SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The injury known as hangman's fracture is described. The patients seen in Belfast with this injury over the past 20 years are reviewed. It is noted that there is disagreement in the literature over the best form of treatment and we strongly advocate the case for conservative management. We also put forward a simple explanation for the absence of neurological sequelae associated with the accidental form of this injury.
A prospective study of 39 patients with traumatic spondylolisthesis of the axis is reported. Classification of the fracture was based on the criteria of White and Punjabi (1978). In previous studies (Effendi et al., 1981; Levine and Edwards, 1985) stability of the undisplaced and slightly displaced fracture was based on flexion/extension radiographs. Union was obtained in all fractures without using a rigid cervical orthosis. We feel that assessing stability dynamically soon after injury when there is marked muscle spasm does not provide an accurate assessment, nor does it not alter the management of these injuries, as shown in this study.
Explore the source record for details and available documents.
In the period from 1981 to 1985, 32 odontoid fractures were treated in the National Institute of Traumatology. In four cases anterior stabilization was provided with compression screws inserted from the front. Two cases of odontoid fracture are shown, one accompanied by ventral, the other by dorsal dislocation. A brief review is provided of the results obtained with different methods of treatment drawing on the international literature.
A series of 42 patients with fractures of the dens is reported. All patients were initially treated on traction and then immobilized in a SOMI brace or a cervical collar with a chin piece. Union was obtained in 37 patients. There has been no case of delayed myelopathy in the severely malunited fractures.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We have reviewed the multiplicity of lesions present in the cervical spine in the adult with RA. The clinicoradiographic correlations are presented, and the techniques available for appropriate investigation are suggested. Readily available, conventional radiology provides useful information for the majority of patients. A standardized system of weighting and grading roentgenographic changes would be a welcome area of future research. Myelography and angiography should be considered in every patient before cervical spine surgery. CT evaluation should be reserved for those without a readily appreciable cause for myelopathy and those undergoing cervical surgical procedures.
In our patients, zygapophyseal joint fusion was the most frequent and characteristic roentgenographic finding of cervical spine involvement in JRA. It was not associated with any subset of patients. Atlanto-dens interval greater than 4.5 mm was present in 20% of patients, but was not related to the development of neurologic manifestations. Mild enthesopathic-like changes around the upper cervical area were observed in some children. In patients with severe long standing disease and extensive zygapophyseal joint fusion, longitudinal ligament calcification was observed. Growth disturbances of the cervical spine were more frequently observed in patients with zygapophyseal joint fusion and earlier onset of disease.
Explore the source record for details and available documents.
The anatomy needed to plan microoperative approaches to the region of the foramen magnum was examined in 25 cadaveric heads. The structures examined included the lower cranial and upper spinal nerves, the caudal brain stem and rostral spinal cord, the vertebral artery and its branches, the veins and dural sinuses at the craniovertebral junction, and the ligaments and muscles uniting the atlas, axis, and occipital bone. The transoral, transpalatal, labiomandibular, glossolabiomandibular, transsphenoidal, transcranial-transbasal, transcervical, and suboccipital operative approaches to the region are also reviewed.
A 21-year-old Japanese man with basilar impression with an anomalous configuration of the odontoid process and many other vertebral anomalies is reported. We thought that posterior decompression alone would be hazardous; therefore, in one session, the odontoid tip and anterior arch of the atlas were removed transorally, and posterior fixation between the occipital squama and the lamina of C-3 using acrylic plastic was performed. This treatment resulted in marked clinical improvement and required only a short hospital stay.
A type 2 odontoid fracture in a nine-month-old infant is presented. To the best of our knowledge, this case has the youngest reported patient with this type of injury having occurred by a mechanism other than direct trauma at birth. The purpose of this communication is to review odontoid fractures in the pediatric age group.
With subaxial cervical spine fractures, it has not been established which injuries can be adequately stabilized by external orthoses and which will require surgical stabilization. After review of 64 consecutive patients with C3-C7 spinal injuries, fracture characteristics on admission roentgenograms were identified that accurately predict the success or failure of nonoperative management. These include evidence of severe ligamentous injury (SLI) and severe vertebral body injury (SVBI). The presence of SLI, SVBI, or both SLI and SVBI correlated strongly with nonoperative stabilization failure (p < 0.001, p = 0.002, and p = 0.004, respectively). Injuries without SLI or SVBI were all successfully stabilized by cervical orthoses. Additionally, characterizing injuries by evidence of SLI and SVBI directs the approach for surgical stabilization.