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cervical instability

Paula Martínez Pascual, Pedro Amaro Merino
INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) pathophysiology is based on otoconia migration from the utricle and saccule to the semicircular canals, however, the role of the saccule is still under study. Our aim is to study the otolith damage in these patients with vestibular evoked myogenic potentials (VEMPS) and correlate the results with those of computerised dynamic posturography (CDP). MATERIAL AND METHODS: We present 79 patients diagnosed with BPPV between March and June 2017...
June 9, 2018: Acta Otorrinolaringológica Española
Joseph R Keen, Robert E Ayer, Asma Taha, Alexander Zouros
STUDY DESIGN: Retrospective review. OBJECTIVE: Evaluate radiographic and clinical outcomes for the largest and youngest series of children, who underwent rigid occipito-cervical fixation for traumatic craniocervical dissociation (tCCD). SUMMARY OF BACKGROUND DATA: Traumatic craniocervical dissociation is devastating. Children are at high risk but make up a large number of survivors. Non-rigid fixation has traditionally been favored over screw and rod constructs due inherent challenges involved with instrumenting the pediatric craniocervical junction...
June 11, 2018: Spine
Charles Raybaud, George I Jallo
The metamerically associated normal hindbrain and normal posterior fossa are programmed to grow together in such a way that the tonsils are located above the foramen magnum and surrounded by the cerebrospinal fluid (CSF) of the cisterna magna. This allows the pulsating CSF to move freely up and down across the craniovertebral junction (CVJ). A developmental mismatch between the rates of growth of the neural tissue and of the bony posterior fossa may result in the cerebellar tonsils being dislocated across the foramen magnum...
2018: Handbook of Clinical Neurology
S Pacreu, S Martínez, E Vilà, L Moltó, J Fernández-Candil
Klippel-Feil Syndrome is a disease characterised by congenital fusion of cervical vertebra, which leads to cervical limitation and instability. In these cases, the best option is the orotracheal intubation with the fibre-optic bronchoscope with the patient awake. The advantage is that cervical movements that could lead to neurological damage are minimised. In these patients, adequate sedation, together with instillation of local anaesthetic in the pharynx and hypopharynx, is the key to reducing patient discomfort and achieving successful orotracheal intubation...
June 7, 2018: Revista Española de Anestesiología y Reanimación
Derek Yecies, Nathaniel Fogel, Michael Edwards, Gerald Grant, Kristen W Yeom, Samuel Cheshier
OBJECT: The need for neurosurgical supervision as well as the general safety and utility of dynamic MRI of the cervical spine in children remains controversial. We present the largest descriptive cohort study of cervical flexion-extension MRIs in a pediatric population to help elucidate the safety and utility of this technique. METHODS: All cervical spine MRIs performed at Lucile Packard Children's Hospital at Stanford from 2009-2015 were retrospectively reviewed...
June 5, 2018: World Neurosurgery
Kelly J Bridges, Lauren N Simpson, Carli L Bullis, Andy Rekito, Christina M Sayama, Khoi D Than
STUDY DESIGN: A literature review. PURPOSE: To explore the utility of laminoplasty in combination with instrumented fusion, with a focus on neurological outcomes and changes in kyphotic deformity. OVERVIEW OF LITERATURE: Management of cervical spondylotic myelopathy (CSM) to reduce morbidity within the neurosurgical population. METHODS: A US National Library of Medicine PubMed search was conducted for manuscripts pertaining to cervical laminoplasty and fusion for the management of CSM...
June 2018: Asian Spine Journal
Joseph P Scollan, Abduljabbar Alhammoud, Mikhail Tretiakov, Douglas A Hollern, Lee R Bloom, Neil V Shah, Qais Naziri, Bassel G Diebo, Hiroyuki Yoshihara, Claude B Scott, Khalid Hesham, Carl B Paulino
STUDY DESIGN: This is a meta-analysis. OBJECTIVE: To establish rates of (1) neurological complications, (2) bony-related complications, (3) complications delaying recovery, (4) reoperation, and (5) fatalities following posterior cervical arthrodesis in Down syndrome (DS) patients with atlantoaxial subluxation. To determine if presenting symptoms had any relationship to postoperative complications. SUMMARY OF BACKGROUND DATA: Posterior arthrodesis is commonly utilized to correct cervical instability secondary to atlantoaxial instability in DS patients...
May 25, 2018: Clinical Spine Surgery
Abhinav Mohan, Eric Chang
Introduction: We present a case describing the management of a woman with severe, functionally limiting cervical myeloradiculopathy in the setting of congenital cervical canal stenosis and Arnold-Chiari I malformation. Case presentation: The subject is a 57-year-old woman with prior anterior cervical discectomy and fusion who presented with left-sided neck pain associated with radiculopathy, migraine, gait incoordination, and cervical dystonia. Cervical stenosis and Chiari malformation were confirmed using MRI...
2018: Spinal Cord Series and Cases
Kemel A Ghotme, Fernando Alvarado-Gomez, Christina Lampe, Klane K White, Martha Solano-Villareal, Roberto Giugliani, Paul R Harmatz
PURPOSE: This study aims to raise awareness of the need for research and appropriate guidelines for managing spinal cord issues in adult patients with mucopolysaccharidosis (MPS) and transition of these patients from pediatric to adult care. METHODS: Pediatric/adult neurosurgeons, orthopedic spine surgeons, and treating physicians with expertise in metabolic disorders and spinal cord issues were invited to complete a survey to assess their experience with spinal cord problems in MPS and their opinion on transitioning routes from pediatric to adult care...
May 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Yang Meng, Xiaofei Wang, Zhengyang Zhao, Beiyu Wang, Tingkui Wu, Hao Liu
BACKGROUND: Two-level artificial cervical disc replacement (ACDR) is gaining attention because of its unique advantages. Among the artificial discs designed for use in ACDR, the Prestige-LP cervical disc is widely used and FDA approved. However, there are no standard implantation sequences for two-level ACDR using the Prestige-LP disc, and complications due to inappropriate implantation sequences remain unknown. CASE DESCRIPTION: A 45-year-old female underwent continuous, two-level ACDR using the Prestige-LP disc and experienced anterior migration of a previously inserted artificial disc after secondary disc implantation at an upper segment due to an inappropriate implantation sequence during surgery...
May 23, 2018: World Neurosurgery
Sebastian Ruetten, Patrick Hahn, Semih Oezdemir, Xenophon Baraliakos, Georgios Godolias, Martin Komp
PURPOSE: Symptomatic intraspinal extradural cysts of the cervical subaxial spine are rare, but usually require surgery. Conventional posterior decompression is the gold standard. However, there is increasing experience with endoscopic surgical techniques. The purpose of the study is to evaluate the technical implementation and outcomes of a full-endoscopic uniportal technique via the posterior approach in patients with symptomatic intraspinal extradural cysts of the cervical subaxial spine...
May 2018: Journal of Orthopaedic Surgery
G Gashi, V Mahovlić, E Bahtiri, F Kurshumliu, A Podrimaj-Bytyqi, I R Elezaj
Human papilloma virus (HPV) infection is the main etiological factor for cervical intraepithelial lesions (CIN). An important characteristic of this process is the loss of genome stability. Therefore, it is imperative to use biomarkers of DNA damage caused by genomic instability to identify high risk individuals. We investigated the frequency of micronuclei (MN) in peripheral blood lymphocytes (PBL) of 20 patients, diagnosed as histologically CIN 1 and 10 healthy controls. We also examined the frequency of other nuclear anomalies including nucleoplasmic bridges (NPBs) and nuclear buds (NBUDs) in PBL of patients with CIN 1 and healthy controls, and evaluated the benefits of p16INK4a and Ki-67 (p16INK4a /Ki-67) immunohistochemical double staining for identifying cervical squamous cells that express HPV E6/E7 oncogenes...
May 23, 2018: Biotechnic & Histochemistry: Official Publication of the Biological Stain Commission
Lijun Qiao, Jingyi Zheng, Yonghao Tian, Qishu Zhang, Xiao Wang, Jason J Chen, Weifang Zhang
Regulator of chromatin condensation 1 (RCC1) is a major guanine-nucleotide exchange factor for Ran GTPase and plays key roles in nucleo-cytoplasmic transport, mitosis, and nuclear envelope assembly. RCC1 is known to be a critical cell cycle regulator whose loss causes G1 phase arrest, but the molecular basis for this regulation is poorly understood. Furthermore, little is known about the relationship between RCC1 and carcinomas. Human papillomavirus (HPV) infection is highly associated with the development of cervical cancer...
May 22, 2018: Cell Death & Disease
Jinwei Ying, Honglin Teng, Yunfan Qian, Yingying Hu, Tianyong Wen, Dike Ruan, Minyu Zhu
Background Ossification of the nuchal ligament (ONL) caused by chronic injury to the nuchal ligament (NL) is very common in instability-related cervical disorders. Purpose To determine possible correlations between ONL, sagittal alignment, and segmental stability of the cervical spine. Material and Methods Seventy-three patients with cervical spondylotic myelopathy (CSM) and ONL (ONL group) and 118 patients with CSM only (control group) were recruited. Radiographic data included the characteristics of ONL, sagittal alignment and segmental stability, and ossification of the posterior longitudinal ligament (OPLL)...
January 1, 2018: Acta Radiologica
Marlene Kranawetter, Sebastian Röhrich, Leonhard Müllauer, Helena Obermair, Alexander Reinthaller, Christoph Grimm, Alina Sturdza, Wolfgang J Köstler, Stephan Polterauer
OBJECTIVES: Recent data support the use of pembrolizumab in cervical cancer. The aim of this study was to investigate pembrolizumab in heavily pretreated patients with recurrent cervical cancer. METHODS: Data from consecutive patients treated with pembrolizumab at a single academic institution were assessed. Programmed cell death ligand 1 (PD-L1) status and microsatellite instability were assessed from tumor samples. Irrespective of PD-L1 expression status, pembrolizumab was administered at fixed dose of 200 mg intravenously every 3 weeks...
May 22, 2018: International Journal of Gynecological Cancer
Andreea Elena Lungu, Madalina Anca Lazar, Andrada Tonea, Horatiu Rotaru, Rares Calin Roman, Mindra Eugenia Badea
Introduction: The bisphosphonate-related osteonecrosis of the jaw was first referred to in 2003. Bisphosphonates action is focused on the osteoclasts. The drastic inhibition of the osteoclastic function is harmful for the jaws which are the only bones of the human skeleton in relative contact with the external environment. The adverse effects of the bisphosphonate-related therapy include the pathology for which they are prescribed, the atypical fractures in pathological bone. Method: The aim of this research was to analyze the risk factors and the treatment methods in case of osteonecrosis of the jaws...
2018: Clujul Medical (1957)
Xingwen Wang, Dean Chou, Fengzeng Jian
BACKGROUND: Postoperative dysphagia is a known complication of anterior cervical surgery, but its incidence and possible mechanisms are seldom reported after occipitocervical fusion (OCF). Our objective was to study the relationship between craniocervical alignment and the development of dysphagia after OCF for the treatment of basilar invagination with atlantoaxial instability. METHODS: The study was consisted of a retrospective series and a prospective series...
May 16, 2018: World Neurosurgery
Jialu Hu, Yiqun Gao, Yan Zheng, Xuequn Shang
BACKGROUND: The human body is colonized by a vast number of microbes. Microbiota can benefit many normal life processes, but can also cause many diseases by interfering the regular metabolism and immune system. Recent studies have demonstrated that the microbial community is closely associated with various types of cell carcinoma. The search for key factors, which also refer to cancer causing agents, can provide an important clue in understanding the regulatory mechanism of microbiota in uterine cervix cancer...
April 24, 2018: BMC Systems Biology
Chaojun Zheng, Yu Zhu, Cong Nie, Feizhou Lu, Dongqing Zhu, Robert Weber, Jianyuan Jiang
OBJECTIVE: To investigate the changes in motor axonal excitability properties in cervical spondylotic amyotrophy (CSA). METHODS: Threshold tracking was used to measure the median motor axons in 21 patients with CSA, 10 patients with cervical spondylotic radiculopathy (CSR) and 16 normal controls. RESULTS: Compared with normal controls, patients with distal-type CSA showed increased threshold electrotonus hyperpolarization (TEh [90-100]) and increased superexcitability on the symptomatic side (P < 0...
April 20, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Deuk Young Yoon, Sung Gyu Moon, Hong-Geun Jung, Na Ra Kim
OBJECTIVE: The purpose of this study was to assess the differences between subtalar instability (STI) and lateral ankle instability (LAI) focusing on subtalar ligaments using 3-dimensional (3D) isotropic magnetic resonance imaging (MRI). METHODS: Preoperative MRIs of 10 patients with STI who failed nonoperative treatment and consequently underwent arthroscopic subtalar reconstruction were compared with preoperative MRIs of 23 patients with LAI who underwent ligament repair or reconstruction...
April 28, 2018: Journal of Computer Assisted Tomography
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