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Peter P Sun - One of the best experts on this subject based on the ideXlab platform.
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cervical spinal stenosis and sports related cervical cord Neurapraxia
Neurosurgical Focus, 2011Co-Authors: Aaron J Clark, Kurtis I Auguste, Peter P SunAbstract:Cervical cord Neurapraxia is a common sports-related injury. It is defined as a transient neurological deficit following trauma localizing to the cervical spinal cord and can be caused by hyperextension, hyperflexion, or axial load mechanisms. Symptoms usually last less than 15 minutes, but can persist up to 48 hours in adults and as long as 5 days in children. While a strong causal relationship exists between cervical spine stenosis and cervical cord Neurapraxia in adult patients, this association has not been observed in children. Likewise, while repeated episodes of Neurapraxia can be commonplace in adult patients, recurrences have not been reported in the pediatric population. Treatment is usually supportive, but in adults with focal cervical lesions or instability, surgery is an option. Surgery for Neurapraxia in children is rarely indicated.
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cervical spinal stenosis and sports related cervical cord Neurapraxia in children
Spine, 2001Co-Authors: John A Boockvar, Susan R Durham, Peter P SunAbstract:STUDY DESIGN Congenital spinal stenosis has been demonstrated to contribute to cervical cord Neurapraxia after cervical spinal cord injury in adult athletes. A sagittal canal diameter <14 mm and/or a Torg ratio (sagittal diameter of the spinal canal: midcervical sagittal vertebral body diameter) of <0.8 are indicative of significant cervical spinal stenosis. Although sports-related cervical spine injuries are common in children, the role of congenital cervical stenosis in the etiology of these injuries remains unclear. OBJECTIVES The authors measured the sagittal canal diameter and the Torg ratio in children presenting with cervical cord Neurapraxia resulting from sports-related cervical spinal cord injuries to determine the presence of congenital spinal stenosis. METHODS A total of 13 children (9 male, 4 female) presented with cervical cord Neurapraxia after a sports-related cervical spinal cord injury. Age ranged from 7 to 15 years (mean +/- SD, 11.5 +/- 2.7 years). The sports involved were football (n = 4), wrestling (n = 2), hockey (n = 2), and soccer, gymnastics, baseball, kickball, and pogosticking (n = 1 each). Lateral cervical spine radiographs were used to determine the sagittal canal diameter and the Torg ratio at C4. RESULTS The sagittal canal diameter (mean +/- SD, 17.58 +/- 1.63 mm) and the Torg ratio (mean +/- SD, 1.20 +/- 0.24) were normal in all of these children. CONCLUSION Using the sagittal canal diameter and the Torg ratio as a measurement of congenital spinal stenosis, the authors did not find evidence of congenital cervical spinal stenosis in a group of children with sports-related cervical spinal cord Neurapraxia. The occurrence of cervical cord Neurapraxia in pediatric patients can be attributed to the mobility of the pediatric spine rather than to congenital cervical spinal stenosis.
David F Paulson - One of the best experts on this subject based on the ideXlab platform.
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transient lower extremity Neurapraxia associated with radical perineal prostatectomy a complication of the exaggerated lithotomy position
The Journal of Urology, 1998Co-Authors: David T Price, Christophe E Iselin, Johannes Vieweg, Frank Roland, Lance J Coetzee, Thomas Spalding, David F PaulsonAbstract:AbstractPurpose: We assess the incidence and risk factors associated with lower extremity Neurapraxia following radical perineal prostatectomy.Materials and Methods: The medical records of 111 consecutive patients undergoing radical perineal prostatectomy at Duke University Medical Center between June 1994 and June 1995 were retrospectively reviewed. Patients were interviewed by telephone to ascertain whether symptoms had resolved.Results: Neuropraxia developed in 23 patients (21%). Symptomatology was variable, including sensory and motor deficits of the lower leg and foot. Although lower extremity Neurapraxia occurred in a significant number of patients undergoing radical perineal prostatectomy, it appeared to resolve in most.Conclusions: Careful attention to detail when positioning the patient and limiting the time in the exaggerated lithotomy position appear to be the most critical aspects to prevent Neurapraxia.
Kurtis I Auguste - One of the best experts on this subject based on the ideXlab platform.
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cervical spinal stenosis and sports related cervical cord Neurapraxia
Neurosurgical Focus, 2011Co-Authors: Aaron J Clark, Kurtis I Auguste, Peter P SunAbstract:Cervical cord Neurapraxia is a common sports-related injury. It is defined as a transient neurological deficit following trauma localizing to the cervical spinal cord and can be caused by hyperextension, hyperflexion, or axial load mechanisms. Symptoms usually last less than 15 minutes, but can persist up to 48 hours in adults and as long as 5 days in children. While a strong causal relationship exists between cervical spine stenosis and cervical cord Neurapraxia in adult patients, this association has not been observed in children. Likewise, while repeated episodes of Neurapraxia can be commonplace in adult patients, recurrences have not been reported in the pediatric population. Treatment is usually supportive, but in adults with focal cervical lesions or instability, surgery is an option. Surgery for Neurapraxia in children is rarely indicated.
John A Boockvar - One of the best experts on this subject based on the ideXlab platform.
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cervical spinal stenosis and sports related cervical cord Neurapraxia in children
Spine, 2001Co-Authors: John A Boockvar, Susan R Durham, Peter P SunAbstract:STUDY DESIGN Congenital spinal stenosis has been demonstrated to contribute to cervical cord Neurapraxia after cervical spinal cord injury in adult athletes. A sagittal canal diameter <14 mm and/or a Torg ratio (sagittal diameter of the spinal canal: midcervical sagittal vertebral body diameter) of <0.8 are indicative of significant cervical spinal stenosis. Although sports-related cervical spine injuries are common in children, the role of congenital cervical stenosis in the etiology of these injuries remains unclear. OBJECTIVES The authors measured the sagittal canal diameter and the Torg ratio in children presenting with cervical cord Neurapraxia resulting from sports-related cervical spinal cord injuries to determine the presence of congenital spinal stenosis. METHODS A total of 13 children (9 male, 4 female) presented with cervical cord Neurapraxia after a sports-related cervical spinal cord injury. Age ranged from 7 to 15 years (mean +/- SD, 11.5 +/- 2.7 years). The sports involved were football (n = 4), wrestling (n = 2), hockey (n = 2), and soccer, gymnastics, baseball, kickball, and pogosticking (n = 1 each). Lateral cervical spine radiographs were used to determine the sagittal canal diameter and the Torg ratio at C4. RESULTS The sagittal canal diameter (mean +/- SD, 17.58 +/- 1.63 mm) and the Torg ratio (mean +/- SD, 1.20 +/- 0.24) were normal in all of these children. CONCLUSION Using the sagittal canal diameter and the Torg ratio as a measurement of congenital spinal stenosis, the authors did not find evidence of congenital cervical spinal stenosis in a group of children with sports-related cervical spinal cord Neurapraxia. The occurrence of cervical cord Neurapraxia in pediatric patients can be attributed to the mobility of the pediatric spine rather than to congenital cervical spinal stenosis.
Joseph S Torg - One of the best experts on this subject based on the ideXlab platform.
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the relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players an epidemiological study
Journal of Bone and Joint Surgery American Volume, 1996Co-Authors: Joseph S Torg, R Naranja, Helene Pavlov, Brian Galinat, Russell F Warren, Robert A StineAbstract:An evaluation of forty-five athletes who had had an episode of transient Neurapraxia of the cervical spinal cord revealed a consistent finding of developmental narrowing of the cervical spinal canal. The purpose of the present epidemiological study was to determine the relationship, if any, between a developmentally narrowed cervical canal and reversible and irreversible injury of the cervical cord with use of various cohorts of football players as well as a large control group. Cohort I comprised college football players who were asymptomatic and had no known history of transient Neurapraxia of the cervical cord. Cohort II consisted of professional football players who also were asymptomatic and had no known history of transient Neurapraxia of the cervical cord. Cohort III was a group of high-school, college, and professional football players who had had at least one episode of transient Neurapraxia of the cervical cord. Cohort IV comprised individuals who were permanently quadriplegic as a result of an injury while playing high-school or college football. Cohort V consisted of a control group of male subjects who were non-athletes and had no history of a major injury of the cervical spine, an episode of transient Neurapraxia, or neurological symptoms. The mean and standard deviation of the diameter of the spinal canal, the diameter of the vertebral body, and the ratio of the diameter of the spinal canal to that of the vertebral body were determined for the third through sixth cervical levels on the radiographs for each cohort. In addition, the sensitivity, specificity, and positive predictive value of a ratio of the diameter of the spinal canal to that of the vertebral body of 0.80 or less was evaluated. The findings of the present study demonstrated that a ratio of 0.80 or less had a high sensitivity (93 per cent) for transient Neurapraxia. The findings also support the concept that symptoms may result from a transient reversible deformation of the spinal cord in a developmentally narrowed osseous canal. The low positive predictive value of the ratio (0.2 per cent) however, precludes its use as a screening mechanism for determining the suitability of an athlete for participation in contact sports. Developmental narrowing of the cervical canal in a stable spine does not appear to predispose an individual to permanent catastrophic neurological injury and therefore should not preclude an athlete from participation in contact sports.
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cervical spinal stenosis with cord Neurapraxia and transient quadriplegia
Sports Medicine, 1995Co-Authors: Joseph S TorgAbstract:Cervical cord Neurapraxia is a transient, totally reversible phenomenon that results from compressive deformation of the spinal cord. It occurs as a result of developmental narrowing of the cervical canal, either as isolated entity or in combination with degenerative changes, instability or congenital abnormalities. Uncomplicated stenosis of the cervical canal in an individual with a stable spine does not predispose to permanent neurological injury. Our data does not indicate a correlation between developmental narrowing and permanent neurological sequelae in a spine rendered unstable by football-induced trauma. However, there are data indicating that the occurrence of an episode of cervical cord Neurapraxia is not a harbinger, or an indication of susceptibility to permanent neurological sequelae. Nevertheless, we recommended that continued participation in collision activities be restricted in individuals who have a documented episode of cervical cord Neurapraxia associated with (i) ligamentous instability; (ii) intervertebral disc disease with cord compression; (iii) significant degenerative changes; (iv) magnetic resonance imaging evidence of cord defect or swelling; (v) symptoms of positive neurological findings lasting more than 36 hours; and (vi) more than one recurrence.