scholarly journals Traumatic Unilateral Sixth to Seventh Cervical Vertebral Facet Luxation in a Dog

VCOT Open ◽  
2018 ◽  
Vol 01 (01) ◽  
pp. e19-e24
Author(s):  
Philemon Karli ◽  
Martin Bass ◽  
Roman Inauen ◽  
Danielle Bass
Keyword(s):  
Open Reduction ◽  
Suture Material ◽  
Facet Joint ◽  
Weight Bearing ◽  
Cord Compression ◽  
Neurological Deficits ◽  
The Right ◽  
Temporary Stabilization ◽  
Cervical Facet ◽  
Joint Luxation

AbstractWe describe the surgical reduction of a traumatic, unilateral cervical vertebral facet joint luxation in a large breed dog. Computed tomography (CT) including CT myelography revealed complete luxation of the left articular processes C6 to C7 without fracture of the main weight-bearing structures. There was marked spinal cord compression secondary to the malalignment. Due to the non-ambulatory tetraparetic status, open reduction was chosen as the treatment of choice. After making a dorsal surgical approach to the caudal cervical spine, the luxated articular processes were visible and repositioned. Owing to marked mobility of this joint, temporary stabilization with a nonabsorbable suture between the spinous processes of C6 and C7 was performed and good stability was obtained. The dog recovered uneventfully from the surgery and regained normal ambulation. Follow-up examination including a second CT 9 months after surgery showed no neurological abnormalities and unrestricted motion of the neck. Normal cervical vertebral alignment with moderate osteoarthritis of the right facet joint and mild spondylosis deformans C6 to C7 were present. The present case report shows successful management of a traumatic cervical facet joint luxation without persistent neurological deficits. Open reduction and temporary stabilization with suture material seem to be a valuable method of treatment. The dorsal approach allowed direct inspection of the facet joints with concurrent access to place suture material for temporary stabilization.

Experimental neck muscle pain increase pressure pain threshold over cervical facet joints

2017 ◽  
Vol 16 (1) ◽  
pp. 182-183
Author(s):  
Ning Qu ◽  
René Lindstrøm ◽  
Rogerio Pessoto Hirata ◽  
Thomas Graven-Nielsen
Keyword(s):  
Injection Site ◽  
Muscle Pain ◽  
Pain Threshold ◽  
Facet Joint ◽  
Pressure Pain Threshold ◽  
Trapezius Muscle ◽  
Facet Joints ◽  
Multifidus Muscle ◽  
The Right ◽  
Cervical Facet

AbstractAimsEvaluate pressure pain threshold (PPT) over cervical facet joints before and after injection of experimental pain in the trapezius and multifidus muscles.MethodsFourteen healthy subjects (6 women) received randomized ultrasound-guided injections of hypertonic saline (5.8%), in the right multifidus muscle medial to C4/C5 facet joint and in the right trapezius muscle at the midpoint between C7 spinous process and acromion. The saline-induced pain intensity was assessed on a VAS scale. Before and during saline-induced pain PPTs were assessed by pressure algometry bilaterally over C2/C3 and C5/C6 facet joints. Three-way repeated-measures ANOVA with factors PPT location, injection site, and time was used for analysis. Post-hoc analysis was done by Bonferroni.ResultsSaline-induced trapezius muscle pain increased PPTs over all facet joints (P < 0.05) compared with before pain. Saline-induced multifidus muscle pain increased PPTs bilaterally over C2/C3 facet joints and over the left C5/C6 facet joint (P < 0.05) compared with before pain.ConclusionsTrapezius muscle pain increased PPT over assessed facet joints. Similar results were found for multifidus muscle pain except for the right C5/C6 facet joint, which was close to the injection site. Such findings may reflect descending inhibitory control acting on structures furthest away from the painful structure.

A Possible Correlation between Facet Orientation and Development of Degenerative Cervical Spinal Stenosis

2021 ◽  
Author(s):  
Yalei Wang ◽  
Ning Ning ◽  
Hao Liu ◽  
Jiali Chen ◽  
Beiyu Wang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Spinal Canal ◽  
Facet Joint ◽  
Degenerative Spondylolisthesis ◽  
Underlying Mechanism ◽  
Control Group ◽  
Facet Orientation ◽  
Cervical Spinal Stenosis ◽  
The Right ◽  
Cervical Facet

Abstract Background Previous studies have demonstrated the relationship between sagittal facet orientation and cervical degenerative spondylolisthesis. However, the associations between facet orientation and cervical spinal stenosis (CSS) have rarely been studied. Methods One hundred and twenty patients with CSS (CSS group) and 120 healthy participants (control group) were consecutively enrolled. The cervical facet angles and anteroposterior diameter (A-P diameter) of spinal canal at each subaxial cervical levels were measured using axial magnetic resonance imaging. The intersection angle of the midsagittal line of the vertebra to the facet line represents the orientation of the facet joint. Results The facet angles on the right side at C2- C3 and C3-C4 in CSS group and at C2- C3 in control group had significantly higher values than those of the other sides. Besides, the facet angles and A-P diameter of spinal canal in CSS group were significantly smaller than those in control group at all levels (p < 0.05). Conclusions Our study demonstrated that patients with CSS have smaller axial cervical facet joint angles compared to the healthy individuals. Further studies are needed to elicit the specific underlying mechanism between sagittalization of the cervical facet joints and the pathology of CSS.

scholarly journals Use of combined transarticular pinning and external skeletal fixation for the reduction and stabilization of multiple metatarsophalangeal luxations in a cat

2020 ◽  
Vol 6 (1) ◽  
pp. 205511692090446
Author(s):  
Valentine D Verpaalen ◽  
Daniel D Lewis ◽  
Erin G Porter
Keyword(s):  
Internal Rotation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
The Third ◽  
Case Summary ◽  
Pelvic Limb ◽  
The Right ◽  
Metatarsophalangeal Joints ◽  
Postoperative Swelling

Case summary A 1-year-old spayed female domestic shorthair cat presented for evaluation of a non-weight bearing right pelvic limb lameness after falling from a 4 m height. On orthopedic examination there was substantial swelling and pain on manipulation of the right pes. Radiographs were obtained under sedation, and these revealed dorsoproximal luxations of the third, fourth and fifth metatarsophalangeal joints, and lateral rotation of the second digit. Closed manual reduction under sedation was unsuccessful and open reduction under general anesthesia was therefore performed. Combined transarticular pinning and external skeletal fixation were performed to maintain reduction of the third and fourth digits. Marked postoperative swelling of the distal pes and internal rotation of the third and fourth digits were noted within 24 h of surgery. Three weeks postoperatively, the cat had a persistent weight bearing right pelvic limb lameness and minor pin tract inflammation. All implants were removed and the limb was splinted for 1 week. Internal rotation and pin tract inflammation had resolved at the time of splint removal, and the lameness resolved within 6 weeks of surgery. The cat was not lame, but radiographs revealed mild-to-moderate degenerative osteoarthrosis when the cat was evaluated 6 months after surgery. Relevance and novel information There are limited reports describing metatarsophalangeal luxations in cats. Although several surgical techniques have been advocated, specific outcomes in clinical cases have not been reported. This report describes the clinical application and outcome of combined transarticular pinning and external skeletal fixation for the management of multiple metatarsophalangeal luxations in a cat.

scholarly journals Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition

2020 ◽  
Vol 12 (3) ◽  
pp. 433-439
Author(s):  
Riwaj Bhagat ◽  
Siddharth Narayanan ◽  
Marwa Elnazeir ◽  
Thong Diep Pham ◽  
Robert Paul Friedland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Mri ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
The Other ◽  
Neurological Deficits ◽  
Brainstem Stroke ◽  
Neurological Features ◽  
The Right ◽  
Core Features

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.

scholarly journals Unprecedented tibial bone lengthening of 33.5 cm by distraction osteogenesis for the reconstruction of a subtotal tibial bone defect. A case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Abdulnassir Ali ◽  
Ying Ren ◽  
Chun-Hao Zhou ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Bone Defect ◽  
Distraction Osteogenesis ◽  
Chronic Osteomyelitis ◽  
Weight Bearing ◽  
Lower Leg ◽  
Bone Lengthening ◽  
Case Presentation ◽  
Tibial Length ◽  
Tibial Bone ◽  
The Right

Abstract Background We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. Case presentation A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient’s right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. Conclusion Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.

Iatrogenic pyogenic osteomyelitis of C-1 and C-2 treated with transoral decompression and delayed posterior occipitocervical arthrodesis

2007 ◽  
Vol 7 (6) ◽  
pp. 664-668 ◽  
Author(s):  
Patrick J. Reid ◽  
Paul J. Holman
Keyword(s):  
Antibiotic Therapy ◽  
Facet Joint ◽  
Trigger Point ◽  
Corticosteroid Injection ◽  
Craniocervical Junction ◽  
Anterior Decompression ◽  
The Right ◽  
Pyogenic Osteomyelitis ◽  
Posterior Instrumented Fusion ◽  
Transoral Decompression

✓The authors describe a case of osteomyelitis of the craniocervical junction caused by iatrogenic infection of the spine during corticosteroid injection therapy. This 58-year-old diabetic man presented with acute exacerbation of neck pain that had began 4 months prior to admission. He did not experience the associated fever, chills, or sweats, but he did notice transient weakness in the right upper extremity. A computed tomography (CT) scan of the cervical spine demonstrated a destructive process involving the odontoid and the left occipitocervical and atlantoaxial joints that was not present on a CT obtained 2 months earlier, just before trigger-point and left-sided C1–2 facet joint corticosteroid injections. A diagnosis of staphylococcal osteomyelitis was made, and initial treatment with external immobilization and appropriate antibiotic therapy failed to control radiographically demonstrated and clinical progression. The patient was successfully treated using staged anterior decompression and posterior instrumented fusion with prolonged antibiotic therapy. To the authors' knowledge this case is the first reported instance of iatrogenic pyogenic osteomyelitis of the craniocervical junction successfully treated with anterior decompression and delayed posterior arthrodesis.

scholarly journals Ruptured Bilateral Pericallosal Artery Aneurysm in Mirror Position: Case Report

2018 ◽  
Vol 37 (03) ◽  
pp. 263-266
Author(s):  
Lucas Meguins ◽  
Linoel Valsechi ◽  
Ronaldo Fernandes ◽  
Dionei Morais ◽  
Antonio Spotti
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
External Ventricular Drain ◽  
Artery Aneurysm ◽  
Operative Management ◽  
Neurological Deficits ◽  
Pericallosal Artery ◽  
Digital Subtraction Arteriography ◽  
The Many ◽  
The Right

Introduction Pericallosal artery (PA) aneurysms represent 2 to 9% of all intracranial aneurysms, and their management remains difficult. Objective The aim of the present study is to describe the case of an adult woman with subarachnoid hemorrhage and bilateral PA aneurysm in mirror position. Case Report A 46-year-old woman was referred to our institution 20 days after a sudden severe headache. She informed that she was treating her arterial hypertension irregularly, and consumed ∼ 20 cigarettes/day. The patient was neurologically intact at admission. A non-contrast computed tomography (CT) on the first day of the onset of the symptoms revealed hydrocephaly and subarachnoid hemorrhage (Fisher III). An angio-CT/digital subtraction arteriography showed bilateral PA aneurysms in mirror position. The patient was successfully treated with surgery via the right interhemispheric approach (because the surgeon is right-handed); the surgeon performed the proximal control with temporary clipping, and introduced an external ventricular drain at the end of the surgery. The patient was discharged on the fourth postoperative day without any additional neurological deficits or ventricular shunts. Conclusion Ruptured PA aneurysm is a surgically challenging aneurysm due to the many anatomical nuances and risk of rebleeding. However, the operative management of ruptured bilateral PA aneurysms is feasible and effective.

scholarly journals Cerebellar peduncle abscess secondary to disseminated strangles in a six-week-old miniature foal

2011 ◽  
Vol 1 (1) ◽  
pp. 12
Author(s):  
Brianne Henderson
Keyword(s):  
Animal Health ◽  
Clinical Signs ◽  
Acute Onset ◽  
Abscess Formation ◽  
Neurological Deficits ◽  
Post Mortem ◽  
Streptococcus Equi ◽  
The Central Nervous System ◽  
Cerebellar Peduncle ◽  
The Right

During a strangles outbreak within a herd of minature horses, a six week old foal developed acute onset clinical signs of sepsis and neurological deficits. The foal was euthanized and submitted for post-mortem at the Animal Health Laboratories, Guelph Ontario. Gross <em>post-mortem</em> examination noted severe bronchopneumonia, hypopyon of the right eye and a singular cerebellar peduncle abscess. Culture of the lungs and cerebellum produced a pure growth of <em>Streptococcus equi</em> ssp. <em>equi</em>. <em>Streptococcus equi</em> ssp. <em>equi</em>, the causative agent of equine strangles, produces an acute pyrexia, purulent lymphadenopathy of submandibular and retropharyngeal lymph nodes. Commonly, lymph node abscesses rupture and resolve without complication. Rarely, complications may include: dissemination of the bacteria with diffuse abscess formation, immune mediated disease (purpura haemorrhagica), rarely abscess formation within the central nervous system (CNS) can occur. These can be managed medically with appropriate antibiotics and drugs to reduce intra-cranial pressure, however surgical drainage and debulking of the abscess has been attempted successfully in a few cases.

Upper Cervical Facet Joint and Spinal Rami Blocks for the Treatment of Cervicogenic Headache

2010 ◽  
Vol 50 (4) ◽  
pp. 657-663 ◽  
Author(s):  
Linqiu Zhou ◽  
Zarinah Hud-Shakoor ◽  
Christopher Hennessey ◽  
Avi Ashkenazi
Keyword(s):  
Facet Joint ◽  
Cervicogenic Headache ◽  
Upper Cervical ◽  
Cervical Facet ◽  
Cervical Facet Joint
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