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PubMed2005

Giant cell tumour of the sixth cervical vertebrae with close relationship to the vertebral artery.

Giant cell tumours of the vertebral column are rare and cervical vertebrae involvement is even less common. As these lesions may be closely related to the vertebral artery, therapeutic decision-making may be complex. Reviewing the literature, we found that there was no consensus on treatment or outcome assessment for these rare and difficult lesions. We present a case of a giant cell tumour of the sixth cervical vertebrae involving the posterior elements, neural foramina and transverse foramina and closely related to the vertebral artery. Radiological evaluation and therapeutic solutions are also discussed.

Adult↗
PubMed1991

Selection of the approach to the distal internal carotid artery from the second cervical vertebra to the base of the skull.

Although several approaches for exposure of distal internal carotid artery lesions have been reported, the precise anatomic levels for which each of these maneuvers are most appropriate have not been well described. Since these techniques may require preoperative preparation, it is useful to determine in advance how much exposure will be needed and to select the most suitable and effective technique. We used anatomic dissection in 12 human cadaver specimens (24 carotid bifurcations) to define the limits of distal internal carotid artery exposure by several commonly advocated methods. The standard anterior approach along the sternocleidomastoid muscle allowed exposure of the internal carotid artery to the level of the upper one third of the second cervical vertebra. The upper limit of this exposure was extended to the middle of the first cervical vertebra by division of the posterior belly of the digastric muscle. Anterior subluxation of the mandible increased the distal exposure of the internal carotid artery to the superior border of the first cervical vertebra. Styloidectomy in combination with the preceding maneuvers extended the exposure an additional 0.5 cm cephalad. Lateral mandibulotomy did not significantly extend exposure beyond that obtained with mandibular subluxation and styloidectomy. Exposure of the internal carotid artery in the 1 cm immediately below the base of the skull required a posterior approach with mastoidectomy.

Adult↗
PubMed1975

Contributions to the anatomy of the cervical spine. Functional and pathogenetic significance of certain structures of the cervical vertebrae.

Following the investigations carried out on about 350 macerated vertebrae by the dissection of 120 human cadavers, a number of structural pecularities of the cervical vertebrae are described, with special emphasis on their functional and pathogenetic significance. The most specific structures of the cervical vertebrae -- the transverse, unciform, and articular processes, and the vertebral pedicle -- embody from the ontogenetic, the morphofunctional and the pathogenetic point of view, a unity named the uncotransversoarticular complex. The components of this complex delimit the spinal nerve groove, the intervertebral canal and participate in the cervical locking mechanism, in this way contributing to the protection of the vasculonervous formations passing through the cervical spine. The osteovasculonervous relationships at the level of the intervertebral canal, the anatomical variants of the intervertebral canal as well as certain possibilities of the occurrence of a cervical locking deficiency are described.

Cadaver↗
PubMed1997

Methanol causes posteriorization of cervical vertebrae in mice.

Inhalation of methanol by pregnant mice before gestation day nine (gd 9) produces fetal skeletal alterations, principally in the cervical region. The appearance of these defects suggests homeotic shifts in segment identity, patterning, or both. To explore this possibility, detailed morphological analyses of the effects of methanol on fetal skeletal development were done. Pregnant mice were gavaged with 0, 4.0, or 5.0 g/kg methanol (MeOH) split in two doses on gd 7, the most sensitive day for induction of skeletal alterations with methanol. Dams were killed on gd 18 and the fetuses were counted, weighed, and examined externally. Fetuses were double stained with alcian blue and alizarin red for examination of cartilaginous and ossified vertebral and rib characteristics, and in selected fetuses cervical vertebrae were disarticulated for more detailed analysis. Observations indicative of methanol-induced homeotic transformations were as follows: [tabular data: see abstract volume] Examination of disarticulated vertebrae revealed foramina and other distinguishing characteristics on vertebrae anterior to those on which they normally appear. These results demonstrate that maternal methanol exposure can alter segment patterning in the developing mouse embryo, producing posteriorization of cervical vertebrae.

Abnormalities, Drug-Induced↗
PubMed1999

Frequency of portrayal of foramen transversarium of the second cervical vertebra on rotational panoramic radiographs.

OBJECTIVES: To determine the prevalence of portrayal of the foramen transversarium of the second cervical vertebra on rotational panoramic radiographs. METHODS: A stratified random sample of 1600 diagnostic-quality rotational panoramic radiographs were retrospectively reviewed. Approximately 100 radiographs each for males and females were reviewed for each of the decades of life up to age 69 and for subjects 70 or older. RESULTS: The foramen was portrayed 29.3% of all radiographs, 35% of females and 22.6% of males. However, when considering only those radiographs in which cervical vertebrae were visible, the foramen was more frequently portrayed in males than in females. Portrayal of the foramen did not differ substantially among age groups. CONCLUSIONS: The foramen transversarium is found sufficiently often on rotational panoramic radiographs that this structure should be identifiable by clinicians who use these images.

Adolescent↗
PubMed1999

Anterior cervical plating for the treatment of neoplasms in the cervical vertebrae.

OBJECT: To assess clinical outcome and survival in patients with cervical vertebral spinal neoplasms after they have undergone anterior decompression and cervical plate stabilization (ACPS) by using either autologous bone graft or polymethylmethacrylate (PMMA) as the anterior load-bearing support structure. METHODS: This was a retrospective case study composed of 30 patients harboring cervical spinal vertebral neoplasms who underwent anterior cervical decompression and (ACPS) within a 7-year period. Postoperative immobilization included treatment in a halo brace in two cases and in a hard cervical collar for the remaining patients. Postoperatively most patients underwent radio- and/or chemotherapy. All patients except one benefited from a significantly improved quality of life with decreased pain and/or improved neurological status. The mean Kaplan-Meier survivoral estimate was 35.8 months (range 8 days-11.3 years, with 10 patients alive at most recent follow-up contact). Patients achieved long-term or lifelong mechanical stability in the cervical spine, and only one patient required a repeated posterior stabilization procedure. No hardware-related complications occurred. One patient died 8 days postoperatively of pneumonia. A nonsignificant difference in survival (p = 0.2164) was observed between patients harboring metastatic neoplasms (26.8 months) and those harboring lymphomatous and multiple myeloma neoplasms (54 months). CONCLUSIONS: Favorable clinical outcome of both neurological symptoms and pain can be achieved using ACPS after surgery for neoplasms in the cervical vertebrae. Furthermore, long-term or lifelong cervical spine mechanical stability with bone fusion is achieved using this technique even when radiation therapy is delivered to the site of the bone graft.

Adult↗
PubMed1994

Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra.

A case of congenital bilateral spondylolysis of fourth cervical vertebra was reported and the characteristic radiological features shown. Although the diagnosis is often suggested by the plain films, demonstration of the typical CT findings is often necessary to reach a final diagnosis. Awareness of this entity and its specific radiological features will help to differentiate this relatively benign cervical anomaly from other, more ominous, unstable causes of cervical spondylolisthesis such as those related to acute cervical injury. It may also prevent any inappropriate treatment from being undertaken.

Adult↗
PubMed1988

Synchondroseal growth in the first cervical vertebra of the rat.

Growth and remodelling of the first cervical vertebra were studied in the rat by means of biometry, vital staining (alizarin red S and oxytetracycline), and histology. The measurements showed a change in the ratio of the dorso-ventral to the transversal diameter in the lumen after obliteration of the dorsal synchondrosis. The pattern of labelling between the three segments of the vertebrae joined by synchondroses in the young animals indicated that expansion of the vertebral lumen took the form of a displacement of all three parts making up the bony ring. After closure of the dorsal synchondrosis the two ventral ones were still active and the lumen size increased more in the dorso-ventral direction than transversally. Alizarin red S and oxytetracycline tended to persist in the ventral part of the vertebra, while the staining almost disappeared from the dorso-lateral segment. Resting lines were found laterally to the ventral synchondroses in haematoxylin and eosin stained sections, but not in the ventral segment between the cartilages. The growth of the rat atlas is the result of an early rapid cartilage-mediated expansion of the vertebral lumen in conjunction with the growth of the spinal cord and, at a later age, mainly of a displacement of the ventral vertebral segment, leading to the final form of the vertebra and its lumen.

Aging↗
PubMed1994

Comparison of anterior cervical fusions using autogenous bone graft obtained from the cervical vertebrae to the modified Smith-Robinson technique.

Anterior cervical discectomy and interbody grafting provide excellent results in treating cervical radiculopathy. This prospective study compares the results of the technique obtaining autogenous bone from the cervical vertebrae for grafting to the modified Smith-Robinson technique using autogenous iliac crest graft. Seven levels in six patients were fused using the vertebral body autograft technique and 43 levels in 40 patients using the standard technique. All patients had radiculopathy and neck pain. Statistically significant differences in fusion rate (4/7 vertebral body autograft; 40/43 modified Smith-Robinson) (p = 0.029), disc height maintenance (p = 0.001), and neck pain improvement (p = 0.05) occurred between the techniques. We do not recommend vertebral body autograft over the modified Smith-Robinson technique for anterior cervical fusion following discectomy.

Adult↗
PubMed1989

[Ossification of the posterior longitudinal ligament of the cervical vertebrae and myelopathy].

6 cases of OPLL of the cervical vertebrae (OPLL = Ossification of the Posterior Longitudinal Ligament), all diagnosed by CT or X-ray, are reported in this paper. With a review of relevant literature and clinical manifestations of the 6 patients, the incidence, clinical features, diagnosis, differential diagnosis of OPLL and the relationship between OPLL and myelopathy are discussed. It is pointed out that OPLL usually appears as a myelopathy.

Aged↗
PubMed1977

Anatomical variations in the articular masses of the seventh cervical vertebra simulating fracture.

The articular masses of the seventh cervical vertebra are variable in that about 87% of patients the superior and inferior facets are not parallel. IN ADDITION, THE INFERIOR FACETS ARE OFTEN POSTERIORLY PLACED IN RELATION TO THE SUPERIOR FACETS. These factors contribute to a notched undulating articular mass seen bilaterally on the lateral and oblique projections simulating fracture. The difference in inclination of the superior and inferior facets may cause either the superior or inferior facets to be obscured on the AP VIEW ANGLED CAUDAD--THE POSTERIOR ARCH VIEW. Since these anomalies are bilateral and fractures are almost always unilateral, the differentiation is most easily made on this posterior arch view.

Cervical Vertebrae↗
PubMed1995

Morphology of the second cervical vertebra and the posterior projection of the C2 pedicle axis.

STUDY DESIGN: This study assessed numerous structural features of the second cervical vertebra (C2), describing the projection point of the pedicle on its posterior aspect. OBJECTIVES: Evaluation of the specimens included quantitative description of 18 linear and four angular parameters, which then were correlated between male and female specimens. The point of projection of the C2 pedicle axis was described with an emphasis on a perspective relevant to a posterior approach. SUMMARY OF BACKGROUND DATA: The literature regarding the anatomy of the axis focuses mainly on the dens. Very little research regarding the quantitative study of the C2 pedicle has been reported. METHODS: Fifty dry C2 cervical vertebrae (30 male, 20 female) were obtained for anatomic measurements. Anatomic evaluation focused on the pedicle, vertebral body, dens, superior facet, and vertebral canal. All measurements were made using calipers and a standard rule linear measurements and a goniometer for angular measures. Based on the measurement of 50 specimens, including 18 linear and four angular parameters, the mean, range, and standard deviation were calculated for all of the specimens and for male and female separately. RESULTS: A significant difference was found to exist for 11 of 18 linear measurements and one of four angular parameters. The projection point of the pedicle axis on the posterior aspect of the lateral mass was described with an emphasis on a perspective relevant to a posterior surgical approach. The location of the projection point of the pedicle axis was found to be 5.4 +/- 1.2 mm inferior to the horizontal line, and 7.2 +/- 1.3 mm lateral to the vertical line. The pedicle axis was found to lie at 33 degrees in the medial direction and 20 degrees in the superior direction form the point of pedicle axis projection. CONCLUSIONS: When the techniques described here are used, the findings may be helpful in cases involving C2 when surgical intervention and instrumentation are desired.

Adult↗
PubMed1995

Skeletal maturation evaluation using cervical vertebrae.

Lateral cephalometric and left hand-wrist radiographs from the Bolton-Brush Growth Center at Case Western Reserve University were reviewed a posteriori to develop a cervical vertebrae maturation index (CVMI). By using the lateral profiles of the second, third and fourth cervical vertebrae, it was possible to develop a reliable ranking of patients according to the potential for future adolescent growth potential.

Adolescent↗
PubMed1999

Myocardial stunning caused by sympathetic nerve injury after an operation on cervical vertebrae.

In this case, electrocardiographic inverted T waves appeared after cervical laminaplasty and echocardiogram showed temporary wall motion abnormality. Myocardial metaiodobenzylguanidine (MIBG) uptake was obviously reduced in the same area where the wall motion abnormalities appeared in the echocardiogram, although no abnormalities were detected with myocardial thallium scintigraphy and coronary angiography. The myocardial stunning was caused by injury to the sympathetic nerves from a surgical procedure on the cervical vertebrae.

3-Iodobenzylguanidine↗