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Results for “Odontoid Process”

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At least 865 records · Page 48Linked to original sources
PubMed1986

The transoral surgical approach to craniovertebral pathology.

The transoral approach is a surgical technique that can be used effectively in the treatment of anterior craniovertebral junction (CVJ) pathology. In this review, we outline the signs, symptoms, and diagnostic studies that identify the pathology and help to determine subsequent therapy. The transoral approach, preoperative and postoperative management problems, and potential complications of the procedure are reviewed. The nursing care of a patient with CVJ pathology is discussed.

Atlanto-Axial Joint↗
PubMed1988

Clinical findings in 12 patients with MPS IV A (Morquio's disease). Further evidence for heterogeneity. Part III: Odontoid dysplasia.

Odontoid dysplasia in the absence or presence of atlanto-axial instability was found in all cases. In general, this correlated well with the overall clinical severity of the condition and illustrates the importance of careful follow-up of these patients. Symptoms or signs of cervical cord compression merit further investigation. Proven compromise of the upper cervical cord is an indication for posterior fusion of the upper cervical spine.

Atlanto-Axial Joint↗
PubMed1992

Spontaneous bone graft resorption in os odontoideum.

Two children are presented who had posterior fusion of the upper cervical spine for os odontoideum. Both patients achieved radiographic fusion but spontaneous bone graft resorption occurred, resulting in a recurrence of the original instability. An awareness of this phenomenon, which has been rarely reported, is important in the pre-operative counselling and postoperative follow-up of these patients.

Bone Resorption↗
PubMed1998

Acquired spinal cord lesion associated with os odontoideum causing deterioration in dystonic cerebral palsy: case report and review of the literature.

A boy with a dystonic quadriparesis presented with acquired paralysis, spasticity, and a feeding disorder. Spinal MRI revealed a cervical cord lesion and os odontoideum. Excessive movement of the neck, leading to failure of ossification of the dens and then to cervical cord trauma was the likely mechanism. The poor outcome of this subject is described, emphasising the need to pay careful attention to neurological changes in children with extrapyramidal cerebral palsy, who may be at particular risk of cord pathology. The management issues are discussed.

Atrophy↗
PubMed1988

Atlantoaxial instability and abnormalities of the odontoid in Down's syndrome.

Radiography of the lateral neck was performed on all children with Down's syndrome aged 4-15 in the Southern Derbyshire health district (n = 67) and a random selection of adults (n = 94). Atlantoaxial instability, defined as a gap of over 4 mm, was present in seven (10%) children and two (2%) adults. Odontoid hypoplasia, defined as an odontoid peg two standard deviations below the mean in an age matched population, was present in 15 (22%) children and 14 (15%) adults, with accessory odontoid ossicles present in two (2%) and two (3%) respectively. No one was found to have symptoms or clinical signs of spinal cord compression. Atlantoaxial instability was therefore found to be commoner in children than adults. Different programmes of management are suggested, in terms of regular clinical examination for signs and symptoms and by radiographic screening. Particular care should be taken with those who have both atlantoaxial instability and odontoid hypoplasia or accessory ossicles as they are at particular risk of spinal cord damage.

Adolescent↗
PubMed1995

Dysphagia and deformity after undetected odontoid fracture in elderly patients.

Trauma in elderly patients is often difficult to evaluate and neck injuries are probably more common than is documented. A case is described of a missed odontoid peg fracture with the unusual presentation of dysphagia and a rapidly developing cervicodorsal kyphos (head falling forward), which may well have been anticipated at several points in the management chain. The lessons to be learned are outlined, together with the subsequent management of this patient.

Accidental Falls↗
PubMed2003

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Cervical spine imaging in children under 9 after trauma.

A short cut review was carried out to establish whether the odontoid peg view is useful to radiologically exclude cervical spine injury in children under 9 years of age. Altogether 156 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. In addition recent guidelines are noted. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Cervical Vertebrae↗
PubMed2005

Odontoid lateral mass asymmetry: do we over-investigate?

OBJECTIVES: This study aimed to evaluate the necessity for further radiological investigation in patients with suspected traumatic rotatory subluxation of the atlanto-axial complex on plain radiography following acute cervical trauma and outline guidelines for assessment of patients with atlanto-axial asymmetry on plain radiography. METHODS: A retrospective review of all patients who had undergone atlanto-axial CT scanning as a result of radiographic C1-C2 asymmetry following cervical spine trauma. The plain x ray and CT images were reviewed retrospectively and correlated with the clinical presentation and outcome. RESULTS AND CONCLUSION: Records of 29 patients (16 men, 13 women; age range 21-44 years) were reviewed. All patients were found to have atlanto-odontoid asymmetry on the initial plain x ray. CT images of none of the patients revealed rotatory subluxation. Ten patients (32%) were found to have congenital odontoid lateral mass asymmetry. All patients were treated conservatively without any further intervention. On review, in 19 patients the orientation of the x ray beam in combination with head rotation was found to be at fault. Approximately 1050 trauma cervical spine x rays were taken in the department where this study was conducted over the period 1999-2001. This study identified 10 patients out of a total of 29 as having congenital odontoid lateral mass asymmetry. This represents approximately 1% of the patients attending the emergency department. Thus congenital odontoid lateral mass asymmetry should be considered in the differential diagnosis following acute cervical trauma.

Adult↗
PubMed1986

The spinal cord in rheumatoid arthritis with clinical myelopathy: a computed myelographic study.

Thirty one patients with suspected myelopathy due to rheumatoid arthritis were examined by plain radiography and 27 had computed myelography. Clinical features and radiological findings were compared. Deformity of the spinal cord could occur in the absence of combined anterior and posterior compression and correlated closely with clinical features only when considered in combination with skeletal and adjacent soft tissue abnormalities. The best surgical results were achieved by transoral odontoidectomy.

Adult↗
PubMed1991

Damaged ligaments at the craniocervical junction presenting as an extradural tumour: a differential diagnosis in the elderly.

An extradural mass at the craniocervical junction causing progressive neurological disability in five elderly patients is described. The lesion, which might be confused with a meningioma or other tumour, is composed of amorphous degenerate fibrocartilaginous material and could be due to degeneration of the ligaments responsible for atlanto-axial stability. Recognition of the condition early is important as the patient's clinical condition will deteriorate without decompression. Anterior transoral removal is relatively simple, unlike surgery for tumours in the area, and will not destabilise the craniovertebral junction. It is likely that a proportion of these lesions are undetected, misdiagnosed or untreated to the detriment of the patient.

Aged↗
PubMed2001

Smiling odontoid.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMed2002

Fatal instability following "odontoid sparing" transoral decompression of a periodontoid pseudotumour.

Pseudotumour of the craniovertebral junction is an uncommon cause of high cervical myelopathy in the elderly. The anterior transoral approach is the preferred means of accessing these lesions. An "odontoid sparing" transoral approach, in which there is only minimal bone removal, is thought to preserve stability of the craniovertebral junction, obviating the need for posterior stabilisation. This report is of an 82 year old man who developed fatal atlanto-axial instability following an odontoid sparing transoral resection of a pseudotumour. This complication has not previously been described and its occurrence has important implications for the surgical management of this condition.

Aged↗
PubMed1996

Quadraplegia in a patient with an undiagnosed odontoid peg fracture. The importance of cervical spine immobilisation in patients with head injuries.

A 59 year old man was found collapsed and unconscious, tracheal intubation was performed without immobilisation of the cervical spine. Examination revealed signs of spinal cord transection with quadraplegia and a lateral cervical spine radiograph showed a displaced fracture of the odontoid peg. This case reinforces the importance of appropriate cervical spine management in all victims of trauma especially those with head injuries and is particularly relevant to the military situation.

Cervical Vertebrae↗
PubMed1992

Staphylococcal infection of the odontoid peg.

An epidural abscess secondary to osteomyelitis of the odontoid peg produced a sudden left-sided weakness. Appropriate antibiotics, transoral evacuation of the pus and subsequent posterior atlanto-axial fusion were associated with a full recovery.

Abscess↗
PubMed1984

Low (type III) odontoid fracture: a new radiographic sign.

Dens fractures are frequently difficult to identify radiographically, particularly when it is only possible to obtain a lateral radiograph of the upper cervical spine. Further, when a dens fracture is identified in lateral projection, it is often difficult to distinguish the "high" (Type II) from the "low" (Type III) fracture. The authors describe an elongated "ring" density superimposed upon the body of the axis in the lateral cervical radiograph which, when horizontally disrupted, indicates a dens fracture and is a specific radiographic sign of the "low" variety.

Axis, Cervical Vertebra↗