Significance of Perinatal Anamnesis for Determination of Treatment Plan and Subsequent Neurological Prognosis for Children with Anomaly Chiari 1

10.12737/4998 ◽  
2014 ◽  
Vol 21 (2) ◽  
pp. 54-57
Author(s):  
Козлитина ◽  
T. Kozlitina ◽  
Глаголев ◽  
Nikolay Glagolev
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Soft Tissues ◽  
Treatment Plan ◽  
Neurological Status ◽  
Pathological Process ◽  
Spine Injury ◽  
Normal Birth ◽  
And Function ◽  
Conservative And Surgical Treatment

The injuries of the cervical spine injury craniovertebral transition, involving in pathological process of vertebral arteries or the spinal cord can cause obstetric benefits as pathological and normal birth. In this article the authors evaluate the effects generic posttraumatic changes soft tissues of the cervical spine in the development of vascular disorders in the field craniovertebral transition. For this study, 112 patients with Chiari anomaly 1, received conservative and surgical treatment, were ex-amined. Children from 2 to 18 years were divided into two groups: the 1st group - children (55 patients) without surgical treatment, and the 2nd group of children after decompressive trepanation about Chiari anomaly 1. Common neurological status, anatomy and function of blood vessels at the level craniovertebral transition were assessed in all children. Perinatal anamnesis, including: cesarean section, rapid delivery, entanglement neck child´s umbilical cord, and use of obstetric benefits in the form of application of forceps and receive «squeezing», was studied. Changes in the normal course of delivery, pointing to birth trauma level craniovertebral transition were noted in 96 patients (85,7%). This fact may have prognostic value in the treatment and follow-up care of children with Chiari anomaly 1.

scholarly journals EXPERIENCE IN THE TREATMENT OF THE FALSE JOINT OF THE DIAPHYSIS OF THE RADIAL BONE COMBINED WITH A MAJOR DEFECT IN THE ULNAR DIAPHYSIS (CASE FROM PRACTICE)

2018 ◽  
Vol 3 (5) ◽  
pp. 159-163
Author(s):  
I. N. Mikhaylov ◽  
M. E. Puseva ◽  
D. B. Balzhinimaev
Keyword(s):  
Surgical Treatment ◽  
Upper Limb ◽  
Soft Tissues ◽  
Treatment Plan ◽  
Surgical Interventions ◽  
The Right ◽  
And Function ◽  
Major Defect ◽  
Radial Bone

This article presents the experience of surgical treatment of rare pathology of the upper limb – pseudoarthrosis of the middle third of the diaphysis of the radius, defect pseudoarthrosis of the upper and middle third of the ulnar diaphysis. The definition and compilation of an accurate model and treatment tactics are critical to restoring the anatomy and function of the injured upper limb. The rarity of this case was the size of the ulna defect, which was up to 4.0 cm, the scarring and cicatricial changes in the soft tissues and muscles of the right forearm, due to the severity of the injury and the multitude of surgical interventions on the right forearm. The chosen treatment tactics consisted of several successive stages: resection of the zone of false joint of the right radial bone, combined transosseous osteosynthesis of the right radius bone, resection of the false elbow joint of the right ulna with replacement of the defect with autograft from the lower third of the fibula, combined strained osteosynthesis and transosseous osteosynthesis by external fixation apparatus with rod configuration of the right ulna. The results of surgical treatment of false joints depend on the determination of the correct indications for a certain type of surgical intervention and the competent implementation of the planned treatment plan. The chosen treatment tactics allowed us to successfully restore the anatomy and function of the damaged segment, thus rehabilitating the patient.

scholarly journals Surgical treatment for irreducible pediatric subaxial cervical unilateral facet dislocation: case report

2016 ◽  
Vol 17 (5) ◽  
pp. 607-611 ◽  
Author(s):  
Wei Qu ◽  
Dingjun Hao ◽  
Qining Wu ◽  
Zongrang Song ◽  
Jijun Liu
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Complete Resolution ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Facet Dislocation ◽  
Unilateral Approach ◽  
Subaxial Cervical Spine

Unilateral facet dislocation at the subaxial cervical spine (C3–7) in children younger than 8 years of age is rare. The authors describe a surgical approach for irreducible subaxial cervical unilateral facet dislocation (SCUFD) at C3–4 in a 5-year-old boy and present a literature review. A dorsal unilateral approach was applied, and a biodegradable plate was used for postreduction fixation without fusion after failed conservative treatment. There was complete resolution of symptoms and restored cervical stability. Two years after surgery, the patient had recovered range of motion in C3–4. In selected cases of cervical spine injury in young children, a biodegradable plate can maintain reduction until healing occurs, obviate the need to remove an implant, and recover the motion of the injured segment.

Surgical Treatment of Cervical Spine Injury

1988 ◽  
Vol 23 (4) ◽  
pp. 1069
Author(s):  
Se Il Suk ◽  
Sang Hoon Lee ◽  
Choon Ki Lee ◽  
Jong Seok Lee
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Cervical Spine Injury ◽  
Spine Injury

scholarly journals The Management of Unstable Cervical Spine Injuries

2014 ◽  
Vol 5 ◽  
pp. CMTIM.S12263
Author(s):  
Venu M. Nemani ◽  
Han Jo Kim
Keyword(s):  
Cervical Spine ◽  
Medical Condition ◽  
Treatment Plan ◽  
Neurological Status ◽  
Patient Specific ◽  
X Rays ◽  
Mechanism Of Injury ◽  
Imaging Studies ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Injuries to the cervical spine can cause potentially devastating morbidity and even mortality. In this review we discuss the anatomy and biomechanics of the cervical spine. The evaluation and treatment of cervical spine injuries begins with the prompt immobilization of suspected injuries in the field. Once an assessment of the patient's neurological status is made, imaging studies are obtained, which can include X-rays, CT, and MRI. Careful scrutiny of the imaging studies for bony and/or ligamentous injury allows the physician to determine the mechanism of injury, which guides treatment. The ultimate treatment plan can consist of non-operative or operative management, and depends on patient specific factors (medical condition and neurological status), the mechanism of injury, and the resultant degree of instability. With prompt diagnosis and appropriate management, the morbidity of these injuries can be minimized.

scholarly journals SUBAXIAL CERVICAL FRACTURE: APPLICATION AND CORRELATION OF AO AND SLIC

2015 ◽  
Vol 14 (3) ◽  
pp. 218-222
Author(s):  
Allan Hiroshi de Araujo Ono ◽  
Ivan Dias da Rocha ◽  
Alexandre Fogaça Cristante ◽  
Raphael Martus Marcon ◽  
Reginaldo Perilo Oliveira ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Neurological Status ◽  
Statistical Correlation ◽  
Neurological Injury ◽  
Spine Injury ◽  
Cervical Fracture ◽  
Subaxial Cervical Spine ◽  
Duration Of Surgery

Objective:To evaluate the AO/Magerl classification and the SLIC (Subaxial Cervical Spine Injury Classification), used in the cervical spine fractures and assess whether they are correlated to the neurological severity of patients, the choice of approach to be used, de duration of surgery an between themselves.Method:Retrospective analysis of medical records and radiological image files of 77 patients surgically treated of subaxial cervical fracture or dislocation from August 2010 to September 2012.Results:The SLIC classification showed a strong correlation with neurological deficit and Pearson correlation value of -0.600. The AO classification was not correlated with the Frankel scale and the value of Pearson was 0.06 with a statistical significance of 0.682 (p<0.05), that is, unable to determine or suggest the severity of the deficit. When compared to each other the two classifications showed statistical correlation and the value of Pearson was 0.282 with a significance value of 0.022 (p<0.05).Conclusion:Among the most used classifications, the SLIC has been able to statistically define the need for surgical treatment and the severity of the neurological status, but was unable to predict the approach or the time of the surgery; the classification AO failed to predict the severity of neurological injury, surgical time, and did not help to choose the approach, just being a morphological classification.

scholarly journals Application of Simulation Methods in Cervical Spine Dynamics

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Meng-Si Sun ◽  
Xin-Yi Cai ◽  
Qing Liu ◽  
Cheng-Fei Du ◽  
Zhong-Jun Mo
Keyword(s):  
Cervical Spine ◽  
Soft Tissues ◽  
Complex Structure ◽  
Spine Injury ◽  
Simulation Methods ◽  
Automobile Safety ◽  
Injury Mechanisms ◽  
Numerical Simulation Methods ◽  
Application Fields ◽  
Spine Dynamics

Neck injury is one of the most frequent spine injuries due to the complex structure of the cervical spine. The high incidence of neck injuries in collision accidents can bring a heavy economic burden to the society. Therefore, knowing the potential mechanisms of cervical spine injury and dysfunction is significant for improving its prevention and treatment. The research on cervical spine dynamics mainly concerns the fields of automobile safety, aeronautics, and astronautics. Numerical simulation methods are beneficial to better understand the stresses and strains developed in soft tissues with investigators and have been roundly used in cervical biomechanics. In this article, the simulation methods for the development and application of cervical spine dynamic problems in the recent years have been reviewed. The study focused mainly on multibody and finite element models. The structure, material properties, and application fields, especially the whiplash injury, were analyzed in detail. It has been shown that simulation methods have made remarkable progress in the research of cervical dynamic injury mechanisms, and some suggestions on the research of cervical dynamics in the future have been proposed.

scholarly journals SURGICAL TREATMENT OF FRACTURES OF THE ANKYLOSED SPINE

2020 ◽  
Vol 19 (1) ◽  
pp. 74-79
Author(s):  
MARTA ALEXANDRA CERQUEIRA SILVA ◽  
DANIELA VILAS BOAS ROSA LINHARES ◽  
JOÃO DUARTE MAGALHÃES COSTA E SILVA ◽  
MANUEL EDUARDO DA CRUZ RIBEIRO DA SILVA ◽  
NUNO SILVA DE MORAIS NEVES
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Case Series ◽  
Neurological Status ◽  
Hospital Length Of Stay ◽  
Minor Trauma ◽  
Level Of Evidence ◽  
Surgical Interventions

ABSTRACT Objective We aim to identify retrospectively surgically treated patients with an ankylosed spine who sustained a vertebral fracture. Our goal is to evaluate the main outcomes and complications. Methods We selected patients through the database of surgical interventions in the setting of fractures of an ankylosed spine segment between January 1st 2008 and June 30th 2018. We collected data from digital medical records. The parameters analyzed include hospital length of stay, Intensive Care Unit (ICU) admission, perioperative and postoperative complications as well as neurological evolution. Results Fractures occurred in 14 patients with ankylosing spondylitis (82%) and 3 patients with diffuse idiopathic skeletal hyperostosis (18%). All patients were male and the mean age was 69 years. Fourteen fractures occurred after minor trauma (83%), of which 11 were due to falls from standing height or lower (65%). The cervical spine represents the majority of the levels involved (65%). Seven patients were admitted to the ICU (41%) and 11 suffered neurological damage. There was improvement of neurological status in less than 50% and there were high percentages of post-operative complications. Conclusion Patients with ankylosed spine diseases are at higher risk for vertebral fracture, even after minor trauma, and these are located predominantly in the cervical spine. The surgical treatment of these conditions is effective as it allows improvement of the patient’s neurological status. However, they still present higher morbidity and mortality, as well as increased post-op complications. Prevention of falls may drastically change patients’ outcome, neurological function and independence in activities of daily living. Level of evidence IV; A case series therapeutic study.

scholarly journals Anterior cervical spine surgery for the treatment of subaxial cervical spondylodiscitis: a report of 30 consecutive patients

2019 ◽  
Vol 46 (1) ◽  
pp. E6 ◽  
Author(s):  
Benedikt W. Burkhardt ◽  
Simon J. Müller ◽  
Anne-Catherine Wagner ◽  
Joachim M. Oertel
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Neck Pain ◽  
Antibiotic Treatment ◽  
Neurological Status ◽  
Neurological Deterioration ◽  
Posterior Fixation ◽  
Cervical Spondylodiscitis ◽  
Cervical Plating

OBJECTIVEInfection of the cervical spine is a rare disease but is associated with significant risk of neurological deterioration, morbidity, and a poor response to nonsurgical management. The ideal treatment for cervical spondylodiscitis (CSD) remains unclear.METHODSHospital records of patients who underwent acute surgical management for CSD were reviewed. Information about preoperative neurological status, surgical treatment, peri- and postoperative processes, antibiotic treatment, repeated procedure, and neurological status at follow-up examination were analyzed.RESULTSA total of 30 consecutive patients (17 male and 13 female) were included in this retrospective study. The mean age at procedures was 68.1 years (range 50–82 years), with mean of 6 coexisting comorbidities. Preoperatively neck pain was noted in 21 patients (70.0%), arm pain in 12 (40.0%), a paresis in 12 (40.0%), sensory deficit in 8 (26.7%), tetraparesis in 6 (20%), a septicemia in 4 (13.3%). Preoperative MRI scan revealed a CSD in one-level fusion in 21 patients (70.0%), in two-level fusions in 7 patients (23.3%), and in three-level fusions in 2 patients (6.7%). In 16 patients an antibiotic treatment was initiated prior to surgical treatment. Anterior cervical discectomy and fusion with cervical plating (ACDF+CP) was performed in 17 patients and anterior cervical corpectomy and fusion (ACCF) in 12 patients. Additional posterior decompression was performed in one case of ACDF+CP and additional posterior fixation in ten cases of ACCF procedures. Three patients died due to multiple organ failure (10%). Revision surgery was performed in 6 patients (20.7%) within the first 2 weeks postoperatively. All patients received antibiotic treatment for 6 weeks. At the first follow-up (mean 3 month) no recurrent infection was detected on blood workup and MRI scans. At final follow-up (mean 18 month), all patients reported improvement of neck pain, all but one patients were free of radicular pain and had no sensory deficits, and all patients showed improvement of motor strength. One patient with preoperative tetraparesis was able to ambulate.CONCLUSIONSCSD is a disease that is associated with severe neurological deterioration. Anterior cervical surgery with radical debridement and appropriate antibiotic treatment achieves complete healing. Anterior cervical plating with the use of polyetheretherketone cages has no negative effect of the healing process. Posterior fixation is recommended following ACCF procedures.

Surgical treatment of craniovertebral stenosis in patients with mucopolysaccharidosis type I, II, and VI

2018 ◽  
Vol 15 (4) ◽  
pp. 32-40
Author(s):  
S. P. Mironov ◽  
S. V. Kolesov ◽  
V. S. Pereverzev ◽  
D. A. Kolbovsky ◽  
A. A. Kuleshov ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Spinal Canal ◽  
Soft Tissues ◽  
Upper Cervical Spine ◽  
Type I ◽  
Timely Initiation ◽  
Enzyme Replacement ◽  
Emergency Tracheostomy

To analyze surgical treatment of craniovertebral stenosis in patients with mucopolysaccharidosis. Material and Methods. A total of 9 patients (4 men, 5 women) with mucopolysaccharidosis were operated on for craniovertebral stenosis in 2012–2017. All patients underwent clinical examination, standard radiography of the cervical spine with functional tests to assess atlantooccipital stability according to Rothman, and MRI to determine the degree of the spinal cord compression, stenosis of the spinal canal, and changes in soft tissues surrounding the spinal canal due to fibrosis and accumulation of glycosaminoglycans. Maximum stenosis at the C0–C2 level was noted in 5 patients, at C1–C2 in 2, at C2–C4 in 1, and at C0–C1 in 1. Myelopathy in the upper cervical spine was detected in five cases. The overall somatic and functional statuses, as well as neurological parameters were assessed. Follow-up examination and X-ray examination were performed at 3, 6 and 12 months after surgery, and further every 6 months. Results. The average follow-up period was 2.5 years. The age of the patients varied from 1.8 to 34 years. After 3, 6, and 12 months after surgery, instrumentation was radiologically stable in all cases, there were no bone resorption signs around the elements of instrumentation. Seven patients showed a regression of neurologic symptoms and positive dynamics in the somatic status according to the assessment scales. In one patient, the neurological status remained unchanged. In one case, a temporary deterioration in the condition was noted after a failed intubation attempt, which required emergency tracheostomy, and operation was postponed to a later date to stabilize the condition. Complications after surgical treatment were observed in five patients. In one case, pseudoarthrosis, rod fracture, and instrumentation instability developed 1.5 years after the intervention, and revision surgery was required. Wound healing problems were observed in three patients and a liquorrhea in the early postoperative period, which was stopped without revision intervention – in one case. Conclusion. Decompression and stabilization in patients with mucopolysaccharidosis should be performed in advance, before any neurological disorder development. Fixation is required to prevent the development of instability, post-laminectomy deformities, and progression of cicatricial stenosis. Timely initiation of enzyme-replacement therapy improves the results of mucopolysaccharidosis treatment.

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