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cervical instability

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https://www.readbyqxmd.com/read/29680991/incidence-and-risk-factors-for-adjacent-segment-degeneration-following-occipitoaxial-fusion-for-atlantoaxial-instability-in-non-rheumatoid-arthritis
#1
Xinjie Wu, Yingna Qi, Mingsheng Tan, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
PURPOSE: To investigate the incidence and risk factors for adjacent segment degeneration (ASD) following occipitoaxial fusion (OAF) for atlantoaxial instability (AAI) in non-rheumatoid arthritis (RA). METHODS: The study group comprised 41 patients without RA who underwent OAF due to AAI. Fifteen patients with postoperative ASD after OAF were classified as the ASD group, and the other 26 patients without postoperative ASD were included in the non-ASD group. There were 12 men and 3 women with a mean age of 43...
April 21, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29676682/growth-and-alignment-of-the-pediatric-subaxial-cervical-spine-following-rigid-instrumentation-and-fusion-a-multicenter-study-of-the-pediatric-craniocervical-society
#2
Hannah E Goldstein, Justin A Neira, Matei Banu, Philipp R Aldana, Bruno P Braga, Douglas L Brockmeyer, Michael L DiLuna, Daniel H Fulkerson, Todd C Hankinson, Andrew H Jea, Sean M Lew, David D Limbrick, Jonathan Martin, Joshua M Pahys, Luis F Rodriguez, Curtis J Rozzelle, Gerald F Tuite, Nicholas M Wetjen, Richard C E Anderson
OBJECTIVE The long-term effects of surgical fusion on the growing subaxial cervical spine are largely unknown. Recent cross-sectional studies have demonstrated that there is continued growth of the cervical spine through the teenage years. The purpose of this multicenter study was to determine the effects of rigid instrumentation and fusion on the growing subaxial cervical spine by investigating vertical growth, cervical alignment, cervical curvature, and adjacent-segment instability over time. METHODS A total of 15 centers participated in this multi-institutional retrospective study...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29671017/-degenerative-cervical-spine-diseases-fusion-vs-total-disc-replacement-what-can-be-done-when
#3
REVIEW
T Pitzen, J Drumm, C Berthold, G Ostrowski, U Heiler, M Ruf
Motion preserving surgery within the cervical spine may be performed by special implants, for example, c spine disc prosthesis or total disc replacement (cTDR), or by simple decompression of the cervical nerve roots. However, also fusion surgery may be performed with good results. Here, we summarize indications as well as contraindications for motion preserving techniques and indications for fusion surgery. cTDR is indicated in special cases of soft disc herniation, especially in younger individuals without signs of myelopathy...
April 18, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29664878/c2-translaminar-screw-fixation-in-children
#4
Brian W Yang, Michael P Glotzbecker, Michael Troy, Mark R Proctor, Michael T Hresko, Daniel J Hedequist
BACKGROUND: Axis (C2) screw fixation has been shown to be effective in treating disorders that necessitate cervical stabilization. Although translaminar C2 screws have demonstrated clinical efficacy in adults, this technique has not yet been thoroughly investigated in children. This study describes the indications, technique, and results of translaminar C2 screw fixation in a case series of pediatric cervical spine disorders. METHODS: We searched the orthopaedic database at our institution for patients who had undergone a cervical spinal fusion that encompassed C2 between 2007 and 2017...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29663734/new-biological-research-and-understanding-of-papanicolaou-s-test
#5
REVIEW
Elizabeth R Smith, Sophia H George, Erin Kobetz, Xiang-Xi Xu
The development of the Papanicolaou smear test by Dr. George Nicholas Papanicolaou (1883-1962) is one of the most significant achievements in screening for disease and cancer prevention in history. The Papanicolaou smear has been used for screening of cervical cancer since the 1950s. The test is technically straightforward and practical and based on a simple scientific observation: malignant cells have an aberrant nuclear morphology that can be distinguished from benign cells. Here, we review the scientific understanding that has been achieved and continues to be made on the causes and consequences of abnormal nuclear morphology, the basis of Dr...
April 16, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29662730/myelopathy-improvement-following-removal-of-cervical-sublaminar-wiring
#6
Hurtis J Tullos, Robert G Briggs, Andrew K Conner, Allison E Williams, John B Maxwell, Michael D Martin
Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord...
February 14, 2018: Curēus
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#7
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29651521/-spondylotic-cervical-myelopathy-indication-of-surgical-treatment
#8
REVIEW
W Pepke, H Almansour, M Richter, M Akbar
BACKGROUND: The pathogenesis of cervical spondylotic myelopathy (CSM) is often multifactorial. Hence, the treatment of this disease requires a differentiated surgical approach in order to adequately address the underlying pathology. PURPOSE: The aim of this review is to identify factors that influence the choice of treatment strategy and to summarize them in an algorithm that serves as a decision aid in choosing the optimal indication for surgical treatment. An attempt is made to define the threshold values for the indication of surgical treatment and to discuss the ideal timing for performing surgery...
April 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29649608/standalone-cranio-cervical-decompression-is-feasible-in-children-with-mucopolysaccharidosis-type-i-iva-and-vi
#9
Harald Krenzlin, Ta-Chih Tan, Christina Lampe, Christian Lampe, Markus Knuf, Peter Horn, Manfred Schwarz
BACKGROUND CONTEXT: In patients with Mucopolysaccharidosis (MPS), glycosaminoglycans deposits in the dura mater and supporting ligaments cause spinal cord compression and consecutive myelopathy, predominantly of the cranio-cervical junction. Disease characteristics of cranio-cervical stenosis (CCS) in MPS patients differ profoundly from other hereditary and degenerative forms. Due to high peri-procedural morbidity and mortality, MPS patients pose a substantial challenge to the unexperienced medical care provider...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29643725/modified-laminoplasty-for-degenerative-cervical-spondylosis-the-technique-of-floating-laminoplasty
#10
Samuel C Ohaegbulam, Wilfred C Mezue, Chika Anele Ndubuisi, Mark O Chikani, Ndubuisi D Achebe, Uwadiegwu A Erechukwu
Background: Laminoplasty is an established alternative to laminectomy for posterior cervical decompression in spondylotic myelopathy. However, standard laminoplasty requires internal fixation, which is often not obtainable in developing countries. We present our experience with a technique of noninstrumented (floating) laminoplasty developed to avoid the need to anchor the laminoplasty to the anterior elements. Methods: We have used floating laminoplasty (FL) for posterior cervical decompression in patients with cervical spondylosis since 2004 and report the technique and our experience with it between 2009 and 2014 when C-arm and magnetic resonance imaging became available in our unit...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29626690/traumatic-postero-lateral-c1-c2-dislocation-complicated-with-locked-lateral-mass-and-type-ii-odontoid-fracture-a-5-year-follow-up-a-case-report
#11
Zhu Minyu, Wu Shiyang, Chandoo Suraj, Huang Kelun, Lin Chaowei, Teng Honglin
STUDY DESIGN: case report: Objective: To document our experience in managing a rare complex of traumatic postero-lateral atlantoaxial dislocation combined with locked lateral mass and type II odontoid fracture. SUMMARY OF BACKGROUND DATA: METHOD: A 30 years-old male patient was referred to the author's department. He complained of a decrease in neck range of motion following a traffic accident. Neurological examination was normal. Computed tomography (CT) and open mouth X-ray showed a type II odontoid fracture and a postero-lateral dislocation with laterally locked left lateral mass at the C1-C2 level...
April 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29624623/motion-and-dural-sac-compression-in-the-upper-cervical-spine-during-the-application-of-a-cervical-collar-in-case-of-unstable-craniocervical-junction-a-study-in-two-new-cadaveric-trauma-models
#12
Shiyao Liao, Niko R E Schneider, Petra Hüttlin, Paul A Grützner, Frank Weilbacher, Stefan Matschke, Erik Popp, Michael Kreinest
BACKGROUND: Unstable conditions of the craniocervical junction such as atlanto-occipital dislocation (AOD) or atlanto-axial instability (AAI) are severe injuries with a high risk of tetraplegia or death. Immobilization by a cervical collar to protect the patient from secondary damage is a standard procedure in trauma patients. If the application of a cervical collar to a patient with an unstable craniocervical condition may cause segmental motion and secondary injury to the spinal cord is unknown...
2018: PloS One
https://www.readbyqxmd.com/read/29608449/conservative-treatment-of-hangman-variant-fractures
#13
Thomas E Niemeier, Sakthevil R Manoharan, Amrita Mukherjee, Steven M Theiss
STUDY DESIGN: This is retrospective cohort study. OBJECTIVE: Investigate the stability of patients with hangman variant fractures and outcomes of treatment with external immobilization. SUMMARY OF BACKGROUND DATA: Traumatic spondylolisthesis of the axis (C2) with the fracture extending into the vertebral body has been incompletely characterized. Small case series have showed high rates of neurological injury and cite difficulty treating closed due to greater instability secondary to extensive ligamentous injury...
March 31, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29603011/post-operative-regression-of-retro-odontoid-pseudotumors-treated-with-and-without-fusion
#14
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro
PURPOSE: Retro-odontoid pseudotumor is common in elderly people and is a cause of cervical myelopathy. The goal of the study was to investigate surgical procedures, outcomes, and post-operative spontaneous regression of posterior cervical retro-odontoid pseudotumors. METHODS: The subjects were 29 patients who underwent surgery for myelopathy due to a retro-odontoid pseudotumor around the craniocervical region at 9 facilities and were followed-up for an average of 54 months (range 12-96 months)...
March 30, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29595654/traumatic-c1-2-rotatory-subluxation-with-dens-and-bilateral-articular-facet-fractures-of-c2-a-case-report
#15
Dong-Gune Chang, Jong-Beom Park, Hyuk-Jin Jang
RATIONALE: To the best of our knowledge, this is an extremely rare case of traumatic C1-2 rotatory subluxation associated with multiple C2 fractures. PATIENT CONCERNS: We report the case of a 63-year-old man with type 2 traumatic C1-2 rotatory subluxation (Fielding and Hawkins classification) associated with type III dens (Anderson and D'Alonzo classification) and bilateral articular facet fractures of C2. This injury occurred as a result of falling down in a drunken state...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29594321/-rheumatoid-instability-in-the-cervical-spine-diagnostic-and-therapeutic-strategies
#16
REVIEW
R Kothe
BACKGROUND: The involvement of the cervical spine in rheumatoid arthritis (RA) continues to be of clinical importance even in this age of biologics. Pathophysiological changes begin with an isolated atlantoaxial subluxation and may progress to a complex craniocervical and subaxial instability. The onset of cervical myelopathy can occur at any time and leads to a deterioration of the prognosis for the patient. THERAPY: Treatment of the rheumatoid cervical spine should be aimed at improvement of the symptoms and prevention of further progress of the disease...
March 29, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29589114/can-neck-pain-be-an-initial-symptom-of-rheumatoid-arthritis-a-case-report-and-literature-review
#17
REVIEW
Erdal Bodakçi, Döndü Üsküdar Cansu, Adem Ertürk, Cüneyt Çalişir, Cengiz Korkmaz
Although rheumatoid arthritis (RA) is most commonly associated with peripheral joints, cervical spine involvement can be seen in almost 80% of patients in the presence of long-term disease, joint erosion, and risk factors such as male sex and rheumatoid factor positivity. It is very rare to have cervical involvement in the initial period of RA. If a patient has isolated cervical spine involvement without peripheral arthritis, it is highly likely that inappropriate investigations and delayed treatment may occur...
March 27, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29572736/anterior-management-of-c2-fractures-using-miniplate-fixation-outcome-function-and-quality-of-life-in-a-case-series-of-15-patients
#18
Axel Franke, Dan Bieler, Rebecca Wern, Tim Trotzke, Sebastian Hentsch, Erwin Kollig
PURPOSE: The classification systems by Anderson and D'Alonzo, Effendi, Benzel and others have limitations when it comes to morphologically categorising fractures of the second cervical vertebral body (C2) that present with or without an additional fracture of the dens or with or without an extension of the fracture line into the vertebral arch and displacement. Currently, there are no definitive recommendations for the treatment of fractures at the junction of the dens with the vertebral body of C2 on the basis of outcome and stability data...
March 23, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29572170/favorable-long-term-outcomes-for-positional-vertebral-artery-occlusion-with-treatment-strategy-prioritizing-spinal-fusion-surgery
#19
Yasuhiro Takeshima, Fumihiko Nishimura, Ichiro Nakagawa, Yasushi Motoyama, Young-Su Park, Hiroyuki Nakase
OBJECT: Positional vertebral artery occlusion (PVAO) has a fundamental problem in the definition. We analyzed the long-term outcomes with a re-definition of the rare clinical entities as PVAO for a broader conceptualization, and discuss the efficacy of fusion surgery as a treatment option. METHODS: We analyzed the clinical and radiological characteristics and outcomes in 8 patients with PVAO who experienced cerebral ischemia during a 10-year period at our institution...
March 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29560277/awareness-of-traumatic-occult-lateral-mass-fracture-of-the-cervical-spine-triggered-by-the-presence-of-unilateral-vertebral-artery-occlusion-a-case-report
#20
Tsunehiko Konomi, Kota Suda, Satoko Matsumoto, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
Introduction: We present an unusual case of traumatic occult lateral mass fracture of the cervical spine with unilateral occlusion of the vertebral artery (VA), that was missed by plain X-ray and magnetic resonance imaging (MRI), but identified by computed tomography (CT) after suspecting high-energy trauma as the underlying cause. Case presentation: A 67-year-old male was injured in a car accident and came to our institute on foot 4 days after injury with complaints of neck pain and numbness in the right hand...
2018: Spinal Cord Series and Cases
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