Evaluation and treatment of congenital and developmental anomalies of the cervical spine

2004 ◽  
Vol 1 (2) ◽  
pp. 188-197 ◽  
Author(s):  
Arnold H. Menezes
Keyword(s):  
Cervical Spine ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Growth Potential ◽  
Limb Weakness ◽  
Content Type ◽  
Spinal Stabilization ◽  
Vascular Abnormalities ◽  
The Stability ◽  
High Index Of Suspicion

✓ Congenital and developmental osseous abnormalities of the cervical spine can result in neural compression ranging from the medulla oblongata to the cervicothoracic spinal cord junction. These may present in infancy as scoliosis and even limb weakness. A high index of suspicion is essential. Neurodiagnostic imaging relies on high-resolution computerized tomography (CT) scanning and three-dimensional CT reconstructions as well as magnetic resonance imaging and angiography. The anatomical/physiological CT factors considered when developing a surgical approach are: 1) the stability and reducibility of the lesions; 2) direction and manner of encroachment of the lesion on the neural structures; 3) neural and vascular abnormalities; and 4) growth potential of the affected area. Primary stabilization is required for reducible lesions, whereas irreducible lesions are decompressed in the manner in which encroachment has occurred. Instability, whether present before or after operative intervention, required spinal stabilization. Illustrative examples of this approach are presented.

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.

Three-dimensional flow of radiative hybrid nanofluid past a permeable stretching/shrinking sheet with homogeneous-heterogeneous reaction

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Najiyah Safwa Khashi'ie ◽  
Norihan Md Arifin ◽  
Natalia C. Rosca ◽  
Alin V. Rosca ◽  
Ioan Pop
Keyword(s):  
Heterogeneous Reaction ◽  
Three Dimensional ◽  
Heterogeneous Reactions ◽  
Shrinking Sheet ◽  
Hybrid Nanofluid ◽  
Three Dimensional Flow ◽  
Suction Parameter ◽  
Content Type ◽  
Fluid Concentration ◽  
The Stability

Purpose The purpose of this paper is to study the effects of thermal radiation and homogeneous-heterogeneous reactions in the three-dimensional hybrid nanofluid flow past a permeable stretching/shrinking sheet. Design/methodology/approach The combination of aluminum oxide (Al2O3) and copper (Cu) nanoparticles with total volumetric concentration is numerically analyzed using the existing correlations of hybrid nanofluid. With the consideration that both homogeneous and heterogeneous reactions are isothermal while the diffusion coefficients of both autocatalyst and reactant are same, the governing model is simplified into a set of differential (similarity) equations. Findings Using the bvp4c solver, dual solutions are presented, and the stability analysis certifies the physical/real solution. The findings show that the suction parameter is requisite to induce the steady solution for shrinking parameter. Besides, the fluid concentration owing to the shrinking sheet is diminished with the addition of surface reaction. Originality/value The present findings are novel and can be a reference point to other researchers to further analyze the heat transfer performance and stability of the working fluids.

Cranial reconstruction using prefabricated direct 3DP porous polyethylene

2019 ◽  
Vol 26 (2) ◽  
pp. 278-287 ◽  
Author(s):  
Pataravit Rukskul ◽  
Waraporn Suvannapruk ◽  
Jintamai Suwanprateeb
Keyword(s):  
Three Dimensional ◽  
Ct Scanning ◽  
Porous Polyethylene ◽  
Content Type ◽  
Three Dimensional Printing ◽  
Long Term Stability ◽  
Aesthetic Results ◽  
Ct Evaluation ◽  
Infection Resistance ◽  
Porous Polyethylene Implants

Purpose The purpose of this study is to evaluate the intra- and post-operative performance and safety of direct three dimensional printing (3DP) porous polyethylene implants in cranial reconstruction. Design/methodology/approach Prefabricated porous polyethylene implants were prepared by direct 3DP, and cranioplasty implantation was performed. Postoperative aesthetics, patient satisfaction, firmness of the implant, reactions to the implant and 3D computed tomography (CT) scanning were assessed after 2, 6, 12 and 24 months postoperatively. Findings No complications after surgery were encountered. Excellent aesthetic results were obtained in all cases, and all the patients were satisfied with the reconstruction outcome. Bone density structure was found to ingrowth into these direct 3DP porous polyethylene implants and the content increased with increasing follow-up times. Research limitations/implications This study was a pilot study conducted in a single group and evaluated in a short-term period. The bone formation and ingrowth were indirectly assessed by 3D CT evaluation. Originality/value This work reported the use and evaluation of direct 3DP porous polyethylene in middle- to large-sized cranial reconstructions. It evidently showed the bonding of implants to surrounding tissues which would result in the long-term stability and infection resistance of the implant.

Three-dimensional computerized tomography angiography in patients with hyperacute intracerebral hemorrhage

1999 ◽  
Vol 91 (3) ◽  
pp. 424-431 ◽  
Author(s):  
Yasuo Murai ◽  
Ryo Takagi ◽  
Yukio Ikeda ◽  
Yasuhiro Yamamoto ◽  
Akira Teramoto
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Three Dimensional ◽  
Ct Scanning ◽  
3D Ct ◽  
Content Type ◽  
Hematoma Enlargement ◽  
3D Ct Angiography ◽  
Fine Print

Object. The authors confirm the usefulness of extravasation detected on three-dimensional computerized tomography (3D-CT) angiography in the diagnosis of continued hemorrhage and establishment of its cause in patients with acute intracerebral hemorrhage (ICH).Methods. Thirty-one patients with acute ICH in whom noncontrast and 3D-CT angiography had been performed within 12 hours of the onset of hemorrhage and in whom conventional cerebral angiographic studies were obtained during the chronic stage were prospectively studied. Noncontrast CT scanning was repeated within 24 hours of the onset of ICH to evaluate hematoma enlargement.Findings indicating extravasation on 3D-CT angiography, including any abnormal area of high density on helical CT scanning, were observed in five patients; three of these demonstrated hematoma enlargement on follow-up CT studies. Thus, specificity was 60% (three correct predictions among five positives) and sensitivity was 100% (19 correct predictions among 19 negatives). Evidence of extravasation on 3D-CT angiography indicates that there is persistent hemorrhage and correlates with enlargement of the hematoma.Regarding the cause of hemorrhage, five cerebral aneurysms were visualized in four patients, and two diagnoses of moyamoya disease and one of unilateral moyamoya phenomenon were made with the aid of 3D-CT angiography. Emergency surgery was performed without conventional angiography in one patient who had an aneurysm, and it was clipped successfully.Conclusions. Overall, 3D-CT angiography was found to be valuable in the diagnosis of the cause of hemorrhage and in the detection of persistent hemorrhage in patients with acute ICH.

Surgical stabilization of traumatic cervical spine dislocation using methyl methacrylate

1986 ◽  
Vol 64 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Thomas A. Duff
Keyword(s):  
Cervical Spine ◽  
Methyl Methacrylate ◽  
Neurological Impairment ◽  
Spine Fracture ◽  
Cervical Spine Fracture ◽  
Content Type ◽  
Spinal Stabilization ◽  
Stainless Steel Screw ◽  
Fracture Dislocations

✓ Twenty-six patients with traumatic cervical spine fracture-dislocations had spinal stabilization with methyl methacrylate (acrylic) as the primary support. In most cases a ¾-in. stainless steel screw was inserted into the articular pillars of the fractured vertebra and of the two adjacent vertebrae, followed by application of the acrylic in the form of an oblong mold over the heads of the screws. The follow-up period in these 26 patients ranged from 6 months to 7 years. There were no instances of wound infection or increased neurological impairment. Vertebral elements remained aligned in 25 of the 26 patients. Breakage of the acrylic support was documented in two patients, but in only one was surgical repair required. The results of this study indicate that the procedure is a safe and effective method for both immediate and long-term stabilization of cervical spine fracture-dislocations.

Three-dimensional angiography for radiosurgical treatment planning for arteriovenous malformations

2003 ◽  
Vol 98 (3) ◽  
pp. 536-543 ◽  
Author(s):  
Federico Colombo ◽  
Carlo Cavedon ◽  
Paolo Francescon ◽  
Leopoldo Casentini ◽  
Umberto Fornezza ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Imaging Modality ◽  
Treatment Plan ◽  
Three Dimensional ◽  
Ct Scanning ◽  
New Method ◽  
Rotational Angiography ◽  
Content Type ◽  
3D Rotational Angiography ◽  
Fine Print

Object. Radiosurgical treatment of a cerebral arteriovenous malformation (AVM) requires the precise definition of the nidus of the lesion in stereotactic space. This cannot be accomplished using simple stereotactic angiography, but requires a combination of stereotactic biplanar angiographic images and stereotactic contrast-enhanced computerized tomography (CT) scans. In the present study the authors describe a method in which three-dimensional (3D) rotational angiography is integrated into stereotactic space to aid treatment planning for radiosurgery. Methods. Twenty patients harboring AVMs underwent treatment planning prior to linear accelerator radiosurgery. Planning involved the acquisition of two different data sets, one of which was obtained using the standard method (a combination of biplanar stereotactic angiography with stereotactic CT scanning), and the other, which was procured using a new technique (nonstereotactic 3D rotational angiography combined with stereotactic CT scanning by a procedure of image fusion). The treatment plan that was developed using the new method was compared with that developed using the standard one. For each patient the number of isocenters and the dimension of selected collimators were the same, based on the information supplied in both methods. Target coordinates were modified in only five cases and by a limited amount (mean 0.7 mm, range 0.3–1 mm). Conclusions. The new imaging modality offers an easier and more immediate interpretation of 3D data, while maintaining the same accuracy in target definition as that provided by the standard technique. Moreover, the new method has the advantage of using nonstereotactic 3D angiography, which can be performed at a different site and a different time with respect to the irradiation procedure.

BIOMECHANICAL STABILITY OF THE CERVICAL SPINE AFTER UNCINATE PROCESS RESECTION: A FINITE ELEMENT ANALYSIS

2015 ◽  
Vol 15 (06) ◽  
pp. 1540049 ◽  
Author(s):  
XUEFENG BO ◽  
XI MEI ◽  
HUI WANG ◽  
WEIDA WANG ◽  
ZAN CHEN ◽  
...  
Keyword(s):  
Finite Element ◽  
Cervical Spine ◽  
Equivalent Stress ◽  
Three Dimensional ◽  
Element Model ◽  
Uncinate Process ◽  
Total Deformation ◽  
Maximum Equivalent Stress ◽  
Left And Right ◽  
The Stability

When performing anterolateral foraminotomy for the treatment of cervical spondylotic radiculopathy, the extent of uncinate process resection affects the stability of the cervical spine. The aim of this study was to determine the stability of the cervical spine after resection of various amounts of the uncinate process. Based on computed tomography (CT) scans of an adult male volunteer, a three-dimensional geometric model of the cervical spine (C4-C6) was established using Mimics 13.1, SolidWorks 2012, and ANSYS 15.0 software packages. Next, the mechanical parameters of the tissues were assigned according to their different material characteristics. Using the tetrahedral mesh method, a three-dimensional finite element model of the cervical spine was then established. In modeling uncinated process resection, two excision protocols were compared. The first excision protocol, protocol A, mimicked the extent of resection used in current clinical surgical practice. The second excision protocol, protocol B, employed an optimal resection extent as predicted by the finite element model. Protocols A and B were then used to resect the left uncinate process of the C5 vertebra to either 50% or 60% of the total height of the uncinate process. The stability of the cervical spine was assessed by evaluating values of deformation and maximum equivalent stress during extension, flexion, lateral bending, and rotation. After protocol A resection, the total deformation was increased as was the maximum equivalent stress during left and right rotation. After protocol B resection, the total deformation was little changed and the maximum equivalent stress was visibly decreased during left and right rotation. As evidenced by these results, protocol B resection had relatively little effect on the stability of the cervical spine, suggesting that resection utilizing the limits proposed in protocol B appears to better maintain the stability of the cervical spine when compared with current clinical surgical practice as replicated in protocol A.

Experimental investigation and modeling study of the fiber orientation behavior

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maoyuan Li ◽  
Yun Zhang ◽  
Shi Zhang ◽  
Binkui Hou ◽  
Huamin Zhou
Keyword(s):  
Fiber Orientation ◽  
Integral Transformation ◽  
Three Dimensional ◽  
Numerical Algorithms ◽  
Tensile Specimen ◽  
Transformation Method ◽  
Orientation Behavior ◽  
Stable Algorithm ◽  
Content Type ◽  
The Stability

Purpose The orientation behavior of fiber is of great significance in improving the performance of fiber-reinforced polymer products. Generally, the Folgar–Tucker equation can accurately describe the variation of orientation vector of fiber, whereas the stability of numerical algorithms was the major challenge. This paper aims to propose an accurate, stable algorithm to solve the Folgar–Tucker equation for the fiber orientation behavior. Design/methodology/approach First, the mismatch problem between the strain rate and the pressure field was solved by using the integral transformation method. Then, an accurate, stable algorithm to solve the Folgar–Tucker equation based on the invariant-based optimal fitting method was proposed. The equation was discretized by finite element/finite difference method, and the Lagrange multiplier method was applied to ensure stability. Findings The proposed algorithm is proven to accurately and steadily coincide with the experimental results for different cases, including the fiber orientation behaviors under combined flow field, rectangular sheet, three-dimensional computed tomography imaging of tensile specimen and box cases. Originality/value The fiber orientation behavior during the injection molding can be accurately predicted, which plays a significant role in determining the mechanical properties of products.

Subluxation of a lumbar vertebra in a patient with Marfan syndrome

2001 ◽  
Vol 94 (1) ◽  
pp. 154-157
Author(s):  
István Domán ◽  
Ferenc Kövér ◽  
Tamás Illés ◽  
Tamás Dóczi
Keyword(s):  
Marfan Syndrome ◽  
Three Dimensional ◽  
Morphological Characteristics ◽  
Lumbar Vertebra ◽  
Spinal Deformities ◽  
Content Type ◽  
Vascular Abnormalities ◽  
Skeletal Manifestation ◽  
Classic Form ◽  
Tomography Scanning

✓ Marfan syndrome is a hereditary disorder of the connective tissue that, in its most classic form, includes cardiovascular, ocular, and skeletal features. The neurological problems associated with the disease are mainly caused by intracranial vascular abnormalities and spinal meningeal defects, but other neurological manifestations are rarely present. Scoliosis, a skeletal manifestation of the syndrome, occurs frequently, but its onset, natural history, and radiological characteristics differ from those of the idiopathic form. Scoliosis in a patient with Marfan syndrome seldom accompanies other spinal deformities. In this article the authors describe the case of a patient with Marfan syndrome and scoliosis in whom lumbar subluxation occurred. This rare deformity, diagnosed on three-dimensional computerized tomography scanning, has not been reported previously in association with Marfan syndrome. Its development can be explained in terms of the theory of progressive rotatory dislocation. The morphological characteristics, clinical features, and surgical treatment of the deformity are presented.

Delayed glossopharyngeal and vagus nerve paralysis following occipital condyle fracture

1996 ◽  
Vol 84 (3) ◽  
pp. 522-525 ◽  
Author(s):  
Enrique Urculo ◽  
Mariano Arrazola ◽  
Mariano Arrazola ◽  
Ignacio Riu ◽  
Arantxa Moyua
Keyword(s):  
Vagus Nerve ◽  
Closed Head Injury ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Occipital Condyle ◽  
Nerve Paralysis ◽  
Content Type ◽  
Depressed Fracture ◽  
Unusual Lesion ◽  
Condyle Fracture

✓ This report describes a case of delayed glossopharyngeal and vagus nerve paralysis following a closed head injury. A depressed fracture of the occipital condyle was diagnosed using high-resolution computerized tomography (CT) scanning and three-dimensional CT images. Magnetic resonance imaging complemented the study. The anatomical features, mechanisms, diagnosis, and treatment of this unusual lesion are discussed.

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