scholarly journals Retroodontoid Pseudotumor Related to Development of Myelopathy Secondary to Atlantoaxial Instability on Os Odontoideum

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
M. Hamard ◽  
S. P. Martin ◽  
S. Boudabbous
Keyword(s):  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Cervical Cord ◽  
Unknown Etiology ◽  
Complete Disappearance ◽  
Pathophysiological Mechanism ◽  
Tissue Mass ◽  
Inflammatory Conditions ◽  
Occipitocervical Fixation ◽  
Compressive Myelopathy

Retroodontoid pseudotumor (ROP) is a nonneoplasic lesion of unknown etiology, commonly associated with inflammatory conditions, and the term of pannus is usually used. Less frequently, ROP formation can develop with other noninflammatory entities, with atlantoaxial instability as most accepted pathophysiological mechanism for posttraumatic or degenerative ROP. As it can clinically and radiologically mimic a malignant tumor, it is paramount for the radiologist to know this entity. Magnetic resonance imaging is the modality of choice to reveal the possible severe complication of ROP in the form of a compressive myelopathy of the upper cervical cord. The purpose of the surgical treatment is the regression or complete disappearance of ROP, with posterior decompression by laminectomy and posterior C1-C2 or occipitocervical fixation. We present the case of an elderly patient with retroodontoid soft tissue mass secondary to a chronic atlantoaxial instability on os odontoideum, an extremely rare cause of ROP. The patient developed a posttraumatic cervical myelopathy related to the decompensation of this C1-C2 instability responsible for the formation of a compressive ROP. We will overview the retroodontoid pseudotumor and its differential diagnosis.

Compressive Myelopathy Secondary to TRPV4 Skeletal Dysplasia: Spondylometaphyseal Dysplasia, Kozlowski Type

2022 ◽  
Author(s):  
Vykuntaraju K. Gowda ◽  
Varunvenkat M. Srinivasan ◽  
Varsha M. Reddy ◽  
Dhananjaya K. Vamyanmane ◽  
Sanjay K. Shivappa ◽  
...  
Keyword(s):  
Transient Receptor Potential ◽  
De Novo ◽  
Lumbar Vertebrae ◽  
Atlantoaxial Instability ◽  
Cervical Cord ◽  
Average Weight ◽  
Transient Receptor Potential Vanilloid ◽  
Hyperintense Signal ◽  
Spondylometaphyseal Dysplasia ◽  
Compressive Myelopathy

AbstractTransient receptor potential vanilloid 4 channel (TRPV4) gene mutations have been described in skeletal system and peripheral nervous system pathology. The case described here is a 9-year-old male child patient, born to a nonconsanguineous marriage with normal birth history who had difficulty in walking and stiffness of joints for the last 7 years, and progressive weakness of all four limbs and urine incontinence for 1 year following falls. Physical examination showed below-average weight and height and short trunk. Musculoskeletal examination revealed bony prominence bilaterally in the knee joints and contractures in knee and elbow joints with brachydactyly; muscle tone was increased, with brisk deep tendon reflexes. Skeletal survey showed platyspondyly with anterior beaking with metaphyseal dysplasia. Magnetic resonance imaging of the spine revealed atlantoaxial instability with hyperintense signal changes at a cervicomedullary junction and upper cervical cord with thinning and spinal canal stenosis suggestive of compressive myelopathy with platyspondyly and anterior beaking of the spine at cervical, thoracic and lumbar vertebrae. Exome sequencing revealed a heterozygous de novo variant c.2389G > A in exon 15 of TRPV4, which results in the amino acid substitution p.Glu797Lys in the encoded protein. The characteristics observed indicated spondylometaphyseal dysplasia, Kozlowski type (SMD-K). The child underwent surgical intervention for compressive myelopathy by reduction of atlantoaxial dislocation with C1 lateral mass and C2 pars fusion using rib graft and fixation using screws and rods. To conclude, for any child presenting with progressive kyphoscoliosis, short stature, platyspondyly, and metaphyseal changes, a diagnosis of SMD-K should be considered and the patient and family should be advised to avoid spinal injuries.

Os Odontoideum with Posterior Atlantoaxial Instability

Spine ◽  
1991 ◽  
Vol 16 (7) ◽  
pp. 706-715 ◽  
Author(s):  
NOBUKI SHIRASAKI ◽  
KOZO OKADA ◽  
SHIRO OKA ◽  
NOBORU HOSONO ◽  
KAZUO YONENOBU ◽  
...  
Keyword(s):  
Atlantoaxial Instability ◽  
Os Odontoideum

Use of a titanium mesh cage for posterior atlantoaxial arthrodesis

2002 ◽  
Vol 96 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Morio Matsumoto ◽  
Kazuhiro Chiba ◽  
Takashi Tsuji ◽  
Hirofumi Maruiwa ◽  
Yoshiaki Toyama ◽  
...  
Keyword(s):  
Donor Site ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Posterior Arch ◽  
Rigid Fixation ◽  
Titanium Mesh ◽  
Content Type ◽  
Atlantoaxial Fixation ◽  
Mesh Cage ◽  
Atlantoaxial Arthrodesis

✓ The authors placed titanium mesh cages to achieve posterior atlantoaxial fixation in five patients with atlantoaxial instability caused by rheumatoid arthritis or os odontoideum. A mesh cage packed with autologous cancellous bone was placed between the C-1 posterior arch and the C-2 lamina and was tightly connected with titanium wires. Combined with the use of transarticular screws, this procedure provided very rigid fixation. Solid fusion was achieved in all patients without major complications. The advantages of this method include more stable fixation, better control of the atlantoaxial fixation angle, and reduced donor-site morbidity compared with a conventional atlantoaxial arthrodesis in which an autologous iliac crest graft is used.

scholarly journals Myofacial Release for the Management of Cervical Compressive Myelopathy – Case Study

2021 ◽  
Vol 1 (2) ◽  
pp. 1-5
Author(s):  
Patitapaban Mohanty ◽  
Keyword(s):  
Soft Tissue ◽  
Disc Herniation ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Cervical Cord ◽  
Myofascial Release ◽  
Cervical Compressive Myelopathy ◽  
Compressive Myelopathy

Cervical compressive myelopathy commonly occurs due to degeneration or disc herniation. The persons with cervical meylopathy are usually advised for surgical decompression. Person with signs of cervical cord compression was treated with myofacial release and found to be improved in signs as well as the symptoms. Total 34 numbers of similar cases (31 males and 3 females) age ranging from 25 to 61 years were treated by myofascial release of periscapular soft tissue structures over last 2 & ½ years (2017 to 2020) and found to return back to their activities after 6 months of follow up.

scholarly journals A Rare Case of Kimura Disease in the Wrist

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4881-4881
Author(s):  
Parastou Tizro ◽  
Taraneh Hashemi Zonouz ◽  
Fawaz Almutairi ◽  
Donald Karcher
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Conflicts Of Interest ◽  
Soft Tissue Mass ◽  
Germinal Centers ◽  
Unknown Etiology ◽  
Inflammatory Disorder ◽  
Kimura Disease ◽  
High Endothelial Venules ◽  
Tissue Mass

Kimura disease is a rare benign chronic inflammatory disorder of unknown etiology that typically involves lymph nodes and soft tissues. This disease is most common in middle-aged Asian men. Although the disorder most frequently involves the head and neck region, it has also been reported to involve the extremities. Lesions typically show follicular lymphocytic hyperplasia with prominent interfollicular venules and a mixed inflammatory infiltrate, including numerous eosinophils. We describe a case of Kimura disease in a 29-year-old female presenting with a slowly enlarging, painless soft tissue mass in her left wrist for five months. The lesion was non-tender, mobile, and compressible. Lab results were significant for peripheral blood eosinophilia and elevated IgE. Microscopically, the mass was circumscribed, with apparent fibrous capsule or pseudocapsule, prominent high-endothelial venules, and inflammatory cells consisting of lymphocytes and eosinophils. There were prominent secondary B-lymphocytic follicles with germinal centers containing many penetrating small blood vessels, and some follicles exhibiting follicle lysis and a small amount of eosinophilic extracellular material. Polykaryocytes were noted in many germinal centers. Angiolymphoid hyperplasia with eosinophilia, a main differential diagnosis of Kimura disease, was considered; however, the combined clinical and morphologic findings appeared to be more consistent with Kimura disease, particularly in the context of eosinophilia and elevated IgE level. Kimura disease may present as a rare cause of a soft tissue mass and a diagnostic challenge for clinicians and pathologists, especially in less common sites such as the wrist. Disclosures No relevant conflicts of interest to declare.

Atlantoaxial Instability

2018 ◽  
pp. 41-48
Author(s):  
Jonathan M. Parish ◽  
Domagoj Coric
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Plain Film ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Cervical Cord ◽  
Screw Length ◽  
Cord Injury ◽  
Bony Anatomy ◽  
Atlantodental Interval

There are a number of different imaging modalities that can be used to confirm atlantoaxial instability. Plain film radiographs of the cervical spine can be used to assess the atlantodental interval (ADI). Cervical CT is necessary to assess the atlantoaxial bony anatomy as well as to assess the foramen transversarium at C1 and C2. In particular, CT scan should be used to estimate screw length, medial/lateral and cranial/caudal screw trajectory. MRI can also evaluate the extent of cervical cord compression or cord injury that has occurred due to atlantoaxial instability.

scholarly journals MR diffusion tensor imaging of the spinal cord: can it help in early detection of cervical spondylotic myelopathy and assessment of its severity?

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Talaat Ahmed Abd El Hameed Hassan ◽  
Ramy Edward Assad ◽  
Shaimaa Atef Belal
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Early Detection ◽  
Cervical Spondylotic Myelopathy ◽  
Diffusion Tensor ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Mr Diffusion ◽  
Compressive Myelopathy ◽  
Mr Diffusion Tensor Imaging

Abstract Background The aim of this study is to evaluate the potential application of MR diffusion tensor imaging (with calculation of fractional anisotropy (FA) values) in assessment of the spondylotic cervical spinal canal compromise and comparison with the information issued from conventional MR sequences for early detection of cervical spondylotic myelopathy (CSM). Thirty patients (11 males and 19 females) were included in this study; age ranged from 22 to 70 years (mean age = 44). All patients had conventional and diffusion tensor imaging (DTI) examinations of the cervical spine for detection and assessment of degree of cervical cord myelopathy. FA values of the whole cord circumference and at 3, 6, 9, 12 o’clock positions of the normal cord (opposite to C2), opposite to the most affected disc, and below the level of the most affected disc were measured. Results High statistically significant P values were obtained when comparing the FA values of the normal cord with the cord opposite to the most affected disc, the normal cord with the cord below the affected disc and the cord at the level of the most affected disc with the cord below the level of the most affected disc. Conclusions DTI of the cervical spinal cord with FA measurement in patients with cervical spondylosis helps in early detection of cervical cord compressive myelopathy prior to appearance of changes in conventional MRI, which can improve the clinical outcome and help in treatment plans.

scholarly journals Transoral intraarticular cage distraction and C-JAWS fixation for revision of basilar invagination with irreducible atlantoaxial dislocation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaobao Zou ◽  
Binbin Wang ◽  
Haozhi Yang ◽  
Su Ge ◽  
Bieping Ouyang ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Odontoid Process ◽  
Basilar Invagination ◽  
Atlantoaxial Dislocation ◽  
Atlantoaxial Instability ◽  
Cervical Cord ◽  
Atlantoaxial Joint ◽  
Japanese Orthopedic Association ◽  
Satisfactory Outcome ◽  
Irreducible Atlantoaxial Dislocation

Abstract Background The revision surgery of basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD) after a previous occipitocervical fusion (OCF) is challenging. Transoral revision surgery has more advantages than a combined anterior and posterior approach in addressing this pathology. The C-JAWS is a cervical compressive staple that has been used in the lower cervical spine with many advantages. Up to now, there is no report on the application of C-JAWS in the atlantoaxial joint. We therefore present this report to investigate the clinical outcomes of transoral intraarticular cage distraction and C-JAWS fixation for revision of BI with IAAD. Methods From June 2011 to June 2015, 9 patients with BI and IAAD were revised by this technique after previous posterior OCF in our department. Plain cervical radiographs, computed tomographic scans and magnetic resonance imaging were obtained pre- and postoperatively to assess the degree of atlantoaxial dislocation and compression of the cervical cord. The Japanese Orthopedic Association (JOA) score was used to evaluate the neurological function. Results The revision surgeries were successfully performed in all patients. The average follow-up duration was 18.9 ± 7.3 months (range 9–30 months). The postoperative atlas-dens interval (ADI), cervicomedullary angle (CMA), distance between the top of the odontoid process and the Chamberlain line (CL) and JOA score were significantly improved in all patients (P < 0.05). Bony fusion was achieved after 3–9 months in all cases. No patients developed recurrent atlantoaxial instability. Conclusions Transoral revision surgery by intraarticular cage distraction and C-JAWS fixation could provide a satisfactory outcome for BI with IAAD after a previous unsuccessful posterior operation.

scholarly journals Role of Human Galectins in Inflammation and Cancers Associated with Endometriosis

Biomolecules ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 230 ◽  
Author(s):  
Brooke V. Hisrich ◽  
R. Brant Young ◽  
Alison M. Sansone ◽  
Zachary Bowens ◽  
Lisa J. Green ◽  
...  
Keyword(s):  
Inflammatory Diseases ◽  
Immune Surveillance ◽  
Chronic Inflammatory Disease ◽  
Cellular Growth ◽  
Unknown Etiology ◽  
Cancer Therapies ◽  
Cellular Functions ◽  
Inflammatory Conditions ◽  
Galectin 3 ◽  
Kras Protein

Galectins are a family of β-galactoside-binding proteins that contribute to multiple cellular functions, including immune surveillance and apoptosis. Human galectins are also important regulators of inflammation, making them a research target for various inflammatory diseases and tumorigenesis associated with pro-inflammatory conditions. This review focuses on the involvement of human galectins in modulation of inflammation and in the pathophysiology of endometriosis and endometriosis-associated neoplasms. Endometriosis is a chronic inflammatory disease with unknown etiology. Galectins-1, -3 and -9 were found to be overexpressed in ectopic and eutopic endometrium of females with endometriosis compared to those without endometriosis. These findings suggest galectins’ role in the progression on endometriotic lesions and their potential use as diagnostic biomarkers and/or targets for therapeutic approaches. Galectins-1, -3, and -9 have also been implicated in the development of endometriosis-associated neoplasms. Furthermore, galectin-3 has been shown to interact with KRAS protein and contribute to cellular growth, proliferation, inflammation, and the uptake of nutrients in endometriotic lesions and may be involved in the maintenance and propagation of endometriosis. These galectins have been shown to be upregulated in certain forms of cervical, ovarian, endometrial, and colon cancer associated with endometriosis and have become a potential target for anti-cancer therapies.

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