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https://www.readbyqxmd.com/read/29451436/novel-posterior-artificial-atlanto-odontoid-joint-for-atlantoaxial-instability-a-biomechanical-study
#1
Kai Shen, Zhongliang Deng, Junsong Yang, Chao Liu, Ranxi Zhang
OBJECTIVE Atlantoaxial instability is usually corrected by anterior and/or posterior C1-2 fusion. However, fusion can lead to considerable loss of movement at the C1-2 level, which can adversely impact a patient's quality of life. In this study, the authors investigated the stability and function of a novel posterior artificial atlanto-odontoid joint (NPAAJ) by using cadaveric cervical spines. METHODS The Oc-C7 regions from 10 cadaveric spines were used for anteroposterior (AP) translation and range of motion (ROM) tests while intact and after destabilization, NPAAJ implantation, and double-rod fixation...
February 16, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29433186/traumatic-atlantoaxial-spondyloptosis-associated-with-displaced-odontoid-fracture-complete-reduction-via-posterior-approach-using-joint-remodeling-technique
#2
Amandeep Kumar, Gaurav Varshney, Pankaj K Singh, Deepak Agrawal, Guru D Satyarthee, Poodipedi S Chandra, Shashank S Kale, Ashok K Mahapatra
BACKGROUND: Atlantoaxial spondyloptosis (AAS), which is defined as complete displacement of facets of atlas anterior to the facets of axis such that there is no contact between the 2 articulating surfaces, is an extremely rare manifestation of atlantoaxial instability. The reason for an extreme rarity of traumatic AAS is probably the severity of injury in traumatic AAS that is usually incompatible to life. It represents the most severe form of atlantoaxial dislocation, and complete reduction in such a case presents a real technical challenge because of the interlocking of C1-C2 facets...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433180/atlantoaxial-fixation-for-odontoid-fracture-analysis-of-124-surgically-treated-cases
#3
Atul Goel, Sonal Jain, Abhidha Shah, Abhinandan Patil, Ravikiran Vutha, Shashi Ranjan, Sandeep More
OBJECTIVE: The authors analyze 124 cases with fracture of odontoid process. All patients were surgically treated by posterior atlantoaxial fixation. METHODS: There were 96 male and 28 female patients. The ages of the patients ranged from 12 to 80 years. Apart from Anderson and D'Alonzo type I (6 cases), type II (93 cases) and type III (25 cases), three sub-types of odontoid fractures were included in the classification. In type A (118 cases), there was vertical compression fracture that resulted in malalignment of the fractured odontoid process segments...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433178/radiological-evaluation-of-510-cases-of-basilar-invagination-with-evidence-of-atlantoaxial-instability-group-a-basilar-invagination
#4
Atul Goel, Sonal Jain, Abhidha Shah
OBJECTIVE: To evaluate the musculoskeletal and soft tissue neural alterations in cases with group A basilar invagination. METHODS: Between January 2007 and August 2016, 510 patients with group A basilar invagination were surgically treated. The radiologic images of these patients were reviewed retrospectively. The patients were divided into 4 groups: group A1, comprising 60 patients with syringomyelia; group A2, comprising 354 patients with "external syrinx," marked by excessive cerebrospinal fluid (CSF) in the extramedullary space; group A3, comprising 51 patients with both syringomyelia and external syrinx; and group A4, comprising 45 patients with no abnormality of CSF cavitation in the spinal canal...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433177/trabecular-anatomy-of-the-axis-vertebra-a-study-of-shaded-volume-rendered-computed-tomography-images
#5
K Venugopal Menon, Sameer B Raniga
BACKGROUND: To date, trabecular morphology studies have been conducted on thin-section computed tomography (CT) scans of cadaveric bone. Here we describe the trabecular anatomy of the axis vertebra as revealed by an innovative imaging tool. METHODS: Ten patients who underwent thin-slice CT scans for suspected cervical spine injury were prospectively subjected to shaded volume-rendered 3-dimensional reconstruction of the images. The trabecular anatomy thus depicted was recreated, and the mechanical vectors were deduced independently by a senior radiologist and spine surgeon and then matched...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29427561/cerebellar-herniation-demonstrated-by-the-occipitum-dens-line-ultrasonography-assessment-of-normal-fetuses-fetuses-with-myelomeningocele-and-fetuses-that-underwent-antenatal-myelomeningocele-surgery
#6
Enoch Quinderé de Sá Barreto, Sérgio Cavalheiro, Herbene José Figuinha Milani, Maurício Mendes Barbosa, Edward Araujo Júnior, Luciano Marcondes Machado Nardozza, Antonio Fernandes Moron
OBJECTIVE: To establish a method to quantify the position of the cerebellum by ultrasonography in normal fetuses, fetuses with myelomeningocele (MMC), and fetuses that underwent in utero MMC repair. METHODS: Reference points identifiable on ultrasound were established. The basilar portion of the occipital bone and upper portion of the odontoid process were considered as the external and internal limits, respectively, of the level zero of a line that was designated the occipitum-dens line (ODL)...
February 10, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29427010/feasibility-of-anterior-screw-fixation-in-children-a-tomographic-study
#7
Lívia Gaspar Fernandes, Alexandre Fogaça Cristante, Raphael Martus Marcon, Tarcísio Eloy Pessoa de Barros Filho, Olavo Biraghi Letaif
PURPOSE: Morphology measures of the odontoid process in children under 12 years old were carried out to demonstrate the viability of anterior internal fixation in this population once their active profile may not be compatible with successful conservative treatment. METHODS: During a 6-month period, 36 tomographic examinations of the cervical spine region that provided visualization of the odontoid process were selected. Group 1 included children between 6 and 9 years of age, and group 2 contained children from 9 to 12 years of age...
February 9, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29390372/dynamic-paraspinal-muscle-impingement-causing-acute-hemiplegia-after-c1-posterior-arch-laminectomy-a-case-report
#8
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Shozo Kanezaki, Hiroshi Tsumura
RATIONALE: Acute neurological deficits following spinal surgery commonly result from epidural hematoma, surgical trauma, vascular compromise, and graft or hardware impingement, with the cause identified by magnetic resonance imaging (MRI). We present a rare case of dynamic paraspinal muscle impingement after C1 posterior arch laminectomy, which was diagnosed by myelography, with no significant findings on MRI. PATIENT CONCERNS: An 81-year-old, severely obese male, was referred to our department for the treatment of vertebral disease of the lumbar spine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381917/changes-of-cervical-sagittal-alignments-during-motions-in-patients-with-cervical-kyphosis
#9
Lingjie Zhou, Jin Fan, Lin Cheng, Tao Jiang, Bo Yun, Guolong Tang, Jian Yin, Jiahu Fang, Guoyong Yin
Changes of cervical sagittal alignment during motion in cervical kyphosis patients have never been published before. This study was to investigate the changes and provide a better reference for orthopedic treatment.Randomized double-blind repeat trial was carried out on 60 patients with cervical kyphosis. On standard position, hyper flexion, and hyper extension sagittal radiographs, the following measurements were made: the C2-7 vertebral body spatial alignment angle (∠A), C2-7 vertebral lower terminal lamina tilt angle (∠B), C2/3 to C6/7 segmental intervertebral space angle (∠C), the distance from the posterior edge of odontoid to C7 vertebral body (D value), and the difference of angle A, B, and C between cervical flexion and extension movement...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29380146/pseudomalignant-osteoblastoma-of-the-odontoid-process
#10
REVIEW
Pedro Fernandes, Joaquim Soares do Brito, Adília Costa, Jacinto Monteiro
INTRODUCTION: The anterior elements of the spine, particularly the odontoid processes, are a rare location for osteoblastomas. Pseudomalignant osteoblastomas are themselves rare histologic types and are also extremely rare in this location. Most osteoblastomas are Enneking stage 2 lesions; less frequently, they can be more aggressive with extra-capsular extension (Enneking stage 3). En bloc resection is recommended for aggressive lesions, but the literature is less clear regarding the approach to stage 2 tumors, particularly those with pseudomalignant histologic features...
January 29, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29376740/evaluation-of-spinal-involvement-in-children-with-mucopolysaccharidosis-vi-the-role-of-mri
#11
Elif Bulut, Emine Pektas, Hatice S Sivri, Burcak Bilginer, Mumtaz M Umaroglu, Burce Ozgen
PURPOSE: To evaluate spinal MRI features of mucopolysaccharidosis (MPS) VI and to assess the correlation with clinical findings. METHODS: We retrospectively evaluated spinal MRI scans and clinical findings at the time of imaging in 14 patients (8 male, 6 female) with MPS VI. Craniometric measurements were performed and the images were assessed for bony anomalies, spinal stenosis and spinal cord compression. The degree of cervical cord compression was scored and correlated with neurological examination findings at the time of imaging...
January 29, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#12
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29338280/variable-skeletal-anatomical-features-of-acromegaly-in-the-skull-and-craniocervical-junction
#13
Maria Piagkou, Othon Manolakos, Theodore Troupis, Nikolaos Lazaridis, Konstantinos Laios, Alexandros Samolis, Konstantinos Natsis
OBJECTIVE: This study adds important information regarding the morphological alterations caused by growth hormone hypersecretion in the skull and craniocervical junction (CCJ). A variably asymmetric skull due to acromegaly coexists with expansion of the paranasal sinuses and multiple Wormian bones. CASE REPORT: A pathologically asymmetric dry skull of a European male, aged 38 years at death, with cranial vault and skull base thickening is described. The extensive paranasal sinus pneumatization caused a generalized thinning of the bony walls...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29310670/the-comparison-of-clinical-outcome-of-fresh-type-ii-odontoid-fracture-treatment-between-anterior-cannulated-screws-fixation-and-posterior-instrumentation-of-c1-2-without-fusion-a-retrospective-cohort-study
#14
Suomao Yuan, Bin Wei, Yonghao Tian, Jun Yan, Wanlong Xu, Lianlei Wang, Xinyu Liu
BACKGROUND: Recently, the excellent outcomes of temporary fixation of C1-2 without fusion in the treatment of odontoid fracture had been reported. It is still unclear if this technique could achieve the equivalent outcomes as the golden standard technique of anterior screw fixation. The objective of this study is to compare the clinical outcome of two treatments of fresh type II odontoid fracture: anterior cannulated screws fixation (ACSF) versus posterior instrumentation of C1-2 without fusion (PIWF)...
January 8, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29303466/delayed-neurological-deterioration-following-atlantoaxial-facet-joint-distraction-and-fixation-in-a-patient-with-chiari-malformation-type-i
#15
Tatsushi Inoue, Natsuki Hattori, Tsukasa Ganaha, Tadashi Kumai, Shinichiro Tateyama, Yuichi Hirose
Chiari malformation type I (CM-I) is typically treated with foramen magnum decompression. However, a recent study proposed a new technique for patients with CM-I, wherein only short atlantoaxial joint fusion and distraction is applied. Posterior fusion with or without atlantoaxial distraction is a potential option for patients with CM-I associated with basilar invagination or complex anomalous bony craniovertebral junction pathology, since this procedure allows clinicians to avoid using the technically demanding transoral approach in which some or all of the odontoid tip is invisible...
January 5, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29284890/a-safe-regional-technique-in-a-high-risk-patient-cervical-plexus-blockage
#16
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Regional anesthesia in the form of combined cervical plexus block is gaining popularity as a technique of choice for cervical spine surgeries, especially for urgent ones. An important advantage is that it allows continuous monitoring of patient's neurological status. The success of the block often depends on accurate placement of the local anesthetic. Landmarks for the block are therefore of great importance. In this case, we aimed to present a 74-year-old man with C4-5 odontoid fracture. We planned to perform a unilateral combined cervical plexus block for anterior cervical instrumentation and fusion (ACIF) operation because of his associated high-risk comorbid disorders...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29247396/the-mechanism-in-junctional-failure-of-thoraco-lumbar-fusions-part-ii-analysis-of-a-series-of-pjk-after-thoraco-lumbar-fusion-to-determine-parameters-allowing-to-predict-the-risk-of-junctional-breakdown
#17
Antonio A Faundez, Jonathon Richards, Philippe Maxy, Rachel Price, Amélie Léglise, Jean-Charles Le Huec
PURPOSE: To identify risk factors, in 12 patients with junctional breakdown (JBD) after thoraco-sacral fusions and to test a software locating maximal bending moment on full spine EOS images. METHODS: Twelve patients underwent long fusions for lumbar degenerative pathologies. Preop EOS images were compared to first postop EOS showing JBD. Parameters analyzed were: spinopelvic parameters [pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA), spinosacral angle (SSA), lordosis, and kyphosis], proximal junctional angle (PJA), odontoid-hip axis angle (ODHA), and CIA...
December 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29243997/transdural-approach-to-resection-of-retro-odontoid-cysts-in-elderly-patients-report-of-3-cases
#18
Karthik Madhavan, Lee Onn Chieng, Brandon G Gaynor, Allan D Levi
Retro-odontoid cysts that arise from the tectorial membrane are uncommon lesions that can occur in elderly patients. They arise secondary to degenerative changes, including calcium pyrophosphate deposition within the ligaments. Surgical treatment is indicated when these lesions result in intractable pain, instability, and/or myelopathy. Several surgical techniques to treat this condition exist, but the optimal approach in elderly patients with comorbidities remains controversial. Here, the authors present a case series of 3 patients who underwent successful resection of a retro-odontoid lesion performed through a transdural approach...
December 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29242977/the-mechanism-in-junctional-failure-of-thoraco-lumbar-fusions-part-i-biomechanical-analysis-of-mechanisms-responsible-of-vertebral-overstress-and-description-of-the-cervical-inclination-angle-cia
#19
Jean-Charles Le Huec, Jonathon Richards, Andreas Tsoupras, Rachel Price, Amélie Léglise, Antonio A Faundez
PURPOSE: The purpose of the study is to describe the biomechanical theory explaining junctional breakdowns in thoraco-lumbar fusions, by taking the example of vertebral compression fractures. Also, a new angle, the cervical inclination angle (CIA), describing the relative position of the head at each vertebral level, is presented. METHODS: For the CIA, the data were collected from 137 asymptomatic subjects of a prospective database, containing clinical and radiologic informations...
December 14, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29235091/upward-displacement-of-the-odontoid-process-into-the-foramen-magnum-a-paleopathological-case
#20
Paola Saccheri, Enrico Crivellato, Francesco Toso, Luciana Travan
An upward displacement of the odontoid process into the foramen magnum was observed in the skeletal remains of a young male unearthed from a 14th-17th century cemetery in the north-eastern Italy. Examination of skull bone vestiges and CT-SCAN analysis of the axis exhibited a clear-cut contact zone between the odontoid process and the anterior border of the foramen magnum. In addition, the odontoid process appeared backward deviated. Findings suggest a possible diagnosis of basilar impression/invagination. This anomalous contact may cause compression of neural and vascular structures with a multifaceted series of clinical symptoms...
December 13, 2017: Folia Morphologica (Warsz)
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