Damaged ligaments at the craniocervical junction presenting as an extradural tumour: a differential diagnosis in the elderly.
(66/133)
An extradural mass at the craniocervical junction causing progressive neurological disability in five elderly patients is described. The lesion, which might be confused with a meningioma or other tumour, is composed of amorphous degenerate fibrocartilaginous material and could be due to degeneration of the ligaments responsible for atlanto-axial stability. Recognition of the condition early is important as the patient's clinical condition will deteriorate without decompression. Anterior transoral removal is relatively simple, unlike surgery for tumours in the area, and will not destabilise the craniovertebral junction. It is likely that a proportion of these lesions are undetected, misdiagnosed or untreated to the detriment of the patient. (+info)
The single transoral approach for Os odontoideum with irreducible atlantoaxial dislocation.
(67/133)
Extended endoscopic endonasal approach to the anterior cranio-vertebral junction: anatomic study.
(68/133)
OBJECTIVE: Our aim in this study was to identify the endoscopic anatomy of the anterior cranio-vertebral junction to be able to perform minimal invasive endoscopic surgical procedures to this region (such as dens resection) safely with better postoperative performance of the patients. MATERIAL AND METHODS: Five fresh adult cadavers were studied (n=5). We used Karl Storz 0 and 30 degree, 4mm, 18 cm and 30 cm rod lens rigid endoscope in our dissections. After cadaveric specimen preparation, we approached the anterior cranio-vertebral junction by binostril extended endoscopic endonasal approach. RESULTS: The cranio-vertebral junction was located by orientating the endoscope between -10 to +10 degrees. The rhinopharynx was widely exposable after resection of the vomer. The safe lateral limit of this approach was the occipital condyles and foramen lacerum. We could perform odontoid process resection with a pure endoscopic endonasal approach. CONCLUSION: Our anatomic study offered the facility to learn the endoscopic anatomy of the anterior cranio-vertebral junction and understand the appropriate approaches to this region. Our approach is appropriate for treatment of some pathologies of this region, with less invasiveness compared to the traditional transoral approach. (+info)
Study on accuracy and interobserver reliability of the assessment of odontoid fracture union using plain radiographs or CT scans.
(69/133)
Imaging findings of chronic subluxation of the os odontoideum and cervical myelopathy in a child with Beare-Stevenson cutis gyrata syndrome after surgery to the head and neck.
(70/133)
INTRODUCTION: Although uncommon, fractures of the os odontoideum are known to occur in children under 7 years old, following acute trauma. CLINICAL PICTURE: We report a case of chronic subluxation of the os odontoideum resulting in cervical myelopathy in a child with Beare-Stevenson cutis gyrata syndrome after surgery to the head and neck. TREATMENT AND OUTCOME: The patient was initially put in a Halo vest, following which occipital cervical fusion was performed. CONCLUSION: Subluxations and fractures at the odontoid synchondrosis are rare but should be anticipated in young children with risk factors for instability of the cervical spine. (+info)
Odontoid metastasis: a potential lethal complication.
(71/133)