"Conservative" cranio-cervical decompression in the treatment of syringomyelia-Chiari I complex. A prospective study of 20 adult cases.


STUDY DESIGN:This study was designed to investigate prospectively a series of patients with syringomyelia-Chiari I complex operated on by a minimally invasive procedure. OBJECTIVE:The objective was to determine whether a relatively simple and low-risk osteo-dural decompression would obtain as good clinico-radiological results as those observed after the commonly used, more complex posterior fossa surgery. SUMMARY OF BACKGROUND DATA:The majority of hypotheses concerning the pathogenesis of syringomyelia link it to the existence of some derangement of the cerebro-spinal fluid flow at the cranio-spinal level and, consequently, surgical procedures are directed toward decompressing the cranio-cervical junction; however, there is no clear-cut evidence that simple osteo-dural decompression should be associated with manipulation of nervous tissue for the purpose of restoring to normal an altered cerebro-spinal fluid flow dynamic. METHODS:The procedure consisted of a small suboccipital craniectomy and laminectomy of C1 (when necessary C2 as well), followed by dura mater opening. Exploration and plugging of the obex, resection of arachnoid adherences, or amputation of the amygdala(e) were never performed. Every effort was made to keep the arachnoid intact. The series included 20 patients with progressive disease treated according the above-mentioned criteria. RESULTS:Mortality and morbidity were nil and MRI controls showed shrinkage of the syrinx in all cases. At long-term follow-up (average, 2.4 years), 8 patients were considered improved, 11 stabilized, and 1 patient continued to deteriorate despite the collapse of the cord cavity. CONCLUSION:Considering that the results of this "conservative" cranio-cervical decompression are at least comparable to those obtained with other surgical procedures, this procedure, which was not associated with mortality or morbidity, currently should be considered the first option in the treatment of syringomyelia-Chiari I complex.


Spine (Phila Pa 1976)




Di Lorenzo N,Palma L,Palatinsky E,Fortuna A




Has Abstract


1995-12-01 00:00:00














  • The Effect of Axial Torsion on the Mechanical Properties of the Annulus Fibrosus.

    abstract:STUDY DESIGN:In-vitro study of the tissue mechanics of annulus fibrosus. OBJECTIVE:To determine the effect of axial torsion on the mechanical properties of the inter- and intralamellar matrices. SUMMARY OF BACKGROUND DATA:Axial torsion, when combined with repetitive flexion, has been associated with an increased risk...


    pub_type: 杂志文章


    authors: Harvey-Burgess M,Gregory DE

    更新日期:2019-02-15 00:00:00

  • Clinical practice guidelines. Particular reference to the management of pain in the lumbosacral spine.

    abstract::Clinical practice guidelines and protocols are a seductive way of trying to improve the standard of clinical practice. If these are to be most effective, they must evaluate rigorously the evidence supporting a particular management strategy and make appropriate recommendations based on this information. This process n...


    pub_type: 杂志文章


    authors: Steven ID,Fraser RD

    更新日期:1996-07-01 00:00:00

  • Iliac Crest Bone Graft for Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Analysis of Inpatient Pain, Narcotics Consumption, and Costs.

    abstract:STUDY DESIGN:Retrospective Analysis OBJECTIVE.: The aim of this study was to determine whether an association between increased acute pain, postoperative time, and direct hospital costs exists between the use of iliac crest bone grafting (ICBG) and bone morphogenic protein (BMP)-2 following a primary, single-level mini...


    pub_type: 杂志文章


    authors: Haws BE,Khechen B,Narain AS,Hijji FY,Cardinal KL,Guntin JA,Singh K

    更新日期:2018-09-15 00:00:00

  • Predicting long-term disability in low back injured workers presenting to a spine consultant.

    abstract::Low back pain (LBP) is the most common, costly, and disabling musculoskeletal condition. Although most LBP patients recover within two months, 2-3% eventually develop disabling chronic low back pain (DCLBP). Due to the prevalence of DCLBP problems, models have been developed to predict which acute low back pain patien...


    pub_type: 杂志文章


    authors: Lehmann TR,Spratt KF,Lehmann KK

    更新日期:1993-06-15 00:00:00

  • The influence of lumbar disc height and cross-sectional area on the mechanical response of the disc to physiologic loading.

    abstract:STUDY DESIGN:The influence of lumbar disc height and cross-sectional area on the mechanical response of the disc to physiologic loading was determined using a finite element model. OBJECTIVES:To identify which geometric characteristics are potentially related to motion segment mechanical response to applied load, such...


    pub_type: 杂志文章


    authors: Natarajan RN,Andersson GB

    更新日期:1999-09-15 00:00:00

  • The natural history of idiopathic scoliosis before skeletal maturity.

    abstract::A retrospective review of 326 female patients with untreated idiopathic scoliosis was performed to determine what factors might be useful in predicting the risk of curve progression. Components such as family history, height-weight ratio, lumbosacral transitional anomalies, kyphosis, lordosis, and trunk balance were n...


    pub_type: 杂志文章


    authors: Bunnell WP

    更新日期:1986-10-01 00:00:00

  • Postoperative spondylolisthesis at L4-5. The role of facet joint morphology.

    abstract::Thirty-three patients underwent decompression without fusion at the L4-5 level for spinal stenosis or degenerative spondylolisthesis. Using preoperative and 1-year postoperative lateral lumbar spine radiographs, the incidence of postoperative spondylolisthesis of greater than 5% was found to be 58%. Computed tomograph...


    pub_type: 杂志文章


    authors: Robertson PA,Grobler LJ,Novotny JE,Katz JN

    更新日期:1993-09-01 00:00:00

  • Motor and Sensory Impairments of the Lower Extremities After L2 Nerve Root Transection During Total en Bloc Spondylectomy.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:The purpose of this study was to examine motor and sensory impairments of the lower extremities after L2 nerve root transection during total en bloc spondylectomy (TES) for spinal tumors. SUMMARY OF BACKGROUND DATA:At our institute, for TES at L3 to L5 lumbar levels, the ne...


    pub_type: 杂志文章


    authors: Kato S,Murakami H,Demura S,Ota T,Takahashi N,Yoshioka K,Shinmura K,Yokogawa N,Kawahara N,Tomita K,Tsuchiya H

    更新日期:2019-08-15 00:00:00

  • The correlation between surface measurement of head and neck posture and the anatomic position of the upper cervical vertebrae.

    abstract:STUDY DESIGN:Repeated measurements were made of surface postural angles registering the relative positions of the head and neck in photographs and of angles of the upper cervical vertebrae recorded in lateral cephalometric radiographs in the same subjects. For all registrations, subjects assumed the natural head rest p...


    pub_type: 杂志文章


    authors: Johnson GM

    更新日期:1998-04-15 00:00:00

  • Transoral endoscopic odontoidectomy to decompress the cervicomedullary junction.

    abstract:STUDY DESIGN:Clinical study. OBJECTIVE:To investigate the feasibility of the transoral endoscopic odontoidectomy without occipitocervical fusion. SUMMARY OF BACKGROUND DATA:Endoscopic transnasal resection of the odontoid process is less invasive than the conventional transoral odontoidectomy. However, the endonasal a...


    pub_type: 杂志文章


    authors: Qiuhang Z,Feng K,Bo Y,Hongchuan G,Mingchu L,Ge C,Feng L

    更新日期:2013-06-15 00:00:00

  • Do corticosteroids produce additional benefit in nerve root infiltration for lumbar disc herniation?

    abstract:STUDY DESIGN:Experimental animal study. OBJECTIVE:To determine whether corticosteroids produce additional benefit to nerve root infiltration (NRI) for experimental lumbar disc herniation. SUMMARY OF BACKGROUND DATA:NRI is used for nonsurgical treatment of radicular symptoms caused by lumbar disc herniation or lumbar ...


    pub_type: 杂志文章


    authors: Tachihara H,Sekiguchi M,Kikuchi S,Konno S

    更新日期:2008-04-01 00:00:00

  • A logical coronal pattern classification of 2,000 consecutive idiopathic scoliosis cases based on the scoliosis research society-defined apical vertebra.

    abstract:STUDY DESIGN:Two thousand consecutive idiopathic scoliosis records and radiographs were reviewed for coronal pattern typing and categorization, based on Scoliosis Research Society definitions of the apical vertebra. Apical frequency was determined for each of the patterns identified, and represents a database from a la...


    pub_type: 杂志文章


    authors: Coonrad RW,Murrell GA,Motley G,Lytle E,Hey LA

    更新日期:1998-06-15 00:00:00

  • Anterior spinal fusion with Zielke instrumentation for idiopathic scoliosis. A frontal and sagittal curve analysis in 36 patients.

    abstract::The authors have reviewed the records of 36 patients with idiopathic scoliosis who underwent a single-stage anterior spinal fusion with Zielke instrumentation to determine if any adverse frontal or secondary sagittal deformities or changes in balance resulted from the surgery. Spontaneous correction of uninstrumented ...


    pub_type: 杂志文章


    authors: Lowe TG,Peters JD

    更新日期:1993-03-15 00:00:00

  • Comparison of radiologic signs and clinical symptoms of spinal stenosis.

    abstract:STUDY DESIGN:Clinical findings of spinal stenosis were compared to graded radiologic findings of dural sac narrowing. OBJECTIVES:To examine the changes of the dural sac area of the lumbar spine on computerized tomography (CT) performed without and with axial loading, and study the correlations between the radiologic f...


    pub_type: 杂志文章


    authors: Lohman CM,Tallroth K,Kettunen JA,Lindgren KA

    更新日期:2006-07-15 00:00:00

  • Thoracic and lumbar spine in diastrophic dysplasia: a clinical and magnetic resonance imaging analysis.

    abstract:STUDY DESIGN:Cross-sectional study to evaluate the thoracic and lumbar spine in patients with diastrophic dysplasia (DD). OBJECTIVES:To find the causative factors behind the spinal deformities and restricted mobility of the spine. SUMMARY OF BACKGROUND DATA:Typical findings in this skeletal dysplasia are short-limbed...


    pub_type: 杂志文章


    authors: Remes V,Tervahartiala P,Poussa M,Peltonen J

    更新日期:2001-01-15 00:00:00

  • Primary spinal natural killer/T-cell lymphoma successfully treated with concurrent chemoradiotherapy and autologous stem cell transplantation.

    abstract:STUDY DESIGN:This case report shows primary natural killer (NK)/T-cell lymphoma originating in the spine as the first case of successful treatment with autologous stem cell transplantation, along with case presentation and literature review. OBJECTIVE:For the proper treatment of this spinal tumor, the pathologic confi...


    pub_type: 杂志文章


    authors: Kim KT,Kim YB,Kim HJ,Cha YJ,Lee SJ,Park E

    更新日期:2012-05-01 00:00:00

  • An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery.

    abstract:STUDY DESIGN:The distribution of the lumbar plexus was analyzed using cadavers. OBJECTIVE:To clarify the safety zone to prevent nerve injuries with respect to retroperitoneal endoscopic surgery. SUMMARY OF BACKGROUND DATA:Surgical approaches to the retroperitoneal space vary among surgeons. Recently, retroperitoneal ...


    pub_type: 杂志文章


    authors: Moro T,Kikuchi S,Konno S,Yaginuma H

    更新日期:2003-03-01 00:00:00

  • Validation of the simplified Chinese version of the functional rating index for patients with nonspecific neck pain in mainland China.

    abstract:STUDY DESIGN:Validation of a self-report questionnaire, Functional Rating Index (FRI). OBJECTIVE:To evaluate the psychometric properties of the simplified Chinese (SC) version of FRI in patients with nonspecific neck pain (NP). SUMMARY OF BACKGROUND DATA:FRI has been cross-culturally validated in few languages with e...


    pub_type: 杂志文章


    authors: Wei X,Xu X,Zhao Y,Chen K,Wang F,Fan J,Yang C,Chen Z,Bai Y,Zhu X,Li M

    更新日期:2015-05-01 00:00:00

  • Short-term Outcomes Following Cervical Laminoplasty and Decompression and Fusion With Instrumentation.

    abstract:STUDY DESIGN:Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2010 to 2015. OBJECTIVE:Investigate which short-term outcomes differ for cervical laminoplasty and laminectomy and fusion surgeries. SUMMARY OF BACKGROUND DATA:Conflicting rep...


    pub_type: 杂志文章


    authors: Boniello A,Petrucelli P,Kerbel Y,Horn S,Bortz CA,Brown AE,Pierce KE,Alas H,Khalsa A,Passias P

    更新日期:2019-09-01 00:00:00

  • Predicting major adverse cardiac events in spine fusion patients: is the revised cardiac risk index sufficient?

    abstract:STUDY DESIGN:Observational cohort study. OBJECTIVE:To determine the accuracy of the Revised Cardiac Risk Index (RCRI) in predicting major adverse cardiac events in patients undergoing spine fusion surgery of 3 levels or more. SUMMARY OF BACKGROUND DATA:Preoperative cardiac testing is extensively guided by the RCRI, w...


    pub_type: 杂志文章


    authors: Carabini LM,Zeeni C,Moreland NC,Gould RW,Hemmer LB,Bebawy JF,Koski TR,McClendon J Jr,Koht A,Gupta DK

    更新日期:2014-08-01 00:00:00

  • Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice.

    abstract:STUDY DESIGN:An observational prospective cohort study in general practice. OBJECTIVES:To describe the clinical course and to identify predictors of recovery, changes in pain intensity, and changes in functional disability in patients with neck or shoulder symptoms at 3- and 12-month follow-up. SUMMARY OF BACKGROUND ...


    pub_type: 杂志文章


    authors: Bot SD,van der Waal JM,Terwee CB,van der Windt DA,Scholten RJ,Bouter LM,Dekker J

    更新日期:2005-08-15 00:00:00

  • Anterior lumbar interbody fusion with processed sea coral (coralline hydroxyapatite) as part of a circumferential fusion.

    abstract:STUDY DESIGN:A retrospective review of 20 patients undergoing circumferential lumbar fusion with coralline hydroxyapatite blocks anteriorly and autograft with transpedicular or translaminar facet screw fixation posteriorly. OBJECTIVES:To examine the efficacy of coralline hydroxyapatite as a bone graft substitute for a...


    pub_type: 杂志文章


    authors: Thalgott JS,Klezl Z,Timlin M,Giuffre JM

    更新日期:2002-12-15 00:00:00

  • Spine update. Impaired cognitive functioning after whiplash injury of the cervical spine.

    abstract::To enhance the awareness of physicians treating whiplash patients, findings from previous research regarding cognitive functioning of these patients are discussed and recommendations for assessment provided. Cognitive disturbances (i.e., deficient attentional functioning and impairment of memory) are frequent complain...


    pub_type: 杂志文章,评审


    authors: Radanov BP,Dvorak J

    更新日期:1996-02-01 00:00:00

  • Comparison of results of total disc replacement in postdiscectomy patients versus patients with no previous lumbar surgery.

    abstract:STUDY DESIGN:Data for this study were collected as part of a prospective Food and Drug Administration regulated IDE trial for the ProDisc total disc replacement. OBJECTIVE:The purpose of the study was to compare the results of total disc replacement (TDR) in patients with previous discectomy to patients who had no suc...


    pub_type: 杂志文章


    authors: Leahy M,Zigler JE,Ohnmeiss DD,Rashbaum RF,Sachs BL

    更新日期:2008-07-01 00:00:00

  • Disc pressure measurements.

    abstract::By measurement of intradiscal pressure in vitro, the hydrostatic properties of the nucleus pulposus of normal lumbar intervertebral disc were proven. The hydrodynamic properties seem to exist also in the somewhat degenerated disc, but not in the more severely deranged ones. Intravitally-performed measurements of disc ...


    pub_type: 杂志文章


    authors: Nachemson AL

    更新日期:1981-01-01 00:00:00

  • Measurement error in assessment of vertebral rotation using the Perdriolle torsionmeter.

    abstract::The Perdriolle torsionmeter assesses vertebral rotation on a spinal radiograph. It is frequently used to measure improvement in spinal derotation following Cotrel-Dubousset instrumentation for scoliosis. In this study, intraobserver and interobserver measurement error was examined during use of the torsionmeter. Intra...


    pub_type: 杂志文章


    authors: Richards BS

    更新日期:1992-05-01 00:00:00

  • Apical lordosating osteotomy and minimal segment fixation for the treatment of thoracic or thoracolumbar osteoporotic kyphosis.

    abstract:STUDY DESIGN:Retrospective review. OBJECTIVE:To assess the effectiveness of apical lordosating osteotomy (ALO) and minimal segment fixation through a posterior approach for correcting thoracic or thoracolumbar osteoporotic kyphosis (OK). SUMMARY OF BACKGROUND DATA:Current surgical options for OK involve a risk of com...


    pub_type: 杂志文章


    authors: Chang KW,Chen YY,Lin CC,Hsu HL,Pai KC

    更新日期:2005-07-15 00:00:00

  • A prospective follow-up study of low back pain in the community.

    abstract:STUDY DESIGN:Opportunistic prospective follow-up study. OBJECTIVE:To describe the natural history of low back pain in the community and to model the factors predictive of recovered versus persistent low back pain. SUMMARY OF BACKGROUND DATA:A two-phase questionnaire was mailed to adults in the Bradford Metropolitan H...


    pub_type: 杂志文章


    authors: Waxman R,Tennant A,Helliwell P

    更新日期:2000-08-15 00:00:00

  • The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery.

    abstract:STUDY DESIGN:A retrospective cohort analysis. OBJECTIVE:The aim of this study was to assess whether duration of symptoms (DOS) has an effect on clinical outcomes in patients undergoing lumbar decompression. SUMMARY OF BACKGROUND DATA:The success of surgical interventions for lumbar spinal stenosis varies depending on...


    pub_type: 杂志文章


    authors: Movassaghi K,Basques BA,Louie PK,Khan JM,Derman PB,Nolte MT,Paul JC,Goldberg EJ,An HS

    更新日期:2019-03-01 00:00:00

  • Minimum 25-year outcome and functional assessment of lumbar discectomy.

    abstract:STUDY DESIGN:A retrospective, follow-up cohort study. OBJECTIVE:To evaluate the 25-year (or longer) outcome of discectomy for lumbar disc herniation by validated instruments. SUMMARY OF BACKGROUND DATA:A comprehensive patient-oriented evaluation should include measurements of pain and disability along with a reliable...


    pub_type: 杂志文章


    authors: Mariconda M,Galasso O,Secondulfo V,Rotonda GD,Milano C

    更新日期:2006-10-15 00:00:00