scholarly journals Fusion of C2 and C3: embryological and clinical perspective

2018 ◽  
Vol 7 (2) ◽  
pp. 1281-1283
Author(s):  
Parul Kaushal ◽  
Subhash Bhukya
Keyword(s):  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Vital Role ◽  
Cervical Region ◽  
Complete Fusion ◽  
Articular Facet ◽  
Upper Cervical ◽  
The Right ◽  
Vertebral Arch

Skeletal abnormalities in the upper cervical region may result in severe neck ache, altered mobility, muscular weakness and sensory deficits. Fused cervical vertebrae (FCV) have been reported in literature, however cases with fused articular facets have scarcely been documented. During routine osteology demonstration, we came across fused axis and the 3rd cervical vertebra. There was complete fusion of the vertebral arch on the left side along with complete fusion between the inferior articular facet of C2 and superior articular facet of C3. There was partial fusion between the bodies of the vertebrae and the right half of the vertebral arch. Owing to the vital role of this region in various neck movements and spinal alignment, knowledge of such asymmetric variations in the upper cervical region, is of immense importance to orthopedicians, radiologists, neurosurgeons, anaesthetists, physiotherapists.Keywords: intubation, synostosis, axis, block vertebrae

scholarly journals The role of B-mode ultrasonography in the musculoskeletal anatomical evaluation of the cervical region of the dog spine

2014 ◽  
Vol 34 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Cibely G. Sarto ◽  
Maria Cristina F. N. S. Hage ◽  
Luciana D. Guimarães ◽  
Robson F. Giglio ◽  
Andréa P. B. Borges ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ultrasound Examination ◽  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Cervical Region ◽  
Resonance Imaging ◽  
Musculoskeletal Anatomy

This study characterized the normal musculoskeletal anatomy of the cervical segment of the spine of dogs by means of B-mode ultrasonography. The objective was to establish the role of B-mode ultrasonography for the anatomical evaluation of the cervical spine segment in dogs, by comparing the ultrasonographic findings with images by computed tomography and magnetic resonance imaging. The ultrasound examination, in transverse and median sagittal sections, allowed to identify a part of the epaxial cervical musculature, the bone surface of the cervical vertebrae and parts of the spinal cord through restricted areas with natural acoustic windows, such as between the atlanto-occipital joint, axis and atlas, and axis and the third cervical vertebra. The images, on transverse and sagittal planes, by low-field magnetic resonance imaging, were superior for the anatomical identification of the structures, due to higher contrast between the different tissues in this modality. Computed tomography showed superiority for bone detailing when compared with ultrasonography. As for magnetic resonance imaging, in addition to the muscles and cervical vertebrae, it is possible to identify the cerebrospinal fluid and differentiate between the nucleus pulposus and annulus fibrosus of the intervertebral discs. Although not the scope of this study, with knowledge of the ultrasonographic anatomy of this region, it is believed that some lesions can be identified, yet in a limited manner, when compared with the information obtained mainly with magnetic resonance imaging. The ultrasound examination presented lower morphology diagnostic value compared with the other modalities.

scholarly journals ROLE OF A PEDODONTIST IN CLEFT LIP AND CLEFT PALATE REHABILITATION - AN OVERVIEW

2021 ◽  
Vol 9 (07) ◽  
pp. 882-906
Author(s):  
Payel Basu ◽  
◽  
Rani Somani ◽  
Deepti Jawa ◽  
Shipra Jaidka ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Care ◽  
Vital Role ◽  
Pediatric Dentist ◽  
Orofacial Region ◽  
The Right ◽  
Potential Area

Cleft lip and palate is one of the most common congenital anomalies requiring multidisciplinary care. Such anomaly is associated with many problems such as impaired feeding, defective speech, hearing difficulties, malocclusion, dental abnormalities, gross facial deformity as well severe psychological problems. Cleft of the lip and palate is one of the complex conditions that occur at a functionally potential area in the orofacial region and also at such a crucial time that strategic interventions at the right age by the concerned specialists becomes the need of the hour. Pediatric dentist is an integral part of the cleft rehabilitative process right from the neonatal period upto the phase of permanent dentition. Being well versed with a childs growth and development, both physical and mental, a Pedodontist helps in restoring function and esthetics in a cleft child, in a most empathetic way. This article describes the enormous challenges faced by these innocent souls and the vital role played by a Pedodontist, to provide comprehensive cleft care, be it preventive, restorative, or interventional care, in order to achieve the best possible outcome and meaningfully improve their quality of life.

Mice homozygous for a targeted disruption of Hoxd-3 (Hox-4.1) exhibit anterior transformations of the first and second cervical vertebrae, the atlas and the axis

Development ◽  
1993 ◽  
Vol 119 (3) ◽  
pp. 579-595 ◽  
Author(s):  
B.G. Condie ◽  
M.R. Capecchi
Keyword(s):  
Hox Genes ◽  
Es Cells ◽  
Cervical Vertebrae ◽  
Expression Patterns ◽  
Cervical Vertebra ◽  
Targeted Disruption ◽  
Paralogous Genes ◽  
Variable Extent ◽  
Basioccipital Bone

Gene targeting in embryo-derived stem (ES) cells was used to generate mice with a disruption in the homeobox-containing gene Hoxd-3 (Hox-4.1). Mice homozygous for this mutation show a radically remodeled craniocervical joint. The anterior arch of the atlas is transformed to an extension of the basioccipital bone of the skull. The lateral masses of the atlas also assume a morphology more closely resembling the exoccipitals and, to a variable extent, fuse with the exoccipitals. Formation of the second cervical vertebra, the axis, is also affected. The dens and the superior facets are deleted, and the axis shows ‘atlas-like’ characteristics. An unexpected observation is that different parts of the same vertebra are differentially affected by the loss of Hoxd-3 function. Some parts are deleted, others are homeotically transformed to more anterior structures. These observations suggest that one role of Hox genes may be to differentially control the proliferation rates of the mesenchymal condensations that give rise to the vertebral cartilages. Within the mouse Hox complex, paralogous genes not only encode very similar proteins but also often exhibit very similar expression patterns. Therefore, it has been postulated that paralogous Hox genes would perform similar roles. Surprisingly, however, no tissues or structures are affected in common by mutations in the two paralogous genes, Hoxa-3 and Hoxd-3.

scholarly journals Eustachian tube diverticulum chondroids and neck abscessation in a case of Streptococcus equi subsp. equi : clinical communication

2007 ◽  
Vol 78 (3) ◽  
Author(s):  
C. Furniss ◽  
A. Carstens ◽  
I. Cilliers
Keyword(s):  
Eustachian Tube ◽  
Spinous Process ◽  
Cervical Vertebra ◽  
Cervical Region ◽  
Carrier Status ◽  
Clinical Communication ◽  
Negative Culture ◽  
Streptococcus Equi ◽  
Scalpel Blade ◽  
The Right

A 12-year-old, grey, crossbred pony mare was presented with a swelling in the neck over the area of the 2nd cervical vertebra (C2), which was found to be painful on palpation. The neck was held stiffly. Radiography of the cervical region showed a focal area of increased radio-opacity over the dorsal, caudal and lateral aspect of the dorsal spinous process of C2. Ultrasound confirmed the presence of a hypoechoic area approximately 15 cm in diameter superimposed over the dorsal spinous process of C2. An aspirate was taken of the mass, which revealed purulent exudate confirming the diagnosis of an abscess. The abscess was lanced with a scalpel blade and samples of the purulent material revealed a pure culture of Streptococcus equi subsp. equi. The guttural pouches (Eustachian tube diverticulae (ETD)) were then evaluated endoscopically and multiple chondroids were seen filling most of the right ETD. Surgery was subsequently performed and 189 chondroids were removed via a right-sided hyovertebrotomy. The ETDs were flushed and penicillin installed into both ETDs on 3 different occasions via a catheter introduced using a fibre optic scope. This procedure was repeated until a negative culture status was achieved in order to eliminate the carrier status.

scholarly journals Incomplete ossification of the atlas in cats: seven cases detected on computed tomography

2021 ◽  
Vol 2021 (3) ◽  
pp. 25-31
Author(s):  
Evgeniy Kemel'man ◽  
Elena Kostygova ◽  
Ivan Tyurenkov ◽  
Maksim Lapshin
Keyword(s):  
Computed Tomography ◽  
Complete Fusion ◽  
Bone Fragment ◽  
Cervical Injury ◽  
Upper Cervical ◽  
Lateral Portion ◽  
Dens Fracture ◽  
The Right ◽  
Upper Cervical Injury ◽  
Exact Origin

Defects of the ventral arch of the atlas were detected on computed tomography in nine cats aged 3…12 months with signs of upper cervical injury including paina and ataxia. Seven cats have an ambulatory tetraparesis, and two cats have a nonambulatory tetraparesis. The bone defects were consistent with the normal location of the ventral arch growth areas of the atlas. In all observed cats, the pattern of ossification abnormalities was similar — the lateral portion of the arch was completely absent in seven cats on the left and in two cats on the right. The structure of the ventral tubercle was traceable in 8 of 9 cats. Also, in 8 of 9 cases an isolated bone fragment was observed lateral to the dens of the axis, the exact origin of which was not determined. This fragment was observed in 6 cases on the right, in two cases on the left, and only in two cases it corresponded to the side of the undeveloped arch. In 7 out of 9 cats, the dorsal arch was not fused; in 2 cats with complete fusion, the dorsal arch was deformed. An dens fracture was visualized in 3 cases, no hypoplasia of the dens was visualized, and one cat have atlantoaxial subluxation. Seven cats received conservative treatment and 2 cats received surgical treatment. Clinical improvement was observed in all cats. Disorder the ossification of the ventral arch of the atlas should be considered as the differential diagnosis in young cats with suspected atlanto-axial instability and trauma of the cervical spine. The authors were unable to find publications describing this atlas developmental abnormality in cats, so the authors believe that this is the first mention of incomplete ossification of the atlas in cats.

scholarly journals Spontaneous retinal pigment epithelial rip

2020 ◽  
Vol 2 (4) ◽  
pp. 300-304
Author(s):  
Kosyilya Arumugam ◽  
Ayesha Mohd Zain ◽  
Mushawiahti Mustapha
Keyword(s):  
Multimodal Imaging ◽  
Retinal Pigment Epithelial ◽  
Retinal Pigment ◽  
Vital Role ◽  
Posterior Pole ◽  
Large Area ◽  
Pigment Epithelial ◽  
Rare Manifestation ◽  
The Right

This is a case report of a spontaneous retinal pigment epithelial (RPE) rip in a 64-year-old woman who presented with progressive, painless, blurring of vision in her right eye for 2 weeks. Her vision was 6/60 in the right eye and 6/6 in the left eye. On fundoscopy, there was a large depigmented area over the right posterior pole. A large area of RPE rip involving the fovea was revealed via optical coherence tomography and angiogram. Spontaneous RPE rip is a rare manifestation. However, when the fovea is involved the visual prognosis is poor. This article aims to highlight the vital role of multimodal imaging in aiding the diagnosis of RPE rips or tears.

scholarly journals Atlantoaxial Instability in Down Syndrome

PEDIATRICS ◽  
1984 ◽  
Vol 74 (1) ◽  
pp. 152-154
Author(s):  
Keyword(s):  
Down Syndrome ◽  
Head And Neck ◽  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Odontoid Process ◽  
Cervical Vertebra ◽  
Cervical Region ◽  
Atlantoaxial Instability ◽  
Atlantoaxial Joint ◽  
Special Olympics

Some issues related to participation in certain sports by persons with Down syndrome require clarification. Since 1965 there have been occasional reports about a condition described at various times as instability, subluxation, or dislocation of the articulation of the first and second cervical vertebrae (atlantoaxial joint) among persons with Down syndrome.1-15 This condition has also been found in patients with rheumatoid arthritis,16,17 abnormalities of the odontoid process of the second cervical vertebra,4,5,12,13,15 and various forms of dwarfism.18 Atlantoaxial (C-1, C-2) instability has not attracted general attention because clinical manifestations are rare and the condition is limited to a small portion of the population. The incidence of atlantoaxial instability among persons with Down syndrome has been reported by various observers to be 10% to 20%.2,9,15 When atlantoaxial instability results in subluxation or dislocation of C-1 and C-2, the spinal cord also may be injured. This is a rare but serious complication. In March 1983, the Special Olympics, Inc, sponsors of a nationwide competitive athletic program for developmentally disabled persons, without prior announcement, mandated for participants with Down syndrome special precautions to prevent serious neurologic consequences from stress on the head and neck in sports competition.19 Although thousands of persons with Down syndrome have taken part in sports events during the 15-year history of the Special Olympics without a known occurrence of neurologic complications due to participation, the new directive requires all persons with Down syndrome who wish to participate in certain sports that might involve stress on the head and neck (gymnastics, diving, pentathlon, butterfly stroke in swimming, diving start in swimming, high jump, soccer, and warm-up exercises that place undue stress on the head and neck muscles) to have a medical examination, lateral-view roentgenograms of the upper cervical region in full flexion and extension, and certification by a physician that the examination did not reveal atlantoaxial instability or neurologic disorder.

scholarly journals Inhibition of Synovial Macrophage Pyroptosis Alleviates Synovitis and Fibrosis in Knee Osteoarthritis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Li Zhang ◽  
Runlin Xing ◽  
Zhengquan Huang ◽  
Nongshan Zhang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Cell Death ◽  
Knee Osteoarthritis ◽  
Synovial Fibroblasts ◽  
Vital Role ◽  
Aseptic Inflammation ◽  
Synovial Macrophage ◽  
The Right ◽  
Related Proteins ◽  
Sirius Red

Increasing evidence has shown that macrophage pyroptosis in different tissues participates in chronic aseptic inflammation and is related to tissue fibrosis. Our last studies also revealed the vital role of synovial fibroblast pyroptosis in the onset and development of knee osteoarthritis (KOA). In this study, we aimed to investigate whether synovial macrophage pyroptosis did occur and whether this form of cell death should be related to synovitis and fibrosis of KOA. In the synovial tissue of KOA model rats, we observed a decrease of caspase1, NLRP3, ASC, and GSDMD caused by macrophage depletion in both the mRNA and protein expressions. Besides, rats treated with the specific caspase1 inhibitor Ac-YVAD-CMK showed less inflammatory reaction and fibrosis, not only in the expression of proinflammatory factors IL-1β, IL-18, and HMGB1 and fibrosis markers TGF-β, PLOD2, COL1A1, and TIMP1 but also in the observation of HE staining, Sirius Red staining, and the transverse diameters of the right knees. Subsequently, we established an LPS+ATP-induced model in macrophages mimicking the inflammatory environment of KOA and inducing macrophage pyroptosis. Macrophages transfected with caspase1 siRNA showed reduced cell death; meanwhile, the relative expression of pyroptosis-related proteins were also downregulated. In addition, the level of fibrotic markers in synovial fibroblasts were significantly decreased after coculture with siRNA GSDMD-transfected macrophages. To conclude, synovial macrophage pyroptosis may occur in the pathological processes of KOA and inhibition of synovial macrophage pyroptosis alleviates synovitis and fibrosis in KOA model rats.

scholarly journals Occipitalization of Atlas: A Case Report with its Ontogenic Basis and Review of Literature

2017 ◽  
Vol 1 (1) ◽  
pp. 34-37
Author(s):  
Sanjay Piplani ◽  
JS Kullar
Keyword(s):  
Case Report ◽  
Cervical Vertebrae ◽  
Clinical Importance ◽  
Signs And Symptoms ◽  
Craniocervical Junction ◽  
Cervical Region ◽  
Upper Cervical Spine ◽  
Review Of Literature ◽  
Flexion Extension ◽  
Upper Cervical

ABSTRACT Introduction Anatomy of the cervical vertebrae allows free flexion, extension, and rotation, which take place almost entirely in the first two cervical vertebrae. Variation in the articulation of upper cervical spine-like congenital fusion of the atlas to the base of the occiput, i.e., occipitalization of the atlas, is one of the common skeletal abnormalities. Such variations will produce irregular motion and at times a definite instability of the joint involved. Conclusion Considering the nature and functional importance of the joints in relation to these bones, the resulting disability is one of the rare occurrences and deserves special attention. Such patients exhibit neurological signs and symptoms usually no sooner than the second decade. Thus, anatomy, variations, and anomalies of the craniocervical junction are of high clinical importance to many specialties like anatomists, neurosurgeons, radiologists, and manipulative therapists, as they markedly influence mobility and stability of the cervical region. How to cite this article Lalit M, Piplani S, Mahajan A, Kullar JS. Occipitalization of Atlas: A Case Report with its Ontogenic Basis and Review of Literature. Curr Trends Diagn Treat 2017;1(1):34-37.

Optimal Fusion Configuration Following C2 Corpectomy

2009 ◽  
Author(s):  
Justin K. Scheer ◽  
John Equizabal ◽  
Jovauna M. Currey ◽  
Jenni M. Buckley ◽  
R. T. McClellan ◽  
...  
Keyword(s):  
Structural Integrity ◽  
Surgical Intervention ◽  
Cervical Vertebrae ◽  
Cervical Region ◽  
Upper Cervical Spine ◽  
Mechanical Instability ◽  
Common Location ◽  
Upper Cervical ◽  
Optimal Fusion ◽  
Base Of The Skull

The upper cervical spine is a common location for metastatic tumors, which often necessitate surgical intervention to prevent neurological compromise [1]. Removal of the tumor often requires partial or complete resection of cervical vertebrae and therefore causes substantial mechanical instability in the cervical region [2]. Structural integrity is restored by fusion of the base of the skull to C5 using various spinal hardware, including cages and posterior screw-rod constructs. Due to the proximity of the spinal cord and vertebral arteries, these procedures have high associated morbidity and mortality, and the biomechanical necessity of more risky procedures, e.g., additional cages replacing the lateral masses of C2, in order to achieve sufficient rigidity has not been evaluated. Thus, the goal of this study is to determine the optimal fusion configuration following C2 corpectomy that maximized segmental rigidity while minimizing risk to the patient.

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