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At least 19 recordsLinked to original sources
PubMed1979

[Changes in the cervical spine in juvenile rheumatoid arthritis (author's transl)].

Changes in the cervical spine in juvenile rheumatoid arthritis can be shown by A.P., lateral and functional views with maximal flexion and extension, and particularly by tomography. The latter is essential for proper evaluation of the atlanto-occipital and atlanto-axial joints and of the odontoid. Atlanto-axial subluxation was found in eight out of eighty-four patients. Destruction of the odontoid was found in twelve out of fifty-three patients examined by tomography. The earliest tomographic changes at the atlanto-occipital joint consists of isolated joint narrowing, erosions and fusion and were observed in sixty-four out of sixty-six patients examined. Similar findings at the atlanto-axial joint were observed in thirty-seven out of sixty-six cases. The severity of the changes correlated with seropositivity and duration of the disease. The most marked changes were found with a prolonged history and a positive Rose-Waaler reaction.

Arthritis, Juvenile↗
PubMed1977

Joint surgery for rheumatoid arthritis.

The state of the art in the surgery of rheumatoid joint disease is discussed with emphasis on guidelines for choosing the patients and the types of procedures available. Strong-willed, strong-boned, strong-muscled, and well-informed patients are the best candidates. Synovectomy is particularly useful in the minimally erosive stages of the disease when the active synovitis is not suppressed by one or more steroid injections or other modalities of therapy. Arthrodeses and arthroplasties are midstage procedures that are now being supplanted by total joint replacement. This is especially true of the knee, but new prostheses for elbows, shoulders, wrists, and ankles are on the horizon.

Ankle Joint↗
PubMed1979

An alternate method for posterior fixation in anterior and inferior atlanto-axial dislocation.

A modification of common methods is described for fixation of anterior and inferior atlanto-axial dislocation (AAD and IAD). In AAD a wire is passed around the atlas arch and knotted around the spinous process of the axis in a way that a figure 8 arrangement is achieved as seen in the lateral view. In IAD a wire is passed through holes in the occiput and knotted around the spinous process of the axis. A rectangular bone graft is inserted between the occiput and the spinous process of the axis, thus preventing further inferior dislocation. In both methods methyl methacrylate and bone grafts are as a rule added for further long-time stabilization. The methods have been used in 15 cases of AAD and in three cases of IAD. On radiologic examination with attention focused on the immediate postoperative fixation the follow-up time has been three months. The long-time results of fixation have been recorded with a follow-up time of six years. The fixation proved to be satisfactory in 14 patients with AAD and in the three patients with IAD. The clinical results were good in the 14 patients with AAD and in the three with IAD.

Adolescent↗
PubMed1979

Atlanto axial rotatory fixation--a cause of torticollis.

Atlanto-axial rotatory fixation is a rare but important cause of persistent torticollis. The diagnosis is confirmed by careful radiological examination of the atlanto-axial joint, also employing tomography if necessary. Treatment is skull traction in an attempt to improve the position followed by posterior atlanto-axial fusion to prevent further, and potentially disastrous, displacement. Atlanto-axial dislocation or subluxation should be looked for in all cases of acute torticollis, when reduction by traction will most likely be successful and prevent the development of atlanto-axial rotatory fixation and the associated persistent torticollis.

Atlanto-Occipital Joint↗
PubMed1975

Lesions of the atlas and axis.

The atlas and axis support the head on the lower cervical spine while providing for considerable mobility in flexion, extension, rotation and lateral bending. The first two vertebrae also function as conduits for the cervical cord and vertebral arteries. Lesions of the atlas and axis, therefore, can cause instability with loss of support and encroachment on the upper cord and vertebral arteries, or less often stiffness with restricted motion. Congenital lesions of the occipito-cervical spine such as occipitalization of the atlas or accessory occipital vertebrae can constrict the upper cord with osseous, dural, or fibrous compression. Such encroachment on the cord at this level produces a varying array of clinical complaints and findings frequently difficult to interpret. Instability of the upper cervical spine can result from congenital, traumatic, inflammatory or neoplastic disruptions of the interlocking mechanism of the atlas and axis. Such factors as the loss of structural integrity of the dens or stretching or tearing of the transverse ligament can permit instability with cord involvement. Because of the serious potential of these lesions, patients with abnormalities of the atlas and axis require prompt recognition and treatment.

Adolescent↗
PubMed1978

Some specific anatomical features of the atlas and axis: dens, epitransverse process and articular facets.

Metrical and morphological findings, based on 107 human vertebral columns, related to the variations of the dens are given, and differences in the depth of the superior articular facets of the atlas and specific pertinent details related to the os odontoideum and epitransverse process are also provided and their possible clinical relevance indicated. Findings reveal considerable variation in the height of the dens (11 to 18 mm), but remarkably little in its anteroposterior and transverse diameters at the root. The use of the term "hypoplasia" with reference to the dens is discussed, and a need for more rigid criterian in the use of this term stressed. It is also suggested that there may be sufficient radiological evidence in a lateral radiography to lead one to suspect the presence of an os odontoideum or a separate dens caused by trauma in the distant past.

Adult↗
PubMed1979

Traumatic anterior atlanto-occipital dislocation.

The five cases of atlanto-occipital dislocation reported in the world literature are reviewed, and four additional cases are presented, including two survivors. The pathological anatomy of this potentially catastrophic injury and its management are briefly discussed. Because immediate recognition of the atlanto-occipital dislocation is critical to proper treatment and because the neurological findings are extremely varied, a new radiographic criterion for its identification has been developed.

Adult↗
PubMed1979

[Surgical treatment of atlanto-axial subluxation by transoropharyngeal approach. Report of a case].

A case of atlanto-axial subluxation in a 17 year old boy with rheumatic disease is reported. The subluxation could not be reduced by cervical traction. Posterior fixation with acrilic and wire was unable to prevent the appearance of signs of spinal cord compression. The odontoid process was removed through a transoral approach leading to neurologic recovery. Treatment of atlanto-axial subluxation is discussed, emphasis being given to the indications for anterior descompression.

Adolescent↗
PubMed1976

Anomalies of the craniovertebral border.

Pertinent embryology is reviewed as a background for understanding anomalies of the craniovertebral border. These anomalies constitute a variable spectrum due either to incomplete assimilation or abnormal fusion.

Animals↗
PubMed1978

Normal movements of the cervical spine.

This paper describes a technique for analyzing movement of the cervical spine. The method consists of superimposition of two films representing the cervical spine in the end positions of the movement under investigation (e.g., flexion and extension). From tracings of selected structures, movement is represented in the form of movement diagrams. Knowledge of cervical spine dynamics is helpful in understanding muscle and ligament function as well as the shape of components in various postures.

Atlanto-Occipital Joint↗
PubMed1976

Atlanto-axial fusion in rheumatoid arthritis. A new method of fixation with wire and bone cement.

Twenty-eight occipito-cervical fusions performed over the past 4 years in patients with rheumatoid arthritis are discussed. All of the patients with one exception had signs of neurological involvement preoperatively due to pressure on occipital nerve roots, spinal cord and/or vertebral arteries. A surgical technique using wire, pin and bone cement and permitting early mobilization without external fixation was used and is described in detail. The clinical results were excellent in 21 cases with an additional five patients showing improvement. One patient did not benefit from surgery and one had no symptoms preoperatively. The results are encouraging and the possibility of early mobilization (the day after surgery) is of the utmost importance for this group of patients.

Adult↗
PubMed1979

[Ossification of the transverse ligament of the atlas. A report on three new cases (author's transl)].

Following the publication of the first two cases reported of ossification of the transverse ligament, the authors describe three recent observations of this lesion. In contrast to the first two cases, in which ossification was reported at the level of the cervico-occipital articulation, which was normal, these three new cases were noted to have associated acquired or congenital abnormalities of the craniovertebral junction.

Aged↗
PubMed1976

Birth defects involving the spine.

There is a multiplicity of birth defects of the spine occurring as isolated anomalies or as aspects of multifaceted syndromes. The clinical significance of these anomalies varies from the asymptomatic to the life threatening. Symptoms and signs may present at birth or not until years later. The optimal clinical result for the patient requires a careful history and physical examination, appropriate routine and specialized roentgenograms, laboratory data, and a high index of suspicion for signs or symptoms of neurological dysfunction. When the diagnosis is made, conservative or surgical treatment may be instituted as appropriate.

Atlanto-Occipital Joint↗