Acute combination fracture of atlas and axis: "triple" anterior screw fixation in a 92-year-old man: technical note.
Journal - Surgical neurology (United States )
BACKGROUND: The combination of odontoid and bilateral transarticular C1-C2 anterior screw fixation is a recent addition in treating C1-type II odontoid fractures. When feasible, it ensures early maximal stability, even if it slightly reduces the mobility of C1-C2 complex. We report a case of combination atlas-type II odontoid fracture that occurred in a 92-year-old man. The instability was treated with odontoid screw fixation and anterior bilateral C1-C2 transarticular screw fixation in a single stage. The aim of the article is to describe the feasibility of "triple" anterior screw fixation in the presence of C1-type II odontoid fracture. METHODS: The diagnosis, treatment, and outcome of a 92-year-old patient with mild tetraparesis caused by C1-type II odontoid fracture were assessed. RESULTS: Cervical x-rays, computed tomographic scan, and magnetic resonance imaging demonstrated a fracture of posterior arch of C1, associated with type II odontoid fracture and with presumable damage of C1 transverse ligament. Magnetic resonance imaging also showed a high cervical centromedullary area slightly hyperintense in T1-weighted images. Treatment consisted of odontoid and bilateral C1-C2 transarticular screw fixation with single anterior approach. The admission neurologic conditions improved and the patient was early mobilized. CONCLUSIONS: The authors suggest that in presence of C1-type II odontoid fracture, the triple anterior screw fixation has to be taken into account as salvage procedure, especially if other methods of stabilization failed or cannot be safely performed. This technique seems to be safety feasible also in old patients, as our report and the experience of others confirm.
|ISSN : ||0090-3019|
|Mesh Heading : ||Acute Disease Aged, 80 and over Cervical Atlas Humans Magnetic Resonance Imaging Male Odontoid Process Spinal Fractures Spinal Fusion Tomography, X-Ray Computed radiography radiography radiography instrumentation|
|Mesh Heading Relevant : ||Bone Screws injuries injuries surgery methods|
Anterior cervical fusion with carbon fiber cage containing coralline hydroxyapatite: preliminary observations in 45 consecutive cases of soft-disc herniation.
Journal - Journal of neurosurgery (United States )
OBJECT: The purposes of bone substitutes for anterior cervical fusion (ACF) are immediate biomechanical support and osteointegration of the graft. The authors report their preliminary results in performing ACF in which carbon fiber cages (CFCs) containing coralline hydroxyapatite (HA) are used as bone substitute. METHODS: During a 24-month period, anterior microsurgical discectomy was performed in 45 consecutive patients for soft-disc cervical herniation. In all cases ACF was performed using a CFC containing a core of granulated coralline HA. Fifty-seven CFCs were implanted in 33 single-level and 12 two-level procedures. The mean operative time was 83 minutes for one-level and 97 minutes for two-level procedures. The mean hospital stay was 1.51 days, and there were no permanent complications. At a mean follow up of 22.3 months, the pain had decreased or disappeared in all patients, and the patients' satisfaction rate was very high. Good results were also obtained in patients who smoked cigarettes. Patients underwent radiographic evaluation at Day 1, and 1, 3, 6, and 12 months postoperatively. Implant-related complications were not observed and revision surgeries were not performed. Twelve-month cervical x-ray films demonstrated complete fusion in all cases, without evidence of breakage, collapse, pseudarthrosis, subsidence, angular deformity, or protrusion. Signs of pathological absorption and necrosis were not found in contiguous vertebral bodies, and inflammatory reactions were never seen around cages. CONCLUSIONS: These preliminary results suggest that implants composed of CFC containing granulated coralline HA are promising bone substitutes to be used in ACF, with a good rate of incorporation and no significant complications.
|ISSN : ||0022-3085|
|Mesh Heading : ||Adult Aged Bone Substitutes Carbon Ceramics Cervical Vertebrae Female Humans Hydroxyapatites Intervertebral Disk Displacement Male Middle Aged Reproducibility of Results Spinal Fusion Treatment Outcome radiography radiography|
|Mesh Heading Relevant : ||Prostheses and Implants therapeutic use therapeutic use therapeutic use surgery therapeutic use surgery instrumentation methods|
Symptomatic cystic dilatation of V ventricle: case report and review of the literature.
Journal - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (GERMANY )
We report a case of V ventricular cystic dilatation, presenting with specific neurological symptoms including low back pain, bilateral sciatica, weakness of dorsiflexion, and urinary retention. MRI showed a large cystic dilatation of the ventriculus terminalis. Surgical fenestration of the cyst allowed complete relief from symptoms and remission of the neurological deficit.
|ISSN : ||0940-6719|
|Mesh Heading : ||Adult Brain Diseases Cysts Humans Magnetic Resonance Imaging Nervous System Diseases complications diagnosis surgery diagnosis etiology|
|Mesh Heading Relevant : ||Cerebral Ventricles complications surgery|
Cervical locked facet: operative management.
Journal - Journal of neurosurgical sciences (ITALY )
Cervical locked facet represent 5.6% of cervical lesion. If an identity of views is present in the use of tractions, we can't say as for the setting fixation techniques. Our cases histories (13 cases) and the experience of other authors incline us to support a precocious surgical treatment characterized by a posterior approach and then anterior in the not reduced cases and a single anterior approach in the reduced cases in anesthesia. The good alignment and the attain stability with the double access, but still more the convinction that the lesions of intervertebral disk and ligamentous tissues (as demonstration at the RMN) is always to remove, support us in the undertaken therapeutic attitude.
|ISSN : ||0390-5616|
|Mesh Heading : ||Adult Decompression, Surgical Female Humans Magnetic Resonance Spectroscopy Male Middle Aged Nervous System Orthopedic Fixation Devices Postoperative Period Spinal Injuries Tomography, X-Ray Computed physiopathology physiopathology radiography|
|Mesh Heading Relevant : ||surgery|
Halifax interlaminar clamps for posterior atlanto-axial arthrodesis with spinal fusion by "H" bone+graft.
Journal - Journal of neurosurgical sciences (ITALY )
The use of Halifax interlaminar clamps in posterior arthrodesis for atlanto-axial instabilities has recently been reported. The four Anderson II fractures submitted were surgically treated by posterior arthrodesis with Halifax clamps and bilateral "H" shaped bone-grafts obtained from the iliac crest. Only in the first case--initially treated without fusion--a review of the system became necessary due to the loosening of one clamp. No post-operative neurological complications appeared and non malunion or nonunion occurred at follow-up. Posterior arthrodesis with Halifax clamps does not involve any complication connected with the use of metal wire and the association of posterior fusion by lateral "H" shaped bone grafts ensures a stable and physiological reduction of dens fractures and atlanto-axial luxations/subluxations often associated.
|ISSN : ||0390-5616|
|Mesh Heading : ||Adult Atlanto-Axial Joint Axis Bone Transplantation Cervical Atlas Dislocations Female Humans Ilium Joint Instability Magnetic Resonance Imaging Male Middle Aged Odontoid Process Spinal Cord Compression Spinal Fractures Spinal Fusion surgery transplantation injuries etiology prevention & control surgery methods|
|Mesh Heading Relevant : ||Internal Fixators surgery injuries methods injuries surgery surgery instrumentation|