Atlanto-axial dislocation in acute rheumatic fever

1987 ◽  
Vol 66 (2) ◽  
pp. 286-289 ◽  
Author(s):  
Joseph M. Bicknell ◽  
Wolff M. Kirsch ◽  
Robert Seigel ◽  
William Orrison
Keyword(s):  
Cervical Spine ◽  
Rheumatic Fever ◽  
Sore Throat ◽  
Acute Rheumatic Fever ◽  
Clinical Aspects ◽  
Halo Vest ◽  
Content Type ◽  
Dislocation Reduction ◽  
Atlanto Axial Joint ◽  
Fine Print

✓ A 10-year-old boy had a sore throat, followed in 4 weeks by acute rheumatic fever and in 6 weeks by atlanto-axial dislocation. Reduction of the dislocation by means of a halo vest relieved his pain, but the cervical spine remained unstable after 3 months of immobilization and required an occiput-C1–2 fusion and rib graft to stabilize the atlanto-axial joint. This is the eighth reported case of atlanto-axial dislocation associated with acute rheumatic fever. The features of previous cases are summarized and the clinical aspects, mechanisms, diagnosis, and treatment of atlanto-axial dislocation are reviewed.

Prediction of stability of cervical spine fracture managed in the halo vest and indications for surgical intervention

1990 ◽  
Vol 72 (3) ◽  
pp. 426-432 ◽  
Author(s):  
William Sears ◽  
Mahmood Fazl
Keyword(s):  
Mathematical Model ◽  
Cervical Spine ◽  
Outcome Prediction ◽  
Facet Joint ◽  
Spine Injury ◽  
Halo Vest ◽  
Content Type ◽  
Joint Dislocation ◽  
Unsuccessful Treatment ◽  
Fine Print

✓ A retrospective study was made of 173 cases of acute cervical spine injury with halo vest management to compare initial injury features with outcome. The object was to determine whether a mathematical model could be developed enabling a prediction to be made at the time of the initial assessment as to the probability of success or failure of conservative management using the halo vest alone, and thus perhaps avoid lengthy, unsuccessful treatment. Patients with facet joint dislocation were found to form a distinct subgroup of the injury population. Of the 70 patients in this subgroup, 44% achieved stability with the halo vest alone, but half of these had a “poor anatomical result.” No mathematical model or associated injury features could be found to assist in the outcome prediction in this subgroup. Of the 103 patients without facet joint dislocation, 70% achieved stability with the vest alone and over 75% of these had a “good anatomical result.” A useful model of outcome prediction was found for this subgroup by logistic regression analysis; the two most important predictors in the model were the amount of subluxation and the degree of angulation in the sagittal plane.

Treatment of nontraumatic atlantoaxial dislocation and fibrous fusion

1982 ◽  
Vol 56 (1) ◽  
pp. 139-142 ◽  
Author(s):  
John T. Lucas ◽  
Gordon D. Hungerford ◽  
Phanor L. Perot
Keyword(s):  
Rheumatic Fever ◽  
Steroid Therapy ◽  
Acute Rheumatic Fever ◽  
Atlantoaxial Dislocation ◽  
Content Type ◽  
Fine Print

✓ The authors describe a case of nontraumatic atlantoaxial dislocation secondary to acute rheumatic fever, in which there appeared to be fibrous fusion between the axis and the atlas in the subluxed position. The dislocation was reduced by means of combined traction and steroid therapy. Fibrous fusion occurred in the realigned position after immobilization.

Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery

2002 ◽  
Vol 97 (2) ◽  
pp. 176-179 ◽  
Author(s):  
Jebadurai Ratnaraj ◽  
Alexandre Todorov ◽  
Tom McHugh ◽  
Mary Ann Cheng ◽  
Carl Lauryssen
Keyword(s):  
Cervical Spine ◽  
Treatment Group ◽  
Sore Throat ◽  
Spine Surgery ◽  
Endotracheal Tube Cuff ◽  
Content Type ◽  
Tube Cuff ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Fine Print

Object. The authors' goal was to determine whether the incidence of postoperative sore throat, hoarseness, and dysphagia associated with anterior spine surgery is reduced by maintaining endotracheal tube cuff pressure (ETCP) at 20 mm Hg during the period of neck retraction. Methods. Fifty-one patients scheduled for anterior cervical spine surgery were enrolled. After intubation, ETCP was adjusted to 20 mm Hg in all patients. Following placement of neck retractors, ETCP was measured. Patients were randomized to a control (no adjustment) or treatment group (ETCP adjusted to 20 mm Hg). A blinded observer questioned the patients about the presence of sore throat, dysphagia, and hoarseness at 1 hour, 24 hours, and 1 week postoperatively. No differences between groups at 1 hour postoperatively were demonstrated. At 24 hours, 51% of patients in the treatment group complained of sore throat compared with 74% of control patients (p < 0.05). Sixty-five percent of the women experienced sore throat compared with 35% of the men (p < 0.05). At 24 hours, longer retraction time correlated with development of dysphagia (p < 0.05, r2 = 0.61). At 24 hours, hoarseness was present in 65% of women and 20% of men (p < 0.05). Conclusions. The results of this study suggest the following three predictors of postoperative throat discomfort following anterior cervical spine surgery in which neck retraction is performed: increased ETCP during neck retraction (sore throat), neck retraction time (dysphagia), and female sex (sore throat and hoarseness). The simple maneuver of decreasing ETCP to 20 mm Hg may be helpful in improving patient comfort following anterior cervical spine surgery.

A new technique for exposure of the cervical spine laminae

2002 ◽  
Vol 96 (1) ◽  
pp. 122-126 ◽  
Author(s):  
Tateru Shiraishi
Keyword(s):  
Cervical Spine ◽  
New Technique ◽  
Diverse Range ◽  
Content Type ◽  
Spinous Processes ◽  
Technical Details ◽  
A New Technique ◽  
Fine Print

✓ The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. In contrast to conventional cervical approaches, none of the muscular attachments to the spinous processes is compromised. In this paper the author describes the technical details and discusses the applications of the procedure.

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.

scholarly journals Clinical Aspects of Acute Rheumatic Fever in Pernambuco, Brazil

2018 ◽  
Vol 2 (1) ◽  
pp. 14-20
Author(s):  
Lurildo Saraiva ◽  
Cleusa Lapa ◽  
Thiago Leão
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Clinical Aspects

Computerized tomographic demonstration of rotational atlanto-axial fixation

1979 ◽  
Vol 50 (1) ◽  
pp. 115-119 ◽  
Author(s):  
Italo Rinaldi ◽  
William J. Mullins ◽  
William F. Delaney ◽  
Peter M. Fitzer ◽  
David N. Tornberg
Keyword(s):  
Computerized Tomography ◽  
Clinical Impression ◽  
Diagnostic Modality ◽  
Content Type ◽  
Difficult Diagnosis ◽  
Atlanto Axial Joint ◽  
Fine Print

✓ The authors report a case of rotational fixation of the atlanto-axial joint in which the diagnosis was not reached by conventional radiographic techniques. The clinical impression of rotational fixation was ultimately confirmed by computerized tomography. This new diagnostic modality can be very helpful in arriving at a very difficult diagnosis.

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.

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