Journal of craniovertebral junction & spine最新文献

{"title":"Syringomyelia secondary to \"occult\" dorsal arachnoid webs: Report of two cases with review of literature.","authors":"Parag P Sayal,&nbsp;Arif Zafar,&nbsp;Thomas A Carroll","doi":"10.4103/0974-8237.181862","DOIUrl":"https://doi.org/10.4103/0974-8237.181862","url":null,"abstract":"<p><p>In a certain group of patients with syringomyelia, even with the advent of sophisticated magnetic resonance imaging (MRI), no associated abnormality or cerebrospinal fluid (CSF) block is easily identified. This type of syringomyelia is often termed idiopathic. Current literature has less than 10 reports of arachnoid webs to be the causative factor. We present our experience in the management of two cases of syringomyelia secondary to arachnoid webs. Both our patients presented with progressive neurological deterioration with MRI scans demonstrating cervical/thoracic syrinx without Chiari malformation or low-lying cord. There was no history of previous meningitis or trauma. Both patients underwent myelography that demonstrated dorsal flow block implying CSF obstruction. Cord displacement/change in caliber was also noted and this was not evident on MRI scans. Both patients underwent thoracic laminectomy. After opening the dura, thickened/abnormal arachnoid tissue was found that was resected thus widely communicating the dorsal subarachnoid space. Postoperatively at 6 months, both patients had significant symptomatic improvement with follow-up MRI scans demonstrating significant resolution of the syrinx. In patients with presumed idiopathic syringomyelia, imaging studies should be closely inspected for the presence of a transverse arachnoid web. We believe that all patients with idiopathic symptomatic syringomyelia should have MRI CSF flow studies and/or computed tomography (CT) myelography to identify such arachnoid abnormalities that are often underdiagnosed. Subsequent surgery should be directed at the establishment of normal CSF flow by laminectomy and excision of the offending arachnoid tissue. </p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"101-4"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/a7/JCVJS-7-101.PMC4872557.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34409183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequality in leg length is important for the understanding of the pathophysiology of lumbar disc herniation.","authors":"Mehmet Sabri Balik,&nbsp;Ayhan Kanat,&nbsp;Adem Erkut,&nbsp;Bulent Ozdemir,&nbsp;Osman Ersagun Batcik","doi":"10.4103/0974-8237.181829","DOIUrl":"https://doi.org/10.4103/0974-8237.181829","url":null,"abstract":"<p><strong>Objective: </strong>Inequality in leg length may lead to to abnormal transmission of load across the endplates and degeneration lumbar spine and the disc space. There has been no study focusing on lumbar disc herniation (LDH) and leg length discrepancy. This subject was investigated in this study.</p><p><strong>Materials and methods: </strong>Consecutive adult patients with leg length discrepancy and low back pain (LBP) admitted to our department were respectivelly studied.</p><p><strong>Results: </strong>A total number of 39 subjects (31 women and eight men) with leg length discrepancy and LBP and 43 (25 females and 18 males) patients with LBP as a control group were tested. Occurrence of disc herniation is statistically different between patients with hip dysplasia and control groups (P < 0.05).</p><p><strong>Conclusion: </strong>The results of this study showed a statistically significant association between leg length discrepancy and occurrence of LDH. The changes of spine anatomy with leg length discrepancy in hip dysplastic patients are of importance in understanding the nature of LDH.</p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"87-90"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/f4/JCVJS-7-87.PMC4872568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34512939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervicomedullary intramedullary peripheral primitive neuroectodermal tumor with intratumoral bleed: Report of one case and review of literature.","authors":"Pradeep Sharma,&nbsp;Kuntal K Das,&nbsp;Anant Mehrotra,&nbsp;Arun K Srivastava,&nbsp;Rabi N Sahu,&nbsp;Awadhesh Jaiswal,&nbsp;Rakesh Pandey,&nbsp;Sanjay Behari,&nbsp;Kamlesh S Bhaisora,&nbsp;Jayesh Sardhara","doi":"10.4103/0974-8237.181874","DOIUrl":"https://doi.org/10.4103/0974-8237.181874","url":null,"abstract":"<p><p>Primitive neuroectodermal tumors (PNET) are highly malignant, yet relatively uncommon neoplasms of the central nervous system. Although a host of different parts of the nervous system can be affected, intramedullary location of PNET is extremely rare. Most reports on intramedullary PNET have reported central PNET (cPNET); peripheral PNET (pPNET) affecting intramedullary spinal location is extremely rare. Till now, seven such cases of intramedullary pPNET have been described in medical literature in English. Here, we report an 11-year-old boy with cervicomedullary junction intramedullary pPNET who presented with intratumoral bleed, wherein the clinical presentation and radiological features gave us no clue preoperatively about the underlying diagnosis. In this report, we additionally review certain salient aspects of this dreaded disease in light of the existing evidence. </p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"111-4"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/9f/JCVJS-7-111.PMC4872560.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34420274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late onset leptomeningeal and whole spine metastasis from supratentorial Glioblastoma multiforme: An uncommon manifestation of a common tumor.","authors":"Divyam Sharma,&nbsp;Anshul Gupta,&nbsp;Gurupal S Dhillon,&nbsp;Satnam Singh Chhabra","doi":"10.4103/0974-8237.181878","DOIUrl":"https://doi.org/10.4103/0974-8237.181878","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM) is one of the most common and aggressive primary brain tumors, composing 12-20% of all the intracranial tumors in adults with a highly malignant course and average life expectancy of approximately 12-14 months following initial diagnosis. Leptomeningeal or intramedullary metastasis from primary GBM is a rare phenomenon with a poor prognosis. We present a rare case of GBM with late onset intramedullary, extramedullary, as well as leptomeningeal spinal metastasis. </p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"118-20"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/5f/JCVJS-7-118.PMC4872562.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34409186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary intradural sacral epidermoid in a nondysraphic spine: Case report and review of literature.","authors":"Laxminadh Sivaraju,&nbsp;Sumit Thakar,&nbsp;Nandita Ghosal,&nbsp;Alangar S Hegde","doi":"10.4103/0974-8237.181866","DOIUrl":"https://doi.org/10.4103/0974-8237.181866","url":null,"abstract":"<p><p>The occurrence of epidermoids within the spinal canal is uncommon. Most of the reported spinal epidermoids (SEs) have been described in the thoracic or lumbar regions. They occur either following trauma or in the setting of coexistent spinal dysraphism. The authors describe an unusual case of a 28-year-old lady who presented with long-standing back pain and urinary incontinence. Magnetic resonance imaging (MRI) of her spine demonstrated a sacral SE without any coexistent spinal dysraphism. The diagnosis of an epidermoid was confirmed by histopathological examination following laminectomy and excision. To the authors' best knowledge, this is the third case of a sacral SE occurring in a non-dysraphic spine. The case is discussed in the light of a relevant literature review. </p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"105-8"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/ae/JCVJS-7-105.PMC4872558.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34409180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital defects of C1 arches and odontoid process in a child with Down's syndrome: A case presentation.","authors":"Catherine Hatzantonis,&nbsp;Samiul Muquit,&nbsp;Luigi Aurelio Nasto,&nbsp;Hossein Mehdian","doi":"10.4103/0974-8237.181877","DOIUrl":"https://doi.org/10.4103/0974-8237.181877","url":null,"abstract":"<p><p>We present the case of a 2-year-old child with Down's syndrome who presented to our unit with torticollis. Imaging studies revealed the rare occurrence of anterior and posterior C1 arch defects, absent odontoid process, and atlantoaxial subluxation. We managed her conservatively for 3 years without neurological deficits or worsening of atlantoaxial subluxation. We discuss the rare occurrences of anterior and posterior arch defects of the atlas, the radiological presentations of axis defects in patients, and the occurrence of atlantoaxial instability in patients with Down's syndrome. Management options with consideration to surgery in asymptomatic and symptomatic patients are also discussed. </p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"115-7"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/84/JCVJS-7-115.PMC4872561.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34409184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantoaxial instability: Analyzing and reflecting on the Nature's reparative games.","authors":"Atul Goel","doi":"10.4103/0974-8237.181823","DOIUrl":"https://doi.org/10.4103/0974-8237.181823","url":null,"abstract":"an error of formation or in nurturing. Th e most mobile joint is the most likely candidate to become unstable. It is like the cells that multiply most rapidly are most likely to become cancerous by multiplying abnormally. Atlantoaxial instability is the most common joint instability and majority of pathological lesions seen in the craniovertebral junction are a consequence of or reparative Natural eff orts that att empt to stall or delay the neurological symptoms and defi cits that can jeopardize the human existence.","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"69-71"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/91/JCVJS-7-69.PMC4872564.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34512935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interfacetal intra-articular spacers: Emergence of a concept.","authors":"Atul Goel","doi":"10.4103/0974-8237.181825","DOIUrl":"https://doi.org/10.4103/0974-8237.181825","url":null,"abstract":"Atlantoaxial joint instability can be identifi ed by facetal malalignment or even by direct observation and bone handling during surgery. We have recently classifi ed the diagnosis of atlantoaxial instability and basilar invagination on the basis of facetal malalignment and instability.[6,7] We observe that there may be instability even when the atlantodental interval is not aff ected and even when there is no evidence of cord alterations or changes. Atlantoaxial instability that is diagnosed only by clinical evaluation and by manual manipulations and without any radiological abnormality has been termed by us as central or axial atlantoaxial instability.[6,7] Intra-articular spacers can be deployed for all forms of atlantoaxial instability.","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"72-4"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/a0/JCVJS-7-72.PMC4872565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34512936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Two-step\" technique with OsiriX™ to evaluate feasibility of C2 pedicle for surgical fixation.","authors":"Luis Miguel Sousa Marques,&nbsp;Gonçalo Neto d'Almeida,&nbsp;José Cabral","doi":"10.4103/0974-8237.181826","DOIUrl":"https://doi.org/10.4103/0974-8237.181826","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of craniovertebral junction pathology has evolved considerably in recent decades with the implementation of short atlanto-axial fixation techniques, notwhithstanding increasing neurovascular risks. Also, there is strong evidence that fixation of C2 anatomical pedicle has the best biomechanical profile of the entire cervical spine. However, it is often difficult and misleading, to evaluate anatomical bony and vascular anomalies using the three orthogonal planes (axial, coronal, and sagittal) of CT.</p><p><strong>Objectives: </strong>The authors describe an innovative and simple technique to evaluate the feasibility of C2 pedicle for surgical screw fixation using preoperative planning with the free DICOM (Digital Imaging and Communications in Medicine) software OsiriX™.</p><p><strong>Materials and methods: </strong>The authors report the applicatin of this novel technique in 5 cases (3 traumatic, 1 Os Odontoideum, and 1 complex congenital malformation) collected from our general case series of the Department in the last 5 years.</p><p><strong>Results: </strong>In this proof of concept study, the pre-operative analysis with the two-step tecnique was detrimental for choosing the surgical tecnique. Detailed post-operative analysis confirmed correct position of C2 screws without cortical breach. There were no complications or mortality reported.</p><p><strong>Conclusion: </strong>This two-step technique is an easy and reliable way to determine the feasibility of C2 pedicle for surgical fixation. The detailed tridimensional radiological preoperative evaluation of craniovertebral junction anatomy is critical to the sucess and safety of this surgeries, and can avoid, to certain degree, expensive intra-operative tridimensional imaging facilities.</p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"75-81"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/96/JCVJS-7-75.PMC4872566.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34512937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical disc hernia operations through posterior laminoforaminotomy.","authors":"Coskun Yolas,&nbsp;Nuriye Guzin Ozdemir,&nbsp;Hilmi Onder Okay,&nbsp;Ayhan Kanat,&nbsp;Mehmet Senol,&nbsp;Ibrahim Burak Atci,&nbsp;Hakan Yilmaz,&nbsp;Mustafa Kemal Coban,&nbsp;Mehmet Onur Yuksel,&nbsp;Umit Kahraman","doi":"10.4103/0974-8237.181854","DOIUrl":"https://doi.org/10.4103/0974-8237.181854","url":null,"abstract":"<p><strong>Objective: </strong>The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015.</p><p><strong>Results: </strong>The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis.</p><p><strong>Conclusion: </strong>Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.</p>","PeriodicalId":520667,"journal":{"name":"Journal of craniovertebral junction & spine","volume":" ","pages":"91-5"},"PeriodicalIF":1.1,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/c1/JCVJS-7-91.PMC4872569.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34512940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}