and prognostic contribution of motor nerve conduction studies (NCS) in addition to neurological examination in patients with acute paraplegia. ⋯ In contrast to patients with an epiconal SCI almost all patients with damage of the conus/cauda present a severe axonal neuropathy of the tibial and peroneal nerves. Pathological CMAPs develop as early as 1 - 2 weeks after onset of acute paraplegia. They allow, at an early stage, to differentiate between conus/cauda or epiconal lesion and to assess the severity of conus/cauda lesion. Thereafter follow-up examinations remain stable and a developing worsening of peripheral nerve or spinal cord function, eg due to post-traumatic syringomyelia, may be indicated by a secondary deterioration of CMAP values. The clinical examination, according to the ASIA protocol, in acute paraplegia patients, in contrast to the motor nerve conduction studies, is of prognostic value in predicting the outcome of ambulatory capacity.
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Six patients with primary malignant tumor of the thoracolumbar spine who underwent total spondylectomy (TS) by en bloc resection were reviewed retrospectively. ⋯ These preliminary results suggested that TS is an effective procedure in control of local recurrence with acceptable complications.
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After presenting in part I the protocol and the methodology of the Tetrafigap Survey, this article is aimed at investigating demographic characteristics, initial cause of trauma and spinal injury in the French tetraplegic spinal cord injured (TSCI) population. ⋯ The results from this survey form the first detailed description of the French TSCI population. Whereas demographic data show many similarities with those of previous studies in other countries, some specific differences are highlighted, in particular relating to the type of accident.
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The treatment of lumbar cerebrospinal fluid fistula in the presence of an intrathecal catheter is known to be difficult. Open revision surgery is recommended in the literature, although the rate of recurrence is high. The epidural blood patch technique is well established as a successful treatment for post-dural-puncture headaches. ⋯ In this note technical details are given for a successful therapy of lumbar cerebrospinal fluid fistula including the right positioning of the opening of the needle (cerebrospinal fluid can be expected intrathecally and epidurally) by injection of contrast medium first for myelography then for epidurography. In this procedure the (epidural) distribution of autologous blood can be indirectly controlled by compression of the dural sac. The method is easy to perform, and the possible risks are small.