posterior arch
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2022 ◽  
Vol 9 (1) ◽  
pp. 31
Author(s):  
Graziano Montaruli ◽  
Simona Virgilio ◽  
Michele Laurenziello ◽  
Michele Tepedino ◽  
Domenico Ciavarella

The aim of this retrospective study was to compare the efficiency of two biologically oriented devices in achieving maxillary expansion: Rapid Palatal Expander (RPE) and Nitanium Palatal Expander-2 (NPE-2). Thirty-six subjects, divided in two equal groups, were included in this study. Maxillary dental arches were scanned using Trios 3 shape®, in order to perform a digital analysis of 3D models. The models were analyzed using Autodesk Fusion 360® and Meshmixer®. All data obtained from analysis of pre-treatment and post-treatment models were processed using Prism® software. The anterior arch width, the posterior arch width, the palate height, and palatal surface were measured to evaluate differences between the devices. A D’Agostino–Pearson normality test was done to check the data. A non-parametric t-test was used to compare the anterior and posterior arch width between the two groups, while a parametric t-test was used to compare the palatal height measurements between the two groups. The p-value was calculated. The limit value fixed was 0.05. Palatal width and surface showed a significant increase in both groups, but no significant changes in palatal height were found. The data processed showed that there were no significant differences between the devices (ΔREP−ΔNPE) in variation of anterior arch width, there were no significant differences in variation of posterior arch width and there were no significant differences in variation of palatal height. The comparison between the two groups showed that both methods were equally effective in correcting transverse defect.


2022 ◽  
Author(s):  
Stefanie WY Yip ◽  
James F Griffith ◽  
Ryan KL Lee ◽  
King Lok Liu

Four-dimensional (4D) CT uniquely allows cinematic visualization of the entirety of joint motion throughout dynamic movement, which can reveal subtle or transient internal joint derangements not evident on static images. As developmental anomalies of the posterior arch can predispose to cervical spinal instability and neurological morbidity, precise assessment of spinal movement during motion is of clinical relevance. We describe the use of 4D-CT in a subject with partial absence of posterior C1 arch. This, to our knowledge, is the first such report. In at-risk individuals, 4D-CT has the potential to enable an assessment of spinal instability with a higher level of clarity and, in this sense, its more routine implementation may be a future direction.


2021 ◽  
Vol 12 ◽  
pp. 623
Author(s):  
Messias Gonçalves Pacheco Junior ◽  
Nicoly Augusta da Silva Quezada dos Santos ◽  
Raphael Tavares Ribeiro ◽  
Jose Alberto Landeiro ◽  
Bruno Lima Pessoa

Background: Congenital anomalies of the atlas are rare and usually occur in conjunction with other congenital variants. They include a wide spectrum of anomalies ranging from clefts to hypoplasia or aplasia of its arches that may contribute to spinal cord compressive syndrome. Case Description: A 54-year-old male presented with the sudden onset of a severe quadriparesis and loss of proprioception after a minor fall. The magnetic resonance (MR) scan showed cord compression at the C1 level attributed to C1 arch hypoplasia. Two months following a decompressive C1 laminectomy without fusion, and the patient was symptom free. Conclusion: Posterior C1 arch hypoplasia is a rare anomaly that can contribute to cervical cord compression and myelopathy. The optimal surgical management may include, as in this case, a posterior decompression without fusion.


Author(s):  
Selda Aksoy ◽  
Bulent Yalcin

Abstract Background Atlantoaxial instability is an important disorder that causes serious symptoms such as difficulties in walking, limited neck mobility, sensory deficits, etc. Atlantal lateral mass screw fixation is a surgical technique that has gained important recognition and popularity. Because accurate drilling area for screw placement is of utmost importance for a successful surgery, we aimed to investigate morphometry of especially the posterior part of C1. Methods One hundred and fifty-eight human adult C1 dried vertebrae were obtained. Measurements were performed directly on dry atlas vertebrae, and all parameters were measured by using a digital caliper accurate to 0.01 mm for linear measurements. Results The mean distance between the tip of the posterior arch and the medial inner edge of the groove was found to be 10.59 ± 2.26 and 10.49 ± 2.20 mm on the right and left, respectively. The mean distance between the tip of the posterior arch and the anterolateral outer edge of the groove was 21.27 ± 2.28 mm (right: 20.96 ± 2.22 mm; left: 21.32 ± 2.27 mm). The mean height of the screw entry zone on the right and left sides, respectively, were 3.86 ± 0.81 and 3.84 ± 0.77 mm. The mean width of the screw entry zone on both sides was 13.15 ± 1.17 and 13.25 ± 1.3 mm. Conclusion Our result provided the literature with a detailed database for the morphometry of C1, especially in relation to the vertebral artery groove. We believe that the data in the present study can help surgeons to adopt a more accurate approach in terms of accurate lateral mass screw placement in atlantoaxial instability.


2021 ◽  
Vol 2 ◽  
Author(s):  
Monica Macrì ◽  
Giada Perrella ◽  
Giuseppe Varvara ◽  
Giovanna Murmura ◽  
Tonino Traini ◽  
...  

Background: The ponticulus posticus (PP) is an important anomaly of the atlas (C1 vertebra) with a complete or partial bone bridge that transforms the groove of the vertebral artery (VA) into a canal (arcuate foramen). The aim was to retrospectively determine prevalence of PP evaluating morphological features and the possible association with other dentoskeletal anomalies in the midface and neck area such as maxillary canine impaction (MCI), atlas posterior arch deficiency (APAD), and sella turcica bridging (SB).Methods: This study was conducted in the Department of Medical, Oral and Biotechnological Sciences of the University “G. D'Annunzio” in Chieti. The detection of PP was performed on 500 patients with cone beam CT (CBCT) images (6 to 87 years).Results: Analysis revealed the presence of uni- and bi-lateral PP in 110 patients (22%): 24 (4.8%) patients with bilateral complete PP, 12 (2.4%) patients with complete PP on the left, 6 (1.2%) patients with complete PP on the right, 8 (1.6%) patients with complete PP on the right and partial PP on the left, 6 (1.2%) patients with complete PP on the left and partial PP on the right, 26 (5.2%) patients with partial bilateral PP, 18 (3.6%) patients with partial left PP, and 10 (2%) patients with partial PP on the right. The Chi-squared statistic confirmed that there are significant associations between MCI and PP (p = 0.020) and between SB and MCI (p <0.00001). No correlation between chronological age and presence of the PP (p = 0.982), between chronological age and morphotypes of the PP (p = 0.779), between APAD and the PP (p = 0.0757), between SB and the PP (p = 0.111), and between APAD and MCI (p = 0.222) were found.Conclusion: This observational study showed how bilateral partial variant and bilateral complete variant are the most represented morphotypes in all the age groups. The prevalence of MCI is positively associated with PP and with SB.


Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S147-S147
Author(s):  
Byung-Jou Lee ◽  
Myeongjong Kim ◽  
Seong Kyun Jeong ◽  
Subum Lee ◽  
Sang-Ryong Jeon ◽  
...  

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
N Khernane ◽  
S Fortas ◽  
M M Makhloufi ◽  
T Boussaha

Abstract Background Osteoid osteoma (OO)also called osteoblastoma, if the localization is in the spine, is a benign osteoblastic tumor of variable clinical expression, depending on the location of the lesion. It represents 2% to 3% of bone tumours and 15% of benign bone tumours in children. It affects mainly older children and adolescents and most often occurs in the lower limb, especially the femur. The diagnosis is radio-clinical. The aim of this study is to demonstrate the effectiveness of surgical removal of the tumor, the therapeutic difficulty in certain osteoarticular localizations and finally the radio-clinical evolution after surgery. Material & methods We report the radio-clinical outcomes of a series of 15 children (4 girls/11 boys; aged of 03–14 years) with OO operated in our department, over a period of 08 years (2011–2019). Results The OO is located in most of cases of the lower limbs: acetabulum (1 case); femoral neck (3 cases); femoral diaphysis (2 cases); tibial diaphysis (4 cases); distal metaphysis of the tibia (1 case); talus (1 case) and in the spine (3 cases: vertebral body of T3, the posterior arch of T12 and the sacrum S3). Nocturnal pain yielding to aspirin, was the main symptom. It was associated with lameness when walking in patients with location of OO in the lower limbs. Diagnosis was delayed in patients with localization of OO in the spine (after 3 years) and in the talus (after 2 years). Imaging (standard Rx, CT scan and MRI) allowed the diagnosis of OO in all cases (nidus and cocarde image) and assessed the loco-regional impact (compression of the spinal canal in the sacral location; eccentricity of the femoral epiphysis, in the acetabular location, scoliosis in the spinal location). Thirteen children received surgical treatment under fluoroscopic guidance, which consisted of: A surgical abstention was decided in 2 cases: an inaccessible location at the bottom of the acetabulum and the T3 thoracic vertebral body localization in a 6-year-old girl. 12 operated children have good outcomes. However, 03 children experienced post-therapy problems: lumbar pain radiating towards the left thigh in the girl with sacral location (S3) despite the large laminectomy; a relapse 7 months later in the child with the femoral neck localization; A valgus misalignment of the right knee after removal of the OO of the proximal metaphysis of the tibia with a relapse 3 months later. Conclusion OO is a rare, benign tumor. However, certain locations can lead to diagnostic difficulties, loco-regional, organic and functional repercussions and certain constraints on their therapeutic management. Modern imaging helps to improve the care of these patients, both in terms of early diagnosis (scintigraphy, CT scan and MRI) and therapeutic precision (photo-coagulation, radiofrequency ablation).


2021 ◽  
pp. 1-8
Author(s):  
Hyung Rae Lee ◽  
Dong-Ho Lee ◽  
Jae Hwan Cho ◽  
Eui Seung Hwang ◽  
Sang Yun Seok ◽  
...  

OBJECTIVE The objective of this study was to evaluate the feasibility and complications of the over-the-arch (OTA) technique for screw insertion into the C1 lateral mass in patients in whom conventional techniques (i.e., posterior arch [PA] and inferior lateral mass [ILM]) are not feasible due to 1) PA with a very small height (< 3.5 mm), 2) a caudally tilted PA blocking the inferior part of the C1 lateral mass, or 3) loss of height at the ILM (< 3.5 mm). METHODS The authors reviewed the medical records of 60 patients who underwent C1 screw fixation with the OTA technique (13 screws) and the PA/ILM technique (107 screws) between 2011 and 2019. Vertebral artery (VA) injuries, screw malposition, and bony union were radiologically assessed. Clinical outcome measures, including Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) scale score, and occipital neuralgia, were recorded. RESULTS Thirteen OTA screws were successfully inserted without any major complications. NDI and JOA scale scores did not show significant differences between the two groups at final follow-up. No VA injuries were recognized during screw insertion. There was no evidence of ischemic damage to the VA or bony erosion in the occiput or atlas. Medial wall violation was observed in 1 screw (7.7%); however, no C0–1, C1–2, or lateral wall violations were observed. No patients developed new-onset neuralgia postoperatively after C1 fixation with the OTA technique. CONCLUSIONS The OTA technique was safe and useful for C1 screw fixation in patients in whom conventional techniques could not be employed.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Amina Chentouf ◽  
Souad Daoud

Abstract Background Munchmeyer's disease (MM) or Fibrodysplasia ossificans progressivais an extremely rare genetic disorder characterized by heterotopic ossification of muscle and connective tissue during flare-ups, which can lead to the creation of a true second skeleton. we report an original observation with diagnostic difficulty. Observation We report the case of 37-year-old women who consulted for cervical stiffness with painful hypertrophy of the left sternocleidomastoid muscle, dorsal scoliosis, tendon retractions in limbs with a semi-flexion attitude. In addition, she presented a deformity of the forefoot with hallux valgus and a triangular shape. X-ray of the right arm showed ossification of the biceps brachii and that of the foot showed interphalangeal ankyloses with agenesis of a phalanx of the big toe. X-rays of the cervical spine revealed posterior arch ankyloses with fusion of some vertebrae. Despite the late onset of symptoms, the diagnosis of MM was suggested and confirmed by a genetic study which revealed a heterozygous c.617G&gt; A [p. Arg206His] mutation, located in exon 6 of the gene. Conclusion MM is an extremely rare but disabling condition. It should be considered in unexplained muscle enlargement occurring at any age particularly if associated with congenital malformations of the Hallux. The discovery of the ACVR1 gene mutation offers hope for the development of therapies for this hitherto incurable disease.


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