RESUMO
SIFs are a common, though often unsuspected, cause of low back pain in the elderly. Although numerous radiographic modalities can be used to diagnose SIFs, bone scintigraphy and MR imaging are the most sensitive. Conservative management involves various combinations of bed rest, rehabilitation, and analgesics. More recently, sacroplasty has emerged as an alternative therapy for the treatment of SIFs, with prospective studies and case reports suggesting that it is a safe and effective therapy. This article reviews the imaging appearance of SIFs and discusses treatment options with a focus on sacroplasty.
Assuntos
Imageamento por Ressonância Magnética , Cintilografia , Sacro/lesões , Fraturas da Coluna Vertebral , Tomografia Computadorizada por Raios X , Humanos , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/cirurgia , Fraturas da Coluna Vertebral/terapiaRESUMO
Spinal cord infarction following lumbar transforaminal epidural steroid injection is a rare and devastating complication. We describe the case of a 55-year-old woman who developed spinal cord infarction following right L2-3 transforaminal epidural injection, diagnosed on the basis of clinical and MR imaging findings. Spinal angiography demonstrated occlusion of the right L2 segmental artery with reconstitution of the radicular branch from collaterals. The artery of Adamkeiwicz could not be demonstrated and was presumably occluded by the steroid injection.
Assuntos
Infarto/diagnóstico , Infarto/etiologia , Injeções Epidurais/efeitos adversos , Isquemia do Cordão Espinal/diagnóstico , Isquemia do Cordão Espinal/etiologia , Medula Espinal/irrigação sanguínea , Esteroides/efeitos adversos , Feminino , Humanos , Vértebras Lombares , Angiografia por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Tomografia Computadorizada por Raios X/métodosRESUMO
The N-methyl-D-aspartate (NMDA)-type glutamate receptor participates in the excitation of olfactory bulb mitral cells and is important in granule-cell-mediated feedback-inhibition. In the present study, extracellular unit recordings were made in vivo to demonstrate that the firing rates of mitral cells are not affected by peripheral administration of the non-competitive NMDA receptor antagonist MK-801. However, while over 50% of odor-driven mitral cell activity is normally correlated with the respiratory cycle, only about 10% of mitral cell activity is correlated with the respiratory cycle 30 min after MK-801 administration. Thus, the NMDA receptor is a participant in normal respiration-related mitral cell activity and may have an important role in the formation of bulb oscillations that encode olfactory information. Furthermore, the NMDA receptor is in a position to mediate activity-dependent changes in the bulb that rely on synchronous activity.