Cervical disc herniation presenting as a mass lesion posterior to the odontoid process

1991 ◽  
Vol 75 (6) ◽  
pp. 954-959 ◽  
Author(s):  
William S. Rosenberg ◽  
Andrew E. Rosenberg ◽  
Charles E. Poletti
Keyword(s):  
Differential Diagnosis ◽  
Intervertebral Disc ◽  
Elderly Women ◽  
Odontoid Process ◽  
Craniovertebral Junction ◽  
Cervical Disc ◽  
Content Type ◽  
Healthy Elderly ◽  
Herniated Intervertebral Disc ◽  
Fine Print

✓ The authors report two cases of herniated intervertebral disc presenting as a mass posterior to the odontoid process and causing myelopathy in previously healthy elderly women. The differential diagnosis of a mass at the craniovertebral junction is reviewed, and the implications of these cases are discussed.

Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation

2004 ◽  
Vol 1 (3) ◽  
pp. 281-286 ◽  
Author(s):  
Atul Goel
Keyword(s):  
Odontoid Process ◽  
Craniovertebral Junction ◽  
Basilar Invagination ◽  
Foramen Magnum ◽  
Atlantoaxial Joint ◽  
Lateral Mass ◽  
Content Type ◽  
Joint Distraction ◽  
History Of ◽  
Fine Print

Object. The author discusses the successful preliminary experience of treating selected cases of basilar invagination by performing atlantoaxial joint distraction, reduction of the basilar invagination, and direct lateral mass atlantoaxial plate/screw fixation. Methods. Twenty-two patients with basilar invagination—in which the odontoid process invaginated into the foramen magnum and the tip of the odontoid process was above the Chamberlain, McRae foramen magnum, and Wackenheim clival lines—were selected to undergo surgery. In all patients fixed atlantoaxial dislocations were documented. The 16 male and six female patients ranged in age from 8 to 50 years. A history of trauma prior to the onset of symptoms was documented in 17 patients. Following surgery, the author observed minimal-to-significant reduction of basilar invagination and alteration in other craniospinal parameters resulting in restoration of alignment of the tip of the odontoid process and the clivus and the entire craniovertebral junction in all patients. In addition to neurological and radiological improvement, preoperative symptoms of torticollis resolved significantly in all patients. The minimum follow-up period was 12 months and the mean was 28 months. Conclusions. Joint distraction and firm lateral mass fixation in selected cases of basilar invagination is a reasonable surgical treatment for reducing the basilar invagination, restoring craniospinal alignment, and establishing fixation of the atlantoaxial joint.

Bilateral sagittal split mandibular osteotomies as an adjunct to the transoral approach to the anterior craniovertebral junction

1999 ◽  
Vol 90 (2) ◽  
pp. 267-270 ◽  
Author(s):  
A. Giancarlo Vishteh ◽  
Stephen P. Beals ◽  
Edward F. Joganic ◽  
Jacque L. Reiff ◽  
Curtis A. Dickman ◽  
...  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Odontoid Process ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Surgical Instruments ◽  
Content Type ◽  
Mucosal Incision ◽  
The Mean ◽  
Fine Print

✓ Transoral approaches are used to expose the craniovertebral junction anteriorly. In patients in whom there is limited mandibular excursion, the placement of retractors and/or surgical instruments is difficult, and midline “stairstep split mandibulotomy” has been advocated as an adjunctive procedure. Although effective, this approach requires external splitting of the lip as well as median glossotomy or a lateral mucosal incision. The purpose of this study was to show that bilateral sagittal split mandibular osteotomies (BSSMOs), which are used in orthognathic surgery, represent a safer and more effective alternative to the stairstep split mandibulotomy when performed as an adjunct to the transoral approach because all incisions are intraoral and the plane of retraction is rostrocaudal instead of lateral. Hospital records and radiographic files of four patients who underwent BSSMO/transoral approach for odontoidectomy between 1994 and 1997 were reviewed retrospectively. There were three women and one boy (mean age 37.8 years, range 11–68 years). Predisposing conditions included rheumatoid arthritis (two patients), Klippel—Feil syndrome (one patient), and congenital occipitocervical instability (one patient). Jaw mobility was limited in all patients. In addition, one patient had macroglossia, another micrognathia, and another retrognathia. The BSSMO provided excellent exposure for resection of the odontoid process, as verified on follow-up magnetic resonance imaging or computerized tomography studies obtained in all patients. All mandibles were rigidly fixed by placing anterior mandibular border titanium plates and unicortical screws, and there was no incidence of nonunion or of lingual or inferior alveolar nerve injuries. The mean follow-up period was 26 months. The BSSMO is an excellent, less invasive adjunct to the transoral approach in patients with limited jaw mobility.

Hemangiopericytoma of the spinal canal

1978 ◽  
Vol 49 (6) ◽  
pp. 914-920 ◽  
Author(s):  
Darrell J. Harris ◽  
Victor L. Fornasier ◽  
Kenneth E. Livingston
Keyword(s):  
Endothelial Cells ◽  
Differential Diagnosis ◽  
High Risk ◽  
Spinal Canal ◽  
Vertebral Column ◽  
Soft Tissues ◽  
Surgical Removal ◽  
Vascular Neoplasm ◽  
Content Type ◽  
Fine Print

✓ Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.

Treatment of protruded lumbar intervertebral discs with chymopapain (Discase)

1973 ◽  
Vol 39 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Dwight Parkinson ◽  
Christopher Shields
Keyword(s):  
Intervertebral Disc ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Intervertebral Discs ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Chemical Action ◽  
Content Type ◽  
Fine Print

✓ Thirty-three intervertebral disc patients who otherwise would have been subjected to surgery were treated by injection with chymopapain. The pharmacology, toxicology, physiology, immunology, and chemical action of this enzyme, which specifically reacts with chondromucoproteins, are discussed. Results indicate that this method, although still experimental and unapproved by the U. S. Food and Drug Administration, may become a useful addition to the surgeon's armamentarium in the treatment of intervertebral disc disease.

Primary eosinophilic granuloma of the oculomotor nerve

1994 ◽  
Vol 81 (5) ◽  
pp. 784-787 ◽  
Author(s):  
Markus Hardenack ◽  
Anje Völker ◽  
J. Michael Schröder ◽  
Joachim M. Gilsbach ◽  
Albrecht G. Harders
Keyword(s):  
Differential Diagnosis ◽  
Eosinophilic Granuloma ◽  
Cranial Nerves ◽  
Oculomotor Nerve ◽  
Content Type ◽  
Osseous Involvement ◽  
Fine Print

The authors report the occurrence of primary eosinophilic granuloma of the oculomotor nerve without osseous involvement in a 68-year-old man. Histopathological and neuroradiological findings are discussed. This case demonstrates that eosinophilic granuloma should be included in the differential diagnosis of tumor in which cranial nerves are involved.

Intervertebral disc space cyst simulating a recurrent herniated nucleus pulposus

1988 ◽  
Vol 69 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Jordan C. Grabel ◽  
Raphael Davis ◽  
Rosario Zappulla
Keyword(s):  
Intervertebral Disc ◽  
Preoperative Diagnosis ◽  
Relevant Literature ◽  
Radicular Pain ◽  
Lumbar Region ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Content Type ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ The case presented is of a patient with an intervertebral disc space cyst producing recurrent radicular pain following microdiscectomy in the lumbar region. Difficulties with the preoperative diagnosis of this and other recurrent radicular syndromes are discussed, and a review of the relevant literature is presented.

Posterolateral microdiscectomy for cervical monoradiculopathy caused by posterolateral soft cervical disc sequestration

1990 ◽  
Vol 72 (3) ◽  
pp. 370-377 ◽  
Author(s):  
Francois Aldrich
Keyword(s):  
Anterior Approach ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Skin Incision ◽  
Posterolateral Approach ◽  
Cervical Disc ◽  
Attractive Alternative ◽  
Disc Space ◽  
Content Type ◽  
Fine Print

✓ The controversy over whether to use a posterior or anterior approach for surgical treatment of soft cervical discs is still largely unsettled. However, although the posterior approach may be underutilized, it has distinct advantages when there are specific indications. Out of a large pool of cases, 53 patients presented with acute monoradiculopathy caused by soft cervical disc herniation. In 36 of these, the disc was sequestered (nonconfined) and was posterolateral to the disc space as seen on computerized tomography-myelography. Distinct motor weakness was a common clinical finding in all 36 cases. These patients were treated by using a 2- to 3-cm skin incision for the posterolateral microsurgical approach. The extent of the lateral facetectomy depended upon the relationship between the nerve root and the disc. All fragments were lateral to the dural sac and were sequestered through the anulus fibrosus and the posterior longitudinal ligament. Sequestrations were removed under direct microscopic vision, but the disc space was not entered. Pain relief and motor-power improvement in the affected radicular distribution were immediate in all patients. Sensory deficit and residual motor loss improved dramatically with normalization at approximately 6 months. No complications occurred and the mean hospital stay was 2 days. The follow-up period varied from 4 to 42 months with a mean of 26 months. Thus far, there have been no recurrences or other associated complications. By using strict selection criteria and a microsurgical posterolateral approach with removal of the sequestered disc fragment, excellent results with normalization of the monoradiculopathy can be obtained. The ease of this technique, low risk, minimal complications, and excellent results make it an attractive alternative to the anterior approach. The clinical presentations, specific indications, surgical technique, and clinical results are discussed; and a prototype of a small cervical self-retaining retractor is described.

Extradural spinal involvement by gout

1979 ◽  
Vol 50 (2) ◽  
pp. 236-239 ◽  
Author(s):  
Steven L. Wald ◽  
James E. McLennan ◽  
Richard M. Carroll ◽  
Harold Segal
Keyword(s):  
Differential Diagnosis ◽  
Spinal Canal ◽  
Lumbar Region ◽  
Content Type ◽  
Spinal Involvement ◽  
Gouty Tophus ◽  
Fine Print

✓ A case of extradural gouty tophus in the lumbar region in a teen-age girl is presented as an addition to the differential diagnosis of erosive lesions of the spinal canal.

Neurosurgical hyponatremia: the role of inappropriate antidiuresis

1971 ◽  
Vol 34 (4) ◽  
pp. 506-514 ◽  
Author(s):  
John L. Fox ◽  
Joel L. Falik ◽  
Robert J. Shalhoub
Keyword(s):  
Differential Diagnosis ◽  
Sodium Concentration ◽  
Fluid Restriction ◽  
Urine Sodium ◽  
Content Type ◽  
Inappropriate Secretion ◽  
Neurosurgical Patients ◽  
Inappropriate Antidiuresis ◽  
Fine Print

✓ Of 80 consecutive neurosurgical patients, 23 exhibited inappropriate secretion of the antidiuretic hormone (ISADH); 11 of these patients required marked fluid restriction. Sodium concentration in the urine characteristically increased as serum values decreased. Only by following the urine sodium concentrations could the differential diagnosis of nutritional hyponatremia and ISADH be made. The role of ISADH in cerebral edema is stressed. The treatment recommended for ISADH is marked fluid restriction, whereas in nutritional hyponatremia, saline replacement is indicated.

Lumbar disc protrusion in children

1981 ◽  
Vol 54 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Robert G. Fisher ◽  
Richard L. Saunders
Keyword(s):  
Differential Diagnosis ◽  
Adult Patient ◽  
Lumbar Disc ◽  
Disc Protrusion ◽  
Content Type ◽  
Sciatic Pain ◽  
Major Complications ◽  
Refractory Case ◽  
Fine Print

✓ Forty-three cases of surgically treated lumbar disc protrusion in patients 21 years or younger are analyzed. The results were generally good. Ten percent of the patients required reoperation within 3 years. No major complications were experienced. Follow-up observation ranged from 4 to 30 years. Disc protrusion should be considered in the differential diagnosis of children with back and sciatic pain, and early myelography should be carried out in the refractory case. The symptoms, signs, myelograms, and surgical findings are usually similar to those of the adult patient with a disc protrusion.

Sign in / Sign up

Export Citation Format

Share Document