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.

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.

scholarly journals Odontoid process fracture in 2 year old child: a rare case report

2017 ◽  
Vol 31 (4) ◽  
pp. 522-525
Author(s):  
Prajapati Hanuman Prasad ◽  
Singh Deepak Kumar ◽  
Singh Rakesh Kumar ◽  
Yadav Kuldeep
Keyword(s):  
Cervical Spine ◽  
Odontoid Process ◽  
The Body ◽  
Upper Cervical Spine ◽  
Age Group ◽  
Spine Injuries ◽  
Rare Case Report ◽  
Upper Cervical ◽  
Cervical Spine Fractures ◽  
Odontoid Process Fracture

Abstract In small childrens spine injuries are rare. In this age group upper cervical spine is commonally affected. Odontoid process fracture involve only a subset of cervical spine fractures. In small childrens, this fracture typically involves the cartilaginousplate that separates the odontoid process from the body of the axis. Odontoid processfracture is rare in children less than 7 years of age.

scholarly journals UPPER CERVICAL SPINE INJURIES: DIAGNOSTICS, CLASSIFICATIONS AND TREATMENT PECULIARITIES

2005 ◽  
pp. 025-044
Author(s):  
Edvard Aleksandrovich Ramikh
Keyword(s):  
Cervical Spine ◽  
Odontoid Process ◽  
Upper Cervical Spine ◽  
Treatment Technique ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Upper Cervical ◽  
Methods Of Treatment ◽  
Traumatic Spondylolisthesis ◽  
Selection Of

Comprehensive diagnostics, accepted classifications, and selection of pathogenetic methods of treatment (including surgery) for axis injuries, odontoid process fractures, axis traumatic spondylolisthesis and hangman’s fractures are discussed in the paper. The presented data prove the necessity and possibility of early exhaustive diagnosing to differentiate the type of a craniocervical disorder and to provide a timely choice of pathogenetic treatment technique, especially of a surgical one.

scholarly journals Surgical Treatment of C2 Odontoid Process Intussusception in Combination with Type I Chiari Malformation

2017 ◽  
pp. 66-72 ◽  
Author(s):  
A. N. Shkarubo ◽  
A. A. Kuleshov ◽  
I. V. Chernov ◽  
V. A. Shakhnovich ◽  
E. V. Mitrofanova ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Chiari Malformation ◽  
Odontoid Process ◽  
Type I ◽  
Basilar Impression ◽  
Posterior Decompression ◽  
Developmental Abnormalities ◽  
Brainstem Compression ◽  
Upper Cervical ◽  
One Step

Type I Chiari malformation is often accompanied by congenital developmental abnormalities such as platybasia, basilar impression and C2 odontoid process retroflexion that may cause anterior compression of brainstem structures and upper cervical segments of spinal cord. Formerly the conventional method was posterior decompression even in presence of anterior brainstem compression. This article presents on a kinetic example the tactics of one-step treatment of patients with type I Chiari malformation accompanied by basilar impression and C2 odontoid process retroflexion via transoral approach only that was used for both decompression and C1-C2 segment anterior stabilization. Surgical intervention enabled to achieve the decompression of brainstem structures and upper cervical segments of spinal cord, normalization liquor dynamics and subsequent redislocation of cerebellar tonsils to normal position (above the Chamberlain line).

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.

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
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