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Craniocervical instability

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https://www.readbyqxmd.com/read/28983222/transoral-approach-for-odontoidectomy-efficacy-and-safety
#1
Ahmed Mohamed Elbadrawi, Tameem Mohamed Elkhateeb
BACKGROUND: Odontoid process pathologies can cause upper motor neuron lesions. These pathologies can be approached through either a high retropharyngeal approach or a transoral approach. The introduction of the surgical microscope, proper instrumentations, and proper antibiotics has increased utilization of the transoral approach. QUESTIONS/PURPOSES: Our approach to anterior odontoid resection through transoral approach for different pathologies resulting in compression the cervical cord or causing craniocervical instability is described here...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28902102/post-traumatic-spinal-hygroma-causing-cord-compression-in-type-iii-odontoid-fracture-with-vertical-atlantoaxial-instability
#2
Salvatore Russo, Antonio Belli, Andy Eynon, Ali Nader-Sepahi
STUDY DESIGN: Case report. OBJECTIVE: To report the first case in the literature of a traumatic cervical spine subdural cerebrospinal fluid (CSF) collection (hygroma) under tension causing cord compression. We suggest etiopathogenesis and modality of treatment. SUMMARY OF BACKGROUND DATA: Hygromas are subdural cranial CSF collection. A literature review showed no previous published case of post-traumatic spinal hygroma. This was a potential life-threatening sequelae of a high cervical injury that warranted early diagnosis and emergency treatment...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28761904/iglon5-antibody-neurological-accompaniments-and-outcomes-in-20-patients
#3
Josephe A Honorat, Lars Komorowski, Keith A Josephs, Kai Fechner, Erik K St Louis, Shannon R Hinson, Sabine Lederer, Neeraj Kumar, Avi Gadoth, Vanda A Lennon, Sean J Pittock, Andrew McKeon
OBJECTIVE: To describe the phenotypes, treatment response, and outcome of IgLON5 autoimmunity. METHODS: Archived serum and CSF specimens from 367 patients known to harbor unclassified antibodies which stained neural synapses diffusely (mimicking amphiphysin-IgG) were reevaluated by indirect immunofluorescence assay (IFA) using a composite of mouse tissues and recombinant IgLON5-transfected cell-based assay (CBA, Euroimmun). RESULTS: Available specimens (serum, 25; CSF, 9) from 26/367 patients (7%) had identical IFA appearance and robust IgLON5 CBA positivity...
September 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28525489/minimum-5-year-follow-up-results-for-occipitocervical-fusion-using-the-screw-rod-system-in-craniocervical-instability
#4
Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Hideki Yagi, Ryuichi Shinjo, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the clinical outcome of patients who had undergone occipitocervical (OC) fusion using pedicle screws and rods over a minimum 5-year follow-up. SUMMARY OF BACKGROUND DATA: Few studies have evaluated occipitocervical (OC) fusion using pedicle screws and rods for long-term follow-up. METHODS: Twenty-seven consecutive patients treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28258417/utility-of-the-clivo-axial-angle-in-assessing-brainstem-deformity-pilot-study-and-literature-review
#5
Fraser C Henderson, Fraser C Henderson, William A Wilson, Alexander S Mark, Myles Koby
There is growing recognition of the kyphotic clivo-axial angle (CXA) as an index of risk of brainstem deformity and craniocervical instability. This review of literature and prospective pilot study is the first to address the potential correlation between correction of the pathological CXA and postoperative clinical outcome. The CXA is a useful sentinel to alert the radiologist and surgeon to the possibility of brainstem deformity or instability. Ten adult subjects with ventral brainstem compression, radiographically manifest as a kyphotic CXA, underwent correction of deformity (normalization of the CXA) prior to fusion and occipito-cervical stabilization...
March 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28220607/neurological-and-spinal-manifestations-of-the-ehlers-danlos-syndromes
#6
REVIEW
Fraser C Henderson, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin extensibility, and tissue fragility. This communication briefly reports upon the neurological manifestations that arise including the weakness of the ligaments of the craniocervical junction and spine, early disc degeneration, and the weakness of the epineurium and perineurium surrounding peripheral nerves. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression...
March 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/27891038/accessory-atlantoaxial-ligament-avulsion-fracture-of-the-axis-are-there-any-clinical-implications
#7
Hamid Reza Niknejad, Frank van Calenbergh, Philippe Demaerel, Johannes van Loon
Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL) also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27800002/single-stage-operation-for-giant-schwannoma-at-the-craniocervical-junction-with-minimal-laminectomy-a-case-report-and-literature-review
#8
Sun Yoon, Hunho Park, Kyu-Sung Lee, Seoung Woo Park, Chang-Ki Hong
Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions. We removed the tumor with a left lateral suboccipital craniectomy with laminectomy only at C1 and without any subsequent surgery-related neurologic deficits...
September 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/27564788/combined-preoperative-traction-with-instrumented-posterior-occipitocervical-fusion-for-severe-ventral-brainstem-compression-secondary-to-displaced-os-odontoideum-technical-report-of-2-cases
#9
Muhammad M Abd-El-Barr, Brian D Snyder, John B Emans, Mark R Proctor, Daniel Hedequist
Severe os odontoideum causing ventral brainstem compression is a rare and difficult entity to treat. It is generally accepted that severe os odontoideum causing ventral brainstem compression and neurological deficits warrants surgical treatment. This often requires both anterior and posterior procedures. Anterior approaches to the craniocervical junction are fraught with complications, including infection and risk of injury to neurovascular structures. External traction systems traditionally require long-term bedrest...
December 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27559444/ankylosing-spondylitis-patterns-of-spinal-injury-and-treatment-outcomes
#10
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
https://www.readbyqxmd.com/read/27544334/radiologic-evaluation-of-basilar-invagination-without-obvious-atlantoaxial-instability-group-b-basilar-invagination-analysis-based-on-a-study-of-75-patients
#11
Atul Goel, Trimurti Nadkarni, Abhidha Shah, Prashant Sathe, Manoj Patil
BACKGROUND: We evaluated the radiologic features of 75 patients with group B basilar invagination who exhibited no evidence of atlantoaxial instability based on the conventional parameter of an abnormal increase in the atlantodental interval. We specifically studied the variability and possible significance of the presence of cerebrospinal fluid (CSF) within and outside the confines of neural tissues. MATERIALS AND METHODS: During the period January 2008-May 2015, we encountered 75 cases with group B basilar invagination...
November 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27506088/surgical-stabilization-of-the-atlanto-occipital-overlap-with-atlanto-axial-instability-in-a-dog
#12
Atsushi Fujita, Ryohei Nishimura
The atlanto-occipital (AO) overlap in combination with atlanto-axial (AA) instability was found in a dog. We hypothesized that ventral fixation of the AA junction can stabilize the atlas and prevent AO overlap by reviewing our past cases with AA instability. A standard ventral fixation of the AA junction using stainless k-wires and polymethyl methacrylate (PMMA) was performed. The dog fully recovered, and no complication was noted. The results of the postoperative CT imaging supported our hypothesis. The ventral fixation of the AA junction is a feasible treatment option for similar cases, although craniocervical junction abnormalities (CJA) including AA instability are varied, and careful consideration is required for each case...
May 2016: Japanese Journal of Veterinary Research
https://www.readbyqxmd.com/read/27363215/anesthetic-management-in-patient-with-neurofibromatosis-a-case-report-and-literature-review
#13
REVIEW
F T Mendonça, I Barreto de Moura, D Pellizzaro, B J Grossi, R Carvalho Diniz
OBJECTIVE: We report the anesthesia management of a 15 years-old patient with neurofibromatosis type 1, scheduled for resection of a tumor located in the occipitocervical region. In addition, we review the pertaining literature, emphasizing the anesthetic implications of neurofibromatosis manipulation. CASE : A 15-years-old female patient, with Neurofibromatosis type 1 was diagnosed with a large tumor in occipitocervical region suggestive of a plexiform neurofibroma. She presented with cervical instability, difficulty in positioning due to the large cervical mass and other predictors of airway difficulty...
2016: Acta Anaesthesiologica Belgica
https://www.readbyqxmd.com/read/27355736/minimum-5-year-follow-up-results-for-occipitocervical-fusion-using-the-screw-rod-system-in-craniocervical-instability
#14
Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Hideki Yagi, Ryuichi Shinjo, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the clinical outcome of patients who had undergone occipitocervical (OC) fusion using pedicle screws and rods over a minimum 5-year follow-up. SUMMARY OF BACKGROUND DATA: Few studies have evaluated occipitocervical (OC) fusion using pedicle screws and rods for long term follow-up. METHODS: Twenty-seven consecutive patients treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up...
June 28, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27283520/the-provocative-radiographic-traction-test-for-diagnosing-craniocervical-dissociation-a-cadaveric-biomechanical-study-and-reappraisal-of-the-pathogenesis-of-instability
#15
Zachary Child, Daniel Rau, Michael J Lee, Randall Ching, Richard Bransford, Jens Chapman, Carlo Bellabarba
BACKGROUND CONTEXT: Craniocervical dissociation is a rare but serious condition, and missed injuries have been associated with poor neurologic outcomes and deterioration. A fluoroscopic traction test is employed to interrogate the craniocervical ligaments when clinical and imaging findings are equivocal. However, no specific protocol or known parameters with respect to traction or force applied have been established. PURPOSE: This study sought to define the parameters of the radiographic traction test with sequential sectioning of the primary ligamentous restraints under controlled distraction of the craniocervical junction in a biomechanical model...
September 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27258364/craniocervical-spinal-instability-after-type-1-arnold-chiari-decompression-a-case-report
#16
Gaston O Camino Willhuber, Santiago T Bosio, Miguel H Puigdevall, Carolina Halliburton, Carlos A Sola, Ruben A Maenza
To present and describe an unusual case of spinal instability after craniocervical spinal decompression for a type-1 Chiari malformation. Type-1 Chiari malformation is a craniocervical disorder characterized by tonsillar displacement greater than 5 mm into the vertebral canal; posterior fossa decompression is the most common surgical treatment for this condition. Postoperative complications have been described: cerebrospinal fluid leak, pseudomeningocele, aseptic meningitis, wound infection, and neurological deficit...
January 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27230912/intradural-synovial-cyst-of-the-atlantoaxial-joint-a-case-report
#17
Sebastian Hartmann, Anja Tschugg, Pujan Kavakebi, Claudius Thomé
BACKGROUND: Intradural synovial cysts of the cervical spine represent a rare disease entity, causing stenosis of the spinal canal and thereby leading to progressive myelopathy. In particular, at the cranio-cervical junction early intervention is necessary to prevent permanent neurological dysfunction. We present the case of a 74-year-old man who presented with moderate cervicogenic headache, gait disturbance and progressive left-sided weakness. Magnetic resonance imaging (MRI) of the cervical spine confirmed a left-sided cystic mass located anteriorly at the craniovertebral junction compressing the surrounding structures...
August 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27196075/endoscopic-endonasal-approach-to-the-craniocervical-junction-the-importance-of-anterior-c1-arch-preservation-or-its-reconstruction
#18
M Re, M Iacoangeli, L Di Somma, L Alvaro, D Nasi, G Magliulo, F M Gioacchini, D Fradeani, M Scerrati
We report our experience with the endoscopic endonasal approaches (EEA) for different craniocervical junction (CCJ) disorders to analyse outcomes and demonstrate the importance and feasibility of anterior C1 arch preservation or its reconstruction. Between January 2009 and December 2013, 10 patients underwent an endoscopic endonasal approach for different CCJ pathologies at our Institution. In 8 patients we were able to preserve the anterior C1 arch, while in 2 post-traumatic cases we reconstructed it. The CCJ disorders included 4 cases of irreducible anterior bulbo-medullary compression secondary to rheumatoid arthritis or CCJ anomalies, 4 cases of inveterate fractures of C1 and/or C2 and 2 tumours...
April 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/26820847/motor-and-somatosensory-evoked-potential-spinal-cord-monitoring-during-intubation-and-neck-extension-for-thyroidectomy-in-a-down-syndrome-boy-with-atlantoaxial-instability
#19
Raiya Saif Al Bahri, David B MacDonald, Ahmed Haroun M Mahmoud
Intubation or neck extension can compress the spinal cord in patients with craniocervical instability. Protective motor evoked potential (MEP) and somatosensory evoked potential (SEP) monitoring of these maneuvers is an obvious consideration when these patients undergo already-monitored spinal surgery, but might be overlooked when they undergo other normally unmonitored procedures. Here we report monitoring intubation and neck extension for the unusual indication of thyroidectomy in a Down syndrome boy with atlantoaxial instability...
February 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/26752003/minimum-5-year-follow-up-results-for-occipitocervical-fusion-using-the-screw-rod-system-in-craniocervical-instability
#20
Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Hideki Yagi, Ryuichi Shinjo, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the clinical outcome of patients who had undergone occipitocervical (OC) fusion using pedicle screws and rods over a minimum 5-year follow-up. SUMMARY OF BACKGROUND DATA: Few studies have evaluated occipitocervical (OC) fusion using pedicle screws and rods for long term follow-up. METHODS: Twenty-seven consecutive patients treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up...
June 28, 2016: Clinical Spine Surgery
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