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JA Clin Rep 2020 Jun 11;6(1):46. Epub 2020 Jun 11.

Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Background: Musculocontractural Ehlers-Danlos syndrome is a new and rare subtype of Ehlers-Danlos syndrome in which anesthetic considerations for airway and respiratory management, prevention of skin injuries and joint dislocations, and hemostatic management for severe perioperative bleeding are required.

Case Presentation: A 19-year-old woman with musculocontractural Ehlers-Danlos syndrome was scheduled to undergo posterior spinal fusion from the 4th thoracic to the 4th lumbar vertebrae under general anesthesia. Her trachea was easily intubated with a videolaryngoscope despite a small mouth and micrognathia. Read More

Accid Anal Prev 2020 Jul 12;142:105571. Epub 2020 May 12.

Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands.

Background: Cervical spine injury is a common result of traffic crashes, and such injuries range in severity from minor (i.e. sprain/strain) to moderate (intervertebral disk derangement) to serious and greater (fractures, dislocations, and spinal cord injuries). Read More

Int Orthop 2020 May 15. Epub 2020 May 15.

Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, S308433, Singapore.

Purpose: Timing of surgery for orthopaedic injuries continues to evolve, as an improved understanding of biology, healing, and technological advances continues to challenge historical norms. With the growing COVID-19 pandemic stretching limited healthcare resources, postponing surgery becomes an inevitable and unenviable task for most orthopaedic surgeons, and a shift in outpatient paradigms is required to mitigate poor outcomes in patients.

Methods: A scoping review of five databases on surgical timing and orthopaedic soft-tissue injuries was performed. Read More

Asian Spine J 2020 Apr 24. Epub 2020 Apr 24.

Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.

Study Design: Retrospective case series.

Purpose: To analyze the clinical and functional outcomes of patients who have undergone anterior cervical discectomy/corpectomy and fusion (ACDF/ACCF) for a three-column cervical spine injury (CSI).

Overview Of Literature: The treatment of choice for a three-column CSI is an area of contention; however, combined anterior and posterior fixation is the preferred method explored in the literature. Read More

Curr Rev Musculoskelet Med 2020 Jun;13(3):240-246

Department of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Purpose Of Review: The orientation of the spine relative to the pelvis-particularly that in the sagittal plane-has been shown in both kinematic and radiographic studies to be paramount in governance of acetabular alignment during normal bodily motion. The purpose of this review is to better understand the challenges faced by arthroplasty surgeons in treating patients that have concurrent lumbar disease and are therefore more likely to have poorer clinical outcomes after THA than in patients without disease.

Recent Findings: The concept of an "acetabular safe zone" has been well described in the past regarding the appropriate orientation of acetabular component in THA. Read More

Curr Osteoporos Rep 2020 Jun;18(3):130-137

Hughston Clinic, Jacksonville, FL, USA.

Purpose Of Review: The purpose is to review current literature on pain management strategies from initial presentation to postoperative care on common fracture types.

Recent Findings: - Hip fractures benefit from use of multimodal pain control for early mobility and decreased narcotic requirement. - Distal radius fracture pain during reduction can be managed with hematoma block. Read More

Medicine (Baltimore) 2020 Mar;99(12):e19578

Department of Spine Surgery, The First Hospital of Jilin University.

Introduction: Spondyloptosis is a form of vertebral dislocation and the most advanced form of spondylolisthesis. Traumatic spondyloptosis is usually caused by high-energy impact and results in unstable spine deformity and spinal canal deformation, which lead to severe spinal cord injury. Traumatic spondyloptosis is mostly reported in the lumbo-sacral junction, while it is rarely documented in mid-lumbar segments. Read More

World Neurosurg 2020 Jun 13;138:e634-e641. Epub 2020 Mar 13.

Department of Neurosurgery, Taipei Medical University, Taipei, Taiwan; Department of Surgery, Taipei Medical University, Taipei, Taiwan; Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.

Objective: The interlaminar fusion combination involving C1-C2 screwing fixation is one of the most effective techniques for atlantoaxial dislocation or subluxation, and the bone graft is usually stabilized by wiring constructs. However, some adverse events were reported during the insertion of sublaminar wiring, such as accidentally damaging the spinal cord or dura. Thus we used the miniplate to stabilize the harvest bone graft on the C1-C2 laminar, which led to a shorter operation time and prevented spinal canal violation. Read More

Zhongguo Gu Shang 2020 Feb;33(2):154-7

Zhuhai Hospital, Guangzhou Provincial Hospital of Traditional Chinese Medicine, Zhuhai 519000, Guangdong, China.

Zhongguo Gu Shang 2020 Jan;33(1):27-37

China-Japan Friendship Hospital, Beijing 100029, China.

Editor's Note: EDITOR'S NOTE In 2019, the clinical practice guideline of integrated traditional Chinese and western medicine atlantoaxial dislocation (ADD) was developed by the professional committee of spine medicine of the Chinese Association for Integration of Chinese and Western medicine, aiming at the major clinical problems of atlantoaxial dislocation (AAD) endangering the life center of the medulla oblongata in the field of spine surgery. More than 40 experts at home and abroad in the field of cervical spine surgery organized the first guide for the diagnosis and treatment of AAD. Guided by the principles of evidence based medicine and the consensus of experts, this guideline is based on the theory of "combination of disease and syndrome, from supervision to treatment" for the diagnosis and treatment of AAD；based on the treatment principles of "spinal cord decompression, reconstruction of atlantoaxial stability"；based on Tan technology, Goel technology, Abumi technology and other core technologies for surgical treatment. Read More

Am J Med Genet A 2020 05 24;182(5):994-1007. Epub 2020 Feb 24.

Ehlers-Danlos Syndrome National Diagnostic Service, Northwick Park and St. Mark's Hospitals, Harrow, London, UK.

Arthrochalasia Ehlers-Danlos syndrome (aEDS) is a rare autosomal dominant connective tissue disorder that is characterized by congenital bilateral hip dislocations, severe generalized joint hypermobility, recurrent joint (sub)luxations, and skin hyperextensibility. To date, 42 patients with aEDS have been published. We report 12 patients with aEDS from 10 families with 6 unpublished individuals and follow-up data on 6 adult patients. Read More

Orthop J Sports Med 2019 Nov 7;7(11):2325967119879927. Epub 2019 Nov 7.

Clinic of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.

Background: The side-comparative coracoclavicular (CC) distance is used to describe the vertical instability component of acute acromioclavicular (AC) joint dislocations. Elevation of the clavicle or a depression of the shoulder girdle can lead to an increased CC distance. The dislocation direction has not yet been investigated and is not included in common classification systems. Read More

Medicine (Baltimore) 2020 Jan;99(5):e18983

Department of Orthopaedics, The Second Hospital, Jilin University, Changchun, Jilin, China.

Introduction: Basilar invagination (BI) is a common deformity in the occipitocervical region. The traditional surgical method of BI is direct transoral decompression followed by posterior decompression and fixation. Posterior-only decompression and fixation have achieved good efficacy in the treatment of BI in recent years, but complications are common due to the operation in the upper cervical vertebra and the medulla oblongata region. Read More

World Neurosurg 2020 Apr 25;136:315-317. Epub 2020 Jan 25.

Department of Neurosurgery, NIMHANS, Bangalore, India. Electronic address:

Spontaneous atlantooccipital dislocation is a rare clinical entity. Patients may present with neck pain and restriction of movements. Rarely does a patient present with hypoglossal nerve palsy. Read More

Spine J 2020 Jun 13;20(6):896-904. Epub 2020 Jan 13.

Australian Institute of Health Innovation, Sydney, Australia.

Background Context: Despite its potential to cause serious and life-long disability or death, population-based data on traumatic spinal injury in pediatric populations is scarce.

Purpose: To quantify and describe the incidence and cost of hospitalizations for traumatic spinal injury among Australian children, and to examine the trend over a 10-year period.

Study Design: Population-based retrospective cohort study. Read More

Acta Chir Orthop Traumatol Cech 2019 ;86(6):403-412

Klinika spondylochirurgie 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha.

PURPOSE OF THE STUDY Atlantoaxial Rotatory Dislocation (AARD) mostly occurs in children and prevailing majority of cases are successfully managed by non-operative treatment. Surgical intervention is necessary in patients in whom non-operative treatment failed, in case of repeated dislocations and in patients with anatomical defects of the atlantoaxial complex. The purpose of the presented study is the radiological and clinical evaluation of patients with AARD surgically treated at our department. Read More

World Neurosurg 2020 Apr 10;136:70-72. Epub 2020 Jan 10.

Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, USA. Electronic address:

Background: Although instrumented stabilization of pediatric atlanto-occipital dislocation (AOD) has been described in the literature, there is little evidence regarding instrumentation techniques in pediatric patients presenting with both AOD and a cervical fracture. We present a case of a 2-year-old male involved in a motor vehicle collision with an unstable C2 fracture and AOD, treated with an occiput-C4 posterior arthrodesis using a rod, crosslink, and cable construct.

Case Description: This patient suffered a type III C2 fracture and AOD with 4 mm craniocaudal and 3 mm anterior displacement. Read More

J Pediatr Orthop 2020 Feb;40(2):65-70

Department of Orthopaedics, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou, People's Republic of China.

Background: There are few studies reporting the use of atlantoaxial pedicle screws and the long-term effects of C1-C2 posterior fusion in children. Our study is to investigate the initial results of C1-C2 pedicle screw fixation for pediatric atlantoaxial dislocation (AAD) and assessed spontaneous change of postoperative radiography after a long-term follow-up period.

Methods: Posterior pedicle screw fixations were performed in 21 pediatric patients with AAD. Read More

Eur Spine J 2020 Feb 8;29(Suppl 1):57-65. Epub 2020 Jan 8.

Orthopedic Spinal Surgery Unit 1, Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux Cedex, France.

Introduction: Dynamic stabilization of the spine has been performed since the 1990s with the double purpose of restoring spinal segmental stability and allowing residual movement at the operated level. When we take into account the different motion-preserving devices and the spinal areas where they are applied, we can identify three categories of spinal implants: anterior cervical, anterior lumbar, and posterior lumbar. However, as in all prosthetic procedures performed in orthopedic surgery, the life span of a joint replacement device is a central topic of discussion, and this is true also for spinal dynamic devices, being revision surgery a complex procedure in specific cases. Read More

Surg Neurol Int 2019 6;10:239. Epub 2019 Dec 6.

Department of Neurosurgery, Caxias do Sul University, RS, Brazil.

Background: The medical literature suggests that facet dislocations (FDs) must be managed surgically, even in the absence of spinal cord injury. In fact, there is no standard guideline for managing FD cases and whether magnetic resonance imaging (MRI) should be utilized for optimizing treatment planning.

Methods: Fifteen cases of FD were evaluated twice by nine spine surgeons. Read More

J Orthop Surg Res 2019 Dec 5;14(1):414. Epub 2019 Dec 5.

Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, China.

Objective: The purpose of this study was to investigate the effects of the number of fused segments, the timing of surgery and their interaction on the prognosis of patients with cervical spinal cord injury without fracture and dislocation (CSCIWFD), and to determine the appropriate time restrictions for early surgery in CSCIWFD patients based on the current diagnosis and treatment system in southern China.

Methods: CSCIWFD patients who underwent anterior cervical decompression and internal fusion (ACDF) from January 2012 to June 2017 were selected. The patients were grouped according to the timing of surgery and the number of fused segments and evaluated based on their American Spinal Injury Association (ASIA) score, ASIA impairment scale, and Japanese Orthopaedic Association (JOA) score before and after surgery. Read More

BMC Musculoskelet Disord 2019 Nov 23;20(1):558. Epub 2019 Nov 23.

Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.

Background: Traumatic bilateral locked facet joints at L4-5 level are a rare entity. A careful review only revealed four case reports. This case presented with an unusual mechanism of injury. Read More

Orthop Surg 2019 Dec 19;11(6):1054-1063. Epub 2019 Nov 19.

Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.

Objective: To observe the effects of occipitoaxial angle (O-C2 angle, OC2A) and posterior occipitocervical angle (POCA) selection on postoperative clinical efficacy and lower cervical curvature in patients with acute acquired atlantoaxial dislocation after occipitocervical fusion (OCF).

Methods: A total of 150 healthy subjects without cervical disease (healthy group) were randomly selected based on gender and age. Three spine surgeons measured the OC2A and POCA of the healthy group and averaged the values. Read More

BMC Musculoskelet Disord 2019 Nov 15;20(1):545. Epub 2019 Nov 15.

The Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.

Background: L3 vertebral fractures with posterior dislocation are rare and usually secondary to high-energy trauma. To assess the outcome of a valuable distraction technique, using long-tail multiaxial pedicle screw which we have employed in reduction of L3 vertebral fracture with posterior dislocation, and emphasize the importance of preoperative blood vessel evaluation.

Case Presentation: A 47-year-old patient fell from a height of 4 m and was paralyzed. Read More

J Forensic Leg Med 2020 Jan 31;69:101883. Epub 2019 Oct 31.

Institute of Forensic and Traffic Medicine, University Hospital of Heidelberg, Heidelberg, Germany.

A fatality of an 83-year-old female experiencing acute circulatory failure as a result of a type II odontoid fracture is compared with the case of an 86-year-old female who died from delayed cardiopulmonary complications due to a lower cervical spine injury. Falls on the forehead from minor height can cause odontoid fractures especially in elderly patients, hyperextension of the neck on the other hand can lead to lower cervical spine injury with prevertebral hematoma. The latter can lead to extensive hematoma of the neck, but might be difficult to diagnose by computed tomography in the living patient. Read More

Medicine (Baltimore) 2019 Nov;98(44):e17776

Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do.

Rationale: To our knowledge, this is the first report of traumatic combined vertical atlanto-occipital dislocation (AOD) and atlanto-axial dislocation (AAD) with 2-part fracture of the atlas.

Patient Concerns: The first case was of a 31-year-old woman admitted to the emergency room comatose after a traffic accident. The second case was of a 21-year-old woman admitted to the emergency room comatose after a fall. Read More

Eur Spine J 2020 Feb 1;29(2):282-294. Epub 2019 Nov 1.

Department of Orthopaedic Surgery, Box Hill Hospital, Box Hill, VIC, Australia.

Background: Hip and spine pathology can alter the biomechanics of spino-pelvic mobility. Lumbar spine fusions can reduce the mobility of the lumbar spine and therefore result in compensatory femoral motion, contributing towards dislocations of THA.

Purpose: This meta-analysis aims to determine the effect of pre-existing spine fusions on THA outcomes, and complication profile including hip dislocations, all-cause revisions and all complications. Read More

Medicine (Baltimore) 2019 Oct;98(43):e17666

Department of Orthopaedic Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul.

Rationale: Traumatic AOD is rare but highly associated with upper cervical spine injuries. We found no references in the literature of traumatic posterior atlantooccipital dislocation (AOD) combined with type II dens fracture (Anderson-D'Alonzo classification) and C1 anterior arch fracture.

Patient Concerns: The first case was a 93-year-old male patient who was admitted to the Emergency Department complaining of incomplete quadriplegia after a fall from a height. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Nov;33(11):1419-1423

Department of Spine, Sichuan Provincial Orthopedic Hospital, Chengdu Sichuan, 610041, P.R.China.

Objective: To investigate reliability and short-term effectiveness of axis laminar screws for reducible atlantoaxial dislocation (RAAD).

Methods: A clinical data of 41 patients with RAAD who were admitted between February 2013 and February 2018 and met the inclusion criteria was retrospectively analyzed. The atlases in all patients were fixated by lateral mass screws, and the axes were fixed by laminar screws in 13 cases (LS group) and by pedicle screws in 28 cases (PS group). Read More

Eur Spine J 2019 Oct 21. Epub 2019 Oct 21.

Department of Orthopedics, Nicosia General Hospital, Strovolos, Cyprus.

Objective: This study evaluates efficacy and safety of contemporary spinal instrumentation for AO/type C posterior pelvic ring (PPR) injuries.

Methods: Twenty-two consecutive patients, aged 36 ± 17 years, were managed with spinal instrumentation with spinopelvic fixation (SPF) or non-spinopelvic fixation (NSPF) and less invasive surgery. There were 16 vertically unstable sacral fractures and six iliosacral dislocations. Read More

World Neurosurg 2020 Feb 16;134:e243-e248. Epub 2019 Oct 16.

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, and Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. Electronic address:

Background: Selection of approach for subaxial cervical fracture-dislocation (SCFD) is controversial. The questions of whether a posterior ligamentous structure (PLS) can be functionally healed in patients with SCFD and how long this healing process takes are critical in these patients.

Methods: This study retrospectively enrolled 394 patients with SCFD who underwent anterior decompression, reduction, and fusion between January 2002 and December 2017. Read More

BMC Musculoskelet Disord 2019 Oct 15;20(1):451. Epub 2019 Oct 15.

Department of Spinal Surgery, Henan provincial people's hospital, Weiwu road No 7, Jinshui district, Zhengzhou City, Henan province, China.

Background: To compare the imaging parameters pre- and post- reductive procedure for atlantoaxial dislocation via posterior fixation using pedicle screw and rod.

Methods: Thirty-seven patients suffering from atlantoaxial dislocation underwent posterior reduction and internal fixation by pedicle screw and rod. We measured pre-operative and post-operative atlantodental interval (ADI), clivus-canal angle (CCA), cervicomedullary angle (CMA), sum of lateral mass interspace (SLMI) of the operation and the control group. Read More

Zhongguo Gu Shang 2019 Sep;32(9):819-823

Department of Orthopaedics, Changzheng Hospital Affiliated to Naval Military Medical University, Shanghai 200003, China;

Objective: To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children.

Methods: From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Read More

Spine (Phila Pa 1976) 2019 Oct;44(20):1412-1417

Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Study Design: A retrospective clinical study.

Objective: The aim of this study was to evaluate the efficacy and safety of fluoroscopy-guided atlantoaxial pedicle screw fixation in patients younger than 12 years.

Summary Of Background Data: C1-C2 pedicle screw fixation is a widely accepted treatment method for atlantoaxial dislocation (AAD). Read More

Surg Neurol Int 2019 26;10:48. Epub 2019 Mar 26.

Vancouver Spinal Surgery Institute and Department of Surgery, Division of Neurosurgery, Vancouver, British Columbia, Canada.

Background: Cervical facet dislocations are rare in patients sustaining traumatic subaxial injuries. They occur due to hyperflexion-distraction and can occur unilaterally or bilaterally resulting in significant spinal instability. Bilateral facet dislocations at one level are less common than unilateral dislocations, while bilateral facet dislocations at adjacent spinal levels have only been reported twice in literature. Read More

Zhonghua Wai Ke Za Zhi 2019 Oct;57(10):63-68

Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.

To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage. Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospital of Hebei Medical University were retrospective analyzed. There were 15 males and 22 females with age of (42. Read More

Ugeskr Laeger 2019 Aug;181(34)

This is a case report of an eight-year-old boy with CT-confirmed changes bringing attention to Grisel's syndrome as a differential diagnosis to torticollis. The syndrome - also known as atlantoaxial subluxation - is a complication to operations or infections in the ear, nose and throat region. It usually presents as a slightly flexed and rotated neck, and characteristic radiographic findings. Read More

World Neurosurg 2019 Dec 4;132:e193-e201. Epub 2019 Sep 4.

Department of Spinal Surgery, Henan Provincial People's Hospital, Henan, China.

Objective: To evaluate the effect of screw-rod fixation and selective axial loosening in the treatment of atlantoaxial instability or dislocation (including reducible and irreducible) caused by os odontoideum (OO) via a single posterior approach.

Methods: A consecutive series of patients with OO surgically treated in our hospital were retrospectively analyzed. For atlantoaxial instability and reducible atlantoaxial dislocation, C1-C2 screw-rod fixation and fusion were performed. Read More

World Neurosurg 2019 Dec 30;132:e324-e332. Epub 2019 Aug 30.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address:

Objective: To assess the value and limitation of cervical traction in the evaluation of the reducibility of atlantoaxial dislocation (AAD) and basilar invagination (BI) using the intraoperative O-arm.

Methods: A total of 22 patients with hyperextensive, irreducible AAD were included. The cervical traction test under general anesthesia was performed, and the degree of reduction was evaluated using the O-arm before the operation started. Read More

World Neurosurg 2019 Nov 16;131:230-233. Epub 2019 Aug 16.

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

Background: Patients with Down syndrome (DS) have an increased incidence of multisystem disorders, like cardiovascular, neurologic, gastrointestinal, respiratory, and musculoskeletal disorders. Craniovertebral junction instability is a common illness in DS patients, and they may often be affected by vertebral artery (VA) anomalies.

Case Description: In this paper we present neuroradiologic findings of a 34-year-old female patient affected by DS with atlantoaxial subluxation, scheduled for transoral decompression of C1-C2 and posterior occipitocervical fixation. Read More

Medicine (Baltimore) 2019 Aug;98(31):e16668

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

Rationale: To the best of our knowledge, this is the first report on a case of a traumatic posterior atlantooccipital dislocation (AOD) with 3-part Jefferson and occipital condyle fractures.

Patient Concerns: We report the case of a 60-year-old male with posterior AOD with 3-part Jefferson fracture and fracture of right occipital condyle. This injury occurred as a result of rolling down from a mountain. Read More

BMC Surg 2019 Jul 29;19(1):101. Epub 2019 Jul 29.

Department of Spine Surgery, Ningbo No.6 Hospital, No.1059, Zhongshan East Road, Ningbo, China.

Background: Spine fractures combined with sternal injury are most commonly occur in the thoracic region. Lower cervical and thoracolumbar injuries have also been reported, especially for the patients with manubriosternal dislocation. The type of spine injury is easily recognized in initial presentation, but we may miss the sternal fracture and manubriosternal dislocation. Read More

World Neurosurg 2019 Nov 16;131:108-111. Epub 2019 Jul 16.

Department of Pediatric Infectious Diseases and Neurology, Adana City Training and Research Hospital, Adana, Turkey.

Background: Atlantoaxial subluxation caused by Brucella infection is rarely seen in children.

Case Description: C1-C2 dislocation, erosion in the odontoid bone, and compression to the brainstem were detected on cervical computed tomography and magnetic resonance imaging in a 6-year-old patient who suffered neck pain, deviation to the right in the neck, fever, and pain in his extremities. He was hospitalized in the Clinic of Pediatric Infectious Diseases. Read More

J Neurotrauma 2020 Feb 1;37(3):448-457. Epub 2019 Aug 1.

Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.

In cervical traumatic spinal cord injury (TSCI), the therapeutic effect of timing of surgery on neurological recovery remains uncertain. Additionally, the relationship between extent of decompression, imaging biomarker evidence of injury severity, and outcome is incompletely understood. We investigated the effect of timing of decompression on long-term neurological outcome in patients with complete spinal cord decompression confirmed on postoperative magnetic resonance imaging (MRI). Read More

Pan Afr Med J 2019 6;33. Epub 2019 May 6.

Department of Neurosurgery, Mohammed VI Hospital, Cadi Ayyad University, Marrakesh, Morocco.

Spontaneous atlanto-axial (C1-C2) dislocation is an atlanto-axial instability, found in 10 to 30% of trisomy 21 patients, the majority of whom is asymptomatic. We report a case of a 21 years-old woman, with trisomy 21, admitted in our department presenting a spinal cord compression syndrome with right hemiparesis associated with a cervicalgia evolving for 3 months of admission without trauma. Standard cervical radiography showed a C1-C2 dislocation with posterior displacement of the odontoid process. Read More

World Neurosurg 2019 Oct 9;130:179-186. Epub 2019 Jul 9.

Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Objective: Besides the facet joints interlocking, the fibrous tissue or bony callus around the dislocated segments make the reduction for this kind of old injury to be more challenging and different from that of acute injuries. This study is aimed to present 4 cases of old subaxial cervical facet dislocations (SCFD) that were successfully treated with posterior unlocking under endoscopy followed by anterior decompression, reduction, and fixation.

Methods: Between January 2017 and December 2017, 4 patients with old SCFD who underwent posterior unlocking of facet joints under endoscopy followed by anterior decompression, reduction, and fixation were enrolled. Read More

CMAJ 2019 07;191(27):E761-E764

Departments of Radiology (Woodworth, Hache), Neurosurgery (Jenkins) and Pathology (Barron), Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld.

Spine J 2019 12 26;19(12):1995-2002. Epub 2019 Jun 26.

Department of Neurosurgery, PLA General Hospital, 28 Fuxing Rd, Haidian District, Beijing 100853, China.

Background Context: The mechanical strength provided by internal fixation is crucial for maintaining reduction and facilitating bony fusion. Though satisfactory results with the C1-C2 technique have been acquired in most clinical reports, the related problems of fusion delay and pseudarthrosis still exist. To increase the chance of bony fusion, a transverse connector (TC) is frequently used to augment torsional stiffness of thoracolumbar screw/rod constructs. Read More