Evaluation the association of facet tropism in multi-sports athletes with cervical disc hernia.

BACKGROUND: Facet tropism (FT) can be defined as the angular difference between the orientation of the right and left facet joints in axial or sagittal planes. Most studies discuss about the relationship with lumbar disc hernia and facet joint angle. However, little is known about the association of facet tropism with disc herniation in the cervical spine in multisports athletes. In this study, We aimed to investigate the relationship between cervical facet tropism and disc hernia in athletes of different branches between the ages of 20-40 from the cervical MR images of the cases. METHODS: This is a retrospective study performed on athletes who applied our hospital between January 2014-2019 with neck pain and have MR imaging of the cervical spine. Cervical MR images of the patients were evaluated by an experienced radiologist from the hospital system database and archives. 79 cases (52 men and 27 women) were included in the study. RESULTS: No statistically significant difference was found between the facet joint angles of both groups at all levels (p˃0.05). Only left C6-7 disc angles of CDH group were measured as 92.99° ± 10.770 (620-1130) and 88.58° ± 7.65° (67°-110°) for the normal group and this difference was found statistically significant (p = 0.007). CONCLUSION: In this study, we did not predict that cervical facet tropism may be a factor associated with cervical disc hernia in young athletes with CDH.

Detailed features and prognostic factors of twenty-three patients with drop finger caused by cervical radiculopathy: a retrospective multicentre study.

PURPOSE: It has been reported that C7 and C8 nerve root impairment can cause drop finger; however, the clinical characteristics of each injured nerve root and post-operative outcomes remain unclear. This study aimed to investigate the detailed features and surgery-related prognostic factors of drop finger caused by cervical radiculopathy. METHODS: We retrospectively investigated the clinical characteristics, paralysis patterns and surgery-related prognostic factors of 23 patients with drop finger caused by cervical radiculopathy who underwent posterior cervical foraminotomy. We classified paralysis into three patterns based on the fingers predominantly exhibiting extensor digitorum communis (EDC) muscle weakness: index finger side-dominant, middle and ring fingers-dominant and little finger side-dominant. RESULTS: The aetiologies were cervical disc hernia (CDH) in ten patients, cervical spondylotic radiculopathy (CSR) in eight and both CDH and CSR in five. The levels of the decompressed root were C7 in one patient, C8 in 11 and both C7 and C8 in 11. Scapular pain was frequently observed as the initial symptom (78%), especially in patients with only C8 nerve root disorder (91%). Drop finger recovered to a score of ≥ 3 on manual muscle testing in 17 patients; patients with the little finger side-dominant pattern tended to have poor recoveries. Patients with CDH improved significantly than those with CSR or both CDH and CSR (p < 0.05). CONCLUSIONS: Good surgical recovery of drop finger can be expected in patients with CDH and in those with index fingers-dominant and middle and ring fingers-dominant patterns.

Simultaneous MR neurography and apparent T2 mapping of cervical nerve roots before microendoscopic surgery to treat patient with radiculopathy due to cervical disc herniation: Preliminary results.

There is no imaging modality to quantitatively evaluate compressed cervical nerve roots in cervical radiculopathy. Here we sought to evaluate the usefulness of simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation-enhancement imaging (SHINKEI-Quant) to evaluate compressed nerves quantitatively in patients with cervical radiculopathy due to cervical disc hernia before microendoscopic surgery. One patient with cervical radiculopathy due to cervical disc hernia before microendoscopic surgery and 5 healthy subjects underwent simultaneous apparent T2 mapping and neurography with SHINKEI-Quant. The patient was a 49-year-old man with severe right upper arm pain and numbness. Based on MRI images, we suspected right C7 radiculopathy due to C6-7 cervical disc hernia. The T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus bilaterally at C5-C8 were measured. We observed no significant differences in T2 relaxation times between the nerve roots on the left and right at each spinal level with values in healthy subjects. In our patient, neurography revealed swelling of the right C7 nerve, and a prolonged T2 relaxation time compared with that of the contralateral, unaffected C7 nerve. We performed microendoscopic surgery and the symptoms improved. We were able to evaluate the injured nerve root quantitatively in a patient with cervical radiculopathy using the SHINKEI-Quant technique, being the first study to our knowledge to show the usefulness of this technique to evaluate cervical radiculopathy quantitatively before microendoscopic surgery.

[Surgical treatment of cervical disc hernia our experience on 9 cases]. / Traitement chirurgical de la hernie discale cervicale: Evaluation de notre expérience à partir de 9 cas.

INTRODUCTION: The cervical disc hernia is uncommon. Its diagnosis is usually easy. But his surgery known controversy between discectomy with or without graft associated or not osteosynthesis. Accordingly we report our experiment of this surgery through a small serie of 9 patients operated by anterior approach. MATERIALS AND METHODS: This was a retrospective study of nine (9) patients supported by an anterior cervical disk herniation between 2001 and 2006 at the General Hospital of Grand Yoff in Dakar. The diagnosis was made on clinical and cervical myéloscanner. The postoperative decline was between 1 and 5 years. RESULTS: The average age of patients was 43 years ranging from 20-68 years. A male prevalence (2/1) was noted. The majority of hernias was degenerative. It was mostly soft disc hernia that prevailed on floors C4-C5 and C5-C6. We always operated on the right side of the patient. We performed a discectomy of a floor in 8 cases and 2 floors in 1 case. The vertebral posterior longitudinal ligament was opened routinely. Graft with osteosynthesis was used in 4 cases. The outcome was good. A spontaneous fusion was noted in 7 cases. CONCLUSION: The surgical treatment of cervical disc hernia is usually anterior approach. It is usually associated with good postoperative results.

INTRODUCTION: La hernie discale cervicale est une pathologie peu fréquente. Son diagnostic est en général facile. Cependant sa prise en charge connaît des controverses entre discectomie avec ou sans greffe associée ou non à une ostéosynthèse. Dans cette optique nous rapportons notre expérience de cette chirurgie à travers une petite série de 9 patients opérés par voie antérieure pré-sterno-cléido-mastoïdienne. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude rétrospective portant sur 9 patients pris en charge par voie antérieure pour hernie discale cervicale entre 2001 et 2006 à l'Hôpital Général de Grand Yoff de Dakar. Le diagnostic avait été fait sur la clinique et le Myelo-scanner cervical. Le recul post-opératoire était compris entre 1 et 5 ans. RÉSULTATS: L'âge moyen des patients était de 43 ans avec des extrêmes de 20 à 68 ans. On notait une prédominance masculine (sexe ratio de 2/1). La majorité des hernies était d'origine dégénérative. Il s'agissait essentiellement des hernies discales molles qui prédominaient aux étages C4-C5 et C5-C6. Tous les patients ont été opérés par la droite. Nous avons réalisé une discectomie d'un étage dans 8 cas et de 2 étages dans 1 cas. Le ligament longitudinal vertébral postérieur était ouvert systématiquement. Une greffe avec ostéosynthèse a été utilisée dans 4 cas. L'évolution a été bonne. Une arthrodèse spontanée a été notée dans 7 cas. CONCLUSION: Le traitement chirurgical de la hernie discale se fait généralement par voie antérieure. Il est généralement associé à de bons résultats post-opératoires.

Features of magnetic resonance imaging (MRI) on 115 cases with cervical disc herniation

The study involved 115 patients who was diagnosed with cervical disc herniation by MRI at the Military Hospital 108 and ViÖt - §øc Hospital from January 1997 to July 2001. Among these, 82 patients underwent cervical discectomy and 33 patients were treated by medication. 15 patients were studied retrospectively, and 100 patients were studied prospectively. Mean age of patients was 49.15 years (ranged from 27 to 78). 93 men, 22 women. The results showed that 1-segment disc herniation was most common (53.9%), followed by 2-segment herniation. 3-segment herniation was seen only in 10 cases. 100% of patients in operative group have post-operative diagnosis as same as MRI diagnosis. 87.5% of patients have excellent and good outcome at 1 week after operation. It was suggested that the diagnosis of cervical disc herniation and operative indication was appropriate.

Primary evaluation of nonoperative management for cervical disc herniation

Participants in this study were 28 patients who were diagnosed with cervical disc herniation by magnetic resonance imaging (MRI) at the Internal Medicine Department of the Military Hospital 108 between July 1997 and July 2001. Mean age of patients was 47.54 years, ranged from 34 to 66. Males: 19, females: 9. It was found that that out of these, 10 patients had 1-segment cervical disc herniation, 15 patients had 2-segment cervical disc herniation, and 3 patients had 3-segment cervical disc herniation. Total of herniated cervical discs was 49 per 28 patients. Good and moderate results of nonoperative management were achieved in 84% of root syndrome sub-group, in 33.3% of myelo-root syndrome sub-group and in 78.57% of total group. Internal management included cervical immobility, analgesics, non-steroid anti-inflammatory drugs, vitamin B, muscle dilation, sedation, cervical block and manipulation, and physiotherapy.

Magnetic resonance imaging of the cervical disc herniation

From November 1996 to December 1998 within 90 MRI diagnosed cases of cervical disc herniation found in Hanoi region. 90 male patients with 23-68 years old (on average 45). The result showed that MRI is the best sensible method to determine the cervical disc herniation. The study is performed separately in two levels of the disc herniation: bulging disc 44% and typical disc herniation 56%, pick levels of the disc herniation occur at levels C4/C5 and C5/C6. Cervical canal stenosis and spondylosis may be combined with the disc herniation.

The diagnosis of the cervical spinal disc herniation by the magnetic resonance image

From November 1996 up to December 1998 with 90 MRI diagnosed cases of cervical disc herniation found in Hµ Néi region. 73 males patients and 23-68 years old (on average 45). We found that MRI is the best sensible method to determine the cervical disc herniation. The study is performed separately in two levels of the disc herniation: Bulging disc 44% and typical disc herniation 56%. Peak levels of the disc herniation occur at levels C4/C5 and C5/C6. Cervical canal stenosis and spondylosis may be combined with the disc herniation.