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At least 163 records · Page 9Linked to original sources
PubMed2006

Preoperative embolization of cervical spine osteoblastomas: report of three cases.

Our aim was to describe the technique and clinical results of preoperative embolization of cervical spine osteoblastomas. We treated 3 patients with these tumors with transarterial embolization and subsequent surgical excision. In all 3 patients, distal access to the tumor-supplying vessels was gained with a microcatheter and embolization was performed with polyvinyl alcohol particles. No complications occurred. Surgical resection was performed in all patients without relevant bleeding. The postoperative course was uneventful in all patients. Preoperative embolization is a valuable adjunct to the surgical treatment of osteoblastomas of the cervical spine.

Adult↗
PubMed1991

Familial cervical dysplasia.

Nine of twelve family members from three generations were affected by an inherited form of cervical vertebral dysplasia. All of the affected people had an abnormality of the first cervical vertebra. Some also had defects of the axis and caudad to it. The mode of transmission of the disorder is autosomal dominant, with apparently complete penetrance and variable expressivity. Two patients had symptoms. One had a passively correctable tilt of the head, with an associated audible clunk and hypoplasia of the left superior facet of the second cervical vertebra. This patient had no local symptoms, neurological involvement, or muscle spasm. In the other patient, suboccipital pain developed. Radiographs revealed an anterior atlanto-occipital dislocation. The symptoms resolved after reduction and arthrodesis. Because of the apparently complete penetrance of this disorder, physicians caring for patients who have this type of congenital malformation of the cervical spine should consider examination of closely related members of the family. Clinical findings such as tilting of the head, torticollis, or limitation of cervical motion suggest that additional evaluation should be done. The examination should include lateral radiographs of the cervical spine in flexion and extension. Three-dimensional computed-tomography reformatting was helpful in demonstrating the complex cervical anatomy in our patients. Patients who have recognized abnormalities should be followed and should be re-examined whenever local or neurological symptoms develop. A magnetic resonance image of the spine in flexion and extension was valuable for identification of the potentially disastrous situation of impending damage to the cord in patients who had instability and evolving symptoms.

Adult↗
PubMed1990

[Craniocervical amyloid tumor with destructive spondyloarthropathy and myelocompression as a rare complication of long-term dialysis].

Dialysis-associated amyloidosis has become a frequent and sometimes disabling complication in long-term dialysis patients. The main protein implicated in amyloidosis is beta 2 microglobulin, which accumulates in patients with renal insufficiency. We report on a 47-year-old patient, who was on haemodialysis treatment for 17 years. After a period of 15 years on dialysis treatment he underwent surgery for a carpal tunnel syndrome. Two years later he developed destructive spondyloarthropathy of the cervical region and destruction of the occipital bone. He lost stability of his neck necessitating his remaining mainly in the lying position. Since the type of dialysis membrane may play an important role in the pathogenesis of dialysis-associated amyloidosis, a dialysator with a polysulfone membrane, which is assume to have a beneficial effect on the progression of amyloidosis, was established.

Amyloidosis↗
PubMedDate not supplied

CT anatomy of the craniovertebral junction in infants and children.

Computed tomographic (GE 9800) images of 129 patients (from newborn to 18 years old) with no evidence of cervical spine pathology were reviewed retrospectively from available material to evaluate normal anatomic appearances in childhood. The synchondroses may appear solid at soft-tissue window settings, while, with appropriate bone-window settings, a lucent line will be seen. Residual lucency and then (generally) sclerosis were seen at synchondroses past the age of classic anatomic fusion. A transversely oriented groove on the undersurfaces of the occipital condyles was imaged in children ages 5-12 years. This groove is described radiologically in that age range for the first time in this report. The development of the ossification centers of C1 was illustrated with CT. The two vertically oriented, rod-shaped ossification centers of the lower dens develop a bilobed appearance in axial section when they begin to fuse. An apparent deficiency of the cortex seen posteriorly in this area (in children as old as 7 years) represents the last remnant of the cleft between the dens centers. The cord was always outlined distinctly by CSF at soft-tissue settings at the foramen magnum and C1 levels without intrathecal or IV contrast enhancement. This anatomic feature is particularly useful since it enables the evaluation of the spinal canal in this region in some cases (especially craniovertebral junction anomalies) without the need for intrathecal contrast materials.

Adolescent↗
PubMed1988

[Acute management of spinal injuries. The cervical spine, conservative therapy].

Stable injuries of the cervical spine can be treated with a cervical collar. Unstable injuries that do not require repositioning can be immobilized with a Minerva plaster cast. Crutchfield's extension is used for extension of short duration during repositioning before setting a cast or performing surgery and for long-term extension in cases of transverse lesions of the spinal cord. The Halo apparatus is especially suitable for treatment requiring extension of long duration when there are no symptoms of transverse lesions of the spinal cord.

Atlanto-Axial Joint↗
PubMed1987

[Suboccipital Pott's disease].

A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.

Adult↗
PubMed1987

[Classification of injuries of the cervical spine].

Recent advances and the technical options that have lately become available in the surgical treatment of spinal injuries mean that clear definition of the indications is essential. Precise observation and classification of each injury to the cervical spine are of paramount importance for this purpose, to allow the comparison of proposed methods of treatment and of the results obtained with them. There are a number of classification systems for injuries to the cervical spine, none of which, however, is generally accepted. These classification systems are based on different criteria, such as nature of the accident at which the injury was sustained, neurologic deficits, morphological criteria, the concept of instability, and implications for treatment and prognosis. These criteria, however, hardly allow the classification of most of the injuries affecting the upper and those affecting the lower cervical spine in a single system. Therefore, the authors propose a system of their own, which draws on the principles of classification suggested by the ASIF for fractures of the extremities. According to this proposed new system, injuries are divided into those of the upper and those of the lower cervical spine, and each of these two main groups is further divided into three subgroups. In the case of the lower cervical spine, injuries are classed according as whether they affect the anterior or the posterior section of the spine more, or both to the same degree. Beyond this, injuries are subdivided with reference to whether they affect primarily bone, bone and ligament equally, or primarily ligament. Further subdivision by severity and implications for treatment allows more detailed differentiation. This classification system is based on the analysis of over 200 cases of injury to the cervical spine treated by the authors and of cases from the literature.

Axis, Cervical Vertebra↗
PubMed1987

[Surgical stabilization of C1 and C2 fractures].

We present operative procedures for the stabilization of fractures of C1 and C2. As is the case for fractures of the extremities, a direct approach to the injury should be attempted in order to avoid the inclusion of intact segments in the spondylodesis. The aim of the three presented techniques - direct screw fixation of fracture of the dens axis and traumatic lysis of C2 - is to active anatomical reconstruction by optimal stabilization. The new technique of transarticular screw fixation of C1-2 developed by Magerl allows unisegmental three-dimensional stabilization in cases in which at least a three-level fusion would have previously been considered necessary.

Bone Screws↗
PubMed1985

Prevertebral soft tissue changes in cervical spine injury.

Primary radiological diagnostics of cervical spine injuries is difficult. It can be improved by making observations on the signs which indicate a fracture, such as alterations in prevertebral soft tissue structures. Several authors have given different suggestions for normal values of prevertebral soft tissue width. It is influenced by the level of the measurement, the posture of the spine, and the patient's age. The soft tissue changes have been stated to often occur with injuries of the anterior parts of the cervical spine, but also with severe injuries in the upper and posterior parts. However, different authors have reported considerably varying figures of incidence of prevertebral soft tissue widening. The article will deal with these matters; it will be based on a material of 165 patients with cervical spine injury, a series of 70 noninjury patients, and the flexion-extension radiograms of the latter group.

Adolescent↗
PubMed1986

Treatment of injuries in the C1-C2 complex.

Trauma to the upper cervical spine results in injuries to the C1-C2 complex that may differ significantly from those in the lower cervical spine. Five major types of injuries occur, and their treatment is based on an understanding of the mechanisms of injury.

Cervical Atlas↗
PubMed1986

[Computer tomography in injuries of the cervical vertebrae].

32 patients with traumatic injuries of the cervical spine were investigated by CT. All patients were initially examined by plain films. CT was definitely superior to conventional radiology in compressive fractures of vertebral bodies. In flexion-extension injuries CT was useful showing fractures of the posterior elements in great detail. Conventional tomography was superior to CT in patients with complex dislocations of vertebral bodies. In the absence of fracture CT failed to detect disruptions of ligaments, which were readily shown by functional examination.

Adolescent↗