scholarly journals Comparison of Cervical Alignment and Clinical Outcomes in Patients with Os Odontoideum versus Non-Os Odontoideum after Atlantoaxial Fixation

2017 ◽  
Vol 14 (4) ◽  
pp. 143-147 ◽  
Author(s):  
Farid Yudoyono ◽  
Jiin Kang ◽  
Yoon Ha
Keyword(s):  
Clinical Outcomes ◽  
Os Odontoideum ◽  
Cervical Alignment ◽  
Atlantoaxial Fixation

Use of a titanium mesh cage for posterior atlantoaxial arthrodesis

2002 ◽  
Vol 96 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Morio Matsumoto ◽  
Kazuhiro Chiba ◽  
Takashi Tsuji ◽  
Hirofumi Maruiwa ◽  
Yoshiaki Toyama ◽  
...  
Keyword(s):  
Donor Site ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Posterior Arch ◽  
Rigid Fixation ◽  
Titanium Mesh ◽  
Content Type ◽  
Atlantoaxial Fixation ◽  
Mesh Cage ◽  
Atlantoaxial Arthrodesis

✓ The authors placed titanium mesh cages to achieve posterior atlantoaxial fixation in five patients with atlantoaxial instability caused by rheumatoid arthritis or os odontoideum. A mesh cage packed with autologous cancellous bone was placed between the C-1 posterior arch and the C-2 lamina and was tightly connected with titanium wires. Combined with the use of transarticular screws, this procedure provided very rigid fixation. Solid fusion was achieved in all patients without major complications. The advantages of this method include more stable fixation, better control of the atlantoaxial fixation angle, and reduced donor-site morbidity compared with a conventional atlantoaxial arthrodesis in which an autologous iliac crest graft is used.

Craniocervical Instability in the Setting of Os Odontoideum

Neurosurgery ◽  
2015 ◽  
Vol 76 (5) ◽  
pp. 514-521 ◽  
Author(s):  
Deng Zhao ◽  
Shenglin Wang ◽  
Peter G. Passias ◽  
Chao Wang
Keyword(s):  
Surgical Management ◽  
Japanese Orthopaedic Association ◽  
Os Odontoideum ◽  
Complication Rates ◽  
Computed Tomographic ◽  
Presenting Symptoms ◽  
Functional Scores ◽  
Atlantoaxial Fixation ◽  
History Of

Abstract BACKGROUND: Our clinical understanding of os odontoideum (OO) remains incomplete. Congenital and traumatic causes have been proposed and advocated. Clinical presentations range from asymptomatic to axial pain to myelopathy or vertebral-basilar ischemia. A consensus for surgical management exists for those found to have an unstable atlantoaxial complex or symptomatic cranial-vertebral junction compression. OBJECTIVE: To evaluate the clinical presentation and surgical outcomes of patients with OO and an unstable atlantoaxial complex or symptomatic cranial-vertebral junction compression. METHODS: Patients with a diagnosis of OO who underwent surgical management were included. Patients were excluded on the basis of previous C2 fracture, Fielding diagnostic criteria, and inadequate follow-up. History of trauma and presenting symptoms were assessed. Clinical and neurological improvements were measured with the use of patient satisfaction scores and the Japanese Orthopaedic Association scores. Fusion status was documented with the use of radiographs and computed tomographic imaging. RESULTS: Of 279 patients, 112 reported a history of cranial-vertebral junction trauma, whereas 28 were diagnosed with congenital malformations. Clinically, 84.9% of patients presented with myelopathy, with pain presented in 42.6%. Atlantoaxial fixation was performed in 240 patients, occiput-to-C2 fixation in 35 patients, and extended occipito-cervical fixation in 4 patients. Mean follow-up was 40.3 months. Complications were reported in 2.4% of patients. Japanese Orthopaedic Association scores improved from a preoperative mean of 12.4 to 14.8. Two hundred thirty-five patients (77.7%) improved, with 30 patients experiencing no change in symptoms and 14 patients deteriorating. Fusion was achieved in 96.8% of patients. CONCLUSION: Our data reveal that surgical treatment for OO using the indications and techniques delineated is associated with high satisfaction rates, improved functional scores, and high fusion rates with low complication rates.

Minimally Invasive Atlantoaxial Fusion

Neurosurgery ◽  
2010 ◽  
Vol 66 (suppl_3) ◽  
pp. A193-A197 ◽  
Author(s):  
Langston T. Holly ◽  
Robert E. Isaacs ◽  
Anthony K. Frempong-Boadu
Keyword(s):  
Minimally Invasive ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Long Term Results ◽  
Os Odontoideum ◽  
Tubular Retractor ◽  
Estimated Blood Loss ◽  
Atlantoaxial Fixation ◽  
The Mean ◽  
Age Range

Abstract BACKGROUND C1–C2 fusion has significantly advanced from predominantly wiring/cable modalities to more biomechanically stable screw-rod techniques. Minimally invasive surgical techniques represents the most recent modification of atlantoaxial fixation. The indications, rationale, and surgical technique of this novel procedure are described. METHODS Six patients requiring C1–C2 fusion (5 type II odontoid fractures and 1 os odontoideum) underwent minimally invasive C1–C2 fusion over a 2-year period. The cohort consisted of 5 men and 1 woman with a mean age of 51 years (age range, 39–64 y). All 6 patients underwent bilateral segmental atlantoaxial fixation using an expandable tubular retractor. RESULTS The mean follow-up time was 32 months (age range, 24–46 mo) There were no intraoperative complications, and the mean estimated blood loss was 100 mL. Solid fusion was achieved in all 6 patients, without pathological motion on dynamic studies. Postoperative computed tomographic images showed no hardware malposition in the scanned patients (4 of the 6 patients). CONCLUSIONS Placement of C1 and C2 instrumentation using minimally invasive techniques is technically feasible. Because the instrumentation and the means of obtaining arthrodesis do not differ substantively from the standard approach, we would not anticipate long-term results to be different from those of an open procedure, apart from the approach-related morbidity.

Mobilization of the Vertebral Artery—Surgical Option for C2 Screw Fixation in Cases With “High Riding” Vertebral Artery

2019 ◽  
Vol 18 (6) ◽  
pp. 648-651 ◽  
Author(s):  
Atul Goel ◽  
Ranjit Rangnekar ◽  
Abhidha Shah ◽  
Survendra Rai ◽  
Ravikiran Vutha
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Basilar Invagination ◽  
Os Odontoideum ◽  
Safe Procedure ◽  
Screw Insertion ◽  
Atlantoaxial Fixation ◽  
Atlantoaxial Stabilization ◽  
C2 Vertebra

Abstract BACKGROUND Mobilization of intraosseous course of vertebral artery for safe screw insertion into pedicle of axis in cases with high riding vertebral artery is discussed. OBJECTIVE To show drilling, exposure, and mobilization of the “high-riding” vertebral artery loop during its course in relationship with superior facet/pedicle of C2 vertebra can provide safety to techniques of atlantoaxial fixation that involve insertion of screws in the pars/pedicle/facet of C2. METHODS During the period June 2016 to April 2018, 15 patients operated for atlantoaxial stabilization underwent vertebral artery exposure and mobilization using the technique discussed. The ages of the patients ranged from 6 to 48 yrs. Four patients had mobile and reducible atlantoaxial dislocation. Seven patients had basilar invagination. Four patients had os-odontoideum. Gentle and precise drilling of bone that covers the “high-riding” vertebral artery can lead to its safe and wide surgical exposure. The arterial loop can then be either completely or partially mobilized out of the vertebral artery groove such that C2 screw insertion can be conducted under direct surgical visualization of the vertebral artery. RESULTS During the average follow-up period of 14 mo, there have been no complications related to the surgical procedure, metal implant, or vertebral artery. CONCLUSION Vertebral artery exposure and mobilization is rather simple and safe procedure and is remarkably effective in providing a space for C2 screw implantation.

scholarly journals Double-level myelopathy due to atlantoaxial dislocation (os odontoideum) and subaxial cervical spondylosis with angular kyphosis

2020 ◽  
Vol 11 ◽  
pp. 100
Author(s):  
Abolfazl Rahimizadeh ◽  
Housain Soufiani ◽  
Shaghayegh Rahimizadeh
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Spondylosis ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Case Description ◽  
Cervical Kyphosis ◽  
Elderly Male ◽  
Atlantoaxial Fixation ◽  
Angular Kyphosis ◽  
Spinal Cord Decompression

Background: The surgical management of cervical spondylotic myelopathy (CSM) attributed to os odontoideum (OO with atlantoaxial instability atlantoaxial instability) and subaxial kyphosis together pose significant surgical challenges. Case Description: An elderly male presented with CSM/myelopathy and severe quadriparesis attributed to an unstable OO and 87° fixed, subaxial cervical kyphosis. After performing a 540° spinal cord decompression with atlantoaxial fixation, the patient did well. Conclusion: Double-level CSM due to an unstable OO and subaxial kyphosis is rare and typically requires combined 540° decompression and stabilization.

Selecting Skills To Teach Communication Partners: Where Do I Start?

2012 ◽  
Vol 21 (4) ◽  
pp. 127-135 ◽  
Author(s):  
Cathy Binger ◽  
Jennifer Kent-Walsh
Keyword(s):  
Clinical Outcomes ◽  
Intervention Program ◽  
Communication Partners ◽  
Multiple Challenges

Abstract Clinicians and researchers long have recognized that teaching communication partners how to provide AAC supports is essential to AAC success. One way to improve clinical outcomes is to select appropriate skills to teach communication partners. Although this sometimes seems like it should be a straightforward component of any intervention program, deciding which skills to teach partners can present multiple challenges. In this article, we will troubleshoot common issues and discuss how to select skills systematically, resulting in the desired effects for both communication partners and clients.

Linguistic Interactions: A Therapeutic Consideration for Adults With Aphasia

2008 ◽  
Vol 17 (3) ◽  
pp. 93-98
Author(s):  
Lynn E. Fox
Keyword(s):  
Clinical Outcomes ◽  
Social Contexts ◽  
Interaction Models ◽  
Social Communities ◽  
Wernicke's Aphasia ◽  
Communication Challenges ◽  
Therapeutic Consideration ◽  
Patterns Of Interaction ◽  
Structural Language

Abstract Linguistic interaction models suggest that interrelationships arise between structural language components and between structural and pragmatic components when language is used in social contexts. The linguist, David Crystal (1986, 1987), has proposed that these relationships are central, not peripheral, to achieving desired clinical outcomes. For individuals with severe communication challenges, erratic or unpredictable relationships between structural and pragmatic components can result in atypical patterns of interaction between them and members of their social communities, which may create a perception of disablement. This paper presents a case study of a woman with fluent, Wernicke's aphasia that illustrates how attention to patterns of linguistic interaction may enhance AAC intervention for adults with aphasia.

The Complexity of Health Disparities: More Than Just Black–White Differences

2021 ◽  
pp. 1-10
Author(s):  
Charles Ellis ◽  
Molly Jacobs
Keyword(s):  
Health Disparities ◽  
Clinical Outcomes ◽  
The United States ◽  
Careful Examination ◽  
White Americans ◽  
Speech Language Pathology ◽  
Death Rates ◽  
The Social ◽  
Health Related ◽  
Language Pathology

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

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