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Objective. To establish predisposing factors of high cervical disc degeneration (HCDD) with an emphasis on the presence or absence of craniovertebral junction (CVJ) pathology by a retrospective analysis of clinical and radiologic parameters of patients operated at our institute. Methods. Thirty-seven patients of C3-4 prolapsed intervertebral disc (PIVD) were compared with 45 patients of C5-6 PIVD. Nurick's grade was used for clinical assessment. Radiological parameters like congenital and osteoarthritic changes at CVJ along with measurement of stress levels in flexion and extension on X-rays were done. Results. Mean age of C3-4 PIVD patients (48.16 years, range 26-65 years) was significantly higher than C5-6 PIVD patients (38.13 years, range 21-55 years) (p < 0.001). CVJ pathology was seen in significantly higher proportion in patients with C3-4 PIVD (18/37) in comparison to C5-6 PIVD (4/45) (p < 0.001). C3-4 PIVD patients presented with a poorer pre-op and post-op Nurick's grade. T2 hyperintense intramedullary signal change was seen in 91.8% (34/37) of C3-4 PIVD patients as compared to 66.67% (30/45) of C5-6 PIVD patients (p < 0.001). Conclusion. CVJ pathology is a predisposing factor for HCDD. HCDD presents in a poorer Nurick's grade compared to lower cervical PIVD and majority of the patients have T2 hyperintense intramedullary signal changes in MRI. Presence of T2 hyperintense intramedullary signal changes is associated with poorer pre-op clinical status and poorer post-op outcome.
Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS) , Bangalore , India.
This article was published in the following journal.
Name: British journal of neurosurgery
Surgery for craniovertebral junction (CVJ) abnormalities like atlantoaxial dislocation (AAD) with or without basilar invagination (BI) and/or with or without associated Arnold-Chiari malformation (ACM...
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A single-center, prospective comparative study of prospectively collected outcomes, with a minimum 12 months follow-up.
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A malignancy arising in uterine cervical epithelium and confined thereto, representing a continuum of histological changes ranging from well-differentiated CIN 1 (formerly, mild dysplasia) to severe dysplasia/carcinoma in situ, CIN 3. The lesion arises at the squamocolumnar cell junction at the transformation zone of the endocervical canal, with a variable tendency to develop invasive epidermoid carcinoma, a tendency that is enhanced by concomitant human papillomaviral infection. (Segen, Dictionary of Modern Medicine, 1992)
Electrophoresis in which discontinuities in both the voltage and pH gradients are introduced by using buffers of different composition and pH in the different parts of the gel column. The term 'disc' was originally used as an abbreviation for 'discontinuous' referring to the buffers employed, and does not have anything to do with the shape of the separated zones.
A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm.
A specialty concerned with the nature and cause of disease as expressed by changes in cellular or tissue structure and function caused by the disease process.
A parameter usually used in PRENATAL ULTRASONOGRAPHY to measure the length of the uterine neck (CERVIX UTERI). Cervical length or its shortening is used to identify and prevent early cervical opening and PRETERM BIRTH.
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Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...
Neurology - Central Nervous System (CNS)
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