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https://www.readbyqxmd.com/read/29777885/posttraumatic-cerebrospinal-fluid-leak-associated-with-an-upper-cervical-meningeal-diverticulum
#1
Noriya Enomoto, Hideo Mure, Toshiyuki Okazaki, Mai Azumi, Shinya Okita, Shinji Nagahiro, Yasushi Takagi
Spontaneous intracranial hypotension (SIH) has been increasingly recognized as a phenomenon caused by cerebrospinal fluid (CSF) leaks; however, its pathogenesis is still unclear. Here, we report two cases of SIH as a result of CSF leak from a meningeal diverticulum at the C2 nerve root sleeve. The first case is that of a 46-year-old man who had suffered from orthostatic headache after a bicycle accident at age 45. Computed tomography (CT) myelography revealed CSF leaks at the C1/2 level. He underwent epidural blood patch (EBP) therapy, but it was unsuccessful...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29706420/spontaneous-resolution-of-a-non-traumatic-vertebro-vertebral-arteriovenous-fistula-in-a-paediatric-patient
#2
Paul Mitchell, Piers Thomas, David Anderson
We report the case of a 10 year old male who presented with right sided tinnitus and a pulsatile neck mass. MRI of the neck demonstrated a vertebro-vertebral arteriovenous fistula (VAVF), with supply from the right vertebral artery and drainage into a paraspinal venous plexus at C1/2. Endovascular treatment would have necessitated vertebral artery sacrifice with significant risk of complication, therefore a conservative approach was adopted; the patient was lost to follow up but presented 5 years later with complete resolution...
April 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29701850/safeguarding-the-anomalous-vertebral-artery-while-dissecting-drilling-and-instrumentation-of-c1-2-joint-for-congenital-atlantoaxial-dislocation-2-dimensional-operative-video
#3
Pravin Salunke, Sushanta K Sahoo
The pathology in congenital atlantoaxial instability is usually in C1-2 joints. Addressing the joints appears to be the most rationale approach. The joints are usually approached posteriorly, manipulated, and fused. Understanding the normal and abnormal anatomy is important. Normally, the third segment of the vertebral artery courses lateral to the C1-2 joint. However, in about 20% of the cases with complex congenital craniovertberal junction anomalies the artery crosses the joint posteriorly. The artery in such cases may be injured while joint manipulation and instrumentation with disastrous consequences...
April 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29649666/a-retrospective-study-does-cigarette-smoking-induce-cervical-disc-degeneration
#4
Zhaoxiong Chen, Xinhua Li, Fumin Pan, Desheng Wu, Haoxi Li
OBJECTIVE: To investigate cigarette smoking's relevance with cervical disc degeneration. METHODS: We randomly selected 320 patients who came to our spine disease department outpatient clinic with chief complaint of neck-shoulder pain during June 2014-June 2016. According to the detailed smoking history, these patients were divided into 3 different groups, which were active smoker group (AS), passive smoking group (PS) and never-smoker group (NS). Each patient's Miyazaki's magnetic resonance imaging (MRI) classification of cervical disc degeneration was analyzed based on their cervical MRI films...
April 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29595654/traumatic-c1-2-rotatory-subluxation-with-dens-and-bilateral-articular-facet-fractures-of-c2-a-case-report
#5
Dong-Gune Chang, Jong-Beom Park, Hyuk-Jin Jang
RATIONALE: To the best of our knowledge, this is an extremely rare case of traumatic C1-2 rotatory subluxation associated with multiple C2 fractures. PATIENT CONCERNS: We report the case of a 63-year-old man with type 2 traumatic C1-2 rotatory subluxation (Fielding and Hawkins classification) associated with type III dens (Anderson and D'Alonzo classification) and bilateral articular facet fractures of C2. This injury occurred as a result of falling down in a drunken state...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29548021/the-utility-of-trough-mycophenolic-acid-levels-for-the-management-of-lupus-nephritis
#6
Negiin Pourafshar, Ashkan Karimi, Xuerong Wen, Eric Sobel, Shirin Pourafshar, Nikhil Agrawal, Emma Segal, Rajesh Mohandas, Mark S Segal
Background: Monitoring of mycophenolic acid (MPA) levels may be useful for effective mycophenolate mofetil (MMF) dosing. However, whether commonly obtained trough levels are an acceptable method of surveillance remains debatable. We hypothesized that trough levels of MPA would be a poor predictor of area under the curve (AUC) for MPA. Methods: A total of 51 patients with lupus nephritis who were on MMF 1500 mg twice a day and had a 4-h AUC done were included in this study...
March 13, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29538245/mortality-rates-following-posterior-c1-2-fusion-for-displaced-type-ii-odontoid-fractures-in-octogenarians
#7
Stephen Clark, Alysa Nash, Mark Shasti, Luke Brown, Julio J Jauregui, Katherine Mistretta, Eugene Koh, Kelley Banagan, Steven Ludwig, Daniel Gelb
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To assess 30-day and one-year mortality rates as well as the most common complications associated with posterior C1-2 fusion in an octogenarian cohort. SUMMARY OF BACKGROUND DATA: Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1-2 fusion results in improved survival as compared to other modes of treatment...
March 13, 2018: Spine
https://www.readbyqxmd.com/read/29529304/diffusion-tensor-imaging-in-a-large-longitudinal-series-of-patients-with-cervical-spondylotic-myelopathy-correlated-with-long-term-functional-outcome
#8
Avinash Rao, Hesham Soliman, Mayank Kaushal, Oleysa Motovylak, Aditya Vedantam, Matthew D Budde, Brian Schmit, Marjorie Wang, Shekar N Kurpad
BACKGROUND: Fractional anisotropy (FA) of the high cervical cord correlates with upper limb function in acute cervical cord injury. We investigated the correlation between preoperative FA at the level of maximal compression and functional recovery in a group of patients after decompressive surgery for cervical spondylotic myelopathy (CSM). OBJECTIVE: To determine the usefulness of FA as a biomarker for severity of CSM and as a prognostic biomarker for improvement after surgery...
February 23, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29526062/c2-segmental-type-vertebral-artery-diagnosed-using-computed-tomographic-angiography
#9
Myoung Soo Kim
OBJECTIVE: Sometimes a vertebral artery (VA) enters the spinal canal via the C1-2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance. METHODS: Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29526061/cold-allodynia-after-c2-root-resection-in-sprague-dawley-rats
#10
Daeyeong Chung, Dae-Chul Cho, Seong-Hyun Park, Kyoung-Tae Kim, Joo-Kyung Sung, Younghoon Jeon
OBJECTIVE: The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats. METHODS: Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); näive, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using 20 μL of 99.7% acetone. c-Fos and c-Jun were immunohistochemically stained to evaluate activation of dorsal horn gray matter in C2 segments of the spinal cord 2 hours, 1 day, 7 days, and 14 days after surgery...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29505977/external-fixation-and-surgical-fusion-for-pediatric-cervical-spine-injuries-short-term-outcomes
#11
Taylor E Purvis, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, C Rory Goodwin, Mari L Groves, Michael C Ain, Daniel M Sciubba
OBJECTIVE: To compare in-hospital complication rates in pediatric patients with atlantoaxial and subaxial injuries undergoing either external fixation or surgical fusion. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2002-2011 Nationwide Inpatient Sample (NIS) for patients under the age of 18 with a diagnosis of cervical spine fracture without spinal cord injury or cervical spine subluxation. Patients who underwent external immobilization or internal fixation were included for analysis...
May 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29462065/biomechanical-comparison-of-four-different-atlantoaxial-posterior-fixation-constructs-in-adults-a-finite-element-study
#12
Dong Hyun Chun, Do Heum Yoon, Keung Nyun Kim, Seong Yi, Dong Ah Shin, Yoon Ha
STUDY DESIGN: Finite element analysis. OBJECTIVE: To compare the biomechanical stability imparted to the C1 and C2 vertebrae by the transarticular(TA), C1 lateral mass(LM)-C2 pedicle(PS), C1LM-C2 pars, and C1LM-C2 translaminar screw(TL) fixation techniques. SUMMARY OF BACKGROUND DATA: Cadaveric biomechanical studies of several atlantoaxial posterior fixation techniques have been performed, showing significant heterogeneity in biomechanical properties among the studies...
February 16, 2018: Spine
https://www.readbyqxmd.com/read/29451436/novel-posterior-artificial-atlanto-odontoid-joint-for-atlantoaxial-instability-a-biomechanical-study
#13
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...
May 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29433185/c1-2-and-c2-3-instability-in-the-presence-of-hypoplastic-posterior-elements-of-c2-vertebra-report-of-2-cases
#14
Atul Goel, Apurva Prasad, Abhidha Shah, Sandeep More
BACKGROUND: We present 2 cases involving a previously unreported clinical situation in which basilar invagination, atlantoaxial instability, and C2-3 instability were associated with a bifid posterior arch of the axis bone. CASE DESCRIPTIONS: Two young males presented with limb weakness, spasticity, and paresthesias. Both patients had altered voice quality, with reduced and thin volume, and difficulty sleeping supine. Radiologic imaging showed an absence of the posterior elements of the C2 vertebrae...
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
#15
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/29424671/reproducibility-temporal-stability-and-functional-correlation-of-diffusion-mr-measurements-within-the-spinal-cord-in-patients-with-asymptomatic-cervical-stenosis-or-cervical-myelopathy
#16
Benjamin M Ellingson, Noriko Salamon, Davis C Woodworth, Hajime Yokota, Langston T Holly
OBJECTIVE The purpose of this study was to quantify the reproducibility, temporal stability, and functional correlation of diffusion MR characteristics in the spinal cord in patients with cervical stenosis with or without myelopathy. The association between longitudinal diffusion tensor imaging (DTI) measurements and serial neurological function assessment was explored at both the group and individual level. METHODS Sixty-six nonoperatively treated patients with cervical stenosis were prospectively followed (3 months to > 5 years) using synchronous serial MRI and functional outcome assessment...
May 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29403249/-soft-that-molds-the-hard-geometric-morphometry-of-lateral-atlantoaxial-joints-focusing-on-the-role-of-cartilage-in-changing-the-contour-of-bony-articular-surfaces
#17
Prashant Kumar Prasad, Pravin Salunke, Daisy Sahni, Parveen Kalra
Purpose: The existing literature on lateral atlantoaxial joints is predominantly on bony facets and is unable to explain various C1-2 motions observed. Geometric morphometry of facets would help us in understanding the role of cartilages in C1-2 biomechanics/kinematics. Objective: Anthropometric measurements (bone and cartilage) of the atlantoaxial joint and to assess the role of cartilages in joint biomechanics. Materials and Methods: The authors studied 10 cadaveric atlantoaxial lateral joints with the articular cartilage in situ and after removing it, using three-dimensional laser scanner...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29403245/machined-cervical-interfacet-allograft-spacers-for-the-management-of-atlantoaxial-instability
#18
Mazda K Turel, Mena G Kerolus, Vincent C Traynelis
Background: The use of cervical interfacet spacers (CISs) to augment stability and provide solid arthrodesis at the atlantoaxial joint has not been studied in detail. The aim of this work is to report the outcomes with the use of machined allograft CISs at C1-2. Methods: A retrospective review of 19 patients who underwent an atlantoaxial fusion with the use of CISs was performed. All patients had instability documented with flexion and extension lateral radiographs...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29402565/advantages-of-an-on-the-screwhead-crosslink-connector-for-atlantoaxial-fixation-using-the-goel-harms-technique
#19
Jun Mizutani, Atsushi Inada, Kenji Kato, Akira Kondo, Shingo Kainuma, Kazuhiko Fujita, Kiyoshi Yagi, Yasuteru Shimamura, Muneyoshi Fukuoka, Yuta Shibamoto, Ikuo Wada, Takanobu Otsuka
The goal of fixation surgery for atlantoaxial instability is to achieve solid bony fusion. Achieving bony fusion as early as possible is beneficial for patients. Although placement of a transverse cross-link connector (XL) provides greater biomechanical strength, XLs have not been able to be placed when performing the Goel/Harms procedure. Recently, placing a XL on the screw head (on-the-head XL [OH-XL]) has become a viable option during the Goel/Harms procedure. However, there is little evidence demonstrating whether applying an OH-XL achieves early solid bony union...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29381638/unilateral-isolated-hypoglossal-nerve-palsy-caused-by-gunshot-injury
#20
Bulent Ozdemir, Ayhan Kanat, Sule Batcik, Osman Ersagun Batcik, Metin Celiker, Kamil Kayayurt
Cranial nerve palsies after gunshot injury are not uncommon. However, in the literature, only 1 patient with isolated hypoglossal nerve paralysis caused by gunshot has been published. The authors describe a 34-year-old man suffering from unilateral isolated hypoglossal nerve palsy caused by gunshot injury as a second reported patient. The bullet entered maxillary sinus, and caused condylar fracture, then ended up C1-2 interspace. The bullet was surgically removed by a posterior approach. It is important to pay attention to hypoglossal nerve injury when confronted with a gunshot wound...
March 2018: Journal of Craniofacial Surgery
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