2011, nr. 1 - Academia de Ştiinţe a Moldovei
2011, nr. 1 - Academia de Ştiinţe a Moldovei
2011, nr. 1 - Academia de Ştiinţe a Moldovei
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148<br />
Meto<strong>de</strong>le neuroimagistice <strong>de</strong> cercetare au contribuit<br />
la evaluarea valorii procesului <strong>de</strong>generativ-distrofi<br />
c vertebral în patogeneza tulburărilor ischemice<br />
medulare.<br />
Concluzii. Factorul spondilotic <strong>de</strong> nivel toracic<br />
s-a dovedit a fi responsabil <strong>de</strong> compresia atât vasculară<br />
primară a vaselor magistrale, cu <strong>de</strong>clanșarea<br />
simptomatologiei clinice simetrice, cât și a măduvei<br />
spinării propriu-zise, cu implicarea secundară<br />
a vaselor piale și evoluarea unui tablou clinic asimetric.<br />
Bibliografi e<br />
1. Belanger T. A., Emery S. E. Th oracic Disc Disease<br />
and Myelopathy. Th e Adult and Pediatric Spine. Eds. J. W.<br />
Frymoyer and S. W. Wiesel. 3rd ed. 2 vols. Phila<strong>de</strong>lphia:<br />
Lippincott, Williams & Wilkins, 2004:855-864.<br />
2. Castro-Moure F., Kupsky W., Coshgarian H.G.,<br />
Pathophysiological classifi cation of human spinal cord ischemia.<br />
J. Spinal. Cord. Med., 1997; 20:74-87.<br />
3. Iizuka H., Iida T., Okamoto K., Takada H., Akai T.<br />
Histopathological Study of Autopsy Cases with Compressive<br />
Myelopathy due to Epidural Malignancy, Cervical Ossifi cation<br />
of the Posterior Longitudinal Ligament, and Cervical<br />
Spondylosis. Journal of Kanazawa Medical University, 2002;<br />
vol. 27, 2:117-121.<br />
4. Lazorthes G. Pathology, classifi cation and clinical<br />
aspects of vascular disease of the spinal cord. Handbook of<br />
clinical neurology, vascular disease of the nervous system.<br />
Part II. Ed. Vinken P.J., BruynG.W., Amsterdam: North-<br />
Holland, 1972:492-506.<br />
5. Lazorthes G. Blood supply and vascular pathology<br />
of the spinal cord. Spinal angiomas. Ed. Pia H.W., Djindjian<br />
R., Berlin, Springer-Verlag, 1978; p.10.<br />
6. Liera E.C. Vascular disor<strong>de</strong>rs of the spinal cord.<br />
Gilman S., Goldstein G.W., Waxman S.G. Editors. Neurobase.<br />
San Diego: Arbor Publshing, 1st 1999 ed.<br />
7. Marsh W.R. Vascular lesions of the spinal cord:<br />
history and classifi cation. Neurosurg. Clin. N. Am., 1998,<br />
10:1-8.<br />
8. Nitin Dange, Amit Mahore, Atul Goel.<br />
Th oracic<br />
compressive myelopathy due to post-traumatic intradural<br />
migartion of ossifi ed yellow ligament: Case report. Indian Journal<br />
of Neurotrauma, 2009; vol. 6, 1:48-53.<br />
9. Natarajan Muthukumar. Dural ossifi cation in ossifi<br />
cation of ligamentum fl avum. Spine, 2009; vol. 34, 24:<br />
2654-2661.<br />
10. Nakanishi Kazuyoshi, Tanaka Nobuhiro, Sasaki<br />
Hirofumi, Kamei Naosuke, Hamasaki Takahiko, Yamada<br />
Kiyotaka, Yamamoto Risako, Nakamae Toshio, Ochi Mitsuo.<br />
Assessment of Central Motor Conduction Time in the<br />
Buletinul AŞM<br />
Diagnosis of Compressive Th oracic Myelopathy. Spine, 2010;<br />
vol. 35, 26: E1593-E1598.<br />
11. Герман Д.Г. Ишемические нарушения спинального<br />
кровообращения. Кишинев, 1972; 268 с.<br />
12. Герман Д.Г., Скоромец А.А. Нарушения спинномозгового<br />
кровообращения. Кишинев, 1981; 318 с.<br />
Rezumat<br />
Prezentul studiu pe un lot <strong>de</strong> 51 <strong>de</strong> pacienţi a contribuit<br />
la evaluarea valorii procesului <strong>de</strong>generative-distrofic<br />
vertebral în patogeneza tulburărilor ischemice<br />
medulare <strong>de</strong> nivel toracic. Meto<strong>de</strong>le neuroimagistice au<br />
pus în evi<strong>de</strong>nţă hernii discale, osificarea ligamentului<br />
flav și longitudinal posterior, în asociere cu stenozarea<br />
congenitală a canalului medular <strong>de</strong> nivel toracic, fracturi<br />
tasate, osteofite posterioare, stenozarea laterală a<br />
canalului medular, cauzată <strong>de</strong> hipertrofia articulaţiilor<br />
intervertebrale, pe fundalul cărora s-au <strong>de</strong>zvoltat atât<br />
forme clinice cu evolutie simetrică prin compresia vaselor<br />
spinale magistrale, cât și asimetrică prin compresia<br />
medulară.<br />
Summary<br />
Th e study of 51 patients contributed to the assessment<br />
of the role of <strong>de</strong>generative-dystrophic modifi cations of the<br />
spinal column in the pathogenesis of thoracic ischemic<br />
medullar disturbances. Neuroimaging investigations highlighted<br />
the disc herniations, ossifi cation of fl avum and<br />
posterior longitudinal ligaments in association with congenital<br />
spinal canal stenosis of the thoracic level, vertebral<br />
compression fractures, posterior osteophytes, lateral spinal<br />
canal stenosis caused by hypertrophy of the facet joints, on<br />
which background both symmetrical and asymmetric clinical<br />
forms <strong>de</strong>veloped due to compression of spine or spinal<br />
vessels.<br />
Резюме<br />
Данное исследование группы из 51 пациентов<br />
позволило оценить роль дегенеративнодистрофического<br />
процесса позвоночника в патогенезе<br />
ишемических нарушений спинного мозга на грудном<br />
уровне. Нейровизуализационные методы выявили<br />
грыжи дисков, оссификацию задней продольной и<br />
жёлтой связок в комбинации с врождённым стенозом<br />
позвоночного канала на грудном уровне, компрессионные<br />
переломы, задние остеофиты, латеральный<br />
стеноз позвоночного канала вызванный гипертрофией<br />
дугоотростчатых суставов, на фоне которых были<br />
отмечаны клинические формы с симметричным и<br />
асимметричным течением, вызванным компрессией<br />
магистральных сосудов или непосредственным сдавлением<br />
спинного мозга.