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https://www.readbyqxmd.com/read/30109422/vertebral-artery-dissection-caused-by-atlantoaxial-dislocation-a-case-report-and-review-of-literature
#1
Yue Hu, Jialin Du, Zhenlei Liu, Hao Wu, Jianping Ding, Fengzeng Jian
BACKGROUND: Atlantoaxial dislocation (AAD) is the most common craniovertebral junction malformation (CVJm) which are anomalies of the bones and soft tissues surrounding the foramen magnum. It usually leads to neurologic abnormalities because of instability of this mobile area. But vertebral artery dissection (VAD) caused by AAD is uncommon. CASE REPORT: We report a 15-year-old boy who presented with acute onset of bilateral VAD leading to posterior circulation ischemic stroke (PCIS)...
August 14, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30095471/traumatic-atlanto-occipital-dissociation-and-atlantoaxial-instability-concomitant-ligamentous-injuries-without-neurologic-deficit-a-case-report
#2
Daniel G Tobert, Marco L Ferrone, Gregory J Czuczman
CASE: A 35-year-old man was involved in a motor-vehicle collision and sustained multiple thoracoabdominal and extremity injuries. A high injury burden and a normal neurologic examination contributed to a delay in diagnosing a ligamentous, combined atlanto-occipital dissociation (AOD) and vertical atlantoaxial injury (AAI). Additional imaging revealed the combined injury, and the patient underwent an occipitocervical fusion. CONCLUSION: To our knowledge, this is the first case of a simultaneous traumatic AOD and AAI without fracture in a neurologically intact patient...
August 8, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/30090135/compressive-myelopathy-secondary-to-atlantoaxial-dislocation-in-a-child-with-congenital-hypothyroidism-a-case-report
#3
Dayanand Hota, Mahesh Kumar, M Kavitha, Jaya S Kaushik
Atlantoaxial dislocation (AAD) occurs secondary to joint laxity between C1 and C2 vertebrae, resulting in loss of normal articulation and movement. Etiology of AAD could be genetic, inflammatory, or rarely traumatic. Majority of children with AAD are syndromic (such as Down syndrome) or genetic (such as Ehler-Danlos syndrome or Marfan syndrome). To the best of literature search, there were no reports of AAD among children with congenital hypothyroidism. This case highlights an uncommon association of AAD presenting with features of compressive myelopathy in a child with congenital hypothyroidism...
April 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/30060381/minimally-invasive-microscope-assisted-stand-alone-transarticular-screw-fixation-without-gallie-supplementation-in-the-management-of-mobile-atlantoaxial-instability
#4
Tarun Dusad, Vishal Kundnani, Shumayou Dutta, Ankit Patel, Gaurav Mehta, Mahendra Singh
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the clinico-radiological efficacy of stand-alone minimally invasive transarticular screw (MIS-TAS) fixation without supplemental Gallie fixation in the management of mobile C1-C2 instability. OVERVIEW OF LITERATURE: Data evaluating the efficacy and feasibility of MIS-TAS in the literature is scanty. METHODS: Patients with mobile atlantoaxial instability and >2 years follow-up were included and managed by stand-alone TAS fixation using the Magerl technique and morselized allograft without additional fixation...
August 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/30049634/neck-stiffness-in-a-post-irradiated-nasopharyngeal-carcinoma-adult-an-unusual-diagnosis
#5
Kang Ni Lorna Ting, Yew Toong Liew, Zulkiflee Abu Bakar, Prepageran Narayanan
Nasopharyngeal carcinoma is a neoplasm commonly found in population of South East Asia. The mainstay of treatment is high dose irradiation. Complications from radiotherapy are not uncommon especially to those nearby structures such as vertebrae and spinal cord. A 57 year-old gentleman with nasopharyngeal carcinoma (NPC) who was treated with chemo-radiation (total of 35 fractions,70Gy) presented to us 6 months post therapy with bilateral nasal discharge and progressive neck stiffness. Nasoendoscopy showed inflamed nasophayngeal mucosa and Computed Tomography (CT) brain and cervical spine showed retropharyngeal and anterior epidural collection with extension into atlantoaxial bone and spinal cord compression...
July 23, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/30043825/clinical-application-of-atlantoaxial-pedicle-screw-placement-assisted-by-a-modified-3d-printed-navigation-template
#6
Xingwei Pu, Chunshan Luo, Tinsheng Lu, Shudan Yao, Qiling Chen
OBJECTIVES: To investigate the primary clinical value of atlantoaxial pedicle screw placement assisted by a modified 3D-printed navigation template. METHODS: We retrospectively analyzed the cases of 17 patients treated from June 2015 to September 2016 with atlantoaxial pedicle screw placement assisted by a modified 3D-printed navigation template. All procedures were performed prior to surgery, including thin-slice CT scanning, medical image sampling and computerized 3D modeling of the atlantoaxial joint, optimal pedicle screw trajectory determination, and anatomical trait acquisition for the atlantoaxial pedicle, spinous process of the axis, vertebral lamina and posterior lateral mass, and design of a reverse template...
July 19, 2018: Clinics
https://www.readbyqxmd.com/read/30038213/three-dimensional-printed-model-assisted-screw-installation-in-treating-posterior-atlantoaxial-internal-fixation
#7
Minyi Yang, Nannan Zhang, Haodong Shi, Hui Li, Shichang Liu, Zongrang Song, Lequn Shan, Qining Wu, Dingjun Hao
The aim of this study was to evaluate the efficacy and feasibility of a life-size 3-dimensional printing assisted posterior internal fixation. We performed a retrospective review of 138 patients who received posterior atlantoaxial internal fixation from October 2009 to March 2015 with a minimum follow-up period of 12 months. Group A included 76 patients who received the conventional free-hand technique. Group B included 62 patients who were treated with internal fixation assisted by 3D printing. The placement accuracy of the screw was evaluated in the computed tomography images according to the methods of Hojo and clinical outcomes were evaluated using the visual analogue scale, the Japanese Orthopedic Association Score, and the Neck Disability Index score...
July 23, 2018: Scientific Reports
https://www.readbyqxmd.com/read/30038084/controversies-in-the-surgical-management-of-congenital-craniocervical-junction-disorders-a-critical-review
#8
REVIEW
Andrei F Joaquim, Helder Tedeschi, P Sarat Chandra
Introduction: Congenital disorders of the craniovertebral junction (CVJ) include a wide range of conditions, such as Chiari malformation (CM), basilar Invagination (BI), and atlantoaxial dislocation (AAD). The objective of this paper is to critically review the literature related to the management of congenital CVJ disorders focusing on: the significant developments in the past (from anterior open ventral decompression to modern CVJ realignment); the diagnosis of CVJ instability; the role of atlantoaxial fixation without posterior fossa decompression in patients with tonsillar herniation and no evidence of CVJ instability; use of C1-2 inter-articular spacers and use of C1-2 interarticular spacers with intra-operative manipulations to correct BI with AAD along with its deformity...
July 2018: Neurology India
https://www.readbyqxmd.com/read/30038072/basilar-invagination-syringomyelia-and-chiari-formation-and-their-relationship-with-atlantoaxial-instability
#9
Atul Goel
No abstract text is available yet for this article.
July 2018: Neurology India
https://www.readbyqxmd.com/read/30031957/-pros-and-cons-of-c2-nerve-sectioning-preservation-in-posterior-fusion-for-congenital-atlantoaxial-dislocation
#10
Pravin Salunke, Madhivanan Karthigeyan, Sameer Futane
OBJECTIVE: Deliberate C2 nerve root sectioning as well as its preservation have been described during posterior fusion for atlantoaxial dislocation (AAD) and are debatable. The associated outcomes have been less studied, particularly in congenital AAD. Our objective was to study the clinical outcome after C2 nerve root sectioning as well as the feasibility of its preservation in these patients. METHODS: One ninety patients were retrospectively studied. The decision to cut/ preserve the C2 nerve root was based on preoperative radiology and intraoperative suitability of its preservation...
July 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30019254/expert-s-comment-concerning-grand-rounds-case-entitled-traumatic-atlantoaxial-rotatory-fixation-in-an-adult-patient-by-ma-garc%C3%A3-a-pallero-et-al-eur-spine-j-2017-doi-10-1007-s00586-016-4916-3
#11
REVIEW
https://www.readbyqxmd.com/read/30017594/designing-patient-specific-3d-printed-devices-for-posterior-atlantoaxial-transarticular-fixation-surgery
#12
Ganesha K Thayaparan, Mark G Owbridge, Robert G Thompson, Paul S D'Urso
Atlantoaxial transarticular screw fixation is an effective technique for arthrodesis. Surgical accuracy is critical due to the unique anatomy of the atlantoaxial region. Intraoperative aids such as computer-assisted navigation and drilling templates offer trajectory guidance but do not eliminate screw malposition. This study reports the operative and clinical performance of a novel process utilising biomodelling and 3D printing to develop patient specific solutions for posterior transarticular atlantoaxial fixation surgery...
July 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/30014570/objective-measurements-of-the-atlantoaxial-joint-on-radiographs-performed-without-flexion-can-increase-the-confidence-of-diagnosis-of-atlantoaxial-instability-in-toy-breed-dogs
#13
Kelly R Cummings, Federico Vilaplana Grosso, George E Moore, Mark Rochat, Stephanie A Thomovsky, R Timothy Bentley
Toy breed dogs are overrepresented for atlantoaxial instability. Radiography is a standard diagnostic test, however published toy breed-specific radiographic measurements are lacking and diagnosis remains largely subjective. Aims of this retrospective, diagnostic accuracy study were to describe normal values and determine whether some quantitative radiographic criteria strongly support a diagnosis of atlantoaxial instability specific to toy breed dogs. Neutral lateral and ventrodorsal radiographs of 102 toy breed dogs (92 control, 10 affected) were reviewed...
July 16, 2018: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/30009085/use-of-intraoperative-x-ray-to-differentiate-between-reducible-versus-irreducible-atlantoaxial-dislocation
#14
Nupur Pruthi, Lokesh S Nehete
Background: The treatment and classification of atlantoaxial dislocations (AADs) remain controversial. Here, we utilized intraoperative X-ray to differentiate between reducible and irreducible AADs. Methods: Five patients were diagnosed as having irreducible AAD on dynamic and post-traction X-rays. Under general anesthesia, they were placed prone in a neutral position utilizing skeletal traction. The X-rays and motor evoked potential (MEP), were then monitored before, during, and after placing a thumb on the C2 spinous process and pushing it anteriorly to attain reduction...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29972858/atlantoaxial-instability-in-patients-older-than-70-years-what-is-the-outcome-when-further-conservative-treatment-is-not-an-option
#15
Christoph Scholz, Jan-Helge Klingler, Christian Scheiwe, Yashar Naseri, Waseem Masalha, UIrich Hubbe
OBJECTIVE:  We report on our experiences of navigated posterior C1-C2 spondylodesis in the elderly (≥ 70 years of age). PATIENTS:  This retrospective cohort study evaluated all patients ≥ 70 years of age treated with navigated posterior spondylodesis C1-C2 (at the most to C3) from 2008 to 2015 with a minimum follow-up of 1 year. Minor and major complications within 30 days after surgery, patient outcome, and the rate of solid fusion in computed tomography were recorded...
July 4, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29966140/vertebral-arteriovenous-fistula-a-rare-complication-following-transpedicular-occipitocervical-fixation-in-a-patient-with-atlantoaxial-dislocation
#16
Rongjun Qian, Zhixiao Li, Ming Li
Vertebral arteriovenous fistula (AVF), a complication of a vertebral artery injury (VAI), is a rare but serious complication of upper cervical spine fixation surgery. We report a case of a 59-year-old female patient who had a vertebral AVF following transpedicular occipitocervical fixation surgery. Endovascular embolization of the AVF was successfully performed using ethylene vinyl alcohol. From this case we learned that preoperative evaluation of the course of the vertebral artery is necessary, and vertebral artery embolism is an effective and safe method to treat vertebral AVF after proof of a patent second vertebral artery...
July 2, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29961910/traumatic-posterior-atlantoaxial-dislocation-with-associated-c1-jefferson-fracture-and-bilateral-vertebral-artery-occlusion-without-odontoid-process-fracture-or-neurological-deficit
#17
Mark Nowell, Richard Nelson
PURPOSE: Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014). METHOD: We present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit...
July 2, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29945002/accuracy-of-screw-placement-and-clinical-outcomes-after-o-arm-navigated-occipitocervical-fusion
#18
Linkai Jing, Zhenxing Sun, Peihai Zhang, James Wang, Guihuai Wang
OBJECTIVE: This study aimed to evaluate the accuracy of screw placement and clinical outcomes in patients undergoing occipitocervical fusion. METHODS: Patients who underwent occipitocervical fusion with O-arm-based navigation were retrospectively reviewed between January 2015 and December 2017. The patients' characteristics, clinical and radiographic outcomes, and surgical complications were recorded and analyzed. Cervical screw insertion accuracy was evaluated using the Richter scale...
June 23, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29939972/comparison-of-two-posterior-three-point-fixation-techniques-for-treating-reducible-atlantoaxial-dislocation
#19
Wenlong Zhao, Yaming Wu, Wei Hu, Bin Ni, Qunfeng Guo, Jinshui Chen, Xiang Guo
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To compare the outcomes of C1-C2 transarticular screw combined with C1 laminar hook (TAS+ C1H) and C1-C2 transarticular screw combined with modified Gallie technique (TAS+ G) for treating reducible atlantoaxial dislocation (AAD). SUMMARY OF BACKGROUND DATA: Both TAS+ C1H and TAS+ G fixation were 3-point fixation techniques for AAD. TAS+C1H technique was comparable to TAS+ G technique in biomechanics...
June 22, 2018: Spine
https://www.readbyqxmd.com/read/29899764/congenital-atlantoaxial-dislocation-nature-s-engineering-gone-wrong-and-surgeon-s-attempt-to-rectify-it
#20
REVIEW
Pravin Salunke
The C1-2 joint is unique and is responsible for more than 50% of the neck rotation. The joints have an ergonomic design that allows maximum motion without getting dislocated. It provides six degrees of freedom, the maximum being axial rotation, and is a marvel of nature's engineering. The morphometry of lateral masses of C1 and C2 joints was analyzed to explain the possible movements despite minor variations. The normal morphometry was compared with the joints of individuals with congenital atlantoaxial dislocation...
January 2018: Journal of Pediatric Neurosciences
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