Posterior atlantal lateral mass fixation technique with polyaxial screw and rod fixation system.
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OBJECTIVE: Atlantoaxial instability may result from various pathologic conditions and operative treatment may be required to correct the deformity, provide stability and prevent neurological deficits. We presented our clinic's experience using C1-C2 fusion with polyaxial screw and rod fixation for C1 and C2 instability for various reasons. METHODS AND MATERIAL: Four patients with atlantoaxial instability were operated using polyaxial C1 lateral mass and C2 lateral mass or pedicle screws. The mean age of the patients was 44+/-14,07 years. RESULTS: Satisfactory screw placement was achieved in all patients. There were no vertebral artery injuries, C2 nerve root injuries or spinal cord injuries. No per-operative or early postoperative instrumentation failure was observed. CONCLUSIONS: C1 lateral mass/C2 pedicle polyaxial screw fixation is a safe technique and can be used to achieve rigid and immediate atlantoaxial stabilization. (+info)
Transmandibular approach for upper cervical pathologies: report of 2 cases and review of the literature.
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In routine surgical practice, anterior approaches are not often used to treat upper cervical pathologies. Such lesions can be difficult to access surgically. This article describes 2 cases in which the transmandibular approach was used to address anterior upper cervical pathology. One case was a chordoma invading the C2-C3 vertebrae and the other case was atlanto-axial instability. Neurological examination revealed myelopathy in both cases. Each patient had already undergone occipito-cervical fusion at a different center and, thus, had limited neck extension and mouth-opening ability. In the first case, the tumor was totally excised. In the second, the dens was removed. We believe that the transmandibular approach is the best option for patients with limited neck mobility and restricted mouth-opening ability. (+info)
Artificial atlanto-odontoid joint replacement through a transoral approach.
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Transoral approach to CT-guided C2 interventions.
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BACKGROUND: Lesions involving C2 are unique as it is challenging to approach these lesions. The transoral approach to C2 lesions has been extensively used by surgeons and increasingly used by interventional radiologists for vertebroplasty as it is safer and less demanding than other approaches like anterolateral and posterolateral (transpedicular). However, using this approach for image-guided biopsies is little described in literature with a few cases described so far being under fluoroscopic guidance. We describe a series of 5 procedures using transoral approach - 4 biopsies (and one vertebroplasty that was published earlier) on C2 lesions under CT guidance. To our knowledge, our series is the first one where the transoral biopsies were performed using Computed Tomography (CT) guidance. OBJECTIVE: To describe our initial experience with the transoral approach to image-guided biopsies on C2 vertebra and its relative advantages and disadvantages. METHODS: We performed 5 procedures - 4 biopsies (and one vertebroplasty published earlier) on different types of lesions involving C2, through the transoral approach, using CT guidance under general anesthesia and appropriate precautions to reduce potential complications like infection, hemorrhage, etc. RESULTS: The procedures were well tolerated by the patients without any complications, immediately as well as at follow-up. All the biopsies in our series were technically successful without any minor or major complications. The biopsy yield was 50% which may be due to the thinner needles used. CONCLUSION: CT-guided transoral approach to biopsies on C2 lesions is a direct, safe, and precise technique when performed with appropriate precautions. (+info)
Tetraplegia and respiratory failure following mild cervical trauma in a child with Cornelia De Lange syndrome.
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Here we report a 6-year-old female patient with Cornelia de Lange syndrome who developed tetraplegia and respiratory failure after a seemingly trivial spinal trauma due to an spinal malformation that has not yet been described. (+info)
Radiological analysis of ponticulus posticus in Koreans.
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