scholarly journals Traumatic Atlantoaxial Dislocation with Type II Odontoid Fractures: A Case Report

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Aldhi Tri Budhi ◽  
Nasrullah ◽  
Andi Asadul Islam ◽  
Djoko Widodo ◽  
Willy Adhimarta ◽  
...  

BACKGROUND፡ Odontoid fracture frequently ensues after a cervical trauma, and most commonly at the junction between the dens and the body (type II odontoid fracture).CASE PRESENTATION: This report is focused on a 24-years-old male patient with right-sided hemiparesis, resulting from traumatic atlantoaxial dislocation with type II odontoid fracture. Cervical CT-scanning showed a spondylolisthesis of the C1-C2 complex with type II odontoid fracture, and the injury was treated using posterior reduction and internal stabilization. Therefore, hemiparesis was reduced, and during the follow-up period, our patients were disease-free.CONCLUSION: Early diagnosis and the appropriate management of atlantoaxial trauma is a possible approach towards preventing severe neurological deficits.

2021 ◽  
Vol 14 (9) ◽  
pp. e241005
Author(s):  
Akiyo Matsumoto ◽  
Takahiko Akao ◽  
Hiroshi Matsumoto ◽  
Naoki Kobayashi ◽  
Makoto Kamiya

A 67-year-old man who had been pinned between a basket crane and a tree complained of severe pain in his lower back and a decreased appetite. Laparotomy after decompressing the gastrointestinal tract revealed incarceration of an ileal loop within a fractured third lumbar vertebra. The damaged bowel was resected, and an end-to-end anastomosis was performed. Once the patient’s condition had stabilised, posterior lumbar fixation was performed. There were no abdominal complications or lower limb neurological deficits during the follow-up period. Enhanced CT and MRI had been helpful in making the diagnoses. Histopathological examination revealed the aetiology of the traumatic incarceration: the intestine had been pinched as the disc space closed, and the body attempted to return to its original state by exerting countertraction.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Christopher Ferari ◽  
Chad Crigger ◽  
Chad Morley ◽  
David Duchene

Background. Fungemia due to obstructive urinary tract fungal ball is exceedingly rare. These patients often have multiple predisposing conditions, including diabetes or antimicrobial exposure. While candiduria can be relatively common in this population, urinary tract fungal balls are a rare entity. Hospitalists should be aware of this rare complication in patients presenting with funguria. Case Presentation. We present a case of a 44-year-old male with type II diabetes, chronic hepatitis C secondary to injection drug use, and chronic kidney disease who developed a urinary tract fungal ball leading to fungemia and subsequent bilateral chorioretinitis, additionally complicated by emphysematous cystitis and pyelonephritis. Additional invasive treatment options beyond typical antifungals are often required in the case of urinary tract fungal ball, and in this case, bilateral nephrostomy tubes and micafungin were employed. Hospital course was complicated by C. tropicalis fungemia with subsequent bilateral fungal chorioretinitis on dilated fundus exam. This was effectively treated with cyclogyl and prednisolone drops along with bilateral voriconazole injections. Follow-up imaging and cultures showed resolution of fungemia, urinary tract masses, and chorioretinal infiltrates; however, recurrent polymicrobial UTIs continue to be an issue for this patient. Conclusions. Special multidisciplinary management is required in the treatment of urinary tract fungal balls with subsequent fungemia, including nephrostomy tubes, antifungal irrigation, ureterorenoscopy, and more powerful antifungals such as amphotericin B and 5-flucytosine. This management draws from a myriad of specialties, including urology, infectious disease, and interventional radiology. Additionally, the literature has demonstrated that only approximately half of patients with fungemia receive an ophthalmologic evaluation. Ophthalmologic and urologic cooperation is essential in the case of obstructive uropathy leading to fungemia as the obstructive uropathy must be relieved and these patients should receive a dilated fundus exam.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chenglong Wang ◽  
Yijia Cao ◽  
Min Zeng ◽  
Lijuan Wang ◽  
Xiaojing Cao ◽  
...  

Abstract Background Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma. Case presentation A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication. Conclusions It is very important to correctly diagnose a lymph node inclusion for proper clinical management.


2020 ◽  
Vol 6 (1) ◽  
pp. 35-40
Author(s):  
Majid Reza Farrokhi ◽  
◽  
Amir Tarokh ◽  
Javad Safaei ◽  
◽  
...  

Background and Importance: Plasmacytoma is more likely to involve the spine with up to 50%, most commonly in the thoracic spine. Case Presentation: This study examined a patient with solitary plasmacytoma with neck pain and abnormal C1-C2 range of motion, which happened to have an osteolytic C2 lesion on CT scanning. The patient underwent a fluoroscopically guided anterior percutaneous C2 vertebroplasty without posterior fusion, leading to management of pain, maintenance of normal motions, and restoration of cervical alignment. Conclusion: This case represents fluoroscopically guided anterior percutaneous C2 vertebroplasty as an effective treatment for C2 osteolytic lesions with an abnormal range of motion, which can be considered in selected cases as an alternative approach for demanding open surgical approaches to this challenging region.


1999 ◽  
Author(s):  
Christian M. Puttlitz ◽  
Vijay K. Goel ◽  
Charles R. Clark

Abstract Fractures of the odontoid process of the second cervical vertebra comprise 7–13% of all cervical spine fractures. Anderson and D’Alzono [1974] have classified these fractures into three categories: Type I, Type II, and Type III. Type I fractures are oblique, usually avulsion, fractures of the superior-most aspect of the odontoid. Type II fractures, the most commonly-occurring, are produced at the juxtaposition of the process and the C2 body. Type III fractures involve propagation of the fracture through the C2 body.


2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Yesaya Yunus ◽  
Julius July ◽  
Lutfi Hendriansyah

Fractures of the odontoid process can lead to gross instability of the atlantoaxial complex and present a significant risk for a potentially catastrophic spinal cord injury. Type II odontoid fractures are the most common odontoid fractures and are unstable that may displace anteriorly or posteriorly.  If left untreated, the patient may develop atlantoaxial dislocation that causes neurological deficit also progressive myelopathy.We described the surgical management of four patients with a delayed neurological deficit after odontoid fracture with a history of trauma and after triggered by traditional massage. Traction several days before operation applied to achieve reduction of atlantoaxial dislocation.Posterior instrumentation and correction of atlantoaxial dislocation were performed with interarticular screw fixation (Harm technique) in all of the patients.All of the four patients showed a reduction of the atlantoaxial dislocation and also a neurological improvement. Cervical traction followed by posterior instrumented correction may be an effective alternative to treating delayed neurological deficits after traumatic odontoid fracture.


2018 ◽  
Vol 1 (2) ◽  
pp. 22
Author(s):  
Yesaya Yunus ◽  
Julius July

Fractures of the odontoid process can lead to gross instability of the atlantoaxial complex and present a significant risk for a potentially catastrophic spinal cord injury. Type II odontoid fractures are the most common odontoid fractures and are unstable that may displace anteriorly or posteriorly.  If left untreated, the patient may develop atlantoaxial dislocation that causes neurological deficit also progressive myelopathy.We described the surgical management of four patients with a delayed neurological deficit after odontoid fracture with a history of trauma and after triggered by traditional massage. Traction several days before operation applied to achieve reduction of atlantoaxial dislocation.Posterior instrumentation and correction of atlantoaxial dislocation were performed with interarticular screw fixation (Harm technique) in all of the patients.All of the four patients showed a reduction of the atlantoaxial dislocation and also a neurological improvement. Cervical traction followed by posterior instrumented correction may be an effective alternative to treating delayed neurological deficits after traumatic odontoid fracture. 


2003 ◽  
Vol 15 (5) ◽  
pp. 1-7 ◽  
Author(s):  
Mehmet Zileli ◽  
Sedat Çagli ◽  
Gülçin Basdemir ◽  
Yusuf Ersahin

Object Osteoid osteomas and osteoblastomas are rare primary bone tumors that usually do not arise in the spine. In this report the authors analyze 16 cases of osteoid osteoma or osteoblastoma of the spine that were surgically treated over a 27-year period. Methods A retrospective study was conducted in which the following data were found: five patients had osteoid osteomas (two male and three female patients) and 11 had osteoblastomas (seven male and four female patients). The site of the tumor was the cervical spine in four, thoracic in six, and lumbar spine in six. In 14 patients, the tumor involved the posterior vertebral elements, with lumbar and thoracic levels being the most common. Only two patients had tumors in the body of a cervical vertebra. The mean age of the patients was 20 years for osteoid osteoma and 19 years for osteoblastoma. The most common symptom was local pain in the area of the tumor. Among 11 patients with osteoblastoma, six (two with paraparesis, four with monoparesis) had neurological deficits caused by extradural compression. None of the patients with osteoid osteoma had neurological deficits. The diameters of osteoblastomas were 3 to 8 cm (mean 4 cm), and those of osteoid osteomas were 1.5 to 2 cm (mean 1.7 cm). Although the peritumoral bone was normal in patients with osteoblastoma, a sclerotic rim was observed in all patients with osteoid osteoma. All patients were treated with resection; tumor excision was complete in 15 cases. Follow-up periods ranged from 2 months to 13 years (mean 36 months). Complete pain relief was achieved in 15 patients; the other patient described mild pain with activity. There was no tumor recurrence except one regrowth in a patient with osteoblastoma who then received radiation therapy. There were two complications: one surgery was performed at the wrong level, and there was one instrument failure that required revision. Conclusions With the help of modern imaging modalities that aid in diagnosis and surgical planning, a complete removal and cure may be achieved for most of these rare tumors.


2018 ◽  
Vol 114 ◽  
pp. 330-334 ◽  
Author(s):  
Zhu Minyu ◽  
Wu Shiyang ◽  
Chandoo Suraj ◽  
Huang Kelun ◽  
Lin Chaowei ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document