Lateral Approach for Resection of the C3 Corpus: Technical Case Report

Neurosurgery ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 977-981 ◽  
Author(s):  
Uğur Türe ◽  
Memet Özek ◽  
M. Necmettin Pamir
Keyword(s):  
Cervical Spine ◽  
Neurological Status ◽  
Cord Compression ◽  
Lateral Approach ◽  
Easy Access ◽  
High Position ◽  
History Of ◽  
Neuroradiological Examination ◽  
Craniocervical Instability ◽  
Second Procedure

Abstract OBJECTIVE AND IMPORTANCE The C3 level is the transition zone between the upper and lower cervical spine. Because of its high position and anatomic relationships to significant structures, exposing C3 is challenging, and the surgical approach is controversial. CLINICAL PRESENTATION A 16-year-old girl was admitted to our institution with a 3-year history of neck pain and progressive quadriparesis. Neuroradiological examination revealed severe spinal cord compression from kyphosis at the C3 level. TECHNIQUE We used the lateral approach to resect the C3 corpus and realign the cervical spine. Resecting the transverse processes of C2–C4 and mobilizing the V2 segment of the vertebral artery adequately exposed C3 for resection. Bilateral occipitocervical fusion was performed in a second procedure, and no postoperative complications occurred. The patient's neurological status improved drastically after surgery, and she has had no craniocervical instability during the follow-up period. CONCLUSION The lateral approach to the C3 corpus offers the greatest degree of cord decompression and easy access to the lesion in a wide and sterile operative field. We describe the surgical technique of this approach as an alternative to the anterior transmucosal or anterolateral retropharyngeal approach.

scholarly journals A rare case of Paget’s disease affecting the cervical spine

2019 ◽  
Vol 101 (2) ◽  
pp. e38-e42
Author(s):  
J Holton ◽  
M Jones ◽  
Z Klezl ◽  
M Czyz ◽  
M Grainger ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Independent Living ◽  
Paget’S Disease ◽  
Posterior Part ◽  
Cord Compression ◽  
Bone Cell ◽  
Paget's Disease ◽  
History Of ◽  
Posterior Instrumented Fusion ◽  
Degenerative Cervical Spine

We present the case of a 75-year-old man with a rapidly progressive cervical myelopathy on a background of a 3-year history of neck pain and a severely degenerative cervical spine. The patient developed progressive myelopathy over a six-month period and suffered from worsening kyphosis. Suspicion of an underlying oncological process prompted transfer to our tertiary referral unit. Biopsy was consistent for Paget’s disease, an extremely rare diagnosis of the cervical spine. Magnetic resonance imaging revealed cord compression between C4 and C6 with associated cord signal change indicative of myelopathy. A three-level corpectomy and posterior instrumented fusion was performed. There was significant blood loss (3.5l) intraoperatively, consistent with a diagnosis of Paget’s disease of the bone. Cell salvage was used, as was neuromonitoring for both the anterior and posterior part of the procedure. Postoperatively, neurological function improved slightly and the patient required community neurorehabilitation to allow independent living.

Cervical Spine Injury From Unrecognized Craniocervical Instability in Severe Pierre Robin Sequence Associated With Skeletal Dysplasia

2018 ◽  
Vol 55 (5) ◽  
pp. 773-777 ◽  
Author(s):  
Xiao Zhu ◽  
Kelly N. Evans ◽  
Areeg El-gharbawy ◽  
Jonathan Y. Lee ◽  
Jack E. Brooker ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Skeletal Dysplasia ◽  
Spinal Injury ◽  
Cord Compression ◽  
Spine Injury ◽  
Cervical Cord ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Craniocervical Instability ◽  
Pierre Robin

Pierre Robin Sequence (PRS) can be associated with skeletal dysplasias, presenting with craniocervical instability and devastating spinal injury if unrecognized. The authors present the case of an infant with PRS and a type II collagenopathy who underwent multiple airway-securing procedures requiring spinal manipulation before craniocervical instability was identified. This resulted in severe cervical cord compression due to odontoid fracture and occipitoatlantoaxial instability. This case highlights the importance of early cervical spine imaging and cautious manipulation in infants with PRS and suspected skeletal dysplasia.

scholarly journals Minimally invasive spinal surgery in a young cat with vertebral hypertrophy

2021 ◽  
Vol 7 (2) ◽  
pp. 205511692110484
Author(s):  
Karin Sakamoto ◽  
Yuta Nozue ◽  
Mami Murakami ◽  
Kohei Nakata ◽  
Yukiko Nakano ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Endoscopic Surgery ◽  
Histopathological Examination ◽  
Neurological Status ◽  
Cord Compression ◽  
Good Prognosis ◽  
Minimally Invasive Spinal Surgery ◽  
Canal Stenosis ◽  
Resected Tissue ◽  
History Of

Case summary A 2-year-old neutered female Scottish Fold cat was presented with an 8-week history of progressive back pain, paraparesis and decrease of postural reactions in both pelvic limbs. MRI showed spinal cord compression from both ventral sides, which originated from the T4 vertebral body and pedicle. The lesion compressing the spinal cord had a bone-like density on CT, and endoscopic surgery was performed to excise it. Histopathological examination of the resected tissue showed no evidence of malignancy and the lesion was diagnosed as vertebral hypertrophy. After surgery, the neurological status of the cat gradually improved. The cat was ambulant at the follow-up evaluation 2 weeks after surgery. Six months later, hindlimb paresis had improved considerably, and no recurrence was observed on CT. Relevance and novel information This is the first description of thoracic vertebral canal stenosis due to hypertrophy of a single vertebra in a young cat. Excision of the hypertrophic vertebra by endoscopic surgery is less invasive than open surgery and may give a good prognosis.

scholarly journals Ossification of the yellow ligament in the cervical spine – an unusual location

BioMedicine ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 14 ◽  
Author(s):  
Jacob Yoong-Leong Oh ◽  
Victor Tzong-Jing Wang ◽  
Timothy Wei Wen Teo ◽  
Arun-Kumar Kaliya-Perumal ◽  
Hwan Tak Hee
Keyword(s):  
Cervical Spine ◽  
Spinous Process ◽  
Neurological Status ◽  
Cord Compression ◽  
Lower Limbs ◽  
Limb Weakness ◽  
Unusual Location ◽  
Unsteady Gait ◽  
Bony Mass ◽  
Immediate Surgery

Ossification of the yellow ligament (OYL) or ligamentum flavum, usually occurs in the thoracic spine. Focal OYL occurring in the cervical spine is considered rare and is sparsely reported in the literature. We came across a 30-year-old male patient with progressive left upper limb and bilateral lower limb weakness over a period of 3 months, associated with an unsteady gait. Clinical examination revealed bilateral generalized hyper-reflexia in both upper and lower limbs, inverted supinator jerk, Hoffman’s sign and clonus. Myelopathy due to cord compression was suspected and further investigations were done. MRI and CT scans revealed a bony mass in relation to the C6 spinous process projecting anterosuperiorly and narrowing the cervical spinal canal causing cord signal changes from C4 to C6 levels. In view of the deteriorating neurological status, immediate surgery in the form of decompression and posterior stabilization from C4-C6 was performed. Patient gradually recovered after surgery and attained full functional status. We report this case considering the unusual location of OYL and its successful management.

scholarly journals Spontaneous ventral spinal epidural hematoma in a child: A case report and review of literature

2016 ◽  
Vol 07 (02) ◽  
pp. 297-299 ◽  
Author(s):  
Shailendra Ratre ◽  
Yadram Yadav ◽  
Sushma Choudhary ◽  
Vijay Parihar
Keyword(s):  
Epidural Hematoma ◽  
Neurological Status ◽  
Cord Compression ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Sensory Loss ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
History Of ◽  
Spinal Epidural

ABSTRACTSpontaneous spinal epidural hematoma is very uncommon cause of spinal cord compression. It is extremely rare in children and is mostly located in dorsal epidural space. Ventral spontaneous spinal epidural hematoma (SSEH) is even rarer, with only four previous reports in childrens. We are reporting fifth such case in a 14 year old male child. He presented with history of sudden onset weakness and sensory loss in both lower limbs with bladder bowel involvment since 15 days. There was no history of trauma or bleeding diasthesis. On clinical examination he had spastic paraplegia.Magnetic resonance imaging (MRI) of dorsal spine was suggestive of ventral spinal epidural hematoma extending from first to sixth dorsal vertebrae. Laminectomy of fourth and fifth dorsal vertebrae and complete evacuation of hematoma was done on the same day of admission. Postoperatively the neurological status was same.

Multiple subluxations and comminuted fracture of the cervical spine in a sheep

2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan
Keyword(s):  
Cervical Spine ◽  
Pain Perception ◽  
Cervical Vertebrae ◽  
Traumatic Injury ◽  
Spinal Reflexes ◽  
Spine Trauma ◽  
Blunt Force Trauma ◽  
Comminuted Fracture ◽  
History Of ◽  
The Right

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

scholarly journals Tophaceous gout of the atlantoaxial joint: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Andrew Benjamin Romero ◽  
Evan Paul Johnson ◽  
John S. Kirkpatrick
Keyword(s):  
Cervical Spine ◽  
Tissue Sample ◽  
Significant Finding ◽  
Atlantoaxial Joint ◽  
Tophaceous Gout ◽  
Case Presentation ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
History Of ◽  
Clinically Significant

Abstract Background To report the occurrence of tophaceous gout in the cervical spine and to review the literature on spinal gout. Case presentation This report details the occurrence of a large and clinically significant finding of tophaceous gout in the atlantoaxial joint of the cervical spine in an 82-year-old Caucasian man with a 40-year history of crystal-proven gout and a 3-month history of new-onset progressive myelopathy. The patient's American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria score was 15.0. Conclusion Spinal gout is more common than previously thought, and it should be considered in patients who present with symptoms of myelopathy. Diagnosis can be made without a tissue sample of the affected joint(s) with tools like the ACR/EULAR criteria and the use of the “diagnostic clinical rule” for determining the likelihood of gout. Early conservative management with neck immobilization and medical management can avoid the need for surgical intervention.

Resection of 2 Intradural Extramedullary Cervical Spine Tumors in a Patient With Neurofibromatosis Type 2: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. 274-274
Author(s):  
Simone E Dekker ◽  
Chad A Glenn ◽  
Thomas A Ostergard ◽  
Osmond C Wu ◽  
Fernando Alonso ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Treatment Options ◽  
Tumor Resection ◽  
Neurofibromatosis Type ◽  
Cord Compression ◽  
Neurofibromatosis Type 2 ◽  
3 Dimensional ◽  
Intradural Extramedullary

Abstract This 3-dimensional operative video illustrates resection of 2 cervical spine schwannomas in a 19-yr-old female with neurofibromatosis type 2. The patient presented with lower extremity hyperreflexity and hypertonicity. Magnetic resonance imaging (MRI) demonstrated 2 contrast-enhancing intradural extramedullary cervical spine lesions causing spinal cord compression at C4 and C5. The patient underwent a posterior cervical laminoplasty with a midline dural opening for tumor resection. Curvilinear spine cord compression is demonstrated in the operative video. After meticulous dissection, the tumors were resected without complication. The dural closure was performed in watertight fashion followed by laminoplasty using osteoplastic titanium miniplates and screws. Postoperative MRI demonstrated gross total resection with excellent decompression of the spinal cord. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

Poster 38: Chondroma of the Cervical Spine Causing Cord Compression: A Case Report

PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S119-S119
Author(s):  
Alain Pierre-Louis ◽  
Seth D. Scholl ◽  
Mark A. Testaiuti
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Cord Compression
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