Intradural extramedullary tuberculoma of the cervical spine

1984 ◽  
Vol 60 (1) ◽  
pp. 200-203 ◽  
Author(s):  
Jeff S. Compton ◽  
Nicholas W. C. Dorsch
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Ct Scanning ◽  
Nerve Roots ◽  
Content Type ◽  
Vehicle Accident ◽  
Calcified Lesion ◽  
Intradural Extramedullary ◽  
Fine Print

✓ A case is reported of a 45-year-old man who developed quadriplegia following a trivial motor-vehicle accident. Investigation including computerized tomography (CT) of the cervical spine revealed a large calcified lesion displacing the spinal cord and nerve roots, which proved to be a tuberculoma. The case is unusual in regard to the age of the patient, the size, location, and nature of the lesion, the mode of presentation, and the delineation of the lesion by CT scanning.

Cruciate paralysis

1986 ◽  
Vol 65 (1) ◽  
pp. 108-110 ◽  
Author(s):  
Daniel Dumitru ◽  
James E. Lang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Rare Case ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Cervical Spinal Cord ◽  
Content Type ◽  
Vehicle Accident ◽  
Cord Injury ◽  
Fine Print

✓ A rare case of cruciate paralysis is reported in a 39-year-old man following a motor-vehicle accident. The differentiation of this syndrome from a central cervical spinal cord injury is delineated.

Preliminary experience with the DOC dynamic cervical implant for the treatment of multilevel cervical spondylosis

2002 ◽  
Vol 97 (3) ◽  
pp. 330-336 ◽  
Author(s):  
Michael P. Steinmetz ◽  
Ann Warbel ◽  
Melvin Whitfield ◽  
William Bingaman
Keyword(s):  
Cervical Spondylosis ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Fusion Rate ◽  
Content Type ◽  
Dynamic Cervical Implant ◽  
Vehicle Accident ◽  
The Mean ◽  
Fine Print

Object. Despite the wide use of anterior cervical instrumentation in the management of multilevel cervical spondylosis, the incidences of pseudarthrosis and instrument-related failure remain high. The use of a dynamic implant may aid in the prevention of these complications. The purpose of this study was to evaluate the DOC dynamic cervical implant in the treatment of multilevel cervical spondylosis. Methods. The authors evaluated 34 cases in which anterior multilevel cervical decompression and fusion were performed using the DOC Ventral Cervical Stabilization System. Postoperatively, and at each follow-up visit, the sagittal angle and the degree of subsidence that developed were measured. Fusion rates and clinical outcomes were also evaluated. The mean postoperative sagittal angle was 14° of lordosis. The mean change in the sagittal angle during the follow-up period was 0.4° of lordosis. By 6 months postoperatively some subsidence had occurred in most patients, with no subsidence occurring in only 15%. By 3 months greater than or equal to 2 mm of subsidence was demonstrated in 61% of cases. The overall fusion rate was 91%. In the majority of patients (79%) symptoms were judged to be improved or resolved. Conclusions. The DOC dynamic cervical implant permitted controlled subsidence and prevented progression of kyphotic deformity. There was one construct failure (related to a motor vehicle accident) and an overall fusion rate of 91%. The DOC implant is a safe and effective cervical construct for multilevel spondylotic disease.

Avulsion transverse ligament injuries in children: successful treatment with nonoperative management

2002 ◽  
Vol 96 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Patrick A. Lo ◽  
James M. Drake ◽  
Douglas Hedden ◽  
Pradeep Narotam ◽  
Peter B. Dirks
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Ct Scanning ◽  
Upper Cervical Spine ◽  
Transverse Ligament ◽  
Ligament Injuries ◽  
Avulsion Fractures ◽  
Content Type ◽  
Transverse Atlantal Ligament ◽  
Fine Print

✓ Neck injuries in children most commonly affect the upper cervical spine. Injuries of the transverse ligament and its attachments may result in C1–2 instability, but the optimum form of treatment is unknown. Three patients, who ranged in age from 5 to 11 years, sustained transverse atlantal ligament injuries with unilateral avulsion fracture of the osseous tubercle of C-1. One child was injured in a fall and two were involved in motor vehicle accidents. Although all patients presented with neck pain, none exhibited neurological deficits. Plain radiography demonstrated no evidence of osseous injury, but an increased predental interval was noted in each case. Computerized tomography (CT) scanning demonstrated the avulsion fractures, and magnetic resonance imaging revealed evidence of soft-tissue injuries in the occipital—C2 ligamentous complex. All children were managed with external immobilization (halo vest in two and a Sterno-Occipito-Mandibular Immobilizer brace in one), for 6 to 12 weeks. Follow-up CT scanning demonstrated reattachment of the avulsed osseous tubercle, and dynamic cervical spine radiographs revealed the absence of C1–2 instability. The results of these cases suggest a role for external immobilization in the treatment of osseous avulsion injuries of the transverse atlantal ligament in children.

Cervical spine fracture following a motor vehicle accident

1988 ◽  
Vol 6 (3) ◽  
pp. 179-183 ◽  
Author(s):  
William F. Eckhardt ◽  
Michael Doyle ◽  
Alan Woodward ◽  
Irwin Freundlich ◽  
Francis X. Rockett
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Spine Fracture ◽  
Cervical Spine Fracture ◽  
Vehicle Accident

Minimally Invasive Lateral Mass Screws in the Treatment of Cervical Facet Dislocations: Technical Note

Neurosurgery ◽  
2003 ◽  
Vol 52 (2) ◽  
pp. 444-448 ◽  
Author(s):  
Michael Y. Wang ◽  
Chad J. Prusmack ◽  
Barth A. Green ◽  
J. Peter Gruen ◽  
Allan D.O. Levi
Keyword(s):  
Cervical Spine ◽  
Minimally Invasive ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Technical Note ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Vehicle Accident ◽  
Lateral Mass Screws ◽  
Facet Fracture

Abstract OBJECTIVE The technique of lateral mass screw and rod or plate fixation is a major advancement in the posterior instrumentation of the cervical spine. This technique provides rigid three-dimensional fixation, restores the dorsal tension band, and provides highly effective stabilization in patients with many types of traumatic injuries. METHODS Patient 1 was a 32-year-old man who had been in a motor vehicle accident. He presented with right C5 radiculopathy. X-ray findings included 45% anterolisthesis of C4 on C5, bilateral facet disruption, and right unilateral C4–C5 facet fracture and dislocation. The patient was placed in Gardner-Wells tongs, and the fracture was reduced with 25 pounds of traction. Patient 2 was a 56-year-old woman who had been in a motor vehicle accident that resulted in complete quadriplegia. Her initial imaging studies revealed a C3–C4 right unilateral facet fracture with subluxation. She was placed in traction, and her neurological status was reassessed. The findings of her neurological examination revealed improvement: she was found to have Brown-Séquard syndrome. Patient 3 was a 33-year-old man who was involved in a diving accident that resulted in bilaterally jumped facets at C3–C4. The patient was neurologically intact, and attempts at closed reduction were not successful. RESULTS Patients 1 and 2 underwent anterior cervical discectomy with iliac crest autograft fusion and plating. They were then placed in the prone position, and a dilator tubular retractor system was used to access the facet joint at the level of interest. The facet joints were then denuded and packed with autograft. Lateral mass screws were then placed by means of the Magerl technique, and a rod was used to connect the top-loading screws. Patient 3 underwent posterior surgery that included only removal of the superior facet, intraoperative reduction, and bilateral lateral mass screw and rod placement. CONCLUSION This technical note describes the successful placement of lateral mass screw and rod constructs with the use of a minimally invasive approach by means of a tubular dilator retractor system. This approach preserves the integrity of the muscles and ligaments that maintain the posterior tension band of the cervical spine.

Endoscopic transpedicular thoracic discectomy

1999 ◽  
Vol 91 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Hae-Dong Jho
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Skin Incision ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Transpedicular Approach ◽  
Thoracic Discectomy ◽  
Fine Print

Object. To minimize the invasiveness and maximize the adequacy of the decompressive procedure in thoracic discectomy, a 70° endoscope was adapted to perform transpedicular thoracic discectomy. Methods. A posterior transpedicular approach was performed via a 2-cm transverse skin incision, aided by an operating microscope or a 0° lens endoscope. Using a 70° lens endoscope, discectomy was performed after obtaining direct visualization of the ventral aspect of the spinal cord dura mater. This surgical technique has been used in 25 patients. There were 12 men and 13 women whose ages ranged from 29 to 74 years (median 46 years). Thirteen patients experienced myelopathy, with or without radiculopathy, 10 presented with radiculopathy, and two patients suffered from segmental pain. The follow-up period ranged from 4 to 60 months (median 27 months). In 12 of 13 patients with myelopathy, excellent improvement was shown postoperatively. In the remaining patient, symptoms recurred after she was injured in a motor vehicle accident 3 months postsurgery. In nine of 10 patients with radiculopathy, pain resolved completely. In the one patient with right-sided hypochondral pain and in the two patients with segmental pain, no relief was obtained despite excellent discectomy results demonstrated on postoperative magnetic resonance images. The average length of hospital stay was overnight. Conclusions. The use of a 70° lens endoscope through a transpedicular route has made thoracic discectomy comparable with cervical or lumbar discectomy in terms of minimal surgical invasiveness, recovery time, and complexity of the procedure.

Atlantooccipital transarticular screw fixation for the treatment of traumatic occipitoatlantal dislocation

2005 ◽  
Vol 2 (3) ◽  
pp. 381-385 ◽  
Author(s):  
Iman Feiz-Erfan ◽  
L. Fernando Gonzalez ◽  
Curtis A. Dickman
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Screw Fixation ◽  
Full Range ◽  
Neurological Injury ◽  
Content Type ◽  
Vehicle Accident ◽  
A New Technique ◽  
Atlantooccipital Dislocation

✓ The authors describe a new technique of internal atlantooccipital screw fixation involving posterior wiring and fusion for the treatment of traumatic atlantooccipital dislocation, which was performed in a 17-year-old male patient involved in a motor vehicle accident and who suffered from atlantooccipital dislocation without neurological injury. At the 6-month follow-up examination, the patient was neurologically intact with a solid occipitocervical fusion and full range of motion of the neck.

Cervical magnetic resonance imaging abnormalities not predictive of cervical spine instability in traumatically injured patients

2004 ◽  
Vol 1 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Eric M. Horn ◽  
Gregory P. Lekovic ◽  
Iman Feiz-Erfan ◽  
Volker K. H. Sonntag ◽  
Nicholas Theodore
Keyword(s):  
Cervical Spine ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Ct Scanning ◽  
Resonance Imaging ◽  
Cervical Instability ◽  
Content Type ◽  
Trauma Service ◽  
Injured Patients ◽  
Fine Print

Object. Identifying instability of the cervical spine can be difficult in traumatically injured patients. The goal of this study was to determine whether cervical abnormalities demonstrated on magnetic resonance (MR) imaging are predictive of spinal instability. Methods. Data in all patients admitted through the Level I trauma service at the authors' institution who had undergone cervical MR imaging were retrospectively reviewed. The reasons for MR imaging screening were neurological deficit, fracture, neck pain, and indeterminate clinical examination (for example, coma). Abnormal soft-tissue (prevertebral or paraspinal) findings on MR imaging were correlated with those revealed on computerized tomography (CT) scanning and plain and dynamic radiography to determine the presence/absence of cervical instability. Of 6328 patients admitted through the trauma service, 314 underwent MR imaging of the cervical spine. Of 166 patients in whom CT scanning or radiography demonstrated normal findings, 70 had undergone MR imaging that revealed abnormal findings. Of these 70 patients, 23 underwent dynamic imaging, the findings of which were normal. In each case of cervical instability (65 patients) CT, radiographic, and MR imaging studies demonstrated abnormalities. Furthermore, there were 143 patients with abnormal CT or radiographic study findings, in 13 of whom MR imaging revealed normal findings. Six of the latter underwent dynamic testing, which demonstrated normal results. Conclusions. Magnetic resonance imaging is sensitive to soft-tissue injuries of the cervical spine. When CT scanning and radiography detect no fractures or signs of instability, MR imaging does not help in determining cervical stability and may lead to unnecessary testing when not otherwise indicated.

scholarly journals Pseudomeningocele From Brachial Plexus Root Avulsion

2019 ◽  
pp. 1-3
Author(s):  
Joseph Yoon ◽  
Michael Redmond
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Management Strategies ◽  
Clinical Findings ◽  
Root Avulsion ◽  
Nerve Roots ◽  
Vehicle Accident ◽  
Uncommon Condition

We report a case of a 42-year-old male involved in a motor vehicle accident. Initial MRI revealed T2 hypo-intensity of the anterior cord at the C6 level of the cervical spine which raised significant discussions within the neurosurgical, radiology and ICU departments at our institution. After careful review of images and patient’s clinical examination we suspected root avulsion of the brachial plexus. Subsequent MRI brachial plexus showed a large axillary pseudomeningocele originating from the C5-T2 nerve roots. Our team concluded the patient suffered a complete brachial plexus injury from right lateral hyperflexion as extrapolated from his injuries. The aim of this report is to highlight the uncommon condition and report of key clinical findings and management strategies.

Posttraumatic cerebrospinal fluid cyst of the orbit

1985 ◽  
Vol 62 (6) ◽  
pp. 922-924 ◽  
Author(s):  
Patrick A. Sibony ◽  
Azad K. Anand ◽  
P. Arjen Keuskamp ◽  
Allen G. Zippen
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Dural Tear ◽  
Pertinent Literature ◽  
Direct Communication ◽  
Content Type ◽  
Specific Diagnosis ◽  
Orbital Roof ◽  
Vehicle Accident ◽  
Metrizamide Cisternography

✓ A 27-year-old man sustained a fracture of the orbital roof and a basofrontal dural tear in a motor-vehicle accident. One week later, he developed an orbitocranial dural fistula manifested by an orbital cyst, pulsatile proptosis, and serous drainage from the eye. Specific diagnosis was established only after computerized tomography metrizamide cisternography demonstrated direct communication of the orbital cyst with the subarachnoid space. The pertinent literature is reviewed.

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