Dynamic Changes in Spinal Cord Compression by Cervical Ossification of the Posterior Longitudinal Ligament Evaluated by Kinematic Computed Tomography Myelography

Yoshii, Toshitaka; Yamada, Takatsugu; Hirai, Takashi; Taniyama, Takashi; Kato, Tsuyoshi; Enomoto, Mitsuhiro; Inose, Hiroyuki; Sumiya, Satoshi; Kawabata, Shigenori; Shinomiya, Kenichi; Okawa, Atsushi

doi:10.1097/brs.0000000000000086

Cited by 27 publications

(29 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Second, CTM provides clear contrasted images with thinner slices and higher image resolution in axial and sagittal reconstructed slices, which effectively demonstrate dynamic changes in spinal cord compression. 6,7 Histopathological analysis of the epidural scar revealed chronic inflammation caused by acellular, amorphous and basophilic deposits. These materials appeared exogenous and were presumably remaining surgical materials from the first operation.…”

Section: Discussionmentioning

confidence: 99%

Postlaminectomy membrane with dynamic spinal cord compression disclosed with computed tomographic myelography: a case report and literature review

Kitahara

Hanakita

Takahashi

2017

Spinal Cord Ser Cases

View full text Add to dashboard Cite

Compared with cervical laminoplasty, cervical laminectomy entails several postoperative problems, including postlaminectomy membrane formation. Postlaminectomy membranes may cause dynamic effects related to late neurological deterioration, and the evaluation of dynamic factors is important for neurological recurrence after cervical laminectomy. In the present case, chronic inflammation caused by surgical materials remaining after the first operation might have contributed to the rapid development of the postlaminectomy membrane.

show abstract

Section: Discussionmentioning

confidence: 99%

Postlaminectomy membrane with dynamic spinal cord compression disclosed with computed tomographic myelography: a case report and literature review

Kitahara

Hanakita

Takahashi

2017

Spinal Cord Ser Cases

View full text Add to dashboard Cite

show abstract

“…3,[8][9][10] Miura et al 11 suggested that it is necessary to evaluate spinal cord compression in patients with cervical myelopathy at different neck positions both pre-operatively and post-operatively because cord compression appeared to vary by position. Although the spinal cord was likely to be compressed during extension, 7,12 greater spinal cord compression was observed during neck flexion with a higher occupying ratio of the OPLL. 12 Clinically, the influences of dynamic factors on the cervical myelopathy have been radiographically examined by evaluating changes in the cross-sectional area (CSA) of the spinal cord or the occupying ratio of spinal cord by the OPLL during flexion-extension positions.…”

Section: Introductionmentioning

confidence: 97%

“…Although the spinal cord was likely to be compressed during extension, 7,12 greater spinal cord compression was observed during neck flexion with a higher occupying ratio of the OPLL. 12 Clinically, the influences of dynamic factors on the cervical myelopathy have been radiographically examined by evaluating changes in the cross-sectional area (CSA) of the spinal cord or the occupying ratio of spinal cord by the OPLL during flexion-extension positions. Recently, the kinematic CT myelography and dynamic multidetector-row CT are used to investigate flexion and extension motion on the spinal cord in patients with the cervical OPLL.…”

Section: Introductionmentioning

confidence: 97%

Increased stress and strain on the spinal cord due to ossification of the posterior longitudinal ligament in the cervical spine under flexion after laminectomy

Khuyagbaatar

Kim

Park

et al. 2017

Proc Inst Mech Eng H

View full text Add to dashboard Cite

Myelopathy in the cervical spine due to cervical ossification of the posterior longitudinal ligament could be induced by static compression and/or dynamic factors. It has been suggested that dynamic factors need to be considered when planning and performing the decompression surgery on patients with the ossification of the posterior longitudinal ligament. A finite element model of the C2-C7 cervical spine in the neutral position was developed and used to generate flexion and extension of the cervical spine. The segmental ossification of the posterior longitudinal ligament on the C5 was assumed, and laminectomy was performed on C4-C6 according to a conventional surgical technique. For various occupying ratios of the ossified ligament between 20% and 60%, von-Mises stresses, maximum principal strains in the spinal cord, and cross-sectional area of the cord were investigated in the pre-operative and laminectomy models under flexion, neutral position, and extension. The results were consistent with previous experimental and computational studies in terms of stress, strain, and cross-sectional area. Flexion leads to higher stresses and strains in the cord than the neutral position and extension, even after decompression surgery. These higher stresses and strains might be generated by residual compression occurring at the segment with the ossification of the posterior longitudinal ligament. This study provides fundamental information under different neck positions regarding biomechanical characteristics of the spinal cord in cervical ossification of the posterior longitudinal ligament.

show abstract

“…Computed tomography following myelography (CTM) plays an important role in the accurate diagnosis of various lesions in the spinal canal lesions that cannot be diagnosed by magnetic resonance imaging (MRI) [1,2]. In our clinic, almost all admitted patients suffering from spinal lesions are examined by CTM, during which we have noted unusual flow patterns of contrast dye into the anterior median fissure (AMF).…”

Section: Introductionmentioning

confidence: 99%

Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography

et al. 2018

View full text Add to dashboard Cite

ObjectiveComputed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. MethodsMorphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). ResultsIn group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). ConclusionOn CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

show abstract

Dynamic Changes in Spinal Cord Compression by Cervical Ossification of the Posterior Longitudinal Ligament Evaluated by Kinematic Computed Tomography Myelography

Abstract: 4.

Cited by 27 publications

References 27 publications

Postlaminectomy membrane with dynamic spinal cord compression disclosed with computed tomographic myelography: a case report and literature review

Postlaminectomy membrane with dynamic spinal cord compression disclosed with computed tomographic myelography: a case report and literature review

Increased stress and strain on the spinal cord due to ossification of the posterior longitudinal ligament in the cervical spine under flexion after laminectomy

Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography

Contact Info

Product

Resources

About