Combined Transoral and Median Labiomandibular Glossotomy Approach to the Upper Cervical Spine

Neurosurgery ◽  
1981 ◽  
Vol 8 (6) ◽  
pp. 672-674 ◽  
Author(s):  
Ehud Arbit ◽  
Russel H. Patterson
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Cervical Spinal Cord ◽  
Transoral Approach ◽  
Direct Approach ◽  
Upper Cervical Spine ◽  
Functional Loss ◽  
Upper Cervical

abstract A surgical approach to the clivus and anterior spine from C-1 to the upper part of C-5 is described. It is a direct approach that provides a wider and longer exposure than does the transoral approach. Despite the seemingly radical incision, the cosmetic deformity and functional loss are minimal. This approach is useful for the surgical treatment of a variety of processes that are situated ventral to the upper cervical spinal cord and the cervicomedullary junction.

Microscopic Decompression of the Anterior Upper Cervical Spine: A Case of Odontoid Malunion to the Atlas

Neurosurgery ◽  
1984 ◽  
Vol 14 (5) ◽  
pp. 583-587 ◽  
Author(s):  
Jimmy Miller ◽  
Andrew D. Parent
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Odontoid Process ◽  
Transoral Approach ◽  
Upper Cervical Spine ◽  
Basilar Impression ◽  
Odontoid Fractures ◽  
Surgical Microscope ◽  
The Past ◽  
Upper Cervical

Abstract For the past 20 years, the transoral approach to the upper cervical spine has been utilized for odontoid fractures, the removal of an abnormal odontoid process, decompression of basilar impression, and biopsy or resection of nasopharyngeal or metastatic tumors. The effectiveness and safety of this procedure is well documented. Use of the surgical microscope adds to the efficiency and safety of the procedure. We are reporting a case of fusion of the odontoid base to the anterior arch of the atlas. To our knowledge, this entity has not been described previously. The spinal cord was protected by an initial posterior fusion of C-1, C-2, followed in 10 days by a tracheostomy and the transoral removal of the anterior C-1 arch and the abnormal dens. Because the medical history did not reveal a source of trauma, it is supposed that the patient had malunion of the odontoid process to C-2, with subsequent migration and fusion of the dens to the C-1 arch.

Labiomandibular, Transoral Approach to Chordomas in the Clivus and Upper Cervical Spine

Neurosurgery ◽  
1981 ◽  
Vol 8 (6) ◽  
pp. 675-679 ◽  
Author(s):  
Tomas E. Delgado ◽  
Eddy Garrido ◽  
Robert D. Harwick
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Transoral Approach ◽  
Upper Cervical Spine ◽  
Total Removal ◽  
Upper Cervical ◽  
Microsurgical Techniques

abstract Three patients with chordomas of the clivus and the upper cervical spine underwent the removal of their tumors through a transoral approach with labiomandibular splitting and microsurgical techniques. This surgical approach provided excellent visualization of the anterior craniocervical area and allowed a gross total removal in each case. Although the lesions in our patients were chordomas, this approach could also be used for other surgical lesions in this area.

scholarly journals Concussion with primary impact to the chest and the potential role of neck tension

2018 ◽  
Vol 4 (1) ◽  
pp. e000362 ◽  
Author(s):  
Ron Jadischke ◽  
David C Viano ◽  
Joe McCarthy ◽  
Albert I King
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Tensile Force ◽  
Impact Testing ◽  
American Football ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Primary Impact

ObjectivesMost biomechanical research on brain injury focuses on direct blows to the head. There are a few older studies that indicate craniocervical stretch could be a factor in concussion by causing strain in the upper spinal cord and brainstem. The objectives of this study are to assess the biomechanical response and estimate the strain in the upper cervical spine and brainstem from primary impact to the chest in American football.MethodsImpact testing was conducted to the chest of a stationary unhelmeted and helmeted anthropomorphic test device (ATD) as well as the laboratory reconstruction of two NFL game collisions resulting in concussion. A finite element (FE) study was also conducted to estimate the elongation of the cervical spine under tensile and flexion loading conditions.ResultsThe helmeted ATD had a 40% (t=9.84, p<0.001) increase in neck tensile force and an 8% (t=7.267, p<0.001) increase in neck flexion angle when compared with an unhelmeted ATD. The case studies indicated that the neck tension in the injured players exceeded tolerable levels from volunteer studies. The neck tension was combined with flexion of the head relative to the torso. The FE analysis, combined with a spinal cord coupling ratio, estimated that the strain along the axis of the upper cervical spinal cord and brainstem was 10%–20% for the combined flexion and tension loading in the two cases presented.ConclusionStrain in the upper spinal cord and brainstem from neck tension is a factor in concussion.

Atlantal fracture with transverse ligament disruption in a child

2009 ◽  
Vol 4 (3) ◽  
pp. 196-198 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Eric C. Peterson
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Upper Cervical Spine ◽  
Transverse Ligament ◽  
Jefferson Fracture ◽  
Fractures In Children ◽  
Upper Cervical ◽  
Almost All ◽  
Ligament Disruption

Even though fractures in children with immature spines occur predominantly in the upper cervical spine, isolated C-1 fractures are relatively rare. The fractures in almost all cases reported to date were considered stable due to the presence of the intact transverse ligament. The authors report the case of a young child who sustained a Jefferson fracture and in whom MR imaging revealed disruption of the transverse ligament. Although surgical treatment has been suggested as the treatment of choice for children with unstable atlantoaxial injuries, external immobilization alone allowed a full recovery in the patient with no evidence of instability at follow-up.

scholarly journals Klippel–Feil Syndrome (KFS) with Multiple Cervical Anomalies Discovered Following Trauma

2020 ◽  
Author(s):  
Fernando Celi ◽  
Giancarlo Saal-Zapata
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Vascular Malformations ◽  
Upper Cervical Spine ◽  
Congenital Disease ◽  
Cervical Injury ◽  
Anatomical Variants ◽  
Complex Anatomy ◽  
Upper Cervical ◽  
Type Of Surgery

AbstractThe approach to the upper cervical spine is a challenge for surgeons, not only for its complex anatomy but also for the great variety of pathologies. Klippel–Feil syndrome (KFS) is a congenital disease characterized by the fusion of two or more cervical segments and is associated with various musculoskeletal and vascular malformations. However, there is no consensus on the type of surgery, approach, level of fixation or fusion. We report the case of a KFS, associated with multiple anatomical variants, who suffered a traumatic cervical injury and underwent surgical treatment.

scholarly journals Problems and Clinical Course after Operation of Spinal Cord Tumor at Upper Cervical Spine

2010 ◽  
Vol 59 (3) ◽  
pp. 656-658
Author(s):  
Ichiro Kawamura ◽  
Kosei Ijiri ◽  
Takuya Yamamoto ◽  
Michihisa Zenmyo ◽  
Ryusaku Nagayoshi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Clinical Course ◽  
Spinal Cord Tumor ◽  
Upper Cervical Spine ◽  
Upper Cervical

Transoral Removal of Missile Fragments from the C1-C2 Area: Report of Four Cases

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 254-257 ◽  
Author(s):  
John R. Mangiardi ◽  
Michael Alleva ◽  
Richard Dynia ◽  
Robert Zubowski
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Neurological Complications ◽  
Transoral Approach ◽  
Upper Cervical Spine ◽  
Mechanical Instability ◽  
Low Velocity ◽  
Upper Cervical

ABSTRACT Low velocity firearm damage to the upper cervical spine without neurological deficit occurs infrequently. Four cases of gunshot fragments involving the anterior elements of C1 and C2 are presented. In all four cases, the fragments were removed via a transoral approach without neurological complications or mechanical instability.

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