Acta Neurochir (Wien)
Department of Neurosurgery, Bicêtre Hospital, AP-HP, Le Kremlin-Bicetre, France.
Published: January 2024
Background: Hirayama disease (HD) is a characterized by progressive amyotrophy of the upper limbs due to a forward displacement of the cervical dura during neck flexion.
Methods: Unlike other treatment options aiming at preventing cervical flexion (e.g., collar or arthrodesis), laminoplasty with tented duraplasty addresses dural dysplasia. Technically, the procedure consists in enlarging the dural sac by performing an expansile duraplasty that is secured to the yellow ligaments, in association with an open-book laminoplasty.
Conclusion: Laminoplasty with tented duraplasty is a surgical option addressing the cause of HD to prevent further neurological deterioration while preserving cervical motion.
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http://dx.doi.org/10.1007/s00701-024-05893-7 | DOI Listing |
Acta Neurochir (Wien)
January 2024
Department of Neurosurgery, Bicêtre Hospital, AP-HP, Le Kremlin-Bicetre, France.
Background: Hirayama disease (HD) is a characterized by progressive amyotrophy of the upper limbs due to a forward displacement of the cervical dura during neck flexion.
Methods: Unlike other treatment options aiming at preventing cervical flexion (e.g.
J Neurosurg Spine
November 2014
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Object: Hirayama disease, juvenile muscular atrophy of the distal upper extremity, is a rare type of cervical flexion segmental myelopathy and its etiology is still being debated. Two theories have been proposed: a "contact pressure" theory and "tight dural canal in flexion" theory. Previously reported treatments, including conservative neck collar therapy and surgical spinal fusion, used fixation of the cervical spine with the aim of avoiding contact pressure between the cord and anterior structures.
View Article and Find Full Text PDFJ Clin Neurosci
January 2001
Department of Neurosurgery, Osaka City University Medical School, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
The authors describe a new surgical technique to minimise the postoperative recurrence of adhesion after microlysis of adhesion to treat syringomyelia associated with spinal adhesive arachnoiditis. A 47 year old male presented with numbness of the lower extremities and urinary disturbance and was demonstrated to have a case of syringomyelia from C1 to T2 which was thought to be secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis. Following meticulous microlysis of the adhesions, maximal expansion of a blocked subarachnoid space was performed by expansive duraplasty with a Gore-Tex surgical membrane, expansive laminoplasty and multiple tenting sutures of the Gore-Tex graft.
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