[Improved magnetic resonance myelography using image fusion].
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[Improved magnetic resonance myelography using image fusion].
Rofo. 2013 Apr;185(4):333-9
Authors: Eberhardt K, Ganslandt O, Stadlbauer A
Abstract
PURPOSE: To demonstrate that the disadvantage of missing anatomical information in heavily T2-weighted MR myelography images can be eliminated by image fusion and phase encoding in the coronal direction of the source images, resulting in MR myelography images comparable to the gold standard, i. e., post-myelography CT.
MATERIALS AND METHODS: This study included 110 patients suffering from extradural pathologies of the cervical and lumbar spine. All patients were investigated using 3D MR myelography and post-myelography CT. The MRI data were post-processed using image fusion and reconstruction algorithms and were compared to the corresponding images of post-myelography CT.
RESULTS: Our approach for visualization (3D MR myelography) was able to depict intradural structures in high spatial resolution and without artifacts. The results of our visualization approach were comparable to the gold standard - post-myelography CT. Anatomical correlation was reached by image fusion of different MR data sets. The required post-processing steps were performed quickly and were available on a commercial workstation.
CONCLUSION: Image fusion of different MR data sets allows for visualization of 3D data sets with enhanced quality. The results for the visualization of MR myelography in particular are comparable to conventional myelography and post-myelography CT. The missing anatomical information in heavily T2-weighted MR myelography images can be compensated by image fusion with conventional MRI.
PMID: 23348124 [PubMed - indexed for MEDLINE]
Pneumorrhachis from a thrown knife.
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Pneumorrhachis from a thrown knife.
Emerg Med J. 2012 Sep;29(9):747
Authors: Grundlingh J, Grier G, Ahmad K
PMID: 22833602 [PubMed - indexed for MEDLINE]
[Quantitative ultrasound of the calcaneus, bone densitometry and vertebral morphometry in men over the age of 60 years].
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[Quantitative ultrasound of the calcaneus, bone densitometry and vertebral morphometry in men over the age of 60 years].
Arq Bras Endocrinol Metabol. 2012 Aug;56(6):370-5
Authors: Barra FR, Leite AF, Souza PT, Pereira FB, Paula AP
Abstract
OBJECTIVES: To compare calcaneal ultrasonometry and bone densitometry in the evaluation of morphometric vertebral fractures in men over 60 years of age.
SUBJECTS AND METHODS: We studied 96 men over 60 years of age by means of bone densitometry of the spine, femur and radius, lateral radiograph of the thoracic and lumbar spine, and calcaneal ultrasonometry.
RESULTS: Fifty-one percent of men had osteoporosis and vertebral fractures. Correlation was found between ultrasonometry stiffness index, T-score and bone mineral density of the spine, femur and radius (p < 0.01). Regarding the presence of fractures, there was a correlation only with BMD of the ultradistal radius (UD) and radius 33%. ROC curve showed accuracy only of UD radius BMD in detecting vertebral fractures.
CONCLUSIONS: Our study showed a correlation between osteoporosis diagnosis by ultrasonometry and densitometry in men over 60 years. It also showed a correlation between morphometric vertebral fracture and bone mineral density of the forearm.
PMID: 22990641 [PubMed - indexed for MEDLINE]
Recurrent solitary fibrous tumour of the thoracic spine. A case-report and literature review.
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Recurrent solitary fibrous tumour of the thoracic spine. A case-report and literature review.
Orthop Traumatol Surg Res. 2012 Nov;98(7):850-3
Authors: Bouyer B, Guedj N, Lonjon G, Guigui P
Abstract
Solitary fibrous tumours (SFTs) are rare tumours originating in the soft tissues. SFT development in the spine is an exceedingly rare event about which little is known. We describe a case of SFT of the thoracic spine in a 56-year-old woman. She presented with neurological deficits that required emergency resection, which was incomplete. Two subsequent local recurrences prompted further surgical procedures. At last follow-up, 12 months after the last procedure, function was satisfactory and there was no evidence of tumour recurrence. The management of SFTs is not well standardised, and no proven adjuvant treatments are available to date. Complete excision is effective in controlling disease progression. Prolonged follow-up is mandatory.
PMID: 23092617 [PubMed - indexed for MEDLINE]
Vesselplasty: a new minimally invasive approach to treat pathological vertebral fractures in selected tumor patients – preliminary results.
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Vesselplasty: a new minimally invasive approach to treat pathological vertebral fractures in selected tumor patients - preliminary results.
Rofo. 2013 Apr;185(4):340-50
Authors: Klingler JH, Sircar R, Deininger MH, Scheiwe C, Kogias E, Hubbe U
Abstract
PURPOSE: To evaluate the effectiveness and safety of percutaneous vesselplasty in pathological vertebral fractures of the thoracolumbar spine in selected tumor patients.
MATERIALS AND METHODS: Eleven pathological vertebral fractures in nine patients were treated with vesselplasty (Vessel-X®, MAXXSPINE). Nine of eleven vertebras (81.8 %) had major posterior wall deficiency (> 30 %). Clinical and radiological (CT) measures were obtained before and 3 months after the procedure.
RESULTS: The mean VAS improved significantly from preoperative to postoperative (6.9 ± 2.2 to 3.7 ± 2.3; p < 0.05), as did the ODI (59.7 %± 19.2 % to 40.3 %± 24.0 %; p < 0.05). The physical component summary of the SF-36 was significantly improved by the operation (19.2 ± 8.0 to 31.0 ± 16.5; p < 0.05). Symptomatic cement leakage or other operation-associated complications were not observed. Three patients were primarily treated with concomitant minimally invasive stabilization via fixateur interne. One patient had to undergo minimally invasive stabilization via fixateur interne 4 months after vesselplasty due to further collapse of the treated vertebral body.
CONCLUSION: From these preliminary results, vesselplasty appears to be a treatment option worth considering in pathological vertebral fractures, even in the case of posterior wall deficiency. Selected tumor patients might benefit from vesselplasty as a minimally invasive procedure for stabilization of the fractured vertebra, pain control, and improvement in body function and quality of life. Long-term prospective studies with a larger sample size are required to validate these results.
PMID: 23471680 [PubMed - indexed for MEDLINE]
Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report.
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Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report.
J Neurosurg Spine. 2013 Feb;18(2):184-8
Authors: Murakami T, Koyanagi I, Kaneko T, Yoneta A, Keira Y, Wanibuchi M, Hasegawa T, Mikuni N
Abstract
Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis. This 16-year-old boy presented with abnormal sweating on the right side of the neck, chest, and the right arm that had been occurring for 6 years. Neurological examination revealed mild motor weakness of the right lower extremity and slightly decreased sensation in the left lower extremity. Hyperhidrosis was observed in the right C3-T8 dermatomes. Magnetic resonance imaging showed an intramedullary tumor at the right side of the spinal cord at the T2-3 level. The tumor showed partial enhancement after Gd administration. The patient underwent removal of the tumor via hemilaminectomy of T2-3. Only subtotal resection was achieved because the margins of the tumor were unclear. Histopathological examination revealed ganglioglioma. Hyperhidrosis gradually improved after surgery. Hyperhidrosis is a rare clinical manifestation of intramedullary spinal cord tumors, and only a few cases have been reported in the literature. The location of the tumor origin, around the right gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in this patient. Physicians should examine the spinal cord using MRI studies when a patient has hyperhidrosis with some motor or sensory symptoms of the extremities.
PMID: 23198806 [PubMed - indexed for MEDLINE]
Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature.
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Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature.
Clin Interv Aging. 2012;7:557-64
Authors: Iacoangeli M, Gladi M, Di Rienzo A, Dobran M, Alvaro L, Nocchi N, Maria LG, Somma D, Colasanti R, Scerrati M
Abstract
Meningiomas of the spine are the most common benign intradural extramedullary lesions and account for 25%-46% of all spinal cord tumors in adults. The goal of treatment is complete surgical resection while preserving spinal stability. Usually, these lesions occur in the thoracic region and in middle-aged women. Clinical presentation is usually nonspecific and the symptoms could precede the diagnosis by several months to years, especially in older people, in whom associated age-related diseases can mask the tumor for a long time. We report a series of 30 patients, aged 70 years or more, harboring intradural extramedullary spinal meningiomas. No subjects had major contraindications to surgery. A minimally invasive approach ( hemilaminectomy and preservation of the outer dural layer) was used to remove the tumor, while preserving spinal stability and improving the watertight dural closure. We retrospectively compared the outcomes in these patients with those in a control group subjected to laminectomy or laminotomy with different dural management. In our experience, the minimally invasive approach allows the same chances of complete tumor removal, while providing a better postoperative course than in a control group.
PMID: 23271902 [PubMed - indexed for MEDLINE]
Prognosis by tumor location in adults with spinal ependymomas.
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Prognosis by tumor location in adults with spinal ependymomas.
J Neurosurg Spine. 2013 Mar;18(3):226-35
Authors: Oh MC, Kim JM, Kaur G, Safaee M, Sun MZ, Singh A, Aranda D, Molinaro AM, Parsa AT
Abstract
OBJECT: Ependymomas are primary central nervous system tumors that occur more frequently in the spines of adults than they do there in children. Previous studies consist mainly of retrospective single-institutional experiences or case studies. In this study, a comprehensive literature review was performed on reported cases of spinal ependymoma treated with resection to determine whether tumor location along the spinal axis conveys important prognostic information.
METHODS: A PubMed search was performed to identify all papers that included data on patients with spinal ependymoma. Only cases involving adult patients who underwent ependymoma resection with a clearly reported tumor location were included for analysis. Tumor locations were separated into 6 groups: cervicomedullary, cervical, cervicothoracic, thoracic, thoracolumbar, and conus + cauda equina. Kaplan-Meier survival and Cox regression analyses were performed to determine the effect of tumor location on progression-free survival (PFS) and overall survival (OS).
RESULTS: A total of 447 patients who underwent resection of spinal ependymomas with clearly indicated location of tumor were identified. The most common locations of spinal ependymomas were the cervical (32.0%) and conus + cauda equina (26.8%) regions. The thoracolumbar and cervicomedullary regions had the fewest tumors (accounting for, respectively, 5.1% and 3.4% of the total number of cases). The conus + cauda equina and thoracolumbar regions had the highest percentage of WHO Grade I tumors, while tumors located above these regions consisted of mostly WHO Grade II tumors. Despite the tendency for benign grades in the lower spinal regions, PFS for patients with spinal ependymomas in the lower 3 regions (thoracic, thoracolumbar, conus + cauda equina) was significantly shorter (p < 0.001) than for those with tumors in the upper regions (cervicomedullary, cervical, cervicothoracic), but the difference in OS did not achieve statistical significance (p = 0.131).
CONCLUSIONS: Spinal ependymomas along different regions of spinal axis have different characteristics and clinical behaviors. Tumor grade, extent of resection, and PFS varied by tumor location (upper vs lower spinal regions), while OS did not. Recurrence rates were higher for the lower spinal cord tumors, despite a greater prevalence of lower WHO grade lesions, compared with upper spinal cord tumors, suggesting that tumor location along the spinal axis is an important prognostic factor.
PMID: 23311515 [PubMed - indexed for MEDLINE]
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