Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Odontoid Process”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed1990

Trans oral approach to the nasopharynx and clivus using the Le Fort I osteotomy with midpalatal split.

The Le Fort I level osteotomy is a procedure well known to oral and maxillofacial surgeons, who routinely use it to correct midfacial skeletal deformities and alter the dental occlusion. This osteotomy can also be used as a maxillotomy for access to more superiorly and posteriorly situated structures. The downfracture technique provides the surgeon with a safe approach that allows visualization of the maxillary sinuses, nasal cavity, nasopharynx, base of the skull and upper cervical spine. This approach can also be combined with a midline lip split, mandibulotomy and glossotomy to give access to retropharyngeal structures. By modifying the combined Le Fort I and transmandibular approach utilizing a midline split of the hard and soft palate, the access to the clivus can be improved considerably. The clinical applications of these combined procedures in the treatment of basilar invagination and tumors of the nasopharynx are discussed.

Adolescent↗
PubMed2003

Cerebellar infarction secondary to os odontoideum.

A 43-year-old man developed cerebellar infarction due to atlantoaxial dislocation associated with os odontoideum. Cervical X-ray films confirmed os odontoideum, and conventional angiography revealed irregular narrowing of the right vertebral artery at the axis level. A correlation between the vertebral artery lesion and atlantoaxial instability was shown with 3-dimensional (3-D) computed tomographic (CT) angiography. This is the first case of atlantoaxial dislocation with vertebral artery stenosis demonstrated 3-D CT angiography. 3-D CT angiography can support the conventional angiography with respect to the diagnosis and management of vertebral artery insufficiency associated with occipitocervical deformity.

Adult↗
PubMed2004

Osteoporotic fracture of the dens revealed by cervical manipulation.

Osteoporotic vertebral fractures selectively affect the thoracolumbar junction, usually sparing the cervical spine. A 65-year-old woman with documented osteoporotic fractures and chronic alcohol abuse presented with neck pain and occipital neuralgia that started after she suddenly flexed then extended her neck. Following several sessions of cervical manipulation, her pain became more severe, and she was admitted. Imaging studies showed multiple fractures in the dens, C6 and C7. These apparently spontaneous fractures suggested a bone tumor, for which investigations were negative. Osteoporosis was the only identifiable cause. The spinal manipulations probably worsened the lesions which were performed by a chiropractor who is not a physician and did not obtain cervical spine radiographs before treating the patient. Osteoporosis contraindicates spinal manipulation at any level, including the cervical spine.

Aged↗
PubMed1988

Laryngeal stridor due to odontoid peg subluxation.

This is a case of a 58-year-old woman who presented with progressive stridor due to immobile vocal cords. This was found to be due to cervical cord compression by an upwardly subluxed odontoid peg. Despite surgical intervention the outcome was fatal.

Axis, Cervical Vertebra↗
PubMed1994

Oblique odontoid fracture. Case report and review of the literature.

The case of a 89 year old patient with an oblique odontoid fracture is reported. The fracture was oblique extending from the middle of the anterior aspect of the dens to the posterior junction with the body. There was also posterior displacement. This fracture was different from the previously reported two vertical fractures of the odontoid. The possible mechanism of the lesion, and the management of this patient are discussed.

Aged↗
PubMed2000

Odontoid fracture complicating ankylosing spondylitis.

Patients with ankylosing spondylitis are prone to fractures. We describe a 32-year-old male patient with an odontoid fracture and anterior dislocation of C1 vertebra relative to C2 complicating ankylosing spondylitis. The importance and difficulties of the rehabilitation program are stressed. The role of magnetic resonance imaging and three-dimensional computerized tomography in diagnosis is emphasized.

Adult↗
PubMed2005

Cervical myelopathy induced by pseudogout in ligamentum flavum and retro-odontoid mass: a case report.

STUDY DESIGN: Retrospective case study. OBJECTIVES: Report a rare case of cervical myelopathy induced by calcium pyrophosphate dehydrate (CPPD) deposition in multiple cervical levels. SETTING: An area teaching hospital in Taiwan. METHOD: A patient with cervical myelopathy was evaluated by computerized tomography (CT) scan and magnetic resonance (MR) image. CPPD deposition known as pseudogout was diagnosed and approved by a polarized microscope. RESULT: A prominent hypertrophy of ligmentum flavum and a retro-odontoid bulging mass induced cord compression were found in CT scan and MR image. CPPD deposition was confirmed by the histological examinations in the ligamentum flavum at the spinal levels of C3-C6. After decompression surgery of spine and comprehensive rehabilitation, the patient's neurological symptoms subsided and her neurological functions improved leading to a good prognosis. CONCLUSION: CPPD deposition in cervical spine occurring at multiple levels is rare. Image studies with CT scan and MR are complementary in the diagnosis of CPPD-induced myelopathy. Surgical decompression is always required and expected to have a good outcome.

Aged↗
PubMed2001

Odontoid fracture following an epileptic seizure.

Fractures of the thoracic and lumber spine are well recognized following an epileptic seizure. Fractures of the cervical spine are not. The rare occurrence of a displaced odontoid fracture type 2, secondary to a grand mal seizure is presented. To our knowledge, this association has not been described previously in the English literature.

Aged↗
PubMedDate not supplied

Os odontoideum in a patient with cervical vertigo: a case report.

Cervical vertebral anomalies are often associated with malformations or traumas, they may be completely asymptomatic and represent an occasional finding in vertigo or can cause severe neurologic complications (ie, compression of the upper cervical spine with myelopathy, epilepsy, or respiratory failure). This clinical case is a patient who came to us for observation for a peripheral harmonic vestibular syndrome, and in whom a malformation of the cervical vertebral joint (os odontoideum) was occasionally found on magnetic resonance imaging.

Anti-Inflammatory Agents↗
PubMed2000

The pediatric trauma C-spine: is the 'odontoid' view necessary?

BACKGROUND/PURPOSE: The "odontoid view" is a difficult and often hazardous film to obtain in young children. The aim of this study was to determine if the transoral roentgenogram is necessary in the evaluation of the pediatric cervical spine. METHODS: A retrospective, multiinstitutional review was performed of all patients 16 years of age and under with documented cervical spine injury in a large metropolitan area during the past decade. Fifty-one children with cervical spine injury were identified from the medical records at 4 hospitals. RESULTS: The 0- to 8-year-old age group had a significantly higher incidence of upper (occiput to C3) cervical injury than the 9- to 16-year-old age group (67% v 39%; P < .05). In the 0- to 8-year-old group the initial lateral/anteroposterior radiograph made the diagnosis of cervical spine injury in 13 of 15 patients (87%), and in no patients was the transoral odontoid view used to make the diagnosis of cervical spine injury. In only 1 patient in the 9- to 16-year-old age group with a type III odontoid fracture was this view deemed useful. The overall mortality rate in this series was 7.8% with all deaths secondary to associated head injury. CONCLUSIONS: In the 0- to 8-year-old age group in whom the incidence of cervical spine injury is rare but frequently involves the upper cervical spine, the transoral odontoid roentgenogram may be of little value in the evaluation of the spine and should not be considered necessary in "clearing" the pediatric cervical spine. An alternative evaluation of these patients would include an initial lateral and AP radiograph, followed by computed tomography scan.

Cervical Vertebrae↗
PubMed2002

Magnetic resonance imaging confirmation of resolution of periodontoid pannus formation following C1/C2 posterior transarticular screw fixation.

Chronic odontoid fractures are considered unstable spinal lesions. Chronic instability in this region leads to the development of an inflammatory pannus, which can progress resulting in spinal cord compression radiographically and a myelopathy syndrome clinically. In this report we document three cases of reversal of pannus after C1/C2 transarticular screw fixation of an unstable odontoid fracture. Three patients were identified with chronic odontoid fractures and spinal cord compression due to periodontoid pannus formation. All patients presented with a progressive myelopathy syndrome. All patients underwent preoperative and postoperative magnetic resonance imaging (MRI) of the craniovertebral junction. C1/C2 transarticular screw fixation was performed for stabilization of C1/C2. Postoperatively there were no complications. Postoperative MRI at 6 months demonstrated resolution of the ventral pannus. Moreover, all patients exhibited improvement of preoperative neurological deficits. MRI is the imaging technique of choice for diagnosis and follow-up of patients with chronic odontoid fractures and ventral pannus. C1/C2 transarticular screw fixation provides a viable method for spinal stabilization in this region. In addition, stabilization can result in resolution of inflammatory pannus formation secondary to instability of the C1/C2 articulation.

Aged↗
PubMedDate not supplied

[Medical-insurance aspects of atlantoaxial instability in children].

INTRODUCTION: An os odontoideum is mostly diagnosed coincidentally on the basis of neurological symptoms or painful movement of the cervical spine. Diagnostic work-up and therapy are currently subjects of controversial discussion in the literature. CASE: Our report is about an eleven-year-old boy with an unknown os odontoideum, who developed neurological symptoms with tetraparesis after a fall from 1.5 m height. Conventional X-ray examination resulted in the diagnosis of a suspected dens fracture, MRI showed atlanto-axial instability and an os odontoideum with significant dural sack compression but no signs of acute bony or ligamentous lesion. CONCLUSION: Because of the importance concerning not only medical but also legal/insurance aspects, a possible coincidental finding of an os odontoideum versus a dens fracture must be included in the differential diagnosis. In the case of an os odontoideum without instability in children, conservative therapy is justified after due enlightenment regarding possible risks. In the event of neurological symptoms and/or persistent instability the authors advocate early surgical stabilization even in patients with little infirmity, particularly in view of the possible consequences.

Accidental Falls↗
PubMedDate not supplied

[Transaxial spongiosa-plasty and ventral, temporary atlanto-axial fixation for therapy of dens pseudarthrosis].

PURPOSE: According to literature there is a pseudarthrosis rate of about 1% up to 64% depending on the treatment of the dens fracture (16). Generally the treatment of dens pseudarthrosis consists of the fusion of the joint C1/C2 with or without dens resection. Now, a method is presented whereby, on the one hand the pseudarthrosis is treated, while on the other hand the anatomical structures and physiological function of the joint C1/ C2 are restored. METHOD: The operation consists of a gradual outboring of the base of the dens and the dens axis and filling with autologous cancellous bone. Then follows a lateral, temporary transarticular screw fixation of C1/C2 which guarantees an immobilisation of the filled out dens. A halo-body-jacket is then applied. The removal of the screws of the temporary fixation follows three months post operatively after X-ray control. Then physiotherapy of the cervical spine follows. RESULTS: During 7/93 and 7/97 this operation was carried out on 11 patients. In 9 cases compression screw osteosynthesis was primarily conducted and in 2 cases conservative therapy had preceded. The X-ray follow ups showed on an average of 14 month a stable bony fusion in 10 patients, the clinical follow up examinations on an average of 14 month a normal function. CONCLUSION: The operation presented is indicated in case of dens pseudarthrosis because this accomplished a definite bony fusion without disturbance of the function of the joint C1/C2 in patients not older than 60 years. Disadvantages are to be found in the intraoperatively high X-ray radiation and the 3 month immobilisation.

Adolescent↗
PubMedDate not supplied

[Indications and results of fusion operations of the upper cervical spine in chronic polyarthritis and psoriatic arthritis].

12 patients suffering from rheumatic or psoriatic instabilities of the upper cervical spine underwent operations by a dorsal approach from September '83 until October '86. They were examined 3 months to 3 years after operation. Different operative procedures were chosen depending upon the extent of the instabilities. Differential indications are discussed on the basis of clinical and x-ray features. Results were good in 10 patients, 1 was satisfactory, 1 patient died one week postoperatively. Rheumatoid and psoriatic instabilities of the upper cervical spine should receive early operative treatment while extent and risks of operative procedures are low.

Arthritis↗
PubMedDate not supplied

[Chiropractic diagnosis of the atlanto-occipital joint with reference to the Palmer-Sandberg-Gutman functional aspects from the traditional medic-radiologic viewpoint].

Owing to joint mechanics, movement of the atlas alone, as envisioned in HIO diagnosis for producing a superior or inferior position, is not possible when the tranverse ligament is intact, since an atlas movement of this kind would necessitate a change in the statics of the dens amounting to kyphosis or lordosis. Only in the superior or inferior position, as defined by Decking and ter Steege, is there a true malposition of the atlas as a result of atlas movement, and this is only possible if the dens assumes a lordotic or kyphotic position. In such cases all the segments of the cervical spine are used to modify dens statics. Aside from this, superior and inferior positions in HIO diagnosis do not represent any pathology requiring treatment, but normal positions of the atlas within a relatively broad physiologic range. In the vast majority of cases, providing the angle of view is horizontal, there are no findings reflecting the current position of the atlas, but rather a finding due to the development of a condyle movement.

Atlanto-Occipital Joint↗
PubMed1985

[Changes in the cervical spine in chronic polyarthritis].

In 93 patients with classical chronic polyarthritis (rheumatoid arthritis) (at least five ARA-criterias) there were inflammatory lesions of dens epistropheus in 48.4%, ventral atlantoaxial subluxations in 25.8%, lateral atlantoaxial dislocations in 14% and pseudobasilary invagination in 5.4%. Step-ladder-subluxation between C 2/C 7 was found in 31.2%, discitis in 12.5% and spondylarthritis in 38% of cases. Inflammatory signs of the cervical spine were correlated to the Steinbrocker-Grade IV, ANA level 1:40 and the degree of Waaler-Rose. The correlation between long standing steroid-therapy and signs of cervical involvement during c.p.--specially in C1/C2--is found to be proven. There are connections between the duration of c.p. (more than 10 years) and manifestation of cervical spine lesions, further, in a protective sense between longstanding gold therapy and cervical spine lesions.

Adult↗