A mielopatia espondilótica cervical (MEC) é afecção relacionada diretamente com o estreitamento do canal vertebral cervical. O objetivo deste estudo foi avaliar variações morfométricas da coluna vertebral cervical em pacientes portadores de MEC por meio da ressonância magnética dinâmica nas posições neutra, em flexão e em extensão. Este é um estudo prospectivo de pacientes portadores de MEC secundária à doença degenerativa da coluna vertebral cervical. Os parâmetros morfométricos foram avaliados pelas sequências de ressonância magnética ponderadas em T2, no plano sagital em posições neutra, flexão e extensão. Os parâmetros estudados foram o comprimento anterior da medula espinhal (CAME), o comprimento posterior da medula espinhal (CPME), o diâmetro do canal vertebral (DCV) e o diâmetro da medula espinhal (DME). O CAME e o CPME foram mais longo em flexão do que nas posições em neutro e extensão, sendo encontrada diferença estatisticamente significativa entre a posição em flexão e extensão. O DCV e o DME foram maiores em flexão do que nas posições neutra e em extensão, no entanto não foi encontrada diferença estatisticamente significativa quando comparados nas posições em neutro, flexão e extensão. Desta forma, o exame de ressonância magnética dinâmica permite avaliar as variações morfométricas do canal vertebral cervical em pacientes portadores de mielopatia cervical espondilótica. / Cervical spondylotic myelopathy is a condition directly related to the narrowing of the cervical vertebral canal. The objective of this study was to evaluate morphometric variations of the cervical spine in patients with CSM using dynamic magnetic resonance imaging (MRI) in neutral, flexion and extension positions. This is a prospective study of patients with CSM secondary to degenerative disease of the cervical spine. The morphometric parameters were evaluated using T2-weighted MRI sequences in the sagittal plane with neutral, flexion and extension position of the neck. The parameters studied were the anterior length of the spinal cord (ALSC), the posterior length of the spinal cord (PLSC), the diameter of the vertebral canal (DVC) and the diameter of the spinal cord (DSC). The ALSC and PLSC were longer in flexion than extension and neutral position, with statistically significant difference between the flexion and extension position. The DVC and the DSC were greater in flexion than in extension and neutral position, however there was no statistically significant difference when comparing the positions in neutral, flexion and extension. Therefore, dynamic MRI allowed to evaluate morphometric variations in the cervical spinal canal in patients with cervical spondylotic myelopathy.

1. INTRODUCTION Injuries of the lower cervical spine can be among the most devastating injuries of the musculoskeletal system because of the increased risk of the injury to the spinal cord, and also because they so often occur to the younger members of the population (Jones A.A.M. et al., 2003; Sekhon H.S.L. et al., 2001; Ball P.A., 2001). The cervical spine is the most vulnerable spinal segment (Sekhon H.S.L. et al., 2001). The mechanism of cervical spine trauma is defined by the direction and magnitude of the forces that have been applied externally to the head and neck complex resulting in injury (Allen B.L.Jr., 1982). Common injury vectors include flexion, compression, rotation and extension (Allen B.L.Jr., 1982). The pattern of injury is related not only to the external applied force, but also to the initial position or posture of the head and neck at the time of injury (Allen B.L.Jr., 1982). One pattern of these injuries of the lower cervical spine is a facet dislocations (Allen B.L.Jr., 1982). The facet dislocation of the cervical spine result from a hyperflexion injury of the neck (Allen B.L.Jr., 1982). These injuries are characterized radiographically by anterolisthesis of one cervical vertebrae over the other and include the slide anteriorly of the inferior facet of the upper dislocated vertebra over the superior facet of the vertebra below (Allen B.L.Jr., 1982; Razack N. et al., 2000). The facet dislocations of the lower cervical spine represent from 4% to 50% of... [to full text]

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Faculty: Health Sciences, Durban University of Technology, 2009 / Aim To determine the profile of traumatic cervical spine fractures with respect to the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and post-surgical) complications and short-term post-surgical rehabilitation of patients presenting at the Spinal Unit of King George V Hospital over a 12-week period. Methods Patients who presented to the King George V Hospital Spinal Unit from surrounding hospitals with traumatic cervical spine fractures were evaluated by the medical staff. Data concerning the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and postsurgical) complications and short-term post-surgical rehabilitation data were recorded by the researcher. A p-value of <0.05 was considered as statistically significant. Appropriate statistical tests were applied to the hypothesis-testing objectives. These involved the Pearson’s Chi Square Tests for categorical variables or Fisher’s Exact Tests as appropriate where sample sizes were small. Paired t-tests were done to compare preand- post-surgical Frankel grading and Norton Pressure Sore Assessment scores. Results The number of patients who presented to the Spinal Unit over a 12-week period was 20, of this number 17 were males, three were females and all were black. Eleven patients were treated surgically while nine patients were treated conservatively. The most frequent aetiology of cervical spine fractures was motor vehicle accidents (n = 10) followed by falls (n = 9). The most common co-existing medical conditions were smoking (n = 7), HIV (n = 5), alcohol abuse (n = 3) and obesity (n = 3). The most frequent locations of cervical spine fractures were C2 (n = 6), C1 (n = 4) and the posterior column of C6 (n = 3), while dislocations occurred primarily at the C5-C6 levels (n = 5) of the lower cervical spine. Odontoid fractures (n = 6), Jefferson’s fractures (n = 4) and unilateral facet dislocations (n = 6) were the most common fractures and dislocations v observed. Head injuries (n = 4) and lower limb fractures (n = 3) were the most common extra-spinal fractures. All subjects who sustained head injuries also had associated C1 or C2 fractures. Neurological complications most frequently involved the upper limb where loss of motor function (n = 8) and weakness (n = 4) were observed. The majority of the patients (n = 8) reported a Frankel Grading of E. There were no significant associations between types of fracture and gender with the exception of fracture/dislocation observed in two females. There was a statistically significant difference in the NPSA score (p = 0.004). Conservative care utilized included soft collar (n = 6), cones calipers (n = 6), physiotherapy (n = 4), Minerva jacket (n = 4) and SOMI (sterno-occipital mandibular immobilization) brace (n = 1) while surgical intervention included anterior decompression (n = 8), anterior fusion (n = 8), allograft strut (n = 8), discectomy (n = 8), anterior cervical plating (n = 8), anterior screw fixation (n = 2), a transoral approach (n = 1) and a corpectomy (n = 1). The short-term post-conservative care complications observed in this study were an occipital pressure sore (n = 1), severe discomfort (n = 1) as well as severe neck pain (n = 1), while the short-term post-surgical complications were severe neck pain (n = 2), oral thrush (n = 1), pneumonia (n = 1), odynophagia (n = 1) and hoarseness (n = 1). Of the 11 patients who underwent cervical spine surgery, ten were sent for physiotherapy and one for occupational therapy. No significant associations were seen between the type of cervical spine fracture and the age of the subject. There was a significant association between fracture/dislocation and the female gender (p = 0.016). There was significant negative association between odontoid fracture and: anterior decompression, anterior fusion, allograft strut, discectomy and anterior cervical plating (p = 0.006). Conclusion The results of this study reflect the presentation and management of cervical spine fractures at a referral spinal unit of a public hospital in KwaZulu Natal. The impact of HIV and other co-existing medical conditions were not determined due to the small sample size in this study. Further epidemiological studies are required to be conducted in the Spinal Units of all South African public hospitals in order to confirm or refute the observation of this study.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [79]-87).

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 13, 2008). Includes bibliographical references.

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Rehabilitation Science, Faculty of Rehabilitation Medicine. Title from pdf file main screen (viewed on April 30, 2010). Includes bibliographical references.

Orientador: Wilter Ricardo Russiano Vicente / Resumo: RESUMO - O objetivo deste trabalho foi desenvolver um recurso videocirúrgico para inseminação artificial (IA) transcervical em ovinos. Foram utilizadas 30 ovelhas da raça Santa Inês com idades entre 2 a 5 anos todas pluríparas, divididas em três grupos experimentais: 1) IA por técnica convencional com tração cervical (GC); 2) IA por vídeo-vaginoscopia com insuflação (GVS) e; 3) IA videoassistida com fixação cervical (GVF). Durante o procedimento foi registrado o tipo do óstio cervical, número de anéis transpassados, local de deposição do sêmen no trato reprodutivo, tempo de manipulação cervical, taxa de passagem e fibrinogênio plasmáticos como marcador de reação inflamatória entre as técnicas. O diagnóstico gestacional foi realizado 21 dias após a inseminação artificial. Todos os dados foram submetidos a teste de normalidade seguido de um pós-teste, utilizando o programa estatístico R versão 3.2.5. Para o GVF a técnica não permitiu a entrada ao interior do útero com o aparelho, devido a ausência de expansão cervical associado à presença de muco no canal cervical, dificultaram a visualização. A insuflação da cavidade vaginal do GVS possibilitou a visualização da entrada do óstio cervical com facilidade, com a deposição do sêmen no interior do útero sem a fixação cervical em 10% dos animais (1/10). O número de anéis transpassados diferiu de acordo com o grupo experimental. Para o tempo de procedimento o GVF apresentou maior tempo de manipulação, quando comparado com os demais g... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Chez les mammifères, les spermatozoïdes, au cours du transit à travers le tractus génital femelle, rencontrent des environnements qui influencent leur mobilité et leur pouvoir fécondant. L’analyse par spectrométrie de masse de ces milieux (plasma séminal, mucus cervical, fluides de l’utérus et de l’oviducte) a permis une caractérisation approfondie de leur protéome et l’identification de protéines modifiant l’activité des gamètes comme la Zinc Alpha Glycoprotein. L’étude du protéome du tractus génital femelle au cours du cycle oestral a montré une régulation différentielle de la sécrétion des protéines selon l’organe et le stade du cycle. La comparaison du protéome et des propriétés mécaniques du mucus cervical a montré l’impact de la mucine 5AC sur la viscosité du mucus et la mobilité des spermatozoïdes dans ce mucus. Cette interaction entre le mucus cervical et les spermatozoïdes se traduit par la fixation à leur surface de nouvelles protéines, comme la myosine 9, ayant un impact potentiel sur leur pouvoir fécondant. / During their transit through the female genital tract, mammalian spermatozoa encounter several environments that influence their mobility and fertilizing ability. Analysis by mass spectrometry of these environments (seminal plasma, cervical mucus, fluids from the uterus and the oviduct) enabled characterization of their proteomes and the identification of proteins able to modify gamete function such as Zinc Alpha Glycoprotein. The study of the female genital tract proteome during the oestrous cycle showed differential regulation of the protein secretion according to the organ and the stage of the cycle. Comparison of the proteome and the mechanical properties of cervical mucus showed the impact of mucin 5AC on the viscosity of mucus and the motility of spermatozoa in its presence. 52 cervical mucus proteins, such as myosin 9, bind to the surface of spermatozoa which may impact sperm function and fertilizing ability.

Dissertação (mestrado) - Pontifícia Universidade Católica do Paraná, Curitiba, 2007 / Bibliografia: p. 73-83 / Acupuntura é uma técnica milenar que consiste na inserção de agulhas no corpo em locais especificamente definidos para fins terapêuticos. Com o avanço dos recursos tecnológicos associou-se a esta técnica estímulos elétricos originando a eletroacupuntura, / Acupuncture is a millenarian technique that consists of the insertion of needles inside the body in places specifically defined for therapeutically goals. With the progress of the technological resources, it was associated to nervous electrical stimulatio

Este trabalho tem como objetivo relatar as implicações da técnica cirúrgica de corpectomia vertebral cervical no diâmetro do canal medular de cadáveres caninos anteriormente congelados através da avaliação mielográfica. Para a padronização da técnica de mielografia cervical foram utilizados 30 cadáveres de cães. Os espécimes foram submetidos a quatro posicionamentos radiográficos para avaliação conjunta: laterolateral neutro, laterolateral em hiperextensão, laterolateral em hiperflexão e ventrodorsal. A opacificação do espaço subaracnóide, a confecção de duas linhas de contraste e a formação de artefatos foram mensurados qualitativamente e depois seu grau de concordância foi avaliado. Na segunda etapa 20 cadáveres foram divididos em dois grupos: o primeiro grupo foi submetido à corpectomia da terceira vértebra cervical, enquanto o segundo grupo à corpectomia da quinta vértebra cervical. Previamente ao procedimento cirúrgico, os cadáveres foram submetidos a um exame mielográfico. Posteriormente foram realizados exames radiográficos seriados após o procedimento de corpectomia cervical e de estabilização vertebral. As projeções radiográficas utilizadas foram as mesmas supracitadas. O diâmetro da medula espinhal foi medido ao longo do canal medular e correlacionado com o comprimento do assoalho vertebral. A corpectomia e a estabilização vertebral alteraram significativamente o diâmetro do canal medular apenas em posições de estresse, permitindo supor que a corpectomia vertebral cervical é um método viável de descompressão medular para a região cervical em cães, proporcionando um acesso adequado ao canal medular do corpo vertebral com mínima manipulação do tecido nervoso. / The aim of this paper is to report the implication of the cervical vertebral corpectomy in the myelography medullary diameter in canine cadavers. In order to standardize the myelograph technique thirty canine bodies were used. The subaracnoid space opacification, the visualization of contrast columns and artifact formation were evaluated in four radiographic projections: laterolateral in neutral position, laterolateral in hyperflexion, laterolateral in hyperextension and ventrodorsal in neutral position. The agreeing ratio was measured. Thereafter, twenty specimens were divided in two groups according to the cervical vertebra in which the procedure would be performed. In the first group the corpectomy was performed in the third cervical vertebrae and in the second group in the fifth vertebrae. Before the surgical procedure, a myelogram was performed. Radiograph exams were done after the corpectomy and after the instrumentation of the cervical spine. The same projections previously described were used. The medullary diameter was measured through the spinal canal. Afterwards, it was correlated to the length of the vertebral floor. The corpectomy and cervical instrumentation changed the medullar diameter solely in stress positions. In addition, it granted proper vertebral channel access with minimal spinal cord manipulation. Therefore, we concluded that the cervical vertebral corpectomy is a viable decompressive surgical technique.