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PubMed2004

Upper cervical vertebrae movement during intubating laryngeal mask, fibreoptic and direct laryngoscopy: a video-fluoroscopic study.

BACKGROUND AND OBJECTIVE: Minimizing cervical vertebrae motion during endotracheal intubation is important in patients with cervical instability. The aim of this study was to compare upper cervical spine extension during endotracheal intubation using three different techniques. METHODS: Duration of intubation and movement of upper cervical vertebrae during endotracheal intubation were compared in 33 patients undergoing lumbar laminectomy. Patients requiring tracheal intubation under general anaesthesia and neuromuscular blockade were randomly allocated into three groups - direct laryngoscopy, intubating laryngeal mask (LM) airway and fibreoptic laryngoscopy. The procedure was recorded by video-fluoroscopy and analysed with computer-assisted measurements. The maximum movement of the C1/C2 and C2/C3 vertebrae during intubation were obtained. Data were analysed using one-way analysis of variance with Bonferroni and Kruskal-Wallis tests. RESULTS: We found statistically significant movement between the first and second, but not between the second and third cervical vertebrae. The mean (+/-SD) movement at C1/C2 was 10.2 +/- 7.3 degrees with direct laryngoscopy, 5.0 +/- 6.3 degrees with LM and 1.6 +/- 3.2 degrees with fibreoptic laryngoscopy. This difference was statistically significant (P = 0.01) between the direct and fibreoptic laryngoscopy groups. The maximum movement at C2/C3 was 2.2 +/- 10.1 degrees with direct laryngoscopy, 3.5 +/- 5.1 degrees with LM and 0.5 +/- 3.2 degrees with fibreoptic laryngoscopy. Duration of intubation was significantly longer in the intubating LM group (P < 0.001). CONCLUSION: We conclude that fibreoptic laryngoscopy is the more suitable intubation technique when cervical spine movement is not desired.

Adult↗
PubMed1994

Homeotic transformation of cervical vertebrae in Hoxa-4 mutant mice.

Hoxa-4 (previously known as Hox-1.4) is a mouse homeobox-containing gene that is expressed in the presumptive hindbrain and spinal cord, prevertebrae, and other tissues during embryogenesis. To understand the role of Hoxa-4 during development, we generated Hoxa-4 mutant mice. Homozygous mutants were viable and fertile. Analysis of neonatal skeletons revealed the development of ribs on the seventh cervical vertebra at variable penetrance and expressivity. A low frequency of alterations in sternal morphogenesis was also observed. In addition, we analyzed the skeletons of transgenic mice that overexpress Hoxa-4 and found that the formation of the small rib anlagen that often develop on the seventh cervical vertebra was suppressed. Analysis of adult homozygous mutant skeletons revealed that the dorsal process normally associated with the second cervical vertebra was also found on the third cervical vertebra. These results demonstrate that Hoxa-4 plays a role in conferring positional information along the anteroposterior axis to specify the identity of the third and the seventh cervical vertebrae.

Animals↗
PubMed1984

Radiology of postnatal skeletal development. XII. The second cervical vertebra.

The development of the second cervical vertebra is complex. The dens (odontoid process) develops two primary ossification centers that usually coalesce within three months following birth. These centers are separated from the primary ossification center of the vertebral centrum by a cartilaginous region--the dentocentral synchondrosis. This synchondrosis is a slow growing, bipolar physis similar to the triradiate cartilage of the acetabulum. It contributes to the overall heights of both the dens as well as the vertebral body. Anatomically the dentocentral synchondrosis is below the level of the C1-C2 articulations. This cartilaginous structure is continuous throughout the vertebral body with similar cartilage in both the facet regions as well as the neurocentral synchondroses. These various cartilaginous continuities progressively close--first, the connections to the facet regions, next the neurocentral synchondroses, and finally the dentocentral synchondrosis. Remnants of the incompletely closed dentocentral synchondrosis must be distinguished from a fracture, which usually propagates along this structure as a physeal injury in infants and children. The cartilaginous epiphysis at the tip of the dens may be transverse or may form a cleft ("V") shape. At eight to ten years, a secondary ossification center--the ossiculum terminale--develops in this proximal dens epiphysis. Fusion of the ossiculum terminale with the rest of the dens occurs between ten and thirteen years.

Age Factors↗
PubMed1992

CT and MRI in hydatid disease of cervical vertebrae.

Hydatid disease (HD) of the cervical spine is rare. A case investigated by computed tomography (CT) and magnetic resonance imaging (MRI) is presented. While CT shows the bone lesion better, MRI is superior in demonstrating compression of neural structures. The complementary use of CT and MRI in such cases is suggested.

Adult↗
PubMed1998

[A correlate study on the first cervical vertebra and mandibular growth:A comparison of Shanghai females between 12 and 15 years old]

OBJECTIVE:To study the correlation between the cervical vertebra and mandibular growth and to reveal the intrinsic rule of the progress of individual growth, especially the trend of craniofacial development.METHODS:The morphological features of the first cervical vertebra and certain variables of craniofacial in lateral cephalometric radiographs from Shanghai females between 12 and 15 years old were measured and correlated. A set of normal values of the atlas vertebra shape of Shanghai 12 and 15 years old females were established.RESULTS:There was a significant correlation between D1 and AP of the first cervical vertebra and the direction of mandibular growth at the age of 12. But the association between atlas size ratio (AP/D1) and the mandibular growth is more notable than either AP or D1. When the atlas size ratio increased, a reduction of the amount of mandibular horizontal growth was showed, and the mandibular rotated backward; on the contrary, when the atlas size ratio decreased, the amount of mandibular horizontal growth increased and the mandibular rotated forward. CONCLUSION: The first cervical vertebra can be used as an indicator to predict the mandibular growth.

Journal Article↗
PubMedDate not supplied

Narrow axis: an inherited anomaly of the second cervical vertebra in the rabbit.

Narrow axis, an inherited anomaly resulting in a marked narrowing of the second cervical vertebra, has been observed in strain X/J rabbits. This condition is first recognizable on X rays at 32-33 days gestation. For size comparisons 21 measurements of the first five cervical vertebrae were taken on the skeletons of each of 14 strain X/J animals (7 normal and 7 with narrow axis) and 14 IIIC/J animals for control at two months of age and 27 strain X/J (11 normal and 16 narrow axis) and 14 strain IIIC/J at seven months of age. The primary effect appeared to be a premature fusion of the centrum with its neural arches. Expression is variable. The effect on the posterior articulation of the atlas appeared to be secondary and adaptive. The other cervical vertebrae and the foramen magnum were relatively unaffected. In the 20-year period encompassed in this report, X rays of 3244 rabbits were used for genetic analysis. Inheritance appears to be due to a single autosomal recessive gene with incomplete penetrance. The condition is neither sex-linked nor sex-limited. We propose the symbol nx for the gene responsible for narrow axis in the rabbit.

Animals↗
PubMed1985

[Fusion of the cervical vertebrae of mammals].

Morphogenesis of the cervical vertebrae has been investigated in Dipis sagitt. and in Rattus norvegicus. The main distinctive feature of the Dipis embryos at the mesenchymal stage is their very thin perichordal intervertebral rings. As a result, short cartilaginous vertebral bodies and thin intervertebral discs develop, cervical segments lengthen more slowly than those of the Rattus. Because of the small length of the Dipis cervical segments, the cartilaginous neural arches and the transverse processes of 2-6 vertebrae draw nearer and fuse. Owing to the insufficient development of the Dipis intervertebral discs and the nuclei pulposae, the normal formation of the vertebral epiphyses is disturbed, this results in fusion of the neighbouring osseous vertebral bodies.

Animals↗
PubMed2001

Correlation of cervical vertebra maturation with hand-wrist maturation in children.

The purpose of this study was to evaluate the reliability of cervical vertebra maturation as an indicator of skeletal age during the circumpubertal period. This was determined by correlating cervical vertebra maturation to hand-wrist maturation. The vertebral skeletal age was assessed using lateral cephalometric radiographs according to maturity indicators modified from Lamparski. The hand-wrist skeletal age was evaluated in radiographs with the system developed by Fishman. The sample consisted of 503 subjects (244 boys and 259 girls), aged 8 through 18 years. The Spearman rank correlation coefficients and Wilcoxon sign rank test showed that a statistically significant relationship existed between the two assessments. Both the intra- and inter-judge tests of reliability displayed no significant differences. The results of this study indicate that skeletal age assessment made from the maturational changes of cervical vertebrae were reliable, reproducible and valid.

Adolescent↗
PubMed1995

Paget sarcoma of the cervical vertebrae: an autopsy case report and review of the literature.

A 69 year old Japanese woman was hospitalized for emergency treatment of sudden onset of tetraplegia and somnolence. The patient had a long history of occipital pain without definite diagnosis. After admission, the patient progressively developed generalized palsy including respiratory paralysis, and died of bronchopneumonia. Autopsy revealed osteosarcoma of the cervical vertebrae with the features of Paget's disease involving the skull and the cervical vertebrae. Paget sarcoma is rare in Japan, where Paget's disease of the bone is an uncommon condition. A review of the world literature failed to reveal any reports describing Paget sarcoma of the cervical vertebrae. The present report indicates that the development of Paget sarcoma in the upper cervical vertebrae may cause life-threatening neurologic complications.

Aged↗
PubMed1995

[Dumbbell like neurinoma at upper cervical vertebra: report of 48 cases].

48 dumbbell like neurinoma at upper cervical vertebra were totally removed operatively and confirmed pathologically. Intermittent pain at neck and occiput limitation of neck movement, and numbness or pain at one or both side limbs were the most common symptoms. In the early stage, the disease was difficalt to recognize. If X-ray film of the cervical vertebra at bioblique position showed an enlarged intervertebral foramen, the diagnosis of neurinoma should be highly considered. MRI could make a definite diagnosis. Vertebral artery angiography is of great value. We also introduced experience in how to protect vertebral artery and respiratory function during operation.

Adolescent↗
PubMed1977

The venous drainage of the cervical vertebrae of the ox (Bos taurus L.).

The venous drainage of the cervical vertebrae of the ox was studied in 16 animals (Friesland, Jersey and Guernsey cross-breeds), ranging from near full-term foetuses to adults. The extra- and intraosseous veins of the cervical vertebrae are described and illustrated. The nutrient vessels are derived from the vertebral, deep cervical, occipital and internal jugular veins. In addition to the dorsal and ventral external venous plexuses, a lateral external venous plexus is described. The intraosseous veins correspond in the main to the arteries. They are described and illustrated with reference to the available literature. In both young and adult animals anastomoses between epi- and metaphysial vessels are reported. The role of the internal ventral vertebral venous system as a collateral pathway is stressed and comments are made on its possible functional role.

Aging↗
PubMed1979

Eosinophilic granuloma of the second cervical vertebra.

The occurrence of eosinophilic granuloma in the body of the second cervical vertebra of a young adult male is presented. The necessity of making a histologic diagnosis and prevention of vertebral instability led to operative intervention. Treatment consisted of posterior fixation of the spinous processes of the second and third cervical vertebrae with size 0 wire. Through a transoral approach the lesion was curetted, and bone chips were placed in the vertebral defect. The patient remains well, and disease-free, after 36 months.

Adult↗
PubMed1989

[CT of fractures and ligament ruptures of the 1st and 2d cervical vertebrae].

On the basis of a patient material from a period of 14 months in a neuroradiological department, the fracture types in the first and second cervical vertebrae are reviewed. Computed tomography is found to be of particular value in cases of suspected fractures of the first cervical vertebrae, which is frequently found to be considerably more fragmented on computed tomography than in conventional x-rays, while fractures can be excluded in other cases. In cases of fracture of the second cervical vertebrae, computed tomography can reveal rotation of fragments of the body into the spinal canal while fractures of the dens may be overlooked if supplementary reconstructive sections are not carried out.

Cervical Vertebrae↗
PubMed2002

Skeletal maturation determined by cervical vertebrae development.

The aim of this study was to determine the validity of cervical vertebrae radiographic assessment to predict skeletal maturation. Left hand-wrist and lateral cephalometric radiographs of 958 Spanish children from 5 to 18 years of age were measured. On the left hand-wrist radiographs the classification of Grave and Brown was used to assess skeletal maturation. Cervical vertebrae maturation was evaluated with lateral cephalometric radiographs using the stages described by Lamparski and by Hassel and Farman. A new method to evaluate the cervical maturation by studying the changes in the concavity of the lower border, height, and shape of the vertebral body was created. Correlation coefficients were calculated to establish the relationship between skeletal maturation values obtained by the three classifications of vertebral and skeletal maturation measured at the wrist. All correlation values obtained were statistically significant (P < 0.001). The results suggest that this new method to determine skeletal maturation is very reliable. A simple method based on morphological characteristics of the cervical vertebral bodies to evaluate the maturation stage has been designed. In the population investigated, this method is as accurate as the Hassel and Farman classification and superior to the Lamparski classification. The morphological vertebral parameter best able to estimate the maturation is the concavity of the lower border of the body.

Adolescent↗