Surgical Management of Chordoma of the Cervical Spine

2021 ◽  
pp. 147-157
Author(s):  
Oliver G. S. Ayling ◽  
Nicolas Dea
Keyword(s):  
Cervical Spine ◽  
Surgical Management

scholarly journals Cervical Myelopathy in Rheumatoid Arthritis

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
N. Mukerji ◽  
N. V. Todd
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Neck Pain ◽  
Surgical Management ◽  
Cervical Myelopathy ◽  
Clinical Presentation ◽  
Indications For Surgery ◽  
Grading Systems

Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

scholarly journals A treatment algorithm for the management of cervical spine fractures and deformity in patients with ankylosing spondylitis

2008 ◽  
Vol 24 (1) ◽  
pp. E11 ◽  
Author(s):  
Adam S. Kanter ◽  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Problem Solving ◽  
Surgical Management ◽  
Treatment Algorithm ◽  
Clinical Problem ◽  
Spine Fractures ◽  
Clinical Problem Solving ◽  
Bone Fusion ◽  
Cervical Spine Fractures

Object Patients with ankylosing spondylitis (AS) who present with cervical spine fractures represent a unique challenge to spine surgeons. These injuries often result in neurological deficits that necessitate early and aggressive surgical management with posterior and/or anterior fixation. The authors introduce a clinical problem-solving algorithm to assist in the surgical management of instability and deformity in this exigent patient population. Methods Thirteen patients with AS and fractures of the cervical spine were radiographically evaluated to determine if spinal realignment was obtainable with cervical manipulation or traction. Seven patients had flexible deformities that were stabilized with either anterior or posterior fixation only, and 6 patients had fixed deformities and required circumferential anterior–posterior instrumentation. All patients were observed for neurological outcome, radiographic evidence of bone fusion, and complications. Results With the use of the authors' treatment algorithm, all patients were able to achieve satisfactory spinal realignment and bone fusion; 92% of patients achieved postoperative stability or improvement in Nurick and modified Japanese Orthopaedic Association scale scores. One patient experienced neurological deterioration following surgery, and 1 patient died at an acute rehabilitative facility following discharge. Conclusions Patients with AS are highly susceptible to extensive neurological injury and spinal deformity after sustaining cervical fractures from even minor traumatic forces. These injuries are uniquely complex in nature and require considerable scrutiny and aggressive surgical management to optimize spinal stability and functional outcomes. The authors' clinical problem-solving algorithm will assist spine surgeons in providing optimal care in this difficult population.

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