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World J Clin Cases 2022 May;10(14):4494-4501

Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy.

Background: Bow hunter's syndrome (BHS) is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery. Typically, patients present with posterior circulation transient ischaemic symptoms such as presyncope, syncope, vertigo, diplopia, and horizontal nystagmus, but irreversible deficits, including medullary and cerebellar infarctions, have also been described.

Case Summary: A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head rotation. Read More

Clin Anat 2022 May 5. Epub 2022 May 5.

Maastricht University, FHML, Department of Anatomy & Embryology, Maastricht, The Netherlands.

Cervical facet joint pain syndrome accounts for a great amount of cervical pain worldwide. This study aims to provide updated knowledge of cervical facet joint innervation with new anatomical findings. Twenty-seven cervical facet joints and their innervating structures were dissected from five halves of three human neck specimens. Read More

Chiropr Man Therap 2022 03 7;30(1):13. Epub 2022 Mar 7.

Center for Advancing Population Science, Medical College of Wisconsin, WI, Milwaukee, USA.

Objective: Cervical spine surgeries for degenerative conditions are rapidly increasing. Cervical post-surgery syndrome consisting of chronic pain, adjacent segment disease, recurrent disc herniation, facet joint pain, and/or epidural scarring is common. Repeat surgery is regularly recommended, though patients are often unable to undergo or decline further surgery. Read More

AME Case Rep 2022 25;6. Epub 2022 Jan 25.

Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Canada.

Computer-assistance for pedicle screw insertion is becoming increasingly common. As in the case presented below, image guided neuronavigation can be used to improve the accuracy and safety of subaxial cervical pedicle screw placement, given their increased difficulty of cannulation relative to the larger pedicles in the thoracolumbar spine. A 49-year-old man presented with a traumatic sagittal split fracture of C4 (AO Classification type A4) and a left lateral mass fracture of C5 (AO Classification type F1) with anterior depression and 50% height loss. Read More

Int J Rheum Dis 2022 Apr 31;25(4):501-503. Epub 2022 Jan 31.

Department of Rheumatology, Hôpital Bichat-Claude Bernard, Paris, France.

Horner syndrome is a rare condition caused by a lesion of the sympathetic cervical chain. Multiple cervical disorders are associated with such lesions. Here we report the first case of Horner syndrome after cervical facet joint corticosteroid injection. Read More

Case Rep Orthop 2021 29;2021:2799749. Epub 2021 Jun 29.

Department of Orthopedic Surgery, The Rothman Institute, 2500 English Creek Ave. Egg Harbor Township, NJ 08234, USA.

Intraspinal extradural synovial cysts are a rare occurrence at the spinal cord level and thus a rare cause of myelopathy. Synovial cysts usually present in the more mobile lumbar and cervical parts of the spine; however, they may also arise in the thoracic spine. We present a case of a 59-year-old male with a left upper thoracic synovial cyst at T2-3 causing disabling, progressive myelopathy, and an incomplete spinal cord injury syndrome with inability to ambulate. Read More

Case Rep Oncol 2021 Jan-Apr;14(1):561-567. Epub 2021 Mar 22.

Pathology and Anatomy Department, Airlangga University, Surabaya, Indonesia.

Schwannomas are the most common peripheral nerve sheath tumors. Benign schwannomas with malignant transformation are rarely reported. Most common schwannomas occur in the head and neck region. Read More

Pain Physician 2021 01;24(S1):S27-S208

, Advanced Pain Institute, Covington, LA.

Background: Chronic spinal pain is the most prevalent chronic disease with employment of multiple modes of interventional techniques including epidural interventions. Multiple randomized controlled trials (RCTs), observational studies, systematic reviews, and guidelines have been published. The recent review of the utilization patterns and expenditures show that there has been a decline in utilization of epidural injections with decrease in inflation adjusted costs from 2009 to 2018. Read More

Neurospine 2020 Dec 31;17(4):809-819. Epub 2020 Dec 31.

Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi, Pakistan.

This comprehensive review article aims to provide some definitive statements on the factors like clinical syndromes, radiological findings, and decompressive surgery, that may influence the outcomes in cervical spinal cord injury management. Literature search on these factors published in the last decade were analyzed and definite statements prepared and voted for consensus opinion by the WFNS Spine Committee members and experts in this field at a meeting in Moscow in June 2019 using Delphi method. This was re-evaluated in a meeting in Pakistan in November 2019. Read More

J Clin Med 2020 Dec 2;9(12). Epub 2020 Dec 2.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, Songpa-gu, Seoul 05505, Korea.

Cervical facet joint (CFJ) syndrome is a common cause of neck pain. For its diagnosis and treatment, CFJ injection with arthrogram is generally performed. This study aimed to investigate the frequency of extra-CFJ flow on CFJ arthrograms during injections and its differences according to age, sex, and cervical vertebral level. Read More

Asian Spine J 2020 Oct 14;14(5):710-720. Epub 2020 Oct 14.

Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea.

Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term "degenerative cervical myelopathy (DCM)" was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. Read More

Mod Rheumatol Case Rep 2020 01 25;4(1):11-15. Epub 2019 Nov 25.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Bow hunter's syndrome, or rotational vertebral artery (VA) occlusion, refers to vertebrobasilar insufficiency due to mechanical occlusion of the VA. We present a case of surgical treatment for bow hunter's syndrome that occurred after cervical laminoplasty in a patient with rheumatoid arthritis with bony ankylosis of the facet joints. A 59-year-old female with rheumatoid arthritis experienced sudden incomplete left hemiplegia. Read More

Am J Med Genet A 2020 12 17;182(12):2902-2908. Epub 2020 Sep 17.

Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Headache and neck pain (cervicalgia) are frequently reported among patients with joint hypermobility but the prevalence and scope of these symptoms has not been studied in the era of contemporary Ehlers-Danlos and hypermobility disorder nosology. We performed a single-center retrospective study on the incidence of head and neck symptoms in 140 patients with hypermobility disorders over a 2-year period. Overall, 93 patients (66%) reported either headache or neck pain with 49 of those (53%) reporting both. Read More

J Vet Intern Med 2020 Sep 14;34(5):2012-2020. Epub 2020 Aug 14.

Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA.

Background: Osseous-associated cervical spondylomyelopathy (OA-CSM) is a complex disorder with limited long-term survival. The longitudinal progression is currently unknown.

Objective: To describe changes on magnetic resonance imaging (MRI) over a 2-year minimum period. Read More

World Neurosurg 2020 10 14;142:460-464. Epub 2020 Jul 14.

Institute of Neurosurgery, Fondazione Policlinico "A. Gemelli," Catholic University, Largo F. Vito, Rome, Italy; Craniovertebral Junction Operative Unit and Master CVJ Surgical Approach Research Center, Fondazione Policlinico "A. Gemelli," Catholic University, Largo F. Vito, Rome, Italy.

Background: Perched facet joint syndrome is a common post-traumatic condition encountered at the level of subaxial cervical spine in acute settings but more rarely found in a chronic manner. We define this dislocation as old subaxial cervical facet dislocation (OSCFD) when adequate treatment is not established within 3 weeks after initial trauma. It is a clinical entity, moreover, associated with significant impact on neurologic functions such as nerve root or spine compression. Read More

Clin Rheumatol 2021 Jan 5;40(1):349-357. Epub 2020 Jun 5.

Department of Nuclear Medicine, Peking University Third Hospital, Beijing, China.

Objectives: The aim was to comparatively assess the clinical and imaging features in patients with SAPHO syndrome.

Methods: The clinical data, laboratory results, imaging data of forty-six SAPHO patients were reviewed and the SAPHO patients were divided into spinal involvement group and non-spinal involvement group. Fifty patients with ankylosing spondylitis were recruited as control group. Read More

Spine (Phila Pa 1976) 2020 Sep;45(17):E1119-E1126

Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Study Design: Clinical case series.

Objective: To present a surgical technique and results of posterior direct reduction of lateral atlantoaxial joints for rigid pediatric atlantoaxial subluxation (AAS) using a fulcrum lever technique.

Summary Of Background Data: The surgical treatment of pediatric rigid AAS is still technically challenging. Read More

World Neurosurg 2020 07 25;139:274-280. Epub 2020 Apr 25.

Duke University School of Medicine, Durham, North Carolina, U.S.A; Division of Spine, Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, U.S.A.

Split cord malformation (SCM) is a developmental disorder that is usually symptomatic and diagnosed in childhood. The majority of these lesions are in the thoracic and lumbar spine, with only 1%-3% of cases found in the cervical spine. This is a case report of a 55-year-old female patient with an unremarkable medical history who presented with neck pain. Read More

World Neurosurg 2020 06 10;138:187-192. Epub 2020 Mar 10.

School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Congenital anatomic variations exist in human anatomy, which create both diagnostic and treatment challenges. Understanding the osteologic and radiographic anatomy of supernumerary ribs arising from the cervical spine and recognizing the morphologic variations thereof is of great importance to clinicians, radiologists, and surgeons alike.

Case Description: This case study describes osteologic morphology and radiologic characteristics of a rare anatomic variant of a cervical rib (CR): a unilateral, right-sided CR synostosis to the first thoracic rib of a 50-year-old South African man of African ancestry. Read More

Pain Med 2020 10;21(10):2071-2076

Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.

Background: Cervical medial branch radiofrequency ablation (CMBRFA) is an effective treatment for facetogenic pain in patients selected by Spine Intervention Society (SIS) guidelines of 100% symptom improvement with dual medial branch blocks (MBBs) ± placebo block. Patient selection for CMBRFA using ≥80% symptom improvement after dual concordant MBBs is common; however, this has not been studied.

Objective: To evaluate the effectiveness of CMBRFA and compare outcomes in individuals selected by 80-99% vs 100% symptom improvement with dual concordant MBBs. Read More

J Clin Neurosci 2020 Jan 9;71:263-270. Epub 2019 Oct 9.

Department of Orthopedic Surgery, University of Pennsylvania Hospital System, Philadelphia, PA, United States.

Occipital neuralgia typically arises in the setting of nerve compression by fibrosis, surrounding anatomic structures, or osseous pathology, such as bone spurs or hypertrophic atlanto-epistropic ligament. It generally presents as paroxysmal bouts of sharp pain in the sensory distribution of the first three occipital nerves. Due to the long course of the greater occipital nerve (GON), and its peculiar anatomy, and location in a mobile region of the neck, it is unsurprising that the GON is at high risk for compression. Read More

J Bodyw Mov Ther 2019 Jul 7;23(3):628-633. Epub 2019 Feb 7.

Palmer College of Chiropractic, Florida Campus, USA. Electronic address:

Introduction: The rationale for this case report was to identify the strengths and weaknesses associated with prescribing the Turkish Get-Up as an isometric shoulder and neck exercise. The Turkish getup is an effective tool for isometrically loading the cervical spine and shoulder and can be used with minimal space and equipment.

Discussion: The Turkish Get-Up was selectively applied as a therapeutic corrective intervention to a patient suffering a mild to moderate cervical, acromio-clavicular and sterno-clavicular joint sprain with associated facet syndrome and muscle spasm. Read More

Pain Physician 2019 09;22(5):421-431

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Neck pain is one of the major conditions attributing to overall disability in the United States. There have been multiple publications assessing clinical and cost effectiveness of multiple modalities of interventions in managing chronic neck pain. Even then, the literature has been considered sparse in relation to cervical interlaminar epidural injections in managing chronic neck pain. Read More

Oper Neurosurg (Hagerstown) 2020 Jun;18(6):E233

Department of Neurosurgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

Unilateral biportal endoscopy (UBE) is a recently introduced technique that utilizes 2 portals, one for endoscopy and one as a working portal, in contrast to full endoscopy, which utilizes a single portal. The advantages are a favorable learning curve and free mobility of instruments in the operative field. UBE is successful in addressing cervical and lumbar disc herniations, lumbar stenosis, and foraminal/extraforaminal pathologies, such as herniations and foraminal stenosis. Read More

World Neurosurg 2019 Jul 4;127:391-396. Epub 2019 Apr 4.

Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address:

Background: Occipitocervical congenital pathologies involving instability of the atlantoaxial joint and basilar invagination are challenging to treat owing to the complex anatomy involving neurovascular structures at the skull base and the high-risk nature of surgery close to the brainstem.

Case Description: A patient presented with Alagille syndrome with multiple segmentation/fusion anomalies of the cervical spine and craniocervical junction, including fusion of the skull base and occipital condyles and partial assimilation of the C1 anterior ring and C2 dens. The head was anteriorly displaced, with C2 located immediately below the foramen magnum. Read More

J Med Case Rep 2019 Mar 14;13(1):60. Epub 2019 Mar 14.

Private Practice Interventional Pain Management, Willow Grove, PA, USA.

Background: The trigeminal autonomic cephalalgias are a group of primary headache syndromes marked by severe head pain and associated cranial autonomic symptoms which can include a full or partial Horner's syndrome. Rarely, the eye-related symptoms will become fixed even between headache attacks. There is minimal documentation that the Horner's syndrome can be reversed if successful treatment of the underlying headache disorder is initiated. Read More

Medicine (Baltimore) 2019 Mar;98(10):e14745

Denver Pain and Spine PC, Golden, CO.

Treatment of back pain due to facet joint syndrome has been a challenge for physicians since its recognition ∼80 years ago. Intra-articular injections of steroids, local anesthetics, and phenol have been widely adopted despite their known shortcomings. Recently, intra-articular injection of amniotic membrane-umbilical cord (AMUC) has been utilized in various orthopedic indications, including those involving synovial joints, due to its reported anti-inflammatory properties. Read More

J Neurosurg Spine 2018 11;30(2):175-181

Departments of1Neurosurgery and.

OBJECTIVEAtlantoaxial instability is an important cause of pain and neurological dysfunction in patients with Down syndrome (DS), frequently requiring instrumented fusion of the upper cervical spine. This study provides a quantitative analysis of C2 morphology in DS patients compared with their peers without DS to identify differences that must be considered for the safe placement of instrumentation.METHODSA retrospective chart review identified age-matched patients with and without DS with a CT scan of the cervical spine. Read More