Volume ratio of spinal canal and its contents in patients with congenital kyphosis

Authors

  • Andrey Mezentsev
  • Dmytro Petrenko
  • Dmytro Demchenko
  • Diana Dupliy

DOI:

https://doi.org/10.15674/0030-59872016322-26

Keywords:

congenital kyphosis, vertebromedular conflict, myelopathy, giant F-vaves

Abstract

Congenital anomalies of the spine combine formation and seg­mentation failures, resulting into asymmetrical and altered growth and kyphotic or kyphoscoliotic deformations that pro­gressing during all the life with the following neurological dis­turbances. There is no consensus today on the main indications for the surgical treatment.

Objective: To study the volume ratios of the spinal canal and its contents in patients with congenital kyphosis (CK) before surgery and to compare the findings with the clinical neurological manifestations.

Methods: A retrospec­tive analysis of medical records, the results of computer (CT) and magnetresonance tomography (MRI) of 15 patients (3 to 20 years) with the CK who received surgical treatment. All the patients were taken about the clinical, radiological, electroneuromyographic (EMG) examination and MRI.

Results: ver­tebromedular (VMC) conflict based on MRI data diagnosed in all patients: I degree — in 6, II — in 8, IV — at 1. As a result of electroneuromyographic studies in patient with an IV degree of VMC revealed severe axonal damage of peroneal and tibial nerves. In the group with grade II VMC in 3 patients decreased motor potential and the conduction of the tibial nerve, and 4 has a violation of conduction and synchronization of motor neurons. Such disorders also detected in 4 of 10 patients with VMC degree I and II, but without evidence of neurological deficit.

Conclu­sion: all patients with CK had failures and VMC varying degrees independently of clinical manifestations of spinal cord compres­sion.Using ENMG in patients with I and II degree of VMC, it is identified violation of motoneuron function and decreased motor conduction in peripheral nerves even without motor and sensory disorders. Indicator of VMC may be informative for predicting the neurological complications, so that all patients with CK CT and MRI studies are indicated.

References

McMaster MJ, Singh H. The surgical management of congenital kyphosis and kyphoscoliosis. Spine. 2001;26(19):2146-54.

Winter RB, Moe JH, Lonstein JE. The surgical treatment of congenital kyphosis. A review of 94 patients age 5 years or older, with 2 years or more follow-up in 77 patients. Spine. 1985;10: 224-31.

Suk SI, Kim JH, Kim WJ, Lee SM, Chung ER, Nah KH. Posterior vertebral column resection for severe spinal deformities. Spine. 2002;27(21): 2374-82.

Bollini G, Docquier PL, Viehweger E, Launay F, Jouve JL. Thoracolumbar hemivertebrae resection by double approach in a single procedure long-term follow-up. Spine. 2006;31(15): 1745-57.

Lavrukov AM, Tomilov AB. Osteosynthesis using device for external fixation in patients with injury and spine pathology. Yekaterinburg, 2002. 207 p.

Nikolaev SG. Atlas of electromyography. 2010. 780 p.

Pan H, Jian F, Lin J, Chen N, Zhang C, Zhang Z, Ding Z, Wang Y, Cui L, Kimura J. F-wave latencies in patients with diabetes mellitus. Muscle Nerve. 2014;49(6):804-8. doi: 10.1002/mus.24127.

Bal S, Celiker R, Palaoglu S, Cila A. F wave studies of neurogenic intermittent claudication in lumbar spinal stenosis. Am J Phys Med Rehabil. 2006;85(2):135-40.

Adamova B, Vohanka S, Dusek L. Dynamic electrophysiological examination in patients with lumbar spinal stenosis: is it useful in clinical practice? Eur Spine J 2005;14(3):269-76.

Adamova B, Vohanka S, Dusek L. Differential diagnostics in patients with mild lumbar spinal stenosis: the contributions and limits of various tests. Eur Spine J 2003;12(2):190-6.

Funaba M, Kanchiku T, Imajo Y, Suzuki H, Yoshida Y, Nishida N, Fujimoto K, Taguchi T. Characteristics of C 6–7 myelopathy: assessment of clinical symptoms and electrophysiological findings. Spinal Cord. 2015. doi: 10.1038/sc.2015.203.

Koarashi M. The clinical significance of the F-wave of upper limb on cervicalmyelopathy. Nihon Seikeigeka Gakkai Zasshi. 1983;57(2):123-35.

Fang J, Cui LY, Liu MS, et al. F wave study in amyotrophic lateral sclerosis: assessment of segmental motoneuronal dysfunction. Chin Med J (Engl). 2015;128(13):1738-42. doi: 10.4103/0366-6999.159346.

Chroni E, Tendero IS, Punga AR, Stalberg E. Usefulness of assessing repeater F-waves in routine studies. Muscle Nerve. 2012;45(4):477-85. doi: 10.1002/mus.22333.

Lomaga IA. Neurologic syndromes in children with scoliosis. Synopsis of PhD thesis. Moscow, 2009.

Magerl F, Aebi M, Gertzbein SD, Harms J. A comprehensive classification of thoracic and lumbar injuries. Eur. Spine Journal. 1994;3(4):184-201.

O. Keynan, C. G. Fisher, A. Vaccaro [et al. Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group. Spine. 2006;31(5):E156–E165.

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