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We studied degenerative changes in the cervical intervertebral discs of 497 asymptomatic subjects by MRI and evaluated disc degeneration by loss of signal intensity, posterior and anterior disc protrusion, narrowing of the disc space and foraminal stenosis. In each subject, five disc levels from C2-C3 to C6-C7 were evaluated. The frequency of all degenerative findings increased linearly with age. Disc degeneration was the most common observation, being present in 17% of discs of men and 12% of those of women in their twenties, and 86% and 89% of discs of both men and women over 60 years of age. We found significant differences in frequency between genders for posterior disc protrusion and foraminal stenosis. The former, with demonstrable compression of the spinal cord, was observed in 7.6% of subjects, mostly over 50 years of age. Our results should be taken into account when interpreting the MRI findings in patients with symptomatic disorders of the cervical spine.

We studied degenerative changes in the cervical intervertebral discs of 497 asymptomatic subjects by MRI and evaluated disc degeneration by loss of signal intensity, posterior and anterior disc protrusion, narrowing of the disc space and foraminal stenosis. In each subject, five disc levels from C2-C3 to C6-C7 were evaluated.The frequency of all degenerative findings increased linearly with age. Disc degeneration was the most common observation, being present in 17% of discs of men and 12% of those of women in their twenties, and 86% and 89% of discs of both men and women over 60 years of age. We found significant differences in frequency between genders for posterior disc protrusion and foraminal stenosis. The former, with demonstrable compression of the spinal cord, was observed in 7.6% of subjects, mostly over 50 years of age.Our results should be taken into account when interpreting the MRI findings in patients with symptomatic disorders of the cervical spine.

Increased signal intensity was not related to a poor outcome of conservative treatment or severity of myelopathy in the patients with mild cervical myelopathy.

Anterior decompression and fusion is an effective surgical procedure for thoracic ossification of the posterior longitudinal ligament with good, stable, long-term results; when thoracic ossification of the posterior longitudinal ligament was extensive or coincident with ossification of the intraspinal ligament, however, the results were not as predictable.

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The factors that reduced %VC were the sagittal diameter of the thoracic cage, total lung area and vertebral rotation at the T8 and T9 levels.

Study design: Retrospective review. Objectives: To clarify the clinical features of patients with spinal ependymomas and to compare the clinical results between the patients in whom microsurgical technique and spinal cord monitoring were used intraoperatively and the patients in whom they were not used. Setting: Keio University Hospital, Tokyo, Japan. Methods: Twenty-six consecutive patients with spinal ependymomas were treated surgically between 1958 and 1995. All patients underwent tumor resection through a posterior approach. Complete tumor resection was possible in 15 patients (57.7%), and subtotal tumor resection (more than 90%) was done in two patients (7.7%). Only a partial tumor resection (less than 90%) was performed in the remainder of the patients (34.6%). The operative results of the patients were evaluated by the Japanese Orthopaedic Association Scoring System (JOA score) and its recovery rate. Results: The overall average recovery rate was 18.3%. The mean recovery rate was 14.4% in cervical lesion, 11.1% in thoracic lesion and 40% in lumbar lesion. The recovery rate of eight patients with cervical ependymomas who underwent tumor resection under both microscopic surgical procedure and intraoperative spinal cord monitoring was 37.1% although the recovery rate of the rest of the patients was 71.6%. There was a statistical di erence between the two groups (P50.02). The survival rate of patients following complete excision was statistically better compared to that of patients after incomplete resection. Conclusion: Both microsurgical technique and spinal cord monitoring are indispensable to achieve total removal of ependymomas and to obtain improvement of neurological recovery.