The efficacy of a glial inhibitor, minocycline, for preventing persistent pain after lumbar discectomy: a randomized, double-blind, controlled study.

Minocycline strongly inhibits microglial activation, which contributes to central sensitization, a major mechanism underlying chronic pain development. We hypothesized that the perioperative administration of minocycline might decrease persistent pain after lumbar discectomy. We randomly assigned 100 patients undergoing scheduled lumbar discectomy to placebo and minocycline groups.

Risk factors for spinal cord lesions in dystonic cerebral palsy and generalised dystonia.

Background: Cervical myelopathy (CM) in patients with cerebral palsy (CP) is underdiagnosed as symptoms of spinal cord lesions, being similar to those due to dystonia, may be overlooked or identified late. The aim of this study is to identify the risk factors and clinical characteristics of CM in patients with generalised dystonia, including dystonic CP.

Methods: The authors conducted a case-control study to identify early clinical signs of CM in consecutive patients with generalised dystonia.

Endoscopic removal of a suprasellar arachnoid cyst: an anatomical study with special reference to skull base.

Background: Suprasellar arachnoid cysts are rare entities in adults, representing 10% of all cysts. Endoscopic treatment is now preferred for this pathology, allowing a new anatomical approach to skull base structures.

Objectives: The aim of this study is to present the relevant anatomy of the skull base viewed during an endoscopic procedure for a suprasellar arachnoid cyst.

Asymptomatic spinal canal migration of clavicular K-wire at the cervicothoracic junction.

Unstable clavicular fractures can be treated surgically with pins and wires or with plates. The migration of metallic devices such as Kirschner wires (K-wires) from the shoulder to a variety of anatomical proximal and distal locations is well documented. Spinal migration, however, is rare and is normally associated with severe spinal injury.

Diffusion tensor magnetic resonance imaging and fiber tracking in spinal cord lesions: current and future indications.

Diffusion-weighted imaging and fractional anisotropy may be more sensitive than other conventional magnetic resonance imaging techniques to detect, characterize, and map the extent of spinal cord lesions. Fiber tracking offers the possibility of visualizing the integrity of white matter tracts surrounding some lesions, and this information may help in formulating a differential diagnosis and in planning biopsies or resection. Fractional anisotropy measurements may also play a role in predicting the outcome of patients who have spinal cord lesions.

Anatomical feasibility of using the ninth, 10th, and 11th intercostal nerves for the treatment of neurological deficits after damage to the spinal cord.

Object: The topographic anatomy of the lower intercostal nerves is less well known than that of the upper ones, except for the 12th intercostal nerve. It is possible to use the lower intercostal nerves to perform a neurotization of the lumbar roots. The authors studied the anatomy of the ninth, 10th, and 11th intercostal nerves to obtain descriptive and topographic anatomical data to aid in establishing optimal conditions for harvesting.

Late paraplegia after scoliosis treatment: an uncommon diagnosis.

We report the case of a young girl treated at age 16 for a progressive scoliosis by posterior instrumented arthrodesis. Ten years later, she suddenly developed lumbar pain and paraplegia. The surgical procedure showed a mass infiltrating the vertebral canal and the dural sheath following a supralaminar hook.

MR diffusion tensor imaging and fiber tracking in spinal cord compression.

Background And Purpose: Spinal cord damage can result in major functional disability. Alteration of the spinal cord structural integrity can be assessed by using diffusion tensor imaging methods. Our objective is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and fiber tracking in both acute and slowly progressive spinal cord compressions.

Management of pituitary apoplexy.

Pituitary apoplexy is a rare clinical syndrome caused by sudden haemorrhaging or infarction of the pituitary gland, generally within a pituitary adenoma. Headache of sudden and severe onset is the main symptom, associated with visual disturbances or ocular palsy. Signs of meningeal irritation or altered consciousness may complicate the diagnosis.