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Mueez Waqar, Dmitri Van-Popta, Damiano G Barone, Zaid Sarsam
INTRODUCTION: The aim of this systematic review was to compare the halo and hard collar in the management of adult odontoid fractures. METHODS: Systematic and independent searches on MEDLINE (PubMed) and the Cochrane database. INCLUSION CRITERIA: (1) clinical outcomes, (2) in adults (≥18), (3) with odontoid fractures, (4) immobilised using a halo or hard collar, (5) in multiple (>5) patients. Treatment failure rates were calculated as the proportion requiring operative intervention...
October 15, 2016: World Neurosurgery
Atul Goel
No abstract text is available yet for this article.
October 14, 2016: Journal of Neurosurgery. Spine
Mark Riebel, Richard Westrick, Donald Goss
A 24-year-old male Marine presented to a direct-access physical therapy clinic with a chief complaint of bilateral hand paresthesia secondary to a parachuting accident when his neck was forced into lateral flexion. Due to the positive neurologic findings and history of trauma, the physical therapist ordered cervical spine imaging. The odontoid was not adequately visualized on radiographs, but computed tomography revealed an os odontoideum. J Orthop Sports Phys Ther 2016;46(10):930. doi:10.2519/jospt.2016.0417...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Eleftherios Archavlis, Lucas Serrano, Eike Schwandt, Amr Nimer, Moisés Felipe Molina-Fuentes, Tamim Rahim, Maximilian Ackermann, Angelika Gutenberg, Sven Rainer Kantelhardt, Alf Giese
OBJECTIVE The goal of this study was to demonstrate the clinical and technical nuances of a minimally invasive, dorsolateral, tubular approach for partial odontoidectomy, autologous bone augmentation, and temporary C1-2 fixation to treat dens pseudarthrosis. METHODS A cadaveric feasibility study, a 3D virtual reality reconstruction study, and the subsequent application of this approach in 2 clinical cases are reported. Eight procedures were completed in 4 human cadavers. A minimally invasive, dorsolateral, tubular approach for odontoidectomy was performed with the aid of a tubular retraction system, using a posterolateral incision and an oblique approach angle...
September 30, 2016: Journal of Neurosurgery. Spine
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
Paresh Golwala, Chirag Kapoor, Aditya Merh, Maulik Jhaveri
Tuberculosis (TB) is an emerging disease which affects about one-third of the world's population, especially in developing countries. TB of the spine is the most common type of skeletal TB. Cervical spine TB is rare, constituting 2-3% of all cases of spinal TB. We would like to present an unusual case of tuberculosis of the C1, C2, and C3 vertebrae with neurological deficit and its difficult management. A new method of treatment was done for this patient, which included reconstruction of the odontoid process using a tricortical iliac crest graft that was fixed with an anterior cervical plate...
2016: Curēus
Ufuk Demirci
No abstract text is available yet for this article.
September 23, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Deng-Wei He, Wen-Jun Huang, Xiao-Yong Sheng, Li-Jun Wu, Shun-Wu Fan
A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction...
August 2016: Orthopaedic Surgery
Wei Tian, Han Wang, Ya-Jun Liu
Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies)...
August 2016: Orthopaedic Surgery
Mauro Dobran, Davide Nasi, Domenico Paolo Esposito, Maurizio Iacoangeli
OBJECTIVE: To evaluate the long term C1-C2 fusion rates, fracture healing and functional outcomes in geriatric patients with type II odontoid fracture treated with posterior fixation with polyaxial C1 lateral mass screws and C2 pars screws. METHODS: Twenty-one consecutive patients between 2005 and 2011 with Anderson and D'Alonzo type II odontoid fracture underwent a posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. A long-term clinical and radiological follow-up was achieved in all patients with a mean follow-up period of 53...
September 1, 2016: World Neurosurgery
R Shane Tubbs, Christina M Kirkpatrick, Christian Fisahn, Joe Iwanaga, Marc D Moisi, David R Hanscom, Jens R Chapman, Rod J Oskouian
OBJECTIVE: We hypothesized that the entry site of the basivertebral vein into the basivertebral foramen of C2 might localize the subdental synchondrosis between the odontoid process and body of C2, which may be helpful for odontoid fracture classification. METHODS: Twenty-five dry adult C2 specimens underwent thin cut CT and were sectioned sagittally. The basivertebral foramen was then correlated to internal bony anatomy. 50 MRIs were reviewed and the location of the subdental synchondrosis determined...
August 30, 2016: World Neurosurgery
J Joestl, N Lang, A Bukaty, P Platzer
AIMS: We performed a retrospective, comparative study of elderly patients with an increased risk from anaesthesia who had undergone either anterior screw fixation (ASF) or halo vest immobilisation (HVI) for a type II odontoid fracture. PATIENTS AND METHODS: A total of 80 patients aged 65 years or more who had undergone either ASF or HVI for a type II odontoid fracture between 1988 and 2013 were reviewed. There were 47 women and 33 men with a mean age of 73 (65 to 96; standard deviation 7)...
September 2016: Bone & Joint Journal
Idiris Altun, Kasım Zafer Yuksel
STUDY DESIGN: Retrospective review. PURPOSE: We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. OVERVIEW OF LITERATURE: Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability...
August 2016: Asian Spine Journal
Yasser Assaghir
STUDY DESIGN: Retrospective comparative clinical case series. OBJECTIVE: Burst C2 fractures are very rare. Treatment options include conservative treatment or fusion (anterior, posterior, or anterior and posterior). Anterior fusion addresses mainly hangman component. The bursting body usually needs posterior or combined anterior-posterior fusion, but both permanently sacrifice atlantoaxial motion. Can anterior-"first" approach preserve C1-C2 motion and restore function? METHODS: We report nine cases of burst C2 combined with C2-C3 spondylolisthesis and an odontoid fracture...
September 2016: Global Spine Journal
Christopher S Graffeo, Avital Perry, Ross C Puffer, Lucas P Carlstrom, Wendy Chang, Grant W Mallory, Michelle J Clarke
OBJECTIVE Type II odontoid fracture is a common injury among elderly patients, particularly given their predisposition toward low-energy falls. Previous studies have demonstrated a survival advantage following early surgery among patients older than 65 years, yet octogenarians represent a medically distinct and rapidly growing population. The authors compared operative and nonoperative management in patients older than 79 years. METHODS A single-center prospectively maintained trauma database was reviewed using ICD-9 codes to identify octogenarians with C-2 cervical fractures between 1998 and 2014...
August 19, 2016: Journal of Neurosurgery. Spine
Asdrubal Falavigna
No abstract text is available yet for this article.
August 19, 2016: Journal of Neurosurgery. Spine
S M Weindling, R D Goff, C P Wood, D R DeLone, J M Hoxworth
Isolated hypoglossal nerve palsy is uncommon, and underlying craniocervical junction degenerative disease has rarely been reported as an underlying cause. To improve understanding of this entity, we present a retrospective series of 18 patients with hypoglossal palsy in whom twelfth cranial nerve compression within the premedullary cistern or hypoglossal canal, or both, was found secondary to craniocervical junction juxta-articular cysts, retro-odontoid fibrous pseudotumors, and osteophytes. The imaging techniques and characteristic craniocervical junction degenerative disease lesion imaging findings presented here might help clinicians interpreting hypoglossal palsy imaging studies avoid perceptual and interpretive errors commonly found in the present series...
August 18, 2016: AJNR. American Journal of Neuroradiology
Jayesh Sardhara, Sindgikar Pavaman, Kuntal Das, Arun Srivastava, Anant Mehrotra, Sanjay Behari
BACKGROUND: Congenital spondylolytic spondylolisthesis of C2 vertebra resulting from deficient posterior element of the axis is very rarely described in the literature. CASE DESCRIPTION: We describe a unique case of agenesis of posterior elements of C2 with cranio-vertebral junction anomalies consist of osseous, vascular and soft tissue anomalies. A young 26 year old young man presented with symptoms of upper cervical myelopathy of 12 months duration. CT scan of the cervical spine including the craniovertebral junction revealed spondylolisthesis of C2 over C3, atlanto axial dislocation, occipitalisation of atlas, hypoplasia of the odontoid and cleft posterior C1 arch...
August 12, 2016: World Neurosurgery
Jared M Pisapia, Nikhil R Nayak, Ryan D Salinas, Luke Macyszyn, John Y K Lee, Timothy H Lucas, Neil R Malhotra, H Isaac Chen, James M Schuster
OBJECTIVE As odontoid process fractures become increasingly common in the aging population, a technical understanding of treatment approaches is critical. 3D image guidance can improve the safety of posterior cervical hardware placement, but few studies have explored its utility in anterior approaches. The authors present in a stepwise fashion the technique of odontoid screw placement using the Medtronic O-arm navigation system and describe their initial institutional experience with this surgical approach...
August 12, 2016: Journal of Neurosurgery. Spine
S Le Pape, R Gauthé, C Latrobe, J Leroux, X Roussignol, M Ould-Slimane
An episode of acute decompensation of cervical myelopathy occurred after an injury without fracture of an os odontoideum associated with a compressive retro-odontoid cyst. The 51-year-old female patient presented Fränkel C, Nurick grade 4 neurological status and pyramid syndrome. The initial MRI demonstrated an intramedullary T2 hyperintense signal in the context of spinal cord narrowing. The retro-odontoid cyst demonstrates atlantoaxial instability related to the os odontoideum. Harms C1-C2 arthrodesis without laminectomy was performed and the cyst disappeared completely...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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