CT-Guided Intranodal Lymphangiography for Postoperative Chylous Ascites.

The utility and minimal invasiveness of ultrasound-guided intranodal lymphangiography have already been reported by several researchers. Although ultrasound-guided intranodal lymphangiography is known to be not technically difficult in general, a patient's edematous groin due to hypoalbuminemia resulting from chylous ascites made it too challenging to detect and prick the lymph nodes precisely. This report describes a 71-year-old female with refractory chylous ascites due to an operation for an extrahepatic bile duct cancer, who was successfully treated by computed tomography (CT)-guided intranodal lymphangiography.

Cervical ossification of the posterior longitudinal ligament: factors affecting the effect of posterior decompression.

Objective: Decompression procedures for cervical myelopathy of ossification of the posterior longitudinal ligament (OPLL) are anterior decompression with fusion, laminoplasty, and posterior decompression with fusion. Preoperative and postoperative stress analyses were performed for compression from hill-shaped cervical OPLL using 3-dimensional finite element method (FEM) spinal cord models.

Methods: Three FEM models of vertebral arch, OPLL, and spinal cord were used to develop preoperative compression models of the spinal cord to which 10%, 20%, and 30% compression was applied; a posterior compression with fusion model of the posteriorly shifted vertebral arch; an advanced kyphosis model following posterior decompression with the spinal cord stretched in the kyphotic direction; and a combined model of advanced kyphosis following posterior decompression and intervertebral mobility.

Stress analysis of the cervical spinal cord: Impact of the morphology of spinal cord segments on stress.

Objective: Although there are several classifications for cervical myelopathy, these do not take differences between spinal cord segments into account. Moreover, there has been no report of stress analyses for individual segments to date.

Methods: By using the finite element method, we constructed 3-dimensional spinal cord models comprised of gray matter, white matter, and pia mater of the second to eighth cervical vertebrae (C2-C8).

A case of an anaplastic meningioma metastasizing to the mediastinal lymph nodes.

Context: Grade II and III (World Health Organization classification) meningiomas rarely develop in the spinal cord. However, we experienced a case with an anaplastic meningioma that developed in the spinal cord at the cervicothoracic junction and metastasized to the mediastinal lymph nodes. No such cases have previously been reported.

Cervical ossification of the posterior longitudinal ligament: Biomechanical analysis of the influence of static and dynamic factors.

Objective: Cervical myelopathy due to ossification of the posterior longitudinal ligament (OPLL) is induced by static factors, dynamic factors, or a combination of both. We used a three-dimensional finite element method (3D-FEM) to analyze the stress distributions in the cervical spinal cord under static compression, dynamic compression, or a combination of both in the context of OPLL.

Methods: Experimental conditions were established for the 3D-FEM spinal cord, lamina, and hill-shaped OPLL.

Biomechanical analysis of cervical myelopathy due to ossification of the posterior longitudinal ligament: Effects of posterior decompression and kyphosis following decompression.

Cervical ossification of the posterior longitudinal ligament (OPLL) results in myelopathy. Conservative treatment is usually ineffective, thus, surgical treatment is required. One of the reasons for the poor surgical outcome following laminoplasty for cervical OPLL is kyphosis.

Biomechanical analysis of cervical spondylotic myelopathy: the influence of dynamic factors and morphometry of the spinal cord.

Objective: Patients with cervical spondylotic myelopathy (CSM) have the same clinical symptoms that vary according to the degree of spinal cord compression and the cross-sectional cord shape. We used a three-dimensional finite element method (3D-FEM) to analyze the stress distributions of the spinal cord with neck extension under three cross-sectional cord shapes.

Methods: Experimental condition for the 3D-FEM spinal cord, ligamentum flavum, and anterior compression shape (central, lateral, and diffuse types) was established.

Prediction of surgical outcome for proximal-type cervical spondylotic amyotrophy novel mode of assessment using compound action potentials of deltoid and biceps brachii and central motor conduction time.

Study Design: Case studies of patients with cervical spondylotic amyotrophy used compound muscle action potentials (CMAPs) of deltoid and biceps brachii muscles and central motor conduction time (CMCT).

Objective: To discuss surgical outcome for proximal-type cervical spondylotic amyotrophy in the context of results obtained with CMAPs and CMCT.

Summary Of Background Data: There have been no reports that correlate surgical outcome with CMAPs of deltoid and biceps brachii muscles or with CMCT.

Regulation of nitric oxide generation by up-regulated arginase I in rat spinal cord injury.

Recently, arginase is suggested to regulate nitric oxide production by competing with nitric oxide synthase for the same substrate, L-arginine, in experimental asthma. We investigated the role of arginase and its relationship to nitric oxide production after spinal cord injury. Rats were subjected to laminectomy and complete transection of their spinal cords (injury group) or laminectomy only (sham group).

Development of less invasive neuromuscular electrical stimulation model for motor therapy in rodents.

Background: Combination therapy is essential for functional repairs of the spinal cord. Rehabilitative therapy can be considered as the key for reorganizing the nervous system after spinal cord regeneration therapy. Functional electrical stimulation has been used as a neuroprosthesis in quadriplegia and can be used for providing rehabilitative therapy to tap the capability for central nervous system reorganization after spinal cord regeneration therapy.

Biomechanical study of the spinal cord in thoracic ossification of the posterior longitudinal ligament.

Background: Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine produces myelopathy. This is often progressive and is not affected by conservative treatment. Therefore, decompressive surgery is usually chosen.

Transplantation of neurospheres derived from bone marrow stromal cells promotes neurological recovery in rats with spinal cord injury.

Previous studies have revealed that cell therapy using bone marrow stromal cells (BMSCs) could promote motor functional recovery in animals with spinal cord injury (SCI). We describe here the development of cell biology technique and the experimental study of regeneration in SCI. The aim of this study was to investigate the potential for neurological recovery by transplantation neurospheres (NS) derived from BMSCs into thoracic SCI.

Pathology and prognosis of proximal-type cervical spondylotic amyotrophy: new assessment using compound muscle action potentials of deltoid and biceps brachii muscles.

Study Design: Case studies of patients with cervical spondylotic amyotrophy (CSA) used compound muscle action potentials (CMAPs) of deltoid and biceps brachii muscles.

Objective: To discuss pathology and prognosis from the magnetic resonance imaging (MRI) and CMAPs of deltoid and biceps brachii muscles.

Summary Of Background Data: CSA is a rare type of cervical spondylotic disorder.

Paraplegia caused by posture during MRI in a patient with cervical disk herniation.

A 48-year-old man presented with numbness in the lower left extremity of 4 months' duration. One month earlier, he presented to an orthopedic clinic and magnetic resonance imaging (MRI) revealed cervical disk herniation. Because the pain did not subside, he visited the clinic again and MRI was performed.

Chronic spinal cord injury in the cervical spine of a young soccer player.

A 17-year-old male soccer player presented with numbness in the upper- and lower-left extremities of 6 months' duration. He had no apparent history of trauma but experienced neck pain during heading of the ball 5 years prior. A high-signal intensity area was seen on T2-weighted magnetic resonance imaging (MRI) of the cervical spine.

Biomechanical study of the effect of degree of static compression of the spinal cord in ossification of the posterior longitudinal ligament.

Object: The authors evaluated the biomechanical effect of 3 different degrees of static compression in a model of the spinal cord in order to investigate the effect of cord compression in patients with ossification of the posterior longitudinal ligament (OPLL).

Methods: A 3D finite element spinal cord model consisting of gray matter, white matter, and pia mater was established. As a simulation of OPLL-induced compression, a rigid plate compressed the anterior surface of the cord.

Etiology of cervical myelopathy induced by ossification of the posterior longitudinal ligament: determining the responsible level of OPLL myelopathy by correlating static compression and dynamic factors.

Study Design: Retrospective study.

Objective: To determine the responsible level of cervical myelopathy induced by ossification of the posterior longitudinal ligament (OPLL). This was achieved by correlating the intervertebral range of motion (ROM) as the dynamic factor with the space available for spinal cord (SAC) as the static compression factor.

Flexion model simulating spinal cord injury without radiographic abnormality in patients with ossification of the longitudinal ligament: the influence of flexion speed on the cervical spine.

Background/objective: It is suspected that the speed of the motion of the spinal cord under static compression may be the cause of spinal cord injury (SCI). However, little is known about the relationship between the speed of the motion of the spinal cord and its stress distributions. The objective was to carry out a biomechanical study of SCI in patients with ossification of the longitudinal ligament without radiologic evidence of injury.

Validation study of a clinical diagnosis support tool for lumbar spinal stenosis.

Background: A clinical diagnosis support tool for lumbar spinal stenosis was developed by the Japanese Society for Spine Surgery and Related Research. However, the use of this tool has not yet been validated.

Methods: Patients with symptoms in the lower extremities and who visited the Department of Orthopedics initially were recruited to the study.

Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report.

Study Design: A preliminary report of a new operative method termed selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials (SCEPs) in elderly patients with cervical spondylotic myelopathy.

Objective: To introduce the method and clinical results for selective laminoplasty.

Summary Of Background Data: Clinical results for conventional laminoplasty and anterior decompression and fusion guided by SCEPs have been reported.

Environmental factors involved in axonal regeneration following spinal cord transection in rats.

A recent study of a rat model treated with grafted collagen filament (CF) after spinal cord transection showed dramatic recovery of motor function but did not report on the acute-stage phenomenon. In the present study, we describe molecular and histological aspects of the axonal regeneration process during the acute stage following spinal cord transection. The spinal cord of 8-week-old rats was completely transected, and a scaffold of almost the same size as the resected portion was implanted in the gap.

Use of the finite element method to study the mechanism of spinal cord injury without radiological abnormality in the cervical spine.

Study Design: Three-dimensional C3-C5 and C3-C4 finite element (FE) models were used to analyze biomechanical responses under compression and extension moments.

Objective: To validate our models against other published FE models and experimental studies and improve our understanding of the mechanism of spinal cord injury without radiologic abnormality (SCIWORA) in cervical spine.

Summary Of Background Data: The underlying mechanism for SCIWORA remains unclear.

Dynamic electrophysiological examination of cervical flexion myelopathy.

Cervical flexion myelopathy is thought to arise following compression of the spinal cord by vertebrae or intervertebral discs and dura mater, or from overstretching of the spinal cord induced by cervical spinal flexion. However, the influence of spinal flexion on the spinal cord and the detailed origins of this disease are unknown. In this article the authors report a case of cervical flexion myelopathy in which dynamic electrophysiological examination was performed using an epidural electrode.

Biomechanical study of cervical flexion myelopathy using a three-dimensional finite element method.

Object: The goal of this study was to perform a biomechanical study of cervical flexion myelopathy (CFM) using a finite element method.

Methods: A 3D finite element model of the spinal cord was established consisting of gray matter, white matter, and pia mater. After the application of semi-static compression, the model underwent anterior flexion to simulate CFM.