[MR diagnosis of degenerative changes in the cervical vertebrae in comparison with cervical myelography].
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Adult↗
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Results for “Cervical Vertebrae”
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Congenital anomaly of the second cervical vertebra predisposing to progressive cervical myelopathy. A case report.
The authors describe a previously unreported constellation of developmental anomalies of the C2 vertebra, which predisposed to the development of cervical myelopathy in a young patient. The embryology of the vertebral column is reviewed briefly, and the origin of each anomaly of the C2 vertebra is traced to one of the two early stages in development as follows: 1) the formation of the mesenchymal vertebra or 2) its induction to cartilage. This case emphasizes the importance of congenital stenosis in the development of cervical myelopathy in young patients. The outcome is favorable when it is treated aggressively.
Cervical Vertebrae↗
Transoral-transpharyngeal approach to the upper cervical vertebrae.
The classical operative approaches to the cervical spine include the posterior one and the anterior exposure along the sternomastoid muscle. However, neither of these are helpful in exposing the upper cervical vertebrae, especially the odontoid process, atlas, and axis. We have used the transoral-transpharyngeal exposure for lesions of the odontoid process and upper (first to third) cervical vertebrae in six patients. The pathologic processes included rheumatoid disease and fracture of the cervical vertebrae, suspected tumor with compression of the spinal cord, basilar invagination, and compression of the medulla. In all six patients, the exposure was excellent, and postoperative morbidity was minimal. Tracheostomy was performed routinely in all these patients. In five patients, vertebral stabilization was performed as a secondary procedure a few days after the initial anterior decompressive surgery. The transoral-transpharyngeal approach appears to be relatively easy. It is associated with minimal complications and provides excellent exposure of the odontoid and upper cervical vertebrae for a microneurosurgical approach. Modifications of this approach include incision of the soft palate, excision of a portion of the hard palate, and, occasionally, transmandibular median labio-mandibulo-glossotomy (Trotter's) approach. Although the technique was described initially approximately 35 years ago, this neglected anatomic approach will facilitate cooperative efforts between head and neck surgeons and neurosurgeons.
Adult↗
[Correlation of the (rotation) traction force with the pressure in the nucleus pulposus in multiple segments of the cervical vertebra].
OBJECTIVE: To study the correlation between cervical (rotation) traction force and the pressure in the cervical nucleus pulposus based on an examination of multiple segments of the cervical vertebra. METHODS: The data obtained from our observation were processed by the exponential model, and the changes in the pressure reduction (P) in the cervical nucleus pulposus were analyzed. RESULTS: When stretching followed by rotation was imposed on the cervical vertebra, an increase of P was first observed due to the stretching before a reduction in P caused by the rotation. The P of C(3-4) segments was constantly greater than that of C(5-6) segments, while the changes in P of C(4-5) followed different patterns. CONCLUSION: Changes of P in each segment of the cervical vertebra are similar in response to the load force, and there is no correlation of monotonic increase or decrease between the changes of P and the location of the cervical vertebra.
Cervical Vertebrae↗
[On a case of vertebra plana totalis with 8 cervical vertebrae].
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Cervical Vertebrae↗
Morphological analysis of cervical vertebrae in ataxic foals.
Morphological differences between cervical vertebrae were statistically analyzed in ataxic foals to clarify abnormal structural factors in the pathogenesis of this problem. At first, multiple regression analysis and cluster analysis were performed with 28 variables in C3-C7 of 39 control foals without lameness. As a result, there were no sex differences in the growth of all cervical vertebral sites, and the most suitable categorization of the age of the foals was 3 clusters of 8 months old or younger, 9-12 months old and 13 months old or older in any sites in the cervical vertebrae. Twenty-eight ataxic and 19 control foals at the age of 13 months or older were then used for discriminant analysis with 20 variables. As a result, 1-7 variables on C3-C7 were selected for sufficient discrimination, in which the heights of the cranial and caudal orifices of the spinal canal, longitudinal length of the vertebral head and height of the vertebral fossa strongly contributed to the discrimination of all the cervical vertebrae. In addition, the widths and longitudinal diameters of the articular processes on articular surfaces strongly contributed to the discrimination of the caudal region of the neck. In conclusion, it was suggested that the lesion in the cervical spinal cord observed in ataxic foals was caused by morphological abnormalities including osteochondrosis and subsequent degenerative joint disease in the cervical vertebrae.
Animals↗
Anatomical variants of the cervical vertebrae and the first thoracic vertebra in man.
Anatomical variants of the cervical part of the human spine were investigated. Morphological variants were studied on 100 cervical vertebrae (37 female and 63 male). The greatest variability was demonstrated by the first cervical vertebra or atlas. The presence of some accessory bony arches embracing the vertebral artery was observed, namely the posterior bridge restraining the arcuate foramen (13.8%) and the lateral bridge restraining the transversovertical foramen (2%). Split posterior (3%) or anterior (1%) arches of the atlas were also encountered in this material. The superior articular face of the atlas divided into two parts was found in 47.8%. Variants of the remaining cervical vertebrae were limited only to the presence of a division of the transverse process foramina or their incomplete closure. Some of these anatomical variants may be a cause of certain clinical symptoms which have previously been described in the literature.
Cervical Vertebrae↗
Why do almost all mammals have seven cervical vertebrae? Developmental constraints, Hox genes, and cancer.
Mammals have seven cervical vertebrae, a number that remains remarkably constant. I propose that the lack of variation is caused by developmental constraints: to wit, changes in Hox gene expression, which lead to changes in the number of cervical vertebrae, are associated with neural problems and with an increased susceptibility to early childhood cancer and stillbirths. In vertebrates, Hox genes are involved in the development of the skeletal axis and the nervous system, among other things. In humans and mice, Hox genes have been shown also to be involved in the normal and abnormal (cancer) proliferation of cell lines; several types of cancer in young children are associated with abnormalities in Hox gene expression and congenital anomalies. In these embryonal cancers the incidence of a cervical rib (a rib on the seventh cervical vertebra, a homeotic transformation of a cervical vertebra towards a thoracic-type vertebra) appears to be increased. The minimal estimate of the selection coefficient acting against these mutations is about 12%. In birds and reptiles variations in the number of cervical vertebrae have frequently occurred and there is often intraspecific variability. A review of the veterinary literature shows that cancer rates appear lower in birds and reptiles than in mammals. The low susceptibility to cancer in these classes probably prevents the deleterious pleiotropic effect of neonatal cancer when changes in cervical vertebral number occur. In mammals there is, thus, a coupling between the development of the axial skeleton and other functions (including the proliferations of cell lines). The coupling of functions is either a conserved trait that is also present in reptiles and birds, but without apparent deleterious effects, or the coupling is new to mammals due to a change in the functioning of Hox genes. The cost of the coupling of functions in mammals appears to be an increased risk for neural problems, neonatal cancer, stillbirths, and a constraint on the variability of cervical vertebral number.
Animals↗
Quantitative anatomy of the second cervical vertebra.
STUDY DESIGN: While the gross anatomy of the second cervical vertebra has been well described qualitatively, our evolving understanding of spinal pathology makes it necessary for the modern surgeon to have more quantitative information. OBJECTIVES: The authors' goal was to directly measure clinically relevant dimensions of the second cervical vertebra, using a collection of anatomic specimens. SUMMARY OF BACKGROUND DATA: Many existing studies have been based on analysis of radiographic images, which are subject to errors of magnification, rotation, and projection. Several recent studies of dens morphology have been based on direct measurements. These studies in general did not extend to the lateral masses or posterior ring, however. METHODS: Direct measurements using digital calipers and goniometer were taken from 51 dried human second cervical vertebrae. The maximum and minimum anteroposterior and lateral diameters of the dens, and the anteroposterior and lateral diameters of the end-plate and foramen and were measured. The heights of the dens and superior facet surfaces were measured relative to a plane defined by the anterior-most point of the inferior endplate and the inferior-most points of the inferior facet surfaces. RESULTS: The greatest variation was found in the dens angle, with specimen dens angles ranging from -2 degrees to 42 degrees. The most significant correlations were between the total height of the vertebra and the height to the base of the dens (r2 = 0.81), between the total height of the vertebra and the maximum lateral diameter of the dens (r2 = 0.77), and between the minimum lateral diameter of the dens and the maximum lateral diameter of the dens (r2 = 0.63). CONCLUSIONS: The dimensions measured in this study confirm a significant degree of anatomic variation in the second cervical vertebra, and show no important correlations among the various measured dimensions. In particular, no significant correlation was found between dens height and canal diameter. Dens angle in the sagittal plane was the most variable measurement.
Axis, Cervical Vertebra↗
Functional morphology of the first cervical vertebra in humans and nonhuman primates.
The cervical vertebral column bears or balances the weight of the head supported by the nuchal muscles that partly originate from the cervical vertebrae. The position of the head relative to the vertebral column, and consequently locomotion and posture behavior, could thus be associated with the form of the cervical vertebrae. In spite of this assumption and some empirical indications along these lines, primate vertebral morphologies have been reported to be very similar and not clearly related to locomotion. We therefore study the relationship between the morphology of the first cervical vertebra, the atlas, and the locomotion pattern within primates using a geometric morphometric approach. Our analysis is based on a total of 116 vertebrae of adult Homo sapiens, Gorilla gorilla, Pan troglodytes, Pongo pygmaeus, Hylobates lar, Macaca mulatta, Papio hamadryas, Ateles geoffroyi, and Alouatta palliata. On each atlas, 56 landmarks were digitized and superimposed by Procrustes registration. The resulting shape variables were analyzed by principal component analysis, multivariate regression, and partial least-squares analysis. We found that the nine primate species differ clearly in their atlas morphology and that allometric shape change is distinct between the nonhuman primates and Homo sapiens. We could further identify morphological features that relate to the species' locomotion pattern. Human atlas shape, however, cannot be predicted by an extrapolation of the nonhuman primate model. This implies that either the primate atlas is generalized enough to allow bipedal locomotion or else the human atlas morphology is a unique adaptation different from that in the more orthograde nonhuman primates.
Alouatta↗
Transoral resection and reconstruction for primary osteogenic sarcoma of the second cervical vertebra.
STUDY DESIGN: A case of primary osteogenic sarcoma at the second cervical vertebra is reported. OBJECTIVES: To document an osteogenic sarcoma of the second cervical vertebra and its treatment, and to review the literature. SUMMARY OF BACKGROUND DATA: Primary osteosarcoma of the cervical spine is encountered infrequently, and its location in the upper cervical spine is extremely rare. Two cases of osteosarcoma in the second cervical vertebra have been reported previously in the literature. METHODS: A 15-year-old boy with a mass lesion in the axis was treated surgically by anterior transoral resection, fusion, and reconstruction of the defect with a Harms cage. The resection was completed by posterior excision of the remaining vertebral elements, and by occipitocervical instrumentation and fusion between the occiput and the fourth cervical vertebra. The therapy was completed by adjuvant chemotherapy and radiotherapy. RESULTS: At this writing, 40 months after the initial diagnosis, the patient was in a good state of health with his underlying disease. CONCLUSIONS: The axis is a very rare location for the occurrence of primary osteosarcoma. Osteosarcoma may histologically mimic chondroblastoma. The axis can be surgically exposed, resected, and instrumented transorally. The stabilization must be augmented by posterior occipitocervical fusion.
Adolescent↗
Relationships between radiography of cervical vertebrae and histopathology of the cervical cord in wobbling 19 foals.
Nineteen wobbling foals (17 males and 2 females) showing lameness of hindlimbs at 6 to 21 months of age were investigated radiographically and histopathologically. Minimum sagittal diameter (MSD), minimum flexion diameter (MFD) and minimum dural sagittal diameter (MDD) were measured on plain radiograms or myelograms taken at neutral and flexed positions as indicators of narrowed vertebral canal. After necropsy, the cervical spines and the spinal cord were examined macroscopically and respectively the relationships between radiographic findings and the corresponding morphological lesions were evaluated. Radiographically, lower values than each minimum reference limits were recorded in 14 foals in MSD, 5 foals in MFD and 6 foals in MDD, respectively. According to the histopathologic examination, the disappearance of axons and myelin sheaths, vacuolated spongy degeneration and appearance of macrophages were recognized symmetrically in the white matter of the cervical cord. These lesions were centrally located at the spinal cord radiographically demonstrated as compressed sites in 12 out of 17 foals examined. Macroscopically, asymmetrical overgrowth of one side of the process, encroachment of articular processes into the intervertebral foramina and proliferation of bone around articular facets were observed in the articular processes of bone specimens in the caudal neck of 6 foals. In conclusion, the equine incoordination might mainly be caused by the cervical stenotic myelopathy resulting from cervical vertebral malformation, and therefore the cervical vertebral radiography, especially myelography, is quite very important and effective for the diagnosis of wobbling foals.
Animals↗
The ossification of the costal element of the seventh cervical vertebra with particular reference to cervical ribs.
During 16 years of study at Northwick Park Hospital 715 fetuses were radiographed to determine the incidence of skeletal malformations. A technique using low kV and industrial film provided higher resolution radiographs than would have been possible in live births because of dose considerations. Gestational age calculated from LMP and ultrasound findings ranged from less than 18 weeks to 42 weeks. A separate costal element of C7, the possible precursor of a cervical rib, could be identified in 63% of fetuses. Males outnumbered females 403:311 but there was no intersex difference in the presence of such rudimentary cervical ribs with 63 and 64% respectively in each group. Of the 452 cases with separate costal elements, 73% were bilateral. Of the unilateral group 60% occurred on the right and 40% on the left. There was no significant difference in the incidence between the gestational age groups from 20 weeks onwards, confirming that the disappearance of the separate element occurs predominantly after birth, 394 cases (87%) of fetuses had an otherwise normal skeleton.
Cervical Rib Syndrome↗
Neurological and osteological definitions of cervical vertebrae in mammals.
The presence of seven cervical vertebrae is an almost universal mammalian trait. The posterior boundary of the cervical series is traditionally defined osteologically, but its location is also predictable using neurological markers of the brachial plexus. The existence of three living mammalian genera with osteologically defined cervical counts other than seven offers the opportunity to examine the coincidence of osteological and neurological definitions of the term 'cervical'. Despite variations in rib and articular processes of cervical vertebrae dissections of the brachial plexuses of these genera reveal that neurological and osteological markers of the cervical series define the same, nontraditional, posterior boundaries of the series. Subdivision of the predetermined cervical mesoderm into a nontraditional number of segments has not altered the relationship of the limb or its innervation to the cervical/thoracic boundary. This nontraditional subdivision appears to have evolved separately at least three times.
Animals↗
[Observation of cervical vertebrae and estimation of their bone age].
There are two objectives in this study: the first is to estimate skeletal age by lateral cephalomatric roentgengram of cervical vertebrae instead of X-ray of handwrist, the second is to study the rules of cervical vertebrae's growth and development of children from Beijing. The Auto CAD 12.0 computer software was used in measuring lateral cephalomatric roentgengrams of cervical vertebrae of 280 children from Beijing aged 9-15. The shape of cervical vertebrae of children with that of adults on X-ray films was compared, and the growth and development of cervical vertebrae of 9-15 years old children from Beijing was observed. We found out that the rapid growth period of cervical vertebrae was 12-14 years old for girls and 14-15 years old for boys. During puberty, the change of vertebrae's shape has no difference between male and female. 42 female and 28 male teenagers from the 280 aged 9-13 years old were taken X-ray films of left handwrist. The comparison between the films and roentgengrams shows that the appearance of sesamoid of hand and the concavity of the second vertebrae body is at the same time, which means that the beginning of rapid growth period can be estimated by the lateral cephalometric roentgengrams of cervical vertebrae.
Adolescent↗
[Degenerative blockbuilding between the 2d and 3d cervical vertebrae].
Two from 59 anatomical samples of the upper cervical spine show an osseous fusion of the axis and the third cervical vertebra. Moreover, a non-osseous but very rigid union between the second and the third cervical vertebrae is observed in five cases. Generally the fusions seem to be caused by degenerative processes. For these, a more horizontal or vertical orientation of the articular facets of the vertebral joints is important. The failure of development of the dorsal part of the axis' transverse process promotes degenerative alterations.
Aged↗
[Surgical treatment of fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae].
OBJECTIVE: To discuss the value of anterior operation in fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae. METHODS: From 1997, 21 patients with fracture-dislocation of connect of cervical vertebra and thoracic vertebrae were operated on. The interval between injury and operation was within 24 hours in 4 cases, 2-7 days in 9 cases, 8-14 days in 3 cases and within 4 weeks in 5 cases. The locations were C6,7 in 7 cases, C7 in 9 cases and T1 in 5 cases. The nerves function of spinal of all the cases have different degrees of injury. Classification of Frankel were the following: 3 cases of grade A, 6 cases of grade B, 9 cases of grade C, and 3 cases of grade D. The operative procedure included the following: anterior operation of cervical vertebrae; incision of most fracture vertebral body to decompress; transplantation of ilium bone grafting fusion; and internal fixation of anterior cervical vertebrae with locking-steel. RESULTS: In 21 patients, 1 died of accompanying by pulmonary infection; 20 were followed up 8 months to 3 years with an average of 21 months. All transplanted ilium had fused. The nerve function of spinal cord had recovered in different degrees(2 cases of grade A, 1 case of grade C, 9 cases of grade D and 8 cases of grade E); the turn of vertebral column was normal. No internal fixation failed. CONCLUSION: Anterior operation is a better way to treat fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae with easy operation, less complications, satisfactory reduction of fracture and good stability.
Adult↗
[Study on the maturation of cervical vertebra for 208 cases Shanghai adolescents growth]
OBJECTIVE:To establish a set of normal values of maturation stages of cervical vertebra for Shanghai adolescents and to provide valid reference index for assessing skeletal age while making diagnosis and treatment plan.METHODS:208 Shanghai adolescents from 11 to 15 years of age were investigated by lateral cephalometric radiographs. The growth status and the relationship of C2-C5 cervical vertebra were observed. RESULTS:The anterior and posterior vertical heights and areas of C2-C5 cervical vertebra increased progressively along with the age, the shapes of cervical vertebra bodies varied regularly. Although female goes into the young quick growing period 2 years earlier than male, the shape changes have no difference between gender. The established standard values of maturation stages of cervical vertebra for Shanghai 11-15 years old adolescents revealed that the growth and development of Shanghai adolescents are getting earlier when comparing with that of GuangDong province. CONCLUSION: The morphological variation of cervical vertebra can be used as an indicator of skeletal age to determine adolescents' growth and development status.
Journal Article↗