Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences

Object Cervical spine clearance after trauma in children 0–3 years of age is deceptively difficult. Young children may not be able to communicate effectively, and severe injuries may require intubation and sedation. Currently, no published guidelines are available to aid in decision-making in these complex situations. The purpose of this study was to determine whether a safe and effective protocol-driven system could be developed for clearance of the cervical spine in noncommunicative children between 0 and 3 years of age. Methods Children 0–3 years of age, including intubated patients, who were admitted after trauma activation at Primary Children's Medical Center in Salt Lake City or the Children's Hospital of New York from 2002 to 2006 were managed according to a cervical spine clearance protocol. Data were collected in a prospective fashion. Radiographic and clinical methods of clearing the cervical spine, as well as the type and management of injuries, were recorded. Results A total of 2828 pediatric trauma activations required cervical spine clearance during the study period. Of these, 575 (20%) were children ≤ 3 years of age who were admitted to the hospital. To facilitate clearing the cervical spine in these children, plain radiographs (100%), CT studies (14%), and MR images (10%) were obtained. Nineteen ligamentous injuries (3.3%) and 9 fractures/dislocations (1.5%) were detected, with 4 patients requiring operative stabilization (0.7%). No late injuries have been detected. Conclusions The protocol used has been effective in detecting cervical spine injuries in noncommunicative children after trauma. The combination of clinical information and radiographic studies is essential for safely clearing the cervical spine in these complex situations. Clearance of the cervical spine without CT or MR imaging studies is possible in the majority of cases, even in very young patients.

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Analysis of the uncinate processes of the cervical spine: an anatomical study

Journal of Neurosurgery Spine ◽

10.3171/2011.12.spine11541 ◽

2012 ◽

Vol 16 (4) ◽

pp. 402-407 ◽

Cited By ~ 18

Author(s):

R. Shane Tubbs ◽

Olivia J. Rompala ◽

Ketan Verma ◽

Martin M. Mortazavi ◽

Brion Benninger ◽

...

Keyword(s):

Cervical Spine ◽

Anatomical Study ◽

Axial Rotation ◽

Intervertebral Discs ◽

Uncinate Process ◽

Surgical Approaches ◽

Intervertebral Foramen ◽

Facet Joints ◽

Vertebral Level ◽

Arthritic Changes

Object Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this region's morphological features. Methods Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. Results The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. Conclusions A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.

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Magnetic Resonance Imaging in Retropharyngeal Tendinitis

Cephalalgia ◽

10.1046/j.1468-2982.1994.1404266.x ◽

1994 ◽

Vol 14 (4) ◽

pp. 266-269 ◽

Cited By ~ 17

Author(s):

K Ekbom ◽

J Tothall ◽

K Annell ◽

J Träff

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Spine ◽

Magnetic Resonance ◽

Soft Tissue ◽

Signal Intensity ◽

Soft Tissues ◽

Resonance Imaging ◽

X Ray ◽

Soft Tissue Swelling ◽

Retropharyngeal Tendinitis

Seven consecutive patients with acute retropharyngeal tendinitis underwent plain X-ray and magnetic resonance imaging (MRI) of the cervical spine. All seven had marked soft tissue swelling anterior to C1 and C2 on plain X-ray, and soft tissue calcification at this level was present in five of them. On MRI, there was markedly increased signal intensity on T2-weighted images in the acute phase and intermediate signal intensity on T1-weighted images, anterior to the level of C1 and C2, often extending as far down as C6. These changes correlated well with the soft tissue swelling seen on conventional X-ray of the cervical spine. The maximum mid-sagittal thickness of the soft tissues was significantly greater in the tendinitis patients ( p < 0.001) than in 12 control subjects free of symptoms from the pharynx or the cervical spine. Treatment with non-steroidal anti-inflammatory drugs rapidly alleviated symptoms, and at follow-up MRI showed regression or complete restitution of the changes. In conclusion, MRI can visualize the edematous changes in the longus colli muscle and adds useful diagnostic information in suspected cases of acute retropharyngeal tendinitis.

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Development of differentiated surgical technique for treating patients with multilevel degenerative diseases of cervical spine

Innovative medicine of Kuban ◽

10.35401/2500-0268-2019-16-4-47-54 ◽

2019 ◽

pp. 47-54

Author(s):

V. A. Byvaltsev ◽

A. A. Kalinin ◽

M. A. Aliyev ◽

V. V. Shepelev ◽

B. R. Yusupov ◽

...

Keyword(s):

Cervical Spine ◽

Disease Duration ◽

Intervertebral Discs ◽

Adverse Outcomes ◽

Neurological Symptoms ◽

Cervical Region ◽

Degenerative Diseases ◽

Facet Joints ◽

On Line ◽

Surgical Tactics

Background. Currently, there is no uniform tactics for the differentiated use of dorsal decompressive-stabilizing techniques for multilevel degenerative diseases of the cervical spine, and the results of these technologies application are largely controversial.Aim. Analysis of the unsatisfactory outcomes of dorsal decompressive-stabilizing interventions in the treatment of patients with multilevel degenerative diseases of the cervical spine and development of a clinicalinstrumental algorithm for differentiated surgical tactics.Material and methods. A retrospective study included 112 patients with degenerative diseases of the cervical spine at two levels or more due to hernias of intervertebral discs, yellow ligament hypertrophy and arthrosis of facet joints, which in 2007-2014 underwent dorsal decompressive-stabilizing interventions in the volume of laminotomy with laminoplasty (LP) and laminectomy with fixation for lateral masses (LF). A correlation analysis of clinical parameters with anamnestic data, instrumental parameters, a feature of accepted surgical tactics and postoperative adverse effects.Results. In the analysis, it was established that «satisfactory» postoperative outcomes of LP are associated with a neutral or lordotic configuration of the cervical spine, the preservation of segmental movements without clinical and instrumental signs of instability; In addition, the use of LF is possible with mobile kyphotization of the cervical spine and the presence of translational instability of the cervical segments. The «unsatisfactory» postoperative results of the LP and LF are in direct correlation with the duration of the disease, the presence of myelopathic focus and rigid kyphosis of the cervical region.Conclusion. Differential use of dorsal decompressive-stabilizing techniques based on a comprehensive assessment of disease duration, configuration of the cervical spine, spinal cord condition and volume of segmental movements allows to reduce neurological symptoms, improve the level of pain and improve the functional status of patients, as well as significantly reduce the number of adverse outcomes associated with the progression of kyphotic deformity, deterioration of neurological symptoms and revision on-line decompressive-stabilizing interventions.

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Diagnosis and treatment of reflex-pain syndromes in patients with herniated intervertebral disc before surgical decompression

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2009-1(2)-111-114 ◽

2009 ◽

Vol 8 (1(2)) ◽

pp. 111-114

Author(s):

Ye. B. Kolotov ◽

A. A. Lutsik ◽

A. V. Mironov ◽

S. V. Yelagin

Keyword(s):

Cervical Spine ◽

Surgical Treatment ◽

Clinical Outcome ◽

Intervertebral Disc ◽

Intervertebral Discs ◽

Intervertebral Disk ◽

Surgical Decompression ◽

Pain Syndromes ◽

Herniated Intervertebral Disc

To upgrade the results of surgical treatment in patients operated on for gerniated intervertebral disk the reflex-pain syndromes of spondylarthrosis and osteohondrous was studied. Before surgical treatment alcohol-novocain blockades have been used to perform denervation of intervertebral discs and joints. The reflex-pain syndromes was evoked by solution injection and then arrested by alcohol-novocain injection. Clinical outcome in long-term period after surgical treatment became good in 89% (p < 0.05) on cervical spine and in 84% (p < 0.05) lumbar.

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A comparative shape analysis of the cervical spine between individuals with cervicogenic headaches and asymptomatic controls

Scientific Reports ◽

10.1038/s41598-021-98981-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Youssef Masharawi ◽

Aumayma Murad Mansour ◽

Natan Peled ◽

Asaf Weisman

Keyword(s):

Cervical Spine ◽

Cervical Vertebrae ◽

Cervicogenic Headache ◽

Intervertebral Discs ◽

Shape Variation ◽

Control Groups ◽

Transverse Foramen ◽

Cervicogenic Headaches ◽

Vertebral Bodies ◽

And Control

AbstractAs some researchers theorized that cervicogenic headache (CEH) might be related to bony and discal features of the cervical spine, this retrospective study examined the shapes of the cervical vertebrae and intervertebral discs (IVDs) of individuals with CEH and compared them to asymptomatic controls. Scans of 40 subjects in their late 20’s–mid 30’s affected with CEH and 40 asymptomatic controls were obtained (overall = 19,040 measurements, age-sex matched, 20 males and 20 females in each group). The following cervical spine variables were measured: Supine lordosis, vertebral body-heights, A-P lengths, mediolateral widths and sagittal-wedging; IVDs heights and sagittal-wedging; pedicle heights, widths and transverse angles; laminar widths and transverse angles; articular facet angles, spinal canal, and transverse foramen lengths, widths, and areas. Both groups had similar shape variation along the cervical in all the measured parameters. There were no significant left–right differences in all measured parameters and no significant differences between the CEH and control groups concerning sex and age. Cervical IVDs were lordotic in shape, whereas their adjacent vertebral bodies were kyphotic in shape except for C2. In conclusion, the shape of the cervical spine and IVDs in subjects in their late 20’s–mid 30’s affected with CEH is identical to asymptomatic controls.

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A BIOMECHANICAL STUDY OF THE EFFECTS OF FLEXION ANGLE ON THE INDUCTION MECHANISM OF CERVICAL SPONDYLOSIS

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519421500536 ◽

2021 ◽

pp. 2150053

Author(s):

FU CAO ◽

RONGCHANG FU ◽

WENYUAN WANG

Keyword(s):

Cervical Spine ◽

Cervical Spondylosis ◽

Element Model ◽

Intervertebral Discs ◽

Biomechanical Study ◽

Flexion Angle ◽

Facet Joints ◽

Load Increase ◽

Spine Motion ◽

Wolff’S Law

Lesions in facet joints such as bone hyperplasia and degenerative changes in the intervertebral discs, can compress nerve roots and the spinal cord, leading to cervical spondylosis (CS). Lesions in these parts of the spine are commonly related to abnormal loads caused by bad posture of the cervical spine. This study aimed to understand the potential mechanical effects of load amplitude on cervical spine motion to provide a theoretical basis for the biomechanical causes of CS, and to provide a reference for preventing of the condition. In this study, a finite element model of the normal human cervical spine (C1-C7) was established and validated using an infrared motion capture system to analyze the effects of flexion angle on the stresses experienced by intervertebral discs, the anterior edge of the vertebral body, the pedicle, uncinate and facet joints. Our analysis indicated that the intervertebral disc load increased by at least 70% during the 20∘ to 45∘ flexion of the neck with 121% load increase in the vertebrae. In the intervertebral discs, the stress was largest at C4-C5, and the stress was moderate at C5-C6. These results are consistent with clinical CS prone site research. According to Wolff’s law, when bones are placed under large stresses, hyperplasia can result to allow adaptation to large loads. Increased cervical spine flexion angles caused the proliferation of bone in the above-mentioned parts of the spine and can accelerate accelerating the appearance of CS.

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