Search Results

You are looking at 1 - 10 of 4,732 items for :

Clear All
Restricted access

Lumbar stenosis: a personal record

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

John A. Jane Sr., Jonathan H. Sherman, Paul T. Boulos, Craig Luce and Aaron S. Dumont

T he possibility that degenerative changes of the lumbar spine can lead to compression of the spinal cord and/or its nerve roots has been recognized for some time. 2, 15 It was not until the descriptions provided by Van Gelderen 27 and Verbiest 29, 31 that the clinical syndrome of lumbar spinal stenosis was systemically described. Van Gelderen 27 reported on two patients, in one of whom successful decompression was performed. Verbiest 29 reported the first series of patients and emphasized that a major contributing factor was developmental narrowing of

Restricted access

Shankar G. Prakash, Mathew J. Chandy and Jacob Abraham

D evelopmental cervical canal stenosis with no radiological features of spondylosis is a recognized cause of cervical myelopathy. 3, 5–7 However, localized spinal canal stenosis due to developmental hypertrophy of the posterior neural arch of C-2 has not been reported to date as a cause of myelopathy. Case Report This 40-year-old man presented with a 4-year history of burning paresthesia and progressive stiffness of all four extremities and urgency of micturition. The paresthesia attacks lasted 2 to 5 seconds and were precipitated by flexion and

Restricted access

Andrew P. Gasecki, Michael Eliasziw, Gary G. Ferguson, Vladimir Hachinski, Henry J. M. Barnett and for the North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group

T he North American Symptomatic Carotid Endarterectomy Trial (NASCET) demonstrated the benefit of endarterectomy for angiographically defined severe (70% to 99%) carotid artery stenosis in patients with symptoms of nondisabling stroke or transient ischemic attacks. 16 Subsequent analyses revealed that the risk of stroke in medically treated patients and the benefit of endarterectomy steadily decreased with declining degrees of carotid artery stenosis. 4, 16 It has been suggested that the presence of contralateral carotid artery disease could further modify

Restricted access

Anthony J. Caputy and Alfred J. Luessenhop

P revious reports have described the short-term outcome for patients undergoing decompressive surgery for neurologically symptomatic lumbar stenosis. 2, 5, 7–10, 14, 16, 22 However, there is very little information regarding the interval incidences of recurrences and causes for surgical failures in long-term follow-up studies. To assess this situation, we studied the outcomes for 100 patients operated on by one of us between 1980 and 1985. This group offers the potential of at least 5 years of follow-up evaluation and as long as 10 years for some. Also

Restricted access

Mark G. Burnett, Sherman C. Stein and Ronald H. M. A. Bartels

L umbar spinal stenosis is a slowly progressive degenerative condition that commonly affects older adults and can lead to significant functional disability. Patients develop LSS due to facet and ligamentous hypertrophy as well as disc bulging that narrows the spinal canal circumferentially and compress the spinal nerves. Presenting symptoms include lower-extremity pain, numbness, and tingling that is often worsened with ambulation. The mainstay of treatment for symptomatic LSS is decompressive surgery via lumbar laminectomy. Recently, interspinous

Free access

Kevin L. Ong, Joshua D. Auerbach, Edmund Lau, Jordana Schmier and Jorge A. Ochoa

S pinal fusion procedures have become increasingly common in the treatment of various spinal disorders, such as spinal stenosis and spondylolisthesis, to facilitate spinal decompression and stabilization. Fusion is also used to treat degenerative disc disorder but remains controversial in the absence of other codiagnoses, in the elderly, and at multiple levels (3 or more). 16 A recent study of the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database showed that from 1998 to 2008, the annual number of spinal fusion discharges in the

Restricted access

Brian T. Andrews, Norman L. Chater and Philip R. Weinstein

embolectomy for middle cerebral artery (MCA) stenosis and occlusion have also been attempted, but the results are not encouraging. 2, 22, 24 Patients with MCA stenosis often present with transient ischemic attacks (TIA's) that may be due to hemodynamic insufficiency, 1, 11 providing an opportunity for therapeutic intervention before total occlusion and severe stroke occur. In some cases, a favorable prognosis with medical treatment alone has been observed with this lesion. 11 In contrast, MCA occlusion appears to carry a worse prognosis. Up to 87% of patients suffer

Restricted access

Bizhan Aarabi, Melvin Alexander, Stuart E. Mirvis, Kathirkamanathan Shanmuganathan, David Chesler, Christopher Maulucci, Mark Iguchi, Carla Aresco and Tiffany Blacklock

T raumatic CCS is the most frequent form of incomplete spinal cord injury. 1 , 33 , 55 Between 35% and 58% of all patients with the clinical picture of ATCCS are those with spinal stenosis who sustained hyperextension injury at the time of an accident with little or no evidence of significant disc sequestration and instability indicators such as compression, distraction, or translation of skeletal segments. 2 , 8 , 20 , 31 , 33 , 58 These patients have disproportionate weakness of the upper extremities, variable degrees of sensory loss, and bladder

Full access

Stephen P. Kalhorn, Russell G. Strom and David H. Harter

H ydrocephalus secondary to stenosis of the foramen of Monro is rare. 18 Foraminal stenosis has been attributed to infectious origins (particularly TORCH infections) causing inflammation and subsequent scarring in the region, 2 , 3 congenital atresia, 7 , 9 , 19 , 22 , 24 vascular malformations, 23 and neoplastic processes, 7 particularly thalamic or intraventricular tumors. Unilateral hydrocephalus from foraminal stenosis may be treated using shunting 7 or endoscopic procedures. 14 We report a case of idiopathic bilateral stenosis of the foramina of

Full access

Thomas J. Buell, Daniel M. S. Raper, I. Jonathan Pomeraniec, Dale Ding, Ching-Jen Chen, Davis G. Taylor and Kenneth C. Liu

T ransverse sinus (TS) and sigmoid sinus (SS) stenosis, with a trans-stenosis pressure gradient, has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH). 2 TS and SS stenosis may cause venous outflow obstruction, reduction in CSF bulk flow, and elevated intracranial pressure (ICP). However, it is incompletely understood whether TS and SS stenosis is actually a downstream effect of IIH, rather than its principal etiological mechanism. 1 Although no definitive conclusion may be drawn from a single report, we provide evidence in