Correction of Kyphotic Deformity of the Cervical Spine in Ankylosing Spondylitis Using General Anesthesia and Internal Fixation

1996 ◽  
Vol 9 (6) ◽  
pp. 540???543 ◽  
Author(s):  
Katsuji Shimizu ◽  
Mutsumi Matsushita ◽  
Shunsuke Fujibayashi ◽  
Junya Toguchida ◽  
Kazuhiro Ido ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Internal Fixation ◽  
General Anesthesia ◽  
Kyphotic Deformity

Surgical treatment of cervical spine fractures in ankylosing spondylitis patients: posterior stabilization using intraoperative CT scanner-based navigation

2020 ◽  
Vol 99 (5) ◽  
pp. 212-218
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Ct Imaging ◽  
Spine Fracture ◽  
Cervical Spine Fracture ◽  
Posterior Stabilization ◽  
Visceral Injury ◽  
Intraoperative Ct ◽  
Screw Insertion ◽  
Spinal Navigation

Introduction: The authors analyzed a series of ankylosing spondylitis patients with cervical spine fracture undergoing posterior stabilization using spinal navigation based on intraoperative CT imaging. The purpose of this study was to evaluate the accuracy and safety of navigated posterior stabilization and to analyze the adequacy of this method for treatment of fractures in ankylosed cervical spine. Methods: Prospectively collected clinical data, together with radiological documentation of a series of 8 consecutive patients with 9 cervical spine fracture were included in the analysis. The evaluation of screw insertion accuracy based on postoperative CT imaging, description of instrumentation- related complications and evaluation of morphological and clinical results were the subjects of interest. Results: Of the 66 implants inserted in all cervical levels and in upper thoracic spine, only 3 screws (4.5%) did not meet the criteria of anatomically correct insertion. Neither screw malposition nor any other intraoperative events were complicated by any neural, vascular or visceral injury. Thus we did not find a reason to change implant position intraoperatively or during the postoperative period. The quality of intraoperative CT imaging in our group of patients was sufficient for reliable trajectory planning and implant insertion in all segments, irrespective of the habitus, positioning method and comorbidities. In addition to stabilization of the fracture, the posterior approach also allows reducing preoperative kyphotic position of the cervical spine. In all patients, we achieved a stable situation with complete bone fusion of the anterior part of the spinal column and lateral masses at one year follow-up. Conclusion: Spinal navigation based on intraoperative CT imaging has proven to be a reliable and safe method of stabilizing cervical spine with ankylosing spondylitis. The strategy of posterior stabilization seems to be a suitable method providing high primary stability and the conditions for a subsequent high fusion rate.

scholarly journals SAT0009 Cervical spine involvement in ankylosing spondylitis

2001 ◽  
Author(s):  
A El Maghraoui ◽  
R Bensabbah ◽  
R Bahiri ◽  
A Bezza ◽  
N Guedira ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis

Comparison of the Bullard and Macintosh Laryngoscopes for Endotracheal Intubation of Patients with a Potential Cervical Spine Injury 

1997 ◽  
Vol 87 (6) ◽  
pp. 1335-1342 ◽  
Author(s):  
Andrew D. J. Watts ◽  
Adrian W. Gelb ◽  
David B. Bach ◽  
David M. Pelz
Keyword(s):  
Cervical Spine ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Cervical Spine Injury ◽  
Cricoid Pressure ◽  
Macintosh Laryngoscope ◽  
Spine Injury ◽  
Neck Extension ◽  
Bullard Laryngoscope ◽  
Spine Movement

Background In the emergency trauma situation, in-line stabilization (ILS) of the cervical spine is used to reduce head and neck extension during laryngoscopy. The Bullard laryngoscope may result in less cervical spine movement than the Macintosh laryngoscope. The aim of this study was to compare cervical spine extension (measured radiographically) and time to intubation with the Bullard and Macintosh laryngoscopes during a simulated emergency with cervical spine precautions taken. Methods Twenty-nine patients requiring general anesthesia and endotracheal intubation were studied. Patients were placed on a rigid board and anesthesia was induced. Laryngoscopy was performed on four occasions: with the Bullard and Macintosh laryngoscopes both with and without manual ILS. Cricoid pressure was applied with ILS. To determine cervical spine extension, radiographs were exposed before and during laryngoscopy. Times to intubation and grade view of the larynx were also compared. Results Cervical spine extension (occiput-C5) was greatest with the Macintosh laryngoscope (25.9 degrees +/- 2.8 degrees). Extension was reduced when using the Macintosh laryngoscope with ILS (12.9 +/- 2.1 degrees) and the Bullard laryngoscope without stabilization (12.6 +/- 1.8 degrees; P < 0.05). Times to intubation were similar for the Macintosh laryngoscope with ILS (20.3 +/- 12.8 s) and for the Bullard without ILS (25.6 +/- 10.4 s). Manual ILS with the Bullard laryngoscope results in further reduction in cervical spine extension (5.6 +/- 1.5 degrees) but prolongs time to intubation (40.3 +/- 19.5 s; P < 0.05). Conclusions Cervical spine extension and time to intubation are similar for the Macintosh laryngoscope with ILS and the Bullard laryngoscope without ILS. However, time to intubation is significantly prolonged when the Bullard laryngoscope is used in a simulated emergency with cervical spine precautions taken. This suggests that the Bullard laryngoscope may be a useful adjunct to intubation of patients with potential cervical spine injury when time to intubation is not critical.

scholarly journals Cervical spine dislocation on ankylosing spondylitis: A case report

2021 ◽  
pp. 102766
Author(s):  
Tarik Mesbahi ◽  
Marouane Makhchoune ◽  
Reda Mouine ◽  
Abederrahmane Rafiq ◽  
Abdelhakim Lakhdar
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Ankylosing Spondylitis

Posterior Temporary C1-2 Pedicle Screws Fixation for the Treatment of Unstable C1-2 Complex Fractures: Minimum of 2-Year Follow-Up

2021 ◽  
pp. 219256822110391
Author(s):  
Yakubu Ibrahim ◽  
Hao Li ◽  
Geng Zhao ◽  
Suomao Yuan ◽  
Yiwei Zhao ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Internal Fixation ◽  
Neck Disability Index ◽  
Pedicle Screws ◽  
Rotary Motion ◽  
Upper Cervical Spine ◽  
Complex Fractures ◽  
Upper Cervical ◽  
Better Than

Study Design: Retrospective. Objectives: To present rarely reported complex fractures of the upper cervical spine (C1-C2) and discuss the clinical results of the posterior temporary C1-2 pedicle screws fixation for C1-C2 stabilization. Methods: A total of 19 patients were included in the study (18 males and 1 female). Their age ranged from 23 to 66 years (mean age of 39.6 years). The patients were diagnosed with complex fractures of the atlas and the axis of the upper cervical spine and underwent posterior temporary C1-2 pedicle screws fixation. The patients underwent a serial postoperative clinical examination at approximately 3, 6, 9 months, and annually thereafter. The neck disability index (NDI) and the range of neck rotary motion were used to evaluate the postoperative clinical efficacy of the patients. Results: The average operation time and blood loss were 110 ± 25 min and 50 ± 12 ml, respectively. The mean follow-up was 38 ± 11 months (range 22 to 60 months). The neck rotary motion before removal, immediately after removal, and the last follow-up were 68.7 ± 7.1°, 115.1 ± 11.7°, and 149.3 ± 8.9° ( P < 0.01). The NDI scores before and after the operation were 42.7 ± 4.3, 11.1 ± 4.0 ( P < 0.01), and the NDI score 2 days after the internal fixation was removed was 7.3 ± 2.9, which was better than immediately after the operation ( P < 0.01), and 2 years after the internal fixation was removed. The NDI score was 2.0 ± 0.8, which was significantly better than 2 days after the internal fixation was taken out ( P < 0.001). Conclusions: Posterior temporary screw fixation is a good alternative surgical treatment for unstable C1-C2 complex fractures.

scholarly journals Nasal/maxillofacial manifestations of head and neck injury

2017 ◽  
Vol 3 (3) ◽  
pp. 555
Author(s):  
Siddaram Patil ◽  
Girish P. B.
Keyword(s):  
Head Injury ◽  
Internal Fixation ◽  
General Anesthesia ◽  
Open Reduction ◽  
Mandibular Fractures ◽  
Medical College ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Waking Up ◽  
Head And Neck Injury

<p class="abstract"><strong>Background:</strong> A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">.</span></p>

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