scholarly journals One-stage surgical management for tuberculosis of the upper cervical spine by posterior debridement, short-segment fusion, and posterior instrumentation in children

2012 ◽  
Vol 22 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Hong-qi Zhang ◽  
Min-zhong Lin ◽  
Hu-Bing Guo ◽  
Lei Ge ◽  
Jian-huang Wu ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Management ◽  
Posterior Instrumentation ◽  
Upper Cervical Spine ◽  
Short Segment ◽  
One Stage ◽  
Upper Cervical ◽  
Posterior Debridement

Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient

2014 ◽  
Vol 13 (6) ◽  
pp. 622-625 ◽  
Author(s):  
Michael M. McDowell ◽  
Simon J. Hanft ◽  
Sophie A. Greenberg ◽  
Rahmatullah Rahmati ◽  
Vincent Carrao ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Pediatric Patient ◽  
Aneurysmal Bone Cyst ◽  
Posterior Instrumentation ◽  
Bone Cyst ◽  
Neurological Complications ◽  
Upper Cervical Spine ◽  
Spinal Reconstruction ◽  
Upper Cervical ◽  
Transmandibular Approach

The authors report on the surgical management of an extensive lesion of the upper cervical spine that required an uncommon transmandibular approach to facilitate exposure, resection, and stabilization in a pediatric patient. A 6-year-old boy with a large aneurysmal bone cyst of the C-2 vertebra presented with progressive weakness and right-sided neck pain. The lesion extended laterally into the soft tissue of the neck, inferiorly to C-4, and posteriorly around the spinal cord. A transmandibular osteotomy was performed to provide adequate exposure for complete resection of the mass and anterior C1–3 instrumentation and fusion. Subsequently, the patient underwent occiput to C-4 posterior instrumentation and fusion. The patient tolerated the operation well and had regained all function at 3 and 11 months' follow-up. No neurological complications or problems of speech, swallowing, or respiration occurred. Even in pediatric patients, the transmandibular approach for the treatment of upper cervical spine lesions is an effective method of maximizing exposure for complex lesions requiring resection and stabilization.

scholarly journals Posterior Resection via Atlantoaxial Lamina Space Without Internal Fixation for C1-C2 Intraspinal Tumors: A Novel Approach

2020 ◽  
Author(s):  
Beiping Ouyang ◽  
Xiaobao Zou ◽  
Ling Ni ◽  
Su Ge ◽  
Yuyue Chen ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Internal Fixation ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Neck Disability Index ◽  
Upper Cervical Spine ◽  
One Stage ◽  
Flexion Extension ◽  
Upper Cervical

Abstract Background: Intraspinal upper cervical C1-C2 tumors pose a challenge in resection. Internal fixation has routinely been used to prevent the occurrence of instability after atlantoaxial laminectomy for resection of C1-C2 intraspinal tumors, that sacrifices the motion of upper cervical spine. We therefore present this report to evaluate the efficacy and safety of one-stage posterior resection of these tumors through the atlantoaxial lamina space without internal fixation.Methods: Ten suitably selected patient with C1-C2 intraspinal tumors were included in this study (period January 2016 to January 2018). All the patients underwent one-stage posterior resection through atlantoaxial lamina space without internal fixation. The efficacy of the procedure was documented by comparing postoperative and preoperative outcome scores [The visual analogue scores (VAS), Japanese Orthopedic Association scores (JOA), neck disability index (NDI)], cervical physiological curvature and range of flexion-extension. Safety was assessed by documenting the complications associated with surgery and subsequent sequale. Results: 6 Male and 4 female patients with mean age 36 years (range 17 years to 50 years) underwent total tumor resection through posterior only approach using the atlantoaxial lamina space for the following tumors: 4 neurofibromas, 3 schwannomas and 3 meningiomas. The mean follow-up was 31.2 months (range 24–36 months). These patients’ pathological types included. Postoperative VAS and NDI were lower than those of pre-operation with statistical significance (p < 0.05) while postoperative JOA was higher than that of pre-operation (p < 0.05). The physiological curvature and activity of cervical spine were maintained at latest follow up. Three patients suffered cerebrospinal fluid leakages that was managed consertaviley with no added intervention required. No patient had local recurrence at latest follow-up.Conclusion: One-stage posterior resection through atlantoaxial lamina space without fixation is an effective and safe treatment for the upper cervical intraspinal tumor. In our experience this technique can remove tumor completely and does not cause instability to C1-C2 joint.

Transoral Approach to Extradural Lesions of the Lower Clivus and Upper Cervical Spine: An Experience of 19 Cases

Neurosurgery ◽  
1989 ◽  
Vol 24 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Nicola Di Lorenzo
Keyword(s):  
Cervical Spine ◽  
Surgical Management ◽  
Transoral Approach ◽  
Long Term Results ◽  
Upper Cervical Spine ◽  
Ventral Aspect ◽  
Upper Cervical ◽  
Lower Clivus ◽  
Postoperative Instability

Abstract An experience with 19 cases of transoral exposure of the lower clivus and ventral aspect of the upper cervical spine is presented. The spectrum of pathological entities in this series includes malformative, neoplastic, and spondylotic conditions. The report is designed to focus upon some points of overall surgical management of patients treated by the transoral approach, with emphasis on management of postoperative instability, and to underline the discrepancy in the prognosis of congenital and acquired disorders, in terms of mortality, morbidity, and long-term results.

Surgical management of Gorham disease involving the upper cervical spine with occipito-cervical-thoracic fusion: a case report

2016 ◽  
Vol 16 (7) ◽  
pp. e467-e472 ◽  
Author(s):  
Adam Schell ◽  
John M. Rhee ◽  
Abigail Allen ◽  
Lindsay Andras ◽  
Feifei Zhou
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Surgical Management ◽  
Upper Cervical Spine ◽  
Upper Cervical

scholarly journals Posterior resection via atlantoaxial lamina space without internal fixation for C1-C2 intraspinal tumors: A novel approach

2020 ◽  
Author(s):  
Beiping Ouyang ◽  
Xiaobao Zou ◽  
Ling Ni ◽  
Su Ge ◽  
Yuyue Chen ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Internal Fixation ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Neck Disability Index ◽  
Upper Cervical Spine ◽  
One Stage ◽  
Flexion Extension ◽  
Upper Cervical

Abstract Background: Intraspinal upper cervical C1-C2 tumors pose a challenge in resection. Internal fixation has routinely been used to prevent the occurrence of instability after atlantoaxial laminectomy for resection of C1-C2 intraspinal tumors, that sacrifices the motion of upper cervical spine. We therefore present this report to evaluate the efficacy and safety of one-stage posterior resection of these tumors through the atlantoaxial lamina space without internal fixation. Methods: Ten suitably selected patient with C1-C2 intraspinal tumors were included in this study (period January 2016 to January 2018). All the patients underwent one-stage posterior resection through atlantoaxial lamina space without internal fixation. The efficacy of the procedure was documented by comparing postoperative and preoperative outcome scores [The visual analogue scores (VAS), Japanese Orthopedic Association scores (JOA), neck disability index (NDI)], cervical physiological curvature and range of flexion-extension. Safety was assessed by documenting the complications associated with surgery and subsequent sequale. Results: 6 Male and 4 female patients with mean age 36 years (range 17 years to 50 years) underwent total tumor resection through posterior only approach using the atlantoaxial lamina space for the following tumors: 4 neurofibromas, 3 schwannomas and 3 meningiomas. The mean follow-up was 31.2 months (range 24–36 months). These patients’ pathological types included. Postoperative VAS and NDI were lower than those of pre-operation with statistical significance (p < 0.05) while postoperative JOA was higher than that of pre-operation (p < 0.05). The physiological curvature and activity of cervical spine were maintained at latest follow up. Three patients suffered cerebrospinal fluid leakages that was managed consertaviley with no added intervention required. No patient had local recurrence at latest follow-up. Conclusion: One-stage posterior resection through atlantoaxial lamina space without fixation is an effective and safe treatment for the upper cervical intraspinal tumor. In our experience this technique can remove tumor completely and does not cause instability to C1-C2 joint.

Endonasal Surgery of the Upper Cervical Spine: A Morphometric Analysis

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Harminder Singh ◽  
Bartosz Grobelny ◽  
Adam Flanders ◽  
Marc Rosen ◽  
Paul Schiffmacher ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Morphometric Analysis ◽  
Upper Cervical Spine ◽  
Endonasal Surgery ◽  
Upper Cervical

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

2021 ◽  
pp. 1-7
Author(s):  
Marko Jug
Keyword(s):  
Cervical Spine ◽  
3D Model ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Upper Cervical Spine ◽  
Spine Instrumentation ◽  
Cord Injury ◽  
Spinal Navigation ◽  
Upper Cervical ◽  
3D Printed

<b><i>Introduction:</i></b> In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. <b><i>Case Presentation:</i></b> We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. <b><i>Discussion/Conclusion:</i></b> Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

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