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Rutsuko Yamaguchi, Yohsuke Makino, Go Inokuchi, Shinya Hattori, Fumiko Chiba, Suguru Torimitsu, Naoki Saito, Takashi Kishimoto, Hirotaro Iwase
A 5-year-old boy with a chromosome-9 abnormality and multiple external and visceral malformations was found in cardiopulmonary arrest during a regular visit to the hospital; he did not respond to cardiopulmonary resuscitation and died. An odontoid process fracture and calcification and fibrosis of the muscles around the superior cervical vertebra were observed during the autopsy. Postmortem computed tomography revealed an anterior dislocation of the atlas; odontoid synchondrosis fracture; and delayed, incomplete bony fusion of the odontoid process relative to his age...
November 29, 2018: Journal of Forensic and Legal Medicine
Chester J Donnally, Evan J Trapana, Spencer W Barnhill, Kevin J Bondar, Sebastian Rivera, Jonathan I Sheu, Michael Y Wang
OBJECTIVE: Management of odontoid fractures has improved and evolved due to advancing diagnostic guidelines and understanding of long-term outcomes. The aim of this study was to quantify the most frequently cited publications pertaining to odontoid fractures and determine their validity as a tool to practice evidence-based medicine. METHODS: A Clarivate Analytics Web of Science search was used to identify all articles related to odontoid fractures. The fifty most cited articles were reviewed...
December 5, 2018: World Neurosurgery
Lei Zhang, Huan Wang
Atlanto-axial instability (AAI) is a congenital or developmental condition that leads to instability/subluxation of the atlantoaxial joint. This study is performed to determine anatomic feasibility of trajectory L and help select an optimal screw trajectory in treating patients with AAI with a narrow C1 posterior arch. Sixty patients who underwent cervical three dimensional-computed tomography (3D-CT) were chosen from the hospital's picture archiving and communication system (PACS). Aquilion Multi 64 helical CT was used to perform CT examinations and measurements on patients...
December 2018: Kaohsiung Journal of Medical Sciences
Manish Kundanmal Kothari, Samir Surendranath Dalvie, Santosh Gupta, Agnivesh Tikoo, Deepak Kumar Singh
Study Design: Retrospective radiological study. Purpose: We aimed to determine the prevalence of ponticulus posticus (PP) and high-riding vertebral artery (HRVA) occurring simultaneously on the same side (PP+HRVA) and in cases of PP+HRVA, to assess C2 radio-anatomical measurements for C2 pars length, pedicle width, and laminar thickness. Overview of Literature: PP and HRVA predispose individuals to vertebral artery injuries during atlantoaxial fixation...
December 7, 2018: Asian Spine Journal
(no author information available yet)
No abstract text is available yet for this article.
October 1, 2018: Journal of Neurosurgery. Spine
Maja A Waschk, Beatriz Vidondo, Inés Carrera, Angel M Hernandez-Guerra, Pierre Moissonnier, Ioannis N Plessas, Martin J Schmidt, Dietmar Schnötzinger, Franck Forterre, Christina Precht
OBJECTIVE:  The main purpose of this study was to define criteria to systemically describe craniovertebral junction (CVJ) anomalies and to report the prevalence of CVJ anomalies in small breed dogs with and without atlantoaxial instability (AAI). METHODS:  Retrospective multicentre matched case-control study evaluating magnetic resonance imaging and computed tomographic images of small breed dogs with and without AAI for the presence of CVJ anomalies. RESULTS:  One hundred and twenty-two dogs were enrolled (61 with and 61 without AAI)...
November 28, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
(no author information available yet)
OBJECTIVETo avoid jeopardizing an aberrant vertebral artery, there are three common options in placing a C2 screw, including pedicle, pars, and translaminar screws. Although biomechanical studies have demonstrated similar strength among these C2 screws in vitro, there are limited clinical data to address their differences in vivo. When different screws were placed in each side, few reports have compared the outcomes. The present study aimed to evaluate these multiple combinations of C2 screws.METHODSConsecutive adult patients who underwent posterior atlantoaxial (AA) fixation were retrospectively reviewed...
October 1, 2018: Journal of Neurosurgery. Spine
Philipp Schleicher, Mehmet Bulent Onal, Frank Hemberger, Matti Scholz, Frank Kandziora
AIM: To compare four different atlantoaxial stabilization techniques. MATERIAL AND METHODS: Eight human cervical spines (segments C0-C3) were tested in flexion/extension, lateral bending and axial rotation. Range of Motion (ROM) at a 1.5 Nm load was recorded. After native testing, the Harms (HARMS), pars screw (PARS), intralaminar screw (INTRA) and anterior transarticular screw (ATA) constructs were applied in a random order. RESULTS: FLEXION/EXTENSION: mean ROM (±SD) in native state was 15...
2018: Turkish Neurosurgery
Alexander Spiessberger, Alexandra Stauffer, Fabian Baumann, Serge Marbacher, Karl Kothbauer, Javier Fandino, Bernhard Moriggl
PURPOSE: Atlantoxial fusion with screw rod constructs traditionally requires subperiostal dissection of the C1/C2 muscle attachments, which may lead to postoperative axial neck pain and intraoperative blood loss. We evaluate a potentially less invasive, muscle splitting approach for atlantoaxial fusion in a cadaver model. METHODS: A technical feasibility study was performed in a human cadaveric specimen with standard surgical instruments and an operating microscope...
November 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yongqiang Wang, Chao Wang, Ming Yan
OBJECTIVE: Atlantoaxial stabilization procedure in high riding of vertebral artery (HRVA) cases is challenging. C-2 translaminar screws (TLS) are reportedly rigid and pose no risk to the VA. We would like to present the clinical outcomes of atlantoaxial dislocation(AAD) combined with HRVA using C-2 TLS. METHODS: Cases of AAD combined with HRVA surgically treated in our institution from 2007 to 2015 were retrospectively reviewed. The atlantodental interval (ADI) and clivus-axial angle (CAA) were measured...
November 20, 2018: World Neurosurgery
Satoru Tanioka, Keita Kuraishi, Masaki Mizuno, Fujimaro Ishida, Ikuko Fuse, Ken Umehara, Hidenori Suzuki
PURPOSE: Although dysphagia is known potential complication of cervical spine surgery, it rarely occurs after a posterior approach. We describe an unusual case of a retro-odontoid pseudotumor that suffered dysphagia following a C1 laminectomy and posterior atlantoaxial fixation. MATERIALS AND METHODS: A 79-year-old man presented with progressive tetraparesis and bladder and bowel dysfunction due to severe compression to cervical cord at C1 from a retro-odontoid pseudotumor...
November 19, 2018: British Journal of Neurosurgery
Shenghua Ning, Sidong Yang, Wenyuan Ding, Tianxiao Ma, Zhanyong Wu
BACKGROUND: Atlantoaxial dislocation usually results from hyperextension trauma and is almost always accompanied by odontoid fracture and neurological symptoms. In most cases, patients with atlantoaxial dislocation die instantly. This is a rare report of posterior atlantoaxial dislocation without fracture and neurological symptoms effectively treated by transoral-posterior approach surgery, and only eleven similar cases have been previously reported. OBJECTIVE: To describe the very rare case of an adult posterior atlantoaxial dislocation patient without fracture who was neurologically treated using transoral-posterior approach surgery and to review the relevant literature...
November 17, 2018: European Spine Journal
Wataru Ishida, Seba Ramhmdani, Yuanxuan Xia, Thomas A Kosztowski, Risheng Xu, John Choi, Rafael De la Garza Ramos, Benjamin D Elder, Nicholas Theodore, Ziya L Gokaslan, Daniel M Sciubba, Timothy F Witham, Ali Bydon, Jean-Paul Wolinsky, Sheng-Fu L Lo
INTRODUCTION: Posterior atlantoaxial fusion is an important armamentarium for neurosurgeons to treat several pathologies involving the craniovertebral junction. Although the potential advantages of recombinant human bone morphogenetic protein -2 (rhBMP-2) are well-documented in the lumbar spine, its indication in C1-2 fusion has not been well-characterized. In our institution, we apply rhBMP-2 to the C1-2 joint either alone or with hydroxyapatite, locally harvested autograft chips, and/or morselized allogenic bone graft for selected cases - without conventional posterior structural bone graft...
November 15, 2018: World Neurosurgery
Junlong Zhong, Zhimin Pan, Yiwei Chen, Haoqun Yao, Zujue Cheng, Quanfei Liu, Zhaoxun Zeng, Zhiyun Li, Pingguo Duan, Jiangwei Chen, Hu Li, Sheng Huang, Zhimin Han, Keung Nyun Kim, Yoon Ha, Kai Cao
BACKGROUND: Chronic atlantoaxial anterior dislocation (AAD) not only results in myelopathy, but dislocation-related kyphosis also results in cervical malalignment, which permanently affects neck function and patient-reported outcomes (PROs). OBJECTIVE: To investigate the effect of kyphotic correction on realigning cervical spine and independent cervical alignment parameters, which may be correlated with an improvement of PROs. METHODS: The study included 21 patients with chronic AAD-related kyphosis who underwent C1-2 reduction and correction surgery...
December 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Abhijeet B Kadam, Ashok K Rathod, Anoop C Dhamangaonkar
Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Involvement of the axial skeleton is very rare and majority of them are seen in the sacrum. The authors report a rare case of a 19-year-old female who presented with a C2 dens GCT with a pathological fracture and atlantoaxial dislocation. The patient was operated in two stages: first stage, with posterior instrumentation and stabilization followed by the second stage, tumor resection by anterior transoral approach...
July 2018: Journal of Craniovertebral Junction and Spine
Yang Yuan, Fei Lei, Chunguang Zhou, Limin Liu, Yueming Song
Objective: To discuss the effectiveness of atlantoaxial joint release through anterior retrophayngeal approach and staged posterior reduction fixation and fusion for irreducible atlantoaxial dislocation (IAAD). Methods: Fifteen patients with IAAD (9 males, 6 females), aged 14-53 years (mean, 31.4 years) were included in the study. The disease duration was 3 months to 17 years (mean, 5.7 years). IAAD was attributed to trauma in 13 cases, and 2 cases were caused by congenital odontoid disconnection...
November 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
A N Shkarubo, A A Kuleshov, I V Chernov, M S Vetrile, G N Berchenko, I N Lisyanskiy, S N Makarov
Treatment of patients with atlantoaxial instability caused by various diseases of the skull base and craniovertebral junction combined with ventral compression of the brainstem is a complex issue that is ambiguously resolved in different ways. We present a case of stepped treatment, the most important component of which was successful transoral removal of an aggressive aneurysmal bone cyst of the CII vertebra with anterior CI-CIII segment stabilization using an individual system, which was performed through the same approach...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Jia Liu, Lingjun Zhu, Enze Jiang, Sili Zou, Guohua Xu
PURPOSE: We present a rare case of atlantoaxial instability as a result of bone erosions in a patient with ankylosing spondylitis and review the literature. We describe the radiographic characters, pathology and treatment of the case, hoping to shed light on the rare clinical manifestation. METHODS: We present a case of a 36-year-old male with an 8-year history of ankylosing spondylitis with a progressive neck pain, low back pain, hand numbness and motion limitation of neck...
November 4, 2018: World Neurosurgery
Keyvan Eghbal, Abbas Rakhsha, Arash Saffarrian, Abdolkarim Rahmanian, Hamid Reza Abdollahpour, Fariborz Ghaffarpasand
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI)...
October 2018: Bulletin of Emergency and Trauma
Fei Ma, Min Kang, Ye Hui Liao, Guang Zhou Lee, Qiang Tang, Chao Tang, Qing Wang, De Jun Zhong
OBJECTIVE: To investigate the usefulness of intraoperative traction in the selection of the surgical procedure for irreducible atlantoaxial dislocation (IAAD) caused by different craniovertebral junction (CVJ) pathologies. PATIENTS AND METHODS: Forty-three patients who were diagnosed with IAAD and who underwent surgery between January 2008 and May 2017 in our hospital were included in the study. All of the patients received skull traction under general anesthesia...
October 29, 2018: Clinical Neurology and Neurosurgery
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