C5-C6 Level Research Articles

Spontaneous Bullet Migration from Cervical to Lumbosacral Spine: Case Report

The spontaneous migration of projectiles in the spinal canal due to gunshot wound are a rare entity, and may be associated with multiple complications in the evolution. Given the low prevalence, there are no large series registered, so there is no standardized therapeutic protocol. We made a review of the subject on purpose and presented the case of a 22-year-old patient who suffered a HAF in the cervical spine lodging the projectile at the level of C6-C7, installing a quadriplegia, and in the evolution we observed how the projectile migrated at the lumbosacral level L5-S. The diagnosis, clinical and surgical treatment performed were evaluated.

Subaxial Cervical Spine Motion With Different Sizes ofHead-supported Mass Under Accelerative Forces.

The evolution of military helmet devices has increased the amount of head-supported mass (HSM) worn by warfighters. HSM has important implications for spine biomechanics, and yet, there is a paucity of studies that investigated the effects of differing HSM and accelerative profiles on spine biomechanics. The aim of this study is to investigate the segmental motions in the subaxial cervical spine with different sizes of HSM under Gx accelerative loading. A three-dimensional finite element model of the male head-neck spinal column was used. Three different size military helmets were modeled and incorporated into head-neck model. The models were exercised under Gx accelerative loading by inputting low and high pulses to the cervical vertebra used in the experimental studies. Segmental motions were obtained and normalized with respect to the non-HSM case to quantify the effect of HSM. Segmental motions increased with an increase in velocity at all segments of the spine. Increasing helmet size resulted in larger motion increases. Angulations ranged from 0.9° to 9.3° at 1.8 m/s and from 1.3° to 10.3° at 2.6 m/s without a helmet. Helmet increased motion between 5% to 74% at 1.8 m/s. At 2.6 m/s, the helmet increased segmental motion anywhere from 10% to 105% in the subaxial cervical spine. The greatest motion was seen at the C5-C6 level, followed by the C6-C7 level. The subaxial cervical spine experiences motion increases at all levels at both velocity profiles with increasing HSM. Larger helmet and greater impact velocity increased motion at all levels, with C5-C6 demonstrating the largest range of motion. HSM should be minimized to reduce the risk of cervical spine injury to the warfighter.

Degenerative Cervical Disc Herniation: Prevalence of Affected Cervical Level in a Hispanic Population in Puerto Rico

BackgroundIn the literature, degenerative cervical disc herniation is considered to occur more frequently at the C5-C6 and C6-C7 levels. This study aimed to evaluate the operated cervical level prevalence among patients with degenerative cervical disc herniation in a Hispanic Puerto Rico population. MethodsThe University of Puerto Rico Neurosurgery database was used to identify patients who underwent anterior cervical discectomy for degenerative cervical disc herniation during a 15-year period from January 1, 2006 until December 31, 2020. Operated cervical levels for each patient were analyzed. ResultsDuring the study period, 409 patients were operated on for degenerative cervical disc herniation. Two hundred-eight patients (50.8%) had disc herniations at more than one cervical level for 663 treated levels. The most prevalent cervical levels in this Hispanic population were C5-C6 (34.8%) and C4-C5 (28.1%). The C6-C7 level was involved in 18.9% of the operated levels, and the C3-C4 level in 17.3%. The C7-T1 level was involved in only 0.6% of the operated levels, and the C2-3 level in 0.3%. The cohort included 51.3% of men and 48.7% of women, with a men-to-women ratio of 1.05:1. The median age of females was 56.5 (range 26 - 82) and 59.0 (range 31 - 85) for males. Operated cervical discs were most common between the ages of 48 and 66 years for either sex. ConclusionIn a Hispanic Puerto Rico population, the most prevalent operated degenerative cervical disc levels were C5-C6 and C4-C5.

Relationship between Cervical Instability in the Course of Rheumatoid Arthritis and Pelvic Parameters of Sagittal Balance.

The aim of the study is to search for a relationship between cervical instability in the course of rheumatoid arthritis (RA) and pelvic parameters of sagittal balance and lumbar lordosis (LL). The study included 47 patients with rheumatoid arthritis with instability of the cervical segment, who were referred for a consultation to assess indications for surgical treatment. The patients underwent a radiological functional examination of the cervical region and postural examination of the entire spine. The basic parameters of the lumbar section and pelvis of these patients were compared with the population values. Then, using statistical methods, the correlation between radiological parameters of various types of instability and lumbar lordosis (LL), pelvic parameters (PI, SS, PT), as well as the patient's age and duration of the disease was assessed. A statistical correlation was found between the instability in the cervical spine C2-C3 level and the value of the PT and PI angles. A statistically significant correlation was discovered between C1-C2 instability and younger patient age. There was no significant difference in the values of the pelvic parameters and lumbar lordosis in patients with rheumatoid arthritis compared to the population values. Preliminary results suggest that there is a relationship between selected pelvic parameters and the development of instability in patients with rheumatoid arthritis. This may be important in planning treatment and assessing disease progression. Further studies on a larger group of patients are needed, as well as studies evaluating the correlation between other sagittal balance parameters and cervical instability in patients with RA.

Minimally invasive resection of cervical schwannoma (C1-C2 level) using tubular retractors.

Cervical schwannoma excision usually involves laminectomy and violation of the facet joints that necessitates the need for fusion with consequent loss of cervical mobility. The authors present the first video demonstration of an excision of the cervical schwannoma at the C1-2 level using minimally invasive spine tubular retractors, which allows direct access to the lesion and prevents the need for any bony removal. It also preserves the paraspinal muscles, which are important for spinal stability, especially at the C2 level. Special attention is given to incision planning and preoperative image analysis for preventing injury to critical neurovascular structures at this level.

Clinical and Radiological Changes at the Adjacent Segments Following Cervical Spine Surgery: A Retrospective Study

Background and Aim: Adjacent segment disease (ASD), radiological and clinical, is observed in many of the patients who undergo cervical inter-body fusion with/without graft, and with/without plating. This study aims to evaluate the proportion of ASD among patients who underwent cervical spine fusion surgery, to study the severity of degenerative radiographic findings at adjacent levels, and to determine sites and patterns of ASD. Methods and Materials/Patients: A descriptive study was performed on patients who underwent a previous cervical arthrodesis procedure in the last 2-5 years and continued follow-up as neurosurgery outpatients. A total of 59 patients who qualified for the inclusion criteria were included in the study. Results: Spine fixation was commonly performed at a single level mostly with sample size (54.2%, n=32) then at two levels (42.4%, n=25) and three levels (3.4%, n=2). Adjacent segment degeneration was present in the spine fixation level subgroup at a single level of 9 cases (28.12%), two levels of 9 cases (36%), and three-level fixations of 2 cases (100%). Six patients (10.2%) out of 59 patients developed radiculopathy. Among twenty-two cases (37.3%) with new changes at adjacent levels, reduced disc height was the most common one (18.6%, n=11). Anterior and posterior osteophytes with reduced disc height were found in 2 cases. Therefore, actual new changes were present in 20 cases only. The most common level of C4-C5 was observed for the development of ASD (13.6%, n=8). ASD developed at cranial to fusion in 13 cases (22%), caudal to fusion in 5 cases (8.5%), and at both levels in 2 patients. Conclusion: Adjacent segment disease was observed in a significant number of patients who underwent cervical spine surgery as evident from the results but only 6 out of 20 cases with radiological evidence of ASD were symptomatic. Changes were observed commonly at the C4/C5 level.

Hemodynamic and Hydrodynamic Pathophysiology in Chiari Type 1 Malformations: Towards Understanding the Genesis of Syrinx.

The pathophysiology of this association of type 1 Chiari malformation (CM1) and syrinxes is still unknown. There is an alteration in the dynamics of neurofluids (cerebrospinal fluid, arterial and venous blood) during the cardiac cycle in CM1. Our objective is to quantify CSF or arterial blood or venous blood flow in patients with Chiari syndrome (CS) with and without syrinxes using phase-contrast MRI (PCMRI). We included 28 patients with CM1 (9 with syrinxes, 19 without). Morphological MRI with complementary PCMRI sequences was performed. We analyzed intraventricular CSF, subarachnoid spaces CSF, blood, and tonsillar pulsatility. There is a highly significant correlation (p < 0.001) between cerebral blood flow, cerebral vascular expansion volume and venous drainage distribution. Venous drainage distribution is significantly inversely correlated with oscillatory CSF volume at the level of the foramen magnum plane [-0.37 (0.04)] and not significantly correlated at the C2C3 level [-0.37 (0.05)] over our entire population. This correlation maintained the same trend in patients with syrinxes [-0.80 (<0.01)] and disappeared in patients without a syrinx [-0.05 (0.81)]. The distribution of venous drainage is an important factor in intracranial homeostasis. Impaired venous drainage would lead to greater involvement of the CSF in compensating for arterial blood influx, thus contributing to syrinx genesis.

Axial Neck Pain after Cervical Laminoplasty with Preserving C7 Spinous Process Using C7 Arcocristectomy: A Prospective Study.

Single-blinded, randomized, single-center, prospective study. This study aims to compare the radiographical and clinical outcomes between C7 laminoplasty and C7 arcocristectomy, which preserves the C7 spinous process. Laminoplasty is a widely used surgical method that decompresses the cervical spinal cord. However, axial neck pain is one of the major factors of dissatisfaction, and still, it is not clearly solved the reduction method of postoperative axial neck pain. Thirty-one patients with multilevel cervical spondylotic myelopathy who required C6-C7 level decompression surgery were operated and followed up for 24 months. One group (15 patients) received C7 arcocristectomy without laminoplasty, and the other group (16 patients) received C7 laminoplasty. Flexion, neutral, and extension angles were measured using the Cobb method at C2-C7 to evaluate preoperative and postoperative radiographic parameters. Range of motion (ROM), ROM preservation rate of the cervical spine, C2-C7 sagittal vertical axis (SVA), and T1 slope were measured using C-spine lateral X-ray. The Visual Analog Scale (VAS) and modified Japanese Orthopedic Association (JOA) score were used to compare preoperative and postoperative clinical symptoms. Flexion, neutral, extension angles of the cervical spine, C2-C7 SVA, T1 slope, ROM, ROM preservation rate, and modified JOA score were not significantly different between the two groups (p>0.05). In the C7 arcocristectomy group, the average postoperative VAS for axial neck pain was increased in 13.3% (2/15) of the patients, whereas in the C7 laminoplasty group, the average postoperative VAS was increased in 43.8% (7/16) of the patients (p=0.018). C7 arcocristectomy, which preserves the C7 spinous process and posterior structures, is a useful technique for relieving axial neck pain.

Atypical extravertebral ventral cervical disc extrusion in a dog

AbstractA 6‐year‐old cocker spaniel dog was investigated by computed tomography for a marked neck pain more evident on ventroflexion. Cervical disc extrusion of mineralised nucleus pulposus material was identified in the vertebral canal dorsally to the C4–C5 intervertebral space, with spinal cord compression. Another mineralised material was also identified at an unusual location, ventrally to the C2–C3 intervertebral space. Ventral slot at C4–C5 intervertebral disc allowed surgical removal of the compressive disc, and longus colli muscles dissection at C2–C3 level allowed removal of the identified material, confirmed histologically as degenerated (mineralised) nucleus pulposus. Ventral paravertebral disc extrusion of degenerated nucleus pulposus extrusion is rarely described in human medicine. This case report illustrates the anatomical and imaging key points that support the diagnostic approach to a previously undescribed presentation of disc extrusion in dog.

Ossification of the Ligamentum Flavum of the Cervical Spine in an Iranian Woman: Report of a Case With Myelopathy and Review of the Literature

Background and Importance: Ossification of the ligamentum flavum (OLF) is a pathological condition that affects the yellow ligaments, mostly in adult males between the ages of 45 to 70. Ossification is more common in the thoracolumbar region with an accompanying progressive neurological deficit, and its occurrence within the cervical spine is quite rare. Ossification of the yellow ligament is so common in East Asian countries that it is regarded as a frequently occurring aging pathology in the people of this region. Its existence in other ethnic groups is significantly lower. Case Presentation: A 68-year-old Iranian woman with progressive quadriparesis is presented. Cervical computerized tomography and MRI scans revealed two-level, bilateral, posteriorly located, ossified masses occurring at the C4-C5 and C5-C6 levels, which coincided with the ossification of the yellow ligament. Cervical laminectomy and excision of both masses were undertaken and the patient gradually recovered from his resultant neurological symptoms. Conclusion: Symptomatic cervical OLF is a markedly rare pathological finding and is typically illustrated as a medical case report. In a careful review of the literature including the presented patient, we could uncover only 77 cases involving a documented symptomatic cervical OLF.

Design and fabrication of a custom molded splint for tetraplegics

BackgroundThe key rehabilitation goal for cervical cord injury is promoting functional hand movement. Patients with mid to low-level cervical spinal cord injury can achieve the useful tenodesis grasp with the assistance of upper extremity orthosis. In this study, a custom molded writing device was fabricated and applied on cervical cord injured patients with the aim of hand rehabilitation. MethodsA total of fourteen individuals with cervical spinal cord injury at C6–C7 level were recruited for the study. They were divided into two groups, where the experimental group was prescribed with the custom molded writing device and the standard-of-care group was prescribed with the traditionally available writing device. The performance of the devices was evaluated using the Quest 2.0 questionnaire and the quality of writing after an intervention time of 4 weeks. ResultThe group that used custom molded writing device performed comparatively better when compared to the conventional design. The data showed a significant difference with average QUEST scores of 4.47 ± 0.33 for the group using the wrist-driven writing device and 3.04 ± 0.70 for group using the conventional design. For better understanding of the device's performance, the writing with both the splints was also assessed. ConclusionA writing device using the tenodesis grasp was fabricated to rehabilitate the writing skills of individuals with cervical spinal cord injuries. The performance of the device provided a favorable result indicating to elaborate the study for future references.

Incidence of Carpal Tunnel Syndrome and Other Coexisting Brachial Plexus Neuropathies in Bullseye Shooters—A Pilot Retrospective Clinical and Neurophysiological Assessment

Shooting may impact the frequency of neuropathies in the upper extremity nerves or of cervical disc–root conflicts. This study was undertaken to assess whether shooting sports trained with a handgun by civilians may influence the risk factor for carpal tunnel syndrome (CTS) and other neuropathies of the brachial plexus nerve fibers. Neurophysiological studies using surface electromyography (rEMG at rest and mcEMG during maximal contraction), electroneurography (ENG), and motor-evoked potential recordings (MEPs) were performed in a select population of nine shooters, which were rigorously screened as positive through a clinical examination for carpal tunnel syndrome and other brachial plexus neuropathies among a population of forty-two subjects, to confirm the existence of pathologies in the upper extremities. Increased muscle tension in rEMG and a simultaneous decrease in motor unit activity in mcEMG were recorded both in the proximal and distal muscles of the upper extremities more frequently in the shooters than in the healthy controls—volunteers. An ENG examination confirmed CTS in the shooting hand of four subjects (4/42; 9.5%), additionally revealing a significantly decreased F-wave at the C6–C7 levels in the dominant extremities of the shooting group in comparison to the control population (p = 0.05). All the examined subjects had revealed brachial plexus pathologies on both sides according to the results of the MEP recordings upon stimulation at the C4–C8 levels (various significant differences between the shooters and control group were found), and two had ulnar neuropathy in the wrist on the shooting side. It was concluded that shooting sports are a moderate risk factor for carpal tunnel syndrome and that they significantly influence the development of other brachial plexus neuropathies.

Is laminectomy necessary for C1-C2 epidural schwannomas?

Spinal schwannomas often require laminectomy for gross total resection. However, laminectomy may not be necessary due to the unique anatomy of epidural schwannomas at the C1-2 level, even with the intradural part. This study aimed to determine the need for laminectomy by comparing factors between patients who underwent laminectomy and those who did not and to identify the benefits of not performing laminectomy. Fifty patients with spinal epidural schwannoma confined to C1-C2 level were retrospectively collected and divided into groups based on whether laminectomy was intended and performed. In all cases where laminectomy was conducted, patients underwent laminoplasty using microplate-and-screws, which deviates from the conventional laminectomy approach. Tumor characteristics were compared, and a cut-off value for laminectomy was determined. Outcomes were compared between groups, and factors influencing laminectomy were identified. Postoperative changes in cervical curves were measured. The diameter of the intradural part of the tumor was significantly longer in the laminectomy performed group, with a 14.86mm cut-off diameter requiring laminectomy. Recurrence rates did not differ significantly between groups. Surgery time was substantially longer for the laminectomy performed group. No significant changes were observed in Cobb's angles of Oc-C2, C1-C2, and Oc-C1 before and after surgery. The study showed that the diameter of the intradural part of the tumor influenced the decision to perform laminectomy for removing epidural schwannomas at C1-C2. The cut-off value of the diameter of the intradural part of the tumor for the laminectomy was 14.86mm. Not performing laminectomy can be a viable option with no significant differences in removal and complication rates.

Association between fatty infiltration in the cervical multifidus and treatment response following cervical interlaminar epidural steroid injection.

Recent attention has been directed towards fatty infiltration in the cervical extensor muscles for predicting clinical outcomes in several cervical disorders. This study aimed to investigate the potential association between fatty infiltration in the cervical multifidus and treatment response following cervical interlaminar epidural steroid injection (CIESI) in patients with cervical radicular pain. The data of patients with cervical radicular pain who received CIESIs between March 2021 and June 2022 were reviewed. A responder was defined as a patient with a numerical rating scale decrease of ≥ 50% from the baseline to three months after the procedure. The presence of fatty infiltration in the cervical multifidus was assessed, along with patient characteristics, and cervical spine disease severity. To assess cervical sarcopenia, fatty infiltration in the bilateral multifidus muscles was evaluated at the C5-C6 level using the Goutallier classification. Among 275 included patients, 113 (41.1%) and 162 (58.9%) were classified as non-responders and responders, respectively. The age, severity of disc degeneration, and grade of cervical multifidus fatty degeneration were significantly lower in responders. Multivariate logistic regression analysis revealed that pre-procedural symptoms (radicular pain with neck pain, odd ratio [OR] = 0.527, P = 0.024) and high-grade cervical multifidus fatty degeneration (Goutallier grade 2.5-4, OR = 0.320, P = 0.005) were significantly associated with an unsuccessful response to CIESI. These results suggest high-grade cervical multifidus fatty infiltration is an independent predictor of poor response to CIESI in patients with cervical radicular pain.

Outpatient minimally invasive spine surgeries during the COVID-19 pandemic – A retrospective analysis of 164 consecutive cases

ObjectiveTo share our surgical experiences of minimally invasive cervical and lumbar procedures for patients who suffered from non-fatal motor vehicle accidents (MVAs) in the ambulatory surgery centers (ASCs) during the coronavirus disease 2019 (COVID-19) pandemic. MethodsAnterior cervical discectomy and fusion (ACDF), anterior lumbar interbody fusion (ALIF), minimally invasive laminotomy and discectomy (MILD), percutaneous endoscopic laser-assisted discectomy (PELD) and percutaneous kyphoplasty (PK) were performed on carefully selected patients. ResultsFrom January 2020 to December 2021, our group performed 164 cases on 153 patients involving 249 intervertebral disc (IVD) levels. Of these, 116 cases (70.73%) on 114 patients (74.51%) were cervical, 48 cases (29.27%) were lumbar (including 8 PK cases). Eight patients had both cervical and lumbar procedures in a single anesthetic session (SAS) and were discharged on the same day. One hundred and six ACDF cases (92.17%) were at the C4–C5 and C5–C6 levels, which comprised of 146 (76.04%) IVDs. Of the 40 non-PK lumbar cases, 38 (95.0%) were at L4 to S1 lumbar levels. Six of these cases (15.0%) involved 2 lumbar levels. In contrast, 6 out of 8 kyphoplasties (75.0%) involved lower thoracic/higher lumbar vertebral columns (T11 to L2) and 2 were at the lower lumbar L4 level. ConclusionsWe successfully and safely performed various cervical and lumbar spine surgeries in the ASCs amid COVID-19 pandemic and all patients achieved the same-day discharge (SDD). In the non-fatal MVAs, mid-lower cervical (C4 to C6) and lower lumbar (L4 to S1) IVDs were the most affected levels.

Treatment of high cervical arteriovenous fistulas in the craniocervical junction region.

The craniocervical junction (CCJ) is a complex region. Rarely, arteriovenous fistulas (AVFs) can occur in the CCJ region. Currently, it is accepted that CCJ AVFs should only refer to AVFs at the C1-C2 levels. It is reasonable to assume that high cervical CCJ AVFs are being referred to when discussing CCJ AVFs. High cervical CCJ AVFs can be divided into the following four types: dural AVF, radicular AVF, epidural AVF and perimedullary AVF. Until now, it was difficult to understand high cervical CCJ AVFs and provide a proper treatment for them. Therefore, an updated review of high cervical CCJ AVFs is necessary. In this review, the following issues are discussed: the definition of high cervical CCJ AVFs, vessel anatomy of the CCJ region, angioarchitecture of high cervical CCJ AVFs, treatment options, prognoses and complications. Based on the review and our experience, we found that the four types of high cervical CCJ AVFs share similar clinical and imaging characteristics. Patients may present with intracranial hemorrhage or congestive myelopathy. Treatment, including open surgery and endovascular treatment (EVT), can be used for symptomatic AVFs. Most high cervical CCJ AVFs can be effectively treated with open surgery. EVT remains challenging due to a high rate of incomplete obliteration and complications, and it can only be performed in superselective AVFs with simple angioarchitecture. Appropriate treatment can lead to a good prognosis.

Glomus tumor mimicking as cervical radiculopathy

Glomus tumors are rare, painful, and usually benign neoplasms typically occurring at the subungual aspect of digits. Patients usually complain of extremely painful episodes. Symptoms occur spontaneously or elicited by local compression and cold environment, in special if the tumor has an acral location. We describe a case of cervical radiculopathy caused by glomus tumor which developed spontaneously causing pain at the right index finger. Pain was excruciating, which increased on touching and sudden striking on objects. There was no neck pain, no sensory loss, and no weakness. Pain radiates to the elbow and sometimes shoulders. The patient was given trial of neuropathic medications without much relief. Nerve conduction studies were normal. Magnetic resonance imaging spine minimal disk bulge at C5–C6 level with no neural compression. On examination, the neck movements were normal and power, tone, and reflexes were normal. Neurological examination was normal. Severe tenderness on palpating the right index finger nail. MRI of the right index finger revealed a glomus tumour. Glomus tumor was diagnosed and the patient underwent surgical excision. There can be a delay in diagnosis in glomus tumours.Cervical radiculopathy may be diagnosed erroneously in patients if careful physical examination and investigations are not done.

Evaluation of hemodynamics in vertebral arteries in case of herniated cervical intervertebral discs using functional tests

Background. Degenerative changes of the vertebral-motor segment occupy an important place among the causes of cervicogenic headache, neck pain with radiation to the shoulder and arm, noise in the head, dizziness. The same symptoms are often found in vertebral artery syndrome, which is a set of disorders of vertebral-basilar dynamics. Dopplerography makes it possible to obtain quantitative parameters of blood flow in the vertebral arteries, thereby assessing the level of pathological changes in blood flow.&#x0D; Purpose. Dopplerographic assessment of blood flow parameters in vertebral arteries in patients with herniated cervical intervertebral discs using functional tests.&#x0D; Materials and methods. An analysis of the results of dopplerography of the vertebral arteries in 42 young patients with herniated cervical intervertebral discs was carried out. Peak systolic velocity (Vs), end-diastolic velocity (Vd), indices of peripheral resistance (RI) and pulsatility (PI), minute volume of blood flow (HOK – Vvol) in the second segment of the VA at the C2-C3 level were determined at functional prob.&#x0D; Results and discussion. With a left-sided hernia, the value of Vs in the left VA during contralateral head rotation was 34.1 ± 2.9 cm/s, RI – 0.71 ± 0.03, PI – 1.04 ± 0.06, HOC – 85 ± 9 ml/min, and in the comparison group – 45.3 ± 3.8 cm/s, 0.59 ± 0.02, 0.85 ± 0.04, 118±13 ml/min, respectively. In patients with a right-sided hernia, Vs in the right VA during contralateral head rotation was 32.6 ± 3.2 cm/s, RI – 0.72 ± 0.03, PI – 1.03 ± 0.06, COC – 83 ± 8 ml/min, and in the comparison group – 44.8 ± 4.1 cm/s, 0.60 ± 0.02, 0.87 ± 0.04, 117 ± 12 ml/min, respectively. The difference between Doppler blood flow parameters obtained during contralateral head rotation in patients with disc herniation and the comparison group (persons without disc herniation) was significant (P &lt; 0.05).&#x0D; Conclusion.Hemodynamically significant disruption of blood flow in the vertebral artery occurs when the paramedian and posterolateral hernia is localized on the side of the same name during head rotation to the opposite side. These violations consist in a significant decrease in systolic speed and minute volume of blood flow, in an increase in indices of resistance and pulsatility compared to persons without disc herniation.

Spinal Meningothelial Meningioma In a Dog

The objective of this study is to report clinical, MRI, surgical and histological findings of spinal meningothelial meningioma in a dog. Study material was a 9 years old, spayed dog with history of progressive non ambulatory tetra paresis. The dog had intact cranial and spinal reflexes, and deep pain perception. Magnetic resonance images revealed a mass located at left side C2-C3 level, hyperintense in T1W, isointense on T2W, well contrast enhancing on postcontrast T1. The mass was microsurgically resected sub gross totally. The dog’s neurological status was improved at one week and survived for 15 months without signs of metastasis. Histological and histochemical workup revealed grade I, meningothelial meningioma. Surgical intervention for spinal meningioma can be suggested as a sole treatment in dogs.

Cervical spondylosis: MRI findings and relative factors

Background: This study was to describe the magnetic resonance imaging (MRI) features of cervical spondylosis, to evaluate the relation between MRI images and other factors. Materials and Methods: This is a cross-sectional study with convenience sampling and was carried out at Hue University of Medicine and Pharmacy Hospital between June 2019 and November 2022. We recruited 184 patients who were diagnosed with cervical spondylosis by clinical symptoms, X ray and MRI images. Results: MRI images of cervical spondylosis were seen most frequently at C4, C5, C6. Approximately 84% of patients had spinal cord stenosis, the ones who had compression images accounted for 50.7%. Cervical neural foraminal stenosis (CNFS) with compression (48.4%) and herniated disc (75%) were found most common at C5-C6 level. There were statistically-significant relations between cervical radiculopathy syndrome and the root compression images on MRI, between cervical myelopathy syndrome and spinal cord signal changes on MRI. Conclusion: Patients with cervical spondylosis symptoms should undergo X-ray and MRI of the cervical spine to get a comprehensive morphological assessment of lesions. Key words: Cervical spondylosis, Magnetic resonance imaging