Swan-neck deformity secondary to osteomyelitis of the posterior elements of the cervical spine

1979 ◽  
Vol 50 (3) ◽  
pp. 388-390 ◽  
Author(s):  
Ghaus M. Malik ◽  
Alvin H. Crawford ◽  
Robert Halter
Keyword(s):  
Cervical Spine ◽  
Cervical Vertebrae ◽  
Cervical Fusion ◽  
Content Type ◽  
Halo Traction ◽  
Posterior Cervical Fusion ◽  
Swan Neck Deformity ◽  
Fine Print ◽  
Posterior Elements ◽  
Excellent Stability

✓ A case of osteomyelitis is described, involving the posterior elements of the cervical vertebrae in a 7-year-old girl and resulting in swan-neck deformity. Treatment was initiated with antibiotics, and the patient was placed in halo traction. Eventually posterior cervical fusion was performed, which provided excellent stability and correction of the deformity.

Posterior cervical fusion in children

1976 ◽  
Vol 45 (2) ◽  
pp. 211-215 ◽  
Author(s):  
Joe M. McWhorter ◽  
Eben Alexander ◽  
Courtland H. Davis ◽  
David L. Kelly
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
The Other ◽  
Congenital Absence ◽  
Cervical Fusion ◽  
Content Type ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Posterior Cervical Fusion ◽  
Fine Print

✓ Six cases of posterior cervical fusion with rib grafts in children are reported. Four of the children had sustained cervical spine injuries in accidents, and two had congenital absence of the odontoid. Three-level fusions (C1–3) were done in four children, and four-level fusions (C1–4) in two. One child died of unrelated causes 3 months after the operation. The other five children have been followed for 5 to 13 years. All are doing well and each has a remarkably supple, stable neck and no neurological deficit.

Delayed intracranial migration of cervical sublaminar and interspinous wires and subsequent cerebellar abscess

2002 ◽  
Vol 97 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Kevin L. Stevenson ◽  
Matthew Wetzel ◽  
Ian F. Pollack
Keyword(s):  
Cervical Spine ◽  
Neurological Injury ◽  
Cervical Fusion ◽  
Content Type ◽  
Cerebellar Abscess ◽  
Delayed Complication ◽  
History Of ◽  
Delayed Complications ◽  
The Wire ◽  
Fine Print

✓ Delayed complications associated with sublaminar and interspinous wiring in the pediatric cervical spine are rare. The authors present a case of delayed complication in which a cervical fusion wire migrated into the cerebellum, causing subsequent cerebellar abscess 2 years after posterior cervical arthrodesis. A craniotomy was required to remove the wire and drain the abscess. Despite their history of safety and successful fusion, procedures involving sublaminar and interspinous wiring carry a risk of neurological injury secondary to wire migration. A thorough neuroimaging evaluation is required in patients who have undergone fusion and who have neurological complaints to detect late instrumentation-related sequelae.

Reduction of traumatic dislocation of the cervical spine with locked facets

1973 ◽  
Vol 38 (4) ◽  
pp. 527-531 ◽  
Author(s):  
Ralph B. Cloward
Keyword(s):  
Cervical Spine ◽  
Cervical Vertebrae ◽  
Content Type ◽  
Traumatic Dislocation ◽  
Fine Print

✓ The author describes a method and an instrument for reduction of dislocated cervical vertebrae. This technique is particularly useful when the facets are locked.

Anterior cervical plating for the treatment of neoplasms in the cervical vertebrae

1999 ◽  
Vol 90 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Wolfhard Caspar ◽  
Tobias Pitzen ◽  
Luca Papavero ◽  
Fred H. Geisler ◽  
Todd A. Johnson
Keyword(s):  
Cervical Spine ◽  
Clinical Outcome ◽  
Bone Graft ◽  
Mechanical Stability ◽  
Cervical Vertebrae ◽  
Autologous Bone Graft ◽  
Retrospective Case ◽  
Content Type ◽  
Fine Print

Object. To assess clinical outcome and survival in patients with cervical vertebral spinal neoplasms after they have undergone anterior decompression and cervical plate stabilization (ACPS) by using either autologous bone graft or polymethylmethacrylate (PMMA) as the anterior load-bearing support structure. Methods. This was a retrospective case study composed of 30 patients harboring cervical spinal vertebral neoplasms who underwent anterior cervical decompression and (ACPS) within a 7-year period. Postoperative immobilization included treatment in a halo brace in two cases and in a hard cervical collar for the remaining patients. Postoperatively most patients underwent radio- and/or chemotherapy. All patients except one benefited from a significantly improved quality of life with decreased pain and/or improved neurological status. The mean Kaplan—Meier survivoral estimate was 35.8 months (range 8 days–11.3 years, with 10 patients alive at most recent follow-up contact). Patients achieved long-term or lifelong mechanical stability in the cervical spine, and only one patient required a repeated posterior stabilization procedure. No hardware-related complications occurred. One patient died 8 days postoperatively of pneumonia. A nonsignificant difference in survival (p = 0.2164) was observed between patients harboring metastatic neoplasms (26.8 months) and those harboring lymphomatous and multiple myeloma neoplasms (54 months). Conclusions. Favorable clinical outcome of both neurological symptoms and pain can be achieved using ACPS after surgery for neoplasms in the cervical vertebrae. Furthermore, long-term or lifelong cervical spine mechanical stability with bone fusion is achieved using this technique even when radiation therapy is delivered to the site of the bone graft.

Monitoring of blood parameters following anterior cervical fusion

2000 ◽  
Vol 92 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Steffen K. Rosahl ◽  
Alireza Gharabaghi ◽  
Peter-Michael Zink ◽  
Madjid Samii
Keyword(s):  
Cervical Spine ◽  
Cell Count ◽  
Postoperative Period ◽  
White Cell Count ◽  
Anterior Cervical Fusion ◽  
Anterior Fusion ◽  
Cervical Fusion ◽  
Content Type ◽  
Cervical Spine Surgery ◽  
Fine Print

Object. Both C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) were measured prospectively in 51 cases in which uncomplicated cervical anterior fusion was performed. The object of the authors was to quantify the differences in the responses of these parameters recorded in the immediate postoperative period and to determine factors influencing their course. Methods. Nineteen one-level, 23 two-level, and nine three-level procedures for disc herniation and degenerative disease of the cervical spine were performed in 22 female and 29 male patients (mean age 49.2 years). Blood samples were obtained 1 day before as well as on 10 consecutive days and 3 months following anterior cervical fusion. Serum CRP level was measured using a fluorescence polarization immunoassay and ESR was determined from the same samples. Operative time, the number of blood transfusions, and drugs administered in the postoperative period were recorded. In addition, hemoglobin, hematocrit, red blood cell count, platelet count, white cell count, and axillary body temperature were checked daily. Conclusions. Monitoring of CRP level is superior to that of ESR for early detection of infections after cervical spine surgery. Although CRP was not related to any of the factors that have been proposed to explain its peak value variance in previous studies, individual acute-phase protein metabolism response to tissue affection appears to be a more decisive element in this respect.

Atlantoaxial interlaminar distances in cervical flexion in children

2003 ◽  
Vol 98 (3) ◽  
pp. 271-274 ◽  
Author(s):  
R. Shane Tubbs ◽  
Matthew D. Smyth ◽  
John C. Wellons ◽  
Jeffrey P. Blount ◽  
Paul A. Grabb ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Atlantoaxial Instability ◽  
Entire Group ◽  
Content Type ◽  
Significant Difference ◽  
Full Flexion ◽  
The Mean ◽  
Atlas And Axis ◽  
Fine Print ◽  
Posterior Elements

Object. To the best of the authors' knowledge, no quantitative analysis of the atlantoaxial interlaminar distance in flexion (ILD) in children exists in the medical literature. In this study they sought to determine the age-matched relationship between the posterior elements of the atlas and axis in children in cervical spine flexion, to be used as an adjunct to the atlantodental interval in common clinical use. Methods. Lateral radiographs of the cervical spine in full flexion were analyzed in 74 children. The atlantoaxial ILD was defined as the distance between a midpoint of the anterior cortices of the atlantal and axial posterior arches. The mean ILD for the entire group was 19 mm (range 8–30 mm). No significant difference was seen between male and female patients (p = 0.084). When stratified by age, the mean ILD was 12.3 ± 3 mm (15 cases) in children age 3 years or younger and 20.5 ± 4.7 mm (59 cases) in children age older than 3 years. Further stratification of the groups yielded a mean ILD of 10.4 ± 1.4 [eight cases]) in children age 1 to 2 years, and 14.4 ± 4.7 mm (seven cases) in children age 3 years. In children older than 3 years of age the mean ILD was consistently approximately 20 ± 5 mm regardless of age. Conclusions. Rapid, safe, and accurate diagnosis of the cervical spine is essential in critical care. Knowledge of the distance between the posterior elements of the atlas and axis in flexion should enhance the clinicians' (those who clear cervical spines) ability to diagnose accurately atlantoaxial instability on lateral radiographs obtained in flexion.

Use of cylindrical titanium mesh and locking plates in anterior cervical fusion

2001 ◽  
Vol 94 (1) ◽  
pp. 174-178 ◽  
Author(s):  
Kaushik Das ◽  
William T. Couldwell ◽  
Gerard Sava ◽  
Rudolph F. Tadonio
Keyword(s):  
Cervical Spine ◽  
Iliac Crest ◽  
Locking Plate ◽  
Anterior Cervical Fusion ◽  
Cervical Fusion ◽  
Titanium Mesh ◽  
Content Type ◽  
Locking Plate System ◽  
Fine Print

✓ After performing anterior cervical corpectomy or discectomy for cervical spondolytic myelopathy or radiculopathy, iliac crest bone graft and fibular auto- or allograft is often used to achieve arthrodesis in the cervical spine. The purpose of this study was to evaluate the use of a cylindrical titanium mesh and locking plate system as an alternative technique in achieving anterior cervical fusion and maintaining lordosis. Hospital records and radiographs of 38 patients who underwent anterior cervical discectomies (28 patients) or corpectomies (10 patients) from 1995 to 1997 were reviewed retrospectively. All patients had undergone arthrodesis in which autograft and a cylindrical titanium mesh and anterior locking plate fixation were used after discectomy or corpectomy. There were 20 men and 18 women (mean age 46.1 years; range 34–72 years). Presenting symptoms included radiculopathy (61%), myelopathy (37%), and neck pain (2%). Preoperative and postoperative radiographs were studied, and data were obtained on the following: overall lordosis or kyphosis of the cervical spine, segmental lordosis or kyphosis at each surgically treated level, and evidence of fusion. In all of the patients in whom lordosis was present preoperatively, lordosis was maintained during the follow-up period. The overall fusion rate was 100%. The average change in overall lordosis or kyphosis related to the fixation devices was 1.2° (range 1–5°); the average segmental change was 2.3° (range 0–5°); and the mean follow up was 16 months (range 12–36 months). Anterior cervical fusion with cylindrical titanium mesh and cervical locking plate system is an effective method of achieving arthrodesis and maintaining alignment in the cervical spine. The construct may provide additional load-sharing function, and it avoids the use of cadaveric bone or the need for harvesting tricortical iliac crest autograft.

Iniencephaly: neuroradiological and surgical features

1998 ◽  
Vol 89 (2) ◽  
pp. 317-320 ◽  
Author(s):  
Pamir Erdinçler ◽  
Mehmet Y. Kaynar ◽  
Bülent Canbaz ◽  
Naci Koçer ◽  
Cengiz Kuday ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Cervical Spine ◽  
Bone Defect ◽  
Cervical Vertebrae ◽  
Psychomotor Retardation ◽  
Occipital Bone ◽  
Content Type ◽  
Rare Congenital Anomaly ◽  
Occipital Bone Defect ◽  
Fine Print

Iniencephaly is a rare congenital anomaly characterized by spina bifida of the cervical vertebrae, fixed retroflexion of the head on the cervical spine, and occipital bone defect. There are only five reports of surviving patients with iniencephaly. The authors report the case of a newborn who presented with iniencephaly and an encephalocele that were surgically treated in our service. Neurological examination of the patient yielded normal results except for a moderate psychomotor retardation. The neuroradiological and surgical findings of the case suggested that the trigger of the anomaly was the occipital bone defect and rachischisis of the posterior vertebral arches.

Use of MR imaging-compatible Halifax interlaminar clamps for posterior cervical fusion

1991 ◽  
Vol 74 (2) ◽  
pp. 185-189 ◽  
Author(s):  
E. Francois Aldrich ◽  
Wayne N. Crow ◽  
Peter B. Weber ◽  
Thomas N. Spagnolia
Keyword(s):  
Mr Imaging ◽  
Bone Grafting ◽  
Ease Of Use ◽  
Rigid Fixation ◽  
Cervical Fusion ◽  
Content Type ◽  
Posterior Cervical Fusion ◽  
Ideal Method ◽  
Fine Print

✓ Twenty-one patients requiring posterior cervical fusion were treated with magnetic resonance (MR) imaging-compatible Halifax interlaminar clamps for internal fixation. Various levels were involved: the C1–2 level in eight cases, the C4–5 level in four, the C5–6 level in three, the C6–7 level in three, the C4–6 level in two, and the C5–7 level in one. Bilateral clamps were used in 18 cases and unilateral clamps in three. Autogenous iliac bone grafting was performed in all cases but one. Follow-up periods ranged from 1 to 18 months (average 9.2 months), with no complications or mechanical failures occurring thus far. Follow-up diagnostic studies revealed rigid fixation and fusion in all cases. The MR imaging-compatibility of the clamps allowed excellent follow-up studies with minimal artifact. Because of their ease of use, rigid stabilization, good results, lack of complications, and compatibility with MR imaging, the Halifax interlaminar clamp with bone grafting provides an ideal method for posterior cervical stabilization.

Hydroxyapatite laminar spacers and titanium miniplates in cervical laminoplasty

2002 ◽  
Vol 97 (3) ◽  
pp. 323-329 ◽  
Author(s):  
Takeo Goto ◽  
Kenji Ohata ◽  
Toshihiro Takami ◽  
Misao Nishikawa ◽  
Naohiro Tsuyuguchi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spinous Process ◽  
Spinal Tumors ◽  
Cervical Laminoplasty ◽  
En Bloc ◽  
Content Type ◽  
Hardware Failure ◽  
Fine Print ◽  
Posterior Elements

Object. The authors describe a new surgical technique for cervical laminoplasty that was performed in 25 patients. The posterior elements along with the various ligaments are removed en bloc and are stabilized in a lift-up position by placing hydroxyapatite (HA) laminar spacers and titanium miniplates and screws. The procedure and clinical results are discussed. Methods. The posterior spinal elements, including the lamina(e), spinous process(es), and various attached ligaments, are removed en bloc by incising the lamina in its lateral aspect. Trapezoid-shaped HA spacers are placed between the cut ends of the laminae or between the laminae and lateral masses bilaterally at each level. Malleable titanium miniplates and screws are used for fixation of the spacers. The fixation of transected laminae was judged to be successful. Postoperative care included application of a soft neck collar for 1 week but no further restriction of activity. Surgery-related outcome was assessed in the 21 patients who attended more than 6 months of follow up after laminoplasty. There were 18 men and three women who ranged in age from 27 to 81 years. Cervical stenotic myelopathy was demonstrated in 15 patients who underwent decompressive and expansive laminoplasty, and spinal tumors were documented in six patients who underwent a nonexpansive laminoplasty. Postoperative and follow-up computerized tomography scans demonstrated no hardware failure. Bone formation around the spacers was observed either at 6- or at 9-month follow-up examination in all 21 patients. Fusion of the reconstructed laminae was found to be completed at 12 months in all 18 patients able to attend follow up for this duration. Spinal alignment and the range of motion of the cervical spine were well preserved. In patients with stenotic cervical myelopathy, neurological and anatomical outcome of canal expansion were satisfactory. Conclusions. This technique enables rigid laminoplasty while maintaining anatomical and biomechanical integrity of posterior elements of cervical spine. Expansive and nonexpansive laminoplasty procedures are possible.

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