Cortical bone trajectory fixation cause low compression force in anterior vertebral column.

Background: The cortical bone trajectory (CBT) screws follow a caudocephalad and lateral path from the pedicle to the vertebral body. The bone fusion rate of CBT fixation is equal to or lower than conventional pedicle screw fixation. It remains unclear whether or not CVT screws exert equally compressive forces across the vertebral column.

An increase in the posterior subarachnoid space accelerates the timing of syrinx resolution after foramen magnum decompression of type I Chiari malformation.

Syrinx resolution has been associated with an increase in the size of the posterior subarachnoid space (pSAS) after foramen magnum decompression (FMD) for type I Chiari malformation (CM1). The present study investigated the influence of pSAS increase on syrinx resolution and symptom improvement after FMD. 32 patients with CM1 with syrinx were analyzed retrospectively.

Report of a familial case of proatlas segmentation abnormality with late clinical onset.

Although proatlas segmentation abnormalities as developmental remnants around the foramen magnum have been reported in postmortem studies, they are rarely documented in a clinical setting. This report details the clinical and radiological characteristics of a rare case of proatlas segmentation abnormalities with clinical onset during the seventh decade of life. This case was suspected to have a familial factor.

Motor evoked potential and voluntary EMG activity after olfactory mucosal autograft transplantation in a case of chronic, complete spinal cord injury: case report.

The efficacy of olfactory mucosal autografts (OMAs) for chronic spinal cord injury (SCI) has been reported, but there is no report documenting electrophysiological conductivity via the emergence of motor evoked potentials (MEPs). We report the case of a 39-year-old man with chronic, complete SCI at T8, who exhibited MEPs after OMA transplantation, and, with intensive rehabilitation, was ultimately able to ambulate with short leg braces and Lofstrand crutches. The initial injury occurred in a motor vehicle accident in November 1999 and resulted in a complete loss of sensorimotor function below T8.

Promotion of astrocytoma cell invasion by micro RNA-22 targeting of tissue inhibitor of matrix metalloproteinase-2.

OBJECTIVE Diffuse astrocytomas (DAs) have a high recurrence rate due to diffuse infiltration into the brain and spinal cord. Micro RNAs (miRNAs) are small noncoding RNAs that regulate gene expression by binding to complementary sequences of target messenger RNA (mRNA). It has been reported that miRNA-22 (miR-22) is involved in the invasion of some cancer cell lines.

Significance of the Pars Interarticularis in the Cortical Bone Trajectory Screw Technique: An Insertional Torque Study.

Study Design: Retrospective study.

Purpose: Cortical bone trajectory (CBT), a more medial-to-lateral and shorter path than the traditional one for spinal fusion, is thought to be effective for severely degenerated vertebrae because screws are primarily stabilized at the posterior elements. We evaluated the efficacy of this approach through insertional torque measurement.

Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis.

Study Design: Retrospective study.

Purpose: To compare initial fixation using the cortical bone trajectory (CBT) technique versus conventional pedicle screws (PS) in radiographs of postsurgical lumbar degenerative spondylolisthesis.

Overview Of Literature: Few reports have documented the holding strength of CBT technique for spondylolisthesis cases.

A Pilot Clinical Study of Olfactory Mucosa Autograft for Chronic Complete Spinal Cord Injury.

Recent studies of spinal cord axon regeneration have reported good long-term results using various types of tissue scaffolds. Olfactory tissue allows autologous transplantation and can easily be obtained by a simple biopsy that is performed through the external nares. We performed a clinical pilot study of olfactory mucosa autograft (OMA) for chronic complete spinal cord injury in eight patients according to the procedure outlined by Lima et al.

Clear Zone Formation around Screws in the Early Postoperative Stages after Posterior Lumbar Fusion Using the Cortical Bone Trajectory Technique.

Study Design: Retrospective study.

Purpose: To evaluate the initial fixation using the cortical bone trajectory (CBT) technique for posterior lumbar fusion through assessment of the clear zones around the screws and the risk factors involved.

Overview Of Literature: Postoperative radiolucent zones (clear zones) are an indicator of poor conventional pedicle screw fixation.

"Do Not Follow the Tail": A Practical Approach to Remove a Sheared Lumbar Catheter Fragment Avoiding Its Migration into the Spinal Canal.

Background: Catheter shearing is one of the most common complications of various neurosurgical modalities that use an intrathecal lumbar catheter. The sheared catheter fragment often can spontaneously migrate into the spinal canal; however, in some cases, the end of the fragment will remain outside the spinal canal. In this situation, the consulting neurosurgeons may try to retrieve the catheter fragment by approaching it directly through the catheter tract.

Extramedullary Conus Ependymoma Involving a Lumbar Nerve Root with Filum Terminale Attachment.

Purpose: In the current report, we describe a case of an extramedullary ependymoma involving a lumbar nerve root near conus medullaris. Spinal ependymomas commonly present as intramedullary tumors in the cervical or thoracic cord or as tumors arising from the conus medullaris or the filum terminale. In this case, we showed an extramedullary conus ependymoma involving a lumbar nerve root with filum terminale attachment.

Isthmus-guided Cortical Bone Trajectory Reduces Postoperative Increases in Serum Creatinine Phosphokinase Concentrations.

Objective: This study aimed to determine whether an isthmus-guided cortical bone trajectory (CBT) technique provides better clinical outcomes than the original cortical bone trajectory CBT technique for screw fixation.

Methods: A consecutive series of 21 patients with lumbar spondylolisthesis who had undergone CBT screw fixation using the original technique from June 2012 to February 2013 and 33 who had undergone the isthmus-guided technique from March 2013 to August 2014 was retrospectively reviewed. The number of screws inserted, interbody fusion and screw misplacements, amount of blood loss, and creatinine phosphokinase (CPK) ratios (postoperative day 1 CPK/preoperative CPK) were reviewed to evaluate clinical outcomes and compared between the original and isthmus-guided CBT techniques.

Isolation of human adult olfactory sphere cells as a cell source of neural progenitors.

Olfactory stem cells are generated from olfactory mucosa. Various culture conditions generate olfactory stem cells that differ according to species and developmental stage and have different progenitor or stem cell characteristics. Olfactory spheres (OSs) are clusters of progenitor or stem cells generated from olfactory mucosa in suspension culture.

Differences between Cervical Schwannomas of the Anterior and Posterior Nerve Roots in Relation to the Incidence of Postoperative Radicular Dysfunction.

Study Design: A retrospective study.

Purpose: To assess the case files of patients who underwent surgery for cervical dumbbell schwannoma for determining the differences between schwannomas of the anterior and posterior nerve roots with respect to the incidence of postoperative radicular dysfunction.

Overview Of Literature: The spinal roots giving origin to schwannoma are frequently nonfunctional, but there is a risk of postoperative neurological deficit once these roots are resected during surgery.

A symptomatic spinal extradural arachnoid cyst with lumbar disc herniation.

Spinal epidural arachnoid cyst (EAC) is a rare, usually asymptomatic condition of unknown origin, which typically involves the lower thoracic spine. We report a case of posttraumatic symptomatic EAC with lumbar disc herniation. A 22-year-old man experienced back pain and sciatica after a traffic accident.

Intranasal delivery of bone marrow stromal cells to spinal cord lesions.

Object: The intranasal delivery of bone marrow stromal cells (BMSCs) or mesenchymal stem cells to the injured brains of rodents has been previously reported. In this study, the authors investigated whether BMSCs migrate to spinal cord lesions through an intranasal route and whether the administration affected functional recovery.

Methods: Forty Sprague-Dawley rats that were subjected to spinal cord injuries at the T7-8 level were divided into 5 groups (injured + intranasal BMSC-treated group, injured + intrathecal BMSC-treated group, injured-only group, injured + intranasal vehicle-treated group, and injured + intrathecal vehicle-treated group).

A Case of Apoplexy of Rathke's Cleft Cyst Followed by Cerebral Infarction.

Rathke's cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious.

Olfactory sphere cells are a cell source for γ-aminobutyric acid-producing neurons.

Olfactory sphere cells (OSCs) are stem cells generated by culturing olfactory mucosa. Adult rat OSCs express oligodendrocyte progenitor cell (OPC) markers and differentiate into mature oligodendrocytes. Although OSCs also express nestin, a marker of neural stem cells (NSCs), it remains unclear whether adult rat OSCs are multipotent and capable of giving rise to neurons as well as oligodendrocytes.

Adjacent lumbar disc herniation after lumbar short spinal fusion.

A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3-5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation.

Syringomyelia associated with spinal arachnoiditis treated by partial arachnoid dissection and syrinx-far distal subarachnoid shunt.

The authors describe a new modified surgical approach to minimize the postoperative recurrence of a syrinx after surgery to treat syringomyelia associated with spinal adhesive arachnoiditis in two cases. Both patients presented with progressive gait disturbance without any remarkable history, and spinal magnetic resonance imaging revealed a syrinx and broad irregular disappearance of the subarachnoid space and/or deformity of the cord. We successfully performed a partial arachnoid dissection and syrinx-far distal subarachnoid shunt for both cases.

Retro-odontoid synovial cyst resected via an anterolateral approach without fusion.

Purpose: Retro-odontoid synovial cysts are rare and attributable to degenerative changes in the atlantoaxial joints. An anterolateral approach facilitates access to lesions located anterior to the craniocervical junction without harming the atlantoaxial joints, and can also treat small lesions in the ventral mid-portion of the craniocervical junction without compression of spinal cord.

Methods: We present herein the case of a 70-year-old man with a retro-odontoid synovial cyst.

Isthmus-guided cortical bone trajectory for pedicle screw insertion.

Herein is described cortical bone trajectory (CBT), a new path for pedicle screw insertion for lumbar vertebral fusion. Because the points of insertion are under the end of the inferior articular process, and because the screws are inserted toward the lateral side, there is less soft tissue development than with the conventional technique; the CBT technique therefore enables less invasive surgery than the conventional technique. However, it has some drawbacks.

Presence of trans-synaptic neurons derived from olfactory mucosa transplanted after spinal cord injury.

Study Design: Using biotinylated dextran amine (BDA) and wheat germ agglutinin (WGA) tracers, we measured the effectiveness of olfactory mucosa (OM) transplantation as a scaffold in a rat model of chronic spinal cord injury (SCI).

Objective: We examined whether OM transplantation for chronic SCI in rats results in reconstruction of neuronal pathways by both regeneration of the remaining axons and supply of OM-derived trans-synaptic neurons.

Summary Of Background Data: OM is one of the ideal scaffolds for axonal regeneration after chronic SCI.