Satoru Kadoya

A microsurgical anterior osteophytectomy for cervical spondylotic myelopathy.

Cervical spondylotic myelopathy was treated by a microsurgical anterior approach removing osteophytes completely. Follow-up results of 43 patients showed that 39 patients (91%) exhibited overall improvements of either 1, 2, or 3 grades on Nuricks grading. Four (9%) remained unchanged. Even severely affected myelopathic patients exhibited neurologic recovery. Cases that also had narrow cervical canals were treated by the same anterior osteophytectomy, and they showed similar responses. Six out of ten patients who had osteophytectomies without fusion developed neck and arm pain postoperatively, although the presence or absence of an interbody fusion did not affect the postoperative recovery from myelopathy.

Magnetic resonance imaging of acute spinal cord injury

SummaryMagnetic resonance imaging of acute spinal cord injury is described. The traumatized cord segment was clearly shown as a hyperintensity in a T2-weighted image whereas it appeared as an isointensity in a moderately T1-weighted image. This different sensitivity may result from parenchymal hemorrhagic tissue and edematous changes due to direct trauma. Hyperintense tissue was also seen in the retro-pharyngeal and-tracheal spaces.

Magnetic resonance imaging of subarachnoid hemorrhage

SummaryMagnetic resonance (MR) imaging of subarachnoid hemorrhage (SAH) due to a ruptured aneurysm has been evaluated in relation to CT findings on 30 patients. In the acute stage, particularly less than 24 hours after the bleeding episode (25 patients), SAH appeared of high intensity relative to the surrounding brain on a T-2 weighted SE image but isointense where the corresponding CT scan showed blood clot of attenuation value over 60H. A T-2 weighted SE image was able to reveal subtle evidence of SAH not visible on the CT scan. The T-1 weighted IR image was not as sensitive. Blood clot (HU>60) appeared isointense, but mild and moderate SAH (HU<60) was indistinguishable from normal CSF. MR imaging was also sensitive to subacute and chronic SAH (5 patients). Three out of four SAH appearing normal on CT showed high intensity on T-2 weighted images. Thirteen out of 24 aneurysms (54%) larger than 5 mm in diameter on angiography were detected on T-2 weighted images. Smaller aneurysms less than 4 mm were not visualized. MR imaging was able to indicate the ruptured one in cases of multiple aneurysms by showing hemorrhagic lesions more clearly than CT. We conclude that MR imaging is very helpful for diagnosing SAH, particularly when CT is normal, and in indicating aneurysm location as well as rupture site.

Alleviation of axonal damage in acute spinal cord injury by a protease inhibitor: automated morphometric analysis of drug-effects

The degenerating axons and axon terminals developed in Rexeds lamina VIII in the anterior horn of the L6 segment after acute spinal cord compression at Th11 level in rats were visualized by the method of Fink-Heimer and the extent of axonal damage was quantitatively assayed with the aid of an automated image analyzer. Leupeptin, a potent protease inhibitor, substantially reduced the extent of the axonal damage (17% on average).

Neuroradiology of Ossification of the Posterior Longitudinal Spinal Ligament

Comparative neuroradiologic studies of the posterior longitudinal spinal ligament were performed in 15 cases showing myelopathy. On visualizing the ossified foci CT scan was found to be superior to the conventional roentgenograms, and detailed evaluation of the constricted spinal canal with related neurologic deficits became possible. CT analysis must be performed to differentiate spondylotic myelopathy, which is essential when considering operative intervention. *** DIRECT SUPPORT *** A2404071 00040