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Da-Geng Huang, Xin-Liang Zhang, Ding-Jun Hao, Bao-Rong He, Xiao-Dong Wang, Tuan-Jiang Liu
BACKGROUND: In theory, temporary posterior atlantoaxial screw-rod fixation for type II odontoid fractures is a way to preserve rotatory motion. However, the healing rate of type II odontoid fractures treated in this way is unknown; that is, the risk associated with conducting a temporary screw-rod fixation for type II odontoid fractures is unknown. This study investigates the healing rate of type II odontoid fractures treated with posterior atlantoaxial screw-rod fixation by CT imaging and evaluates the feasibility of conducting a temporary screw-rod fixation for type II odontoid fractures...
October 17, 2018: Journal of the American Academy of Orthopaedic Surgeons
Gergely Bodon, Kristof Kiraly, Miklos Tunyogi-Csapo, Bernhard Hirt, Hans-Joachim Wilke, Juergen Harms, Lajos Patonay
PURPOSE: We examined the accessory atlantoaxial ligaments and found them to be a part of a complex ligamentous structure, which we named craniocervical Y-ligament with respect to its shape. METHODS: The ligaments of the upper cervical spine were dissected in ten Thiel embalmed human cadavers. Origin and attachment of the Y-ligament were described and a detailed photo and video-documentation was carried out with the head in the neutral position, flexion, extension and rotation to study the ligament during these movements...
October 15, 2018: Surgical and Radiologic Anatomy: SRA
Atul Goel, Arjun Dhar, Abhidha Shah, Dikpal Jadhav, Nilesh Bakale, Tejas Vaja, Neha Jadhav
AIM: The implications of diagnosis and treatment of central or axial atlantoaxial dislocation (CAAD) as a cause of symptoms of cervical myelopathy is evaluated. MATERIAL AND METHODS: This is a report of a series of 5 patients who presented with the primary symptoms of spasticity and motor weakness and paresthesiae in all the limbs. There was no evidence of any significant compression of the dural tube or neural structures at the craniovertebral junction. There was no craniovertebral junction instability when assessed by classically described radiological parameters...
October 10, 2018: World Neurosurgery
Puneet Malik, Pravin Salunke, Mandeep Kataria, Madhivanan Karthigeyan, Nirmalya Ray
BACKGROUND: An anomalous vertebral artery (VA) is not a deterrent for posterior C1-C2 joint manipulation and reduction of atlantoaxial dislocation (AAD). However, presence of an incidental aneurysm in the aberrant segment of artery with concurrent AAD adds to the surgical challenge. CASE DESCRIPTION: A 30-year-old woman presented with neck pain and spastic quadriparesis. Her imaging revealed atlantoaxial dislocation and bony segmentation defects. Three-dimensional computed tomography angiography showed bilateral anomalous vertebral arteries (V3 segment) and an incidental aneurysm on the arterial segment that crossed the right C1-C2 joint posteriorly...
October 9, 2018: World Neurosurgery
Kern H Guppy, Darin J Lee, Jessica Harris, Harsimran S Brara
No abstract text is available yet for this article.
September 26, 2018: World Neurosurgery
Renata E Husnudinov, George M Ibrahim, Evan J Propst, Nikolaus E Wolter
PURPOSE: Children with trisomy 21 are at a greater risk for craniocervical junction instability than the general population. These children frequently require administration of anesthesia due to surgical (including otolaryngological) interventions and are at risk for neurological injury. We reviewed the current literature describing iatrogenic neurological injury in children with trisomy 21 undergoing anesthesia in order to facilitate the development of safety recommendations. METHODS: A systematic review of the literature was performed using Medline, Embase, Scopus, and Google Scholar, following the PRISMA statement...
November 2018: International Journal of Pediatric Otorhinolaryngology
Fumitaka Takahashi, Takaharu Hakozaki, Shigenori Kouno, Shuji Suzuki, Asaka Sato, Nobuo Kanno, Yasuji Harada, Shinya Yamaguchi, Yasushi Hara
OBJECTIVE To retrospectively evaluate the epidemiological and morphological features and outcome of surgical treatment of incomplete ossification of the dorsal neural arch of the atlas (IODA) in dogs with atlantoaxial instability (AAI). ANIMALS 106 AAI-affected dogs that underwent ventral fixation of the atlantoaxial joint. PROCEDURES Medical records and CT images for each dog were reviewed. Dogs were allocated to 1 of 2 groups on the basis of the presence or absence of IODA or of dens abnormalities (DAs) in CT images...
October 2018: American Journal of Veterinary Research
Atul Goel, Apurva Prasad, Abhidha Shah, Sandeep Gore, Pralhad Dharurkar
OBJECTIVE: Voice alteration as a presenting symptom in cases with Chiari formation is analysed.Outcome following atlantoaxial fixation is analysed. MATERIAL AND METHODS: During the period January 2016 to June 2017, 25 cases of Chiari formation presented with associated or a major presenting symptom of voice or speech quality alteration related to inadequate breathing efforts. All patients underwent atlantoaxial fixation. No foramen magnum decompression was done...
September 22, 2018: World Neurosurgery
Nirmal Raj Gopinathan, Vibhu Krishnan Viswanathan, Alvin H Crawford
The clinical presentation and diagnostic workup in pediatric cervical spine injuries (CSI) are different from adults owing to the unique anatomy and relative immaturity. The current article reviews the existing literature regarding the uniqueness of these injuries and discusses the current guidelines of radiological evaluation. A PubMed search was conducted using keywords "paediatric cervical spine injuries" or "paediatric cervical spine trauma." Six hundred and ninety two articles were available in total...
September 2018: Indian Journal of Orthopaedics
Young Lu, Yu-Po Lee, Nitin N Bhatia, Thay Q Lee
STUDY DESIGN: A biomechanical in vitro study using human cadaveric spines. OBJECTIVE: To compare atlantoaxial stability and stiffness of a C1 lateral mass - C2 short pedicle - C3 lateral mass screw-rod construct versus C1 lateral mass - C2 pedicle screw-rod construct. SUMMARY OF BACKGROUND DATA: The C1 lateral mass - C2 pedicle screw-rod construct provides excellent atlantoaxial fixation but C2 pedicle screw placement is associated with risk of vertebral artery injury...
September 17, 2018: Spine
Peng Liu, Jun Zhu, Zhong Wang, Yufei Jin, Yingbo Wang, Weili Fan, Mingyong Liu, Jianhua Zhao
STUDY DESIGN: a retrospective study. OBJECTIVE: To evaluate the prediction accuracy of "Rule of Spence" and Dickman's classification of the transverse atlantal ligament (TAL) injury on clinical outcomes (mainly focused on atlantoaxial stability) of atlas fractures treated non-operatively. SUMMARY OF BACKGROUND DATA: TAL is regarded as primary stabilizer of the atlantoaxial complex. Atlas fractures are categorized as unstable and stable according to TAL injury or not...
September 14, 2018: Spine
Marco Crostelli, Osvaldo Mazza, Massimo Mariani, Dario Mascello, Carlo Iorio
PURPOSE: Mucopolysaccharidosis (MPS) are rare inherited metabolic diseases, causing lysosomal storage of mucopolysaccharides; clinical presentation involves skeletal system and particularly the spine. Anomalies include developing kyphosis at thoracolumbar junction, that can causes nervous symptoms, and dens hypoplasia with associated atlantoaxial subluxation that can cause myelopathy. We present our experience in the treatment of spine pathology in MPS. METHODS: Medical treatments of MPS seem to have little impact on spine disease: treatment of cervical instability often includes surgical decompression and stabilization, as in patient MPS1 that we present, while thoracic lumbar kyphosis is treated by bracing and, in severe cases, with surgery...
September 14, 2018: International Orthopaedics
Feride Fatma Görgülü, Ayşe Selcan Koç, Orhan Görgülü
Adenotonsillectomy is a common surgical otolaryngology procedure that is associated with several complications, including hemorrhage, odynophagia, damage to teeth, taste disorders, atlantoaxial subluxation, lingual edema, infection, and injury of the carotid artery. Pneumomediastinum, pneumopericardium, and epidural pneumatosis are an extremely unusual condition in children with adenotonsillectomy. Treatment should be conservative in the majority of cases and based on benign self-limiting course of these diseases; early recognition can prevent further complications...
2018: Case Reports in Otolaryngology
Raffaele Falsaperla, Gianluca Piattelli, Silvia Marino, Simona Domenica Marino, Alessandra Fontana, Piero Pavone
BACKGROUND: Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joints, which is caused by an inflammatory process involving the upper neck. Torticollis, neck pain, and reduced neck mobility are the main clinical signs of presentation. Predisposing factors are trauma, hyperlaxity of the transverse and alar ligaments of the atlantoaxial joints, and surgical interventions carried out in this area. Several viral and bacterial pathogens have been reported as causative events of Grisel's syndrome, including Epstein-Barr virus, Kawasaki disease, Streptococcus pyogenes, Staphylococcus aureus, and other infectious agents...
September 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Meghan E O'Neill, Alexandra Ryan, Soyang Kwon, Helen J Binns
The American Academy of Pediatrics's guideline on health supervision for children with Down syndrome (DS) offers pediatricians guidance to improve detection of comorbid conditions. Pediatrician adherence has not yet been comprehensively evaluated. Medical records of 31 children with DS who received primary care at two urban academic clinic sites from 2008-2012 were reviewed. Data was extracted on adherence to age-specific individual guideline components for each subject by year-of-life (total 84 years-of-life)...
September 2018: American Journal on Intellectual and Developmental Disabilities
Masashi Uehara, Tomoki Kosho, Noriaki Yamamoto, Hideaki E Takahashi, Taketoshi Shimakura, Jun Nakayama, Hiroyuki Kato, Jun Takahashi
Musculocontractural Ehlers-Danlos syndrome caused by mutations in CHST14 (mcEDS-CHST14) is a recently delineated disorder, characterized by craniofacial, skeletal, visceral, and ocular malformations; and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Spinal lesions, though one of the most serious complications, have not been investigated systematically. In this study, we report detailed and comprehensive information about spinal lesions of 12 patients with a mean age at the first visit of 13...
September 8, 2018: American Journal of Medical Genetics. Part A
Atul Goel
No abstract text is available yet for this article.
August 31, 2018: Journal of Neurosurgery. Spine
Hitoshi Yamahata, Tadaaki Niiro, Masanao Mori, Satoshi Yamaguchi, Masanori Yonenaga, Jun Sugata, Takaaki Hiwatari, Tomohisa Okada, Masamichi Atsuchi, Kazunori Arita, Koji Yoshimoto
Narrow cervical spinal canal is an important risk factor for the development of cervical myelopathy. Patients with this disease often present with congenital narrowness of the cervical spinal canal. While there are studies on patients with subaxial spinal canal stenosis (SAS), few examined the coexistence of congenital narrow spinal canal in patients with cervical myelopathy at the C1 level. We investigated the characteristics of patients with C1 stenosis (C1S) with special reference to the size of the atlas...
November 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jie-Hong Zhang, Zhi-Jing Zhang, Ya Zhu, Jian-Dong Shi, Bin Li, Yi-Sheng Lu
OBJECTIVE: We sought to develop a new posterior fusion technique composed of bilateral C1 titanium cables and C2 pedicle screw-rods for treatment of atlantoaxial instability not suitable for C1 screw placement. METHODS: A study was conducted of 18 patients with atlantoaxial instability who had C1 broken screw trajectory or anatomic anomalies. All patients underwent posterior fixation with bilateral C1 titanium cables and C2 pedicle screws. The follow-up period was a minimum 1 year...
August 24, 2018: World Neurosurgery
Guillaume Leblond, Noël M M Moens, Luis Gaitero, Alex Zur Linden, Fiona M K James, Gabrielle Monteith, Robert J Runciman
OBJECTIVES:  Canine ventral atlantoaxial stabilization methods have been constantly evolving over the past few decades. Yet, proper experimental data comparing the feasibility and biomechanical properties of currently available surgical options are lacking. The aims of this study were (1) to describe and compare the safety profiles and biomechanical properties of three ventral atlantoaxial stabilization methods; and (2) to test whether recently reported optimal implant definitions constitute reasonable guidelines...
September 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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