2,751 results match your criteria Atlantoaxial Injury and Dysfunction


Novel unilateral C1 double screw and ipsilateral C2 pedicle screw placement combined with contralateral laminar screw-rod fixation for atlantoaxial instability.

Eur Spine J 2018 Dec 11. Epub 2018 Dec 11.

Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China.

Purpose: To investigate the anatomical and biomechanical feasibility of the unilateral C1 double screw [pedicle screw (PS) + lateral mass screw (LMS)] and ipsilateral C2 PS combined with contralateral C2 laminar screw (LS)-rod fixation for atlantoaxial instability by comparison with traditional posterior fixation methods.

Methods: Fifteen sets of complete dry bony specimens of atlas were used for morphometric analysis. The working length, width and thickness of the C1 PSs and LMSs were manually measured. Read More

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December 2018

Fatal atlantoaxial dislocation due to an odontoid synchondrosis fracture in a child with chromosome 9 abnormality: A case report.

J Forensic Leg Med 2018 Nov 29;61:92-96. Epub 2018 Nov 29.

Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba Prefecture, 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

A 5-year-old boy with a chromosome-9 abnormality and multiple external and visceral malformations was found in cardiopulmonary arrest during a regular visit to the hospital; he did not respond to cardiopulmonary resuscitation and died. An odontoid process fracture and calcification and fibrosis of the muscles around the superior cervical vertebra were observed during the autopsy. Postmortem computed tomography revealed an anterior dislocation of the atlas; odontoid synchondrosis fracture; and delayed, incomplete bony fusion of the odontoid process relative to his age. Read More

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November 2018

The Most Influential Publications in Odontoid Fracture Management.

World Neurosurg 2018 Dec 5. Epub 2018 Dec 5.

University of Miami Miller School of Medicine, Department of Neurological Surgery, 1475 NW 12th St, 1st Floor, Miami, FL 33136, USA.

Objective: Management of odontoid fractures has improved and evolved due to advancing diagnostic guidelines and understanding of long-term outcomes. The aim of this study was to quantify the most frequently cited publications pertaining to odontoid fractures and determine their validity as a tool to practice evidence-based medicine.

Methods: A Clarivate Analytics Web of Science search was used to identify all articles related to odontoid fractures. Read More

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December 2018

Computed tomographic morphometric analysis of lateral inclination C1 pedicle screw for atlantoaxial instability patients with a narrow C1 posterior arch.

Authors:
Lei Zhang Huan Wang

Kaohsiung J Med Sci 2018 Dec 19;34(12):700-704. Epub 2018 Sep 19.

Spinal Surgery Unit, Shengjing Hospital of China Medical University, Shenyang, PR China. Electronic address:

Atlanto-axial instability (AAI) is a congenital or developmental condition that leads to instability/subluxation of the atlantoaxial joint. This study is performed to determine anatomic feasibility of trajectory L and help select an optimal screw trajectory in treating patients with AAI with a narrow C1 posterior arch. Sixty patients who underwent cervical three dimensional-computed tomography (3D-CT) were chosen from the hospital's picture archiving and communication system (PACS). Read More

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December 2018

The C2 Pedicle Width, Pars Length, and Laminar Thickness in Concurrent Ipsilateral Ponticulus Posticus and High-Riding Vertebral Artery: A Radiological Computed Tomography Scan-Based Study.

Asian Spine J 2018 Dec 7. Epub 2018 Dec 7.

Department of Orthopaedics, P D Hinduja National Hospital & MRC, Mumbai, India.

Study Design: Retrospective radiological study.

Purpose: We aimed to determine the prevalence of ponticulus posticus (PP) and high-riding vertebral artery (HRVA) occurring simultaneously on the same side (PP+HRVA) and in cases of PP+HRVA, to assess C2 radio-anatomical measurements for C2 pars length, pedicle width, and laminar thickness.

Overview Of Literature: PP and HRVA predispose individuals to vertebral artery injuries during atlantoaxial fixation. Read More

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December 2018

Posterior Sublaminar Wiring and/or Transarticular Screw Fixation for Reducible Atlantoaxial Instability Secondary to Symptomatic Os Odontoideum: A Neglected Technique?

Asian Spine J 2018 Dec 7. Epub 2018 Dec 7.

Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Study Design: Retrospective case analysis.

Purpose: We retrospectively evaluated the clinical and radiological outcomes of posterior sublaminar wiring (PSLW) and/or transarticular screw fixation (TASF) for reducible atlantoaxial instability (AAI) secondary to os odontoideum.

Overview Of Literature: Limited information is available about the surgical outcomes of symptomatic os odontoideum with AAI. Read More

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December 2018
2 Reads

Atlantoaxial pseudoarticulation as a cause of neck pain: case illustration.

Authors:

J Neurosurg Spine 2018 Oct 1:1-2. Epub 2018 Oct 1.

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October 2018
1 Read

Craniovertebral Junction Anomalies in Small Breed Dogs with Atlantoaxial Instability: A Multicentre Case-Control Study.

Vet Comp Orthop Traumatol 2018 Nov 28. Epub 2018 Nov 28.

Department of Clinical Veterinary Medicine, Clinical Radiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Objective:  The main purpose of this study was to define criteria to systemically describe craniovertebral junction (CVJ) anomalies and to report the prevalence of CVJ anomalies in small breed dogs with and without atlantoaxial instability (AAI).

Methods:  Retrospective multicentre matched case-control study evaluating magnetic resonance imaging and computed tomographic images of small breed dogs with and without AAI for the presence of CVJ anomalies.

Results:  One hundred and twenty-two dogs were enrolled (61 with and 61 without AAI). Read More

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November 2018
1 Read

Differences in fixation strength among constructs of atlantoaxial fixation.

Authors:

J Neurosurg Spine 2018 Oct 1:1-8. Epub 2018 Oct 1.

OBJECTIVETo avoid jeopardizing an aberrant vertebral artery, there are three common options in placing a C2 screw, including pedicle, pars, and translaminar screws. Although biomechanical studies have demonstrated similar strength among these C2 screws in vitro, there are limited clinical data to address their differences in vivo. When different screws were placed in each side, few reports have compared the outcomes. Read More

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October 2018
1 Read

The C2-Pars Interarticularis Screw as an Alternative in Atlanto-Axial Stabilization. A Biomechanical Comparison of Established Techniques.

Turk Neurosurg 2018 ;28(6):995-1004

Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, DE-60389 Frankfurt, Germany.

Aim: To compare four different atlantoaxial stabilization techniques.

Material And Methods: Eight human cervical spines (segments C0-C3) were tested in flexion/extension, lateral bending and axial rotation. Range of Motion (ROM) at a 1. Read More

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January 2018
1 Read

Splitting of the semispinalis capitis muscle as a less invasive approach for atlantoaxial fusion - A technical note.

J Clin Neurosci 2018 Nov 21. Epub 2018 Nov 21.

Department of Anatomy, Histology and Embryology, Medical University of Innsbruck, Innsbruck, Austria.

Purpose: Atlantoxial fusion with screw rod constructs traditionally requires subperiostal dissection of the C1/C2 muscle attachments, which may lead to postoperative axial neck pain and intraoperative blood loss. We evaluate a potentially less invasive, muscle splitting approach for atlantoaxial fusion in a cadaver model.

Methods: A technical feasibility study was performed in a human cadaveric specimen with standard surgical instruments and an operating microscope. Read More

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November 2018
2 Reads

Clinical outcomes of atlantoaxial dislocation combined with high-riding vertebral artery using C-2 translaminar screws.

World Neurosurg 2018 Nov 20. Epub 2018 Nov 20.

Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.

Objective: Atlantoaxial stabilization procedure in high riding of vertebral artery (HRVA) cases is challenging. C-2 translaminar screws (TLS) are reportedly rigid and pose no risk to the VA. We would like to present the clinical outcomes of atlantoaxial dislocation(AAD) combined with HRVA using C-2 TLS. Read More

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November 2018
2 Reads

Dysphagia following C1 laminectomy and posterior atlantoaxial fixation for retro-odontoid pseudotumor: a case report.

Br J Neurosurg 2018 Nov 19:1-4. Epub 2018 Nov 19.

b Department of Neurosurgery , Mie University Graduate School of Medicine , Tsu , Mie , Japan.

Purpose: Although dysphagia is known potential complication of cervical spine surgery, it rarely occurs after a posterior approach. We describe an unusual case of a retro-odontoid pseudotumor that suffered dysphagia following a C1 laminectomy and posterior atlantoaxial fixation.

Materials And Methods: A 79-year-old man presented with progressive tetraparesis and bladder and bowel dysfunction due to severe compression to cervical cord at C1 from a retro-odontoid pseudotumor. Read More

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November 2018
6 Reads

Posterior atlantoaxial dislocation without fracture or neurological symptoms treated by transoral-posterior approach surgery: a case report and literature review.

Eur Spine J 2018 Nov 17. Epub 2018 Nov 17.

Department of Orthopedic Surgery, Orthopedic Hospital of Xingtai, Xingtai, 054000, Hebei, China.

Background: Atlantoaxial dislocation usually results from hyperextension trauma and is almost always accompanied by odontoid fracture and neurological symptoms. In most cases, patients with atlantoaxial dislocation die instantly. This is a rare report of posterior atlantoaxial dislocation without fracture and neurological symptoms effectively treated by transoral-posterior approach surgery, and only eleven similar cases have been previously reported. Read More

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November 2018
4 Reads

Use of Recombinant Human Bone Morphogenetic Protein-2 at the C1-2 Lateral Articulation Without Posterior Structural Bone Graft in Posterior Atlantoaxial Fusion in Adult Patients.

World Neurosurg 2018 Nov 15. Epub 2018 Nov 15.

Department of Neurosurgery, The Johns Hopkins University, School of Medicine, Maryland, USA. Electronic address:

Introduction: Posterior atlantoaxial fusion is an important armamentarium for neurosurgeons to treat several pathologies involving the craniovertebral junction. Although the potential advantages of recombinant human bone morphogenetic protein -2 (rhBMP-2) are well-documented in the lumbar spine, its indication in C1-2 fusion has not been well-characterized. In our institution, we apply rhBMP-2 to the C1-2 joint either alone or with hydroxyapatite, locally harvested autograft chips, and/or morselized allogenic bone graft for selected cases - without conventional posterior structural bone graft. Read More

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November 2018
4 Reads

Postoperative Cervical Sagittal Realignment Improves Patient-Reported Outcomes in Chronic Atlantoaxial Anterior Dislocation.

Oper Neurosurg (Hagerstown) 2018 Dec;15(6):643-650

Spine Surgery, Department of Ortho-paedics, The First Affiliated Hospital of Nanchang University, Nanchang, China.

Background: Chronic atlantoaxial anterior dislocation (AAD) not only results in myelopathy, but dislocation-related kyphosis also results in cervical malalignment, which permanently affects neck function and patient-reported outcomes (PROs).

Objective: To investigate the effect of kyphotic correction on realigning cervical spine and independent cervical alignment parameters, which may be correlated with an improvement of PROs.

Methods: The study included 21 patients with chronic AAD-related kyphosis who underwent C1-2 reduction and correction surgery. Read More

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December 2018
4 Reads

Giant cell tumor with pathological fracture of C2 with C1-C2 instability: A rare case with review of literature.

J Craniovertebr Junction Spine 2018 Jul-Sep;9(3):205-208

Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Involvement of the axial skeleton is very rare and majority of them are seen in the sacrum. The authors report a rare case of a 19-year-old female who presented with a C2 dens GCT with a pathological fracture and atlantoaxial dislocation. Read More

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November 2018
4 Reads

Management of occipitocervical junction and upper cervical trauma.

J Craniovertebr Junction Spine 2018 Jul-Sep;9(3):148-155

Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA.

Objective: The treatment modality of occipitocervical junction (OCJ) and upper cervical traumas carries great importance because of unique form of bone, complex ligamentous, and neurovascular structure.

Materials And Methods: Eighty-eight patients were admitted to Mersin University Department of Neurosurgery between January 2007 and January 2017 for injuries of the OCJ and upper cervical spine and evaluated retrospectively. In the group, there were 60 male, 28 female patients in the mean age of 42. Read More

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November 2018
2 Reads

[Cervical spine involvement in rheumatoid arthritis : Diagnostics and treatment of instability due to rheumatism].

Z Rheumatol 2018 Dec;77(10):889-895

Klinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679, München, Deutschland.

In addition to involvement of small peripheral joints, the cervical spine is the second most affected body region in rheumatoid arthritis (RA). Due to improvement of pharmaceutical treatment in recent years, new data show that there is a decreasing prevalence of cervical involvement; however, depending on the severity of cervical lesions surgical treatment still plays an important role. The sequelae of involvement of the cervical spine are craniocervical and atlantoaxial instability, which can cause severe pain, neural deficits and even death. Read More

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December 2018
1 Read

[Atlantoaxial joint release through anterior retrophayngeal approach and staged posterior reduction fixation and fusion for irreducible atlantoaxial dislocation].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Nov;32(11):1377-1381

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To discuss the effectiveness of atlantoaxial joint release through anterior retrophayngeal approach and staged posterior reduction fixation and fusion for irreducible atlantoaxial dislocation (IAAD).

Methods: Fifteen patients with IAAD (9 males, 6 females), aged 14-53 years (mean, 31.4 years) were included in the study. Read More

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November 2018
3 Reads

[Anterior stabilization of the CI-CIII vertebrae after transoral removal of an aggressive aneurysmal bone cyst of the CII vertebra (a case report and literature review)].

Zh Vopr Neirokhir Im N N Burdenko 2018 ;82(5):111-118

Priorov National Medical Research Center of Traumatology and Orthopedics, Moscow, Russia.

Treatment of patients with atlantoaxial instability caused by various diseases of the skull base and craniovertebral junction combined with ventral compression of the brainstem is a complex issue that is ambiguously resolved in different ways. We present a case of stepped treatment, the most important component of which was successful transoral removal of an aggressive aneurysmal bone cyst of the CII vertebra with anterior CI-CIII segment stabilization using an individual system, which was performed through the same approach.

Clinical Case: A 31-year-old male patient presented with destruction of the CII body and odontoid process affected by an aggressive aneurysmal bone cyst causing disintegration of the CII posterior wall and odontoid process, which clinically manifested by constricted motion and pain in the cervical spine. Read More

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January 2018
5 Reads

Ankylosing Spondylitis Manifested by Extensive Cervical Erosions with Spontaneous Anterior Atlantoaxial Subluxation.

World Neurosurg 2018 Nov 4. Epub 2018 Nov 4.

Department of Orthopaedic Surgery, Changzheng Hospital, Shanghai, China. Electronic address:

Purpose: We present a rare case of atlantoaxial instability as a result of bone erosions in a patient with ankylosing spondylitis and review the literature. We describe the radiographic characters, pathology and treatment of the case, hoping to shed light on the rare clinical manifestation.

Methods: We present a case of a 36-year-old male with an 8-year history of ankylosing spondylitis with a progressive neck pain, low back pain, hand numbness and motion limitation of neck. Read More

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November 2018
3 Reads

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review.

Bull Emerg Trauma 2018 Oct;6(4):367-371

Resident of Neurosurgery, Student Research Committee, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. Read More

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October 2018
5 Reads

The use of intraoperative traction for achieving reduction of irreducible atlantoaxial dislocation caused by different craniovertebral junction pathologies.

Clin Neurol Neurosurg 2018 Dec 29;175:98-105. Epub 2018 Oct 29.

Department of Spine Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China. Electronic address:

Objective: To investigate the usefulness of intraoperative traction in the selection of the surgical procedure for irreducible atlantoaxial dislocation (IAAD) caused by different craniovertebral junction (CVJ) pathologies.

Patients And Methods: Forty-three patients who were diagnosed with IAAD and who underwent surgery between January 2008 and May 2017 in our hospital were included in the study. All of the patients received skull traction under general anesthesia. Read More

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December 2018
2 Reads

Radiographic and clinical outcomes of C1-C2 intra-articular screw fixation in patients with atlantoaxial subluxation.

J Orthop Surg Res 2018 Oct 29;13(1):273. Epub 2018 Oct 29.

Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.

Background: The Magerl and Goel-Harms techniques have been reported to produce excellent treatment outcomes in cases of atlantoaxial subluxation, but they also carry a risk of vertebral artery injuries. In order to completely prevent such injuries, we developed a surgical procedure, involving bone grafting between the C1 posterior arch and C2 lamina with clamp- or hook-and-rod-based fixation combined with the insertion of an interference screw into the posterior atlantoaxial joint.

Methods: This was a retrospective single-center study. Read More

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October 2018
3 Reads

Atlantoaxial Subluxation Secondary to Unstable Os Odontoideum in a Patient With Arrested Hydrocephalus Due to Congenital Aqueductal Stenosis: A Case Report.

Int J Spine Surg 2018 Oct 15;12(5):549-556. Epub 2018 Oct 15.

Department of Spinal Surgery, Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran.

Background: In a small percentage of children born with congenital hydrocephalus, enlargement of the head and the presence of ventriculomegaly may halt and ultimately stabilize the condition designated as arrested hydrocephalus. Arrested hydrocephalus in children is typically due to congenital aqueduct stenosis, which can be described appropriately as a stasis existing within the channel between the third and fourth ventricles. Os odontoideum (OO) is an uncommonly occurring pathology at the craniovertebral junction. Read More

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October 2018
7 Reads

Retroodontoid Pseudotumor Related to Development of Myelopathy Secondary to Atlantoaxial Instability on Os Odontoideum.

Case Rep Radiol 2018 30;2018:1658129. Epub 2018 Sep 30.

Department of Imaging and Medical Information Sciences, Division of Radiology, Geneva University Hospitals, Geneva, Switzerland.

Retroodontoid pseudotumor (ROP) is a nonneoplasic lesion of unknown etiology, commonly associated with inflammatory conditions, and the term of pannus is usually used. Less frequently, ROP formation can develop with other noninflammatory entities, with atlantoaxial instability as most accepted pathophysiological mechanism for posttraumatic or degenerative ROP. As it can clinically and radiologically mimic a malignant tumor, it is paramount for the radiologist to know this entity. Read More

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September 2018
4 Reads

Early diagnosis of Grisel's syndrome in children with favorable outcome.

Childs Nerv Syst 2018 Oct 25. Epub 2018 Oct 25.

Department of Neurological Surgery, University of Mersin, Mersin, Turkey.

Purpose: The painful torticollis only itself may be a major sign for the diagnosis of Grisel's syndrome (GS). It is known as an inflammatory atlantoaxial rotatory subluxation following upper respiratory tract infections (URTI) and surgical otolaryngological procedures.

Patients And Methods: The analysis of 16 pediatric GS patients were reviewed retrospectively by considering the diagnosis, the treatment modality, and the prognosis at the Department of Neurosurgery and Otorhinolaryngology in Mersin University, Faculty of Medicine between 2008 and 2018. Read More

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October 2018
10 Reads

The Healing Rate of Type II Odontoid Fractures Treated With Posterior Atlantoaxial Screw-rod Fixation: A Retrospective Review of 77 Patients.

J Am Acad Orthop Surg 2018 Oct 17. Epub 2018 Oct 17.

From the Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Shaanxi, China.

Background: In theory, temporary posterior atlantoaxial screw-rod fixation for type II odontoid fractures is a way to preserve rotatory motion. However, the healing rate of type II odontoid fractures treated in this way is unknown; that is, the risk associated with conducting a temporary screw-rod fixation for type II odontoid fractures is unknown. This study investigates the healing rate of type II odontoid fractures treated with posterior atlantoaxial screw-rod fixation by CT imaging and evaluates the feasibility of conducting a temporary screw-rod fixation for type II odontoid fractures. Read More

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October 2018

Introducing the craniocervical Y-ligament.

Surg Radiol Anat 2018 Oct 15. Epub 2018 Oct 15.

Department of Anatomy, Histology and Embriology, Laboratory for Applied and Clinical Anatomy, Semmelweis University Budapest, Tuzolto u. 58, Budapest, Hungary.

Purpose: We examined the accessory atlantoaxial ligaments and found them to be a part of a complex ligamentous structure, which we named craniocervical Y-ligament with respect to its shape.

Methods: The ligaments of the upper cervical spine were dissected in ten Thiel embalmed human cadavers. Origin and attachment of the Y-ligament were described and a detailed photo and video-documentation was carried out with the head in the neutral position, flexion, extension and rotation to study the ligament during these movements. Read More

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October 2018
1 Read

Central or Axial Atlantoaxial Dislocation as a Cause of Cervical Myelopathy: A Report of Outcome of 5 Cases Treated by Atlantoaxial Stabilization.

World Neurosurg 2018 Oct 10. Epub 2018 Oct 10.

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

Objective: The implications of diagnosis and treatment of central or axial atlantoaxial dislocation (CAAD) as a cause of symptoms of cervical myelopathy are evaluated.

Methods: This is a report of a series of 5 patients who presented with the primary symptoms of spasticity and motor weakness and paresthesias in all the limbs. There was no evidence of any significant compression of the dural tube or neural structures at the craniovertebral junction. Read More

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October 2018
10 Reads

Aneurysm of anomalous V3 segment in association with congenital atlantoaxial dislocation: Case report and challenges in management.

World Neurosurg 2018 Oct 9. Epub 2018 Oct 9.

Dept of Neurosurgery and Radiodiagnosis, PGIMER, Chandigarh,Neurosurgery, PGIMER Chandigarh, INDIA.

Background: An anomalous vertebral artery (VA) is not a deterrent for posterior C1-C2 joint manipulation and reduction of atlantoaxial dislocation (AAD). However, presence of an incidental aneurysm in the aberrant segment of artery with concurrent AAD adds to the surgical challenge.

Case Description: A 30-year-old woman presented with neck pain and spastic quadriparesis. Read More

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October 2018
1 Read
2.420 Impact Factor

Atlantoaxial rotatory dislocation in a patient with psoriatic spondyloarthritis.

Joint Bone Spine 2018 Oct 4. Epub 2018 Oct 4.

Rheumatology, Xarxa Universitària Fundació Althaia, Manresa, Joan Soler, 1-3, Manresa 08243, Barcelona, Spain.

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October 2018
2 Reads

Reoperation for Symptomatic Nonunions in Atlantoaxial (C1-C2) Fusions with and without Bone Morphogenetic Protein: A Cohort of 108 Patients with >2 Years Follow-Up.

World Neurosurg 2018 Sep 27. Epub 2018 Sep 27.

Department of Neurosurgery, Kaiser Permanente Southern California, Los Angeles, California, USA.

Objective: To determine if there is a difference in reoperation rates for symptomatic nonunions in atlantoaxial (C1-C2) fusions with or without bone morphogenetic protein (BMP) using data from a national spine registry and to analyze the different types of bone grafts used in the non-BMP group.

Methods: Data from the Kaiser Permanente spine registry were used to identify patients with C1-C2 fusions with >2 years follow-up. Patient characteristics, diagnosis, operative times, length of stay, and reoperations were extracted from the registry. Read More

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September 2018
7 Reads

Iatrogenic neurological injury in children with trisomy 21.

Int J Pediatr Otorhinolaryngol 2018 Nov 27;114:36-43. Epub 2018 Aug 27.

Department of Otolaryngology, Hospital for Sick Children, Toronto, ON, Canada; Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address:

Purpose: Children with trisomy 21 are at a greater risk for craniocervical junction instability than the general population. These children frequently require administration of anesthesia due to surgical (including otolaryngological) interventions and are at risk for neurological injury. We reviewed the current literature describing iatrogenic neurological injury in children with trisomy 21 undergoing anesthesia in order to facilitate the development of safety recommendations. Read More

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November 2018
5 Reads

Epidemiological and morphological characteristics of incomplete ossification of the dorsal neural arch of the atlas in dogs with atlantoaxial instability.

Am J Vet Res 2018 Oct;79(10):1079-1086

OBJECTIVE To retrospectively evaluate the epidemiological and morphological features and outcome of surgical treatment of incomplete ossification of the dorsal neural arch of the atlas (IODA) in dogs with atlantoaxial instability (AAI). ANIMALS 106 AAI-affected dogs that underwent ventral fixation of the atlantoaxial joint. PROCEDURES Medical records and CT images for each dog were reviewed. Read More

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October 2018
1 Read

Voice Quality Affection as a Symptom of Chiari Formation.

World Neurosurg 2018 Sep 22. Epub 2018 Sep 22.

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

Objective: Voice alteration as a presenting symptom in cases with Chiari formation is analyzed, as well as outcome after atlantoaxial fixation.

Methods: During the period January 2016 to June 2017, 25 cases of Chiari formation presented with associated or a major presenting symptom of voice or speech quality alteration related to inadequate breathing efforts. All patients underwent atlantoaxial fixation. Read More

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September 2018

Cervical Spine Evaluation in Pediatric Trauma: A Review and an Update of Current Concepts.

Indian J Orthop 2018 Sep-Oct;52(5):489-500

Department of Pediatric Orthopedics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.

The clinical presentation and diagnostic workup in pediatric cervical spine injuries (CSI) are different from adults owing to the unique anatomy and relative immaturity. The current article reviews the existing literature regarding the uniqueness of these injuries and discusses the current guidelines of radiological evaluation. A PubMed search was conducted using keywords "paediatric cervical spine injuries" or "paediatric cervical spine trauma. Read More

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September 2018

Biomechanical Comparison of C1 Lateral Mass - C2 Short Pedicle Screw - C3 Lateral Mass Screw-Rod Construct Versus Goel-Harms Fixation For Atlantoaxial Instability.

Spine (Phila Pa 1976) 2018 Sep 17. Epub 2018 Sep 17.

Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System, Long Beach and Department of Orthopaedic Surgery, University of California, Irvine, CA, USA.

Study Design: A biomechanical in vitro study using human cadaveric spines.

Objective: To compare atlantoaxial stability and stiffness of a C1 lateral mass - C2 short pedicle - C3 lateral mass screw-rod construct versus C1 lateral mass - C2 pedicle screw-rod construct.

Summary Of Background Data: The C1 lateral mass - C2 pedicle screw-rod construct provides excellent atlantoaxial fixation but C2 pedicle screw placement is associated with risk of vertebral artery injury. Read More

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September 2018
5 Reads

"Rule of Spence" and Dickman's Classification of Transverse Atlantal Ligament Injury Revisited: Discrepancy of Prediction on Atlantoaxial Stability Based on Clinical Outcome of Non-Operative Treatment for Atlas Fractures.

Spine (Phila Pa 1976) 2018 Sep 14. Epub 2018 Sep 14.

Department of Spine Surgery, Center for Orthopedics, Daping Hospital, Army Medical University.

Study Design: a retrospective study.

Objective: To evaluate the prediction accuracy of "Rule of Spence" and Dickman's classification of the transverse atlantal ligament (TAL) injury on clinical outcomes (mainly focused on atlantoaxial stability) of atlas fractures treated non-operatively.

Summary Of Background Data: TAL is regarded as primary stabilizer of the atlantoaxial complex. Read More

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September 2018
2 Reads

Spine challenges in mucopolysaccharidosis.

Int Orthop 2018 Sep 14. Epub 2018 Sep 14.

Spine Surgery Unit, Surgery and Transplantations Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy.

Purpose: Mucopolysaccharidosis (MPS) are rare inherited metabolic diseases, causing lysosomal storage of mucopolysaccharides; clinical presentation involves skeletal system and particularly the spine. Anomalies include developing kyphosis at thoracolumbar junction, that can causes nervous symptoms, and dens hypoplasia with associated atlantoaxial subluxation that can cause myelopathy. We present our experience in the treatment of spine pathology in MPS. Read More

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September 2018
1 Read

Posterior C2 fixation using trans-C2 inferior articular process screws: A case series and technical note.

World Neurosurg 2018 Sep 10. Epub 2018 Sep 10.

Department of Neurosurgery, General Hospital of People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing 100853, China. Electronic address:

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September 2018

Safety and Accuracy of Anatomic and Lateral Fluoroscopic-Guided Placement of C2 Pars/Pedicle Screws and C1 Lateral Mass Screws, and Freehand Placement of C2 Laminar Screws.

World Neurosurg 2018 Oct 2;118:e304-e315. Epub 2018 Jul 2.

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore, India.

Objective: To evaluate the safety and accuracy of anatomic- and lateral fluoroscopic-guided placement of C2 pars/pedicle, C1 lateral mass screws, and freehand placement of C2 laminar screws.

Methods: All the patients who underwent posterior cervical/occipitocervical fixation that involved the placement of C1/C2 screws during a 5-year period (2011-2015) at our institute were included in this study.

Results: C1/C2 screws were placed in a total of 94 patients during this period. Read More

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October 2018
10 Reads
2.420 Impact Factor

Pneumomediastinum, Pneumopericardium, and Epidural Pneumatosis following Adenotonsillectomy: A Very Rare Complication.

Case Rep Otolaryngol 2018 19;2018:4531364. Epub 2018 Aug 19.

Otorhinolaryngology Department, Adana City Research and Training Hospital, University of Health Sciences, Adana, Turkey.

Adenotonsillectomy is a common surgical otolaryngology procedure that is associated with several complications, including hemorrhage, odynophagia, damage to teeth, taste disorders, atlantoaxial subluxation, lingual edema, infection, and injury of the carotid artery. Pneumomediastinum, pneumopericardium, and epidural pneumatosis are an extremely unusual condition in children with adenotonsillectomy. Treatment should be conservative in the majority of cases and based on benign self-limiting course of these diseases; early recognition can prevent further complications. Read More

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August 2018
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Grisel's syndrome caused by Mycoplasma pneumoniae infection: a case report and review of the literature.

Childs Nerv Syst 2018 Sep 12. Epub 2018 Sep 12.

Department of Pediatrics, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy.

Background: Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joints, which is caused by an inflammatory process involving the upper neck. Torticollis, neck pain, and reduced neck mobility are the main clinical signs of presentation. Predisposing factors are trauma, hyperlaxity of the transverse and alar ligaments of the atlantoaxial joints, and surgical interventions carried out in this area. Read More

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September 2018
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Treatment of spinal cord compression caused by C2 osteochondroma with reconstruction and fusion after total resection: Case report and literature review.

J Spinal Cord Med 2018 Sep 12:1-6. Epub 2018 Sep 12.

a Department of Orthopedics, Tongji Hospital, Tongji Medical College , Huazhong University of Science and Technology , Wuhan , Hubei , People's Republic of China.

Context: Osteochondroma is the most common benign tumor of the bone, but spinal osteochondroma is rare. We report a case of cervical osteochondroma in multiple exostoses arising from the lamina of the C2 vertebra, presenting with features of compressive myelopathy in a 22-year-old male. Total resection of the tumor and atlantoaxial fixation and fusion after reconstruction of the C1 posterior arch were performed. Read More

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September 2018
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Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis.

Skeletal Radiol 2018 Sep 11. Epub 2018 Sep 11.

Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.

Objective: To assess the involvement of the atlantoaxial joint in patients with early rheumatoid arthritis (ERA) and to elucidate the risk profile for the individual patient.

Materials And Methods: Consecutive ERA patients (disease duration < 12 months) were included in our study. A cervical spine magnetic resonance imaging (MRI) and X-rays (cervical spine, hands, wrists, and feet) were performed in all patients. Read More

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September 2018
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Evaluation of Pediatrician Adherence to the American Academy of Pediatrics Health Supervision Guidelines for Down Syndrome.

Am J Intellect Dev Disabil 2018 Sep;123(5):387-398

Meghan E. O'Neill, Alexandra Ryan, Soyang Kwon, and Helen J. Binns, Ann & Robert H. Lurie Children's Hospital of Chicago.

The American Academy of Pediatrics's guideline on health supervision for children with Down syndrome (DS) offers pediatricians guidance to improve detection of comorbid conditions. Pediatrician adherence has not yet been comprehensively evaluated. Medical records of 31 children with DS who received primary care at two urban academic clinic sites from 2008-2012 were reviewed. Read More

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September 2018

Spinal manifestations in 12 patients with musculocontractural Ehlers-Danlos syndrome caused by CHST14/D4ST1 deficiency (mcEDS-CHST14).

Am J Med Genet A 2018 Nov 8;176(11):2331-2341. Epub 2018 Sep 8.

Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

Musculocontractural Ehlers-Danlos syndrome caused by mutations in CHST14 (mcEDS-CHST14) is a recently delineated disorder, characterized by craniofacial, skeletal, visceral, and ocular malformations; and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Spinal lesions, though one of the most serious complications, have not been investigated systematically. In this study, we report detailed and comprehensive information about spinal lesions of 12 patients with a mean age at the first visit of 13. Read More

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November 2018
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Letter to the Editor. Artificial atlantoaxial joint.

Authors:
Atul Goel

J Neurosurg Spine 2018 Aug 31:1-3. Epub 2018 Aug 31.

King Edward VII Memorial Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

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August 2018
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