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Results for “Odontoid Process”

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At least 973 records · Page 54Linked to original sources
PubMed2005

Type II odontoid fracture from frontal impact: case report and biomechanical mechanism of injury.

The authors report a case of Type II odontoid fracture from a frontal impact sustained in the crash of a late-model motor vehicle. They discuss the biomechanical mechanisms of injury after considering patient demographic data, type and use of restraint systems including seatbelt and airbags, crash characteristics, and laboratory-based experimental studies. Multiple factors contributed to the Type II odontoid fracture: the patient's tall stature and intoxicated state; lack of manual three-point seat belt use; obliqueness of the frontal impact; and the most likely preflexed position of the head-neck complex at the time of impact, which led to contact of the parietal region with the A-pillar roof-rail area of the vehicle and resulted in the transfer of the dynamic compressive force associated with lateral bending. Odontoid fractures still occur in individuals involved in late-model motor vehicle frontal crashes, and because this injury occurs secondary to head impact, airbags may not play a major role in mitigating this type of trauma to an unrestrained occupant. It may be more important to use seat belts than to depend on the airbag alone for protection from injury.

Accidents, Traffic↗
PubMed2006

Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass. Case report.

Atlantoaxial fixation in which C1-2 screw-rod fixation is performed is a relatively new method. Because reports about this technique are rather scant, little is known about its associated complications. In this report the authors introduce hypoglossal nerve palsy as a complication of this novel posterior atlantoaxial stabilization method. A 67-year-old man underwent a C1-2 screw-rod fixation for persistent neck pain resulting from a Type 2 odontoid fracture that involved disruption of the transverse atlantal ligament. Posterior instrumentation in which a C-1 lateral mass screw and C-2 pedicle screw were placed was performed. Postoperatively, the patient suffered dysphagia with deviation of the tongue to the left side. At the 4-month follow-up examination, bone fusion was noted on plain x-ray studies of the cervical spine. His hypoglossal nerve palsy resolved completely 2 months postoperatively. To the authors' knowledge, this is the first report in the literature of hypoglossal nerve palsy following C1-2 screw-rod fixation. The hypoglossal nerve is one of the structures that can be damaged during C-1 lateral mass screw placement.

Aged↗
PubMed2006

Remarkable reduction or disappearance of retroodontoid pseudotumors after occipitocervical fusion. Report of three cases.

Retroodontoid or periodontoid pseudotumor unassociated with rheumatoid arthritis or hemodialysis is clinically rare. The authors report three cases of retroodontoid pseudotumor that they treated surgically. All patients exhibited myelopathy of the upper cervical spinal cord. Plain radiography depicted atlantoaxial instability in two of the three patients. Spinal cord compression caused by a mass lesion in all patients was clearly demonstrated on magnetic resonance images. In two patients, the mass lesion was not limited to the retroodontoid region and expanded continuously to the cranial base. Posterior laminectomy of the atlas and occipitocervical fusion were performed. After surgery, the pseudotumor disappeared in two cases and was clearly reduced in one case, and neurological symptoms also improved. Retroodontoid pseudotumor is a lesion for which symptomatic improvement can be expected with posterior decompression and fusion, even without direct tumor excision.

Aged↗
PubMed2006

Regression of retroodontoid pseudotumors following C-1 laminoplasty. Report of three cases.

The authors report a new technique for C-1 laminoplasty without fusion in the treatment of cervical myelopathy associated with a retroodontoid pseudotumor (also known as a phantom tumor). The authors review the cases of three patients who underwent C-1 laminoplasty in which hydroxyapatite was used and fusion was not performed. All patients suffered from severe progressive myelopathy before surgery. Magnetic resonance imaging revealed a retroodontoid pseudotumor compressing the spinal cord at the C-1 level in all cases. Computed tomography was performed to examine the extent of bone erosion at the atlantoaxial joint and dens. Clinical parameters included neurological function, measured using the Japanese Orthopaedic Association score, and neck pain. Imaging parameters included pre- and postoperative atlas-dens intervals; the space available for the spinal cord; instability of the atlantoaxial joints; osteoarthritic changes of the atlantoaxial joint; postoperative changes in T2 high-intensity signal; and postoperative alteration in the size of the pseudotumor. Magnetic resonance imaging demonstrated complete disappearance of the pseudotumor in two cases and partial reduction in one case. In all three cases sufficient neurological recovery was observed. The mean recovery rate was 87.0%. This new technique is less invasive than standard procedures, preserves the cervical range of motion, and avoids the morbidity of obtaining a bone graft and placing instrumentation. The authors conclude that C-1 laminoplasty without fusion is an option in the surgical management of cervical myelopathy associated with a retroodontoid pseudotumor, either without C1-2 instability or with slight, but reducible, C1-2 instability.

Aged↗
PubMed2007

Application of a novel headrest system for odontoid screw fixation. Technical note.

The authors describe a unique headholder device adapted to facilitate the placement of anterior odontoid screws. The patient's head is affixed in the headholder equipped with an articulating arm that can be placed in a paramedian fashion. This configuration rigidly fixates the head and provides an unencumbered open-mouth view of the odontoid using radiographic images, thus making screw placement easier.

Adult↗
PubMed1997

Management of odontoid fractures.

During the past two decades, various reports on the management of odontoid and axis body fractures have been published and new methods of treatment have been developed. So far, there is no consensus, and management remains controversial. This article reviews the literature and formulates recommendations based on clinical experience.

Adult↗
PubMed2006

Clinical implications of alignment of upper and lower cervical spine.

AIMS AND OBJECTIVES: The alignment of upper and lower cervical spine is presumed to be closely interrelated and the knowledge of this is mandatory when performing occipito-cervical and upper cervical fusions. The aim of this study was to establish standard values for upper and lower cervical spine alignment in the Indian population. MATERIALS AND METHODS: Five hundred eighteen asymptomatic volunteers (261 males and 257 females) between 12 and 80 years of age underwent lateral radiography with their neck in the neutral position. Angles for occipital to 2nd cervical (Oc-C2), 1st to 2nd cervical (C1-C2) and sagittal alignment of 2nd to 7th cervical vertebrae (C2-C7) were measured. Statistical analyses were performed using a statistical package SPSS 10 for windows and the students 't' test. RESULTS: The mean Oc-C2, C1-C2 and C2--C7 angles were 14.66+9.5 degrees , 25.6+7.9 degrees and 16.8+12.7 degrees in male, while same angles in female were 15.59+8.26 degrees, 26.9+6.8 degrees and 9.11+10.4 degrees respectively. Weak statistically significant negative correlation was observed between the measured angles of the upper (Oc-C2 and C1-C2) and lower (C2-C7) cervical spines, which means if the lordosis of the occiput and upper cervical spine increases (if the Oc-C2 angle increases), the alignment of lower cervical spine becomes kyphotic and vice versa. This negative correlation was stronger between the Oc-C2 and C2-C7 angles than between the C1-C2 and C2-C7 angles. CONCLUSIONS: Relationship between alignment of the upper and the lower cervical spine should be taken into consideration when performing cervical fusion.

Adolescent↗
PubMedDate not supplied

Upper cervical spine injuries.

The unique anatomy of the upper cervical spine and the typical mechanisms of injury yield a predictable variety of injury patterns. Traumatic ligamentous injuries of the atlanto-occipital joint and transverse atlantal ligament are relatively uncommon, have a poor prognosis for healing, and often respond best to surgical stabilization. Bony injuries, including occipital condyle fractures, atlas fractures, most odontoid fractures, and traumatic spondylolisthesis of the axis, generally respond well to nonsurgical management. Controversy in management remains, however, especially with type II odontoid fractures.

Atlanto-Occipital Joint↗
PubMed1999

[Vertical development of the face and cervical spine. Diagnostic and therapeutic significance in orthodontics and maxillofacial surgery].

Vertical growth of the cervical spine, of the mandibula and the upper maxilla are normally anatomically and physiologically correlated. At a very early age the relationships are established between the cervical spine and the angle of the mandibula which is normally level with C2's antero-inferior angle. A parallelism can be noticed between the rhythms of the vertical growth of the cervical spine and the changes of the maxillary in relation to the skull. So relationships are gradually established between the palate level, the top of the odontoid, and the foramen magnum. These relationships are well objectivized on a lateral teleradiography by Delaire' analysis. Lateral teleradiography of the situation of the angle of the mandibula, in relation to the basis of the C2 body should be systematic. It provides much information concerning the growth potential of the condylar unit, and makes possible a differential diagnosis between true or false posterior vertical insufficiency (PVI) and true or false posterior vertical excess (PVE) and to recognize clinical types of skeletal class II and class III of vertical origin.

Adolescent↗