scholarly journals Dynamic CT scan of the craniovertebral junction: a role in the management of os odontoideum

2010 ◽  
Vol 44 (6) ◽  
pp. 603-608 ◽  
Author(s):  
Abad Cherif El Asri ◽  
Ali Akhaddar ◽  
Miloudi Gazzaz ◽  
Naama Okacha ◽  
Omar Boulhroud ◽  
...  
Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 666-670 ◽  
Author(s):  
Paul M. Kelly ◽  
John G. Hopkins ◽  
Andrew J. Furey ◽  
Daniel S. Squire

Background: Injuries to the scapholunate can have severe long-term effects on the wrist. Early detection of these injuries can help identify pathology. The purpose of this study was to evaluate the motions of the scapholunate joint in normal wrists in a clenched fist and through radial and ulnar deviation using novel dynamic computed tomography (CT) imaging. Methods: Fifteen participants below 40 years of age consented to have their wrist scanned. Eight participants were randomized to have the right wrist scanned and 7 the left wrist. Volunteers were positioned at the back of the gantry with the wrist placed on the table, palmar side down. Participants began with the hand in a relaxed fist position and then proceeded through an established range of motion protocol. Dynamic CT imaging was captured throughout the range of motion. Results: The movement in the healthy scapholunate joint through a clenched fist and radial and ulnar deviation is minimal. The averages were 1.19, 1.01, and 0.95 mm, representing the middle, dorsal, and volar measurements, respectively. Conclusions: This novel dynamic CT scan of the wrist is a user-friendly way of measuring of the scapholunate distance, which is minimal in the normal wrist below 40 years of age.


Stroke ◽  
1994 ◽  
Vol 25 (3) ◽  
pp. 576-581 ◽  
Author(s):  
M Zuber ◽  
E Meary ◽  
J F Meder ◽  
J L Mas

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
V Malamutmann ◽  
K Matyssek ◽  
M Stolze ◽  
K Mathias ◽  
R Krakor

2019 ◽  
Vol 12 (11) ◽  
pp. e230945
Author(s):  
Christopher Shane Buntting ◽  
Ashraf Dower ◽  
Haider Seghol ◽  
Saeed Kohan

Syncopal events are a concerning presentation and timely evaluation is warranted. Common aetiologies include cardiac and neurological pathology such as arrhythmias, vertebrobasilar arterial disease and vasovagal syncope. We describe the case of a 65-year-old man who presented to our emergency department with symptoms of vertigo and syncope. He was investigated extensively for both cardiac and neurological causes of his symptoms which returned negative results. An outpatient CT scan demonstrated the presence of Os odontoideum and dynamic instability of the atlantoaxial junction, with presumed dynamic obstruction of the vertebral arterial system. This was successfully managed with a posterior atlantoaxial lateral mass fusion with resolution of syncopal symptoms.


Neurosurgery ◽  
2015 ◽  
Vol 77 (2) ◽  
pp. 296-306 ◽  
Author(s):  
Atul Goel ◽  
Trimurti Nadkarni ◽  
Abhidha Shah ◽  
Raghvendra Ramdasi ◽  
Neeraj Patni

Abstract BACKGROUND: On reviewing the database of patients with craniovertebral junction anomalies, the authors identified 70 patients with a bifid posterior arch of atlas. OBJECTIVE: To speculate on the pathogenesis of spondyloschisis of both the anterior and posterior arches of atlas, particularly as it relates to atlantoaxial instability. METHODS: Seventy patients with bifid anterior and posterior arches were identified by a retrospective review of the database from 2007 to 2013. RESULTS: The ages of the patients ranged from 14 months to 50 years. The patients were divided into 3 groups. Group 1 (3 patients) had multiple additional spinal bony and neural abnormalities. Group 2 (34 patients) had mobile and partially (5) or completely (29) reducible atlantoaxial dislocation. Group 3 (33 patients) had atlantoaxial instability and related basilar invagination. The os odontoideum was identified in 21 patients, and C2-3 fusion was seen in 24 patients. Two of 3 patients in group 1 were treated conservatively and without any surgery. All patients in groups 2 and 3 were surgically treated. Surgery was done using lateral mass plate/rod and screw fixation techniques. The general observation during surgery included identification of discrete movements of both halves of the atlas, lateral positioning of the facets of atlas in relation to the facets of the axis and occipital condyle and closer approximation of the occipital bone, atlas, and axis resulting in “crumpling” of bone and neural elements. CONCLUSION: Understanding of the pathogenesis and mechanical alterations in cases with a bifid arch of atlas can assist in evaluating the clinical implications and in conduct of surgery.


Author(s):  
Vamsi Krishna Yerramneni ◽  
Neeraj Sharma

AbstractOs odontoideum is an independent ossicle of variable size and shape separated from the body of C2. There are various theories on the etiology. Different hypothesis on etiology include traumatic and congenital. Because of the laxity of the ligaments associated with the anomalous odontoid, there can be associated instability at the craniovertebral junction. The authors presented their experience of treating these anomalies, their clinical presentations, evolution of the treatment strategies over years, and a brief review of literature on etiopathogenesis.


Spine ◽  
2011 ◽  
Vol 36 (12) ◽  
pp. E814-E818 ◽  
Author(s):  
Dhananjaya Sabat ◽  
Sumit Arora ◽  
Vinod Kumar ◽  
Ajay Gupta

2011 ◽  
Vol 14 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Sun-Ho Lee ◽  
Eun-Sang Kim ◽  
Whan Eoh

The authors report the case of a patient with os odontoideum, myelopathy secondary to atlantoaxial instability, and bilaterally persistent first intersegmental artery at the craniovertebral junction. Instead of occipitocervical fusion, C1–2 posterior fusion was performed using a polyaxial screw/rod system. The information obtained from 3D CT angiography studies may highlight the potential risk of vertebral artery injury in advance and reduce the risk of an intraoperative vertebral artery injury. In addition, C-1 lateral mass screw placement may be a safe procedure for cases of atlantoaxial subluxation in which there are persistent C-1 intersegmental arteries.


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