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Kristen S Pan, John D Heiss, Sydney M Brown, Michael T Collins, Alison M Boyce
Fibrous dysplasia (FD) is a mosaic disorder of benign fibro-osseous lesions, which may be associated with extraskeletal features as part of McCune-Albright syndrome (MAS). Cranial base abnormalities, including Chiari I malformation (CM1), in which the cerebellum extends below the foramen magnum, and secondary basilar invagination (BI), in which the odontoid prolapses into the posterior cranial fossa, are potentially serious complications of metabolic bone disorders. The purpose of this study was to determine the prevalence, natural history, and risk factors for CM1 and BI in patients with FD/MAS, and to determine mechanisms of cranial base deformities...
June 20, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Zhigang Li, Xiaoqiang Han, Cheng Ji, Xinfeng Han
Cervical spinal injuries of children in motor vehicle crashes have high morbidity and mortality rates. Cervical vertebrae change rapidly in both size and shape during growth. To accurately assess the risk of spinal injury for children of different ages, it is necessary to understand how the spatial geometric features of vertebrae change with the child's age and neck size. In this study, an innovative semi-automated method was developed that can extract and align geometric points from computed tomography scans to accurately represent complex three-dimensional vertebral geometry...
June 19, 2018: Annals of Biomedical Engineering
J A Suby, P Novellino, G Da Peña, C D Pandiani
The odontoid process of the axis can be affected by congenital or acquired pathologies. While abnormalities such as os odontoideum, agenesis, and fractures are reported in archaeological remains, the abnormality of an elongated length of the odontoid process has not been described in the paleopathological literature. The aim of this paper is to evaluate two individuals with elongated odontoid processes from a skeletal assemblage from the B6 archaeological site (Mendoza, Argentina), and to discuss the possible etiologies of the condition, with particular attention given to the relation to trauma and Crowned Dens Syndrome (CDS), a condition characterized by the ossification of ligaments of the odontoid process of the second cervical vertebra...
June 12, 2018: International Journal of Paleopathology
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: To assess mid-term safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. DESIGN: Longitudinal prospective cohort study. SETTING: Urban Level 1 Trauma Center in Southwest Germany. PATIENTS/PARTICIPANTS: Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤ 24 hours. MAIN OUTCOME MEASUREMENTS: The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications...
June 4, 2018: Journal of Orthopaedic Trauma
Ali Harati, Rolf Schultheiß
Background: There are several techniques for treating atlantoaxial instability, including the Magerl transarticular screw fixation and the Harms/Goel C1-C2 screw rod techniques. Here, we present a novel technique utilizing a polyaxial screw rod system and a combination of C1 lateral mass and C1-C2 transarticular screws. Methods: We retrospectively reviewed 14 patients (7 women, 7 men; mean age 62) who underwent surgery for type II odontoid fractures ( n = 7), pseudarthrosis after anterior odontoid screw placement ( n = 3), Os odontoideum ( n = 2), atlantoaxial instability after C3-C5 fusion ( n = 1), and craniovertebral rheumatoid arthritis ( n = 1)...
2018: Surgical Neurology International
Deep P Sarode, Andreas K Demetriades
BACKGROUND: Odontoid process fractures, of which type II constitute the majority, are an increasingly important cause of morbidity and mortality in the elderly population. The incidence of geriatric type II fractures is steadily increasing in line with the ageing population. However, the decision between surgical and non-surgical intervention for type II fractures in the elderly remains controversial. PURPOSE: To synthesise the current published literature comparing outcomes following surgical and non-surgical interventions for type II odontoid fractures in the elderly population (≥65 years old)...
June 7, 2018: Spine Journal: Official Journal of the North American Spine Society
Joshua P Herzog, Nicholas J Zarkadis, Gautham Prabhakar, Nicholas A Kusnezov
Background: Compare the biomechanical stability of a novel "U" posterior cervical fixation construct to four other posterior cervical atlantoaxial fixation constructs. Methods: Eight fresh frozen human cadaver spines were tested after a simulated odontoid fracture, and following stabilization with each construct. Results: All constructs significantly decreased flexion-extension and axial rotation compared to the destabilized spine...
June 2018: Journal of Orthopaedics
Yasuhiko Hayashi, Masahiro Oishi, Yasuo Sasagawa, Daisuke Kita, Kazuto Kozaka, Mitsutoshi Nakada
INTRODUCTION: Chiari malformation type I (CM-I) is a well-known hindbrain disorder in which the cerebellar tonsils protrude through the foramen magnum. The soft tissues, including the transverse ligament and the tectorial membrane at the retro-odontoid space, can compress the cervicomedullary junction if they become hypertrophic. METHODS: Twenty-two symptomatic CM-I patients (aged 5 to 19 years) were treated between 2007 and 2017 at our institute. The retro-odontoid soft tissue was evaluated using T2-weighted magnetic resonance imaging...
June 2, 2018: World Neurosurgery
Aymeric Faure, Solène Prost, Nacer Mansouri, Kaissar Farah, Benjamin Blondel, Stéphane Fuentes
CONTEXT: In the elderly population over 70 years-old, odontoid fracture is the most common lesion of the cervical spine. Management of these fractures is becoming nowadays a public health issue. OBJECTIVES: Evaluate bone fusion, early complications, and mortality in patients over 75 years-old surgically managed for an odontoid fracture using the Harms' technique. METHODS: Retrospective analysis of 57 patients treated surgically between 2002 and 2016 in a single spine surgery institution...
June 1, 2018: World Neurosurgery
José J C Nascimento, Nayyara M F Carreiro, Gabriela T Oliveira, Elayne C O Ribeiro, Maurus M A Holanda, Eulâmpio J S Neto, Severino A Araújo-Neto
BACKGROUND: Basilar invagination (BI) is an abnormality characterized by a superior projection at the craniovertebral junction (CVJ). The high prevalence of BI in Northeastern Brazil associated with brachycephaly, which is measured by the cranial index (CI), has been widely reported by several neurosurgeons and radiologists from that region since the 1950s. However, strong evidence for this relationship is still pending. The aim of this study is to investigate whether there is a relationship between BI and CI in a sample with participants from Northeastern Brazil...
July 2018: European Journal of Radiology
Wei Zhang, Haiyang Yu, Chengmin Liang, Wei Jiao, Jie Cao, Chao Li
Objective: To discuss the clinical characteristics, mechanism, and treatment of odontoid fracture combined with lower cervical spinal cord injuries without fracture or dislocation. Methods: According to the inclusion and exclusion criteria, 7 male patients aged 37-71 years (mean, 51.4 years), suffered from odontoid fractures combined with lower cervical spinal cord injuries without fracture or dislocation were analyzed retrospectively between June 2007 and October 2015...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
X M Tang, C Liu, K Huang, G T Zhu, H L Sun, J Dai, J W Tian
Objective: To explored the clinical application of the three-dimensional finite element model of atlantoaxial complex fracture. Methods: A three-dimensional finite element model of cervical spine (FEM/intact) was established by software of Abaqus6.12.On the basis of this model, a three-dimensional finite element model of four types of atlantoaxial complex fracture was established: C(1) fracture (Jefferson)+ C(2) fracture (type Ⅱfracture), Jefferson+ C(2) fracture(type Ⅲfracture), Jefferson+ C(2) fracture(Hangman), Jefferson+ stable C(2) fracture (FEM/fracture)...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Wei Ji, Xiaolin Xu, Zenghui Wu, Xiang Liu, Ganggang Kong, Zucheng Huang, Jianting Chen
STUDY DESIGN: A retrospective analysis of collected data. OBJECTIVE: Our study aims to present the morphology of cranial-cervical spinal canal in basilar invagination (BI) patients. SUMMARY OF BACKGROUND DATA: BI is characterized by protrusion of the odontoid process into the foramen magnum (C0), leading to compression of the cervicomedullary junction. However, no study has ever clarified the anatomical diameters of spinal canal in patients with BI...
April 22, 2018: Spine
Petr Rehousek, Edward Jenner, James Holton, Marcin Czyz, Lukas Capek, Petr Henys, Marketa Kulvajtova, Martin Krbec, Jiri Skala-Rosenbaum
Background Context Odontoid process fractures are the most common injuries of the cervical spine in the elderly. Anterior screw stabilisation of type 2 odontoid process fractures improves survival and function in these patients but may be complicated by failure of fixation. Purpose To determine whether cement augmentation of a standard anterior screw provides biomechanically superior fixation of type II odontoid fractures in comparison to a non-cemented standard screw. Study design Twenty human cadaveric C2 vertebrae from elderly donors (mean age 83 years) were obtained...
May 18, 2018: Spine Journal: Official Journal of the North American Spine Society
Hira Peracha, Kazuki Sawamoto, Lauren Averill, Heidi Kecskemethy, Mary Theroux, Mihir Thacker, Kyoko Nagao, Christian Pizarro, William Mackenzie, Hironori Kobayashi, Seiji Yamaguchi, Yasuyuki Suzuki, Kenji Orii, Tadao Orii, Toshiyuki Fukao, Shunji Tomatsu
Mucopolysaccharidosis IVA (MPS IVA, Morquio A syndrome) is an autosomal recessive disorder caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase. Deficiency of this enzyme leads to the accumulation of specific glycosaminoglycans (GAGs), chondroitin-6-sulfate (C6S) and keratan sulfate (KS), which are mainly synthesized in the cartilage. Therefore, the substrates are stored primarily in the cartilage and its extracellular matrix (ECM), leading to a direct impact on bone development and successive systemic skeletal spondylepiphyseal dysplasia...
May 15, 2018: Molecular Genetics and Metabolism
Aaron Wold, Jonelle Petscavage-Thomas, Eric A Walker
OBJECTIVE: The objective was to determine if there is a significant difference between rates of non-union of type II and III odontoid fractures in patients with calcium pyrophosphate dihydrate deposition (CPPD) compared with a control population. MATERIALS AND METHODS: A 10-year retrospective picture archive and communications system review was performed of 31 CPPD patients and 31 control patients. Imaging studies were reviewed for radiographic or CT evidence of osseous union and complications...
May 19, 2018: Skeletal Radiology
Jinhao Miao, Yu Chen, Bangke Zhang, Tiefeng Li, Yibing Luo, Lei Shi, Jiangang Shi, Deyu Chen
No abstract text is available yet for this article.
May 16, 2018: World Neurosurgery
Malte Ottenhausen, Andrew F Alalade, Kavelin Rumalla, Prakash Nair, Ali Baaj, Roger Hartl, Ashutosh Kacker, Jeffrey P Greenfield, Vijay K Anand, Theodore H Schwartz
INTRODUCTION: Basilar invagination can result from a variety of systemic diseases that can weaken the structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression along with posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure, however, quality of life after this procedure has not been reported. METHODS: We reviewed a consecutive database of endonasal odontoidectomy patients and identified those having posterior decompression and fusion...
May 15, 2018: World Neurosurgery
Chinmaya Dash, Raghav Singla, Mohit Agarwal, Ambuj Kumar, Hitesh Kumar, Shashwat Mishra, Bhawani S Sharma
Background: The available literature on the anatomy and imaging of the craniovertebral junction (CVJ) focusses on the osteometric indices described for the detection of abnormal relationships between the components of CVJ. However, a knowledge of the normal osteometry of this region in the Indian population is critically important for the operating surgeon as it may influence the surgical technique as well as the choice, size and configurations of the implants. It is also important to determine whether critical differences exist between the osteometric data of Indians and the rest of the world for this part of the anatomy...
May 2018: Neurology India
Thomas E Niemeier, Adam R Dyas, Sakthivel R Manoharan, Steven M Theiss
Study Design: Retrospective cohort study. Objective: Type III odontoid fractures are classically treated nonoperatively, yet, the current literature on Type III odontoid fractures includes fractures of multiple etiologies and fracture morphologies. We hypothesize that a subgroup of complex, Type III fractures caused by high-energy mechanisms are more likely to fail nonoperative treatment. Materials and Methods: Acute Type III odontoid fractures were identified at a single institution from 2008 to 2015...
January 2018: Journal of Craniovertebral Junction and Spine
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