Chordoma of the Cervical Spine

Neurosurgery ◽  
1981 ◽  
Vol 9 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Raj Murali ◽  
Richard L. Rovit ◽  
M. Vallo Benjamin
Keyword(s):  
Cervical Spine ◽  
Interbody Fusion ◽  
Biological Behavior ◽  
Diagnostic Feature ◽  
Halo Vest ◽  
Postoperative Radiation Therapy ◽  
Vertebral Involvement ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Radical Removal

Abstract Etight cases of chordoma limited to the cervical spine are presented. The radiological features are analyzed. Although there is no single diagnostic feature, the combination of osteosclerosis and lysis, multiple vertebral involvement, and the presence of a pre- or paracervical mass is strongly suggestive of a chordoma. Although none of our patients can be considered cured, we recommend an anterior cervical approach with radical removal of the tumor and interbody fusion followed by immobilization in a halo vest and postoperative radiation therapy. The biological behavior of the tumor is extremely variable, and multiple operations for symptomatic recurrences may be helpful.

ANTERIOR CERVICAL APPROACH FOR THE TREATMENT OF CERVICAL MYELOPATHY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-64-S1-70 ◽  
Author(s):  
Paul G. Matz ◽  
Patrick R. Pritchard ◽  
Mark N. Hadley
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Surgical Technique ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Clinical Symptoms ◽  
Recovery Of Function ◽  
Surgical Decompression ◽  
Cervical Approach ◽  
Anterior Cervical Approach

Abstract COMPRESSION OF THE spinal cord by the degenerating cervical spine tends to lead to progressive clinical symptoms over a variable period of time. Surgical decompression can stop this process and lead to recovery of function. The choice of surgical technique depends on what is causing the compression of the spinal cord. This article reviews the symptoms and assessment for cervical spondylotic myelopathy (clinically evident compression of the spinal cord) and discusses the indications for decompression of the spinal cord anteriorly.

scholarly journals Alterations in axial curvature of the cervical spine with a combination of rotation and extension in the conventional anterior cervical approach

2013 ◽  
Vol 22 (12) ◽  
pp. 2850-2856 ◽  
Author(s):  
Hiroyuki Tanahashi ◽  
Kei Miyamoto ◽  
Akira Hioki ◽  
Nobuki Iinuma ◽  
Takatoshi Ohno ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Axial Curvature

scholarly journals The Application of Endoscopic Technique in High Cervical Anterior Approach to the Craniovertebral Junction

2020 ◽  
Author(s):  
Jiangtao Liu ◽  
Hongming Ji ◽  
Gangli Zhang ◽  
Shengli Chen ◽  
Shiyuan Zhang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Anterior Approach ◽  
Craniovertebral Junction ◽  
Close Proximity ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Surgical Corridor ◽  
High Cervical ◽  
Neurovascular Structures

Abstract Objectives: Surgery on the craniovertebral junction (CVJ) presents particular challenges owing to the close proximity of critical neurovascular structures and the brainstem. It is difficult for classic approaches to obtain the extra exposure of neurovascular structures of the CVJ in practice.The surgical approach to the craniovertebral junction (CVJ) offers specific challenges. We explored the feasibility of an endoscope-assisted high anterior cervical approach to the CVJ. Methods: We quantitatively assessed the surgical corridor to, and extent of exposure of, the CVJ in six cadaveric specimens, using 0° and 30° endoscopes. Results: The endoscope provided sufficient exposure of neurovascular structures and the brainstem in the CVJ. Resection of the anterior arch of C1 was avoided in minimal anterior clivectomy. After removing the odontoid, greater exposure of the CVJ was obtained. Conclusion: An endoscope-assisted high anterior cervical approach to the CVJ preserves cervical spine stability while minimizing the risk of neurovascular injury within the surgical corridor.

scholarly journals Management of C2-C3 fracture subluxation by anterior cervical approach and C2-C3 trans-cortical screw placement

2018 ◽  
Vol 32 (1) ◽  
pp. 170-173
Author(s):  
Amit Agrawal
Keyword(s):  
Cervical Spine ◽  
Morbidity And Mortality ◽  
Screw Placement ◽  
Upper Cervical Spine ◽  
Cervical Spine Injuries ◽  
Cortical Screw ◽  
Spine Injuries ◽  
Upper Cervical ◽  
Cervical Approach ◽  
Anterior Cervical Approach

AbstractCervical spine injuries are the major cause of morbidity and mortality in trauma victims. Upper cervical spine injuries account for about 24% of acute fractures and dislocations and one third of fractures occur at the level of C2, while one half of injuries occur at the C6 or C7 levels. In contrast to this approach we used the transverse cervical, platysma splitting incision at a lower (C3-C4 disc) to expose the upper cervical spine particularly lower border of C3 (entry point for the screw).

High anterior cervical approach to the upper cervical spine

2007 ◽  
Vol 68 (5) ◽  
pp. 519-524 ◽  
Author(s):  
Seong-Hyun Park ◽  
Joo-Kyung Sung ◽  
Sun-Ho Lee ◽  
Jaechan Park ◽  
Jeong-Hyun Hwang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Cervical Approach ◽  
Anterior Cervical Approach

scholarly journals Surgical treatment of degenerative cervical spine diseases: Analyses of 90 patients clinical study

2012 ◽  
Vol 59 (3) ◽  
pp. 61-68
Author(s):  
M. Markovic ◽  
N. Zivkovic ◽  
D. Stojanovic ◽  
M. Samardzic
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Iliac Crest ◽  
Cervical Disc ◽  
Cervical Spine Surgery ◽  
Clinical Series ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Cervical Plating ◽  
Degenerative Cervical Spine

The effect of degenerative cervical spine surgery depends on good understanding of the pathogenesis and clinical course of disease with a detailed neurological and neuroradiological examination. Surgical approach should be considered separately for each pathological substrate in order to avoid additional morbidity. The aim of our study is to present the results of treatment through analysis of large clinical series focusing on anterior surgical approach with iliac crest graft fusion without cervical plating. The retrospective analysis of 90 patients operated on Neurosurgery of CHC Zemun, from 2008 to 2011, was done. In 81 patients cervical disc herniation was found in one or two levels, and 9 patients had spinal canal stenosis with polydiscopathy. Preoperatively 50 patients had cervical myelopathy, and 40 patients had radiculopathy as dominating clinical sign. Anterior cervical approach was performed in 79 patients, and 11 patients were operated by posterior approach. The treatment outcome was as follows: good outcome 16 (16.8%) patients, improved condition 65 (72.2%), without improvement 6 (6.7%), bad outcome 3 (4.3%). The anterior cervical approach with iliac crest autologous graft fusion, and without additional cervical plating, is reliable treatment option with results comparable to reported clinical series with sintetic graft placement and anterior cervical plate stabilisation.

Vocal Fold Paralysis following the Anterior Approach to the Cervical Spine

1996 ◽  
Vol 105 (2) ◽  
pp. 85-91 ◽  
Author(s):  
James L. Netterville ◽  
Michael J. Koriwchak ◽  
Mark S. Courey ◽  
Mark Winkle ◽  
Robert H. Ossoff
Keyword(s):  
Cervical Spine ◽  
Vagus Nerve ◽  
Vocal Fold ◽  
Geometric Analysis ◽  
Vocal Fold Paralysis ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Recurrent Laryngeal Nerves ◽  
The Right ◽  
Lost To Follow Up

The anterior cervical approach is commonly used for access to the cervical spine. Vocal fold paralysis (VFP), a complication of this approach, is underrepresented in the literature. A review of the database of the Vanderbilt Voice Center revealed 289 patients with VFP, including 16 patients who developed paralysis as a result of an anterior cervical approach. The paralysis was on the right side in all but 1 patient. Compared to patients who developed VFP after thyroidectomy and carotid endarterectomy, patients with VFP after an anterior cervical approach have a higher incidence of aspiration and dysphagia, suggesting the presence of trauma to the superior laryngeal and pharyngeal branches as well as the recurrent branch of the vagus nerve. Two patients had partial return and 1 patient had complete return of vocal fold movement within 10 months. Of the remaining 13 patients, 8 underwent vocal fold medialization with improvement of symptoms. Two patients are 6 and 7 months postinjury and await vocal fold medialization. Two patients are 27 months and 45 months postinjury and are considering vocal fold medialization. The remaining patient was lost to follow-up. An anatomic-geometric analysis of the right and left recurrent laryngeal nerves was performed by using measurements obtained from computed tomography scans of 8 patients with idiopathic unilateral VFP, as well as experience gained through surgical and cadaveric dissections. We conclude 1) the anterior cervical approach may place multiple branches of the vagus nerve at risk; 2) because of anatomic-geometric factors, die right-sided anterior cervical approach may carry a greater risk to the ipsilateral recurrent laryngeal nerve than does the left; and 3) an understanding of the anatomy and geometry presented herein allows relatively safe exposure from either side of the neck.

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