Twelve dogs developed a delayed onset of neurological abnormalities from chronic cervical cord compression that was characteristic of myelopathy. The animals were divided into two groups and matched according to degree of neurological deficit. Six animals underwent decompression through removal of the anteriorly placed compressive device. Throughout the experiment, serial neurological examinations and somatosensory evoked potential studies were performed on each animal. Spinal cord blood flow measurements were obtained during each surgical procedure and at sacrifice. Magnetic resonance images were obtained after compression and before sacrifice. All animals in the decompressed group showed significant neurological improvement after decompression; no spontaneous improvement in neurological function was seen in the compressed group. On pathological examination, irreversible changes including large motor neuron loss, necrosis, and cavitation were seen in four of the animals in the decompressed group and five in the compressed group. Cervical spondylotic myelopathy in humans is known to respond to decompression; this study provides further evidence that this animal model for chronic compressive cervical myelopathy accurately reflects the disease process seen in humans.
An ectopic pituitary adenoma is a rare entity that may occur in several anatomic locations, the sphenoid sinus being the most common. Many of these tumors are amenable to surgical resection by means of a transsphenoidal approach. A more aggressive surgical approach is needed to attempt resection of extensive tumors that involve the clivus and the nasopharynx. Complete resection in these areas cannot always be guaranteed or determined, necessitating postoperative radiotherapy. Many different tumors of the sphenoid sinus and skull base can resemble ectopic pituitary adenomas on radiologic assessments. Because of this, preoperative endocrine assessment is recommended.
We present a case report and a review of the literature. Our patient was the first to exhibit no radicular complaints. The diagnosis was delayed in all four cases and was not determined until the time of surgery. Complete excision offers the best chance for cure, and spinal angiography can aid in diagnosis. However, a high index of suspicion is needed for preoperative detection.
A modification of the C
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C
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transfacet stabilization is reported. This technique allows a smaller incision to be made and provides a method for easier screw insertion.
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