Pyogenic Osteomyelitis of an Invaginated Odontoid Process with Rapid Deterioration of High Cervical Myelopathy: A Case Report

1998 ◽  
Vol 140 (10) ◽  
pp. 1093-1094 ◽  
Author(s):  
M. Kurimoto ◽  
S. Endo ◽  
M. Ohi ◽  
Y. Hirashima ◽  
N. Matsumura ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Myelopathy ◽  
Odontoid Process ◽  
Rapid Deterioration ◽  
Pyogenic Osteomyelitis ◽  
High Cervical

Upper cervical myelopathy due to arachnoiditis and spinal cord tethering from adjacent C-2 osteomyelitis

2007 ◽  
Vol 6 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Sharad Rajpal ◽  
Krisada Chanbusarakum ◽  
Praveen R. Deshmukh
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Complete Resolution ◽  
Magnetic Resonance Image ◽  
Epidural Abscess ◽  
Odontoid Process ◽  
Surgical Decompression ◽  
Upper Cervical ◽  
High Cervical ◽  
Spinal Cord Tethering

✓Myelopathy caused by a spinal cord infection is typically related to an adjacent compressive lesion such as an epidural abscess. The authors report a case of progressive high cervical myelopathy from spinal cord tethering caused by arachnoiditis related to an adjacent C-2 osteomyelitis. This 70-year-old woman initially presented with a methicillin-sensitive Staphylococcus aureus osteomyelitis involving the C-2 odontoid process. She was treated with appropriate antibiotic therapy but, over the course of 4 weeks, she developed progressive quadriparesis. A magnetic resonance image revealed near-complete resolution of the C-2 osteomyelitis, but new ventral tethering of the cord was observed at the level of the odontoid tip. She subsequently underwent open surgical decompression and cord detethering. Postoperatively she experienced improvement in her symptoms and deficits, which continued to improve 1 year after her surgery. To the authors’ knowledge, this is the first reported case of progressive upper cervical myelopathy due to arachnoiditis and cord tethering from an adjacent methicillin-sensitive S. aureus C-2 osteomyelitis.

scholarly journals High cervical myelopathy due to bony craniovertebral junction anomalies (atlantoaxial dislocation) in pediatric population- clinical scoring system

2016 ◽  
Vol 52 (02) ◽  
pp. 131-138
Author(s):  
Raj Kumar
Keyword(s):  
Cervical Myelopathy ◽  
Scoring System ◽  
Odontoid Process ◽  
Craniovertebral Junction ◽  
Atlantoaxial Dislocation ◽  
Surgical Approaches ◽  
Lower Cranial Nerve ◽  
Complex Anatomy ◽  
Clinical Scoring ◽  
High Cervical

SUMMARYBony craniovertebral junction anomalies are rare anomalies to cause high cervical myelopathy. Atlantoaxial dislocation (congenital) is one of the commonest bony anomaly in children presenting with high cervical compression. It is relatively common in India with an incidence of 5-8 / 1000. When the distance of atlas (anterior arch) is more than 3mm ( 4 mm children) from odontoid process, it is called as Atlantoaxial dislocation (AAD) resulting into bony compression of high cervical cord. The patients may present with quadriparesis, sensory impairment in all limbs along with lower cranial nerve involvement. Because of lower medullary involvement the respiratory compromises are also frequent, posing a threat to life. Complex anatomy of foramen magnum, plethora of clinical conditions and atypical surgical approaches are responsible for poor outcome in these children. A new clinical scoring system for myelopathy was evolved in order to have an objective and precise grading of these cases preoperatively and postoperatively. The need of precise scoring system was felt to have reproducibility and easy applicability in children of craniovertebral junction anomalies in order to fetch even minimal improvement or deterioration following complex surgery. Motor functions, gait, sensory, sphincteric, respiratory function & spasticity were the parameters included in study of scoring system. This study was done in 177 operated cases of AAD (67 patients, below 14 years of age included for statistical analysis). Their detailed clinical & radiological evaluation was done preoperatively & postoperatively. The Kumar & Kalra high cervical myelopathy grading system was thus, introduced in literature. System was easy to use, interpret and was more sensitive to the changes in neurological status. It helped neurosurgeons and neurologists globally to evaluate and prognosticate the cases of Atlantoaxial dislocation.

Malunion of the Odontoid Process Developing Cervical Myelopathy: A Case Report

2006 ◽  
Vol 19 (3) ◽  
pp. 378
Author(s):  
Teak Soo Jeon ◽  
Sang Bum Kim ◽  
Whan Yong Chung ◽  
Woo Sik Kim ◽  
Sung Hun Kim ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Myelopathy ◽  
Odontoid Process

Odontoid cervical gout causing atlantoaxial instability: case report

2019 ◽  
Vol 30 (4) ◽  
pp. 541-544
Author(s):  
Justin Slavin ◽  
Marcello DiStasio ◽  
Paul F. Dellaripa ◽  
Michael Groff
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Case Report ◽  
Physical Examination ◽  
Odontoid Process ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Posterior Stabilization ◽  
Rotatory Subluxation

The authors present a case report of a patient discovered to have a rotatory subluxation of the C1–2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1–2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.

Brodie’s Abscess of the Proximal Humerus Metaphysis: A Case Report

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Nilesh Vishwakarma ◽  
Shaival Chauhan ◽  
Shrey S Binyala ◽  
Sanjeev K Singh
Keyword(s):  
Case Report ◽  
Shoulder Joint ◽  
Proximal Part ◽  
Focal Lesion ◽  
Posterior View ◽  
Brodie’S Abscess ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Pyogenic Osteomyelitis ◽  
Metaphyseal Region

Introduction:Primary subacute pyogenic osteomyelitis, or Brodie’s abscess was initially documented by Sir Benjamin Brodie in 1832. We present a case report with a 6-months follow-up period, demonstrating the successful diagnosis and surgical treatment of a focal lesion of the proximal metaphysis of the right humerus in a 21-years-old female. The pathology of hematologic osteomyelitis and its role in the development of a subacute abscess along with a review of literature and an in detail description of the pathogenesis of Brodie’s abscess is discussed and submitted. Case Report:A 21- years -old healthy female with a history of fall sustaining injury to the right shoulder one 1 year back followed by which she presented to the outpatient clinic with a swelling over her right shoulder. The patient was managed conservatively with analgesics and was relieved of pain over a course of one 1 week of medications, the patient now presents with pain and swelling in the right shoulder joint on and off since the episode of fall one 1 year back, which had increased over a period of past one 1 week. A week before the most recent presentation she started experiencing some discomfort and pain in her right shoulder. No recent trauma was reported. A mild swelling appeared over the proximal part of the humerus. There were no constitutional symptoms of fever or any illness reported. On examination, there was noted a painful restriction of ROM at the right shoulder joint with no rotator cuff injury. Laboratory investigations were suggestive of raised inflammatory markers. Radiograph of the right shoulder taken in the true antero-posterior view with the shoulder in the neutral rotation was suggestive of an oval lucency with surrounding sclerosis in the proximal metaphyseal region of the humerus. Magnetic resonance imaging MRI of the right shoulder joint showed features consistent with Brodie’s abscess in the proximal metaphyseal region of the humerus. Surgical debridement of the abscess w

Vertical translocation: the enigma of the disappearing atlantodens interval in patients with myelopathy and rheumatoid arthritis. Part I. Clinical, radiological, and neuropathological features

1997 ◽  
Vol 87 (6) ◽  
pp. 856-862 ◽  
Author(s):  
Adrian T. H. Casey ◽  
H. Alan Crockard ◽  
Jennian F. Geddes ◽  
John Stevens
Keyword(s):  
Cervical Myelopathy ◽  
Survival Rates ◽  
Cord Compression ◽  
Atlantoaxial Subluxation ◽  
Lateral Mass ◽  
Progressive Decrease ◽  
Content Type ◽  
Statistical Comparison ◽  
High Cervical ◽  
Fine Print

✓ This statistical comparison between patients with cervical myelopathy secondary to horizontal atlantoaxial subluxation and those with vertical translocation is designed to elucidate the mechanisms responsible for cranial settling and the effect of translocation on the development of spinal cord compression. In a 10-year study of a cohort of 256 patients, 186 suffered from myelopathy and 116 (62%) of these exhibited vertical translocation according to the Redlund-Johnell criteria. Vertical translocation occurred after a significantly longer period of disease than atlantoaxial subluxation (p < 0.001). Translocation was characterized clinically by a high cervical myelopathy with features of a cruciate paralysis present in 35% of individuals compared with 26% who exhibited horizontal atlantoaxial subluxation (p = 0.29), but there was a surprising paucity of cranial nerve problems. The patients with vertical translocation had a greater degree of neurological disability (p = 0.002) and poorer survival rates (p = 0.04). Radiologically, vertical translocation was secondary to lateral mass collapse and associated with a progressive decrease in the atlantodens interval ([ADI], r = 0.4; p < 0.001) and pannus (p = 0.003). Thirty percent of patients exhibited an ADI of less than 5 mm. This phenomenon has been termed pseudostabilization. The authors' studies emphasize that the ADI (frequently featured in the literature) is totally unreliable as an indicator of neuraxial compromise in the presence of vertical translocation.

scholarly journals Cicatricial Fibromatosis causing Cervical Myelopathy due to Rapid Growth after Removal of Meningioma: A Case Report

2021 ◽  
Author(s):  
Shunsuke Kanbara ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Hiroaki Nakashima ◽  
Masaaki Machino ◽  
...  
Keyword(s):  
Case Report ◽  
Rapid Growth ◽  
Cervical Myelopathy
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