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At least 73 records · Page 4Linked to original sources
PubMed1986

[Fractures of the cervical spine].

A gentle traction is often sufficient to repose unstable lesions of the cervical spine, when a retention by means of conservative methods is not possible. Therefore a ventral, intracorporal fusion with autologous, corticospongious chip material combined with a plate fixation is an adequate solution to obtain a stable, movable blocking of the lower six cervical vertebrae. In case of a completely ruptured dorsal ligamentous apparatus, a ventral bone-chip blocking is generally insufficient. Ventral spondylodesis should be combined with a dorsal traction belt in these cases. Fresh, instable fractures of the odontoid process can be stabilized for exercise by means of two traction screws fastened from the front side. However, the best method to treat a pseudarthrosis of the odontoid process is a fusion performed from the dorsal side.

Atlanto-Occipital Joint↗
PubMed1999

The extent of drilling in lateral approaches to the cranio-cervical junction area from a series of 125 cases.

The trans-condylar approach to the craniocervical junction area (CCJA) requires a more or less extensive drilling of the two first cervical joints (C0-C1 and C1-C2). The extent of drilling necessary to resect a lesion at the CCJA was analyzed from a series of 125 cases including 114 tumours and 11 non-tumoural processes treated using a lateral approach (postero-lateral or antero-lateral) over a 15-year period (1980-1995). The extent of drilling was estimated on CT scanner axial views from the reduction of the joints surface and three groups were determined: A/less than one third B/between one third and one half, and C/more than one half. The extent of drilling was compared with the lesion location in relation to the bone limits of the CCJA: within these limits, outside them and into the bony structures. It was also analyzed with regard to pathology when separated into three groups non-osseous tumours, osseous tumours and chordomas, and non tumoural processes. Only 26 cases had a significant drilling, i.e., more than one third of the joint surfaces and of these, 14 were more than one half. In all these 14 cases, the bone structures were already invaded and 13 of them were, to some extent, beyond the bone limits of the CCJA. Of the 12 cases with drilling between one third and one half, 11 involved the bone structures and 1 was located inside the CCJA bone limits. Drilling of more than one third was required only in the case of bone lesions: 10 out of 23 bone tumours, all the 14 cases of chordomas, one case of rheumatoid arthritis and one case of C1-C2 joint spondylosis. In the other cases including mostly non-osseous tumours, drilling was limited to less than one third, though a high rate of complete removal was achieved (98%). Stabilization by arthrodesis with posterior grafting (N = 10) or by lateral bone grafting (N = 5) was achieved in all cases involving more than one half drilling, and in one case of tuberculosis. By adequately choosing the surgical approach, the extent of drilling can always be minimal. Extensive bone resection is only necessary when the tumour has already destroyed the joints. In that case, lateral or posterior fusion is an efficient technique.

Axis, Cervical Vertebra↗
PubMedDate not supplied

Treatment of bipolar, seizure, and sleep disorders and migraine headaches utilizing a chiropractic technique.

OBJECTIVE: To discuss the use of an upper cervical technique in the case of a 23-year-old male patient with rapid-cycling bipolar disorder, sleep disorder, seizure disorder, neck and back pain, and migraine headaches. CLINICAL FEATURES: The patient participated in a high school track meet at age 17, landing on his head from a height of 10 ft while attempting a pole vault. Prior to the accident, no health problems were reported. Following the accident, the patient developed numerous neurological disorders. Symptoms persisted over the next 6 years, during which time the patient sought treatment from many physicians and other health care practitioners. INTERVENTION AND OUTCOME: At initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermography and radiography. Chiropractic care using an upper cervical technique was administered to correct and stabilize the patient's upper neck injury. Assessments at baseline, 2 months, and 4 months were conducted by the patient's neurologist. After 1 month of care, the patient reported an absence of seizures and manic episodes and improved sleep patterns. After 4 months of care, seizures and manic episodes remained absent and migraine headaches were reduced from 3 per week to 2 per month. After 7 months of care, the patient reported the complete absence of symptoms. Eighteen months later, the patient remains asymptomatic. CONCLUSION: The onset of the symptoms following the patient's accident, the immediate reduction in symptoms correlating with the initiation of care, and the complete absence of all symptoms within 7 months of care suggest a link between the patient's headfirst fall, the upper cervical subluxation, and his neurological conditions. Further investigation into upper cervical trauma as a contributing factor to bipolar disorder, sleep disorder, seizure disorder, and migraine headaches should be pursued.

Adolescent↗
PubMed1998

Cervical trauma: rationale for selecting the appropriate fusion technique.

The selection of the appropriate surgical approach in the management of an unstable cervical spine injury is predicated on the biomechanic deficiencies of the bony and ligamentous structures, the age of the patient, the level of experience of the surgeon, and the concomitant medical comorbidities. The optimal approach ideally is the least invasive, provides the greatest benefit-to-risk ratio in terms of potential injury to contiguous neurovascular structures, and provides adequate stabilization to avoid cumbersome external immobilization and allows early rehabilitation. This article discusses anterior, posterior, and combined stabilization techniques in patients who have sustained trauma to the upper and lower cervical spine.

Atlanto-Occipital Joint↗
PubMed1992

The ring of C2 and evaluation of the cross-table lateral view of the cervical spine.

The cross-table lateral view is essential in the initial workup of a trauma patient with a suspected cervical-spine injury. The identification of the radiographic "ring" of C2 on the cross-table lateral view is discussed. When a type III odontoid fracture is present, the ring of C2 is disrupted. We propose that "identification of the ring of C2" should be added to the emergency physicians' systematic checklist when clearing a cross-table lateral view of the cervical spine.

Axis, Cervical Vertebra↗
PubMed2006

[Three-dimensional 3D modeling: First applications in radioanatomy and interventional radiology under CT guidance].

PURPOSE: To model vertebrae in 3D to improve radioanatomic knowledge of the spine with the vascular and nerve environment and simulate CT-guided interventions. METHOD AND MATERIALS: Vertebra acquisitions were made with multidetector CT. We developed segmentation software and specific viewer software using the Delphi programming environment. RESULTS: This segmentation software makes it possible to model 3D high-resolution segments of vertebrae and their environment from multidetector CT acquisitions. Then the specific viewer software provides multiplanar reconstructions of the CT volume and the possibility to select different 3D objects of interest. DISCUSSION: This software package improves radiologists' radioanatomic knowledge through a new 3D anatomy presentation. Furthermore, the possibility of inserting virtual 3D objects in the volume can simulate CT-guided intervention. CONCLUSION: The first volumetric radioanatomic software has been born. Furthermore, it simulates CT-guided intervention and consequently has the potential to facilitate learning interventions using CT guidance.

Algorithms↗
PubMed2004

Pseudogout of the transverse atlantal ligament: an unusual cause of cervical myelopathy.

BACKGROUND: Calcium pyrophosphate dihydrate deposition in the cervical spine is infrequently symptomatic. This is especially true at the craniocervical junction and upper cervical spine. CASE REPORT: A 70-year-old previously healthy woman presented with a progressive cervical myelopathy of four months duration. RESULTS: Examination revealed sensorimotor findings consistent with an upper cervical myelopathy. Radiological studies (plain radiographs, computed tomography, and magnetic resonance imaging) revealed C1-2 instability, and a well-defined extradural 3 cm x 1 cm retro-odontoid mass causing spinal cord compression. Transoral resection of the mass was performed followed by posterior C1-2 stabilization. Histological examination of the mass confirmed calcium pyrophosphate dihydrate deposition. Follow-up examination showed marked clinical and radiological improvement. CONCLUSION: Although uncommon, calcium pyrophosphate dihydrate deposition disease should be considered in the differential diagnosis of extradural mass lesions in the region of the odontoid.

Aged↗
PubMed1992

Comparison of mandibular growth with other variables during puberty.

The purpose of this investigation was to compare growth characteristics of the mandible during puberty with growth characteristics of the hyoid bone, cervical vertebrae, hand bones and standing height. Data were compiled from serial lateral cephalometric roentgenograms, hand-wrist roentgenograms and body height records of 33 Japanese girls between 9 and 14 years old. Records were updated annually. The mandibular growth rate differed from the other growth rates. The timing of maximum growth velocity of the mandible varied more widely than the timing of maximum growth velocity of the other parameters measured, and the total amount of mandibular growth did not correlate to any other measurement. The timing and magnitude of circumpubertal growth acceleration of various components of the body vary within a certain range of difference. However, the amount and timing of mandibular growth seems to be more variable than the other areas studied.

Adolescent↗
PubMed1975

[Dorsal stabilization in dislocated fractures of C-1 and C-2 vertebrae with Palacos and wiring].

During 1 year 6 patients with dislocated fractures of C-1 and C-2 vertebrae (fractures of the odontoid process) and 1 patient with a pseudarthrosis of the odontoid process have been treated. 6 patients have been treated surgically by internal fixation of the arch of C-1 and C-2 spinous process by wiring and plastic material (Palacos). No complications occurred. The advantage of the method was early mobilization of the patients and reduction of hospitalization. Clinical and radiographic follow-up studies showed stable fusion on Flexion-extension X-rays and boney union of the fracture of the odontoid process.

Adolescent↗
PubMed1979

[Changes in the cervical spine in juvenile rheumatoid arthritis (author's transl)].

Changes in the cervical spine in juvenile rheumatoid arthritis can be shown by A.P., lateral and functional views with maximal flexion and extension, and particularly by tomography. The latter is essential for proper evaluation of the atlanto-occipital and atlanto-axial joints and of the odontoid. Atlanto-axial subluxation was found in eight out of eighty-four patients. Destruction of the odontoid was found in twelve out of fifty-three patients examined by tomography. The earliest tomographic changes at the atlanto-occipital joint consists of isolated joint narrowing, erosions and fusion and were observed in sixty-four out of sixty-six patients examined. Similar findings at the atlanto-axial joint were observed in thirty-seven out of sixty-six cases. The severity of the changes correlated with seropositivity and duration of the disease. The most marked changes were found with a prolonged history and a positive Rose-Waaler reaction.

Arthritis, Juvenile↗
PubMed1981

The course of atlanto-axial involvement and disc narrowing of the cervical spine in rheumatoid arthritis.

In 188 patients with rheumatoid arthritis 585 radiological examinations of the cervical spine were performed. Subluxation of C1-2 was found more often than expected; it was often the only radiological change in that segment, and its degree was not related to the duration of the disease. Lateral radiographs taken in full flexion were important for the diagnosis. Age over 40 years at the onset of RA, increased ESR at least on one occasion and seropositivity were related to more severe degrees of involvement. The presence of subcutaneous nodules, high titres of the Rose-Waaler reaction and the presence of antinuclear antibodies had no definite relation to the degree of involvement.

Adolescent↗