Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects.

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Caldas, Maria de Paula; Ambrosano, Gláucia Maria Bovi; Haiter Neto, Francisco

2010-01-01

The aims of this study were to develop a computerized program for objectively evaluating skeletal maturation on cephalometric radiographs, and to apply the new method to Brazilian subjects. The samples were taken from the patient files of Oral Radiological Clinics from the North, Northeast, Midwest and South regions of the country. A total of 717 subjects aged 7.0 to 15.9 years who had lateral cephalometric radiographs and hand-wrist radiographs were selected. A cervical vertebral computerized analysis was created in the Radiocef Studio 2 computer software for digital cephalometric analysis, and cervical vertebral bone age was calculated using the formulas developed by Caldas et al.17 (2007). Hand-wrist bone age was evaluated by the TW3 method. Analysis of variance (ANOVA) and the Tukey test were used to compare cervical vertebral bone age, hand-wrist bone age and chronological age (P cervical vertebral bone age and chronological age in all regions studied. When analyzing bone age, it was possible to observe a statistically significant difference between cervical vertebral bone age and hand-wrist bone age for female and male subjects in the North and Northeast regions, as well as for male subjects in the Midwest region. No significant difference was observed between bone age and chronological age in all regions except for male subjects in the North and female subjects in the Northeast. Using cervical vertebral bone age, it might be possible to evaluate skeletal maturation in an objective manner using cephalometric radiographs.

Closed cervical spine trauma associated with bilateral vertebral artery injuries

NARCIS (Netherlands)

Kloen, P.; Patterson, J. D.; Wintman, B. I.; Ozuna, R. M.; Brick, G. W.

1999-01-01

Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature

Correlation of Improved Version of Cervical Vertebral Maturation Indicator with Other Growth Maturity Indicators

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Tripti Tikku

2013-01-01

Conclusion: The correlation between middle phalanx of 3rd finger (MP3 and cervical vertebral maturation method (CVMI and CVMS was higher as compared to the correlation of either of the cervical vertebral maturation method or MP3 with dental maturation indicator.

Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects

Directory of Open Access Journals (Sweden)

Maria de Paula Caldas

2010-03-01

Full Text Available The aims of this study were to develop a computerized program for objectively evaluating skeletal maturation on cephalometric radiographs, and to apply the new method to Brazilian subjects. The samples were taken from the patient files of Oral Radiological Clinics from the North, Northeast, Midwest and South regions of the country. A total of 717 subjects aged 7.0 to 15.9 years who had lateral cephalometric radiographs and hand-wrist radiographs were selected. A cervical vertebral computerized analysis was created in the Radiocef Studio 2 computer software for digital cephalometric analysis, and cervical vertebral bone age was calculated using the formulas developed by Caldas et al.17 (2007. Hand-wrist bone age was evaluated by the TW3 method. Analysis of variance (ANOVA and the Tukey test were used to compare cervical vertebral bone age, hand-wrist bone age and chronological age (P < 0.05. No significant difference was found between cervical vertebral bone age and chronological age in all regions studied. When analyzing bone age, it was possible to observe a statistically significant difference between cervical vertebral bone age and hand-wrist bone age for female and male subjects in the North and Northeast regions, as well as for male subjects in the Midwest region. No significant difference was observed between bone age and chronological age in all regions except for male subjects in the North and female subjects in the Northeast. Using cervical vertebral bone age, it might be possible to evaluate skeletal maturation in an objective manner using cephalometric radiographs.

Correlation between dental and cervical vertebral maturation in Iranian females.

Science.gov (United States)

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-12-01

Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall's tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor.

Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment.

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Crawford, Bethany; Kim, Do-Gyoon; Moon, Eun-Sang; Johnson, Elizabeth; Fields, Henry W; Palomo, J Martin; Johnston, William M

2014-08-01

The cervical vertebral maturation (CVM) stages have been used to estimate facial growth status. In this study, we examined whether cone-beam computed tomography images can be used to detect changes of CVM-related parameters and bone mineral density distribution in adolescents during orthodontic treatment. Eighty-two cone-beam computed tomography images were obtained from 41 patients before (14.47 ± 1.42 years) and after (16.15 ± 1.38 years) orthodontic treatment. Two cervical vertebral bodies (C2 and C3) were digitally isolated from each image, and their volumes, means, and standard deviations of gray-level histograms were measured. The CVM stages and mandibular lengths were also estimated after converting the cone-beam computed tomography images. Significant changes for the examined variables were detected during the observation period (P ≤0.018) except for C3 vertebral body volume (P = 0.210). The changes of CVM stage had significant positive correlations with those of vertebral body volume (P ≤0.021). The change of the standard deviation of bone mineral density (variability) showed significant correlations with those of vertebral body volume and mandibular length for C2 (P ≤0.029). The means and variability of the gray levels account for bone mineral density and active remodeling, respectively. Our results indicate that bone mineral density distribution and the volume of the cervical vertebral body changed because of active bone remodeling during maturation. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

A comparison of hand-wrist bone and cervical vertebral analyses in measuring skeletal maturation.

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Gandini, Paola; Mancini, Marta; Andreani, Federico

2006-11-01

To compare skeletal maturation as measured by hand-wrist bone analysis and by cervical vertebral analysis. A radiographic hand-wrist bone analysis and cephalometric cervical vertebral analysis of 30 patients (14 males and 16 females; 7-18 years of age) were examined. The hand-wrist bone analysis was evaluated by the Bjork index, whereas the cervical vertebral analysis was assessed by the cervical vertebral maturation stage (CVMS) method. To define vertebral stages, the analysis consisted of both cephalometric (13 points) and morphologic evaluation of three cervical vertebrae (concavity of second, third, and fourth vertebrae and shape of third and fourth vertebrae). These measurements were then compared with the hand-wrist bone analysis, and the results were statistically analyzed by the Cohen kappa concordance index. The same procedure was repeated after 6 months and showed identical results. The Cohen kappa index obtained (mean +/- SD) was 0.783 +/- 0.098, which is in the significant range. The results show a concordance of 83.3%, considering that the estimated percentage for each case is 23.3%. The results also show a correlation of CVMS I with Bjork stages 1-3 (interval A), CVMS II with Bjork stage 4 (interval B), CVMS III with Bjork stage 5 (interval C), CVMS IV with Bjork stages 6 and 7 (interval D), and CVMS V with Bjork stages 8 and 9 (interval E). Vertebral analysis on a lateral cephalogram is as valid as the hand-wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects.

Correlation Between Dental and Cervical Vertebral Maturation in Iranian Females

Science.gov (United States)

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-01-01

Background Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. Objectives The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Patients and Methods Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall’s tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Results Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. Conclusion The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor. PMID:23599706

A comparison of hand wrist bone analysis with two different cervical vertebral analysis in measuring skeletal maturation.

Science.gov (United States)

Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

2014-09-01

Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. Hand wrist radiographs and lateral cephalograms of 72 subjects aged between 7 and 16 years both male and female from the patients visiting Department of Orthodontics and Dentofacial Orthopedics, R.V. Dental College and Hospital. The 9 stages were reduced to 5 stages to compare with cervical vertebral maturation stage by Baccetti et al. The Bjork, Grave and Brown stages were reduced to six intervals to compare with cervical vertebral maturational index (CVMI) staging by Hassel and Farman. These measurements were then compared with the hand wrist bone analysis, and the results were statistically analyzed using the Mann-Whitney test. There was no significant difference between the hand wrist analysis and the two different cervical vertebral analyses for assessing skeletal maturation. There was no significant difference between the two cervical vertebral analyses, but the CVMI method, which is visual method is less time consuming. Vertebral analysis on a lateral cephalogram is as valid as the hand wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects.

Significance of magnetic resonance imaging in the diagnosis of vertebral artery injury associated with blunt cervical spine trauma

International Nuclear Information System (INIS)

Yokota, Hiroyuki; Atsumi, Takahiro; Araki, Takashi; Fuse, Akira; Sato, Hidetaka; Kawai, Makoto; Yamamoto, Yasuhiro

2007-01-01

Vertebral artery injury associated with non-penetrating cervical trauma is rare. We report 11 cases of vertebral artery injury diagnosed with magnetic resonance imaging (MRI) after blunt trauma to the cervical spine and discuss about the importance of MRI in the diagnosis of this injury. Seven cases were caused by motor vehicle accidents, three by diving accidents, and one by static compression of the neck. All of the patients had documented cervical spine fractures and dislocations. In three patients, the diagnosis of complete occlusion of the vertebral artery was made on the basis of MRI and digital subtraction angiography (DSA). In the other patients, mural injuries of the vertebral artery were demonstrated with DSA. These 11 patients presented with acute, nonspecific changes in neurological status. Two had infarctions of the cerebellum and brainstem. None were treated with anticoagulants. All of them survived and were discharged to other hospitals for physical and occupational therapy. Although DSA remains the gold standard for diagnosing vertebral artery injuries, MRI is a newer modality for assessing cervical cord injury, and it may be useful for evaluating the presence of vertebral injury after blunt cervical spine trauma. (author)

Correlations between Cervical Vertebral Maturation (CVM) and Dental Development in Thai Cleft Patients.

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Chongcharueyskul, Pathomporn; Wangsrimonkol, Tasanee; Pisek, Poonsak; Pisek, Araya; Manosudprasit, Montian

2015-08-01

To examine correlations between cervical vertebral maturation stages (CVMs) and dental development stages, and cervical vertebral maturation (CVM) stage 6 and completion of root formation of mandibular third molar in Thai cleft patients. Lateral cephalograms of 366 cleft subjects aged 7-9 years were assessed for CVMs using Baccetti method. Calcication stages of all left mandibular teeth within each CVMs were assessed from panoramic films using Demirjian method. Spearman rank correlation coefficients comparing CVMs and teeth were 0.51-0.79 (pmaturation indicators.

New method for evaluation of cervical vertebral maturation based on angular measurements.

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Alhadlaq, Adel M; Al-Shayea, Eman I

2013-04-01

To investigate the validity of a new approach to assess the cervical vertebral maturation based on angular measurements of the lower border concavity of cervical vertebral bodies. Hand-wrist and lateral cephalometric radiographs of 197 male subjects with age range of 10-15 years attending the orthodontic clinic at King Saud University, Riyadh, Kingdom of Saudi Arabia were utilized. The study was carried out between September 2009 and May 2011. The study sample was divided into 6 groups (group 1: 10 years to group 6: 15 years) based on the chronological age of the subject. The skeletal age of the subjects was determined using Greulich and Pyle's standard radiographic atlas, and skeletal maturation was assessed by Fishman's skeletal maturity indicators. The cervical vertebral maturation (CVM) of subjects was determined using angular measurements of the second, third, and fourth cervical vertebral bodies. The validity of the newly developed method was assessed by examining the correlation between CVM stages determined by the angular measurements and the skeletal maturation level as determined by the standard hand-wrist methods. A significant correlation (r=0.94) was found between the angular CVM stages and the skeletal age determined by Greulich and Pyle's atlas from hand-wrist radiographs. Also, a high correlation (r=0.94) was found between the angular CVM stages and the Fishman's hand-wrist skeletal maturity indicators. The new angular measurement approach to determine CVM is valid and has the potential to be applied in assessing skeletal maturity level in growing male children.

Vertebral Arteriovenous Fistula Presenting as Cervical Myelopathy: A Rapid Recovery with Balloon Embolization

International Nuclear Information System (INIS)

Modi, Manish; Bapuraj, J. Rajiv; Lal, Anupam; Prabhakar, S.; Khandelwal, N.

2010-01-01

A 24-year-old male presented with progressive cervical myelopathy of 2 months' duration. Magnetic resonance imaging of the cervical spine and angiography revealed a large arteriovenous fistula arising from the left vertebral artery. The present case highlights the clinical features and dramatic recovery following endovascular balloon occlusion of a giant cervical arteriovenous fistula.

Quantitative assessment of cervical vertebral maturation using cone beam computed tomography in Korean girls.

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Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Son, Woo-Sung

2015-01-01

This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6-18 years of age). CBCT-generated cervical vertebral maturation (CVM) was used to demarcate the odontoid process and the body of the second cervical vertebra, based on the dentocentral synchondrosis. Correlation coefficient analysis and multiple linear regression analysis were used for each parameter of the cervical vertebrae (P cervical vertebral body and odontoid process, respectively, for the multiple regression models. This suggests that quantitative analysis might be used to estimate skeletal maturation status.

A Comparison of Hand Wrist Bone Analysis with Two Different Cervical Vertebral Analysis in Measuring Skeletal Maturation

Science.gov (United States)

Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

2014-01-01

Background: Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. Materials and Methods: Hand wrist radiographs and lateral cephalograms of 72 subjects aged between 7 and 16 years both male and female from the patients visiting Department of Orthodontics and Dentofacial Orthopedics, R.V. Dental College and Hospital. The 9 stages were reduced to 5 stages to compare with cervical vertebral maturation stage by Baccetti et al. The Bjork, Grave and Brown stages were reduced to six intervals to compare with cervical vertebral maturational index (CVMI) staging by Hassel and Farman. These measurements were then compared with the hand wrist bone analysis, and the results were statistically analyzed using the Mann–Whitney test. Results: There was no significant difference between the hand wrist analysis and the two different cervical vertebral analyses for assessing skeletal maturation. There was no significant difference between the two cervical vertebral analyses, but the CVMI method, which is visual method is less time consuming. Conclusion: Vertebral analysis on a lateral cephalogram is as valid as the hand wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects. PMID:25395791

Correlation Between Dental and Cervical Vertebral Maturation in Iranian Females

OpenAIRE

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-01-01

Background Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. Objectives The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Patients and Methods Four hundred females (age range, 8 to 14 years) participate...

Reference values for radiological evaluation of cervical vertebral body shape and spinal canal

Energy Technology Data Exchange (ETDEWEB)

Remes, V.M. [Hospital for Children and Adolescents, Helsinki University Central Hospital (Finland); Heinaenen, M.T.; Marttinen, E.J. [Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Kinnunen, J.S. [Department of Radiology, Helsinki University Central Hospital, HYKS (Finland)

2000-03-01

Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated. This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.)

Reference values for radiological evaluation of cervical vertebral body shape and spinal canal

International Nuclear Information System (INIS)

Remes, V.M.; Heinaenen, M.T.; Marttinen, E.J.; Kinnunen, J.S.

2000-01-01

Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated. This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.)

Use of cervical vertebral maturation to determine skeletal age.

Science.gov (United States)

Wong, Ricky W K; Alkhal, Hessa A; Rabie, A Bakr M

2009-10-01

The purpose of this study was to evaluate the validity of the cervical vertebral maturation (CVM) method as an indicator of skeletal age in the circumpubertal period by correlating it to the hand-wrist method (HWM). Hand-wrist and lateral cephalometric radiographs of 400 Chinese subjects were randomly selected. Their ages were 10 to 15 years for girls and 12 to 17 years for boys, so they were within the circumpubertal period. Skeletal ages were assessed according to the CVM method and the HWM. The CVM was significantly correlated with HWM skeletal age (Spearman r = 0.9521 [boys] and 0.9408 [girls]). All patients in cervical vertebral stage 3 of the CVM corresponded to stages MP3-FG or MP3-G (around the peak of the growth spurt) in the HWM. The CVM is a valid indicator of skeletal growth during the circumpubertal period, providing information for timing of growth modification.

Cervical vertebral maturation and dental age in coeliac patients.

Science.gov (United States)

Costacurta, M; Condò, R; Sicuro, L; Perugia, C; Docimo, R

2011-07-01

The aim of the study was to evaluate the cervical vertebral maturation and dental age, in group of patients with coelic disease (CD), in comparison with a control group of healthy subjects. At the Paediatric Dentistry Unit of PTV Hospital, "Tor Vergata" University of Rome, 120 female patients, age range 12.0-12.9 years were recruited. Among them, 60 subjects (Group 1) were affected by CD, while the control group (Group 2) consisted of 60 healthy subjects, sex and age-matched. The Group 1 was subdivided, according to the period of CD diagnosis, in Group A (early diagnosis) and Group B (late diagnosis). The skeletal age was determined by assessing the cervical vertebral maturation, while the dental age has been determined using the method codified by Demirjiyan. STATISTICS.: The analyses were performed using the SPSS software (version 16; SPSS Inc., Chicago IL, USA). In all the assessments a significant level of alpha = 0.05 was considered. There are no statistically significant differences between Group 1 and Group 2 as for chronological age (p=0.122). Instead, from the assessment of skeletal-dental age, there are statistically significant differences between Group 1 - Group 2 (pcervical vertebral maturity can be assessed with a low cost, non invasive, easy to perform exam carried out through the routine radiographic examinations such as orthopanoramic and lateral teleradiography.

Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

Energy Technology Data Exchange (ETDEWEB)

Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M. [Department of Radiology, University Hospital, Gent (Belgium); Vandekerckhove, T. [Department of Neurosurgery, University Hospital, Gent (Belgium)

2000-06-01

A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

International Nuclear Information System (INIS)

Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M.; Vandekerckhove, T.

2000-01-01

A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

Cervical vertebral fusion (Klippel-Feil) syndrome with consanguineous parents.

Science.gov (United States)

Juberg, R C; Gershanik, J J

1976-06-01

We describe a female infant with the cervical vertebral fusion (Klippel-Feil) syndrome whom we recognized at birth because of her short neck, restriction of cervical movement, and low posterior hairline. X-ray examination showed anomalies of C1, and between C2-3 and C3-4; thus, we classified her as type II, with variable cervical fusion. At 24 months she was small and manifested hearing deficiency. The mother and father were consanguineous with five common ancestors four generations ago, which resulted in a coefficient of inbreeding equivalent to a second cousin relationship. The parents and grandparents were phenotypically normal, and the parents were radiologically normal. This form of the syndrome has previously been said to be autosomal dominant. Our conclusion of determination by a single autosomal recessive gene is evidence of genetic heterogeneity.

An Improved Version of the Cervical Vertebral Maturation (CVM) Method for the Assessment of Mandibular Growth in Deutero-Malay Sub Race

Science.gov (United States)

Oscandar, Fahmi; Malinda, Yuti; Azhari, H.; Murniati, Nani; Yeh Ong, Sing; Subiyanto; Supian, Sudradjat

2018-01-01

In this paper, Cervical Vertebral Maturation method was used to assess the mandibular growth in Deutero-Malay sub race. Twenty eight laterals Cephalometric radiographs of Deutero-Malay sub race aged 9-15 were observed. The observation used stratified random sampling by measuring the quantitative and qualitative assessment of the 2nd through 4th cervical vertebra of the subjects. It produced the diagram of developmental stages of cervical vertebrae for Deutero-Malay sub race. The diagram can be used to determine mandibular growth in term of qualitative by matching the shape of cervical vertebrae. It was obtained that the Cervical Vertebral Maturation method can be used to assess mandibular growth in Deutero-Malay sub race by matching the shape of cervical vertebrae to the diagram of developmental stages of cervical vertebrae. In addition, Cervical Vertebral Maturation method can be used to identification person’s age.

Estudo anatômico do trajeto da artéria vertebral na coluna cervical inferior humana Anatomical study of the vertebral artery path in human lower cervical spine

Directory of Open Access Journals (Sweden)

Ben Hur Junitiro Kajimoto

2007-01-01

Full Text Available O aumento da utilização de novas técnicas e materiais de síntese para o tratamento cirúrgico de afecções da coluna cervical baixa foi acompanhado da crescente preocupação em relação às complicações que podem ocorrer. A técnica de fixação transpedicular, amplamente utilizada para os outros níveis da coluna vertebral, quando realizada na coluna cervical, apesar de conferir maior estabilidade quando comparada a outras técnicas, pode cursar com complicações graves como lesão da artéria vertebral, lesão de raiz nervosa, além de lesão da articulação facetária. A vértebra C7, no entanto, é considerada mais segura para a realização de tal procedimento, já que, na grande maioria das pessoas, segundo os estudos anatômicos disponíveis, esta não possui a artéria vertebral dentro de seu forame transverso, pois este vaso irá penetrar tal estrutura apenas na vértebra C6. Como hoje existem apenas estudos de imagem para avaliação do trajeto desta artéria e suas variações anatômicas, realizamos este estudo anatômico dissecando 40 artérias vertebrais de cadáveres para avaliar a incidência das variações anatômicas. Encontramos 3 casos onde a artéria vertebral penetrou o forame transverso já em C7 (7,5%, o que aumentaria o risco de uma técnica transpedicular neste nível. O restante das peças anatômicas possuíam anatomia habitual.The increasing use of new techniques and materials for surgical treatment of lower cervical spine conditions has come along with an increasing concern regarding potential complications that might occur. The transpedicular fixation technique, frequently used in other spine levels, is used on the cervical spine, while providing more stability than other techniques, it may cause serious complications such as vertebral artery injury, nervous root injury, or facet joint injuries. However, the C7 vertebra is considered safer for performing this procedure, since, in the vast majority of

Application of Cervical Vertebral Maturation Stages Index in Orthodontics

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Z.Dalili

2005-02-01

Full Text Available Evaluation of skeletal age and determination of growth status had important and special roie in orthodontic treatment planning (such as functional orthopedic treatment and orthognatic surgery and also in stability of it. There were several biologic indicators for the detection of the peak in mandibular growth. Due to the limitations of biological indicators application, idea of new indicators was seemed importantly. Cervical vertebral maturation (CVM method is one of them. At first the detection of the peak in mandibular growth was based on the analysis of the second through sixth cervical vertebrae in six developmental stages. But a few improvements of the original CVM analysis were still needed. In this method, the peak in mandibular growth was determined based on the analysis of the second through fourth cervical vertebrae in five developmental stages. This method is easy, applicable and more valid than hand-wrist analysis method.

Epiphyseal union of the cervical vertebral centra: its relationship to skeletal age and maturation of thoracic vertebral centra.

Science.gov (United States)

Albert, Midori A; Maier, Christopher A

2013-11-01

Epiphyseal union stages for cervical vertebral centra (ring epiphyses) were documented for 55 individuals (females and males, ages 14-27 years) from the Terry Collection, using the Albert and Maples method 1, to examine both its relationship to age at death and to thoracic data collected from the same individuals using the same method. Results showed a moderate correlation between cervical ring union and age (r = 0.63, p = 0.000), and a fairly low correlation between cervical and thoracic ring union (r = 0.41, p = 0.002). Paired samples t-tests yielded a statistically significant difference between cervical and thoracic union mean values (p = 0.01). Union progressed earlier in cervical vertebrae and in females. Results indicated fairly substantial variation in both sexes. Findings may serve as a basic guideline for estimating a general age range at death for unknown skeletal remains and to corroborate findings from other skeletal age indicators. © 2013 American Academy of Forensic Sciences.

Vertebral artery injury in cervical spine surgery: anatomical considerations, management, and preventive measures.

Science.gov (United States)

Peng, Chan W; Chou, Benedict T; Bendo, John A; Spivak, Jeffrey M

2009-01-01

Vertebral artery (VA) injury can be a catastrophic iatrogenic complication of cervical spine surgery. Although the incidence is rare, it has serious consequences including fistulas, pseudoaneurysm, cerebral ischemia, and death. It is therefore imperative to be familiar with the anatomy and the instrumentation techniques when performing anterior or posterior cervical spine surgeries. To provide a review of VA injury during common anterior and posterior cervical spine procedures with an evaluation of the surgical anatomy, management, and prevention of this injury. Comprehensive literature review. A systematic review of Medline for articles related to VA injury in cervical spine surgery was conducted up to and including journal articles published in 2007. The literature was then reviewed and summarized. Overall, the risk of VA injury during cervical spine surgery is low. In anterior cervical procedures, lateral dissection puts the VA at the most risk, so sound anatomical knowledge and constant reference to the midline are mandatory during dissection. With the development and rise in popularity of posterior cervical stabilization and instrumentation, recognition of the dangers of posterior drilling and insertion of transarticular screws and pedicle screws is important. Anomalous vertebral anatomy increases the risk of injury and preoperative magnetic resonance imaging and/or computed tomography (CT) scans should be carefully reviewed. When the VA is injured, steps should be taken to control local bleeding. Permanent occlusion or ligation should only be attempted if it is known that the contralateral VA is capable of providing adequate collateral circulation. With the advent of endovascular repair, this treatment option can be considered when a VA injury is encountered. VA injury during cervical spine surgery is a rare but serious complication. It can be prevented by careful review of preoperative imaging studies, having a sound anatomical knowledge and paying attention

Aberrant articulation of cervical vertebral transverse process: An uncommon normal variant and review of the literature

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Ryu, Jeong Ah; Cha, Seung Woo [Dept. of Radiology, Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of); Song, Yoon Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Hanyang University College of Medicine, Seoul Hospital, Seoul (Korea, Republic of)

2013-09-15

Aberrant articulation between two anterior tubercles is a rare congenital anomaly that should be considered for patients showing a bony projection anterior to the vertebral body on a lateral radiograph of the cervical spine. We present a case of an elongation of the anterior tubercles of the transverse processes of both the fifth and sixth cervical vertebrae. This finding is probably a form of supernumerary cervical rib developing at a level above the lowest cervical spine.

Aberrant articulation of cervical vertebral transverse process: An uncommon normal variant and review of the literature

International Nuclear Information System (INIS)

Ryu, Jeong Ah; Cha, Seung Woo; Song, Yoon Ah; Lee, Seung Hun; Joo, Kyung Bin

2013-01-01

Aberrant articulation between two anterior tubercles is a rare congenital anomaly that should be considered for patients showing a bony projection anterior to the vertebral body on a lateral radiograph of the cervical spine. We present a case of an elongation of the anterior tubercles of the transverse processes of both the fifth and sixth cervical vertebrae. This finding is probably a form of supernumerary cervical rib developing at a level above the lowest cervical spine.

[Establishment of cervical vertebral skeletal maturation of female children in Shanghai].

Science.gov (United States)

Sun, Yan; Chen, Rong-jing; Yu, Quan; Fan, Li; Chen, Wei; Shen, Gang

2009-06-01

To establish a method for quantitatively evaluating skeletal maturation of cervical vertebrae of female children in Shanghai. The samples were selected from lateral cephalometric radiographs of 240 Shanghai girls, aged 8 to 15 years. The parameters were measured to indicate the morphological changes of the third (C3) and fourth (C4) vertebrae in width, height and the depth of the inferior curvature. The independent-sample t test and stepwise multiple regression analysis were used to estimate the growth status and the ratios of C3, C4 cervical vertebrae by SPSS 15.0 software package. The physical and morphological contour of C3, C4 cervical vertebrae increased proportionately with the increment of age. The regression formula for indicating cervical vertebral skeletal age of female children in Shanghai was expressed by the equation Y= -5.696+8.010 AH3/AP3+6.654 AH3/H3+6.045AH4/PH4 (r=0.912). The regression formula resulted from morphological measurements quantitatively indicates the skeletal maturation of cervical vertebrae of female children in Shanghai.

Characterizing the location of spinal and vertebral levels in the human cervical spinal cord.

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Cadotte, D W; Cadotte, A; Cohen-Adad, J; Fleet, D; Livne, M; Wilson, J R; Mikulis, D; Nugaeva, N; Fehlings, M G

2015-04-01

Advanced MR imaging techniques are critical to understanding the pathophysiology of conditions involving the spinal cord. We provide a novel, quantitative solution to map vertebral and spinal cord levels accounting for anatomic variability within the human spinal cord. For the first time, we report a population distribution of the segmental anatomy of the cervical spinal cord that has direct implications for the interpretation of advanced imaging studies most often conducted across groups of subjects. Twenty healthy volunteers underwent a T2-weighted, 3T MRI of the cervical spinal cord. Two experts marked the C3-C8 cervical nerve rootlets, C3-C7 vertebral bodies, and pontomedullary junction. A semiautomated algorithm was used to locate the centerline of the spinal cord and measure rostral-caudal distances from a fixed point in the brain stem, the pontomedullary junction, to each of the spinal rootlets and vertebral bodies. Distances to each location were compared across subjects. Six volunteers had 2 additional scans in neck flexion and extension to measure the effects of patient positioning in the scanner. We demonstrated that substantial variation exists in the rostral-caudal position of spinal cord segments among individuals and that prior methods of predicting spinal segments are imprecise. We also show that neck flexion or extension has little effect on the relative location of vertebral-versus-spinal levels. Accounting for spinal level variation is lacking in existing imaging studies. Future studies should account for this variation for accurate interpretation of the neuroanatomic origin of acquired MR signals. © 2015 by American Journal of Neuroradiology.

Cervical vertebral maturation of female children with orofacial clefts.

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Sun, Ling; Li, Wei Ran

2013-09-01

Objective : To evaluate the skeletal maturation of girls with orofacial clefts using the cervical vertebral maturation method. Design : Case-control study. Setting : The School of Stomatology, Peking University. Patients : A total of 173 girls with cleft lip and/or palate from 8 to 16 years old were compared with 1038 age-matched girls without clefts. Results : In the 8- to 9-year-olds, most of the girls from both groups were in cervical stage 1. In the 14- to 15-year-olds and 15- to 16-year-olds, almost all the girls from both groups were in cervical stages 5 and 6, and most of the 15- to 16-year-old girls were in cervical stage 6. Differences existed in each year for 9- to 14-year-olds, which was confirmed by statistical analysis. After ordinal logistical regression of data from girls 9 to 14 years of age, girls of the same age in the non-cleft lip and/or palate group were associated with 1.559 times the odds of having achieved higher cervical stages than those in the cleft lip and/or palate group. Most girls without cleft lip and/or palate were in cervical stages 3 and 4 in the 11- to 12-year-olds; whereas, it was not so obvious in the girls with cleft lip and/or palate. By the age of 12, girls with cleft lip and/or palate had 2.667 times the risk of delayed cervical stage 3, and the 95% confidence interval for the odds ratio was 1.013 to 7.019. Conclusions : Girls with cleft lip and/or palate are at a higher risk of delayed pubertal growth.

Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite

DEFF Research Database (Denmark)

Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

2014-01-01

INTRODUCTION: Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. METHODS: One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were...... posture were made on profile radiographs. RESULTS: Deviations in the cervical vertebral column morphology occurred in 23.7% of the subjects in the skeletal open-bite group and in 19.2% in the dentoalveolar open-bite group, but the difference was not significant. Head posture was significantly more...... extended in the skeletal open-bite group compared with the dentoalveolar open-bite group (craniovertical angle [Mx/VER], P posture was associated with craniofacial morphology: extended posture was associated with a large cranial base angle...

Reliability of cervical vertebral maturation staging.

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Rainey, Billie-Jean; Burnside, Girvan; Harrison, Jayne E

2016-07-01

Growth and its prediction are important for the success of many orthodontic treatments. The aim of this study was to determine the reliability of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. A group of 20 orthodontic clinicians, inexperienced in CVM staging, was trained to use the improved version of the CVM method for the assessment of mandibular growth with a teaching program. They independently assessed 72 consecutive lateral cephalograms, taken at Liverpool University Dental Hospital, on 2 occasions. The cephalograms were presented in 2 different random orders and interspersed with 11 additional images for standardization. The intraobserver and interobserver agreement values were evaluated using the weighted kappa statistic. The intraobserver and interobserver agreement values were substantial (weighted kappa, 0.6-0.8). The overall intraobserver agreement was 0.70 (SE, 0.01), with average agreement of 89%. The interobserver agreement values were 0.68 (SE, 0.03) for phase 1 and 0.66 (SE, 0.03) for phase 2, with average interobserver agreement of 88%. The intraobserver and interobserver agreement values of classifying the vertebral stages with the CVM method were substantial. These findings demonstrate that this method of CVM classification is reproducible and reliable. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Ehlers Danlos type IV syndrome presenting with simultaneous dissection of both internal carotid and both vertebral arteries].

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Mondon, K; de Toffol, B; Georgesco, G; Cassarini, J-F; Machet, M-C; Cottier, J-P; Arbeille, B; Autret, A

2004-04-01

Dissection of cervical arteries is a frequent cause of stroke in young subjects. We report the case of a 34-year-old patient who experienced simultaneous dissection of both internal carotid arteries and both vertebral arteries leading to repeated motor deficit of the right half-body associated with persistent otalgia. Search for an etiology led to the diagnosis of Ehlers-Danlos syndrome type IV. Search for the cause of cervical artery dissection must consider connective tIssue disease, particularly vascular forms of Ehler-Danlos syndrome. Diagnostic, therapeutic as well as prognostic aspects are discussed.

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit.

Science.gov (United States)

Mazensky, David; Petrovova, Eva; Danko, Jan

2013-01-01

The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%). In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%). We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%). The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

Mechanism and patterns of cervical spine fractures-dislocations in vertebral artery injury

Directory of Open Access Journals (Sweden)

Pankaj Gupta

2012-01-01

Full Text Available Purpose: To identify the fracture patterns and mechanism of injury, based on subaxial cervical spine injury classification system (SLIC, on non-contrast computed tomography (NCCT of cervical spine predictive of vertebral artery injury (VAI. Patients and Methods: We retrospectively analyzed cervical spine magnetic resonance imaging (MRI of 320 patients who were admitted with cervical spine injury in our level I regional trauma center over a period of two years (April 2010 to April 2012. Diagnosis of VAI was based on hyperintensity replacing the flow void on a T2-weighted axial image. NCCT images of the selected 43 patients with MRI diagnosis of VAI were then assessed for the pattern of injury. The cervical spinal injuries were classified into those involving the C1 and C2 and subaxial spine. For the latter, SLIC was used. Results: A total of 47 VAI were analyzed in 43 patients. Only one patient with VAI on MRI had no detectable abnormality on NCCT. C1 and C2 injuries were found in one and six patients respectively. In subaxial injuries, the most common mechanism of injury was distraction (37.5% with facet dislocation with or without fracture representing the most common pattern of injury (55%. C5 was the single most common affected vertebral level. Extension to foramen transversarium was present in 20 (42.5% cases. Conclusion: CT represents a robust screening tool for patients with VAI. VAI should be suspected in patients with facet dislocation with or without fractures, foramina transversarium fractures and C1-C3 fractures, especially type III odontoid fractures and distraction mechanism of injury.

Quantitative Assessment of Cervical Vertebral Maturation Using Cone Beam Computed Tomography in Korean Girls

Directory of Open Access Journals (Sweden)

Bo-Ram Byun

2015-01-01

Full Text Available This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT images were obtained from 74 Korean girls (6–18 years of age. CBCT-generated cervical vertebral maturation (CVM was used to demarcate the odontoid process and the body of the second cervical vertebra, based on the dentocentral synchondrosis. Correlation coefficient analysis and multiple linear regression analysis were used for each parameter of the cervical vertebrae (P<0.05. Forty-seven of 64 parameters from CBCT-generated CVM (independent variables exhibited statistically significant correlations (P<0.05. The multiple regression model with the greatest R2 had six parameters (PH2/W2, UW2/W2, (OH+AH2/LW2, UW3/LW3, D3, and H4/W4 as independent variables with a variance inflation factor (VIF of <2. CBCT-generated CVM was able to include parameters from the second cervical vertebral body and odontoid process, respectively, for the multiple regression models. This suggests that quantitative analysis might be used to estimate skeletal maturation status.

Quantitative Assessment of Cervical Vertebral Maturation Using Cone Beam Computed Tomography in Korean Girls

OpenAIRE

Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Son, Woo-Sung

2015-01-01

This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6?18 years of age). CBCT-generated cervical vertebral maturation ...

Intrinsic Vertebral Markers for Spinal Level Localization in Anterior Cervical Spine Surgery: A Preliminary Report.

Science.gov (United States)

Jha, Deepak Kumar; Thakur, Anil; Jain, Mukul; Arya, Arvind; Tripathi, Chandrabhushan; Kumari, Rima; Kushwaha, Suman

2016-12-01

Prospective clinical study. To observe the usefulness of anterior cervical osteophytes as intrinsic markers for spinal level localization (SLL) during sub-axial cervical spinal surgery via the anterior approach. Various landmarks, such as the mandibular angle, hyoid bone, thyroid cartilage, first cricoid ring, and C6 carotid tubercle, are used for gross cervical SLL; however, none are used during cervical spinal surgery via the anterior approach. We present our preliminary assessment of SLL over anterior vertebral surfaces (i.e., intrinsic markers) in 48 consecutive cases of anterior cervical spinal surgeries for the disc-osteophyte complex (DOC) in degenerative diseases and granulation or tumor tissue associated with infectious or neoplastic diseases, respectively, at an ill-equipped center. This prospective study on patients undergoing anterior cervical surgery for various sub-axial cervical spinal pathologies aimed to evaluate the feasibility and accuracy of SLL via intraoperative palpation of disease-related morphological changes on anterior vertebral surfaces visible on preoperative midline sagittal T1/2-weighted magnetic resonance images. During a 3-year period, 48 patients (38 males,10 females; average age, 43.58 years) who underwent surgery via the anterior approach for various sub-axial cervical spinal pathologies, including degenerative disease (n= 42), tubercular infection (Pott's disease; n=3), traumatic prolapsed disc (n=2), and a metastatic lesion from thyroid carcinoma (n=1), comprised the study group. Intrinsic marker palpation yielded accurate SLL in 79% of patients (n=38). Among those with degenerative diseases (n=42), intrinsic marker palpation yielded accurate SLL in 76% of patients (n=32). Intrinsic marker palpation is an attractive potential adjunct for SLL during cervical spinal surgeries via the anterior approach in well-selected patients at ill-equipped centers (e.g., those found in developing countries). This technique may prove helpful

Bone density assessment for evaluation of gender differences in cervical vertebral maturation: A computed tomography study.

Science.gov (United States)

Usha, K; Baskaranarayanan, Balashanmugam; Nagarajan, D; Selvarani, R; Vijjaykanth, M

2016-10-01

The cervical vertebral maturation (CVM) method is a vital tool for assessing the biological maturation of the orthodontic patient to evaluate the amount of mandibular bone growth left. To assess and visualize the cervical vertebral morphology (bone density) of orthodontic patients of the age group 9,16,27 years. Twenty four subjects with age group of 9,16,27 who were randomly selected and subjected to 3d tomographic study to estimate the biological age of the orthodontic patients by analyzing c1 c2 and c3 vertebrae. The results showed that bone density of males is lesser than females in 9 and 16 years, whereas they have more bone density than females in 27 years. The study provides qualitative method of assessing the biological age of the patient by using images of cervical vertebrae by three dimensional approach. Hence it can be useful for orthodontic diagnosis and treatment plan.

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit

Directory of Open Access Journals (Sweden)

David Mazensky

2013-01-01

Full Text Available The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%. In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%. We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%. The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

Life-threatening bleeding from a vertebral artery pseudoaneurysm after anterior cervical spine approach: endovascular repair by a triple stent-in-stent method. Case report

Energy Technology Data Exchange (ETDEWEB)

Alzamora, M.G.; Klisch, J. [Section of Neuroradiology, Neurocenter, University of Freiburg (Germany); Rosahl, S.K.; Lehmberg, J. [Department of Neurosurgery, Neurocenter, University of Freiburg (Germany)

2005-04-01

The incidence of injury to the cervical vertebral artery during surgery for stenosis of the cervical neuroforamina is very low. We present a case in which bleeding during microforaminotomy at the level C6/7 occurred. The bleeding could be controlled intraoperatively. Two days later, a life-threatening cervical hematoma required urgent bedside evacuation. A false aneurysm of the left cervical vertebral artery was successfully occluded by a modified triple stent-in-stent technique, maintaining the flow in the vessel.

Life-threatening bleeding from a vertebral artery pseudoaneurysm after anterior cervical spine approach: endovascular repair by a triple stent-in-stent method. Case report

International Nuclear Information System (INIS)

Alzamora, M.G.; Klisch, J.; Rosahl, S.K.; Lehmberg, J.

2005-01-01

The incidence of injury to the cervical vertebral artery during surgery for stenosis of the cervical neuroforamina is very low. We present a case in which bleeding during microforaminotomy at the level C6/7 occurred. The bleeding could be controlled intraoperatively. Two days later, a life-threatening cervical hematoma required urgent bedside evacuation. A false aneurysm of the left cervical vertebral artery was successfully occluded by a modified triple stent-in-stent technique, maintaining the flow in the vessel

Bone density assessment for evaluation of gender differences in cervical vertebral maturation: A computed tomography study

Directory of Open Access Journals (Sweden)

K Usha

2016-01-01

Full Text Available Introduction: The cervical vertebral maturation (CVM method is a vital tool for assessing the biological maturation of the orthodontic patient to evaluate the amount of mandibular bone growth left. Aim: To assess and visualize the cervical vertebral morphology (bone density of orthodontic patients of the age group 9,16,27 years. Material and Methods: Twenty four subjects with age group of 9,16,27 who were randomly selected and subjected to 3d tomographic study to estimate the biological age of the orthodontic patients by analyzing c1 c2 and c3 vertebrae. Result: The results showed that bone density of males is lesser than females in 9 and 16 years, whereas they have more bone density than females in 27 years. Conclusion: The study provides qualitative method of assessing the biological age of the patient by using images of cervical vertebrae by three dimensional approach. Hence it can be useful for orthodontic diagnosis and treatment plan.

Association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity.

Science.gov (United States)

Mahmood, Hafiz Taha; Shaikh, Attiya; Fida, Mubassar

2016-10-01

Various methods have been proposed to evaluate a patient's developmental status. However, most of them lacked precision and failed to give a reliable estimate of skeletal maturity. The aims of this study were to evaluate the association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity and to determine its validity in assessing the different stages of the adolescent growth spurt. A cross-sectional study was performed on the pretreatment lateral cephalograms of 252 subjects aged 8 to 21 years. The sample was divided into 6 groups based on the cervical vertebral maturation stages. The frontal sinus index was calculated by dividing the frontal sinus height and width, and the cervical stages were evaluated on the same radiograph. The Kruskal-Wallis test was applied to compare frontal sinus index values at different cervical stages, and the post hoc Dunnett T3 test was applied to compare frontal sinus index values between adjacent cervical stages for each sex. The Kendall tau-b values were computed to assess the correlation between the cervical stages and the sinus index. A P value of ≤0.05 was considered statistically significant. The height and width of the frontal sinus were significantly larger in the male subjects than in the females. A significant association was found between the frontal sinus height and width and cervical stages (P ≤0.001) in both sexes. However, the changes in the frontal sinus index across the different cervical stages were found to be significant (P ≤0.001) in male subjects only. Similarly, a weak negative correlation was found between the sinus index and the cervical stages in male subjects (tau-b = -0.271; P cervical stages. The frontal sinus index cannot be used to identify the prepubertal, pubertal, and postpubertal stages of the adolescent growth spurt. Therefore, it cannot be used as a reliable maturity indicator. Copyright © 2016 American Association of

Cervical vertebral maturation of children with orofacial clefts.

Science.gov (United States)

Sun, Ling; Li, Wei Ran

2012-11-01

To evaluate the skeletal maturation of male children with orofacial clefts using the cervical vertebral maturation (CVM) method. Case-control study. The School of Stomatology, Peking University. Subjects were 443 boys with cleft lip and/or cleft palate (CL/P) aged 8 to 16 years who were compared with 1772 boys without clefts in an age-matched control group. The 8- to 10-year-old boys of both groups were in CS1. Most of the 11- to 14-year-old boys without CL/P were in CS3 and CS4, though it was not so obvious in boys with CL/P. Most 15- to 16-year-old boys without CL/P were in CS5 and CS6, while there were a lot of boys with CL/P who were still in cervical stages before CS5. Clefts had a significant effect on growth, and boys without CL/P were 1.737 times more likely to have achieved higher cervical stages. From Mann-Whitney test of every age phase, the difference existed in each year of the age range of 11 to 16 years, except from 12 to 13 years (p  =  .100). In these age phases, the cervical stages of boys with CL/P were lower than those for boys without CL/P. By the age of 14, children with CL/P had a 4.679 times higher risk of delayed CS3, and the 95% confidence interval for the odds ratio was 2.129 to 10.286. Boys with CL/P are at a higher risk of delayed growth period and retarded pubertal growth peak.

New software for cervical vertebral geometry assessment and its relationship to skeletal maturation--a pilot study.

Science.gov (United States)

Santiago, R C; Cunha, A R; Júnior, G C; Fernandes, N; Campos, M J S; Costa, L F M; Vitral, R W F; Bolognese, A M

2014-01-01

In the present study, we developed new software for quantitative analysis of cervical vertebrae maturation, and we evaluated its applicability through a multinomial logistic regression model (MLRM). Digitized images of the bodies of the second (C2), third (C3) and fourth (C4) cervical vertebrae were analysed in cephalometric radiographs of 236 subjects (116 boys and 120 girls) by using a software developed for digitized vertebrae analysis. The sample was initially distributed into 11 categories according to the Fishman's skeletal maturity indicators and were then grouped into four stages for quantitative cervical maturational changes (QCMC) analysis (QCMC I, II, III and IV). Seven variables of interest were measured and analysed to identify morphologic alterations of the vertebral bodies in each QCMC category. Statistically significant differences (p cervical vertebrae maturation categories was constructed by taking into account gender, chronological age and four variables determined by digitized vertebrae analysis (Ang_C3, MP_C3, MP_C4 and SP_C4). The MLRM presented a predictability of 81.4%. The weighted κ test showed almost perfect agreement (κ = 0.832) between the categories defined initially by the method of Fishman and those allocated by the MLRM. Significant alterations in the morphologies of the C2, C3 and C4 vertebral bodies that were analysed through the digitized vertebrae analysis software occur during the different stages of skeletal maturation. The model that combines the four parameters measured on the vertebral bodies, the age and the gender showed an excellent prediction.

New software for cervical vertebral geometry assessment and its relationship to skeletal maturation—a pilot study

Science.gov (United States)

Cunha, A R; Júnior, G C; Fernandes, N; Campos, M J S; Costa, L F M; Vitral, R W F; Bolognese, A M

2014-01-01

Objectives: In the present study, we developed new software for quantitative analysis of cervical vertebrae maturation, and we evaluated its applicability through a multinomial logistic regression model (MLRM). Methods: Digitized images of the bodies of the second (C2), third (C3) and fourth (C4) cervical vertebrae were analysed in cephalometric radiographs of 236 subjects (116 boys and 120 girls) by using a software developed for digitized vertebrae analysis. The sample was initially distributed into 11 categories according to the Fishman's skeletal maturity indicators and were then grouped into four stages for quantitative cervical maturational changes (QCMC) analysis (QCMC I, II, III and IV). Seven variables of interest were measured and analysed to identify morphologic alterations of the vertebral bodies in each QCMC category. Results: Statistically significant differences (p cervical vertebrae maturation categories was constructed by taking into account gender, chronological age and four variables determined by digitized vertebrae analysis (Ang_C3, MP_C3, MP_C4 and SP_C4). The MLRM presented a predictability of 81.4%. The weighted κ test showed almost perfect agreement (κ = 0.832) between the categories defined initially by the method of Fishman and those allocated by the MLRM. Conclusions: Significant alterations in the morphologies of the C2, C3 and C4 vertebral bodies that were analysed through the digitized vertebrae analysis software occur during the different stages of skeletal maturation. The model that combines the four parameters measured on the vertebral bodies, the age and the gender showed an excellent prediction. PMID:24319125

Percutaneous vertebroplasty performed with an 18 G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy

International Nuclear Information System (INIS)

Chen Long; Ni Caifang; Wang Zhentang; Liu Yizhi; Jin Yonghai; Zhu Xiaoli; Zou Jianwei; Xiao Xiangsheng

2010-01-01

Objective: To investigate the clinical feasibility and efficacy of percutaneous vertebroplasty performed with an 18G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy. Methods: During the period of 2006-2010 percutaneous vertebroplasty was performed in 10 patients with severe compression fracture of cervical vertebral body due to metastatic lesions. A total of 12 diseased vertebral bodies were detected, which distributed in the C 4 (n = 3), C 5 (n = 3), C 6 (n = 4) and C 7 (n = 2) vertebral bodies. Under DSA guidance an 18G needle was punctured into the target vertebral body and then polymethylmethacrylate bone cement was injected in. A follow-up lasting for one month was conducted. Results: The technical success of both needle puncturing and bone cement injection was achieved in all patients. The mean amount of bone cement injected in each diseased vertebra was 2.2 ml(1.5-3.2)ml. Marked pain relief was quickly obtained in al1 10 patients. No major complications occurred in this series, except for asymptomatic bone cement leaking around vertebra which appeared in 4 vertebral bodies. Conclusion: Percutaneous vertebroplasty, which is performed with an 18G needle, is a safe and effective technique for the treatment of severe compression fracture of cervical vertebral body due to malignancy. (authors)

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages.

Science.gov (United States)

Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-06-01

To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . When compared with controls, there was a significant reduction in ANB angle (p cervical stages (p cervical stages (p cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage.

Effectiveness of the cervical vertebral maturation method to predict postpeak circumpubertal growth of craniofacial structures.

NARCIS (Netherlands)

Fudalej, P.S.; Bollen, A.M.

2010-01-01

INTRODUCTION: Our aim was to assess effectiveness of the cervical vertebral maturation (CVM) method to predict circumpubertal craniofacial growth in the postpeak period. METHODS: The CVM stage was determined in 176 subjects (51 adolescent boys and 125 adolescent girls) on cephalograms taken at the

Quantitative skeletal maturation estimation using cone-beam computed tomography-generated cervical vertebral images: a pilot study in 5- to 18-year-old Japanese children.

Science.gov (United States)

Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Hwang, Dea-Seok; Park, Soo-Byung; Son, Woo-Sung

2015-11-01

The purpose of this study was to establish multivariable regression models for the estimation of skeletal maturation status in Japanese boys and girls using the cone-beam computed tomography (CBCT)-based cervical vertebral maturation (CVM) assessment method and hand-wrist radiography. The analyzed sample consisted of hand-wrist radiographs and CBCT images from 47 boys and 57 girls. To quantitatively evaluate the correlation between the skeletal maturation status and measurement ratios, a CBCT-based CVM assessment method was applied to the second, third, and fourth cervical vertebrae. Pearson's correlation coefficient analysis and multivariable regression analysis were used to determine the ratios for each of the cervical vertebrae (p maturation status according to the CBCT-based quantitative cervical vertebral maturation (QCVM) assessment was 5.90 + 99.11 × AH3/W3 - 14.88 × (OH2 + AH2)/W2 + 13.24 × D2; for the Japanese girls, it was 41.39 + 59.52 × AH3/W3 - 15.88 × (OH2 + PH2)/W2 + 10.93 × D2. The CBCT-generated CVM images proved very useful to the definition of the cervical vertebral body and the odontoid process. The newly developed CBCT-based QCVM assessment method showed a high correlation between the derived ratios from the second cervical vertebral body and odontoid process. There are high correlations between the skeletal maturation status and the ratios of the second cervical vertebra based on the remnant of dentocentral synchondrosis.

Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?

Science.gov (United States)

Grave, Keith; Townsend, Grant

2003-11-01

Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians. Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt. Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.

Question of radiation exposure of the cervical vertebral column in the palliative X-ray irradiation in case of therapy-resistant scapulohumeral periarthritis with local cervical syndrome and/or cervicobrachial syndrome

Energy Technology Data Exchange (ETDEWEB)

Hoenle, R

1985-08-01

An improvement is achieved by palliative X-ray irradiation in about 70% out of 47 patients with scapulohumeral periarthritis and local cervival syndrome and/or cervicobrachial syndrome which was hitherto resistant to medicomechanical treatment. Higher rates of success (84%) can be achieved if the patients present an identical symptomatology, but less severe alterations of the vertebral column, even if the vertebral column is not irradiated. In case of severe alterations of the vertebral column, the success of palliative irradiation is diminished, even if the cervical vertebral column is additionally irradiated.

A Comparison of Hand Wrist Bone Analysis with Two Different Cervical Vertebral Analysis in Measuring Skeletal Maturation

OpenAIRE

Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

2014-01-01

Background: Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. M...

[Contribution of the cervical vertebral maturation (CVM) method to dentofacial orthopedics: update].

Science.gov (United States)

Elhaddaoui, R; Benyahia, H; Azaroual, F; Zaoui, F

2014-11-01

The successful orthopedic treatment of skeletal Class II malocclusions is closely related to the reasoned determination of the optimal time to initiate the treatment. This is why various methods have been proposed to assess skeletal maturation, such as a hand-wrist radiograph or the cervical vertebral maturation (CVM) method. The hand-wrist radiograph was up to now the most frequently used method to assess skeletal maturation. However, the clinical and biological limitations of this technique, as well as the need to perform an additional radiograph, were reasons to develop another method to explore the maturation stages of visible cervical vertebrae on a simple lateral cephalometric radiograph. The authors compare the 2 methods and prove the greater contribution of the CVM method compared to the hand-wrist radiograph. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

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Kishi S

2012-04-01

Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

Correlation between Dental Maturity by Demirjian Method and Skeletal Maturity by Cervical Vertebral Maturity Method using Panoramic Radiograph and Lateral Cephalogram

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Madhusudhanan Mallika Mini

2017-01-01

Full Text Available Introduction: Radiographs are effective tools in assessing the stages of bone maturation in dentistry. The cervical vertebral maturation method is a proven effective tool in assessing the adolescent growth spurt than hand-wrist radiographs in an individual. Assessment of dental calcification stages are a reliable method for determining dental maturity. Panoramic imaging can be used as the primary imaging modality for assessing maturity if a correlation can be found out between tooth calcification stages and cervical vertebral maturation stages. This study was conducted to determine the correlation between dental maturity stage and cervical vertebral maturity stage and to estimate predictor variables for cervical vertebral maturation stages (CVMS stratified by gender in a tertiary hospital setting. Materials and Methods: A descriptive study was conducted among patients accessing orthodontic care in radiology outpatient clinic, Oral Medicine and Radiology department, Government Dental College Thiruvananthapuram for a period of 15 months. Participants were selected between the ages of 8 and 16 years. Panoramic radiographs and lateral cephalograms were used to determine dental maturity stages using Demirjian method and CVMS using Bacetti and Franchi method, respectively. Results: One hundred patients (males = 46, females = 54 were included in the study; the spearman rank order correlation revealed significant relationship. The correlation ranged from 0.61 to 0.74 for females and 0.48 to 0.51 for males. Second premolar showed highest correlation and canine the lowest for both females and males. Stage G of mandibular second premolar signifies the pubertal growth period in this study population. By ordinal regression model, G stage of second premolar was found to be a significant predictor in males and stage H followed by G and F in females for the age group of 12–14 years. Conclusion: Dental maturation stages were significantly correlated with CVMS

Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease.

Science.gov (United States)

Jabłońska, Renata; Ślusarz, Robert; Królikowska, Agnieszka; Haor, Beata; Antczak, Anna; Szewczyk, Maria

2017-01-01

The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease. The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140). Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery ( p =0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery ( p =0.368). This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.

On the question of radiation exposure of the cervical vertebral column in the palliative X-ray irradiation in case of therapy-resistant scapulohumeral periarthritis with local cervical syndrome and/or cervicobrachial syndrome

International Nuclear Information System (INIS)

Hoenle, R.

1985-01-01

An improvement is achieved by palliative X-ray irradiation in about 70% out of 47 patients with scapulohumeral periarthritis and local cervival syndrome and/or cervicobrachial syndrome which was hitherto resistant to medicomechanical treatment. Higher rates of success (84%) can be achieved if the patients present an identical symptomatology, but less severe alterations of the vertebral column, even if the vertebral column is not irradiated. In case of severe alterations of the vertebral column, the success of palliative irradiation is diminished, even if the cervical vertebral column is additionally irradiated. (orig.) [de

Objective evaluation of cervical vertebral bone age' its reliability in comparison with hand-wrist bone age: by TW3 method.

Science.gov (United States)

Prasad, Cms Krishna; Reddy, Vamsi Nilay; Sreedevi, Gojja; Ponnada, Swaroopa Rani; Priya, K Padma; Naik, B Raveendra

2013-09-01

The aim of this study was to establish the validity of a new method for evaluating skeletal maturation by assessing the 3rd and 4th cervical vertebrae seen in the cephalometric radiograph. This study consisted of a sample of 50 patients in the age group of 8 to 14 years of age. Chronologically, they were divided into six groups, based on the age consisting of a minimum of six to a maximum of 10 subjects. All the patients included in the study were females. The selected subjects were clinically examined and then age and date of birth of the patient in years and months was noted. Then lateral cephalograms and hand-wrist radiographs of the patient were taken on the same day with good clarity and contrast. The results suggested that cervical vertebral bone age on cephalometric radiographs calculated with this method is as reliable at estimating bone age as is the Tanner-Whitehouse 3 (TW3) method on hand-wrist radiographs. By determining the cervical vertebral bone age, skeletal maturity can be evaluated in a detailed and objective manner with cephalometric radiographs. The ability to accurately appraise skeletal maturity from cervical vertebral maturation, without the need for additional radiographs, has the potential to improve orthodontic diagnostic and therapeutic decisions. The technique's simplicity and ease of use should encourage this method as a frst level diagnostic tool to assess skeletal maturation. Clinical signifcance: This study revealed that the timing and sequence of ossifcation of the bones in hand and wrist and cervical vertebrae were able to relate the skeletal development of the various skeletal maturity indicators to a child's development. This method provided a mean with which one can determine the skeletal maturity of a person and thereby determine whether the possibility of potential growth existed.

The biomechanical assessment of the cervical inter-vertebral kinematics, between DDD patients ICR based study

Science.gov (United States)

Saveh, Amir Hossein; Zali, Ali Reza; Seddighi, Amir Saeed; Zarghi, Afsaneh; Chizari, Mahmoud; Hanafiah, Yussof

2012-01-01

Abstract: It is very important to pay more attention to spine from the biomechanical perspective. It would allow the analysis of initial conditions of the vertebral disc degeneration syndrome and adopting of normal spine kinematics to compare and match it with a degenerated disc and providing a biomechanical index as an indicator for the conduct of any surgical intervention including arthroplasty to maximize restoring spinal biomechanical motion. It is clear that the head movement is possible with the help of muscles. However, the shape and type of motion depends on the structure and shape of the cervical spine and the interaction between them. Cervical spine kinematics depends on the anatomy of the bones and joints. Bazhdok et al (2000) investigated the cervical kinematics and mechanical behavior of the spine and its anatomical connections. They have examined the atlanto- occipital joint motion during flexion-extension and rotation as well as the mechanism of paradoxical motion of atlanto- axial joint by radiography. Bifalkou et al (2011) studied the inter-vertebral motion based on arc kinematic commentary of video fluoroscopy. They showed that the diagnosis of biomechanical instability can be done based on the kinematic examination of the spine obtained in sagittal images. They also declared that the fluoroscopy can be used as a tool for study. Using an automated algorithm, image adaption was carried out and the motion direction of vertebrae was tracked. In the present study, some patients were selected among patients with cervical disc degeneration. Following imaging by fluoroscopy, the instantaneous center of the spinal action was calculated. It was used as a biomechanical criterion and the treatment group was compared with the healthy group. The loci of the instantaneous centers of the two groups were compared and its difference with the value of healthy group was calculated. A biomechanical criterion was introduced as a basis for comparison of normal and

[The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

Science.gov (United States)

Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

2009-11-01

To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

A Case of Duplicated Right Vertebral Artery.

Science.gov (United States)

Motomura, Mayuko; Watanabe, Koichi; Tabira, Yoko; Iwanaga, Joe; Matsuuchi, Wakako; Yoshida, Daichi; Saga, Tsuyoshi; Yamaki, Koh-Ichi

2018-04-27

We encountered a case of duplicated right vertebral artery during an anatomical dissection course for medical students in 2015. Two vertebral arteries were found in the right neck of a 91-year-old female cadaver. The proximal leg of the arteries arose from the area between the right subclavian artery and the right common carotid artery that diverged from the brachiocephalic artery. The distal leg arose from the right subclavian artery as expected. The proximal leg entered the transverse foramen of the fourth cervical vertebra and the distal leg entered the transverse foramen of the sixth cervical vertebra. The two right vertebral arteries joined to form one artery just after the origin of the right vertebral artery of the brachiocephalic artery entered the transverse foramen of the fourth cervical vertebra. This artery then traveled up in the transverse foramina and became the basilar artery, joining with the left vertebral artery. We discuss the embryological origin of this case and review previously reported cases.

The Difference in Cervical Vertebral Skeletal Maturation between Cleft Lip/Palate and Non-Cleft Lip/Palate Orthodontic Patients.

Science.gov (United States)

Batwa, Waeil; Almoammar, Khalid; Aljohar, Aziza; Alhussein, Abdullah; Almujel, Saad; Zawawi, Khalid H

2018-01-01

The aim was to evaluate differences in the cervical vertebral skeletal maturity of unilateral cleft lip and palate (UCLP) and non-cleft lip/palate (non-CLP) Saudi male orthodontic patients. This cross-sectional multicenter study took place at the dental school, King Saud University and King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between October 2014 and September 2015. The records of Saudi male orthodontic patients with UCLP ( n = 69) were collected. Cervical vertebral maturation was assessed using their cephalometric radiographs. The records of 138 age-matched non-CLP Saudi male orthodontic patients served as controls. There was a significant difference in skeletal maturity between the UCLP and non-CLP groups, as evident in the delayed skeletal development among the UCLP participants. Moreover, pubertal growth spurt onset was significantly earlier in the non-cleft participants in comparison with the UCLP participants ( p = 0.009). There is delayed skeletal maturity among the UCLP Saudi male population in comparison with their non-CLP age-matched peers.

THE CERVICAL VERTEBRAL BONE MATURATION OF Hb E BETA THALASSEMIA PATIENTS OF DEUTEROMALAY AGED 9 – 14 YEARS

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Loes D. Sjahruddin

2006-04-01

Full Text Available One of the growth indicators that can be used to assess a child’s developmental growth is through skeletal maturation. Skeletal maturity can be evaluated by using anatomical changes of the cervical vertebral bones observed on the lateral cephalometric radiographs. The purpose of this study was to determine the stage of cervical vertebrae maturation of Hb E β thalassemia patients by comparing the shape changes of the second to fourth cervical vertebrae bodies with a control group. The design of this study was cross sectional. The subjects were children with Hb E β thalassemia aged 9 – 14 years. The results showed that the retarded maturation of the cervical vertebrae in Hb E β thalassemia was not found in the subjects of pre-puberty age (9 – 11 years old, but in those of puberty age (12 – 14 years old.

A semi-automated method for bone age assessment using cervical vertebral maturation.

Science.gov (United States)

Baptista, Roberto S; Quaglio, Camila L; Mourad, Laila M E H; Hummel, Anderson D; Caetano, Cesar Augusto C; Ortolani, Cristina Lúcia F; Pisa, Ivan T

2012-07-01

To propose a semi-automated method for pattern classification to predict individuals' stage of growth based on morphologic characteristics that are described in the modified cervical vertebral maturation (CVM) method of Baccetti et al. A total of 188 lateral cephalograms were collected, digitized, evaluated manually, and grouped into cervical stages by two expert examiners. Landmarks were located on each image and measured. Three pattern classifiers based on the Naïve Bayes algorithm were built and assessed using a software program. The classifier with the greatest accuracy according to the weighted kappa test was considered best. The classifier showed a weighted kappa coefficient of 0.861 ± 0.020. If an adjacent estimated pre-stage or poststage value was taken to be acceptable, the classifier would show a weighted kappa coefficient of 0.992 ± 0.019. Results from this study show that the proposed semi-automated pattern classification method can help orthodontists identify the stage of CVM. However, additional studies are needed before this semi-automated classification method for CVM assessment can be implemented in clinical practice.

Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

Energy Technology Data Exchange (ETDEWEB)

Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

2014-01-15

Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

X-ray image segmentation for vertebral mobility analysis

International Nuclear Information System (INIS)

Benjelloun, Mohammed; Mahmoudi, Said

2008-01-01

The goal of this work is to extract the parameters determining vertebral motion and its variation during flexion-extension movements using a computer vision tool for estimating and analyzing vertebral mobility. To compute vertebral body motion parameters we propose a comparative study between two segmentation methods proposed and applied to lateral X-ray images of the cervical spine. The two vertebra contour detection methods include (1) a discrete dynamic contour model (DDCM) and (2) a template matching process associated with a polar signature system. These two methods not only enable vertebra segmentation but also extract parameters that can be used to evaluate vertebral mobility. Lateral cervical spine views including 100 views in flexion, extension and neutral orientations were available for evaluation. Vertebral body motion was evaluated by human observers and using automatic methods. The results provided by the automated approaches were consistent with manual measures obtained by 15 human observers. The automated techniques provide acceptable results for the assessment of vertebral body mobility in flexion and extension on lateral views of the cervical spine. (orig.)

Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study

DEFF Research Database (Denmark)

Sonnesen, L; Jensen, K E; Petersson, A R

2013-01-01

beam CT (CBCT) in adult patients with OSA and to compare 2D lateral cephalograms with three-dimensional (3D) CBCT images. METHODS: For all 57 OSA patients, the cervical vertebral column morphology was evaluated on lateral cephalograms and CBCT images and compared according to fusion anomalies...... and posterior arch deficiency. RESULTS: The CBCT assessment showed that 21.1% had fusion anomalies of the cervical column, i.e. fusion between two cervical vertebrae (10.5%), block fusions (8.8%) or occipitalization (1.8%). Posterior arch deficiency occurred in 14% as partial cleft of C1 and in 3...

The pattern and prevalence of vertebral artery injury in patients with ...

African Journals Online (AJOL)

Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA) in patients with cervical spine fractures. Method.

Quantitative cervical vertebral maturation assessment in adolescents with normal occlusion: a mixed longitudinal study.

Science.gov (United States)

Chen, Li-Li; Xu, Tian-Min; Jiang, Jiu-Hui; Zhang, Xing-Zhong; Lin, Jiu-Xiang

2008-12-01

The purpose of this study was to establish a quantitative cervical vertebral maturation (CVM) system for adolescents with normal occlusion. Mixed longitudinal data were used. The subjects included 87 children and adolescents from 8 to 18 years old with normal occlusion (32 boys, 55 girls) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 years. The lateral cephalograms of all subjects were divided into 11 maturation groups according to the Fishman skeletal maturity indicators. The morphologic characteristics of the second, third, and fourth cervical vertebrae at 11 developmental stages were measured and analyzed. Three characteristic parameters (H4/W4, AH3/PH3, @2) were selected to determine the classification of CVM. With 3 morphologic variables, the quantitative CVM system including 4 maturational stages was established. An equation that can accurately estimate the maturation of the cervical vertebrae was established: CVM stage=-4.13+3.57xH4/W4+4.07xAH3/PH3+0.03x@2. The quantitative CVM method is an efficient, objective, and relatively simple approach to assess the level of skeletal maturation during adolescence.

Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Buell, U.; Winkler, U.

1983-09-01

Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

The Difference in Cervical Vertebral Skeletal Maturation between Cleft Lip/Palate and Non-Cleft Lip/Palate Orthodontic Patients

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Waeil Batwa

2018-01-01

Full Text Available Objective. The aim was to evaluate differences in the cervical vertebral skeletal maturity of unilateral cleft lip and palate (UCLP and non-cleft lip/palate (non-CLP Saudi male orthodontic patients. Method. This cross-sectional multicenter study took place at the dental school, King Saud University and King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between October 2014 and September 2015. The records of Saudi male orthodontic patients with UCLP n=69 were collected. Cervical vertebral maturation was assessed using their cephalometric radiographs. The records of 138 age-matched non-CLP Saudi male orthodontic patients served as controls. Results. There was a significant difference in skeletal maturity between the UCLP and non-CLP groups, as evident in the delayed skeletal development among the UCLP participants. Moreover, pubertal growth spurt onset was significantly earlier in the non-cleft participants in comparison with the UCLP participants p=0.009. Conclusions. There is delayed skeletal maturity among the UCLP Saudi male population in comparison with their non-CLP age-matched peers.

Cervical vertebral maturation method and mandibular growth peak: a longitudinal study of diagnostic reliability.

Science.gov (United States)

Perinetti, Giuseppe; Primozic, Jasmina; Sharma, Bhavna; Cioffi, Iacopo; Contardo, Luca

2018-03-28

The capability of the cervical vertebral maturation (CVM) method in the identification of the mandibular growth peak on an individual basis remains undetermined. The diagnostic reliability of the six-stage CVM method in the identification of the mandibular growth peak was thus investigated. From the files of the Oregon and Burlington Growth Studies (data obtained between early 1950s and middle 1970s), 50 subjects (26 females, 24 males) with at least seven annual lateral cephalograms taken from 9 to 16 years were identified. Cervical vertebral maturation was assessed according to the CVM code staging system, and mandibular growth was defined as annual increments in Co-Gn distance. A diagnostic reliability analysis was carried out to establish the capability of the circumpubertal CVM stages 2, 3, and 4 in the identification of the imminent mandibular growth peak. Variable durations of each of the CVM stages 2, 3, and 4 were seen. The overall diagnostic accuracy values for the CVM stages 2, 3, and 4 were 0.70, 0.76, and 0.77, respectively. These low values appeared to be due to false positive cases. Secular trends in conjunction with the use of a discrete staging system. In most of the Burlington Growth Study sample, the lateral head film at age 15 was missing. None of the CVM stages 2, 3, and 4 reached a satisfactorily diagnostic reliability in the identification of imminent mandibular growth peak.

Calcifying discopathy in infancy in the cervical spine: Evaluation of vertebral alterations over a period of time

Energy Technology Data Exchange (ETDEWEB)

Urso, S; Colajacomo, M; Migliorini, A; Fassari, F M

1987-07-01

CDI in the cervical spine has already been observed and described by many authors, as a well-defined clinico-radiological syndrome with a benign course. The clinical picture is composed of: pain and functional limitation, sometimes with a stiff neck, more rarely slight fever, increase of the erythrocyte sedimentation rate or leukocytosis. The radiographic picture consists of the association of morphological and structural alterations of vertebral bodies adjacent to one or more disc calcifications usually centrally sited, sometimes associated with anterior or posterior herniations. On the basis of the observation of 7 patients, in the 15-year-old range, the authors propose to evaluate the changes of both the vertebral bodies and the discs involved in the disease over a period of time. The repetition of even modest alterations, that persist in time, testify to the involvement of the vertebral growth perhaps, more than the discal alterations connected with the calcification.

Cervical Vertigo(Vertigo)

OpenAIRE

本間, 隆夫; Homma, Takao

1992-01-01

Cervical vertigo was reviewed as to its mechanism, diagnosis and treatment, and nine cases which had operation done were briefly presented. Cervical vertigo has been seen occasionaly in the cases of cervical spondylosis, frequently in the cases of traumatic cervical syndrome. The mechanism is attributed to either vertebrobasilar insufficiency caused by compression on vertebral artery or irritation of poterior cervical sympathetic system. The diagnosis consists of reccurent vertigo attack with...

ORIGINAL ARTICLE The pattern and prevalence of vertebral artery ...

African Journals Online (AJOL)

vertebral artery injury in all patients who have fractures involving the transverse foraminae of the cervical spine, those with facet joint dislocations, and those with fractures involving the first to the third cervical vertebrae. The aim of this study was to determine the pattern and prevalence of vertebral artery injury using CTA in ...

Cervical lordosis: the effect of age and gender.

Science.gov (United States)

Been, Ella; Shefi, Sara; Soudack, Michalle

2017-06-01

similar total cervical lordosis (FM-C7) to adults. The sum of vertebral body wedging for children was more kyphotic-by 7°-than that of adults, whereas the sum of intervertebral disc wedging in children was more lordotic-by11°-than that of adults. Seventy-one percent of the children had lordotic cervical spine, 23% had straight spine, and less than 6% had double curve spine. Gender differences are already apparent in children as girls had higher upper cervical lordosis (FM-C3; C1-C3) than boys do. Although the total cervical lordosis (FM-C7) did not change between age groups, and between males and females, the internal architecture of the cervical lordosis changed significantly. Practitioners before neck stabilization procedures or correction and restoration should therefore take into account the gender and age differences in cervical lordosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

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Aisha Khoja

Full Text Available ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1 were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05 . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001, which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001, and in SNA (p < 0.001 and SNB (p = 0.016 angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007 and CS-4 (p = 0.024, and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05. There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05. There was significant retraction of the upper lip in CS-3 (p = 0.001, protrusion of the lower lip in CS-2 (p = 0.005, increase in nasolabial angle in CS-4 (p = 0.006 and Z-angle in CS-3 (p = 0.016, reduction in H-angle in CS-2 (p = 0.013 and CS-3 (p = 0.002 groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and

A novel decision tree approach based on transcranial Doppler sonography to screen for blunt cervical vascular injuries.

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Purvis, Dianna; Aldaghlas, Tayseer; Trickey, Amber W; Rizzo, Anne; Sikdar, Siddhartha

2013-06-01

Early detection and treatment of blunt cervical vascular injuries prevent adverse neurologic sequelae. Current screening criteria can miss up to 22% of these injuries. The study objective was to investigate bedside transcranial Doppler sonography for detecting blunt cervical vascular injuries in trauma patients using a novel decision tree approach. This prospective pilot study was conducted at a level I trauma center. Patients undergoing computed tomographic angiography for suspected blunt cervical vascular injuries were studied with transcranial Doppler sonography. Extracranial and intracranial vasculatures were examined with a portable power M-mode transcranial Doppler unit. The middle cerebral artery mean flow velocity, pulsatility index, and their asymmetries were used to quantify flow patterns and develop an injury decision tree screening protocol. Student t tests validated associations between injuries and transcranial Doppler predictive measures. We evaluated 27 trauma patients with 13 injuries. Single vertebral artery injuries were most common (38.5%), followed by single internal carotid artery injuries (30%). Compared to patients without injuries, mean flow velocity asymmetry was higher for single internal carotid artery (P = .003) and single vertebral artery (P = .004) injuries. Similarly, pulsatility index asymmetry was higher in single internal carotid artery (P = .015) and single vertebral artery (P = .042) injuries, whereas the lowest pulsatility index was elevated for bilateral vertebral artery injuries (P = .006). The decision tree yielded 92% specificity, 93% sensitivity, and 93% correct classifications. In this pilot feasibility study, transcranial Doppler measures were significantly associated with the blunt cervical vascular injury status, suggesting that transcranial Doppler sonography might be a viable bedside screening tool for trauma. Patient-specific hemodynamic information from transcranial Doppler assessment has the potential to alter

CT and MR angiographic findings in dissection of cervical vessels

International Nuclear Information System (INIS)

Link, J.; Brinkmann, G.; Heuser, K.; Heller, M.

1996-01-01

Purpose: To determine the usefulness of CT angiography (CTA) and MR angiography (MRA) for evaluation of dissection in cervical vessels. Material and methods: Dissection of cervical vessels was revealed by conventional angiography in 4 patients (two female, two male) of 30-62 years of age. Dissection was located in the carotid artery (n=3) and in the vertebral artery (n=1). In two patients CTA and in two patients MRA was performed. Results: Diagnosis of dissection was possible by CTA (internal carotid artery: n=2) and by MRA (internal carotid artery and vertebral artery). Imaging of the dissection membrane of the vessel wall was possible in one case with MRA. Conclusion: CT and MR angiography was successful for detection of typical morphology of dissection in all cases. If results in a greater number can be obtained it seems to be conceivable that both methods can be used in primary diagnosis. (orig.) [de

Primary extracranial vertebral artery aneurysms.

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Morasch, Mark D; Phade, Sachin V; Naughton, Peter; Garcia-Toca, Manuel; Escobar, Guillermo; Berguer, Ramon

2013-05-01

Extracranial vertebral artery aneurysms are uncommon and are usually associated with trauma or dissection. Primary cervical vertebral aneurysms are even rarer and are not well described. The presentation and natural history are unknown and operative management can be difficult. Accessing aneurysms at the skull base can be difficult and, because the frail arteries are often afflicted with connective tissue abnormalities, direct repair can be particularly challenging. We describe the presentation and surgical management of patients with primary extracranial vertebral artery aneurysms. In this study we performed a retrospective, multi-institutional review of patients with primary aneurysms within the extracranial vertebral artery. Between January 2000 and January 2011, 7 patients, aged 12-56 years, were noted to have 9 primary extracranial vertebral artery aneurysms. All had underlying connective tissue or another hereditary disorder, including Ehler-Danlos syndrome (n=3), Marfan's disease (n=2), neurofibromatosis (n=1), and an unspecified connective tissue abnormality (n=1). Eight of 9 aneurysms were managed operatively, including an attempted bypass that ultimately required vertebral ligation; the contralateral aneurysm on this patient has not been treated. Open interventions included vertebral bypass with vein, external carotid autograft, and vertebral transposition to the internal carotid artery. Special techniques were used for handling the anastomoses in patients with Ehler-Danlos syndrome. Although endovascular exclusion was not performed in isolation, 2 hybrid procedures were performed. There were no instances of perioperative stroke or death. Primary extracranial vertebral artery aneurysms are rare and occur in patients with hereditary disorders. Operative intervention is warranted in symptomatic patients. Exclusion and reconstruction may be performed with open and hybrid techniques with low morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights

Analysis on Biomechanical Characteristics of Post-operational Vertebral C5-C6 Segments

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Heqiang Tian

2016-03-01

Full Text Available Both anterior cervical decompression and fusion (ACDF and artificial cervical disc replacement (ACDR have obvious advantages in the treatment of cervical spondylosis. To analyze the operation results, it is absolutely necessary to study the biomechanics of the movement range of post-operational vertebral C5-C6 segments, especially the biomechanical characteristics in cervical tissues in actual movements. In this study, using the human vertebral 3D graph gained by imaging diagnosis (CT, a vertebral solid model is established by the 3D reconstruction algorithm and reverse engineering technology. After that, with cervical soft tissue structure added to the solid model and set with a joint contact mechanism, a finite element model with a complete, accurate cervical C5-C6 kinematic unit is constructed, based on relevant physiological anatomical knowledge. This model includes vertebral segments, an intervertebral disc, ligament and zygopophysis in the cervical C5-C6 kinematic unit. In the created vertebral finite element model, the model is amended, referring to ACDF and ACDR, and the load and constraint are applied to a normal group, a fusion group and a displacement group, so as to analyze the biomechanical characteristics of the cervical vertebra after ACDF and ACDR. By comparing the finite element simulation results of different surgeries, this paper is intended to evaluate the functions and biomechanical behaviors of the post-operational vertebra, and explore the influence of the operation on the biomechanical stability of the cervical vertebra. This will provide theoretical guidance for implementation and optimization of ACDF and ACDR.

Acute headache and persistent headache attributed to cervical artery dissection

DEFF Research Database (Denmark)

Schytz, Henrik W; Ashina, Messoud; Magyari, Melinda

2014-01-01

for Headache or facial or neck pain attributed to cervical carotid or vertebral artery dissection or Headache attributed to intracranial arterial dissection. Six months after dissection five of 19 patients still reported persistent headache attributed to dissection. The study demonstrates that the ICHD......The criteria for headache attributed to cervical artery dissection have been changed in the new third edition of the International Classification of Headache Disorders (ICHD-III beta). We have retrospectively investigated 19 patients diagnosed from 2001 to 2006 with cervical artery dissection......-III beta criteria for cervical artery dissection are useful for classifying patients at the first encounter. We show for the first time that persistent headache attributed to arterial dissection is frequent....

Validity and reliability of a method for assessment of cervical vertebral maturation.

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Zhao, Xiao-Guang; Lin, Jiuxiang; Jiang, Jiu-Hui; Wang, Qingzhu; Ng, Sut Hong

2012-03-01

To evaluate the validity and reliability of the cervical vertebral maturation (CVM) method with a longitudinal sample. Eighty-six cephalograms from 18 subjects (5 males and 13 females) were selected from the longitudinal database. Total mandibular length was measured on each film; an increased rate served as the gold standard in examination of the validity of the CVM method. Eleven orthodontists, after receiving intensive training in the CVM method, evaluated all films twice. Kendall's W and the weighted kappa statistic were employed. Kendall's W values were higher than 0.8 at both times, indicating strong interobserver reproducibility, but interobserver agreement was documented twice at less than 50%. A wide range of intraobserver agreement was noted (40.7%-79.1%), and substantial intraobserver reproducibility was proved by kappa values (0.53-0.86). With regard to validity, moderate agreement was reported between the gold standard and observer staging at the initial time (kappa values 0.44-0.61). However, agreement seemed to be unacceptable for clinical use, especially in cervical stage 3 (26.8%). Even though the validity and reliability of the CVM method proved statistically acceptable, we suggest that many other growth indicators should be taken into consideration in evaluating adolescent skeletal maturation.

Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo.

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Li, Yongchao; Peng, Baogan

2015-01-01

Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients' subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with Barré-Liéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment.

Arthroplasty-CervicalP001 - Double Crush Syndrome of the Vertebral Artery Loop and Foraminal Stenosis Causing Monoparesis

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Rho, Young Joon; Choi, Hoon; Kurpad, Shekar; Soliman, Hesham; Heo, Dong Hwa; Park, Choon Keun; Lee, Jun Ho; Lee, Jung Hwan; Benitez, Hugo Alberto Santos; Rivera, Miguel Angel Fuentes; Moga, Amado Gonzalez; Hernandez, Gabriel Huerta; Urbina, Mizraim Castillo; Ozkunt, Okan; Sariyilmaz, Kerim

2017-01-01

Introduction: To report a case of monoparesis caused by a vertebral artery (VA) anomaly and foraminal stenosis treated with microvascular decompression by the posterior approach. Material and Methods: A 51-year-old man was referred because of a 4-year history of progressive left shoulder pain refractory to other forms of treatment and a 7-month history of arm weakness. Clinical and radiologic evaluation showed an abnormally tortuous loop of left C5-6 cervical foramina with foraminal stenosis ...

Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards.

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Davies, Mark; Moore, Isabel S; Moran, Patrick; Mathema, Prabhat; Ranson, Craig A

2016-05-01

To provide normative values for cervical range of motion (CROM), isometric cervical and shoulder strength for; International Senior professional, and International Age-grade Rugby Union front-row forwards. Cross-sectional population study. All international level front-row players within a Rugby Union Tier 1 Nation. Nineteen Senior and 21 Age-grade front-row forwards underwent CROM, cervical and shoulder strength testing. CROM was measured using the CROM device and the Gatherer System was used to measure multi-directional isometric cervical and shoulder strength. The Age-grade players had significantly lower; cervical strength (26-57% deficits), cervical flexion to extension strength ratios (0.5 vs. 0.6), and shoulder strength (2-36% deficits) than the Senior players. However, there were no differences between front-row positions within each age group. Additionally, there were no differences between age groups or front-row positions in the CROM measurements. Senior Rugby Union front-row forwards have greater cervical and shoulder strength than Age-grade players, with the biggest differences being in cervical strength, highlighting the need for age specific normative values. Importantly, Age-grade players should be evaluated to ensure they have developed sufficient cervical strength prior to entering professional level Rugby Union. Copyright © 2015 Elsevier Ltd. All rights reserved.

On the cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

International Nuclear Information System (INIS)

Buell, U.; Winkler, U.

1983-01-01

Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases. (orig.) [de

Epidemiologia do traumatismo da coluna vertebral

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Marcelo Ferraz de Campos

Full Text Available OBJETIVO: Avaliação epidemiológica retrospectiva de 100 casos de traumatismo da coluna vertebral. MÉTODO: Estudo transversal de dados colhidos por levantamento de prontuário, segundo protocolo de decodificação local. RESULTADOS: Predomínio etário de 20 a 40 anos em 64% dos casos; sexo masculino em 86%; segmento toracolombar mais comumente atingido 64% e 36% para o segmento cervical; principais causas foram às quedas em 40%, seguidas de acidentes automobilísticos em 25% e quedas da laje 23%. A prevalência dos ferimentos por arma de fogo foi de 7%, mergulho em águas rasas 3% e agressões 2%. Houve análise complementar com cruzamentos entre idade, sexo, causa e segmento da coluna vertebral acometido, observando que o segmento cervical teve grande predomínio nas mulheres em relação aos homens em 85,7% X 14,3%. CONCLUSÃO: O traumatismo da coluna vertebral ocorreu predominantemente em homens entre 20 e 40 anos e o segmento cervical foi o mais acometido nas mulheres em relação aos homens na proporção de 6:1.

Dissecting aneurysm of the cervical internal carotid artery

International Nuclear Information System (INIS)

Itoh, Yoshihiro; Itoyama, Youichi; Fukumura, Akinobu; Matsukado, Yasuhiko; Kodama, Takafumi.

1987-01-01

On lifting a heavy case, a 51-year-old male experienced a sudden onset of headache with giddiness and clouded vision. A week later, vertigo and right hand numbness were added to his symptoms. The next day anisocoria (right > left) and dilation of the left retinal veins were noted. Cranial computed tomography (CT) scan appeared normal and there were no other remarkable neurological findings. The patient was treated conservatively for cerebral infarction, however, the headache worsened and diplopia occurred. Neurological examination on admission revealed nothing unusual except for left Horner's syndrome. Physical examination showed a palpable sausage-like painless tumor on the left side of the neck. Angiography showed a narrowing of the internal carotid artery in the cervical region with a small dissecting aneurysm at the C3 level. Cervical CT scan at the upper C3 level showed a low density lunar defect in the high density section of the enlarged left internal carotid artery. The patient was operated on by superficial temporal artery-middle cerebral artery anastomosis to increase the intracranial blood flow. Postoperatively the symptoms were quickly relieved. Angiography 1 month later showed less narrowing of the carotid artery, though the dissecting aneurysm still remained. Postoperative cervical CT scan showed the left internal carotid artery to be of normal size. The patient returned to his work in normal condition 2 months later. It is emphasized that cervical CT scan may be useful in the diagnosis of this unusual type of cervical dissecting aneurysm. (author)

[A vertebral arteriovenous fistula diagnosed by auscultation].

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Iglesias Escalera, G; Diaz-Delgado Peñas, R; Carrasco Marina, M Ll; Maraña Perez, A; Ialeggio, D

2015-01-01

Cervical artery fistulas are rare arteriovenous malformations. The etiology of the vertebral arteriovenous fistulas (AVF) can be traumatic or spontaneous. They tend to be asymptomatic or palpation or continuous vibration in the cervical region. An arteriography is necessary for a definitive diagnosis. The treatment is complete embolization of the fistula. We present the case of a two year-old male, where the mother described it «like a washing machine in his head». On palpation during the physical examination, there was a continuous vibration, and a continuous murmur in left cervical region. A vascular malformation in vertebral region was clinically suspected, and confirmed with angio-MRI and arteriography. AVF are rare in childhood. They should be suspected in the presence of noises, palpation or continuous vibration in the cervical region. Early diagnosis can prevent severe complications in asymptomatic children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

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Beauchamp Kathryn M

2011-07-01

Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

Growth indicators in orthodontic patients. Part 1: comparison of cervical vertebral maturation and hand-wrist skeletal maturation.

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Litsas, G; Ari-Demirkaya, A

2010-12-01

The purpose of this study was to predict the skeletal maturation status based on the assessment of cervical vertebrae from lateral cephalometric radiographs and to compare these findings with the skeletal maturity of the same individuals judged from the hand-wrist radiographs. Lateral cephalometric and left hand-wrist radiographs of 393 Caucasian children from 8 to 18 years old were evaluated. On the hand-wrist radiographs the classification of Bjork [1972] and Grave and Brown [1976] was used to assess skeletal maturity (HWSS). Cervical vertebral maturation was also evaluated on lateral cephalometric radiographs using the improved CVMS method described by Baccetti, Franchi, and McNamara [2002]. These methods were correlated using the chi-square test. The chi-square test showed that skeletal maturational values obtained by the CVMS method were significantly correlated with the skeletal values obtained from the hand-wrist analysis for both genders (pmaturity.

Feasibility Study of a Standardized Novel Animal Model for Cervical Vertebral Augmentation in Sheep Using a PTH Derivate Bioactive Material

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Karina Klein

2014-08-01

Full Text Available Prophylactic local treatment involving percutaneous vertebral augmentation using bioactive materials is a new treatment strategy in spine surgery in humans for vertebral bodies at risk. Standardized animal models for this procedure are almost non-existent. The purpose of this study was to: (i prove the efficacy of PTH derivate bioactive materials for new bone formation; and (ii create a new, highly standardized cervical vertebral augmentation model in sheep. Three different concentrations of a modified form of parathyroid hormone (PTH covalently bound to a fibrin matrix containing strontium carbonate were used. The same matrix without PTH and shams were used as controls. The bioactive materials were locally injected. Using a ventral surgical approach, a pre-set amount of material was injected under fluoroscopic guidance into the intertrabecular space of three vertebral bodies. Intravital fluorescent dyes were used to demonstrate new bone formation. After an observation period of four months, the animals were sacrificed, and vertebral bodies were processed for µCT, histomorphometry, histology and sequential fluorescence evaluation. Enhanced localized bone activity and new bone formation in the injected area could be determined for all experimental groups in comparison to the matrix alone and sham with the highest values detected for the group with a medium concentration of PTH.

A comparison of cervical vertebral maturation assessment of skeletal growth stages with chronological age in Thai between cleft lip and palate and non-cleft patients.

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Pisek, Poonsak; Godfrey, Keith; Manosudprasit, Montian; Wangsrimongkol, Tasanee; Leelasinjaroen, Pornnapha

2013-09-01

(1) To search for any difference in chronological age related to stages of the cervical vertebral maturation index stages (CVMIs) comparing groups of cleft lip and palate (CLP) and non-cleft (non-CLP) subjects; (2) To investigate the relationship between chronological age and CVMIs in both groups of subjects. Cervical vertebrae C2, C3, C4 were assessed on 1,549 cephalometric films (503 CLP films, 1,046 non-CLP films of subjects aged 5 to 18 years) using Hassel and Farman's method. T-tests showed mean chronological ages of CVMIs 2, 3 and 6 were different at p = 0.001, 0.024 and 0.016, respectively. CVMIs 1, 4 and 5 showed no significant differences. The CLP group achieved each CVMI score one year ahead of the non-CLP group, except for CVMI 4. Spearman's rank order correlations were r = 0.80 (95% CI: 0.76-0.83) for CLP, and 0.77 (95% CI: 0.74-0.79) for non-CLP. CLP subjects tended to have a slightly advanced growth compared with non-CLP subjects. A high correlation coefficient was found between chronological age and cervical vertebral skeletal maturation.

Epidemiology and Outcomes of Vertebral Artery Injury in 16 582 Cervical Spine Surgery Patients: An AOSpine North America Multicenter Study.

Science.gov (United States)

Hsu, Wellington K; Kannan, Abhishek; Mai, Harry T; Fehlings, Michael G; Smith, Zachary A; Traynelis, Vincent C; Gokaslan, Ziya L; Hilibrand, Alan S; Nassr, Ahmad; Arnold, Paul M; Mroz, Thomas E; Bydon, Mohamad; Massicotte, Eric M; Ray, Wilson Z; Steinmetz, Michael P; Smith, Gabriel A; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Isaacs, Robert E; Wang, Jeffrey C; Lord, Elizabeth L; Buser, Zorica; Riew, K Daniel

2017-04-01

A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI). To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery. Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36). VAIs were identified in a total of 14 of 16 582 patients screened (8.4 per 10 000). The mean age of patients with VAI was 59 years (±10) with a female predominance (78.6%). Patient diagnoses included myelopathy, radiculopathy, cervical instability, and metastatic disease. VAI was associated with substantial blood loss (770 mL), although only 3 cases required transfusion. Of the 14 cases, 7 occurred with an anterior-only approach, 3 cases with posterior-only approach, and 4 during circumferential approach. Fifty percent of cases of VAI with available preoperative imaging revealed anomalous vessel anatomy during postoperative review. Average length of hospital stay was 10 days (±8). Notably, 13 of the 14 (92.86%) cases resolved without residual deficits. Compared to preoperative baseline NDI, Nurick, mJOA, and SF-36 scores for these patients, there were no observed changes after surgery ( P = .20-.94). Vertebral artery injuries are potentially catastrophic complications that can be sustained from anterior or posterior cervical spine approaches. The data from this study suggest that with proper steps to ensure hemostasis, patients recover function at a high rate and do not exhibit residual deficits.

Phenotypic integration of the cervical vertebrae in the Hominoidea (Primates).

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Villamil, Catalina I

2018-03-01

Phenotypic integration and modularity represent important factors influencing evolutionary change. The mammalian cervical vertebral column is particularly interesting in regards to integration and modularity because it is highly constrained to seven elements, despite widely variable morphology. Previous research has found a common pattern of integration among quadrupedal mammals, but integration patterns also evolve in response to locomotor selective pressures like those associated with hominin bipedalism. Here, I test patterns of covariation in the cervical vertebrae of three hominoid primates (Hylobates, Pan, Homo) who engage in upright postures and locomotion. Patterns of integration in the hominoid cervical vertebrae correspond generally to those previously found in other mammals, suggesting that integration in this region is highly conserved, even among taxa that engage in novel positional behaviors. These integration patterns reflect underlying developmental as well as functional modules. The strong integration between vertebrae suggests that the functional morphology of the cervical vertebral column should be considered as a whole, rather than in individual vertebrae. Taxa that display highly derived morphologies in the cervical vertebrae are likely exploiting these integration patterns, rather than reorganizing them. Future work on vertebrates without cervical vertebral number constraints will further clarify the evolution of integration in this region. © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

Dissecting aneurysm of the cervical internal carotid artery. Cervical CT scan findings and treatment - case report

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Itoh, Yoshihiro; Itoyama, Youichi; Fukumura, Akinobu; Matsukado, Yasuhiko; Kodama, Takafumi

1987-06-01

On lifting a heavy case, a 51-year-old male experienced a sudden onset of headache with giddiness and clouded vision. A week later, vertigo and right hand numbness were added to his symptoms. The next day anisocoria (right > left) and dilation of the left retinal veins were noted. Cranial computed tomography (CT) scan appeared normal and there were no other remarkable neurological findings. The patient was treated conservatively for cerebral infarction, however, the headache worsened and diplopia occurred. Neurological examination on admission revealed nothing unusual except for left Horner's syndrome. Physical examination showed a palpable sausage-like painless tumor on the left side of the neck. Angiography showed a narrowing of the internal carotid artery in the cervical region with a small dissecting aneurysm at the C3 level. Cervical CT scan at the upper C3 level showed a low density lunar defect in the high density section of the enlarged left internal carotid artery. The patient was operated on by superficial temporal artery-middle cerebral artery anastomosis to increase the intracranial blood flow. Postoperatively the symptoms were quickly relieved. Angiography 1 month later showed less narrowing of the carotid artery, though the dissecting aneurysm still remained. Postoperative cervical CT scan showed the left internal carotid artery to be of normal size. The patient returned to his work in normal condition 2 months later. It is emphasized that cervical CT scan may be useful in the diagnosis of this unusual type of cervical dissecting aneurysm.

CT imaging techniques for describing motions of the cervicothoracic junction and cervical spine during flexion, extension, and cervical traction.

Science.gov (United States)

Simon, Scott; Davis, Martin; Odhner, Dewey; Udupa, Jayaram; Winkelstein, Beth

2006-01-01

Computerized tomographic study of human cadavers undergoing traction and flexion-extension bending. To investigate the feasibility of using computerized tomography techniques to quantify relative vertebral motions of the cervical spine and cervicothoracic junction (CTJ), and to define normative CTJ kinematics. Despite developing an understanding of the mechanical behavior of the cervical spine, little remains known about the cervicothoracic junction. The CTJ is more difficult to image than other cervical regions given the anatomic features of the surrounding bones obstructing CTJ visualization. As such, limited data have been reported describing the responses of the CTJ for motions and loading in the sagittal plane, confounding the clinical assessment of its injuries and surgical treatments used at this region. Helical CT images of the cervical spine and CTJ were acquired incrementally during each of flexion, extension, and cervical traction. Vertebral surfaces were reconstructed using the specialized image analysis software, 3DVIEWNIX. A mathematical description of relative vertebral motions was derived by computing rigid transformations. Euler angles and translations were calculated. Regional spine stiffness was defined for traction. The CTJ was found to be much stiffer (779 N/mm) than the cervical spine (317 N/mm) in tension. In flexion-extension bending, the CTJ was similar to the lower cervical spine. The CTJ demonstrated significantly less coupled motion than the cervical spine. The CTJ, as a transition region between the cervical and thoracic spines, has unique kinematic characteristics. This application of kinematic CT methods is useful for quantifying unreported normative ranges of motion for the CTJ, difficult by other conventional radiologic means.

Serum insulin-like growth factor-1 levels in females and males in different cervical vertebral maturation stages

Science.gov (United States)

Gupta, Shreya; Deoskar, Anuradha; Gupta, Puneet; Jain, Sandhya

2015-01-01

OBJECTIVE: The aim of this cross sectional study was to assess serum insulin-like growth factor-1 (IGF-1) levels in female and male subjects at various cervical vertebral maturation (CVM) stages. MATERIAL AND METHODS: The study sample consisted of 60 subjects, 30 females and 30 males, in the age range of 8-23 years. For all subjects, serum IGF-1 level was estimated from blood samples by means of chemiluminescence immunoassay (CLIA). CVM was assessed on lateral cephalograms using the method described by Baccetti. Serum IGF-1 level and cervical staging data of 30 female subjects were included and taken from records of a previous study. Data were analyzed by Kruska-Wallis and Mann Whitney test. Bonferroni correction was carried out and alpha value was set at 0.003. RESULTS: Peak value of serum IGF-1 was observed in cervical stages CS3 in females and CS4 in males. Differences between males and females were observed in mean values of IGF-1 at stages CS3, 4 and 5. The highest mean IGF-1 levels in males was observed in CS4 followed by CS5 and third highest in CS3; whereas in females the highest mean IGF-1 levelswas observed in CS3 followed by CS4 and third highest in CS5. Trends of IGF-1 in relation to the cervical stages also differed between males and females. The greatest mean serum IGF-1 value for both sexes was comparable, for females (397 ng/ml) values were slightly higher than in males (394.8 ng/ml). CONCLUSIONS: Males and females showed differences in IGF-1 trends and levels at different cervical stages. PMID:25992990

Serum insulin-like growth factor-1 levels in females and males in different cervical vertebral maturation stages.

Science.gov (United States)

Gupta, Shreya; Deoskar, Anuradha; Gupta, Puneet; Jain, Sandhya

2015-01-01

The aim of this cross sectional study was to assess serum insulin-like growth factor-1 (IGF-1) levels in female and male subjects at various cervical vertebral maturation (CVM) stages. The study sample consisted of 60 subjects, 30 females and 30 males, in the age range of 8-23 years. For all subjects, serum IGF-1 level was estimated from blood samples by means of chemiluminescence immunoassay (CLIA). CVM was assessed on lateral cephalograms using the method described by Baccetti. Serum IGF-1 level and cervical staging data of 30 female subjects were included and taken from records of a previous study. Data were analyzed by Kruska-Wallis and Mann Whitney test. Bonferroni correction was carried out and alpha value was set at 0.003. Peak value of serum IGF-1 was observed in cervical stages CS3 in females and CS4 in males. Differences between males and females were observed in mean values of IGF-1 at stages CS3, 4 and 5. The highest mean IGF-1 levels in males was observed in CS4 followed by CS5 and third highest in CS3; whereas in females the highest mean IGF-1 levelswas observed in CS3 followed by CS4 and third highest in CS5. Trends of IGF-1 in relation to the cervical stages also differed between males and females. The greatest mean serum IGF-1 value for both sexes was comparable, for females (397 ng/ml) values were slightly higher than in males (394.8 ng/ml). Males and females showed differences in IGF-1 trends and levels at different cervical stages.

Mandibular growth changes and cervical vertebral maturation. a cephalometric implant study.

Science.gov (United States)

Gu, Yan; McNamara, James A

2007-11-01

To evaluate mandibular dimensional changes and regional remodeling occurring during five intervals of circumpubertal growth. This investigation evaluated a unique sample of subjects in whom tantalum implants were placed into the craniofacial complex during childhood. The sample was obtained from the Mathews and Ware implant study originally conducted at the University of California San Francisco in the 1970s, with longitudinal cephalometric records of 20 subjects (13 female, 7 male) available for evaluation. Cephalograms at six consecutive stages of cervical vertebral maturation (CS1 through CS6) were analyzed. Peak mandibular growth was noted during the interval from CS3 to CS4. Forward rotation of the mandible was due to greater mandibular growth posteriorly than anteriorly. Progressive closure of the condylar-ramus-occlusal (CRO) angle resulted in a forward and upward orientation of the ramus relative to the corpus of the mandible due to increased vertical growth of the condyle. A peak in mandibular growth at puberty was substantiated. Mandibular remodeling and condylar rotation continue to occur after the growth spurt.

Correlation between cervical vertebral maturation and chronological age in a group of Iranian females

Directory of Open Access Journals (Sweden)

Seyed Mohammadreza Safavi

2015-01-01

Full Text Available Background: Correlation between chronological age at different stages of cervical vertebral maturation (CVM is important in clinical orthodontic practice. The objective of this study was to evaluate the correlation between CVM stage and chronological age in a group of Iranian female patients. Materials and Methods: This study was conducted on 196 digital lateral cephalometry of female patients with the age ranged 9-14 years. The CVM stage was determined with two calibrated examiners, using the method developed by Baccetti and its correlation with mean chronological age was assessed by the Spearman rank-order. The intra and inter-agreements were evaluated by weighted Kappa statistics in overall diagnosis of stages, in addition to determination of presence or absent of concavities at the lower border of second, third and fourth cervical vertebrae and the shapes of the third and fourth vertebrae. P < 0.05 was considered as significant. Results: The correlation coefficient between CVM stages and chronological age was relatively low (r = 0.62. The least amount of inter-observer agreement was determined to be at the clinical decision of the shape of the fourth vertebra. Conclusion: Regarding the low reported correlation, the concomitant usage of other skeletal indicators seems necessary for precise determination of physiological age of the patients.

Correlation between cervical vertebral maturation and chronological age in a group of Iranian females

Science.gov (United States)

Safavi, Seyed Mohammadreza; Beikaii, Hanie; Hassanizadeh, Raheleh; Younessian, Farnaz; Baghban, Alireza Akbarzadeh

2015-01-01

Background: Correlation between chronological age at different stages of cervical vertebral maturation (CVM) is important in clinical orthodontic practice. The objective of this study was to evaluate the correlation between CVM stage and chronological age in a group of Iranian female patients. Materials and Methods: This study was conducted on 196 digital lateral cephalometry of female patients with the age ranged 9-14 years. The CVM stage was determined with two calibrated examiners, using the method developed by Baccetti and its correlation with mean chronological age was assessed by the Spearman rank-order. The intra and inter-agreements were evaluated by weighted Kappa statistics in overall diagnosis of stages, in addition to determination of presence or absent of concavities at the lower border of second, third and fourth cervical vertebrae and the shapes of the third and fourth vertebrae. P < 0.05 was considered as significant. Results: The correlation coefficient between CVM stages and chronological age was relatively low (r = 0.62). The least amount of inter-observer agreement was determined to be at the clinical decision of the shape of the fourth vertebra. Conclusion: Regarding the low reported correlation, the concomitant usage of other skeletal indicators seems necessary for precise determination of physiological age of the patients. PMID:26604958

Correlation between cervical vertebral maturation and chronological age in a group of Iranian females.

Science.gov (United States)

Safavi, Seyed Mohammadreza; Beikaii, Hanie; Hassanizadeh, Raheleh; Younessian, Farnaz; Baghban, Alireza Akbarzadeh

2015-01-01

Correlation between chronological age at different stages of cervical vertebral maturation (CVM) is important in clinical orthodontic practice. The objective of this study was to evaluate the correlation between CVM stage and chronological age in a group of Iranian female patients. This study was conducted on 196 digital lateral cephalometry of female patients with the age ranged 9-14 years. The CVM stage was determined with two calibrated examiners, using the method developed by Baccetti and its correlation with mean chronological age was assessed by the Spearman rank-order. The intra and inter-agreements were evaluated by weighted Kappa statistics in overall diagnosis of stages, in addition to determination of presence or absent of concavities at the lower border of second, third and fourth cervical vertebrae and the shapes of the third and fourth vertebrae. P < 0.05 was considered as significant. The correlation coefficient between CVM stages and chronological age was relatively low (r = 0.62). The least amount of inter-observer agreement was determined to be at the clinical decision of the shape of the fourth vertebra. Regarding the low reported correlation, the concomitant usage of other skeletal indicators seems necessary for precise determination of physiological age of the patients.

Dissecting aneurysm of the cervical internal carotid artery. Cervical CT scan findings and treatment - case report

Energy Technology Data Exchange (ETDEWEB)

Itoh, Yoshihiro; Itoyama, Youichi; Fukumura, Akinobu; Matsukado, Yasuhiko; Kodama, Takafumi

1987-06-01

On lifting a heavy case, a 51-year-old male experienced a sudden onset of headache with giddiness and clouded vision. A week later, vertigo and right hand numbness were added to his symptoms. The next day anisocoria (right > left) and dilation of the left retinal veins were noted. Cranial computed tomography (CT) scan appeared normal and there were no other remarkable neurological findings. The patient was treated conservatively for cerebral infarction, however, the headache worsened and diplopia occurred. Neurological examination on admission revealed nothing unusual except for left Horner's syndrome. Physical examination showed a palpable sausage-like painless tumor on the left side of the neck. Angiography showed a narrowing of the internal carotid artery in the cervical region with a small dissecting aneurysm at the C3 level. Cervical CT scan at the upper C3 level showed a low density lunar defect in the high density section of the enlarged left internal carotid artery. The patient was operated on by superficial temporal artery-middle cerebral artery anastomosis to increase the intracranial blood flow. Postoperatively the symptoms were quickly relieved. Angiography 1 month later showed less narrowing of the carotid artery, though the dissecting aneurysm still remained. Postoperative cervical CT scan showed the left internal carotid artery to be of normal size. The patient returned to his work in normal condition 2 months later. It is emphasized that cervical CT scan may be useful in the diagnosis of this unusual type of cervical dissecting aneurysm.

Cervical Length & Leading Placental Edge to Internal OS Measurements - TA vs TV

DEFF Research Database (Denmark)

Westerway, Sue Campbell; Pedersen, Lars Henning; Hyett, Jon

Brief Description of the Purpose of the Study: To compare cervical length/leading placental edge from the internal cervical os measurements obtained by both transabdominal (TA) and transvaginal (TV) approach and to assess intra / inter-observer variation for these measurements. Methods: Cross...... sectional study of 374 consecutive pregnancies with gestation 12 weeks to term. The cervical length was estimated as the distance from internal to external os, and the placenta / cervix distance as the leading placental edge to internal cervical os. Bland-Altman plots were used to evaluate the two methods....... Importance of the Conclusions: TA estimates of cervix and placental edge position did not reflect the estimates obtained by TV assessment. As both measures are important markers of pregnancy outcome and management, the transabdominal method in the present form is insuffi- cient in clinical management....

CT diagnosis in the evaluation of vertebral trauma

International Nuclear Information System (INIS)

Emori, Takumi; Kadoya, Satoru; Nakamura, Tsutomu; Ito, Shotaro; Kwak, Ryungchan

1984-01-01

The diagnostic capability of the CT scan of the vertebral trauma and a comparison with the results of a routine roentgenogram and tomogram were studied in 11 patients. In total, there were 15 fractured vertebrae: 3 in the upper cervical, 3 in the lower cervical, and 9 in the thoracic and thoraco-lumbar vertebrae. In the detailed evaluation of the vertebral fractures, CT provided more information than plain films in all 15 fractured vertebrae, with a better visualization of the spinal bony details, particularly at the upper cervical, thoracic, and thoraco-lumbar levels, where the interpretation of the spinal abnormalities is usually difficult because of adjacent structures such as the skull and thorax. Only CT was able to demonstrate impingements on the vertebral canal by bony fragments. Post-traumatic syringomyelia was incidentally demonstrated in one patient on a plain CT. In 6 patients, conventional tomography was done, but no additional information with regard to spinal instability and spinal-cord compression was obtained. The usage of sagittal tomography was also limited, because it required a change in the patient's position, which might worsen the neurological deficits. On the other hand, a plain roentgenogram and conventional tomography were superior in the evaluation of spinal malalignment and fractures running horizontally. In summary, both plain roentgenograms and CT images provided detailed information about vertebral injury, whereas conventional tomography is judged to be inferior and not always necessary. Based on these results, our new diagnostic and therapeutic approaches using CT for the vertebral injuries were presented. (author)

The Neandertal vertebral column 1: the cervical spine.

Science.gov (United States)

Gómez-Olivencia, Asier; Been, Ella; Arsuaga, Juan Luis; Stock, Jay T

2013-06-01

This paper provides a metric analysis of the Neandertal cervical spine in relation to modern human variation. All seven cervical vertebrae have been analysed. Metric data from eight Neandertal individuals are compared with a large sample of modern humans. The significance of morphometric differences is tested using both z-scores and two-tailed Wilcoxon signed rank tests. The results identify significant metric and morphological differences between Neandertals and modern humans in all seven cervical vertebrae. Neandertal vertebrae are mediolaterally wider and dorsoventrally longer than modern humans, due in part to longer and more horizontally oriented spinous processes. This suggests that Neandertal cervical morphology was more stable in both mid-sagittal and coronal planes. It is hypothesized that the differences in cranial size and shape in the Neandertal and modern human lineages from their Middle Pleistocene ancestors could account for some of the differences in the neck anatomy between these species. Copyright © 2013 Elsevier Ltd. All rights reserved.

Serum insulin-like growth factor-1 levels in females and males in different cervical vertebral maturation stages

Directory of Open Access Journals (Sweden)

Shreya Gupta

2015-04-01

Full Text Available OBJECTIVE: The aim of this cross sectional study was to assess serum insulin-like growth factor-1 (IGF-1 levels in female and male subjects at various cervical vertebral maturation (CVM stages. MATERIAL AND METHODS: The study sample consisted of 60 subjects, 30 females and 30 males, in the age range of 8-23 years. For all subjects, serum IGF-1 level was estimated from blood samples by means of chemiluminescence immunoassay (CLIA. CVM was assessed on lateral cephalograms using the method described by Baccetti. Serum IGF-1 level and cervical staging data of 30 female subjects were included and taken from records of a previous study. Data were analyzed by Kruska-Wallis and Mann Whitney test. Bonferroni correction was carried out and alpha value was set at 0.003. RESULTS: Peak value of serum IGF-1 was observed in cervical stages CS3 in females and CS4 in males. Differences between males and females were observed in mean values of IGF-1 at stages CS3, 4 and 5. The highest mean IGF-1 levels in males was observed in CS4 followed by CS5 and third highest in CS3; whereas in females the highest mean IGF-1 levelswas observed in CS3 followed by CS4 and third highest in CS5. Trends of IGF-1 in relation to the cervical stages also differed between males and females. The greatest mean serum IGF-1 value for both sexes was comparable, for females (397 ng/ml values were slightly higher than in males (394.8 ng/ml. CONCLUSIONS: Males and females showed differences in IGF-1 trends and levels at different cervical stages.

[The implications of cervical spine degenerative and traumatic diseases in the pathogenesis of cervical vertigo and hearing loss].

Science.gov (United States)

Cobzeanu, M D; Rusu, Daniela; Moraru, R; Boboc, Andreea; Hănţăscu, I; Imbrea, Alice; Stratulat, S; Gheorghe, Liliana; Indrei, Anca

2009-01-01

Cervical spine together with vestibular system,visual system and proprioceptive afferents plays an important role in mentaining balance. Spine damage causes distortions in transmitting informations to the brain,favoring vertigo. The authors point out the occurrence of positional vertigo on 23 patients (20 patients with cervical spondylosis and 3 patients with cervical spine injury) due to blood flow disturbance through vertebral artery. The mechano-receptors located in intervertebral disks and cervical spine muscles are activated by column movement. Changes of blood flow in the vertebral and basilar arteries are showed up by cervical X-Rays, intracranial Doppler ultrasound or angio-MRI, an audiogram marking out the degree of hearing loss or tinnitus occurence. ENT complex treatment outcomes are analyzed and balneo-physio-therapy performed in order to improve vertigo and hearing loss. Stress beside muscle overload and cervical spine injures causes alteration in the ear blood-flow circulation that leads to hearing loss, vertigo and tinnitus. It emphasies the need for collaboration between balneologist and ENT specialist in solving balance and hearing disorders with cervicogenic cause.

Design and preliminary biomechanical analysis of artificial cervical joint complex.

Science.gov (United States)

Jian, Yu; Lan-Tao, Liu; Zhao, Jian-ning; Jian-ning, Zhao

2013-06-01

To design an artificial cervical joint complex (ACJC) prosthesis for non-fusion reconstruction after cervical subtotal corpectomy, and to evaluate the biomechanical stability, preservation of segment movements and influence on adjacent inter-vertebral movements of this prosthesis. The prosthesis was composed of three parts: the upper/lower joint head and the middle artificial vertebrae made of Cobalt-Chromium-Molybdenum (Co-Cr-Mo) alloy and polyethylene with a ball-and-socket joint design resembling the multi-axial movement in normal inter-vertebral spaces. Biomechanical tests of intact spine (control), Orion locking plate system and ACJC prosthesis were performed on formalin-fixed cervical spine specimens from 21 healthy cadavers to compare stability, range of motion (ROM) of the surgical segment and ROM of adjacent inter-vertebral spaces. As for stability of the whole lower cervical spine, there was no significant difference of flexion, extension, lateral bending and torsion between intact spine group and ACJC prosthesis group. As for segment movements, difference in flexion, lateral bending or torsion between ACJC prosthesis group and control group was not statistically significant, while ACJC prosthesis group showed an increase in extension (P inter-vertebral ROM of the ACJC prosthesis group was not statistically significant compared to that of the control group. After cervical subtotal corpectomy, reconstruction with ACJC prosthesis not only obtained instant stability, but also reserved segment motions effectively, without abnormal gain of mobility at adjacent inter-vertebral spaces.

Analysis of Class II patients, successfully treated with the straight-wire and Forsus appliances, based on cervical vertebral maturation status.

Science.gov (United States)

Servello, David F; Fallis, Drew W; Alvetro, Lisa

2015-01-01

To assess skeletal and dental changes in patients successfully treated with the Forsus appliance based on cervical vertebral maturation status. Forty-seven Class II patients, successfully treated with the Forsus appliance, were divided into peak and postpeak growth groups determined immediately prior to Forsus placement. The mean (SD) ages of the peak and postpeak groups were 13.4 (1.0) and 14.1 (1.3) years, respectively. Superimpositions of initial, Forsus placement, Forsus removal, and final cephalometric radiographs were completed, allowing the measurement of changes during three treatment phases. There were no significant differences between groups during treatment phase 1 (alignment/leveling), with both groups demonstrating a worsening of the Class II molar relationship. However, during treatment phase 2 (Class II correction), patients within the peak group demonstrated significantly higher mean apical base, mandibular and molar changes, and an increased rate of change compared with those in the postpeak group. No significant differences were observed during treatment phase 3 (detail/finishing). Following an initial worsening of the Class II molar relationship as a result of straight-wire appliance effects, Forsus appliance treatment initiated during cervical vertebral maturation status (CS) 3-4 elicits more effective and efficient correction of Class II molar relationships than when initiated during CS 5-6. Data support that these effects are due mainly to maxillary skeletal and dentoalveolar restraint during a period of more rapid mandibular growth.

Reevaluation of the Pavlov ratio in patients with cervical myelopathy.

Science.gov (United States)

Suk, Kyung-Soo; Kim, Ki-Tack; Lee, Jung-Hee; Lee, Sang-Hun; Kim, Jin-Soo; Kim, Jin-Young

2009-03-01

This study was designed to reevaluate the effectiveness of the Pavlov ratio in patients with cervical myelopathy. We studied 107 patients who underwent open door laminoplasty for the treatment of cervical myelopathy between the C3 to C7 levels. We determined the Pavlov ratio on preoperative and postoperative cervical spine lateral radiographs, the vertebral body-to-canal ratio on sagittal reconstruction CT scans, and the vertebral body-to-cerebrospinal fluid (CSF) column ratio on T2-weighted sagittal MR images from C3 to C6. The severity of myelopathy was determined using the JOA score on both preoperative and postoperative images. The recovery rate was also calculated. The Pavlov ratio in plain radiographs from patients with myelopathy was compared with the ratio of the vertebral body to the spinal canal on CT and MRI. The average Pavlov ratio between C3 and C6 ranged from 0.71 to 0.76. On CT scan, the average vertebral body-to-canal ratio between C3 and C6 ranged from 0.62 to 0.66. On MRI, the vertebral body-to-CSF column ratio between C3 and C6 ranged between 0.53 and 0.57. A positive correlation was noted between the Pavlov ratio and the vertebral body-to-canal ratio on sagittal-reconstruction CT (correlation coefficient = 0.497-0.627, p = 0.000) and between the Pavlov ratio and the vertebral body-to-CSF column ratio on MRI (correlation coefficient = 0.511-0.649, p = 0.000). We demonstrated a good correlation between the Pavlov ratio and both the vertebral body-to-canal ratio on CT and the vertebral body-to-CSF column ratio on MRI. Therefore, the Pavlov ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane.

The accuracy of the lateral vertebral notch-referred pedicle screw insertion technique in subaxial cervical spine: a human cadaver study.

Science.gov (United States)

Luo, Jiaquan; Wu, Chunyang; Huang, Zhongren; Pan, Zhimin; Li, Zhiyun; Zhong, Junlong; Chen, Yiwei; Han, Zhimin; Cao, Kai

2017-04-01

This is a cadaver specimen study to confirm new pedicle screw (PS) entry point and trajectory for subaxial cervical PS insertion. To assess the accuracy of the lateral vertebral notch-referred PS insertion technique in subaxial cervical spine in cadaver cervical spine. Reported morphometric landmarks used to guide the surgeon in PS insertion show significant variability. In the previous study, we proposed a new technique (as called "notch-referred" technique) primarily based on coronal multiplane reconstruction images (CMRI) and cortical integrity after PS insertion in cadavers. However, the PS position in cadaveric cervical segment was not confirmed radiologically. Therefore, the difference between the pedicle trajectory and the PS trajectory using the notch-referred technique needs to be illuminated. Twelve cadaveric cervical spines were conducted with PS insertion using the lateral vertebral notch-referred technique. The guideline for entry point and trajectory for each vertebra was established based on the morphometric data from our previous study. After 3.5-mm diameter screw insertion, each vertebra was dissected and inspected for pedicle trajectory by CT scan. The pedicle trajectory and PS trajectory were measured and compared in axial plane. The perforation rate was assessed radiologically and was graded from ideal to unacceptable: Grade 0 = screw in pedicle; Grade I = perforation of pedicle wall less than one-fourth of the screw diameter; Grade II = perforation more than one-fourth of the screw diameter but less than one-second; Grade III = perforation more than one-second outside of the screw diameter. In addition, pedicle width between the acceptable and unacceptable screws was compared. A total of 120 pedicle screws were inserted. The perforation rate of pedicle screws was 78.3% in grade 0 (excellent PS position), 10.0% in grade I (good PS position), 8.3% in grade II (fair PS position), and 3.3% in grade III (poor PS position). The

Repair and regeneration of vertebral body after antero-lateral partial vertebrectomy using beta-tricalcium phosphate

International Nuclear Information System (INIS)

Momma, Fumiyuki; Amagasa, Masaharu; Nakazawa, Teruo

2008-01-01

Antero-lateral partial vertebrectomy (ALPV) was used for decompression in 91 patients with multilevel cervical disorders. The high-speed drill was used to excise about 1/3 of the vertebral body for relief of anterior compression of the cord and nerve roots under the operating microscope. The key point was opening of the medial wall of the foramen of transverse process at the beginning of the ALPV, allowing the determination of the lateral borders of the ALPVs. To repair and regenerate the vertebral body, a beta-tricalcium phosphate (β-TCP) block was trimmed into a cuneiform shape and implanted into the sites of the ALPV excluding the upper and lowermost vertebral bodies. Postoperative computed tomography confirmed that β-TCP was gradually replaced by newly formed bone from the surface towards the center of the block, and that the affected vertebral body was remodeled by 6 to 12 months after the implantation of β-TCP. The cortical bone borders on the bone marrow at the site of the regeneration. The pedicles on the side of the ALPVs were rebuilt during regeneration of the affected vertebrae. Thus, the vertebral foramen of the cervical spine was widened in the anterior direction at the levels of the ALPVs, resulting in restoration of the physiological size of the cervical cord. The cervical curvature remained unchanged and a certain degree of cervical mobility (mean 86%) was preserved in this series. (author)

Loss of inter-vertebral disc height after anterior cervical discectomy.

Science.gov (United States)

Haden, N; Latimer, M; Seeley, H M; Laing, R J

2005-12-01

Most surgeons undertaking anterior cervical discectomy (ACD) introduce a bone graft or cage into the disc space when the decompression is complete. This is done to prevent segmental collapse, preserve cervical spine alignment and to promote fusion. We have conducted a prospective observational cohort study to investigate the relationship between loss of disc height, cervical spine alignment and clinical outcome in 140 patients undergoing ACD without inter-body graft or cage. At a minimum of 12 months after operation changes in disc space height and cervical spine alignment were correlated with clinical outcome measured by SF36, Neck Disability Index, and visual analogue neck and arm pain scores. There was no relationship between loss of disc height and outcome. Loss of the overall cervical lordosis was present in 71 patients and segmental kyphosis was found in 69. Analysis of clinical outcome showed no significant differences between patients with preserved and abnormal cervical alignment. Neither loss of disc height nor disturbance of cervical alignment compromised clinical outcome in the first year following ACD.

Tetanus with multiple wedge vertebral collapses

African Journals Online (AJOL)

owner

2012-07-06

Jul 6, 2012 ... associated with traumatic injury, often a penetrating wound inflicted by dirty ... multiple vertebral collapses and the management chal- .... back pains and swelling as in our patient.9 There are usually no ... The cervical and.

Agreement of Tracing and Direct Viewing Techniques for Cervical Vertebral Maturation Assessment.

Science.gov (United States)

Wiwatworakul, Opas; Manosudprasit, Montian; Pisek, Poonsak; Chatrchaiwiwatana, Supaporn; Wangsrimongkol, Tasanee

2015-08-01

This study aimed to evaluate agreement among three methods for cervical vertebral maturation (CVM) assessment, comprising direct viewing, tracing only, and tracing with digitized points. Two examiners received training and tests of reliability with each CVM method before evaluation of agreement among methods. The subjects were 96 female-cleft lateral cephalometric radiographs (films of eight subjects for each age ranged from seven to 18 years). The examiners interpreted CVM stages of the subjects with four-week interval between uses of each method. The range of weighted kappa values for paired comparisons among the three methods were: 0.96-0.98 for direct viewing and tracing only comparison; 0.93-0.94 for direct viewing and tracing with digitized points comparison; and 0.96-0.97 for tracing only and tracing with digitized points comparison. The intraclass correlation coefficient (ICC) value among the three methods was 0.95. These results indicated very good agreement among methods. Use of direct viewing is suitable for CVM assessment without spending more time for tracing. However, the three methods might be used interchangeably.

MRA of fibromuscular dysplasia in cervical vessels

International Nuclear Information System (INIS)

Link, J.; Steffens, J.C.; Mueller-Huelsbeck, S.; Brossmann, J.; Heller, M.

1996-01-01

In 386 selective angiograms of cervical vessels fibromuscular dysplasia was revealed in 4 female patients in the age of 30-54 years. FMD was located in the carotid artery (n=5) and in the vertebral artery (n=2) with a total of 8 lesions. 6/8 of the lesions of the seven cervical vessels were located typically in the mid cervical portion of the vessels and 2/6 lesions were located in the atlas loop of the vertebral artery. 4 lesions showed moderate stenosis and 4 vessels showed only mild stenosis. These patterns which demonstrated the typical morphology of fibromuscular dysplasia with alternating irregular zones of widening and narrowing were evaluated well with MR angiography, the others were missed. (orig./MG) [de

Cervical spine motion: radiographic study

International Nuclear Information System (INIS)

Morgan, J.P.; Miyabayashi, T.; Choy, S.

1986-01-01

Knowledge of the acceptable range of motion of the cervical spine of the dog is used in the radiographic diagnosis of both developmental and degenerative diseases. A series of radiographs of mature Beagle dogs was used to identify motion within sagittal and transverse planes. Positioning of the dog's head and neck was standardized, using a restraining board, and mimicked those thought to be of value in diagnostic radiology. The range of motion was greatest between C2 and C5. Reports of severe disk degeneration in the cervical spine of the Beagle describe the most severely involved disks to be C4 through C7. Thus, a high range of motion between vertebral segments does not seem to be the cause for the severe degenerative disk disease. Dorsoventral slippage between vertebral segments was seen, but was not accurately measured. Wedging of disks was clearly identified. At the atlantoaxio-occipital region, there was a high degree of motion within the sagittal plane at the atlantoaxial and atlanto-occipital joints; the measurement can be a guideline in the radiographic diagnosis of instability due to developmental anomalies in this region. Lateral motion within the transverse plane was detected at the 2 joints; however, motion was minimal, and the measurements seemed to be less accurate because of rotation of the cervical spine. Height of the vertebral canal was consistently noted to be greater at the caudal orifice, giving some warning to the possibility of overdiagnosis in suspected instances of cervical spondylopathy

An unusual cause of chest pain: Fused cervical vertebra (C3-C4

Directory of Open Access Journals (Sweden)

Daipayan Chatterjee

2014-01-01

Full Text Available Cervicogenic angina is paroxysmal precordialgia usually due to lower cervical vertebral involvement. But upper cervical vertebral segmental anomaly causing cervicogenic angina is rare. Herein, we report a case of cervicogenic angina due to fused 3 rd and 4 th cervical vertebra in a 37-year female, which was initially misdiagnosed as angina and treated likewise. But, persistence of symptoms led to evaluation of her cervical spine and subsequent diagnosis. Cervical traction, physiotherapy and posture training relieved her of her symptoms with no recurrence till 6 months of follow-up. Fused C3-C4 can be a cause of precordialgia and physicians should be aware of it.

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

International Nuclear Information System (INIS)

Remes, Ville M.; Helenius, Ilkka J.; Peltonen, Jari I.; Marttinen, Eino J.; Poussa, Mikko S.

2002-01-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and displacement

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

Energy Technology Data Exchange (ETDEWEB)

Remes, Ville M; Helenius, Ilkka J; Peltonen, Jari I [Hospital for Children and Adolescents, Helsinki University Central Hospital, P.O. Box 281, 00029 HUS (Finland); Marttinen, Eino J [Helsinki University Central Hospital (Finland); Poussa, Mikko S [Orton Orthopaedic Hospital, Helsinki (Finland)

2002-09-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and displacement

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

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Remes, Ville M.; Helenius, Ilkka J.; Peltonen, Jari I. [Hospital for Children and Adolescents, Helsinki University Central Hospital, P.O. Box 281, 00029 HUS (Finland); Marttinen, Eino J. [Helsinki University Central Hospital (Finland); Poussa, Mikko S. [Orton Orthopaedic Hospital, Helsinki (Finland)

2002-09-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and

MRI findings in posterior disc prolapse associated with cervical fracture dislocation

International Nuclear Information System (INIS)

Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami

1994-01-01

Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: 1) discontinuity of injured disc, 2) anterior indentation of spinal cord at the site of dislocated vertebral body, and 3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author)

MRI findings in posterior disc prolapse associated with cervical fracture dislocation

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Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

1994-03-01

Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

The surgical treatment of instability of the upper part of the cervical spine in children and adolescents.

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Koop, S E; Winter, R B; Lonstein, J E

1984-03-01

In a retrospective review of the cases of thirteen skeletally immature children and adolescents (four to eighteen years old) with instability of the upper part of the cervical spine (occiput to fifth cervical vertebra), we determined the efficacy of posterior arthrodesis and halo-cast immobilization in the management of this condition. The patients were divided into two groups: those with congenital vertebral anomalies alone (fusion or structural defects, or both) and those with cervical anomalies and systemic disorders (dwarfism, juvenile rheumatoid arthritis, Down syndrome, and cerebral palsy). Two patterns of instability were found: instabilities at intervertebral joints adjacent to vertebral fusions, and instabilities located in vertebral defects. For all patients treatment included a posterior arthrodesis with external immobilization by a halo cast, and in two patients internal fixation with wire was also used. Solid arthrodesis was obtained in the twelve patients who were treated with autogenous grafts (iliac cancellous bone in eleven and rib bone in one), and a non-union developed in a child who was treated with bank-bone rib segments. Posterior cervical arthrodesis with wire fixation carries some risk of neural injury and often is not applicable in children with anomalous vertebrae. Spine fusion using delicate exposure, decortication using an air-drill, and placement of autogenous cancellous iliac grafts with external immobilization by a halo cast minimizes the risk of neural damage and is a reliable way to obtain a solid arthrodesis.

Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder.

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Munhoz, Wagner Cesar; Marques, Amélia Pasqual; Siqueira, José Tadeu Tesseroli de

2004-01-01

Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same images. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%), but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03). After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.

CrossFit-related cervical internal carotid artery dissection.

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Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

2015-08-01

CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

Effects of posttreatment skeletal maturity measured with the cervical vertebral maturation method on incisor alignment relapse.

Science.gov (United States)

Fudalej, Piotr; Rothe, Laura E; Bollen, Anne-Marie

2008-08-01

Our aim was to test the hypothesis that relapse of incisor alignment is associated with skeletal maturity at the end of treatment, as assessed with the cervical vertebral maturation (CVM) method. This was a case-control study with information from the postretention database at the University of Washington. Mandibular incisor irregularity (II) at least 10 years out of retention (T3) was used to define the subjects (II >6 mm, relapse group) and the controls (II 0.05). Pretreatment II and postretention time were found to be correlated with long-term incisor stability (P = 0.007 and 0.034, respectively). Sex was not related to relapse (P = 0.33). Maturity of craniofacial structures at the end of treatment evaluated with the CVM method is not associated with long-term stability of incisor alignment.

Congenital abnormalities of the vertebral column in ferrets.

Science.gov (United States)

Proks, Pavel; Stehlik, Ladislav; Paninarova, Michaela; Irova, Katarina; Hauptman, Karel; Jekl, Vladimir

2015-01-01

Vertebral column pathologies requiring surgical intervention have been described in pet ferrets, however little information is available on the normal vertebral formula and congenital variants in this species. The purpose of this retrospective study was to describe vertebral formulas and prevalence of congenital vertebral anomalies in a sample of pet ferrets. Radiographs of 172 pet ferrets (96 males and 76 females) were included in this retrospective study. In 143 ferrets (83.14%), five different formulas of the vertebral column were recorded with normal morphology of vertebrae (rib attachment included) but with a variable number of thoracic (Th), lumbar (L), and sacral (S) vertebrae. The number of cervical (C) vertebrae was constant in all examined animals. Observed vertebral formulas were C7/Th14/L6/S3 (51.74%), C7/Th14/L6/S4 (22.10%), C7/Th14/L7/S3 (6.98%), C7/Th15/L6/S3 (1.74%), and C7/Th15/L6/S4 (0.58%). Formula C7/Th14/L6/S4 was significantly more common in males than in females (P < 0.05). Congenital spinal abnormalities were found in 29 ferrets (16.86%), mostly localized in the thoracolumbar and lumbosacral regions. The cervical region was affected in only one case. Transitional vertebrae represented the most common congenital abnormalities (26 ferrets) in the thoracolumbar (13 ferrets) and lumbosacral regions (10 ferrets) or simultaneously in both regions (three ferrets). Other vertebral anomalies included block (two ferrets) and wedge vertebra (one ferret). Spina bifida was not detected. Findings from the current study indicated that vertebral formulas may vary in ferrets and congenital abnormalities are common. This should be taken into consideration for surgical planning. © 2014 American College of Veterinary Radiology.

Cervical myelopathy: magnetic imaging findings

International Nuclear Information System (INIS)

Kholin, A.V.; Makarov, A.Yu.; Gurevich, D.V.

1996-01-01

69 patients with clinical signs of cervical myelopathy were examined using magnetic imaging (T1- and T2-suspended tomograms of the sagittal and transverse section using a device with 0.04 T field intensity). Vertebral disk hernias were revealed in 35 patients, compression of the spinal cord with metastases into vertebral body in 2, extramedullary tumor in 11, intramedullary tumor in 9, and syringomyelia in 12 patients. T2-suspended tomograms proved to be more informative due to their higher sensitivity to aqueous content. T1-suspended tomograms help assess the degree of spinal cord compression and the direction of the disk protrusion. Magnetic imaging is an informative method used for objective identification of the cases of myelopathy of cervical localization [ru

Block vertebra: fusion of axis with the third cervical vertebra – a case report

OpenAIRE

Shankar VV; Kulkarni RR

2011-01-01

Skeletal abnormalities at the craniocervical junction or cervical region may result in severe neck pain and sudden unexpected death. During the osteology demonstration of cervical vertebrae for the MBBS Phase I students at M. S. Ramaiah Medical College, it was observed that the axis vertebra is fused with the 3rd cervical vertebra. In this case, the vertebral bodies, vertebral arches and spines were completely fused. This is a condition of block vertebra which has embryological importance and...

Morphometry of the spinal canal at cervical region in asymptomatic military young men Morfometria do canal vertebral no segmento cervical em militares jovens assintomáticos

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Augustin Malzac

2002-12-01

Full Text Available Spinal canal measurements obtainned from radiographic imaging studies are an integral part of diagnostic evaluation of cervical spine stenosis. Before abnormal spinal morphometry can be determined, it is first necessary to establish normal values for the specific patient population being evaluated. Cervical spinal canal stenosis increase risk of quadriplegia after "minor trauma" in the head or neck, mainly in athletes who participate in contact or collision sports. Prospective and random selection of 500 plain film of the lateral cervical spine in young militaries population in age group 18-20 years old. Those were performed a hundred set of film were for each geographic region, including Manaus, Recife, São Paulo, Porto Alegre and Campo Grande. The first part of this study established normal values for cervical morphometry. The second part determined the most accurate screenning method for detecting cervical spinal stenosis. Normal spinal canal mean value for C3 was 18,27mm, C4 17,98mm, C5 18,33mm and 18,76mm in C6. The TORG ratio was evaluated as a method to detect significant cervical spinal stenosis and was shown to have sensitivity and high positive predictive value. It was observed TORG's ratio of 0,80 or less in 14,4% of the X-rays.A medição do diâmetro sagital do canal vertebral é parte integrante da avaliação diagnóstica de estenose da coluna cervical. Antes de identificar a morfometria anormal é necessário estabelecer valores normais para uma população específica. A estenose do canal cervical pode se converter em fator agravante na vigência de um "trauma menor" na cabeça ou no pescoço, aumentando o risco de dano medular especialmente naqueles que praticam esporte de contato. Foram selecionadas de maneira prospectiva e randomizada quinhentas radiografias em perfil da coluna cervical de militares jovens assintomáticos na faixa etária dos 18 aos 20 anos, agrupados em cem em cada região geográfica, nas cidades de Manaus

The vertebral morphology of the estuarine dolphin, Sotalia guianensis (Cetacea, Delphinidae

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Paulo César Simões-Lopes

2004-12-01

Full Text Available We present a description of the backbone of the marine tucuzi (Sotalia guianensis vertebrae (n= 34, including the variations in the vertebral formula (n= 32(UFSC- Universidade Federal de Santa catarina: Ce7, T12,L10-12,Ca23-25= 52-56. Species diagnostic characters and intraspecific variations are presented. Cervical ribs occur in 22.5% of the samples. The metapophyses start from the fourth thoracic vertebra, and the zigapophyses start at the cervical level, being observed up to T11. The inclination of the transverse processes and neurapophyses is most reduced around L5 or L6. Transverse processes on caudal vertebrae disappear between Ca9 and Ca13. The neurapophyses, neural arches and metapophyses are observed up to Ca13 or Ca15. Caudal foramina appear between Ca3 and Ca6. The height of the vertebral body increases up to Ca13, then starts to decrease. The maximum width is found around Ca6, where the vertebral body becomes laterally compressed. The length of the vertebral body increases from the last cervical to T7 and then remains constant up to Ca13, decreasing from then on. This is the first study to take into account intraspecific shape and count variations, representing an improvement over the traditional typologic approach.

The Effect of Technological Devices on Cervical Lordosis

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Ahmet Öğrenci

2018-03-01

CONCLUSION: The use of computing devices, especially mobile telephones, and the increase in the flexion of the cervical spine indicate that cervical vertebral problems will increase even in younger people in future. Also, to using with attention at this point, ergonomic devices must also be developed.

Radiological evaluation of the cervical spinal trauma

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Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J. [School of Medicine, Hanyang University, Seoul (Korea, Republic of)

1983-03-15

Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal.

Radiological evaluation of the cervical spinal trauma

International Nuclear Information System (INIS)

Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J.

1983-01-01

Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal

Visual assessment of the cervical vertebral maturation stages: A study of diagnostic accuracy and repeatability.

Science.gov (United States)

Perinetti, Giuseppe; Caprioglio, Alberto; Contardo, Luca

2014-11-01

To evaluate the diagnostic accuracy and repeatability of the visual assessment of the cervical vertebral maturation (CVM) stages. Ten operators underwent training sessions in visual assessment of CVM staging. Subsequently, they were asked to stage 72 cases equally divided into the six stages. Such assessment was repeated twice in two sessions (T1 and T2) 4 weeks apart. A reference standard for each case was created according to a cephalometric analysis of both the concavities and shapes of the cervical vertebrae. The overall agreement with the reference standard was about 68% for both sessions and 76.9% for intrarater repeatability. The overall kappa coefficients with the reference standard were up to 0.86 for both sessions, and 0.88 for intrarater repeatability. Overall, disagreements one stage and twp stage apart were 23.5% (T1) and 5.1% (T2), respectively. Sensitivity ranged from 53.3% for CS5 (T1) to 99.9% for CS1 (T2), positive predictive values ranged from 52.4% for CS5 (T2) to 94.3% for CS6 (T1), and accuracy ranged from 83.6% for CS4 (T2) to 94.9% for CS1 (T1). Visual assessment of the CVM stages is accurate and repeatable to a satisfactory level. About one in three cases remain misclassified; disagreement is generally limited to one stage and is mostly seen in stages 4 and 5.

Diagnostic value of the 2011 International Federation for Cervical Pathology and Colposcopy Terminology in predicting cervical lesions

Science.gov (United States)

Zhang, Liqin; Yan, Ye; Han, Cha; Xue, Fengxia

2018-01-01

Objective To evaluate the diagnostic accuracy of the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) colposcopic terminology. Methods The clinicopathological data of 2262 patients who underwent colposcopy from September 2012 to September 2016 were reviewed. The colposcopic findings, colposcopic impression, and cervical histopathology of the patients were analyzed. Correlations between variables were evaluated using cervical histopathology as the gold standard. Results Colposcopic diagnosis matched biopsy histopathology in 1482 patients (65.5%), and the weighted kappa strength of agreement was 0.480 (Pterminology can improve the diagnostic accuracy for all lesion severities. The categorization of major changes and minor changes is appropriate. However, colposcopic diagnosis remains unsatisfactory. Poor reproducibility of type 2 transformation zone and the significance of leukoplakia require further study. PMID:29507681

Clinical features of 10 patients with spontaneous cervical internal carotid artery dissection

International Nuclear Information System (INIS)

Nagoya, Harumitsu; Takeda, Hidetaka; Dembo, Tomohisa; Kato, Yuzi; Deguchi, Ichiro; Fukuoka, Takuya; Maruyama, Hazime; Horiuchi, Yohsuke; Tanahashi, Norio

2011-01-01

We clinically investigated 10 patients with spontaneous cervical internal carotid artery dissections (age range 36-70, mean 52±12 years; 8 male and 2 female) who were admitted to our university hospital between August 2002 and 2009. Cervical internal carotid artery dissection was diagnosed using findings from MRI, MR angiography (MRA), 3D-CTA, cerebral angiography, and carotid artery ultrasonography according to the diagnostic criteria of brain artery dissociation defined by the brain artery dissociation working group of the Strategies Against Stroke Study for Young Adults in Japan. The initial symptoms were stroke in eight patients, only neck pain in another, and no symptoms in the last. Four patients (40%) had neck pain or headache at onset. Five of the 10 patients had radiological improvements within three months after onset. The outcomes at three months were relatively good, with seven and three patients scoring 1 and 2, respectively, on the modified Rankin Scale. Disease did not recur in any patients during an average of 17.2 months of follow up. Spontaneous cervical internal carotid artery dissection is not rare in Japan. This condition should be considered when patients present with internal carotid artery occlusion or stenosis. (author)

Quantification of pediatric and adult cervical vertebra-anatomical characteristics by age and gender for automotive application.

Science.gov (United States)

Parenteau, Chantal S; Wang, Nicholas C; Zhang, Peng; Caird, Michelle S; Wang, Stewart C

2014-01-01

The cervical anatomy has been shown to affect injury patterns in vehicle crashes. Characterizing the spine anatomy and changes associated with growth and gender is important when assessing occupant protection. In this study, selected cervical characteristics were quantified. Computed tomography (CT) scans of 750 patients were selected from the University of Michigan trauma database; 314 were children and 436 were adults. Four variables were obtained: the maximum spinal canal radius, vertebral body depth, facet angles, and retroversion angles. The cervical spine measurements varied with age and gender. The body depth increased nonlinearly with age. The average vertebral body depth at C4 was 9.2 ± 0.38 mm in the 0-3 age group, 15.7 ± 0.29 mm in the 18-29 age group, and 17.2 ± 0.46 mm in the 60+ age group. Pediatric and adult males had larger vertebral body depth than females overall, irrespective of vertebral level (P vertebral body depth was 8-9 percent greater in male children and 13-16 percent greater in adult males. The average radius varied with gender, with male children generally having a larger radius than females irrespective of vertebral level (P vertebral level (P maturation by the age of 7. Facet angles decreased with age in children and increased with age in adults. The average facet angles were largest in the 0-3 age group (P cervical anatomical changes associated with age and gender. The information is useful when assessing differences in injury patterns between different segments of the population. Anatomical measurements of the cervical spine should be considered for the development of models used to assess injury mechanisms for various occupant age groups.

Episodic vertigo resulting from vascular risk factors, cervical spondylosis and head rotation: Two case reports.

Science.gov (United States)

Owolabi, Mayowa O; Ogah, Okechukwu S; Ogunniyi, Adesola

2007-01-01

Vascular risk factors predispose to vertebrobasilar ischemia. Cervical osteophytes can impinge on the vertebral artery causing mechanical occlusion during head turning. Presentation with vertigo in such instances is a common finding. A patient with obesity, hyperlipidemia, hypertension, cervical spondylosis, and vertigo triggered by head rotation is presented. She responded to antihypertensive and lipid-lowering drugs, vestibular sedative and application of cervical collar. The second patient also exhibited similar features and responded to conservative treatment. Rotational vertebral artery occlusion resulting from cervical spondylosis in the presence of atherosclerosed collateral vessels is a cause of posterior circulation insufficiency manifesting as vertigo. The tetrad of vertigo resulting from vascular risk factors, cervical spondylosis, and head rotation is proposed for further research.

Experimental evaluation of the stability of goat's cervical spine after percutaneous cervical diskectomy

International Nuclear Information System (INIS)

Du Zhongli; Zhou Yicheng; Wang Chengyuan; Hong Cheng; Liu Hanqiao; Zhang Jiangfan; Ding Hui; Feng Dingyi

1999-01-01

Objective: To evaluate the stability of the goat's cervical spine after PCD (percutaneous cervical diskectomy). Methods: Ten adult goats were studied. Seven had PCD at C 3-4 , and three at C 4-5 . The cervical spine of the goat was studied with MR using axial, corona land sagittal images and with anteroposterior and lateral radiographs before and after PCD. The height of the disk, the disk space angle and dislocation were measured respectively before and after PCD. The data were examined by t-test. Results: The disk space (7 cases, 70%) became narrow obviously, and hyperostosis (5 cases, 50%) disk bulging (4 cases, 40%) appeared after PCD, but there was no obvious dislocation or angulation between the adjacent vertebral bodies. Conclusions: The stability of the goat's cervical spine is not affected after PCD. Indicating that this might also hold true for human cervical spine

A case of marked short-neck with fusion of cervical vertebrae in a Holstein cow

International Nuclear Information System (INIS)

Ogawa, J.; Ando, T.; Otsuka, H.; Paku, T.; Yoshioka, I.; Saruyama, Y.; Yamada, H.; Iso, H.; Oyamada, T.; Watanabe, D.

2007-01-01

An 11-month old Holstein cow with congenitally shortened neck was subjected to clinical, radiographic and myelographic examination, and also autopsy and histopathological examination. Skeletal preparations of the cervical region were made to investigate the abnormality of the vertebrae. The cow was growing normally, and no critical neurological signs were observed. Radiographic examination showed marked kyphosis of the cervical spine, and fusion of posterior cervical vertebrae was suspected. Myelographic examination showed curvature of the spinal cord, but no narrowing at any part. Atrophy, hyaline degeneration, and hydropic degeneration of muscle fibers were seen in the dorsal part of the cervical region in the histopathological examination, but there was no abnormality in the cervical spinal cord. Deformation, fusion, and hypoplasia of the cervical vertebrae and posterior thoracic vertebrae were observed. It is suggested that in the organ system-wise classification of congenital abnormalities, this may be classified as a case of defective vertebrae with the coexisting congenital anomalies of kyphosis, scoliosis and vertebral fusion. The cause of this defect was not clear, but the observed vertebral fusion and hypoplasia indicated defective development of the vertebral segment during the early fetal stage

Deep time perspective on turtle neck evolution: chasing the Hox code by vertebral morphology.

Science.gov (United States)

Böhmer, Christine; Werneburg, Ingmar

2017-08-21

The unparalleled ability of turtle neck retraction is possible in three different modes, which characterize stem turtles, living side-necked (Pleurodira), and hidden-necked (Cryptodira) turtles, respectively. Despite the conservatism in vertebral count among turtles, there is significant functional and morphological regionalization in the cervical vertebral column. Since Hox genes play a fundamental role in determining the differentiation in vertebra morphology and based on our reconstruction of evolutionary genetics in deep time, we hypothesize genetic differences among the turtle groups and between turtles and other land vertebrates. We correlated anterior Hox gene expression and the quantifiable shape of the vertebrae to investigate the morphological modularity in the neck across living and extinct turtles. This permitted the reconstruction of the hypothetical ancestral Hox code pattern of the whole turtle clade. The scenario of the evolution of axial patterning in turtles indicates shifts in the spatial expression of HoxA-5 in relation to the reduction of cervical ribs in modern turtles and of HoxB-5 linked with a lower morphological differentiation between the anterior cervical vertebrae observed in cryptodirans. By comparison with the mammalian pattern, we illustrate how the fixed count of eight cervical vertebrae in turtles resulted from the emergence of the unique turtle shell.

Internal jugular phlebectasia as an incidental finding in cervical spine surgery

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Thulasiraman V

2010-01-01

Full Text Available Idiopathic internal jugular phlebectasia, occurs either unilaterally or bilaterally affecting the internal jugular vein is a rare congenital variation often diagnosed during childhood. It usually presents with a benign swelling over the lateral side of neck on the affected side, seen on exertion. A-30-year old male was operated for anterior cervical dissectomy from right lateral approach and was diagnosed per-operatively as internal jugular phlebectasia.The surgery was abandoned at this stage on the advice of cardiothoracic surgeon to investigate the patient for the secondary etiological factors for internal jugular vein dilatation. The patient was reassured without any active intervention for the phlebectasia and cervical dissectomy was performed in the second surgery through the lateral approach from left side. This case is presented in view of rarity and suggested that during preoperative workup the nearby structures like carotid sheath should be evaluated by magnetic resonance imaging to avoid such per-operative surprises.

Correlation between chronological age, cervical vertebral maturation and Fishman's skeletal maturity indicators in southern Chinese.

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Alkhal, Hessa Abdulla; Wong, Ricky W K; Rabie, A Bakr M

2008-07-01

To investigate the correlation between chronological age, cervical vertebral maturation (CVM), and Fishman's hand-wrist skeletal maturity indicators in southern Chinese. Four hundred contemporary hand-wrist and lateral cephalometric radiographs of southern Chinese subjects were randomly selected and analyzed. The female subjects were between 10 and 15 years of age, and the male subjects were between 12 and 17 years of age; all subjects were within the circumpubertal period. The CVM was assessed using the method developed by Baccetti and coworkers, but the hand-wrist maturation was assessed using the method developed by Fishman. These two methods and the chronological age were correlated using the Spearman rank correlation analysis. The CVM was significantly correlated with the hand-wrist skeletal age (Spearman r male = 0.9206, female = 0.9363). All patients in the cervical maturation stage (CS3) of CVM were discovered to be in the skeletal maturational indicator (SMI2 or SMI3) stages of hand-wrist maturation (HWM), which was around the peak of the growth spurt. Low correlations were found between the CVM and chronological age (male r = 0.7577; female r = 0.7877) and between the HWM and chronological age (male r = 0.7492; female r = 0.7758). CVM is a valid indicator of skeletal growth during the circumpubertal and has a high correlation with the HWM for the southern Chinese population. However, the low correlations found between the chronological age and both CVM and HWM showed that the chronological age was not suitable to measure skeletal maturity.

Vertebral metastases with high risk of symptomatic malignant spinal cord compression

International Nuclear Information System (INIS)

Hamamoto, Yasushi; Kataoka, Masaaki; Senba, Takatoshi

2009-01-01

To find vertebral metastases with high risk of symptomatic malignant spinal cord compression (MSCC), features of vertebral metastases caused motor deficits of the lower extremities were examined. From 2004 through 2006, 78 patients with metastases of the thoracic and/or the cervical spine were treated with radiation therapy (RT). Of these, 86 irradiated lesions in 73 patients were evaluable by magnetic resonance imaging and/or computed tomography at the initiation of RT and were reviewed retrospectively in this study. Twenty-eight patients (38%) had motor deficits at the initiation of RT. Assessed factors were age, sex, primary disease (lung, breast, digestive system and other cancer), lamina involvement, main level of tumor location and vertebral-body involvement. Incidence of motor deficits at the initiation of RT was 55% for lesions with lamina involvement and 5% for lesions without lamina involvement (P 0.9999, P=0.7798, P=0.1702 and P=0.366, respectively). Vertebral metastases with lamina involvement tended to cause symptomatic MSCC. Latent development of MSCC occurred more frequently in the MTS compared with other levels of the thoracic and the cervical spine. (author)

Investigation of vertebral ''end plate sclerosis''

International Nuclear Information System (INIS)

Lee, S.W.; Mathie, A.G.; Jackson, J.E.; Hughes, S.P.F.

2001-01-01

To evaluate the association between vertebral ''end plate sclerosis'' and neck pain. A retrospective study was carried out of lateral cervical spine radiographs with a Picture Archive and Communication System (PACS). Two hundred patients' files were randomly assessed, comprising four equal groups, A to D. The mean ages of the patients were 62±7.4 years, 61±7.5 years, 40±5.6 years and 23±5.6 years respectively. In group A, all patients had symptoms of neck pain and a radiographic diagnosis of ''end plate sclerosis'' of the cervical spine. In groups B to D, asymptomatic patients were recruited and their age groups were 50-69, 30-49 and 10-29 years respectively. Using the PACS, the radiographic density and the sagittal diameter, thickness and area of the end plates at the C5 level were measured. Results and conclusions: No significant differences were found in the radiographic density of the end plates either between the symptomatic and asymptomatic groups (groups A and B), or between different age groups (groups B, C and D). A significant increase in end plate area and thickness was found, however, in both group B (P<0.005) and group C (P<0.01) in comparison with group D. This indicates that the extent of end plate sclerosis increases with age. Our results suggest that the radiographic density of cervical vertebral end plates correlates neither with neck pain nor with increasing age. The radiological sign of ''end plate sclerosis'' may be over-reported, further limiting its value in the assessment of patients with cervical spondylosis. (orig.)

Analysis of cervical and global spine alignment under Roussouly sagittal classification in Chinese cervical spondylotic patients and asymptomatic subjects.

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Yu, Miao; Zhao, Wen-Kui; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Zeng, Lin; Liu, Zhong-Jun

2015-06-01

To explore the relationship between cervical spine and the global spine alignment and to postulate the hypotheses that a lordotic alignment of cervical spine is not the only standard to identify asymptomatic subjects, and the degenerative modification of cervical curves depends primarily on their spinal-pelvic alignment. A cohort of 120 cases of Chinese asymptomatic subjects and a cohort of 121 cases of Chinese cervical spondylotic patients were recruited prospectively from 2011 to 2012. Roussouly Classification was utilized to categorize all subjects and patients according to their thoracic spine, lumbar spine and pelvic alignment. The cervical alignments were evaluated as lordosis, straight, sigmoid or kyphosis. Through the lateral X-ray images of neutral cervical and global spine, a number of parameters were measured and analyzed, including pelvic incidence, pelvic tilt, sacral slope, thoracic kyphosis (TK), lumbar lordosis, global cervical angles (angles between two lines parallel with posterior walls of C2 and C7), practical cervical angles (the addition of different cervical end plate angles from C3 to C7, and inter-vertebral angles from C23 to C67), T1 slope, spinal sacral angles (SSA), Hip to C7/Hip to Sacrum and C0-C2 angle. The percentages of cervical lordosis were 28.3% and 36.4% in asymptomatic and spondylotic group, respectively. The cervical spine alignments correlated with Roussouly types of global spine alignment in both asymptomatic and cervical spondylotic group (P inter-vertebral angle in Roussouly Type 2 at C4-5 and C5-6 levels (P = 0.04 and 0.04, respectively), and in Roussouly Type 3 at C6-7 level (P = 0.01). The SSA showed significant difference between Roussouly Type 2 and 4 in asymptomatic subjects (P = 0.00), and between Type 1 and 3, 1 and 4, 2 and 3, 2 and 4 in cervical spondylotic patients (P = 0.01, 0.02, 0.00 and 0.01, respectively). The T1 slope was significantly different among Roussouly types (P = 0.04) with its largest value in

Tuina treatment in cervical spondylosis

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Florin Mihai Hinoveanu

2010-12-01

Full Text Available Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the principles of Traditional Chinese Medicine (TCM, especially suitable for use on the elderly population and on infants. While performing Tuina, the therapist concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. For a better result is recommended to try to combine acupuncture with tuina treatment. Tuina can help relieve the pain associated with spondylosis. After this kind of treatment, the symptomes produced by irritated nerves and sore muscles can find some relief. Tuina helps patients with cervical spondylosis regain muscle control, nerve function and flexibility, all through the restoration of the life force flow.

Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

DEFF Research Database (Denmark)

Westerway, Susan Campbell; Hyett, Jon; Henning Pedersen, Lars

2017-01-01

We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra-/interobserver var......We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra......-/interobserver variation for these measurements and the efficacy of TA measures in screening for a low placenta. Methodology Transabdominal and TV measurements of the leading placental edge to the internal cervical os were performed on 369 consecutive pregnancies of 16–41 weeks' gestation. The difference (TA-TV) from...... the area under the receiver operator characteristics (ROC) curve. Intra-/interobserver variations were also calculated. Results Of the pregnancies, 278 had a leading placental edge that was visible with the TV approach. Differences (TA-TV) ranged from −50 mm to +57 mm. Bland-Altman plot shows that TA...

Real-time tracking of vertebral body movement with implantable reference microsensors.

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Mularski, Sven; Picht, Thomas; Kuehn, Björn; Kombos, Theodoros; Brock, Mario; Suess, Olaf

2006-05-01

In the spine, navigation techniques serve mainly to control and accurately target insertion of implants. The main source of error is that the spine is not a rigid organ, but rather a chain of semiflexible movement segments. Any intraoperative manipulation of the patient alters the geometry and volumetry as compared to the 3D volume model created from the image data. Thus, the objective of the study was to implement the theoretical principle of microsensor referencing in a model experiment and to clarify which anatomical structures are suitable for intermittent implantation of positional sensors, as illustrated with cervical vertebral bodies. Laboratory tests were conducted using 70 models of human cervical vertebral bodies. The first experiment investigated whether arbitrary movements of vertebral bodies can be tracked with the positional information from the implanted microsensors. The accuracy of this movement monitoring was determined quantitatively on the basis of positional error measurement. In the second experiment, different ventral and dorsal surgical operations were simulated on five models of the cervical spine. Quantifiable measurement values such as the spatial extension of the intervertebral space and the relative positions of the planes of the upper plates were determined. With respect to the differing anatomy of the individual vertebral bodies of the cervical spine, the sensors could be placed securely with a 5x2 mm drill. The registration error (RE) was determined as a root mean square error. The mean value was 0.9425 mm (range: 0.57-1.2 mm; median: 0.9400 mm; SD: 0.1903 mm). The precision of the movement monitoring of the vertebral body was investigated along its three main axes. The error tolerance between post-interventional 3D reconstruction and direct measurement on the model did not exceed 1.3 mm in the distance measurements or 2.5 degrees in the angular measurements. The tomograms on the system monitor could be updated in close to real time

Unicameral bone cyst of a cervical vertebral body and lateral mass with associated pathological fracture in a child. Case report and review of the literature.

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Snell, B E; Adesina, A; Wolfla, C E

2001-10-01

The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. Magnetic resonance imaging demonstrated mixed signal on both T1- and T2-weighted sequences, with cystic and enhancing solid portions. Magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.

Pathophysiology of cervical myelopathy.

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Baptiste, Darryl C; Fehlings, Michael G

2006-01-01

Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes. Clinicians who treat cervical myelopathy cord injuries should have a basic understanding of the pathophysiology and the processes that are initiated after the spinal cord has been injured. Literature review. Literature review of human cervical myelopathy and clinically relevant animal models to further our understanding of the pathological mechanisms involved. The pathophysiology of cervical myelopathy involves static factors, which result in acquired or developmental stenosis of the cervical canal and dynamic factors, which involve repetitive injury to the cervical cord. These mechanical factors in turn result in direct injury to neurons and glia as well as a secondary cascade of events including ischemia, excitotoxicity, and apoptosis; a pathobiology similar to that occurring in traumatic spinal cord injury. This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.

Diagnostic radiology for functional analysis of the cervical vertebral column

International Nuclear Information System (INIS)

Kamieth, H.

1986-01-01

The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs [de

Incidence of second cervical vertebral fractures far surpassed the rate predicted by the changing age distribution and growth among elderly persons in the United States (2005-2008).

Science.gov (United States)

Zusman, Natalie L; Ching, Alexander C; Hart, Robert A; Yoo, Jung U

2013-04-20

Nationwide epidemiological cohort study. To characterize the incidence of second cervical vertebral (C2) fractures by age and geographical region among the elderly Medicare population and to elucidate if the rate changed in the years 2005 to 2008. Recent publications hypothesized that the rate of cervical vertebral fractures may be increasing. To date, there are no published nationwide reports describing the incidence and demographics of these injuries in the elderly US population. Incidence of C2 fracture in the years 2005 to 2008 was determined by querying PearlDiver Technologies, Inc. (Warsaw, IN), a commercially available database, using International Classification of Diseases code 805.02. Rates were calculated using the PearlDiver reported person-counts as the numerator and the Center for Medicare and Medicare Services midyear population file as the denominator, and reported per 10,000 person-years (10,000 p-y). The age and geographical distributions of fractures were examined. Variability in rates was analyzed using the mean, standard deviation, 95% confidence intervals, χ tests, and Pearson correlation coefficients. Although the elderly population increased by 6% between 2005 and 2008, the annual incidence of C2 fracture rose by 21%, from 1.58 to 1.91 per 10,000 p-y, trending upward in a straight-line function (r = 0.999, P = 0.0006). The incidence of fracture varied between age groups; however, an increase was observed in all age groups. Persons aged 65 to 74 years (the youngest age group) experienced the lowest incidence (0.63 in 2005 to 0.71 in 2008), and the rate of increase was the smallest among the age groups examined (13%). Persons aged 85 and older demonstrated the highest incidence (4.36-5.67) and the greatest increase (30%). From 2005 to 2008, the overall incidence of C2 fracture rose at a rate that was 3.5 times faster than the elderly population growth.

Bilateral Internal Carotid Artery Occlusion, External Carotid Artery Stenosis, and Vertebral Artery Kinking: May It Be Asymptomatic?

Science.gov (United States)

Fatic, Nikola; Jaffer, Usman; Ivana, Saicic; Gordana, Globarevic-Vukcevic; Markovic, Dragan; Kostic, Dusan; Davidovic, Lazar

2017-10-01

The clinical spectrum of internal carotid artery occlusion ranges from being a completely asymptomatic occlusion to a devastating stroke or death. The prevalence of asymptomatic internal carotid artery occlusion is unknown, particularly for bilateral occlusion. The distal branches of the external carotid artery anastomose with distal branches of the internal carotid artery provide important sources of collateral circulation to the brain. Stenosis of the external carotid artery with ipsilateral/bilateral internal occlusion may result in ischemic sequelae. Coiling or kinking of the vertebral artery is a rare morphological entity that is infrequently reported because it remains asymptomatic and has no clinical relevance. Currently, there is little evidence to support management strategies for this disease entity and no official recommendations for asymptomatic bilateral carotid artery occlusion. We present a case of a 62-year-old female with asymptomatic bilateral internal carotid artery occlusion, bilateral external carotid artery stenoses, and bilateral kinking of the vertebral artery at the V2 segment, who has been successfully managed conservatively for over 5 years. An individualized approach to management of patients with bilateral internal carotid artery occlusion, especially in combination with external carotid artery stenosis and elongation malformations of the vertebral artery is key to a successful strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

Computerized axial tomography in traumatic cervical lesions

International Nuclear Information System (INIS)

Koyama, Tsunemaro

1982-01-01

Although plain computerized axial tomography cannot routinely demonstrate the spinal cord, it does provide excellent visualization of the bony outline of the spinal canal and vertebral column. So it should be reasonable to use this technique in cases of cervical traumatic disorders. In this paper we presented 10 cases of cervical traumatic lesions; 3 atlanto-axial dislocation, 2 cervical canal stenosis, 3 OPLL, 1 intramedullary hematoma and 1 C 2 -neurinoma. In some patients neurologic deficits were induced by cervical trauma. Bony lesions appeared more adequately deliniated than intraspinal lesions, however, in some cases intramedullary changes could also be demonstrated. The use of metrizamide with high resolution CT-scanner could improve the usefullness of this technique. (author)

Percutaneous vertebroplasty via anterolateral approach for the treatment of C4 to C7 vertebral tumor

International Nuclear Information System (INIS)

Wu Chungen; Cheng Yongde; Gu Yifeng; Zhang Ji; Wang Tao; Li Minghua; Apitzsch, D.E.

2009-01-01

Objective To investigate the feasibility and clinical efficacy of percutaneous vertebroplasty via anterolateral approach in treating the middle and lower cervical (C4-C7) vertebral tumor. Methods: During the past four years, percutaneous vertebroplasty via anterolateral approach was performed in 16 patients with middle or lower cervical tumor, including metastases (n=12), myeloma (n=3) and eosinophilic granuloma (n=1). Under fluoroscopic guidance, needle puncture was operated via the anterolateral approach, bone cement was injected into the target cervical body when the needle was in place. A follow-up of three months was made. Results: Twenty-one cervical bodies in the range of C4 to C7 were successfully punctured and injected with bone cement. Marked pain relief was obtained in all 16 patients. The average score of visual analogue scale (VAS) was dramatically decreased from 7 before the procedure to 1.7 after the procedure. The cervical motor function returned to good condition. Conclusion: Percutaneous vertebroplasty via anterolateral approach is a safe, effective and minimally-invasive technique in treating the middle and lower cervical (C4-C7) vertebral tumor. (authors)

Combined endovascular and surgical treatment in vertebral arteriovenous fistula

International Nuclear Information System (INIS)

Nakstad, P.H.; Haakonsen, M.; Magnaes, B.; Hetland, S.

1997-01-01

A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful. She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery. Her heart size, heart rate and blood pressure were successively normalized. (orig.)

Vertebral Artery Caught in the Fracture Gap after Traumatic C2/3 Spondylolisthesis

Directory of Open Access Journals (Sweden)

Ralf Henkelmann

2017-01-01

Full Text Available Background Context. Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap. Purpose. Presentation of a case with follow-up until end of treatment. Study Design. Case report. Methods. A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment. Radiological diagnostics revealed a traumatic C2/3 spondylolisthesis. A computer tomography (CT angiographic scan showed a dislocation of the right vertebral artery into the fracture gap without injury to the artery. Open reduction and osteosynthesis were considered of too high risk. Therefore, we conducted fracture treatment with closed reduction and halo fixation. After removal of the halo fixator, the patient was given a soft cervical collar and was advised to rest for additional 6 weeks before beginning gradual activity. Results. Conventional follow-up revealed osseous consolidation and a CT angiographic scan showed consistent blood flow to the artery. Conclusion. Halo fixation was a safe and effective therapy strategy in the case of vertebral artery entrapment after traumatic C2 spondylolisthesis.

Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

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Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M. [AORNA Cardarelli, Neuroradiology Service, Naples (Italy); Pezzullo, M.G. [Seconda Universita degli studi di Napoli - SUN, Radiology Service, Naples (Italy)

2009-07-15

This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

International Nuclear Information System (INIS)

Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M.; Pezzullo, M.G.

2009-01-01

This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

Comorbidity of internal derangement of the temporomandibular joint and silent dysfunction of the cervical spine.

Science.gov (United States)

Stiesch-Scholz, M; Fink, M; Tschernitschek, H

2003-04-01

The aim of this evaluation was to examine correlations between internal derangement of the temporomandibular joint (TMJ) and cervical spine disorder (CSD). A prospective controlled clinical study was carried out. Thirty patients with signs and symptoms of internal derangement but without any subjective neck problems and 30 age- and gender-matched control subjects without signs and symptoms of internal derangement were examined. The investigation of the temporomandibular system was carried out using a 'Craniomandibular Index'. Afterwards an examiner-blinded manual medical investigation of the craniocervical system was performed. This included muscle palpation of the cervical spine and shoulder girdle as well as passive movement tests of the cervical spine, to detect restrictions in the range of movement as well as segmental intervertebral dysfunction. The internal derangement of the TMJ was significantly associated with 'silent' CSD (t-test, P temporomandibular system exhibited significantly more often pain on pressure of the neck muscles than patients without muscle tenderness of the temporomandibular system (t-test, P < 0.05). As a result of the present study, for patients with internal derangement of the TMJ an additional examination of the craniocervical system should be recommended.

Angiographic frequency of blunt cerebrovascular injury in patients with carotid canal or vertebral foramen fractures on multidetector CT

International Nuclear Information System (INIS)

McKinney, Alexander; Ott, Frederick; Short, James; McKinney, Zeke; Truwit, Charles

2007-01-01

Purpose: Blunt carotid injuries (BCI's) and blunt vertebral artery injuries (BVI's), known jointly as BCVI's, are common in 'high risk' patients. The purpose is to evaluate the rate of occurrence of BCI/BVI in patients screened purely by the radiologic criteria of fracture through the carotid canal or vertebral transverse foramina, or significant cervical subluxation, noted by multidetector CT. Methods: Seventy-one patients with 108 catheterized vessels were included over a 13-month interval. The angiographic examinations were prompted by current hospital protocol, solely by the presence of fractures involving/adjacent to the carotid canal, cervical fractures involving/adjacent to the foramen transversarium, or cervical fractures with significant subluxation. The incidence of each grade of blunt injury was calculated after review of the CT scans and catheter angiograms by two neuroradiologists. Results: Two thousand and seventy-three total blunt trauma admissions occurred during the time period, with a BCVI rate of 0.92-1.0% (depending on the reviewer), similar to previous studies. Mean time to catheter angiography was 16.6 h. Of the 71 included patients, there were 11-12 BCI's and 10-12 BVI's, an overall rate of 27-30% of BCVI in the patients with foraminal fractures. Interobserver agreement in reviewing the catheter angiograms was excellent (Kappa 0.795). Of note, three internal carotid pseudoaneurysms resolved spontaneously after anticoagulation or aspirin. Conclusion: This study confirms that there is a high rate of BCVI in the presence of carotid canal or vertebral foramen fractures that are noted by multidetector CT. Utilization of purely radiologic criteria of foraminal involvement may be a significant screening tool in the decision of whether to evaluate these patients acutely by catheter or CT angiography, and for early detection of patients at risk for symptomatology, to initiate prompt, prophylactic treatment

Angiographic frequency of blunt cerebrovascular injury in patients with carotid canal or vertebral foramen fractures on multidetector CT

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McKinney, Alexander [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States)]. E-mail: mckin022@umn.edu; Ott, Frederick [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); Short, James [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); McKinney, Zeke [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); Truwit, Charles [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States)

2007-06-15

Purpose: Blunt carotid injuries (BCI's) and blunt vertebral artery injuries (BVI's), known jointly as BCVI's, are common in 'high risk' patients. The purpose is to evaluate the rate of occurrence of BCI/BVI in patients screened purely by the radiologic criteria of fracture through the carotid canal or vertebral transverse foramina, or significant cervical subluxation, noted by multidetector CT. Methods: Seventy-one patients with 108 catheterized vessels were included over a 13-month interval. The angiographic examinations were prompted by current hospital protocol, solely by the presence of fractures involving/adjacent to the carotid canal, cervical fractures involving/adjacent to the foramen transversarium, or cervical fractures with significant subluxation. The incidence of each grade of blunt injury was calculated after review of the CT scans and catheter angiograms by two neuroradiologists. Results: Two thousand and seventy-three total blunt trauma admissions occurred during the time period, with a BCVI rate of 0.92-1.0% (depending on the reviewer), similar to previous studies. Mean time to catheter angiography was 16.6 h. Of the 71 included patients, there were 11-12 BCI's and 10-12 BVI's, an overall rate of 27-30% of BCVI in the patients with foraminal fractures. Interobserver agreement in reviewing the catheter angiograms was excellent (Kappa 0.795). Of note, three internal carotid pseudoaneurysms resolved spontaneously after anticoagulation or aspirin. Conclusion: This study confirms that there is a high rate of BCVI in the presence of carotid canal or vertebral foramen fractures that are noted by multidetector CT. Utilization of purely radiologic criteria of foraminal involvement may be a significant screening tool in the decision of whether to evaluate these patients acutely by catheter or CT angiography, and for early detection of patients at risk for symptomatology, to initiate prompt, prophylactic treatment.

'Wildlife 2001: Populations', an International Conference on Population Dynamics and Management of Vertebrates

CERN Document Server

Barrett, Reginald

1992-01-01

In 1984, a conference called Wildlife 2000: Modeling habitat relationships of terrestrial vertebrates, was held at Stanford Sierra Camp at Fallen Leaf Lake in the Sierra Nevada Mountains of California. The conference was well-received, and the published volume (Verner, J. , M. L. Morrison, and C. J. Ralph, editors. 1986. Wildlife 2000: modeling habitat relationships of terrestrial vertebrates, University of Wisconsin Press, Madison, Wisconsin, USA) proved to be a landmark publication that received a book award by The Wildlife Society. Wildlife 2001: populations was a followup conference with emphasis on the other major biological field of wildlife conservation and management, populations. It was held on July 29-31, 1991, at the Oakland Airport Hilton Hotel in Oakland, California, in accordance with our intent that this conference have a much stronger international representation than did Wildlife 2000. The goal of the conference was to bring together an international group of specialists to address the state ...

Large armored bridging over fractured vertebra with intraspinal tumor mimicking bony mass caused by migrated fragments of burst cervical vertebra presenting with severe cervical myelopathy

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Satyarthee Guru Dutta

2017-06-01

Full Text Available Vertebral body may get displaced anterior or posteror with elements of rotation. However, burst cervical spine vertebral fracture may migrate anteriorly and posteriorly simultaneously. However anterior displaced fragment forming armor like mass is very rare. Similarly, the posteriorly propelled fragments migrating caudally and posterolaterally producing a large osseous mass inside spinal canal mimicking bony tumour causing severe cervical canal stenosis and presenting with marked myelopathy is extremely rare. To the best knowledge of authors, association of such traumatic dual pathology represents first of its kind in western literature, who was neglected early medical advice and presenting with marked compressive cervical myelopathy. She underwent successful surgical decompression with gradual recovery of spastic limb weakness and recovery of sensation. Authors also highlights the importance of early resuscitation and adequate maintainace of mean arterial pressure following acute spinal cord injury. Pertinent literature is briefly reviewed.

Spontaneous dissecting aneurysm of the extracranial vertebral artery (20 cases)

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Chiras, J; Marciano, S; Vega Molina, J; Touboul, J; Poirier, B; Bories, J

1985-07-01

Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such as hypertension or fibromuscular dysplasia: on clinical findings they insist upon the diagnostic value of preliminary symptoms, cervical pain or posterior headaches; the most frequent angiographic appearance was a long and irregular stenosis of one or two segments of the vertebral artery. The prognosis of these aneurysms most often appears favourable in this group.

Imaging assessment of vertebral burst fracture

International Nuclear Information System (INIS)

Ding Jianlin; Liang Lihua; Wang Yujia

2006-01-01

Objective: To investigate the diagnostic value of radiography, CT and MRI in diagnosis of vertebral burst fracture. Methods: 51 patients with vertebral burst fracture were evaluated with X-ray, CT and MRI, including 3 cases in cervical vertebra, 18 cases in thoracic vertebra, and 30 cases in lumbar vertebra. The imaging features were comparatively studied. Results: Radiography showed decreased height of the vertebral body, increased antero-posterior diameter and the transverse diameter, and/or the widened interpedicle distance, the inter-spinous distance, as well as the bony fragment inserted into the vertebral canal in 28 cases(54.90%). X-ray findings similar to the compression fracture were revealed in 20 cases(39.21%). And missed diagnosis was made in 3 cases (5.88%). CT clearly demon-strated the vertebral body vertically or transversely burst crack in 49 cases (96.07%); bony fragment inserted into the vertebral canal and narrowed vertebral canal in 35 cases(68. 62% ); fracture of spinal appendix in 22 cases(43.14%). Meanwhile MRI showed abnormal signals within the spinal cord in 35 cases (68.62%),injured intervertebral disk in 29 cases(56.86% ), extradural hematoma in 12 cases(23.52% ) and torn posterior longitudinal ligament in 6 cases (11.76%). Conclusions: Radiography is the routine examination, while with limited diagnostic value in vertebral burst fracture. These patients who have nervous symptoms with simple compression fracture or unremarkable on X-ray should receive the CT or MRI examination. CT is better than MRI in demonstrating the fracture and the displaced bony fragment, while MRI is superior to CT in showing nervous injuries. CT and MRI will provide comprehensive information guiding clinical treatment of vertebral burst fracture. (authors)

MRI in degenerative diseases of the cervical spine

International Nuclear Information System (INIS)

Schubeus, P.; Sander, B.; Hosten, N.; Mayer, H.M.; Weber, U.; Felix, R.

1994-01-01

MRI has grown increasingly important in recent years in diagnosis of degenerative diseases of the cervical spine, due to improvements of method that have made it a valuable diagnostic tool. The following contribution gives a brief introduction to the pathophysiology of degenerative changes in the cervical vertebral column and to the indications for MRI, describing within the framework of imaging the present state of MR examination technique. The ranking of the various gradient echo sequences, of the 3D methods and of the administration of contrast media in cervical myelopathy and radiaculopathy is discussed. (orig.) [de

Vertebral chondroblastoma

International Nuclear Information System (INIS)

Ilaslan, Hakan; Sundaram, Murali; Unni, Krishnan K.

2003-01-01

To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral. Secondary

Complicações determinadas por placas de cloreto de polivinila (PVC na estabilização da porção cervical caudal da coluna vertebral de cães Complications determined by polyvinylchloride (PVC plates in the stabilization of caudal cervical vertebral column of dogs

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Mônica Vicky Bahr Arias

2003-12-01

Full Text Available Em 10 cães com peso médio de 14,6kg, as vértebras cervicais 5 e 6 foram cirurgicamente desestabilizadas através da secção do disco intervertebral e, em seguida, estabilizadas com placas ortopédicas confeccionadas com PVC de 2mm de espessura, para após 180 dias, proceder-se ao estudo histológico do tecido ósseo e conjuntivo circunvizinho. Constatou-se que o PVC causou alterações ósseas que podem ter favorecido o afrouxamento dos parafusos e a falha do implante. O material induziu ainda à formação de granuloma de corpo estranho e a reações inflamatórias locais que podem ter causado degradação do material implantado. Assim, placas de PVC, apesar de proporcionarem estabilidade e alinhamento da coluna vertebral, não satisfazem a maioria das propriedades necessárias a um biomaterial, não sendo recomendadaa a sua utilização em ortopedia veterinária.In ten dogs with an average mean weight of 14,6 kg, the cervical vertebra 5 and 6 were destabilized and fixed with plates of 2mm of thickness. The purpose of this work was to verify the effect of orthopedic PVC plates on the internal stabilization of the caudal cervical spine of dogs by studying the occurrence of alterations in the bone tissue and fibrous tissue adjacent to the plate after 180 days of permanence of the material in the dogs' organism. PVC causes progressive bone alterations, which, in the long term, could promote the loosening of the screws and failure of the implant. It also induces the formation of foreign body granuloma and inflammatory reactions which could cause degradation of the implant. Thus, PVC plates do not satisfy the majority of properties required of a biomaterial, its use not being recommended in veterinary orthopedics.

Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection

NARCIS (Netherlands)

Debette, S.; Kamatani, Y.; Metso, T.M.; Kloss, M.; Chauhan, G.; Engelter, S.T.; Pezzini, S; Thijs, V.; Markus, H.S.; Dichgans, M.; Wolf, C.; Dittrich, R.; Touze, E.; Southerland, A.M.; Samson, Y.; Abboud, S.; Bejot, Y.; Caso, V.; Bersano, A.; Gschwendtner, A.; Sessa, M.; Cole, J.; Lamy, C.; Medeiros, E.; Beretta, S.; Bonati, L.H.; Grau, A.J.; Michel, P.; Majersik, J.J.; Sharma, P.; Kalashnikova, L.; Nazarova, M.; Dobrynina, L.; Bartels, E.; Guillon, B.; Herik, E.G. van den; Fernandez-Cadenas, I.; Jood, K.; Nalls, M.A.; Leeuw, H.F. de; Jern, C.; Cheng, Y.C.; Werner, I.; Metso, A.J.; Lichy, C.; Lyrer, P.A.; Brandt, T.; Boncoraglio, G.B.; Wichmann, H.E.; Gieger, C.; Johnson, A.D.; Bottcher, T.; Castellano, M.; Arveiler, D.; Ikram, M.A.; Breteler, M.M.; Padovani, A.; Meschia, J.F.; Kuhlenbaumer, G.; Rolfs, A.; Worrall, B.B.; Ringelstein, E.B.; Zelenika, D.; Tatlisumak, T.; Lathrop, M.; Leys, D.; Amouyel, P.; Dallongeville, J.

2015-01-01

Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year). Minor cervical traumas, infection, migraine and hypertension are

CT findings of cervical spondylosis associated with muscle atrophy in the upper extremity

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Torigoe, Yasuyuki [Okayama Univ. (Japan). School of Medicine

1995-11-01

The shape, site and size of osteophytes in cervical spondylosis associated with muscle atrophy were studied by CT to know their relation with pathogenesis. Subjects were: muscle atrophy group (30 cases, 59.5-year-old in a mean, operation was performed on 26), spondylosis group (20, 60.0 year-old) and normal group (10, 60.2-year-old). Their cervical vertebral regions were subjected to the scout roentgenography, CT and myelography. Osteophytes were measured on the x-ray film copied from CT-monitoring image. In the muscle atrophy group, about the shape around vertebral foramen, the occipitofrontal diameter of vertebral canal was found larger than in spondylosis group. Osteophytes were often localized at the outer position of paramedian site, of which constriction was rather smaller. The shape of the vertebral arch was keen. Clinically, the muscle atrophy group was considered to be of myelosis under such conditions as having less affective lesion on spinal cord. (H.O.)

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine.

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Fei Guo

Full Text Available Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine.Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis. The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group, pedicle screws fixation were guided by the navigation template; in the second set (Control group, the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is 1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable.A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group.The individualized 3D printing navigation template for pedicle screw fixation is easy and safe, with a high success rate in the upper cervical spine surgery.

Cervical artery dissection following a turbulent flight.

LENUS (Irish Health Repository)

Quinn, Colin

2012-01-31

BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

CT-guided percutaneous vertebroplasty for the treatment of metastases in the cervical spine

International Nuclear Information System (INIS)

Wang Jianhua; Wang Zhentang; Zuo Changjing; Shao Chenwei; Chen Wei; Lv Taozhen; Dong Aisheng

2009-01-01

Objective: To assess the clinical efficacy and complications of CT-guided percutaneous vertebroplasty in the treatment of metastases of the cervical spine, and to discuss the proper needle path for different cervical vertebra. Methods: CT-guided percutaneous vertebroplasty was performed in 17 patients with cervical vertebral metastatic neoplasm, and the results of the treatment were retrospectively analyzed. Close observation was carded out after the procedure and a follow-up of 3-17 months was conducted. A comparison of the visual analogue pain scale (VAS) and Frankel's classification between pre-and post- operation was made. The occurrence of complications was recorded. The optimal needle path was summarized. Results: (1) The successful puncture was achieved in all 17 cases. The needle pathway included: the front of carotid sheath (n=4), between carotid sheath and vertebral artery (n=11) and behind the vertebral artery and carotid sheath (n=2). (2) Before the procedure the VAS was 7.24 ± 1.01, and at the time of one hour, one week and three months after the procedure it was decreased to 3.24 ± 1.09, 2.40 ± 0.80 and 1.82 ± 0.53 respectively. Wilcoxon signed-rank test showed that the difference in VAS between pre-and post- operation was statistically significant (T=76.5, P 2 =4.52, P=0.033 and P<0.05 when Kruskal-Wallis test was adopted. (3) CT scanning immediately after the procedure showed that slight leakage of cement to the adjacent disc, epidural fat, parosteal tissue or to the needle path occurred in 35.3% with no serious complications. In a follow-up period of 3-17 months, the metastatic lesions remained stable in 14 cases (82.4%). Conclusion: (1) The optimal needle path for upper cervical vertebrae is posterolateral transpedicular approach while for the lower cervical vertebrae it is more reasonable to puncture via the front carotid sheath or between carotid sheath and vertebral artery. Nevertheless, the puncture pathway should be devised individually

Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment

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Koeroglu, M.; Arat, A.; Cekirge, S.; Akpinar, E. [Hacettepe University, Department of Radiology, 06100 Ankara (Turkey); Eryilmaz, A.; Akmansu, H. [Ankara Numune Research and Education Hospital, ENT Department, Ankara (Turkey); Koeroglu, Kale B. [Ankara Numune Research and Education Hospital, Internal Medicine Department, Ankara (Turkey)

2002-10-01

We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. Rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome. (orig.)

Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment

International Nuclear Information System (INIS)

Koeroglu, M.; Arat, A.; Cekirge, S.; Akpinar, E.; Eryilmaz, A.; Akmansu, H.; Koeroglu, Kale B.

2002-01-01

We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. Rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome. (orig.)

Effect of Cervical Siphon of External and Internal Carotid Arteries.

Science.gov (United States)

Singh, Rajani; Tubbs, Richard Shane

2017-10-01

Variant courses, configuration, and branching pattern of the external and internal carotid arteries, especially when curved in S-shape, are important for hemodynamic changes and clinical implications. Therefore, the aim of the study is to report abnormal cervical siphons observed in external and internal carotid arteries to explore clinical significance by review of literature and hemodynamic changes theoretically.The right common carotid artery bifurcated into external and internal carotid arteries at the level of the upper border of thyroid cartilage in a 70-year-old female cadaver. After bifurcation, the external carotid artery underwent severe tortuosity coursing through 5 bends at points A, B, C, D, and E from its origin to termination and 2 bends at A' and B' in internal carotid artery in the cervical region. The angles between inflow and out flow of the blood at the bends were measured and the change in velocity at each bend was computed for both arteries. Hemodynamic changes were calculated, compared and relevant clinical complications were theoretically correlated.The angles of 20°, 30°, 51°, 52°, 60°, and 28°, 48° were formed by 5 bends of external and 2 bends of internal carotid arteries, respectively. The curved courses of these arteries caused reduction in velocity/stasis, turbulence, and low shear stress. Such kinks might cause stroke, ischemia and mistaken for tumors and abscess in imagery leading to or otherwise producing iatrogenic repercussions. This study will be useful for anatomists, clinicians, and radiologists.

Percutaneous vertebroplasty for eosinophilic granuloma of the cervical spine in a child

International Nuclear Information System (INIS)

Tan, Hua-Qiao; Li, Ming-Hua; Wu, Chun-Gen; Gu, Yi-Feng; Zhang, He; Fang, Chun

2007-01-01

We report a case of eosinophilic granuloma at the fourth cervical vertebra in a 10-year-old girl presenting with a 1-month history of cervical pain and stiffness. This lesion was histologically diagnosed by needle biopsy and then treated by percutaneous vertebroplasty. After the procedure, the cervical pain and stiffness resolved rapidly. The height of the vertebral body remained stable without further collapse over a 6-month follow-up period. (orig.)

Post-traumatic cerebellar infarction due to vertebral artery foramina fracture: case report

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Moscote-Salazar Luis Rafael

2016-03-01

Full Text Available Posttraumatic cerebral infarction is an uncommon cause of morbidity and mortality and many studies have highlighted that trauma needs to considered as causative factor for cerebellar infarction. We present a case of cerebellar infarction in a 35 year old young patient secondary to vertebral fracture involving the vertebral foramen and vertebral artery injury. CT scan cervical spine showed C2-3 fracture on left side with fracture extending into the left vertebral foramen. A CT scan angiogram could not be performed because of poor neurological status. Possibly the infarction was due to left vertebral artery injury. Without surgical intervention prognosis of these patients remain poor. Prognosis of patients with traumatic cerebellar infarction depends on the neurological status of the patient, intrinsic parenchymal damage and more importantly extrinsic compression of the brainstem by the edematous cerebellar hemispheres.

Stent-Graft Repair of a Large Cervical Internal Carotid Artery Pseudoaneurysm Causing Dysphagia

International Nuclear Information System (INIS)

Gupta, Vivek; Niranjan, Khandelwal; Rawat, Lokesh; Gupta, A. K.

2009-01-01

Pseudoaneurysms of the cervical internal carotid artery (ICA) are rare and most frequently result from trauma, infection, or sometimes spontaneously. They have the potential to cause life-threatening hemorrhage; thus, their immediate management is necessary. Endovascular treatment by stent graft placement in the affected artery appears to be a safe and effective treatment option. We present a case of a child who presented with neck swelling and dysphagia caused by a ruptured cervical ICA pseudoaneurysm which was managed by stent graft placement.

The internal vertebral venous plexus prevents compression of the dural sac during atlanto-axial rotation

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Reesink, E.M.; Lataster, L.M.A.; Mameren, H. van [Dept. of Anatomy/Embryology, Maastricht Univ. (Netherlands); Wilmink, J.T. [Dept. of Radiology, University Hospital Maastricht (Netherlands); Kingma, H. [Dept. of ENT, University Hospital Maastricht (Netherlands)

2001-10-01

Deformation of the extradural space and the possibility of impression upon the dural sac during atlanto-axial rotation are investigated. Atlanto-axial rotation leads to a reduction in the cross-sectional area of the bony spinal canal of approximately 40 %. Atlanto-axial rotation was recorded by endocanalar views from a video camera fixed inside the skull of six unembalmed cadavers. Axial thin-section T1-weighted MRI slice sets were acquired from three volunteers (mid-position and maximal left and right rotation of the head and cervical spine). The axial cross-sectional areas of the bony spinal canal, dural sac and spinal cord were measured. In two other persons post-gadolinium contrast-enhanced T1-weighted MRI volume scans with fat-suppression prepulse were acquired (mid-position and rotation) to determine venous contents of the extradural space. The 50:50 ratio between left and right extradural halves in mid-position changed to an ipsilateral:contralateral ratio of 20:80 in maximum rotation at the level just above the lateral C1-C2 joints. Directly below these joints the opposite occurred. The post-contrast studies showed an enhancing internal vertebral venous plexus (IVVP), which almost completely occupied the extradural space at the atlanto-axial level. This could not be shown in the cadaver experiments, because of absence of blood and cerebrospinal fluid (CSF) pressure. During atlanto-axial rotation blood displacement in the IVVP allows major deformations of the extradural space. This prevents dural sac impression. (orig.)

Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship?

Science.gov (United States)

Uysal, Tancan; Ramoglu, Sabri Ilhan; Basciftci, Faruk Ayhan; Sari, Zafer

2006-11-01

The aims of this study were (1) to investigate the relationship between chronologic age and maturation of cervical vertebrae, (2) to identify the relationship between chronologic age and maturation stage evaluated by hand-wrist radiographs, and (3) to determine whether the maturation of cervical vertebrae correlates with maturation indicated by hand-wrist radiographs in a Turkish population. The samples were derived from lateral cephalometric and hand-wrist radiographs of 503 subjects (213 male, 290 female; ages, 5.3-24.1 years). Cervical vertebral development was evaluated by the method of Hassel and Farman. Skeletal maturation of each hand-wrist radiograph was determined according to the method described by Björk and Grave, and Brown's system. The Spearman rank-order correlation coefficients were estimated separately for males and females to measure the relationships among chronologic age, cervical vertebral maturation, and the skeletal maturation measured at the hand-wrist. The Spearman correlation coefficients were 0.72 (P cervical vertebrae skeletal maturation, and 0.79 (P maturation via hand-wrist radiographs. The correlation coefficient between hand-wrist and cervical-vertebrae maturation was 0.86 (P cervical-vertebrae maturation stages are clinically useful maturity indicators of the pubertal growth period Turkish subjects.

Case Report: Multiple cervical vertebral fusion with ossification of ...

African Journals Online (AJOL)

The CT image of the specimen confirmed the ossification of the anterior longitudinal ligament with mild calcification of intervertebral discs. With the above features and bony ankylosis of articular facets, it was concluded that this fusion might be due to ankylosing spondylitis. Keywords: cervical vertebra; ossification; ligaments ...

Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

International Nuclear Information System (INIS)

Sommer, A.; Neff, W.; Schwartz, A.

1998-01-01

We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.)

Complex Vertebral Malformation (CVM) in an Italian Holstein calf

International Nuclear Information System (INIS)

Gentile, A.; Diana, A.; Testoni, S.; Olzi, E.

2004-01-01

Complex Vertebral Malformation, a congenital and lethal genetic defect of Holstein breed, has been recently observed in different Countries all over the world. In this paper the AA describe the clinical and radiological aspects of CVM in a two day old female calf. The disease was characterized by low body weight, symmetrical arthrogryposis and partial rotation of all legs and scoliosis. Calf was alert and showed physiological appetite, but was not able to maintain the quadrupedal stance. Radiographs of the vertebral column showed multiple vertebral anomalies, including hemivertebrae, fused and misshapen vertebrae and ribs and scoliosis, that affected mainly the caudal, cervical and thoracic regions. At necropsy, besides the skeleton anomalies, complex malformation of the heart was observed, which included atrial and interventricular defects and patent ductus arteriosus. This is the first case of CVM completely documented and genetically tested in Italy [it

Restenosis after stenting in symptomatic vertebral arterial orifice disease and considerations for better outcome

Science.gov (United States)

Chang, Jun Young; Park, Hyun; Kwon, Oki

2017-01-01

We have performed stenting in 11 patients with symptomatic vertebral arterial orifice stenosis refractory to medical treatment or impairment in anterior circulation. Three of the 11 patients experienced asymptomatic severe in-stent restenosis or occlusion. Bare metal stents were used in those three patients, two of whom received revascularization therapy. Development of sufficient cervical collateral channels reconstituting the distal vertebral artery was the common feature in patients with asymptomatic in-stent restenosis. In selecting appropriate stents, consideration of mechanical strength and drug-eluting properties of a stent according to characteristics of the target vessel is important to reduce the risk of in-stent restenosis. Any decision to perform revascularization should be based on the presence of abundant cervical collaterals as well as clinical symptoms of vertebrobasilar ischemia. PMID:28304206

Cervical myelography with iohexol in horses

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Fialho, S. A.G.; Graca, D. L.; Silva, A.M. da; Pellegrine, L.C. de; Oliveira, L. S.S. de; Lopes, S. T.D.A.

1989-08-15

Five horses, weighing 337 to 400 kg, were used in this research, one of them being used as control. Cervical myelography with iohexol (Omnipaque) was performed on four horses tranquilized with flunitrazepan before induction of anesthesia with sodium thiopental. Anesthesia was maintained with fluothane and oxygen. Cerebrospinal fluid (CSF) was analysed before and after an injection of ioxheol into the subarachnoid space. The animals received 25 to 50 ml of iohexol, after removal of 20 ml cerebrospinal fluid. Radiographies were taken with the horses at lateral recumbency, and the cranial, central and caudal regions of the cervical spine being focalized. No significant changes occurred in the cerebrospinal fluid after injecting the contrast medium. Pathologic changes were not found by gross or microscopic examination of the brain and the cervical spinal cord. Radiographies of good to excellent image quality were obtained. At autopsy, radiographic diagnosis of cervical vertebral instability was confirmed in the animal that had pelvic limb ataxia.

Cervical myelography with iohexol in horses

International Nuclear Information System (INIS)

Fialho, S.A.G.; Graca, D.L.; Silva, A.M. da; Pellegrine, L.C. de; Oliveira, L.S.S. de; Lopes, S.T.D.A.

1989-01-01

Five horses, weighing 337 to 400 kg, were used in this research, one of them being used as control. Cervical myelography with iohexol (Omnipaque) was performed on four horses tranquilized with flunitrazepan before induction of anesthesia with sodium thiopental. Anesthesia was maintained with fluothane and oxygen. Cerebrospinal fluid (CSF) was analysed before and after an injection of ioxheol into the subarachnoid space. The animals received 25 to 50 ml of iohexol, after removal of 20 ml cerebrospinal fluid. Radiographies were taken with the horses at lateral recumbency, and the cranial, central and caudal regions of the cervical spine being focalized. No significant changes occurred in the cerebrospinal fluid after injecting the contrast medium. Pathologic changes were not found by gross or microscopic examination of the brain and the cervical spinal cord. Radiographies of good to excellent image quality were obtained. At autopsy, radiographic diagnosis of cervical vertebral instability was confirmed in the animal that had pelvic limb ataxia

Episodic vertigo resulting from vascular risk factors, cervical spondylosis and head rotation: Two case reports

OpenAIRE

Owolabi, Mayowa O; Ogah, Okechukwu S; Ogunniyi, Adesola

2007-01-01

Background Vascular risk factors predispose to vertebrobasilar ischemia. Cervical osteophytes can impinge on the vertebral artery causing mechanical occlusion during head turning. Presentation with vertigo in such instances is a common finding. Case presentation A patient with obesity, hyperlipidemia, hypertension, cervical spondylosis, and vertigo triggered by head rotation is presented. She responded to antihypertensive and lipid-lowering drugs, vestibular sedative and application of cervic...

Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

Energy Technology Data Exchange (ETDEWEB)

Sommer, A.; Neff, W.; Schwartz, A. [Department of Neurology, Klinikum Mannheim, Medical Faculty, University of Heidelberg, Theodor-Kutzer-Ufer 1, D-68132 Mannheim (Germany)

1998-04-01

We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.) With 4 figs., 8 refs.

Vertebral chondroblastoma

Energy Technology Data Exchange (ETDEWEB)

Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States); Unni, Krishnan K. [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States)

2003-02-01

To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral

The polymethyl methacrylate cervical cage for treatment of cervical disk disease Part III. Biomechanical properties.

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Chen, Jyi-Feng; Lee, Shih-Tseng

2006-10-01

In a previous article, we used the PMMA cervical cage in the treatment of single-level cervical disk disease and the preliminary clinical results were satisfactory. However, the mechanical properties of the PMMA cage were not clear. Therefore, we designed a comparative in vitro biomechanical study to determine the mechanical properties of the PMMA cage. The PMMA cervical cage and the Solis PEEK cervical cage were compressed in a materials testing machine to determine the mechanical properties. The compressive yield strength of the PMMA cage (7030 +/- 637 N) was less than that of the Solis polymer cervical cage (8100 +/- 572 N). The ultimate compressive strength of the PMMA cage (8160 +/- 724 N) was less than that of the Solis cage (9100 +/- 634 N). The stiffness of the PMMA cervical cage (8106 +/- 817 N/mm) was greater than that of the Solis cage (6486 +/- 530 N/mm). The elastic modulus of the PMMA cage (623 +/- 57 MPa) was greater than that of the Solis cage (510 +/- 42 MPa). The elongation of PMMA cage (43.5 +/- 5.7%) was larger than that of the Solis cage (36.1 +/- 4.3%). Although the compressive yield strength and ultimate compressive strength of the PMMA cervical cage were less than those of the Solis polymer cage, the mechanical properties are better than those of the cervical vertebral body. The PMMA cage is strong and safe for use as a spacer for cervical interbody fusion. Compared with other cage materials, the PMMA cage has many advantages and no obvious failings at present. However, the PMMA cervical cage warrants further long-term clinical study.

Pathogenesis of spinal cord involvement induced by lower cervical instability in rheumatoid spondylitis

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Taniguchi, Hironobu; Kuwabara, Shigeru; Fukuda, Kenji; Kuroki, Tatsuji; Tajima, Naoya (Miyazaki Medical Coll., Kiyotake (Japan))

1994-07-01

To examine prognostic factors in rheumatoid arthritis (RA), plain radiography findings and magnetic resonance imaging (MRI) findings were compared with histopathological findings in 129 RA patients who had local or neurologic symptoms due to the cervical spine. All patients underwent plain radiography, and subdislocation more than 2 mm towards the anterior and posterior directions on plain radiographs was defined as instability. In predicting induction of instability of the inferior cervical spine and risk for spinal compression, erosion of the vertebral rim, as seen on plain X-rays, and irregular findings of the end-plate of the vertebral body and Gd-enhanced nodules around the intervertebral disk, as seen on MRI, seemed to be important. (N.K.).

Investigation of vertebral ''end plate sclerosis''

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Lee, S.W. [Dept. of Rehabilitation Sciences, Hong Kong Polytechnic Univ., Hung Hom (Hong Kong); Mathie, A.G.; Jackson, J.E. [Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, London (United Kingdom); Hughes, S.P.F. [Div. of Surgery, Anaesthetics and Intensive Care, London (United Kingdom)

2001-08-01

To evaluate the association between vertebral ''end plate sclerosis'' and neck pain. A retrospective study was carried out of lateral cervical spine radiographs with a Picture Archive and Communication System (PACS). Two hundred patients' files were randomly assessed, comprising four equal groups, A to D. The mean ages of the patients were 62{+-}7.4 years, 61{+-}7.5 years, 40{+-}5.6 years and 23{+-}5.6 years respectively. In group A, all patients had symptoms of neck pain and a radiographic diagnosis of ''end plate sclerosis'' of the cervical spine. In groups B to D, asymptomatic patients were recruited and their age groups were 50-69, 30-49 and 10-29 years respectively. Using the PACS, the radiographic density and the sagittal diameter, thickness and area of the end plates at the C5 level were measured. Results and conclusions: No significant differences were found in the radiographic density of the end plates either between the symptomatic and asymptomatic groups (groups A and B), or between different age groups (groups B, C and D). A significant increase in end plate area and thickness was found, however, in both group B (P<0.005) and group C (P<0.01) in comparison with group D. This indicates that the extent of end plate sclerosis increases with age. Our results suggest that the radiographic density of cervical vertebral end plates correlates neither with neck pain nor with increasing age. The radiological sign of ''end plate sclerosis'' may be over-reported, further limiting its value in the assessment of patients with cervical spondylosis. (orig.)

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine.

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Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

2017-01-01

Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. The individualized 3D printing navigation template for pedicle screw fixation is easy and safe

Cervical vertebral maturation: An objective and transparent code staging system applied to a 6-year longitudinal investigation.

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Perinetti, Giuseppe; Bianchet, Alberto; Franchi, Lorenzo; Contardo, Luca

2017-05-01

To date, little information is available regarding individual cervical vertebral maturation (CVM) morphologic changes. Moreover, contrasting results regarding the repeatability of the CVM method call for the use of objective and transparent reporting procedures. In this study, we used a rigorous morphometric objective CVM code staging system, called the "CVM code" that was applied to a 6-year longitudinal circumpubertal analysis of individual CVM morphologic changes to find cases outside the reported norms and analyze individual maturation processes. From the files of the Oregon Growth Study, 32 subjects (17 boys, 15 girls) with 6 annual lateral cephalograms taken from 10 to 16 years of age were included, for a total of 221 recordings. A customized cephalometric analysis was used, and each recording was converted into a CVM code according to the concavities of cervical vertebrae (C) C2 through C4 and the shapes of C3 and C4. The retrieved CVM codes, either falling within the reported norms (regular cases) or not (exception cases), were also converted into the CVM stages. Overall, 31 exception cases (14%) were seen. with most of them accounting for pubertal CVM stage 4. The overall durations of the CVM stages 2 to 4 were about 1 year, even though only 4 subjects had regular annual durations of CVM stages 2 to 5. Whereas the overall CVM changes are consistent with previous reports, intersubject variability must be considered when dealing with individual treatment timing. Future research on CVM may take advantage of the CVM code system. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Cervical myelopathy from an aspect of a neurological surgeon].

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Koyama, T

1994-12-01

More than 65 per cent of intramedurally tumors and intradural extramedurally tumors were located in cervical region. They enact a cause of cervical myelopathy. A special attention should be paid to solitaly intramedurally vascular malformations, when the patients show an acute progressive myelopathy. In very rare cases of syringomyelia, intramedurally tumors such as hemangioblastoma or ependymoma could be found, so that enhanced MRI or angiography should be done if necessary. In cases of a herniated disc, cervical spondylosis and OPLL, the distance between articulo-pillar line and spinolaminal line must be measured. If the distance of both lines is near or the same, that means narrow cervical canal. In rare cases the form of the vertebral body is round. This is a rare cause of a type of narrow canal.

A Nearly Lethal Screw: An Unusual Cause of Recurrent Bradycardia and Asystole Episodes after Fixation of the Cervical Spine

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Amit Frenkel

2017-01-01

Full Text Available We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR. Initially, these episodes were attributed to the high cervical spine injury, but, later on, CT scan suggested that a fixation screw abutted on the esophagus and activated the vagus nerve by direct pressure. After repositioning of the cervical fixation, the bradycardia and asystole episodes were no longer observed and the patient was released to a rehabilitation ward. This case is presented in order to alert practitioners to the possibility that, after operative fixation of cervical spine injuries, recurrent episodes of bradyarrhythmia can be caused by incorrect placement of the fixation screws and might be confused with the natural history of the high cervical cord injury.

Aberrant right vertebral artery originating from the aortic arch distal to the left subclavian artery: A case report

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Baek, Soo Heui; Baek, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2014-03-15

We present a rare case of an aberrant right vertebral artery originated from the distal aortic arch. This issue has been incidentally detected on a preoperative CT angiography after a stabbing injury of the cervical spinal cord. Normally, the right vertebral artery originates from the right subclavian artery. Therefore, in this case report we will review the incidence and the embryological mechanism of this aberrant course of the right vertebral artery and we will discuss as well the clinical importance of this variation.

Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages.

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Choi, Youn-Kyung; Kim, Jinmi; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Kim, Yong-Il

2016-01-01

This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5-18 years of age). We performed Pearson's correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level.

Cervical vertigo and dizziness after whiplash injury.

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Endo, Kenji; Ichimaru, Katsuji; Komagata, Mashashi; Yamamoto, Kengo

2006-06-01

Whiplash injury is not only limited to neck injury but also brainstem injury that does not involve direct damage to the neck or head. The symptoms of whiplash injury are polymorphous, with the most common complaints being cervical pain, headache and scapulodynia. Vertigo and dizziness are also reported in 25-50% of the cases. In otoneurologic studies, magnetic resonance angiography (MRA) is used for the evaluation of vertebrobasilar hemodynamics in patients who complain of dizziness and vertigo. It is reported that vertebrobasilar artery insufficiency (VBI) leads to brainstem and cerebellar ischemia and infarction following cervical manipulation. Here we examined the correlation between vertigo or dizziness and the right and left side difference in vertebral arteries after whiplash injury using MRA. We studied 20 patients who complained of neck pain with vertigo or dizziness after whiplash injury and 13 healthy volunteers as a control. In the control group, abnormal MRA findings in the vertebral arteries such as occlusion, stenosis or slow blood flow were seen in 77% of the cases. In the patient group, abnormal MRA findings were seen in 60%. The side difference in blood flow was 3.5+/-2.5 cm/s in the control group and 6.1+/-3.0 cm/s in the patient group. Our findings suggest that some subjects with persistent vertigo or dizziness after whiplash injury are more likely to have VBI on MRA. VBI might be an important background factor to evoke cervical vertigo or dizziness after whiplash injury. The side difference between the two vertebral arteries could cause a circulation disorder in the vertebrobasilar system after whiplash injury. However, the VBI on MRA itself was also seen in the control group, and thus it is not clear whether it is due to whiplash injury in the patient group.

The longitudinal sagittal growth changes of maxilla and mandible according to quantitative cervical vertebral maturation.

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Chen, Lili; Lin, Jiuxiang; Xu, Tianmin; Long, Xiaosi

2009-04-01

To investigate the longitudinal sagittal growth changes of maxilla and mandible according to the quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion, mixed longitudinal data were used. The samples included 87 adolescents aged from 8 to 18 y old with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year, lasting for 6 y. The longitudinal sagittal growth changes of maxilla and mandible according to QCVM were measured. There were some significant differences between maxilla and mandible according to QCVM. The sagittal growth change of maxilla showed a trend towards high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. The sagittal growth change of mandible showed a trend towards accelerating velocity-->high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. With sagittal relationship, growth magnitude was almost the same between maxilla and mandible at QCVM stage I. At stage II the growth of mandible exceeded that of maxilla and growth in mandible continued at stages III and IV, while the maxilla ceased to grow. Growth magnitude was greater and the growth duration was longer with male mandible. It is concluded that the longitudinal sagittal growth changes of maxilla and mandible on the basis of QCVM is of value in the orthodontic practice.

Analysis of cervical spine function in healthy persons

International Nuclear Information System (INIS)

Weh, L.; Roettker, H.

1990-01-01

Radiograms were taken of subjects with no symptoms of cervical spine problems; the cervical spine was evaluated in the spontaneous posture and at maximal flexion and extension. The position and movement of the vertebra, intervertebral height and gliding were calculated. The results showed that (1) lordosis in women occurred less pronouncedly than in men, and that there was an increase with age; (2) C 2-3 was the least flexible segment and mobility increased in the caudal direction; mobility decreased with age and the segments of the lower cervical spine with the highest mobility decreased the most; (3) all posterior and ventral intervertebral heights showed a decrease with age at C 5-6 and C 6-7; (4) vertebral gliding decreased with age. (orig.) [de

Evaluation of skeletal maturity in North Indian subjects using an objective method based on cervical vertebral bone age and assessment of its reliability as compared to hand wrist radiographic method

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Sandeep Kumar

2016-01-01

Full Text Available Aim: To evaluate the skeletal maturity objectively and assess the reliability and validity of this method in North Indian subjects. Materials and Methods: Sixty subjects (8-16 years were taken and divided into two groups of 30 males and 30 females. For each subject, cervical vertebral bone age (VA was evaluated by the objective method described by Mito et al., and bone age (BA was estimated by Grave and Brown method of hand wrist radiograph. Correlations and average differences between various ages were determined. An analysis of variance and Tukey′s post-hoc tests were used to compare various ages at 5% significance level. Results: The correlations between cervical VAs and BAs were higher than other ages and also more in females than males. The analysis of female data showed no statistically significant difference (P > 0.05 whereas analysis of male data showed statistically significant difference (P < 0.05 between various ages. Conclusion: The findings of the present study suggest that this method of objectively evaluating skeletal maturation is reliable and can be applied to North Indian females only. The development of a new method to objectively evaluate cervical VA in males is needed.

Diagnostic radiology for functional analysis of the cervical vertebral column. Roentgenfunktionsdiagnostik der Halswirbelsaeule

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Kamieth, H

1986-01-01

The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs..

Pyogenic cervical spondylitis with quadriplegia as a complication of severe burns: Report of a case.

Science.gov (United States)

Asakage, Naoki; Katami, Atsuo; Takekawa, Satoru; Suzuki, Tetsuya; Goto, Michitoshi; Fukai, Ryuta

2006-01-01

We report a case of cervical pyogenic spondylitis complicated by epidural abscess with quadriplegia during treatment of severe burns. The patient was a 49-year-old man with 3rd-degree burns to 20% of his body, involving the lower extremities. We performed escharectomy of the 3rd-degree necrosis on days 7 and 16, followed by the first skin graft on day 23. Pseudomonas aeruginosa was detected in the postoperative graft wound culture. On day 23 after the skin graft, he became febrile and began to experience cervical pain and muscle weakness of the extremities. By day 24, quadriplegia had developed. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylitis with an epidural abscess, which was causing the quadriplegia. We treated the patient by performing curettage of the pyogenic lesion and anterior fixation of the cervical vertebral bodies. The fact that P. aeruginosa was detected in the pyogenic focus culture indicated that burn wound sepsis was responsible for the infection. This case reinforces that acting on a strong suspicion helps to establish a diagnosis and initiate appropriate treatment early.

Spondilitis Tuberkulosa Cervical

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Roni Eka Saputra

2015-05-01

Full Text Available Abstrak Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dariseluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifikhingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempatanggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahudan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menolehkesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan danberkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batukatau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan  pada keempat ekstremitas. Hasil laboratoriumditemukan peningkatan Laju Endap Darah (LED. Rontgen foto toraks dalam batas normal. Roentgen foto cervicalmenunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan padadiscus intervertebrae C5-6 disertai dengan  massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakaltampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitistuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graftdari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBCkaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasidengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasiensudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuktuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2

Application of Piezosurgery in Anterior Cervical Corpectomy and Fusion.

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Pan, Sheng-Fa; Sun, Yu

2016-05-01

Anterior cervical corpectomy and fusion (ACCF) is frequently used to decompress the cervical spine; however, this procedure is risky when dealing with a hard disc or ossification of the posterior longitudinal ligament (OPLL). Piezosurgery offers a useful tool for performing this procedure. In this article, we present a 50 years old man who had cervical spondylotic myelopathy with OPLL at the C 6 level and segmental stenosis of the cervical spinal canal. When removing the posterior wall of his C 6 vertebral body and OPLL, piezosurgery was used to selectively cut hard structures piece by piece without injuring delicate soft tissues like the nerve roots and spinal cord. Because there is no bleeding from the bone surface with piezosurgery, it provides a clean operative field. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Dynamic function MR of the cervical vertebral column

International Nuclear Information System (INIS)

Naegele, M.; Woell, B.; Reiser, M.; Koch, W.; Kaden, B.

1992-01-01

To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T 1 and T 2 * weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations. (orig.) [de

[Spondylarthrosis of the cervical spine. Therapy].

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Radl, R; Leixner, G; Stihsen, C; Windhager, R

2013-09-01

Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied.

Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae?

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Lai, Eddie Hsiang-Hua; Liu, Jen-Pei; Chang, Jenny Zwei-Chieng; Tsai, Shih-Jaw; Yao, Chung-Chen Jane; Chen, Mu-Hsiung; Chen, Yi-Jane; Lin, Chun-Pin

2008-04-01

The skeletal maturation status of a growing patient can influence the selection of orthodontic treatment procedures. Either lateral cephalometric or hand-wrist radiography can be used to assess skeletal development. In this study, we examined the correlation between the maturation stages of cervical vertebrae and hand-wrist bones in Taiwanese individuals. The study group consisted of 330 male and 379 female subjects ranging in age from 8 to 18 years. A total of 709 hand-wrist and 709 lateral cephalometric radiographs were analyzed. Hand-wrist maturation stages were assessed using National Taiwan University Hospital Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages were determined by the latest Cervical Vertebral Maturation Stage (CVMS) Index. Spearman's rank correlation was used to correlate the respective maturation stages assessed from the hand-wrist bones and the cervical vertebrae. The values of Spearman's rank correlation were 0.910 for males and 0.937 for females, respectively. These data confirmed a strong and significant correlation between CVMS and NTUH-SMI systems (p less than 0.001). After comparison of the mean ages of subjects in different stages of CVMS and NTU-SMI systems, we found that CVMS I corresponded to NTUH-SMI stages 1 and 2, CVMS II to NTUH-SMI stage 3, CVMS III to NTUHSMI stage 4, CVMS IV to NTUH-SMI stage 5, CVMS V to NTUH-SMI stages 6, 7 and 8, and CVMS VI to NTUH-SMI stage 9. Our results indicate that cervical vertebral maturation stages can be used to replace hand-wrist bone maturation stages for evaluation of skeletal maturity in Taiwanese individuals.

The value of MR and other methods in evaluation of cervical spondylosis

International Nuclear Information System (INIS)

Konopka, M.; Rejniak, I.; Kluczewska, E.; Baron, J.; Collie, D.

1995-01-01

38 patients with clinical symptoms of myelopathy, radiculopathy and neck pain have undergone X-ray and MR examinations in order to estimate spinal canal and degenerative changes of cervical vertebral column. The correlation between degree of degenerative changes and myelopathy or radiculopathy or neck pain was established on MR. In patients with myelopathy advanced degeneration changes (2. and 3. degree) were observed more often than in radiculopathy and neck pain. Disorders of mobility and cervical spine instability were found in 50%. Focal changes with high signal on T2 images in cervical cord were found in 2 cases. (author)

The Torg-Pavlov ratio for the prediction of acute spinal cord injury after a minor trauma to the cervical spine.

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Aebli, Nikolaus; Wicki, Anina G; Rüegg, Tabea B; Petrou, Nassos; Eisenlohr, Heidrun; Krebs, Jörg

2013-06-01

Acute cervical spinal cord injury (SCI) has been observed in some patients after a minor trauma to the cervical spine. The discrepancy between the severity of the trauma and the clinical symptoms has been attributed to spinal canal stenosis. However, to date, there is no universally established radiological parameter for identifying critical spinal stenosis in these patients. The spinal canal-to-vertebral body ratio (Torg-Pavlov ratio) has been proposed for assessing developmental spinal canal stenosis. The relevance of the Torg-Pavlov ratio for predicting the occurrence and severity of acute cervical SCI after a minor trauma to the cervical spine has not yet been established. To investigate the Torg-Pavlov ratio values of the cervical spine in patients suffering from acute cervical SCI after a minor trauma to the cervical spine and the use of the Torg-Pavlov ratio for identifying patients at risk of cervical SCI and predicting the severity and course of symptoms. Retrospective radiological study of consecutive patients. Forty-five patients suffering from acute cervical SCI and 68 patients showing no neurologic symptoms after a minor trauma to the cervical spine. Midvertebral sagittal cervical spinal canal diameter and the sagittal vertebral body diameter. Calculation of the Torg-Pavlov ratio values. Conventional lateral radiographs of the cervical spine (C3-C7) were analyzed to determine the Torg-Pavlov ratio values. Receiver operating characteristic curves were calculated for evaluating the classification accuracy of the Torg-Pavlov ratio for predicting SCI. The Torg-Pavlov ratio values in the SCI group were significantly (pPavlov ratio cutoff value of 0.7 yielded the greatest positive likelihood ratio for predicting the occurrence of SCI. However, there were no significant differences in the Torg-Pavlov ratio values between the different American Spinal Injury Association Impairment Score groups and between patients with complete, partial, and no recovery of

MRI of acute cervical injury: correlation with neurologic deficit

International Nuclear Information System (INIS)

Hyun, Chang Dong; Kwon, Soon Tae; Lim, Seung Chul; Shin, Myung Jin; Han, Boo Kyung; Kim, Sang Joon; Park, Man Soo; Yoon, Hyun Ki; Suh, Dae Chul

1995-01-01

To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1Wl (TR/TE: 500/20), gradient-echo (TR/TE: 300/14), sagittal T1Wl (TR/TE: 500/20), proton (TR/TE: 2000. 20 msec), T2Wl (TR/TE: 2000/80) were performed. In 11 patients, post-enhancement T1Wl was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. 15 patients had flexion injury, seven had extension injury and three had injury of unknown mechanism. Twelve patients showed iso-signal intensity on T2Wl and high signal intensity on T2Wl. Three patients showed low signal intensity on T1Wl and high signal intensity on T2Wl. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16 (64%), 17 (68%), 15 (60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6 (eight patients) and C5 (five patients). MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent

Correlation between Cervical Vertebral Maturation Stages and Dental Maturation in a Saudi Sample

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Nayef H Felemban

2017-01-01

Full Text Available Background: The aim of the present study was to compare the cervical vertebra maturation stages method and dental maturity using tooth calcification stages. Methods: The current study comprised of 405 subjects selected from orthodontic patients of Saudi origin coming to clinics of the specialized dental centers in western region of Saudi Arabia. Dental age was assessed according to the developmental stages of upper and lower third molars and skeletal maturation according to the cervical vertebrae maturation stage method. Statistical analysis was done using Kruskal-Wallis H, Mann-Whitney U test, Chi-Square test; t-test and Spearman correlation coefficient for inter group comparison. Results: The females were younger than males in all cervical stages. The CS1-CS2 show the period before the peak of growth, during CS3-CS5 it’s the pubertal growth spurt and CS6 is the period after the peak of the growth. The mean age and standard deviation for cervical stages of CS2, CS3 and CS4 were 12.09 ±1.72 years, 13.19 ±1.62 and 14.88 ±1.52 respectively. The Spearman correlation coefficients between cervical vertebrae and dental maturation were between 0.166 and 0.612, 0.243 and 0.832 for both sexes for upper and lower third molars. The significance levels for all coefficients were equal at 0.01 and 0.05. Conclusion: The results of this study showed that the skeletal maturity increased with the increase in dental ages for both genders. An early rate of skeletal maturation stage was observed in females. This study needs further analysis using a larger sample covering the entire dentition.

Direct bolus imaging of cervical blood vessels by means of MRI

International Nuclear Information System (INIS)

Satoh, Toshihiko; Fujioka, Mutsuhisa; Watari, Tsutomu; Nishimura, Gen; Matsumoto, Toshihiko; Washiya, Sumio; Inoue, Kiyoshi; Horita, Masatoshi; Shimizu, Kohji.

1991-01-01

Direct bolus imaging (DBI) is one of the non-invasive method for flow measurements which is based on the bolus tracking technique. DBI permits the direct visualization of flow velocity profiles and vessel band width. We performed screening for cervical vessel disease in patients with vertigo by means of DBI. MR system used here was 0.5 T superconducting imager-SMT-50A (Shimazu Co. Ltd). Pulse sequence parameters were TR= 60 ms, TE= 50 ms, NEX= 1, acquisition matrix; 128 x 256, slice thickness= 5 mm, with cardiac gating. Pulse sequence employed a slice selective RF pulse at the level of C5 vertebral body to tag a disk of fluid perpendicular to the direction of flow, followed by a gradient reforcussed echo. We evaluated each peak high and band width of the common-carotid arteries and the vertebral arteries. Seventy nine of 83 cases had optimal examinations. Abnormal findings of DBI were seen in 15 of 79 cases, (including 2 of subclavian steal syndrome, 1 of carotid obstruction, 5 of vertebral obstruction, 1 of basilar artery obstruction, and 6 of hypoplasia of vertebral artery). The abnormal findings of DBI were well correlated with those of angiographic examinations. We concluded that DBI was suitable to the screening for cervical vessel diseases in patients with vertigo, and should be added to the routine MR studies. (author)

[Effects on cervical spondylosis of vertebral artery type and the concentrations of plasma NPY and UII in the patients treated with the modified acupuncture at unilateral/bilateral Renying (ST 9)].

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Wang, Yanfu; Ma, Chaoyang; Li, Lingxiao; Zhang, Ting; Gui, Xinghua; Chen, Hao

2018-05-12

To observe the differences in the clinical therapeutic effects on cervical spondylosis of vertebral artery type (CSA) between the modified acupuncture and the routine acupuncture at unilateral/bilateral Renying (ST 9) as well as the impacts on the concentrations of plasma neuropeptide Y (NPY) and urotensinⅡ(UⅡ) in the patients. A total of 160 patients were divided into a modified bilateral acupuncture group, a modified unilateral acupuncture group, a routine bilateral acupuncture group and a routine unilateral acupuncture group, 40 cases in each one according to the random number table. In the modified bilateral acupuncture group, the modified acupuncture was applied bilaterally to Renying (ST 9). In the modified unilateral acupuncture group, the modified acupuncture was applied unilaterally to Renying (ST 9). In the routine bilateral acupuncture group, the routine acupuncture was applied bilaterally to Renying (ST 9). In the routine unilateral acupuncture group, the routine acupuncture was applied unilaterally to Renying (ST 9). The treatment was given once every day, continuously for 6 days as one course. Two courses of treatment were required at the interval of 1 day. In each group, before and after treatment, we observed the peak systolic blood flow velocity (Vs) of the vertebral artery (VA) and the basilar artery (BA), cervical vertigo symptoms and functional assessment scales (ESCV) and the concentration of plasma NPY and UⅡ. The clinical therapeutic effects were compared among the groups. After treatment, the clinical therapeutic effect in the modified bilateral acupuncture group was 90.0% (36/40), which was better than 80.0% (32/40) in the modified unilateral acupuncture group, 77.5% (35/40) in the routine bilateral acupuncture group and 65.0% (26/40) in the routine unilateral acupuncture group (all P ST 9) effectively regulates the blood supply of the vertebral basilar artery and improves the cerebral circulation. The effects are superior to those of

A comparative study of bone scintigraphy and NMR for vertebral diseases

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Nakatani, Mariko; Sekiya, Toru; Hata, Yuichi; Mori, Yutaka; Yasuda, Masanobu; Kawakami, Kenji; Tada, Sinpei

1985-01-01

A comparative study of NMR and bone scintigraphy was performed in vertebral disorders, and the significance of both modalities was evaluated. Twelve patients with various vertebral abnormalities including ten cases of vertebral metastases, one case of cervical caries and one case of Granular cell tumor of L3, were examined. In 4 patients, NMR showed abnormalities in the same regions as the bone scintigrams. In another 3 patients. NMR did not show the disorders reported on bone scintigrams. This may be due to the low NMR sensitivity to tiny infiltration of tumor cells in the bone marrow. In 3 out of the remaining 5 patients, NMR demonstrated abnormal findings, whilst the bone scintigrams were normal. Previous bone scintigrams in these patients before treatment had shown abnormal accumulation of activity in the region of abnormal NMR findings. This may be due to the fact that NMR detects the irreversible change of bone marrow, and bone scintigram demonstrates the turn over of bone minerals. This limited experience suggests that both madalities are complementary in the evaluation of vertebral abnormalities. (author)

'Fingerprints' of vertebral trauma - a unifying concept based on mechanisms

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Daffner, R.H.; Deeb, Z.L.; Rothfus, W.E.

1986-01-01

Vertebral fractures, like fractures in the peripheral skeleton, occur in predictable and reproducible patterns that are related to the kind of force applied to the affected bone. The same force applied to the cervical, thoracic, or lumbar column will result in injuries which appear quite similar. A review of 621 injuries to the vertebral column revealed that there are basically four mechanisms of injury: flexion, extension, shearing, and torque (rotation). These injuries may occur by themselves or in combination with one another. The severity and extent of damage produced by any mechanism is dependent upon the incident force, the position of the patient at the time of injury, and the velocity of the patient. Thus, there is a pattern of recognizable signs which span the spectrum from mild soft tissue damage to severe skeletal and ligamentous disruption. These patterns are termed the 'fingerprints' of the injury, and this presentation illustrates the four basic types of vertebral injury producing those 'fingerprints'. (orig.)

Anthropometric assessment of cervical neurovascular structures using CTA to determine zone-specific vulnerability to penetrating fragmentation injuries

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Breeze, J.; West, A.; Clasper, J.

2013-01-01

Aim: To determine military-specific cervical neurovascular and external anthropometric data to scale future numerical injury models of the neck and improve body armour design with a view to prevention or mitigation of combat neck injury. Materials and methods: Contrast-enhanced computed tomography (CT) angiograms of 50 UK servicemen were analysed. Mean diameters and distances from the skin surface were determined for the carotid artery (CA), internal jugular vein (IJV), vertebral artery (VA) and spinal cord (SC) at the three surgical neck zones. Horizontal neck circumference at C6 and three potential vertical cervical anthropometric measurements were analysed to determine which had the least variability between subjects. Results: The diameters of cervical vascular structures are greater and the vessels more superficial as the anatomical plane moves caudally. The SC and VA are better protected than the IJV and CA due to their greater depth and bony coverage, except for the VA in zone 1. Conclusion: Future cervical anthropometric assessments should use the vertical angle of mandible to mid-claviclular distance in combination with the horizontal neck circumference as these demonstrated the least variability. Cervical neurovascular structures are least vulnerable posterosuperiorly and therefore extending the posterior aspect of a ballistic helmet inferiorly or adding a nape protector would appear to be less justified. Cervical vessels are most vulnerable in zone 1 and a circumferential collar of ballistic material at least 75 mm high would cover this area in 95% of this population.

Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

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Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

2009-03-01

Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

Percutaneous vertebroplasty for multiple myeloma of the cervical spine

International Nuclear Information System (INIS)

Mont'Alverne, Francisco; Vallee, Jean-Noel; Guillevin, Remy; Cormier, Evelyne; Jean, Betty; Rose, Michelle; Chiras, Jacques; Caldas, Jose Guilherme

2009-01-01

Spinal involvement is a common presentation of multiple myeloma (MM); however, the cervical spine is the least common site of myelomatous involvement. Few studies evaluate the results of percutaneous vertebroplasty (PV) in the treatment of MM of the spine. The purpose of this series is to report on the use of PV in the treatment of MM of the cervical spine and to review the literature. From January 1994 to October 2007, four patients (three men and one woman; mean age, 45 years) who underwent five PV for painful MM in the cervical spine were retrospectively reviewed. The pain was estimated by the patient on a verbal analogic scale. Clinical follow-up was available for all patients (mean, 27.5 months; range, 1-96 months). The mean volume of cement injected per vertebral body was 2.3 ± 0.8 mL (range, 1.0-4.0 mL) with a mean vertebral filling of 55.0 ± 12.0% (range, 40.0-75.0%). Analgesic efficacy was achieved in all patients. One patient had a spinal instability due to a progression of spinal deformity noted on follow-up radiographs, without clinical symptoms. Cement leakage was detected in three (60%) of the five treated vertebrae. There was no clinical complication. The present series suggests that PV for MM of the cervical spine is safe and effective for pain control; nonetheless, the detrimental impact of the disease on bone quality should prompt close radiological follow-up after PV owing to the risk of spinal instability. (orig.)

Morphometric analysis of diameter and relationship of vertebral artery with respect to transverse foramen in Indian population

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Binit Sureka

2015-01-01

Full Text Available Purpose: To study the location, origin, size and relationship of the vertebral artery and the transverse foramina in the lower cervical spine by computed tomographic angiography (CTA measurements in the Indian population. Materials and Methods: A retrospective review of multi-detector CT (MDCT cerebral angiography scans was done between June 2011 and February 2014. A total of 120 patients were evaluated. The diameter of the vertebral artery (AL and the shortest distance between the vertebral artery and the medial (M, lateral (L, anterior (A, and posterior (P borders of transverse foramen were studied. In addition, the shortest distance between the vertebral artery and pedicle (h was also analyzed. Statistical Analysis: The means and their standard deviations (SD were calculated in both the sexes. The t-tests were performed to look for significant sexual difference. Results: The largest vertebral artery diameter (AL was at level C7 on the right side (3.5 ± 0.8 and at the level of C5 on the left side (3.7 ± 0.4. Statistically significant difference between males and females were seen at levels C4, C5, and C7. The diameter of the vertebral artery was smaller in females than males. The L value was greater than other parameters (M, A, P at the same level in all the measurements. The h value was greatest at C6 level and shortest at C5. Conclusion: CTA is necessary before pedicle screw fixation due to variation in measurements at all levels. The highest potential risk of vertebral artery injury during cervical pedicle screw implantation may be at C5, then at C4, and the safest is at C7.

Cervical Vertebral Body’s Volume as a New Parameter for Predicting the Skeletal Maturation Stages

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Youn-Kyung Choi

2016-01-01

Full Text Available This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5–18 years of age. We performed Pearson’s correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P<0.05. The simple regression model with the greatest R-square indicated the fourth-cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level.

Magnetic resonance angiography of the extracranial carotid and vertebral arteries

International Nuclear Information System (INIS)

Akimura, Tatsuo; Saito, Kenichi; Nakayama, Hisato; Kashiwagi, Shiro; Kato, Shoichi; Ito, Haruhide.

1994-01-01

To evaluate the contribution of magnetic resonance angiography (MRA) in the screening study of the extracranial carotid and vertebral arteries using the conventional head and neck coils, 500 consecutive MRAs of the cervical vessels were performed using 1.5 tesla magnetic resonance unit with circularly polarized head coil. The 5 cm-thick imaging plane was placed in coronal fashion including both carotid and vertebral arteries. The imaging sequence was three-dimensional (3D) fast imaging with steady precession (FISP). In 10 patients with failed head coil examination, 10 patients with possible carotid and vertebral diseases and 10 volunteers, the extracranial carotid and vertebral arteries were examined with the Helmholtz neck coil. Both 3D- and 2D-FISP were performed in each case. The imaging plane was placed in oblique sagittal fashion. In 458 out of 500 cases (91.6%), the extracranial carotid and vertebral arteries were successfully depicted using head coil. In 20 patients with high shoulders, the carotid bifurcations were out of range of the head coil. In these cases, carotid bifurcations and the origins of the carotid and vertebral arteries were successfully revealed using a neck coil. To evaluate the stenotic lesions and tortuous vessels, 2D-FISP sequence seemed to be more suitable than 3D-FISP. Compared with conventional angiography, MRA caused overestimation of the degree of stenotic lesions. For screening examination of the extracranial carotid and vertebral arteries, most cases can be evaluated only with the conventional head coil. If depiction of the carotid bifurcation fails and the examination of carotids or vertebrals down to the aortic arch is needed, neck coil examination is required. (author)

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

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Huang, Dong-Ning; Yu, Miao; Xu, Nan-Fang; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Liu, Zhong-Jun

2017-02-20

Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study

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Dong-Ning Huang

2017-02-01

Full Text Available Abstract Background Anterior cervical discectomy and fusion (ACDF is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. Methods A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2–C7 angles (C2–C7, C0–C7 angles (C0–C7, external auditory meatus (EAM tilt, sacral slope (SS, thoracic kyphosis (TK, lumbar lordosis (LL, spinal sacral angles (SSA, Superior adjacent inter-vertebral angle (SAIV, inferior adjacent inter-vertebral angle (IAIV and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Results Among the parameters, C2–C7 and C0–C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0–C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2–C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. Conclusion The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment

Relationship between vertebral artery blood flow in different head positions and vertigo.

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Araz Server, Ela; Edizer, Deniz Tuna; Yiğit, Özgür; Yasak, Ahmet Görkem; Erdim, Çağrı

2018-01-01

To identify the vertebral artery blood flow in different head positions in patients with positional vertigo with no specific diagnosis. Patients with history of vestibular symptoms associated with changes in head position were enrolled into the study. Healthy volunteers were evaluated as control group. Doppler ultrasonography examination of the cervical segment of the vertebral arteries was performed under three different head positions: (i) supine position, (ii) head hyperextended and rotated to the right side and (iii) head hyperextended and rotated to the left side. In the study group, right and left vertebral artery blood flow was significantly lower in the ipsilateral hyperextended position compared to standard supine position (respectively p = .014; p = .001), but did not differ significantly when compared between the standard supine and contralateral hyperextended positions (respectively = .959; p = .669). In the control group, left and right vertebral artery blood flow did not differ significantly when the head was hyperextended to the right or left sides compared to standard supine position (p > .05). Our data demonstrated that the etiology of vestibular complaints in patients with undiagnosed positional vertigo might be related to impairment in vertebral artery blood flow according to head positions.

The Effect of Technological Devices on Cervical Lordosis

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Öğrenci, Ahmet; Koban, Orkun; Yaman, Onur; Dalbayrak, Sedat; Yılmaz, Mesut

2018-01-01

PURPOSE: There is a need for cervical flexion and even cervical hyperflexion for the use of technological devices, especially mobile phones. We investigated the effect of this use on the cervical lordosis angle. MATERIAL AND METHODS: A group of 156 patients who applied with only neck pain between 2013–2016 and had no additional problems were included. Patients are specifically questioned about mobile phone, tablet, and other devices usage. The value obtained by multiplying the year of usage and the average usage (hour) in daily life was determined as the total usage value (an average hour per day x year: hy). Cervical lordosis angles were statistically compared with the total time of use. RESULTS: In the general ROC analysis, the cut-off value was found to be 20.5 hy. When the cut-off value is tested, the overall accuracy is very good with 72.4%. The true estimate of true risk and non-risk is quite high. The ROC analysis is statistically significant. CONCLUSION: The use of computing devices, especially mobile telephones, and the increase in the flexion of the cervical spine indicate that cervical vertebral problems will increase even in younger people in future. Also, to using with attention at this point, ergonomic devices must also be developed. PMID:29610602

The Effect of Technological Devices on Cervical Lordosis.

Science.gov (United States)

Öğrenci, Ahmet; Koban, Orkun; Yaman, Onur; Dalbayrak, Sedat; Yılmaz, Mesut

2018-03-15

There is a need for cervical flexion and even cervical hyperflexion for the use of technological devices, especially mobile phones. We investigated the effect of this use on the cervical lordosis angle. A group of 156 patients who applied with only neck pain between 2013-2016 and had no additional problems were included. Patients are specifically questioned about mobile phone, tablet, and other devices usage. The value obtained by multiplying the year of usage and the average usage (hour) in daily life was determined as the total usage value (an average hour per day x year: hy). Cervical lordosis angles were statistically compared with the total time of use. In the general ROC analysis, the cut-off value was found to be 20.5 hy. When the cut-off value is tested, the overall accuracy is very good with 72.4%. The true estimate of true risk and non-risk is quite high. The ROC analysis is statistically significant. The use of computing devices, especially mobile telephones, and the increase in the flexion of the cervical spine indicate that cervical vertebral problems will increase even in younger people in future. Also, to using with attention at this point, ergonomic devices must also be developed.

Cervical artery dissection: early recognition and stroke prevention [digest].

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Cadena, Rhonda; Kim, Jeremy

2016-07-22

Cervical artery dissections involve the carotid or vertebral arteries. Although the overall incidence is low, they remain a common cause of stroke in children, young adults, and trauma patients. Symptoms such as headache, neck pain, and dizziness are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient. A missed diagnosis of cervical artery dissection can result in devastating neurological sequelae, so emergency clinicians must act quickly to recognize this event and begin treatment as soon as possible while neurological consultation is obtained. This issue reviews the evidence in applying advanced screening criteria and choosing imaging and antithrombotic treatment strategies for patients with cervical artery dissections to reduce the occurrence of ischemic stroke. [Points & Pearls is a digest of Emergency Medicine Practice].

Impact of Cervical Spine Deformity on Preoperative Disease Severity and Postoperative Outcomes Following Fusion Surgery for Degenerative Cervical Myelopathy: Sub-analysis of AOSpine North America and International Studies.

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Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

2018-02-15

Sub-analysis of the prospective AOSpine CSM North America and International studies. The aim of this study was to investigate the impact of cervical spine deformity on pre- and postoperative outcomes in fusion surgeries for degenerative cervical myelopathy. The associations between cervical alignment and patient outcomes have been reported but are not well established in a myelopathy cohort. The impact of deformity correction in this population also needs to be elucidated. A total of 757 patients were enrolled in two prospective international multicenter AOSpine studies. Among those who underwent anterior or posterior fusion surgeries, pre- and 1-year postoperative upright neutral lateral radiographs of cervical spine were investigated to measure C2-7 Cobb angle and C2-7 sagittal vertical axis (SVA). Patient outcome measures included the modified Japanese Orthopedic Association score for myelopathy severity, Neck Disability Index (NDI), and Short-form 36 (SF-36). These scores were compared between patients with and without cervical deformity, which was defined as C2-7 Cobb >10° kyphosis and/or SVA >40 mm. A total of 178 patients were included with complete pre- and postoperative radiographs. SVA significantly increased postoperatively (27.4 vs. 30.7 mm, P = 0.004). All outcome measurement showed significant improvements above minimal clinically important differences. 23.6% of the patients had cervical deformity preoperatively; preoperative deformity was associated with worse preoperative NDI scores (45.7 vs. 38.9, P = 0.04). Postoperatively, those with deformity exhibited significantly lower SF-36 physical component scores (37.2 vs. 41.4, P = 0.048). However, when focusing on the preoperatively deformed cohort, we did not find any significant differences in the postoperative outcome scores between those with and without residual deformity. There was a significant association between cervical deformity and both preoperative disease severity and

[Three-dimensional finite element modeling and biomechanical simulation for evaluating and improving postoperative internal instrumentation of neck-thoracic vertebral tumor en bloc resection].

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Qinghua, Zhao; Jipeng, Li; Yongxing, Zhang; He, Liang; Xuepeng, Wang; Peng, Yan; Xiaofeng, Wu

2015-04-07

To employ three-dimensional finite element modeling and biomechanical simulation for evaluating the stability and stress conduction of two postoperative internal fixed modeling-multilevel posterior instrumentation ( MPI) and MPI with anterior instrumentation (MPAI) with neck-thoracic vertebral tumor en bloc resection. Mimics software and computed tomography (CT) images were used to establish the three-dimensional (3D) model of vertebrae C5-T2 and simulated the C7 en bloc vertebral resection for MPI and MPAI modeling. Then the statistics and images were transmitted into the ANSYS finite element system and 20N distribution load (simulating body weight) and applied 1 N · m torque on neutral point for simulating vertebral displacement and stress conduction and distribution of motion mode, i. e. flexion, extension, bending and rotating. With a better stability, the displacement of two adjacent vertebral bodies of MPI and MPAI modeling was less than that of complete vertebral modeling. No significant differences existed between each other. But as for stress shielding effect reduction, MPI was slightly better than MPAI. From biomechanical point of view, two internal instrumentations with neck-thoracic tumor en bloc resection may achieve an excellent stability with no significant differences. But with better stress conduction, MPI is more advantageous in postoperative reconstruction.

Anterior cervical fusion: the role of anterior plating.

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Daffner, Scott D; Wang, Jeffrey C

2009-01-01

Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

Development of the Synarcual in the Elephant Sharks (Holocephali; Chondrichthyes: Implications for Vertebral Formation and Fusion.

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Zerina Johanson

Full Text Available The synarcual is a structure incorporating multiple elements of two or more anterior vertebrae of the axial skeleton, forming immediately posterior to the cranium. It has been convergently acquired in the fossil group 'Placodermi', in Chondrichthyes (Holocephali, Batoidea, within the teleost group Syngnathiformes, and to varying degrees in a range of mammalian taxa. In addition, cervical vertebral fusion presents as an abnormal pathology in a variety of human disorders. Vertebrae develop from axially arranged somites, so that fusion could result from a failure of somite segmentation early in development, or from later heterotopic development of intervertebral bone or cartilage. Examination of early developmental stages indicates that in the Batoidea and the 'Placodermi', individual vertebrae developed normally and only later become incorporated into the synarcual, implying regular somite segmentation and vertebral development. Here we show that in the holocephalan Callorhinchus milii, uniform and regular vertebral segmentation also occurs, with anterior individual vertebra developing separately with subsequent fusion into a synarcual. Vertebral elements forming directly behind the synarcual continue to be incorporated into the synarcual through growth. This appears to be a common pattern through the Vertebrata. Research into human disorders, presenting as cervical fusion at birth, focuses on gene misexpression studies in humans and other mammals such as the mouse. However, in chondrichthyans, vertebral fusion represents the normal morphology, moreover, taxa such Leucoraja (Batoidea and Callorhinchus (Holocephali are increasingly used as laboratory animals, and the Callorhinchus genome has been sequenced and is available for study. Our observations on synarcual development in three major groups of early jawed vertebrates indicate that fusion involves heterotopic cartilage and perichondral bone/mineralised cartilage developing outside the regular

MR imaging of acute cervical spine injuries

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Kim, Kyu Hwa; Lee, Jung Hyung; Joo, Yang Goo [School of Medicine, Keimyung University, Daegu (Korea, Republic of)

1995-01-15

To describe magnetic resonance (MR) findings of the patients with acute cervical spinal injury and to assess the usefulness of the MR imagings. We retrospectively reviewed the MR images of 32 patients with acute cervical spinal injury. MR images were obtained with a 2.0 T superconductive MR imaging units (Spectro-20000, Gold-Star, Seoul), using spin-echo and gradient-echo technique. Most of patients were in their 3rd-4th decades and motor vehicle accident was the most frequent cause of acute cervical trauma. We assessed the MR findings with respect to the spinal cord, ligaments, paravertebral soft tissues, intervertebral disk, and bony spine. Spinal cord injury was the most common (65%), where cord swelling, edema, and/or hematoma were demonstrated most frequently at C5-6 level. Traumatic intervertebral disk herniations were the second most common (62.5%) and frequently occurred at the lower cervical levels, mostly at C5-6. Paravertebral soft tissue injury, vertebral body fracture, bone marrow edema and displacement were also well shown on MR images. MR imaging appears to be essential for the evaluation of traumatic disk herniations, spinal cord abnormalities, and injury of paravertebral soft tissue in the acute injury of the cervical spine.

MR imaging of acute cervical spine injuries

International Nuclear Information System (INIS)

Kim, Kyu Hwa; Lee, Jung Hyung; Joo, Yang Goo

1995-01-01

To describe magnetic resonance (MR) findings of the patients with acute cervical spinal injury and to assess the usefulness of the MR imagings. We retrospectively reviewed the MR images of 32 patients with acute cervical spinal injury. MR images were obtained with a 2.0 T superconductive MR imaging units (Spectro-20000, Gold-Star, Seoul), using spin-echo and gradient-echo technique. Most of patients were in their 3rd-4th decades and motor vehicle accident was the most frequent cause of acute cervical trauma. We assessed the MR findings with respect to the spinal cord, ligaments, paravertebral soft tissues, intervertebral disk, and bony spine. Spinal cord injury was the most common (65%), where cord swelling, edema, and/or hematoma were demonstrated most frequently at C5-6 level. Traumatic intervertebral disk herniations were the second most common (62.5%) and frequently occurred at the lower cervical levels, mostly at C5-6. Paravertebral soft tissue injury, vertebral body fracture, bone marrow edema and displacement were also well shown on MR images. MR imaging appears to be essential for the evaluation of traumatic disk herniations, spinal cord abnormalities, and injury of paravertebral soft tissue in the acute injury of the cervical spine

Vertebral artery dissection in weightlifter with performance enhancing drug use

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Low, Andrew; Dovey, Julie; Ash-Miles, Janice

2011-01-01

This case report describes a transient ischaemic attack secondary to vertebral artery dissection (VAD) in a young male body builder. This occurred following weight training with weights across the back and shoulders. The patient was also known to take multiple performance enhancing agents including anabolic steroids, slimming agents, stimulants and human growth hormone. Cases of VAD have been described with cervical manipulation in the past and an association between the use of anabolic stero...

[The preliminary study of the efficiency of using cervical vertebral maturation of growth level of female adolescent idiopathic scoliosis].

Science.gov (United States)

Zhang, Di-qing; Chen, Zi-qiang; Li, Ming

2011-03-01

To investigate the reliability of cervical vertebral maturation (CVM) and to verify the possibility in the growth evaluation of female adolescent idiopathic scoliosis patients as a helpful supplementary to the Risser sign. Coronal and lateral full-length spine X-ray film and left hand-wrist radiographs of 77 female adolescent patients with idiopathic scoliosis were selected from January 2010 to October 2010. The interval period between lateral length of the spine and left hand-wrist radiographs did not exceed 3 months. The CVM was assessed by a method developed by Baccetti and co-workers, whereas hand-wrist maturation was assessed by Fishman's method. The results were analyzed by Spearman correlation with patients Risser sign, chronological age, and menarche period. There were strong correlations between CVM and SMI or Risser sign (r = 0.862 and 0.762, P < 0.01). While in 26 patients whose Risser sign were 0-I, the correlation between CVM and SMI was more pronounced (r = 0.761, P < 0.01), compared with the correlation between Risser sign and SMI (r = 0.641, P < 0.01). CVM is a valid indicator of skeletal growth evaluation and can be used as a helpful supplementary to Risser sign.

Analysis of progression of cervical OPLL using computerized tomography: typical sign of maturation of OPLL mass.

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Choi, Byung-Wan; Baek, Dong-Hoon; Sheffler, Lindsey C; Chang, Han

2015-07-17

OBJECT The progression of cervical ossification of the posterior longitudinal ligament (OPLL) can lead to increase in the size of the OPLL mass and aggravation of neurological symptoms. In the present study, the authors aimed to analyze the progression of cervical OPLL by using CT imaging, elucidate the morphology of OPLL masses, and evaluate the factors associated with the progression of cervical OPLL. METHODS Sixty patients with cervical OPLL were included. All underwent an initial CT examination and had at least 24 months' follow-up with CT. The mean duration of follow-up was 29.6 months. Fourteen patients (Group A) had CT evidence of OPLL progression, and 46 (Group B) did not show evidence of progression on CT. The 2 groups were compared with respect to the following variables: sex, age, number of involved segments, type of OPLL, and treatment methods. The CT findings, such as the connection of an OPLL mass with the vertebral body and formation of trabeculation in the mass, were evaluated. RESULTS Sex and treatment modality were not associated with OPLL progression. The mean age of the patients in Group A was significantly lower than that in Group B (p = 0.03). The mean number of involved segments was 5.3 in Group A and 3.6 in Group B (p = 0.002). Group A had a higher proportion of cases with the mixed type of OPLL, whereas Group B had a higher proportion of cases with the segmental type (p = 0.02). A connection between the vertebral body and OPLL mass and trabeculation formation were more common in Group B (p cervical OPLL is associated with younger age, involvement of multiple levels, and mixed-type morphology. OPLL masses that are contiguous with the vertebral body and have trabecular formation are useful findings for identifying masses that are less likely to progress.

Complications of the lateral C1-C2 puncture myelography for cervical spinal canal

International Nuclear Information System (INIS)

Mihale, J.; Traubner, P.

1998-01-01

This reviewed the complications of 106 patients of the lateral C1-C2 puncture myelography for cervical spinal canal and cervical spinal cord disorders. Spinal cord puncture and contrast injection, puncture between the occiput and C1, and blood vessel puncture were the main complications. These principally depended on the misdirection of the X ray beam. For preventing major arterial puncture determined the pathway of the vertebral arteries and incidence of anomaly. (authors)

Radiological evaluation of the cranio vertebral junction; Avaliacao radiologica da transicao cranio-vertebral

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Mello, Silvia Marcal Benicio de; Haetinger, Rainer Guilherme [Med Imagem - Beneficiencia Portuguesa de Sao Paulo, SP (Brazil). Setor de Cabeca e Pescoco]. E-mail: sbm@uol.com.br; Schettini, Marianna Cunha; Lima, Sergio Santos [Med Imagem - Beneficiencia Portuguesa de Sao Paulo, SP (Brazil); Mourao, Maria Lucia; Mendonca, Renato Adam [Med Imagem - Beneficiencia Portuguesa de Sao Paulo, SP (Brazil). Setor de Neuroradiologia

2005-04-15

The cranio vertebral junction (CVJ) comprises the occiput, atlas, their joints and ligaments. Besides conventional x-rays other imaging methods are need for the assessment of CVJ including high resolution computerized tomography (CT) and magnetic resonance imaging (MRI) which provide specific parameters such as field of view, slice thickness and incremental movement of the patient. A dynamic study is also important to assess the stability of the cranio vertebral junction and the effect upon the bulbomedullary junction. The aim of this study is to review the techniques used in the evaluation of the CVJ, the semiological parameters, and the most frequent disorders affecting this region. We review the literature and present conventional x-ray, CT and MRI images from the didactic file of the Radiology service 'Med Imagem - Beneficiencia Portuguesa de Sao Paulo, SP, Brazil, of cases with normal anatomy and the main congenital and acquired disorders of the CVJ. In daily practice, CVJ disorders are diagnoses using CT and MRI scans of the head and cervical spine. It is essential to be familiar with these conditions in order to preform specific tests which will allow a detailed study of the CVJ, thus providing the basis for the treatment, whenever indicated. (author)

Vertebral artery injury in patients with isolated transverse process fractures.

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Bonney, Phillip A; Burks, Joshua D; Conner, Andrew K; Glenn, Chad A; Baker, Cordell M; Cheema, Ahmed A; Archer, Jacob B; Buster, Bryan E; Albrecht, Roxie M; Bohnstedt, Bradley N

2017-07-01

We sought to assess the rate of CTA-diagnosed vertebral artery injury in patients with isolated transverse process fractures, with and without extension into the transverse foramen, in the blunt-trauma population served by our hospital. We queried our universities trauma registry between January 2009 and July 2014 for ICD-9 codes pertaining to cervical spine fractures. Of 330 patients identified, 45 patients had fractures limited to the transverse process and were selected for the study population. For each patient identified, demographics, injury mechanism, imaging reports, angiography findings, and treatments were recorded. In total, 69 fractures were identified in 45 patients. Of the 45 patients, 15 (33%) had transverse process fractures at multiple cervical levels. 23/45 (51%) patients had at least one fracture extending into TF. Four patients with transverse process fractures and one patient without transverse process fractures were diagnosed with vertebral artery injury by CT angiogram (17.4% vs. 4.5%, p=0.35). The number of transverse process fractures in patients with VAI was greater than those without VAI (3.0 vs. 1.4, p<0.001). None of the 30 patients with any one-level TPF (with or without extension into TF) was diagnosed with VAI (p=0.003). None of 17 patients with isolated C7-level TPFs were diagnosed with VAI (p=0.15). The incidence of cervical VAI was greater in patients with multiple-level TPFs than in patients with single-level TPFs. While patients with a single, isolated TPF have a low probability of VAI, patients with numerous TPF fractures may benefit from CTA. Copyright © 2017 Elsevier Ltd. All rights reserved.

Analysis of the vertebral venous system in relation to cerebral venous drainage on MR angiography

International Nuclear Information System (INIS)

Baik, Seung Kug; Sohn, Chul Ho; Kim, Gab Chul; Kim, Yong Sun

2004-01-01

In the supine position, cerebral venous drainage occurs primarily through the internal jugular veins, as seen on venous phase cerebral angiography. However, in the erect position, the vertebral venous system represents the major alternative pathway of cerebral venous drainage, while outflow through the internal jugular veins is absent or negligible. The purpose of this study is to evaluate the vertebral venous system and its relationship between the surrounding venous structures using magnetic resonance angiography (MRA) in the case of subjects in the supine position. We retrospectively reviewed the results of 65 patients (M:F = 31: 34, mean age 61.6 years) who underwent multi-phase contrast-enhanced carotid MRA. The imaging studies were performed using a 3.0 T MR unit (TR: 5.2, TE: 1.1, FA: 20, 3.8 thickness, EC: 1). We analyzed the appearance and extent of the vertebral venous system (vertebral venous plexus and vertebral artery venous plexus) and the internal jugular vein on the venous phase images. We also evaluated the main drainage pattern of the cerebral venous drainage and the drainage pattern of the vertebral venous system. The visualized vertebral venous system was defined as either poor, vertebral venous plexus dominant, vertebral artery venous plexus dominant or mixed. In the vertebral venous system, the vertebral artery venous plexus was visualized in 54 cases (83%). The appearance of the visualized vertebral artery venous plexus was symmetrical in 39 cases (72%) and asymmetrical in 15 cases (28%). The extent of the visualized vertebral artery venous plexus was partial in 26 cases (48%) and complete in 28 cases (52%). The vertebral venous plexus was visualized in 62 cases (95%). The appearance of the visualized vertebral artery venous plexus was symmetrical in 43 cases (69%) and asymmetrical in 19 cases (31%). The extent of the visualized vertebral artery venous plexus was partial in 35 cases (56%) and complete in 27 cases (44%). The appearance of the

Vertebral osteoradionecrosis. Report of a new case with a review of the literature

International Nuclear Information System (INIS)

Deshayes, P.; Laplagne, A.; Le Loet, X.; Daragon, A.

1987-01-01

With reference to the eighth case of vertebral radionecrosis reported in the literature, developed three years after radiotherapy for cervical cancer, the authors recall that diagnosis rests on a set of clinical evidence: development of one or several compression fractures within the irradiated area and following exposure to more than 30 grays; roentgenologic evidence consisting in integrity of the neural arch and stability of roentgenologic evidence findings over time; lastly, pathologic evidence, especially the absence of metastatic cells in biopsy specimens from the vertebral body. Supportive management usually allows to wait out the period of pain resulting from collapse of the gangrenous areas [fr

Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages

OpenAIRE

Choi, Youn-Kyung; Kim, Jinmi; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Kim, Yong-Il

2016-01-01

This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies ...

Predictors of cervical lordosis loss after laminoplasty in patients with cervical spondylotic myelopathy.

Science.gov (United States)

Zhang, Jing Tao; Li, Jia Qi; Niu, Rui Jie; Liu, Zhao; Tong, Tong; Shen, Yong

2017-04-01

To determine whether radiological, clinical, and demographic findings in patients with cervical spondylotic myelopathy (CSM) were independently associated with loss of cervical lordosis (LCL) after laminoplasty. The prospective study included 41 consecutive patients who underwent laminoplasty for CSM. The difference in C2-7 Cobb angle between the postoperative and preoperative films was used to evaluate change in cervical alignment. Age, sex, body mass index (BMI), smoking history, preoperative C2-7 Cobb angle, T1 slope, C2-7 range of motion (C2-7 ROM), C2-7 sagittal vertical axis (C2-7 SVA), and cephalad vertebral level undergoing laminoplasty (CVLL) were assessed. Data were analyzed using Pearson and Spearman correlation test, and univariate and stepwise multivariate linear regression. T1 slope, C2-7 SVA, and CVLL significantly correlated with LCL (P < 0.001), whereas age, BMI, and preoperative C2-7 Cobb angle did not. In multiple linear regression analysis, higher T1 slope (B = 0.351, P = 0.037), greater C2-7 SVA (B = 0.393, P < 0.001), and starting laminoplasty at C4 level (B = - 7.038, P < 0.001) were significantly associated with higher postoperative LCL. Cervical alignment was compromised after laminoplasty in patients with CSM, and the degree of LCL was associated with preoperative T1 slope, C2-7 SVA, and CVLL.

[Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy for treating spastic cerebral paralysis of the upper limbs caused by cerebral palsy].

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Zhang, Peng; Hu, Wei; Cao, Xu; Xu, Shi-gang; Li, De-kui; Xu, Lin

2009-10-01

To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy. From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment. All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

Traumatic Migration of the Bryan Cervical Disc Arthroplasty.

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Wagner, Scott C; Kang, Daniel G; Helgeson, Melvin D

2016-02-01

Study Design Case study. Objective To describe a case of dislodgment and migration of the Bryan Cervical Disc (Medtronic Sofamor Danek, Memphis, Tennessee, United States) arthroplasty more than 6 months after implantation secondary to low-energy trauma. Methods The inpatient, outpatient, and radiographic medical records of a patient with traumatic migration of the Bryan Cervical Disc arthroplasty were reviewed. The authors have no relevant disclosures to report. Results A 36-year-old man with chronic left upper extremity radiculopathy underwent uncomplicated Bryan Cervical Disc arthroplasty at C5-C6, with complete resolution of his symptoms. Approximately 6 months after his index procedure, he sustained low-energy trauma to the posterior cervical spine, after being struck by a book falling from a shelf. The injury forced his neck into flexion, and though he did not have recurrence of his radiculopathy symptoms, radiographs demonstrated anterior migration of the arthroplasty device. He underwent revision to anterior cervical diskectomy and fusion. Conclusions Although extremely rare, it is imperative that surgeons consider the potential for failure of osseous integration in patients undergoing cervical disk arthroplasty, even beyond 3 to 6 months postoperatively. This concern is especially relevant to press-fit or milled devices like the Bryan Cervical Disc arthroplasty, which lack direct fixation into adjacent vertebral bodies. We are considering modification of our postoperative protocol to improve protection of the device after implantation, even beyond 3 months postoperatively.

The lamprey: a jawless vertebrate model system for examining origin of the neural crest and other vertebrate traits.

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Green, Stephen A; Bronner, Marianne E

2014-01-01

Lampreys are a group of jawless fishes that serve as an important point of comparison for studies of vertebrate evolution. Lampreys and hagfishes are agnathan fishes, the cyclostomes, which sit at a crucial phylogenetic position as the only living sister group of the jawed vertebrates. Comparisons between cyclostomes and jawed vertebrates can help identify shared derived (i.e. synapomorphic) traits that might have been inherited from ancestral early vertebrates, if unlikely to have arisen convergently by chance. One example of a uniquely vertebrate trait is the neural crest, an embryonic tissue that produces many cell types crucial to vertebrate features, such as the craniofacial skeleton, pigmentation of the skin, and much of the peripheral nervous system (Gans and Northcutt, 1983). Invertebrate chordates arguably lack unambiguous neural crest homologs, yet have cells with some similarities, making comparisons with lampreys and jawed vertebrates essential for inferring characteristics of development in early vertebrates, and how they may have evolved from nonvertebrate chordates. Here we review recent research on cyclostome neural crest development, including research on lamprey gene regulatory networks and differentiated neural crest fates. Copyright © 2014 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

Asymptomatic grotesque deformities of the cervical spine. An occupational hazard in railway porters.

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Kelkar, P; O'Callaghan, B; Lovblad, K O

1998-03-15

A case report. To illustrate an extremely rare occurrence of chronic, occupational, low-grade trauma leading to asymptomatic grotesque cervical spine deformities in railroad station porters. Occupational trauma causing spinal deformities has been described in relation to thoracic and lumbar spines in miners. To the authors' knowledge, this is the first reported case of asymptomatic cervical spinal deformity in railway porters as a result of chronic occupational trauma. A magnetic resonance imaging study was performed on both patients. The magnetic resonance images showed advanced degenerative changes in the cervical spine causing obvious deformities, along with apparently normal cord signal intensity. Chronic, occupational, low-grade trauma of the cervical vertebral region is extremely unusual in industrialized countries. Nevertheless, in view of the increasing mobility of people in general and of the labor force in particular, this complication of an occupational exposure deserves attention as an unusual cause of cervical spinal deformity.

Assessment of the cervical spine denticulate ligament using MRI volumetric sequence: Comparison between 1.5 Tesla and 3.0 Tesla.

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Seragioli, Rafael; Simao, Marcelo Novelino; Simao, Gustavo Novelino; Herrero, Carlos Fernando P S; Nogueira-Barbosa, Marcello H

2018-03-01

Denticulate ligaments (DLs) are pial extensions on each side of the spinal cord, comprising about 20 to 21 pairs of fibrous structures connecting the dura mater to the spinal cord. These ligaments are significant anatomical landmarks in the surgical approach to intradural structures. To our knowledge, there is no previous study on the detection of DLs using MRI. After IRB approval, we retrospectively evaluated 116 consecutive MRI scans of the cervical spine, using the volumetric sequence 3D COSMIC, 65 and 51 studies with 1.5T and 3.0T respectively. We did not include trauma and tumor cases. Two independent radiologists assessed the detection of cervical spine DLs independently and blinded for each cervical vertebral level. We compared the frequency of detection of these ligaments in 1.5 Tesla and 3.0 Tesla MRI using Fisher exact test considering P<0.05 as significant. We evaluated interobserver agreement with Kappa coefficient. We observed high detection frequency of the cervical spine DLs using both 1.5T (70 to 91%) and 3.0T (68 to 98%). We found no statistically significant difference in the detection frequency of ligaments between the 1.5T and 3.0T MRI in all vertebral levels. Using 3.0T, radiologists identified ligaments better in higher vertebral levels than for lower cervical levels (P=0.0003). Interobserver agreement on the identification of DL was poor both for 1.5T (k=0.3744; CI 95% 0.28-0.46) and 3.0T (k=0.3044; CI 95% 0.18-0.42) MRI. Radiologists identified most of the cervical DLs using volumetric MRI acquisition. Our results suggest 1.5T and 3.0T MRI performed similarly in the detection of DLs. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Vertebral Pneumaticity in the Ornithomimosaur Archaeornithomimus (Dinosauria: Theropoda Revealed by Computed Tomography Imaging and Reappraisal of Axial Pneumaticity in Ornithomimosauria.

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Akinobu Watanabe

Full Text Available Among extant vertebrates, pneumatization of postcranial bones is unique to birds, with few known exceptions in other groups. Through reduction in bone mass, this feature is thought to benefit flight capacity in modern birds, but its prevalence in non-avian dinosaurs of variable sizes has generated competing hypotheses on the initial adaptive significance of postcranial pneumaticity. To better understand the evolutionary history of postcranial pneumaticity, studies have surveyed its distribution among non-avian dinosaurs. Nevertheless, the degree of pneumaticity in the basal coelurosaurian group Ornithomimosauria remains poorly known, despite their potential to greatly enhance our understanding of the early evolution of pneumatic bones along the lineage leading to birds. Historically, the identification of postcranial pneumaticity in non-avian dinosaurs has been based on examination of external morphology, and few studies thus far have focused on the internal architecture of pneumatic structures inside the bones. Here, we describe the vertebral pneumaticity of the ornithomimosaur Archaeornithomimus with the aid of X-ray computed tomography (CT imaging. Complementary examination of external and internal osteology reveals (1 highly pneumatized cervical vertebrae with an elaborate configuration of interconnected chambers within the neural arch and the centrum; (2 anterior dorsal vertebrae with pneumatic chambers inside the neural arch; (3 apneumatic sacral vertebrae; and (4 a subset of proximal caudal vertebrae with limited pneumatic invasion into the neural arch. Comparisons with other theropod dinosaurs suggest that ornithomimosaurs primitively exhibited a plesiomorphic theropod condition for axial pneumaticity that was extended among later taxa, such as Archaeornithomimus and large bodied Deinocheirus. This finding corroborates the notion that evolutionary increases in vertebral pneumaticity occurred in parallel among independent lineages of bird

Cervical vertebrae maturation method morphologic criteria: poor reproducibility.

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Nestman, Trenton S; Marshall, Steven D; Qian, Fang; Holton, Nathan; Franciscus, Robert G; Southard, Thomas E

2011-08-01

The cervical vertebrae maturation (CVM) method has been advocated as a predictor of peak mandibular growth. A careful review of the literature showed potential methodologic errors that might influence the high reported reproducibility of the CVM method, and we recently established that the reproducibility of the CVM method was poor when these potential errors were eliminated. The purpose of this study was to further investigate the reproducibility of the individual vertebral patterns. In other words, the purpose was to determine which of the individual CVM vertebral patterns could be classified reliably and which could not. Ten practicing orthodontists, trained in the CVM method, evaluated the morphology of cervical vertebrae C2 through C4 from 30 cephalometric radiographs using questions based on the CVM method. The Fleiss kappa statistic was used to assess interobserver agreement when evaluating each cervical vertebrae morphology question for each subject. The Kendall coefficient of concordance was used to assess the level of interobserver agreement when determining a "derived CVM stage" for each subject. Interobserver agreement was high for assessment of the lower borders of C2, C3, and C4 that were either flat or curved in the CVM method, but interobserver agreement was low for assessment of the vertebral bodies of C3 and C4 when they were either trapezoidal, rectangular horizontal, square, or rectangular vertical; this led to the overall poor reproducibility of the CVM method. These findings were reflected in the Fleiss kappa statistic. Furthermore, nearly 30% of the time, individual morphologic criteria could not be combined to generate a final CVM stage because of incompatible responses to the 5 questions. Intraobserver agreement in this study was only 62%, on average, when the inconclusive stagings were excluded as disagreements. Intraobserver agreement was worse (44%) when the inconclusive stagings were included as disagreements. For the group of subjects

Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc

International Nuclear Information System (INIS)

Biederer, J.; Hutzelmann, A.; Heller, M.; Rama, B.

1999-01-01

Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.) [de

Cervical spine fracture in a boxer a rare but important sporting injury ...

African Journals Online (AJOL)

Cervical vertebral injuries are rare in boxing. The case of an adult boxer with an isolated vertical fracture of the anterior arch of the atlas is described. The mechanism of injury, clinical presentation, complications and treatment are discussed. Measures to prevent head and neck injury in boxing are discussed.

Radiographic findings of degeneration in cervical spines of middle-aged soccer players

International Nuclear Information System (INIS)

Kurosawa, Hideki; Yamakoshi, Ken-ichi

1991-01-01

Twelve amateur veteran soccer players (average age 40.1 ± 5.4 years), who began playing in their teens and who were admitted with symptoms most likely to be related to cervical spondylosis, were examined by cervical radiography. Abnormal radiographic findings included: calcification of anterior longitudinal ligament (25%), anterior (75%) and posterior vertebral spurs (75%), ossicle between spinous processes (75%), calcification of nuchal ligament (Barsony) (58%), ossicle on spinous process (25%), and bony spur of Luschka's joints (83%). It was shown in the stress distribution by finite element method analysis that the stress in heading the ball was applied mainly to the lower parts of the cervical spine. The results of this analysis also corresponded well with some of the radiographic findings. (orig.)

Radiographic findings of degeneration in cervical spines of middle-aged soccer players

Energy Technology Data Exchange (ETDEWEB)

Kurosawa, Hideki; Yamakoshi, Ken-ichi (Hokkaido Univ., Sapporo (Japan). Research Inst. of Applied Electricity); Yamanoi, Takahiro (Hokkaigakuen Univ., Sapporo (Japan))

1991-08-01

Twelve amateur veteran soccer players (average age 40.1 {+-} 5.4 years), who began playing in their teens and who were admitted with symptoms most likely to be related to cervical spondylosis, were examined by cervical radiography. Abnormal radiographic findings included: calcification of anterior longitudinal ligament (25%), anterior (75%) and posterior vertebral spurs (75%), ossicle between spinous processes (75%), calcification of nuchal ligament (Barsony) (58%), ossicle on spinous process (25%), and bony spur of Luschka's joints (83%). It was shown in the stress distribution by finite element method analysis that the stress in heading the ball was applied mainly to the lower parts of the cervical spine. The results of this analysis also corresponded well with some of the radiographic findings. (orig.).

Radical surgery for early stage cervical cancer

NARCIS (Netherlands)

Derks, M.

2017-01-01

Cervical cancer is one of the most common malignancies in women worldwide. Due to an effective screening programme, in the Netherlands cervical cancer is often detected in early stages of disease. For early stage (International Federation of Gynaecology and Obstetrics (FIGO) stage IB/IIA) cervical

Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Directory of Open Access Journals (Sweden)

Li Bao

2017-01-01

Full Text Available Percutaneous vertebroplasty (PVP has been shown to release spinal pain and stabilize the vertebral body. PVP is suggested as an alternative treatment in spinal metastasis. Although cervical metastases is less prevalent than thoracic and lumbar spine, PVP procedure in cervical vertebrae remains technical challenging. We retrospectively analyzed the data from patients (n=9 who underwent PVP using anterolateral approach to treat severe neck pain and restricted cervical mobility from metastatic disease. Patients were rated using modified Tokuhashi score and Tomita score before the procedure. Visual analog scale (VAS, neck disability index (NDI, analgesic use, and imaging (X-ray or CT were evaluated before PVP and 3 days, 3 months, and 6 months after PVP. All patients were in late stage of cancer evaluated using modified Tokuhashi and Tomita score. The cement leakage rate was 63.6% (14 of the 22 vertebrae with no severe complications. VAS, NDI, and analgesic use were significantly decreased 3 days after the procedure and remained at low level until 6 months of follow-up. Our result suggested PVP effectively released the pain from patients with cervical metastasis. The results warrant further clinical investigation.

Comparative study between the hand-wrist method and cervical vertebral maturation method for evaluation skeletal maturity in cleft patients.

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Manosudprasit, Montian; Wangsrimongkol, Tasanee; Pisek, Poonsak; Chantaramungkorn, Melissa

2013-09-01

To test the measure of agreement between use of the Skeletal Maturation Index (SMI) method of Fishman using hand-wrist radiographs and the Cervical Vertebral Maturation Index (CVMI) method for assessing skeletal maturity of the cleft patients. Hand-wrist and lateral cephalometric radiographs of 60 cleft subjects (35 females and 25 males, age range: 7-16 years) were used. Skeletal age was assessed using an adjustment to the SMI method of Fishman to compare with the CVMI method of Hassel and Farman. Agreement between skeletal age assessed by both methods and the intra- and inter-examiner reliability of both methods were tested by weighted kappa analysis. There was good agreement between the two methods with a kappa value of 0.80 (95% CI = 0.66-0.88, p-value <0.001). Reliability of intra- and inter-examiner of both methods was very good with kappa value ranging from 0.91 to 0.99. The CVMI method can be used as an alternative to the SMI method in skeletal age assessment in cleft patients with the benefit of no need of an additional radiograph and avoiding extra-radiation exposure. Comparing the two methods, the present study found better agreement from peak of adolescence onwards.

Variations in Transverse Foramina of Cervical Vertebrae: Morphology & Clinical Importance

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Vaishakhi Gonsai

2015-12-01

Full Text Available Background: The purpose of this study is to investigate variations in transverse foramina in the cervical vertebrae and its morphological and clinical importance. Materials and Method : The variations in the number and size of transverse foramina was studied in total 200 human dried cervical vertebrae, which were taken from the Department of Anatomy, B.J.Medical College, Ahmedabad. All the vertebrae were observed for variation in number and size of transverse foramina. Results: Out of 200 cervical vertebrae, complete double transverse foramina were observed in 40 vertebrae (20%, among them unilateral double foramina were found in 31 vertebrae (15.5% and the bilateral double foramina were found in 9 vertebrae (4.5%. Incomplete double transverse foramina were observed in 22 vertebrae (11%, among them unilateral double foramina were found in 16 vertebrae (8% and bilateral double foramina were observed in 6 vertebrae (3%. Conclusion: Complete unilateral double transverse foramina of cervical vertebrae were more common than bilateral. Also unilateral small size transverse foramina of cervical vertebrae were also common. This variation is important for the neurosurgeon during cervical surgery. Under such condition the course of the vertebral artery may be distorted. It is also useful for Radiologist during CT and MRI scan.

Globally threatened vertebrates on islands with invasive species.

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Spatz, Dena R; Zilliacus, Kelly M; Holmes, Nick D; Butchart, Stuart H M; Genovesi, Piero; Ceballos, Gerardo; Tershy, Bernie R; Croll, Donald A

2017-10-01

Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earth's terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in vertebrates was available for 1030 islands (80% of islands with highly threatened vertebrates). Invasive vertebrates were absent from 24% of these islands, where biosecurity to prevent invasions is a critical management tool. On the 76% of islands where invasive vertebrates were present, management could benefit 39% of Earth's highly threatened vertebrates. Invasive mammals occurred in 97% of these islands, with Rattus sp. as the most common invasive vertebrate (78%; 609 islands). Our results provide an important baseline for identifying islands for invasive species eradication and other island conservation actions that reduce biodiversity loss.

Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

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Pua, Uei; Chan, Stephen Yung-Wei

2013-01-01

Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

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Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Chan, Stephen Yung-Wei [Tan Tock Seng Hospital, Department of Anaesthesiology, Intensive Care and Pain Medicine (Singapore)

2013-06-15

Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

The Use of Tissue Plasminogen Activator in the Treatment of Wallenberg Syndrome Caused by Vertebral Artery Dissection.

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Salerno, Alexis; Cotter, Bradford V; Winters, Michael E

2017-05-01

Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. The administration of a thrombolytic medication has been recommended in the treatment of patients with stroke caused by cervical artery dissection. Surprisingly, there is scant literature on the use of this medication in the treatment of this condition. We describe a 42-year-old man with the sudden onset of headache, left-sided neck pain, vomiting, nystagmus, and ataxia 1 h after completing a weightlifting routine. Computed tomography angiography revealed a grade IV left vertebral artery injury with a dissection flap extending distally and resulting in complete occlusion. Subsequent magnetic resonance imaging and angiography demonstrated acute left cerebellar and lateral medullary infarcts, consistent with Wallenberg syndrome. The patient was treated with tissue plasminogen activator, which failed to resolve his symptoms. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians frequently manage patients with acute CVAs. For select patients, the administration of tissue plasminogen activator can improve outcomes. However, the risk of major hemorrhage with this medication is significant. Cervical artery dissection is an important cause of acute stroke in young patients and is often missed on initial presentation. It is imperative for the emergency physician to consider acute cervical artery dissection as a cause of stroke and to be knowledgeable regarding the efficacy of thrombolytic medications for this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

Chiropractic care of a patient with vertebral subluxation and Bell's palsy.

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Alcantara, Joel; Plaugher, Gregory; Van Wyngarden, Darwin L

2003-05-01

To describe the chiropractic care of a patient medically diagnosed with Bell's palsy and discuss issues clinically relevant to this disorder, such as its epidemiology, etiology, diagnosis, care, and prognosis. A 49-year-old woman with a medical diagnosis of Bell's palsy sought chiropractic care. Her symptoms included right facial paralysis, extreme phonophobia, pain in the right temporomandibular joint (TMJ), and neck pain. Signs of cervical vertebral and TMJ subluxations included edema, tenderness, asymmetry of motion and posture, and malalignment detected from plain film radiographs. The patient was cared for with full spine contact-specific, high-velocity, low-amplitude adjustments (Gonstead Technique) to sites of vertebral and occipital subluxations. The patient's left TMJ was also adjusted. The initial symptomatic response to care was positive, and the patient made continued improvements during the 6 months of care. There are indications that patients suffering from Bell's palsy may benefit from a holistic chiropractic approach that not only includes a focus of examination and care of the primary regional areas of complaint (eg, face, TMJ) but also potentially from significant vertebral subluxation concomitants.

The analysis of imaging diagnosis and misdiagnosis of vertebral eosinophilic granuloma

International Nuclear Information System (INIS)

Liang Weiqiang; Li Sheng

2007-01-01

Objective: To analyze the imaging features of vertebral eosinophilic granuloma and the reasons of misdiagnosis, so as to improve the diagnosis accuracy of the disease. Methods: The clinical materials and images findings of 10 patients with vertebral eosinophilic granuloma proved by surgery and histopathology were analyzed retrospectively. Results: Of all the cases, 3 of them were located in cervical vertebra, 5 in thoracic vertebra and 2 in lumbar vertebra. 8 lesions were single and 2 involved the adjacent 2 vertebrae. 4 lesions showed obvious sinking and flattening of the vertebra body, with widening anteroposterior and transverse diameters, 4 cases showed wedge-shaped appearance, 2 cases showed well-defined oval deossification. The appendix of vertebrae in 3 lesions were destroyed with surrounding mass. The intervertebral spaces were normal in 7 cases, slightly widened in 2 cases and slightly narrowed in 1 case. 6 cases showed paravertebra soft tissue swelling or soft tissue mass formation. Conclusion: Though there are some imaging features of vertebral eosinophilic granuloma, close combination with clinical dates and careful analysis of imaging findings can effectively improved the diagnosis accuracy. (authors)

Longitudinal study of relative growth rates of the maxilla and the mandible according to quantitative cervical vertebral maturation.

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Chen, Lili; Liu, Jiarong; Xu, Tianmin; Lin, Jiuxiang

2010-06-01

The purpose of this study was to investigate the relative growth rates (RGR) of the maxilla and the mandible according to quantitative cervical vertebral maturation (QCVM) of adolescents with normal occlusion. Mixed longitudinal data were used. The sample included 87 adolescents (32 boys, 55 girls) from 8 to 18 years of age with normal occlusion, selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 consecutive years. The growth magnitude (GM) and RGR of the maxilla and the mandible were measured and analyzed. GM and RGR were not always consistent, because subjects had different periods of time between the QCVM stages. GM was not as reliable as RGR. RGR had no significant sex differences in the maxilla and the mandible, in spite of different decelerating curves. However, statistically significant sex differences were found in the GM of mandibular measurements. The greatest growth potentials were not synchronized between the maxilla and the mandible. For both sexes, the greatest RGR of maxillary length and height was in QCVM stage I; then, deceleration occurred. The greatest RGR of mandibular length and height was in QCVM stage II, and the next largest was in QCVM stage I. Understanding the RGR can provide references for orthodontic treatment and orthognathic surgery. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Mid-cervical flame-shaped pseudo-occlusion: diagnostic performance of mid-cervical flame-shaped extracranial internal carotid artery sign on computed tomographic angiography in hyperacute ischemic stroke

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Prakkamakul, Supada; Pitakvej, Nantaporn [King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Department of Radiology, Bangkok (Thailand); Dumrongpisutikul, Netsiri; Lerdlum, Sukalaya [King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Department of Radiology, Bangkok (Thailand); Chulalongkorn University, Department of Radiology, Faculty of Medicine, Bangkok (Thailand)

2017-10-15

Flame-shaped pseudo-occlusion of the extracranial internal carotid artery (ICA) is a flow-related phenomenon that creates computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings that mimic tandem intracranial-extracranial ICA occlusion or dissection. We aim to determine the diagnostic performance of mid-cervical flame-shaped extracranial ICA sign on CTA in hyperacute ischemic stroke patients. We retrospectively included consecutive anterior circulation ischemic stroke patients presenting within 6 h of symptom onset who underwent 4D brain CTA and arterial-phase neck CTA using a 320-detector CT scanner during August 2012 to July 2015. Two blinded readers independently reviewed arterial-phase neck CTA and characterized the extracranial ICA configurations into mid-cervical flame-shaped, proximal blunt/beak-shaped, and tubular-shaped groups. 4D whole brain CTA was used as a reference standard for intracranial ICA occlusion detection. Diagnostic performance of the mid-cervical flame-shaped extracranial ICA sign and interobserver reliability were calculated. Of the 81 cases, 11 had isolated intracranial ICA occlusion, and 6 had true extracranial ICA occlusion. Mid-cervical flame-shaped extracranial ICA sign was found in 45.5% (5/11) of isolated intracranial ICA occlusions but none in the true extracranial ICA occlusion group. The sensitivity, specificity, PPV, NPV, and accuracy of the mid-cervical flame-shaped extracranial ICA sign for the detection of isolated intracranial ICA occlusion were 45.5, 100, 100, 92.1, and 92.6%, respectively. Interobserver reliability was 0.90. The mid-cervical flame-shaped extracranial ICA sign may suggest the presence of isolated intracranial ICA occlusion and allow reliable exclusion of tandem extracranial-intracranial ICA occlusion in hyperacute ischemic stroke setting. (orig.)

Mid-cervical flame-shaped pseudo-occlusion: diagnostic performance of mid-cervical flame-shaped extracranial internal carotid artery sign on computed tomographic angiography in hyperacute ischemic stroke

International Nuclear Information System (INIS)

Prakkamakul, Supada; Pitakvej, Nantaporn; Dumrongpisutikul, Netsiri; Lerdlum, Sukalaya

2017-01-01

Flame-shaped pseudo-occlusion of the extracranial internal carotid artery (ICA) is a flow-related phenomenon that creates computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings that mimic tandem intracranial-extracranial ICA occlusion or dissection. We aim to determine the diagnostic performance of mid-cervical flame-shaped extracranial ICA sign on CTA in hyperacute ischemic stroke patients. We retrospectively included consecutive anterior circulation ischemic stroke patients presenting within 6 h of symptom onset who underwent 4D brain CTA and arterial-phase neck CTA using a 320-detector CT scanner during August 2012 to July 2015. Two blinded readers independently reviewed arterial-phase neck CTA and characterized the extracranial ICA configurations into mid-cervical flame-shaped, proximal blunt/beak-shaped, and tubular-shaped groups. 4D whole brain CTA was used as a reference standard for intracranial ICA occlusion detection. Diagnostic performance of the mid-cervical flame-shaped extracranial ICA sign and interobserver reliability were calculated. Of the 81 cases, 11 had isolated intracranial ICA occlusion, and 6 had true extracranial ICA occlusion. Mid-cervical flame-shaped extracranial ICA sign was found in 45.5% (5/11) of isolated intracranial ICA occlusions but none in the true extracranial ICA occlusion group. The sensitivity, specificity, PPV, NPV, and accuracy of the mid-cervical flame-shaped extracranial ICA sign for the detection of isolated intracranial ICA occlusion were 45.5, 100, 100, 92.1, and 92.6%, respectively. Interobserver reliability was 0.90. The mid-cervical flame-shaped extracranial ICA sign may suggest the presence of isolated intracranial ICA occlusion and allow reliable exclusion of tandem extracranial-intracranial ICA occlusion in hyperacute ischemic stroke setting. (orig.)

Human vagus nerve branching in the cervical region.

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Niels Hammer

Full Text Available Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation.Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections.Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally and proven histologically in all cases. Right-sided branching (22% was more common than left-sided branching (12% and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm and cross-sections (7.24 mm2 vs. 5.28 mm2.Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.

[Total cervical disk replacement--implant-specific approaches: keel implant (Prodisc-C intervertebral disk prosthesis)].

Science.gov (United States)

Korge, Andreas; Siepe, Christoph J; Heider, Franziska; Mayer, H Michael

2010-11-01

Dynamic intervertebral support of the cervical spine via an anterolateral approach using a modular artificial disk prosthesis with end-plate fixation by central keel fixation. Cervical median or mediolateral disk herniations, symptomatic cervical disk disease (SCDD) with anterior osseous, ligamentous and/or discogenic narrowing of the spinal canal. Cervical fractures, tumors, osteoporosis, arthrogenic neck pain, severe facet degeneration, increased segmental instability, ossification of posterior longitudinal ligament (OPLL), severe osteopenia, acute and chronic systemic, spinal or local infections, systemic and metabolic diseases, known implant allergy, pregnancy, severe adiposity (body mass index > 36 kg/m2), reduced patient compliance, alcohol abuse, drug abuse and dependency. Exposure of the anterior cervical spine using the minimally invasive anterolateral approach. Intervertebral fixation of retainer screws. Intervertebral diskectomy. Segmental distraction with vertebral body retainer and vertebral distractor. Removal of end-plate cartilage. Microscopically assisted decompression of spinal canal. Insertion of trial implant to determine appropriate implant size, height and position. After biplanar image intensifier control, drilling for keel preparation using drill guide and drill bit, keel-cut cleaner to remove bone material from the keel cut, radiologic control of depth of the keel cut using the corresponding position gauge. Implantation of original implant under lateral image intensifier control. Removal of implant inserter. Functional postoperative care and mobilization without external support, brace not used routinely, soft brace possible for 14 days due to postoperative pain syndromes. Implantation of 100 cervical Prodisc-C disk prostheses in 78 patients (average age 48 years) at a single center. Clinical and radiologic follow-up 24 months postoperatively. Significant improvement based on visual analog scale and Neck Disability Index. Radiologic

Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine

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Olow-Nordenram, M.A.K.; Raadberg, C.T.

1984-01-01

Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or serverity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo-nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage. (orig.)

Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine

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Olow-Nordenram, M.A.K.; Raadberg, C.T.

1984-01-01

Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or serverity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo-nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage.

Role of MRI in detecting involvement of the uterine internal os in uterine cervical cancer: Systematic review of diagnostic test accuracy

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Boer, Peter de, E-mail: p.deboer@amc.uva.nl [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Adam, Judit A. [Department of Radiology, AMC, UvA (Netherlands); Department of Nuclear Medicine, AMC, UvA (Netherlands); Buist, Marrije R. [Department of Gynaecology and Obstetrics, AMC, UvA (Netherlands); Vijver, Marc J. van de [Department of Pathology, AMC, UvA (Netherlands); Rasch, Coen R. [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Stoker, Jaap; Bipat, Shandra [Department of Radiology, AMC, UvA (Netherlands); Stalpers, Lukas J.A. [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

2013-09-15

Purpose: In patients with uterine cervical cancer, pretreatment recognition of uterine extension is crucial in treatment decision-making for fertility-sparing surgery and for target delineation in radiotherapy. Although MRI is generally considered the most reliable method, its value for detecting involvement of the uterine internal os is unclear. Methods: Medline, Embase and Cochrane databases were systematically searched (January 1997–December 2012) for MRI studies that measured the accuracy of involvement of the uterine internal os compared to histopathology as reference standard in patients with uterine cervical cancer. Data were assessed using the QUADAS tool. Accuracy concerned either involvement (yes/no) of the uterine internal os, or measuring invasion distance toward the uterine corpus. Results: Two retrospective and two prospective studies described 366 patients diagnosed with uterine cervical cancer FIGO stage IIB or below, in whom 64 (17%) had uterine internal os involvement. For three studies the summary estimates of specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were 91%, 97%, 99%, 79% and 95%, respectively; one study had an area under the curve (AUC) of 0.8. Conclusion: MRI has a high level of accuracy; however, data are limited and for validation a large prospective study is needed that compares actual measurements on MRI with histopathological examination.

MRI of cervical spine injuries complicating ankylosing spondylitis

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Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

2008-09-15

The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

Pediatric cervical spine marrow T2 hyperintensity: a systematic analysis

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Gefen, Ron [Cooper University Hospital, Department of Diagnostic Radiology, Candem, NJ (United States); Schweitzer, Mark E. [The Ottawa Hospital and University of Ottawa, Department of Diagnostic Imaging, Ottawa (Canada); Shabshin, Nogah [Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel-HaShomer (Israel); Hospital of University of Pennsylvania, Department of Diagnostic Imaging, Philadelphia, PA (United States)

2011-08-15

Hyperintense areas of vertebral bone marrow on fluid-sensitive sequences are at times seen on pediatric MRI of the cervical spine in children without suspicious clinical conditions to explain marrow pathology. Although these likely have no clinical significance they may be mistaken for pathology. The purpose of this study is to systematically evaluate the locations and patterns of marrow T2 hyperintensity in the pediatric cervical spine, with respect to age. At 1.5 T, the C2 through T3 vertebrae of 82 children aged 0-17 years without clinically suspicious marrow abnormality were retrospectively reviewed by two musculoskeletal radiologists, who were blinded to patients' age. The frequency, intensity, and location of the foci of marrow T2 hyperintensity were recorded for each vertebra on a 12-point scoring system and were correlated with the patients' age. Foci of marrow hyperintensity were seen in 46/82 (56.1%) patients and in 241/734 (32.8%) vertebrae. Foci were most common in C4 (42% of patients), C5 (45.7%), and C6 (37.8%). The foci of T2 hyperintensity were more common inferiorly (188 foci) and adjacent to the anterior cortex (123). Analysis revealed no significant correlation between age and marrow score (Spearman = -0.147, P = 0.19), but did find a trend towards increased presence of marrow T2 hyperintensity in the ages of most rapid growth, 8-14 years (81.5% of patients). Vertebral body marrow T2 hyperintensity was most common endosteally and in the mid-cervical spine with a slight peak in adolescence. We therefore believe that these pediatric cervical marrow changes may be related to rapid bone growth at the point of maximal kyphotic stress. (orig.)

Juvenile Stroke: Cervical Artery Dissection in a Patient after a Polytrauma

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Nicole Marschner-Preuth

2013-01-01

Full Text Available Dissections of the cervical arteries cause about 20% of total juvenile strokes. Approximately 4% of the carotid artery dissections are due to a (polytrauma such as car accidents. Despite improved diagnostic facilities, traumatic dissections are often underdiagnosed or diagnosed too late due to a lack of awareness of potential initial signs and symptoms.We report here a case of a delayed embolic stroke after a car accident caused by a dissection of the carotid artery and subsequent pseudoaneurysm.To reduce the long-term morbidity or mortality of multiple trauma patients, an early detection of cervical carotid and vertebral dissections is strictly necessary.

Post-traumatic upper cervical subluxation visualized by MRI: a case report

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Demetrious James

2007-12-01

Full Text Available Abstract Background This paper describes MRI findings of upper cervical subluxation due to alar ligament disruption following a vehicular collision. Incidental findings included the presence of a myodural bridge and a spinal cord syrinx. Chiropractic management of the patient is discussed. Case presentation A 21-year old female presented with complaints of acute, debilitating upper neck pain with unremitting sub-occipital headache and dizziness following a vehicular collision. Initial emergency department and neurologic investigations included x-ray and CT evaluation of the head and neck. Due to persistent pain, the patient sought chiropractic care. MRI of the upper cervical spine revealed previously unrecognized clinical entities. Conclusion This case highlights the identification of upper cervical ligamentous injury that produced vertebral subluxation following a traumatic incident. MRI evaluation provided visualization of previously undetected injury. The patient experienced improvement through chiropractic care.

Maturação das vértebras cervicais e sua correlação com a idade óssea da mão e punho como indicadores no tratamento ortodôntico Cervical vertebral maturation and the correlation between the skeletal age of the hand-wrist as orthodontic treatment indicators

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Vitoria Aparecida Muglia Moscatiello

2008-08-01

Full Text Available OBJETIVOS: a proposta deste estudo prospectivo, transversal e multicêntrico foi correlacionar as alterações morfológicas das vértebras cervicais C2, C3 e C4, com a idade cronológica e comparar com a idade esqueletal dos ossos da mão e punho; e verificar se existem diferenças no padrão de crescimento ósseo entre os gêneros masculino e feminino. METODOLOGIA: a amostra foi constituída por 140 pacientes, 74 do gênero feminino e 66 do masculino. A avaliação das alterações das vértebras cervicais foi feita pelo método de Hassel e Farman modificado por Baccetti, Franchi e McNamara para 5 estágios que se correlacionam com o crescimento puberal em telerradiografias cranianas em norma lateral. As radiografias da mão e punho avaliaram os eventos de ossificação por meio do método de Greulich e Pyle. RESULTADOS: os resultados demonstraram correlação dos estágios de maturação das vértebras cervicais com a idade cronológica; e correlação positiva e moderada, estatisticamente significante entre os dois métodos com r = 0,6326 (IC = 95% e p AIM: The aim of this prospective, transversal, multicentric study was to determine the correlation between the morphologic changes of the second, third and fourth cervical vertebral bodies and the chronological age; to compare with the skeletal age of the hand and wrist bones; and to verify the differences in the bone growth pattern between male and female. METHODS: The sample was constituted by 140 subjects, 74 girls and 66 boys. The morphologic alterations of the cervical vertebrae was analyzed by the Hassel and Farman method modified by Baccetti, Franchi and McNamara to 5 stages that correlate to the puberal growth in lateral cephalometric radiographs. The hand-wrist radiographs evaluated the events of ossification by the method of Greulich and Pyle. RESULTS: The results demonstrated: correlation of the stages of cervical vertebral maturation with the chronological age; positive and

Malignant paraganglioma with vertebral metastasis: case report Paraganglioma maligno com metástase vertebral: relato de caso

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Bruno Lázaro

2003-06-01

Full Text Available A paraganglioma is a rare tumor, composed of chromaffin cells, groups of cells associated to the autonomous system. When the tumor occurs in the adrenal gland, it is called pheochromocitoma. The malignant paraganglioma is a very rare presentation; it is diagnosed by local recurrence after total resection of the primary mass, or findings of distant metastases. We present a case report of a 29-year-old woman with cervico-brachial pain. In 1995 she underwent a carotid body tumor resection. Magnetic resonance imaging (MRI, plain X-rays and computerized tomography scan revealed multiple lesions in C5, T5 and T12. She underwent a surgical procedure to correct the cervical lesion. The histological and immunohistochemical assays revealed a malignant paraganglioma. She received adjuvant radiotherapy, showing clinical improvement after treatment, presenting no symptoms after one year. The therapeutic approach is based on the total resection of the tumor. The treatment of distant metastases can be made with adjuvant measures such as conventional radiotherapy, I¹³¹-MIBG, or chemotherapy, especially in malignant pheochromocitomas.O paraganglioma é tumor raro, composto de células cromafins, associado ao sistema nervoso autônomo. Quando localizado na glândula supra-renal, o tumor é chamado feocromocitoma. Descreve-se um caso de paciente do sexo feminino, 29 anos, que se apresentou com cervicobraquialgia e que havia sido operada em 1995 para exérese de tumor glômico da carótida cervical. RM, RX e TC revelaram múltiplas lesões acometendo o corpo vertebral de C5, T5 e T12. Foi submetida à ressecção cirúrgica radical da lesão cervical, com substituição do corpo vertebral por prótese de titânio. A histopatologia e o estudo imunohistoquímico da lesão confirmaram o diagnóstico de paraganglioma maligno. As outras lesões foram tratadas com radioterapia. Um ano após os procedimentos, a paciente apresenta-se assintomática. O tratamento destas

Associations between craniofacial morphology, head posture, and cervical vertebral body fusions in men with sleep apnea

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Svanholt, Palle; Petri, Niels; Wildschiødtz, Gordon

2009-01-01

. The patients were divided into 4 groups according to fusion in the cervical vertebrae: group I, no fusions (42 subjects); group II, fusion of cervical vertebrae 2 and 3 (15 subjects); group III, occipitalization (10 subjects); and group IV, block fusion (11 subjects). Mean differences of craniofacial...... dimensions between the groups were assessed by unpaired t tests. RESULTS: No significant differences were seen between groups I and III. Between groups I and II, significant differences were seen in jaw relationship (P face height and mandibular length deviated...... significantly. No significant differences were seen in head posture. CONCLUSIONS: OSA patients with block fusions in the cervical vertebrae and fusion of 2 vertebrae differed significantly in craniofacial profile from other OSA patients....

Comparação do Índice de Torg obtido por meio de radiografia e ressonância magnética nos pacientes com mielopatia cervical espondilótica Comparación del Índice de Torg, obtenido por medio de radiografía y resonancia, en los pacientes con mielopatía espondilótica cervical Comparison of the Torg Index obtained by radiography and magnetic resonance in patients with spondylotic cervical myelopathy

Directory of Open Access Journals (Sweden)

Alexandre de Oliveira Zam

2012-01-01

Full Text Available OBJETIVO: A Mielopatia Cervical Espondilótica (MCE é uma disfunção da medula espinhal relacionada à degeneração típica do envelhecimento. No estudo de imagem podemos obter a medida do Índice de Torg, para estimar a estenose cervical. Objetivamos, assim, medir o Índice de Torg através de radiografia e ressonância magnética (RM, possibilitando verificar possíveis discrepâncias entre os métodos de medida. MÉTODOS: Realizada mensuração do Índice de Torg na radiografia e na RM da coluna cervical, sendo obtido através da relação entre a superfície posterior do corpo vertebral e o ponto mais próximo à linha laminar correspondente, dividido pelo diâmetro sagital do corpo vertebral. RESULTADOS: Participaram 29 pacientes, sendo 10 mulheres e 19 homens, com médias de idade 48,1 ± 11 anos, de peso 68,7 ± 5 Kg e de altura 1,68 ± 0,6 m. Houve diferença significativa entre o Índice de Torg calculado através de radiografia e RM, sendo menores os índices observados na RM (radiografia: 0,73 ± 0,17 vs. RM: 0,48 ± 0,14, pOBJETIVO: La Mielopatía Cervical Espondilótica (MCE es un trastorno relacionado con la degeneración de la médula espinal, típica del envejecimiento. En el estudio de imagen se puede obtener la medida del Índice de Torg para estimar la estenosis cervical. Nuestro objetivo es, por tanto, medir el índice de Torg mediante rayos-X y resonancia magnética (RM, posibilitando verificar posibles discrepancias entre los métodos de medición. MÉTODOS: Se realiza la medición del Índice de Torg en la radiografía y en la resonancia magnética de la columna cervical, siendo obtenido mediante la determinación de la relación entre la superficie posterior del cuerpo vertebral y el punto más cercano a la línea de la lámina correspondiente, dividido por el diámetro sagital del cuerpo vertebral. RESULTADOS: Participó un total de pacientes 29, siendo 10 mujeres y 19 hombres, edad promedio de 48,1 ± 11 años, peso

Vertebral artery dissection in hypertensive disorders of pregnancy: a case series and literature review.

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Shanmugalingam, Renuka; Reza Pour, Nina; Chuah, Siang Chye; Vo, Thi Mong; Beran, Roy; Hennessy, Annemarie; Makris, Angela

2016-07-16

Arterial dissection is a rare complication of pregnancy and puerperium. There have been reports of aortic, coronary and cervical artery dissection in association with preeclampsia, however, vertebral artery dissection is rarely reported particularly in the antenatal setting in the presence of a Hypertensive Disorder of Pregnancy (HDP).The general annual incidence of symptomatic spontaneous cervicocephalic arterial dissection is 0.0026 % and a data registry reported that 2.4 % of these occurred in the post-partum period. The actual incidence of vertebral artery dissection in HDP is unknown as the current literature consists of case series and reports only with most documenting adverse outcomes. Given the presence of collateral circulation, unilateral vertebral artery dissections may go unrecognised and may be more common than suspected. We present a case series of four patients with vertebral artery dissection in association with HDP, two of which occurred in the antenatal setting and two in the post-partum setting. All our patients had favourable outcome with no maternal neurological deficit and live infants. Our discussion covers the proposed pathophysiology of vertebral artery dissection in HDP and the management of it. Our case series highlights the need to consider VAD an important differential diagnosis when assessing pregnant women with headache and neck pain particularly in the context of HDP.

Predicting vertebral bone strength by vertebral static histomorphometry

DEFF Research Database (Denmark)

Thomsen, Jesper Skovhus; Ebbesen, Ebbe Nils; Mosekilde, Lis

2002-01-01

of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly....... No gender-related differences were found in any of the relationships. Neither static histomorphometry nor biomechanical testing of iliac crest bone biopsies is a good predictor of vertebral bone strength.......The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...

Morphology of the human internal vertebral venous plexus : A cadaver study after latex injection in the 21-25-week fetus

NARCIS (Netherlands)

Groen, RJM; Grobbelaar, M; Muller, GIF; van Solinge, G; Verhoof, O; du Toit, DF; Hoogland, P.V.J.M.

The morphology of the anterior and posterior internal vertebral venous plexus (IVVP) in human fetuses between 21-25 weeks of gestational age is described. The results are compared to the findings of a previous morphological study of the IVVP in the aged. The morphological pattern of the anterior

Candida albicans osteomyelitis of the cervical spine

International Nuclear Information System (INIS)

Cha, Jang-Gyu; Hong, Hyun-Sook; Koh, Yoon-Woo; Kim, Hee-Kyung; Park, Jung-Mi

2008-01-01

Fungal osteomyelitis is a rare infection that usually develops in immunocompromised patients. Additionally, involvement of the cervical spine by Candida albicans is extremely rare; only three previous cases of Candida vertebral osteomyelitis have been reported in the literature. The diagnosis may be delayed due to nonspecific radiologic findings and a slow progression. We report the CT, MRI, bone scan, and PET-CT findings in a patient who developed Candida osteomyelitis, which was initially misdiagnosed as metastasis, at the atlas and axis following treatment for nasopharyngeal cancer. (orig.)

The German cervical cancer screening model: development and validation of a decision-analytic model for cervical cancer screening in Germany.

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Siebert, Uwe; Sroczynski, Gaby; Hillemanns, Peter; Engel, Jutta; Stabenow, Roland; Stegmaier, Christa; Voigt, Kerstin; Gibis, Bernhard; Hölzel, Dieter; Goldie, Sue J

2006-04-01

We sought to develop and validate a decision-analytic model for the natural history of cervical cancer for the German health care context and to apply it to cervical cancer screening. We developed a Markov model for the natural history of cervical cancer and cervical cancer screening in the German health care context. The model reflects current German practice standards for screening, diagnostic follow-up and treatment regarding cervical cancer and its precursors. Data for disease progression and cervical cancer survival were obtained from the literature and German cancer registries. Accuracy of Papanicolaou (Pap) testing was based on meta-analyses. We performed internal and external model validation using observed epidemiological data for unscreened women from different German cancer registries. The model predicts life expectancy, incidence of detected cervical cancer cases, lifetime cervical cancer risks and mortality. The model predicted a lifetime cervical cancer risk of 3.0% and a lifetime cervical cancer mortality of 1.0%, with a peak cancer incidence of 84/100,000 at age 51 years. These results were similar to observed data from German cancer registries, German literature data and results from other international models. Based on our model, annual Pap screening could prevent 98.7% of diagnosed cancer cases and 99.6% of deaths due to cervical cancer in women completely adherent to screening and compliant to treatment. Extending the screening interval from 1 year to 2, 3 or 5 years resulted in reduced screening effectiveness. This model provides a tool for evaluating the long-term effectiveness of different cervical cancer screening tests and strategies.

Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae.

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Chuang, Hao-Che; Wei, Sung-Tai; Lee, Han-Chung; Chen, Chun-Chung; Lee, Wen-Yuen; Cho, Der-Yang

2008-11-01

The advantages and disadvantages of titanium mesh cages (TMCs) assisted by anterior cervical plates (ACPs) for interbody fusion following cervical corpectomy were investigated. Between January 2002 and September 2006, 17 patients with cervical radiculomyelopathy caused by metastasis-induced pathologic fractures were selected for anterior corpectomy. TMCs were inserted into the post-corpectomy defect and stabilized by placement of ACPs filled with Triosite. Post-operative plain X-ray films indicated maintenance of spinal stability. No ceramic, donor site or surgery-related complications were observed. True trabeculation was observed in axial and reconstructive CT scans in all surviving patients one year after surgery. Neurological recovery, pain control, and good quality of life were achieved. Short hospital stays, minimal blood loss, short operation times and brief periods of bed confinement were also observed. We conclude that a TMC assisted by an ACP is safe and effective for interbody fusion following cervical corpectomy for pathological fractures resulting from cervical vertebral metastases.

Prevalence Study of Proximal Vertebral Artery Stenosis Using High-Resolution Contrast-Enhanced Magnetic Resonance Angiography

International Nuclear Information System (INIS)

Kim, S.H.; Lee, J.S.; Kwon, O.K.; Han, M.K.; Kim, J.H.

2005-01-01

Purpose: To evaluate the prevalence of proximal vertebral artery stenosis, compared with those of the distal vertebral/basilar artery and extracranial internal carotid artery, in a large population of stroke and non-stroke patients. Material and Methods: Nine-hundred-and-thirty-five patients who underwent high-resolution contrast-enhanced magnetic resonance angiography in a regional general hospital were categorized into six groups based on neurological symptoms and disease: an asymptomatic group (n ∼ 182), a minor symptom group with headache or dizziness (n ∼ 519), a cardiac group with coronary artery steno-occlusive disease (n ∼ 15), a hemorrhagic group with old cerebral hemorrhage (n ∼ 26), an anterior circulation infarct group (n ∼ 121), and posterior circulation infarct group (n ∼ 72). Prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was analyzed. Results: The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 12.9%, 5.5%, and 7.2%, respectively, in the study population, and rose as the age increased (P <0.0001 for all arteries). The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 3.3%, 0.5%, and.1%, respectively, in the asymptomatic group; 8.3%, 2.1%, and 3.7%, respectively, in the minor symptom group; 13.3%, 6.7%, and 6.7%, respectively, in the cardiac group; 19.2%, 7.7%, and 7.7%, respectively, in the hemorrhagic group; 27.3%, 8.3%, and 25.6%, respectively, in the anterior circulation infarct group; and 44.4%, 36.1%, and 16.7%, respectively, in the posterior circulation infarct group. This increasing tendency of stenosis accordingly was statistically significant ( P <0.0001 for all arteries). Conclusion: The prevalence of proximal vertebral artery stenosis was highest, compared with those of the distal vertebral/basilar artery and

Cervical Spine pain as a presenting complaint in metastatic pancreatic cancer: a case report.

Science.gov (United States)

Rosenberg, Emily; Buchtel, Lindsey

2016-01-01

A 48 year-old female presented to her primary care physician with a two-month history of neck pain with negative cervical spine x-rays. During that office visit, the patient was noted to be tachycardic with EKG revealing ST depressions, which led to hospital admission. Acute coronary syndrome was ruled out, however, persistent neck pain warranted inpatient MRI of the cervical spine, which revealed a cervical spine lesion. Extensive investigation and biopsy ultimately confirmed stage IV pancreatic adenocarcinoma with metastases to the bone, liver, and likely lung. In the literature, the findings of a primary metastatic site being bone is rare with only a few case reports showing vertebral or sternal metastasis as the first clinical manifestation of pancreatic cancer. The uniqueness of this case lies in the only presenting complaint being cervical spine pain in the setting of extensive metastases to the liver, bone, and likely lung.

The cat vertebral column: stance configuration and range of motion

Science.gov (United States)

Macpherson, J. M.; Ye, Y.; Peterson, B. W. (Principal Investigator)

1998-01-01

This study examined the configuration of the vertebral column of the cat during independent stance and in various flexed positions. The range of motion in the sagittal plane is similar across most thoracic and lumbar joints, with the exception of a lesser range at the transition region from thoracic-type to lumbar-type vertebrae. The upper thoracic column exhibits most of its range in dorsiflexion and the lower thoracic and lumbar in ventroflexion. Lateral flexion is limited to less than 5 degrees at all segments. The range in torsion is almost 180 degrees and occurs primarily in the midthoracic region, T4-T11. Contrary to the depiction in most atlases, the standing cat exhibits several curvatures, including a mild dorsiflexion in the lower lumbar segments, a marked ventroflexion in the lower thoracic and upper lumbar segments, and a profound dorsiflexion in the upper thoracic (above T9) and cervical segments. The curvatures are not significantly changed by altering stance distance but are affected by head posture. During stance, the top of the scapula lies well above the spines of the thoracic vertebrae, and the glenohumeral joint is just below the bodies of vertebrae T3-T5. Using a simple static model of the vertebral column in the sagittal plane, it was estimated that the bending moment due to gravity is bimodal with a dorsiflexion moment in the lower thoracic and lumbar region and a ventroflexion moment in the upper thoracic and cervical region. Given the bending moments and the position of the scapula during stance, it is proposed that two groups of scapular muscles provide the major antigravity support for the head and anterior trunk. Levator scapulae and serratus ventralis form the lateral group, inserting on the lateral processes of cervical vertebrae and on the ribs. The major and minor rhomboids form the medial group, inserting on the spinous tips of vertebrae from C4 to T4. It is also proposed that the hypaxial muscles, psoas major, minor, and quadratus

Cervical carcinoma and sexual behavior: collaborative reanalysis of individual data on 15,461 women with cervical carcinoma and 29,164 women without cervical carcinoma from 21 epidemiological studies

DEFF Research Database (Denmark)

Kjær, Susanne Krüger

2009-01-01

of sexual partners and age at first sexual intercourse from 21 studies, or groups of studies, including 10,773 women with invasive cervical carcinoma, 4,688 women with cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ, and 29,164 women without cervical carcinoma. Relative risks......High-risk human papillomavirus (HPV) types cause most cervical carcinomas and are sexually transmitted. Sexual behavior therefore affects HPV exposure and its cancer sequelae. The International Collaboration of Epidemiological Studies of Cervical Cancer has combined data on lifetime number...... for invasive cancer and CIN3 were estimated by conditional logistic regression. Risk of invasive cervical carcinoma increased with lifetime number of sexual partners (P for linear trend or =6 versus 1 partner, conditioned on age, study, and age at first intercourse, was 2...

Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissection – case report

International Nuclear Information System (INIS)

Nesteruk, Tomasz; Nesteruk, Marta; Bulik-Pasińska, Marta; Boroszko, Dariusz; Ostrowska, Monika

2012-01-01

Internal carotid artery dissection (ICAD) is a frequent cause of a stroke in young patients. Risk factors which can lead to dissection include neck injury and diseases of the inner wall of the artery. Common symptoms in ICAD are cervical pain and headache, Horner’s syndrome, paralysis of the cranial nerves and subsequently cerebral and retinal ischemia. MR angiography in TOF technique and brain MRI in T1- and T2-weighted images, FLAIR and DWI sequences are the method of choice in patients with ICAD but contrast-enhanced multislice computed tomography remains the fastest and the most available diagnostic method. A 39-year old woman, previously healthy, presented to the Hospital Emergency Department because of increasing neck pain on the right side and difficulty in swallowing. The neurological examination revealed: drooping of the right eyelid with narrow palpebral fissure, dysarthria, anisocoria (narrower pupil on the right side), unilateral hypoesthesia on the left side, weak palatal and pharyngeal reflexes on both sides, paresthesia within the left half of the body. Seven days before, the patient felt a sudden, severe neck pain radiating to the temporal apophysis. CT angiography revealed a defect in contrast filling within the left internal carotid artery and right vertebral artery. MRI of the head with MR angiography showed internal carotid artery dissection on the left side and dissection of the right vertebral artery and no ischemic changes within the brain. CT and MR angiography are methods characterized by high sensitivity in detecting dissection of the cervical arteries

Computer tomographic investigations of cervical spinal stenosis

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Rodiek, S.O.

1983-10-01

Computed tomography was applied in 29 patients with cervical spinal stenosis. In 8 cases there was a congenital narrowed spinal canal. In 18 cases we found dorsal spondylotic ridges of the vertebral bodies and in three cases an atlanto-dental dislocation. The complaints showed either radicular character or in case of myelopathy came out as para- and quadriplegia. In 25 cases the spinal sagittal diamter was a lot below a critical borderline of about 13 mm. The kind and localisation of the underlying process can be demonstrated very excellent by computed tomography.

Computer tomographic investigations of cervical spinal stenosis

International Nuclear Information System (INIS)

Rodiek, S.O.

1983-01-01

Computed tomography was applied in 29 patients with cervical spinal stenosis. In 8 cases there was a congenital narrowed spinal canal. In 18 cases we found dorsal spondylotic ridges of the vertebral bodies and in three cases an atlanto-dental dislocation. The complaints showed either radicular character or in case of myelopathy came out as para- and quadriplegia. In 25 cases the spinal sagittal diamter was a lot below a critical borderline of about 13 mm. The kind and localisation of the underlying process can be demonstrated very excellent by computed tomography. (orig.) [de

Tricortical cervical inter-body screw fixation.

Directory of Open Access Journals (Sweden)

Goel A

1997-01-01

Full Text Available A new tricortical method of screw implantation for anterior cervical interbody plate fixation is described. The screws are placed obliquely such that they engage the anterior cortex of the body and traverse through the cortices adjoining the disc space. By this method the screws not only hold the plate firmly with a tricortical purchase, but by virtue of their course stabilize the two adjoining vertebral bodies by themselves. Sixteen patients were treated by this method. In three of these cases only tricortical screws without the metal plate were used for fixation. The advantages of the technique are discussed.

Hypertrophic anterior cervical osteophytes causing dysphagia and airway obstruction.

Science.gov (United States)

Lin, Harrison W; Quesnel, Alicia M; Holman, Allison S; Curry, William T; Rho, Michael B

2009-10-01

Hyperostosis of anterior cervical vertebral osteophytes can produce otolaryngological symptoms ranging from mild dysphagia, dysphonia, and foreign body sensation to severe food impaction and stridulous dyspnea. Airway compromise necessitating a tracheostomy is very rare. We discuss the case of an elderly man who presented with progressive dysphagia and a large hypopharyngeal mass as his initial manifestations of hypertrophic anterior cervical osteophytes. After a biopsy of the mass, the patient went into airway distress due to bilateral vocal fold fixation by the enlarging mass and consequently required a surgical airway. A combined team approach to the removal of the osteophytes successfully resolved his symptoms. The clinical, diagnostic, radiologic, and therapeutic principles involved in this case are presented and discussed. The recognition of hypertrophic osteophytes as a potential cause of common otolaryngological symptoms in the elderly population is paramount, as these symptoms can rapidly progress and lead to life-threatening airway obstruction. Medical and surgical interventions can be employed for the treatment of hypertrophic anterior cervical osteophytes, and they often result in favorable outcomes.

Variability in Treatment for Patients with Cervical Spine Fracture and Dislocation: An Analysis of 107,152 Patients.

Science.gov (United States)

Wang, Jing; Eltorai, Adam E M; DePasse, J Mason; Durand, Wesley; Reid, Daniel; Daniels, Alan H

2018-06-01

Cervical spine injuries are a common cause of morbidity and mortality; however, the optimal treatment of many of these injuries is debated, and previous studies have shown substantial variation in treatment. We sought to examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients over a 12-year period. Data from the Healthcare Cost and Utilization Project National Inpatient Sample, from 2000 to 2011, were used for this study. Patients were identified with a cervical vertebral facture or dislocation based on the International Classification of Diseases, 9th Revision codes. Using χ 2 analysis, spinal arthrodesis rates and halo/tong placement rates were compared between hospitals based on teaching status for patients with and without spinal cord injury (SCI). The records of 107,152 patients with cervical fractures were examined. From 2000 to 2011, the overall arthrodesis rates fell from 25.2% to 20.6% (P < 0.001), and halo/tong placement rates fell from 13.2% to 3.6% (P < 0.001). In patients with cervical fracture without SCI, arthrodesis rates fell from 17.6% to 13.9% (P < 0.001), in cervical fracture patients with SCI, arthrodesis rates rose from 50.0% to 58.9% (P < 0.001), and in cervical dislocation patients, arthrodesis rates rose from 47.6% to 57.5% (P < 0.001). During the 12-year period, teaching hospitals had higher arthrodesis rates compared with nonteaching hospitals for patients with cervical fractures with SCI (57.3% vs. 53.4%, P = 0.001) and higher halo/tong placement rates for patients with cervical dislocations (2.7% vs. 1.7%, P = 0.004). Individual hospital variation showed a 3.5-fold variation in arthrodesis rates in 2000 to 2002, which fell to 3.0-fold by 2009 to 2011. Arthrodesis rates for cervical fracture patients significantly decreased, and arthrodesis rates for cervical dislocation and SCI patients increased from 2000 to 2011, with variability in treatment based on hospital teaching status

Normal morphology of the cervical spinal cord and spinal canal using MRI in Japanese

International Nuclear Information System (INIS)

Kato, Fumihiko; Yukawa, Yasutsugu; Suda, Kota; Yamagata, Masatsune; Ueta, Takayoshi

2010-01-01

The purpose of this study was to establish standard MRI values for the cervical spinal canal, dural tube, and spinal cord in healthy Japanese subjects and to define developmental stenosis of the cervical spinal canal based on MRI data. To establish standard values for ''finger grip and release in 10 seconds (G and R test)'' and ''10 second step test'' in healthy Japanese subjects. There were approximately 100 volunteers representing each gender and generation, including persons aged in their 20s to 70s. The sagittal diameter of the spinal canal, and the sagittal diameter and axial area of the dural tube and spinal cord were measured on MRIs of 1,211 subjects. From this data, we calculated the spinal cord occupation rate in the dural tube for defining developmental stenosis of the cervical spinal canal. ''Finger grip and release in 10 seconds (G and R test)'' and ''10 second step test'' were also examined on 1,211 subjects. The spinal canal diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 11.7±1.6 mm in males and 11.6±1.5 mm in females, while that at the C5 vertebral body level was 12.9±1.4 mm in males and 12.5±1.3 mm in females. Dural tube diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 9.5±1.8 mm in males and 9.6±1.6 mm in females, while that at the C5 vertebral body level was 11.2±1.4 mm in males and 11.1±1.4 mm in females. Dural tube area in axial images for all ages at the C5/6 intervertebral disc level was 155.7±32.1 mm 2 in males and 149.6±29.0 mm 2 in females, while that at the C5 vertebral body level was 187.4±32.6 mm 2 in males and 177.0±32.7 mm 2 in females. Spinal cord diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 5.9±1.0 mm in males and 5.8±0.9 mm in females, while that at the C5 vertebral body level was 6.5±0.7 mm in males and 6.4±0.7 mm in females. Spinal cord area in axial images for all ages at the C5/6 intervertebral disc level

A comparison of skeletal maturation in patients with tooth agenesis and unaffected controls assessed by the cervical vertebral maturation (CVM) index.

Science.gov (United States)

Casey, Christine; Gill, Daljit S; Jones, Steven P

2013-12-01

The aims of this study were to (1) investigate if there is a difference in skeletal maturation between tooth agenesis and control patients and (2) whether skeletal maturation is affected by the severity of tooth agenesis. The cervical vertebral maturation (CVM) index can be used to assess skeletal maturation. A retrospective cross-sectional study. Eastman Dental Hospital, London, UK. A total of 360 cephalograms of patients aged 9-17 years (164 males and 196 females) allocated to four subgroups (mild, moderate and severe tooth agenesis patients, and controls) were assessed retrospectively. There were 90 patients in each of the four subgroups. The skeletal maturation of each subject was assessed both quantitatively and qualitatively using the CVM index. All patients in the study were either currently receiving treatment or had been discharged from the hospital. There was no statistically significant relationship between skeletal maturation and the presence of tooth agenesis. Furthermore, there was no statistically significant relationship between the skeletal maturity of patients and different severities of tooth agenesis. The data obtained from this group of patients and using this measurement tool alone does not supply sufficient reason to reject the null hypothesis. However, it suggests that it is possible that no difference exists between the groups.

The spontaneous spinal epidural hematoma : A clinical and anatomical study with correlations to the morphology of the internal vertebral venous plexus

NARCIS (Netherlands)

Groen, Rob

1997-01-01

This thesis concerns a clinical study of the spontaneous spinal epidural hematoma (SSEH) and a study of the vascular anatomy of the spinal epidural space. In particular the morphology of the internal vertebral venous plexus is studied, in an attempt to find an explanation for the etiology of this

An experimental study on the computed tomography of the cervical spinal canal

International Nuclear Information System (INIS)

Wakabayashi, Tsuguru

1980-01-01

A study was carried out to investigate how accurately CT could delineate the vertebral canal, vertebral body, lamina, intervertebral foramen and transverse process, and which factor influences the size of the vertebral canal, using cervical vertebrae obtained from four cadavers and one skeleton. EMI CT 5005 scanner was used. CT picture depicted accurate shapes of the vertebral canal, body and transverse process. The sagittal diameter of the vertebral canal of CT picture varied by various conditions, such as difference of scanning chance, scanning angle, window width and level, but variations due to different absorption coefficients of the bone surrounding the vertebral canal were negligible. It was most significantly changed by scanning angle. Permissible scanning angle was within 5 0 , and morphological findings were not influenced up to 15 0 . The size of the vertebral canal was most accurately measured under the condition of 400 in width and 250 in level. The optimal condition for delineation of the spine seemed to be 400 in width and 100 - 150 in level. Under the condition at width 400 and level 100, the vertebral canal was delineated narrower by an average 0.6 mm and 0.2 mm in the sagittal and transverse diameter respectively. In CT picture of the imitational ossified posterior Longitudinal ligament made of plastic and alginate, the average narrowing rate of the vertebral canal was 4.4% greater than the one obtained by lateral view of radiograph, but both correlated well with each other. The narrowing rate of the vertebral canal by CT tended to increase in proportion to the increase in scanning angle. (J.P.N.)

Direct Posterior Bipolar Cervical Facet Radiofrequency Rhizotomy: A Simpler and Safer Approach to Denervate the Facet Capsule.

Science.gov (United States)

Palea, Ovidiu; Andar, Haroon M; Lugo, Ramon; Granville, Michelle; Jacobson, Robert E

2018-03-14

Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root. Bilateral lesions require the repositioning of the patient's neck. Poorly positioned electrodes can also pass anteriorly and contact the nerve root or vertebral artery. The direct posterior approach presented allows electrode positioning over a broader expanse of the facet joint without risk to the nerve root or vertebral artery. Over a four-year period, direct posterior radiofrequency ablation was performed under fluoroscopic guidance at multiple levels without neuro-stimulation testing with zero procedural neurologic events even as high as the C2 spinal segment. The direct posterior approach allows either unipolar or bipolar lesioning at multiple levels. Making a radiofrequency lesion along the larger posterior area of the facet capsule is as effective as the traditional target point closer to the nerve root but technically easier, allowing bilateral access and safety. The article will review the anatomy and innervation of the cervical facet joint and capsule, showing the diffuse nerve supply extending into the capsule of the facet joint that is more extensive than the recurrent medial sensory branches that have been the focus of radiofrequency lesioning.

MR imaging studies of multiple myeloma in the vertebral column

International Nuclear Information System (INIS)

Albert, S.; Leeds, N.E.

1990-01-01

This paper studies the sensitivity and characteristics of MR imaging in the diagnosis of myeloma in the vertebral column. The cervical, thoracic, and lumbar spines of 12 patients with known multiple myeloma were imaged with small flip angle, fast gradient-echo, proton-density (FPD) as well as spin-echo T1-weighted, T2-weighted, and intermediate (SE 2,000/20-30) imaging. The FPD images were acquired with pulse sequence gradient recalled acquisition in a steady state at a magnetic field strength of 1.5T with use of a license-plate and a circular surface coil

Study of cervical cord injury without radiological abnormality using MRI at injury

International Nuclear Information System (INIS)

Park, Jin-Soo; Ei, Terumi; Uchida, Yoko; Kodai, Yujiro; Yasumatsu, Hideo; Yoshino, Kazutaka; Hirakawa, Takashi.

1994-01-01

This study was undertaken, using MRI at the time of injury, to examine cervical cord injury without radiological abnormality. The subjects were 30 patients (24 men and 6 women) seen during the 4-year period 1989-1993, who ranged in age from 31 to 83 years (an average age of 62.8 years). Of these patients, 10 had a slightly irregular alignment of the vertebral body on plain X-rays. These 10 patients were examined using MRI early after sustaining trauma (within 24 hours in 9 and 48 hours in one). As a result, spinal cord was seen as isointensity on T1-weighted images and hyperintensity on T2-weighted images, corresponding to irregular alignment. These findings suggest that reduction of a dislocation may transiently occur due to patient transfer or natural elasticity, as plain X-rays indicated no evidence of bone abnormalities. Thus injuries like dislocations may have occurred at the time of trauma, and structural changes of the vertebral body may be responsible for the occurrence of cervical spinal cord. Spinal cord injuries, even if not evidenced on plain X-rays, should not be categorized as non-osseous injuries. (N.K.)

USE OF CT FOR ANALYSIS OF THE VERTEBRAL FORAMEN IN THE HOSPITAL OF QUERÉTARO

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JESÚS CISNEROS LÁMBARRI

Full Text Available ABSTRACT Objective: To determine the morphology of the vertebral foramen and its distance to the midline. Methods: Twenty cervical CT scans from the radiographic record of 12 men and 8 women, 18 to 74 years old, of C1 to C6 segments were evaluated, measuring the foramen diameter and its distance to the midline. We look for anomalies of vertebral foramen morphology, using Philips Ingenuity CT equipment with Philips IntelliSpace Portal software. Results: The mean age was 47 years; the segment with the most anomalies was C1, with 10% (increase in foramen diameter, followed by C2 and C6, with 5% (vertebral foramen hypotrophy; the mean diameter of the C1 to C6 segment was 6.081 mm, and the median distance from the midline to the vertebral foramen of C2 to C6 was 13.215 mm. The largest diameter of the vertebral foramen was C2, with a mean of 6.67 mm and the smallest was C4, with a mean of 5.75 mm; the greatest distance from the midline to the vertebral foramen was C1, with a mean of 22.59 mm and the shortest was C4, with a mean of 12.13 mm. Conclusions: The mean diameter of the vertebral foramen and its distance to the midline was determined, setting a safety region for procedures. In our city, there is no study that determines the means of the vertebral foramina diameters, the distance from the midline and its anomalies. It is necessary to rely on CT scans and to make a preoperative plan to avoid complications associated with morphological alterations.

Cervical peridural calcification in dialysed patients. Report of seven cases

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Okubo, Yasuhiro; Komura, Masayoshi; Fukuda, Minoru; Yamanaka, Mariko; Inose, Kazuto; Honda, Masanori; Shiraishi, Tateru

2007-01-01

Though a variety of bone joint complications are widely recognized in long-term dialysis patients, myelopathy caused by ectopic calcification surrounding the cervical spinal dura has not been reported. We encountered seven patients with the cervical peridural calcification (CPC) and performed surgery on four. The present study investigated the clinical features of this condition. All seven had a dialysis history over 20 years, and the Ca X P product was high. Plain cervical CT scan was the most useful diagnostic tool for CPC, though was quite difficult to establish the diagnosis by plain X-ray, MRI or myelography. Clinical symptoms of CPC resembled those of spinal canal stenosis caused by thickening or ossification of the ligament. The spinal cord in the area of CPC was comppressed with calcified fibrous membrane surrounding the cervical dura mater, swelling and pulsation of spinal cord was obtained after not only excising the vertebral arch but also opening and removing the calcified membrane from the dura. Clinical improvement was obtained only in two patients with a short symptomatic period. Based on these findings, CPC should be recognized as an important complication in dialysed patients. Patients demonstrating any sign of numbness and/or muscle weakness in upper and/or lower limbs should be examined by plain cervical CT scan. If calcification around the spinal dura is identified, surgery should be considered in the early stage. (author)

Optimized image processing with modified preprocessing of image data sets of a transparent imaging plate by way of the lateral view of the cervical spine

International Nuclear Information System (INIS)

Reissberg, S.; Hoeschen, C.; Redlich, U.; Scherlach, C.; Preuss, H.; Kaestner, A.; Doehring, W.; Woischneck, D.; Schuetze, M.; Reichardt, K.; Firsching, R.

2002-01-01

Purpose: To improve the diagnostic quality of lateral radiographs of the cervical spine by pre-processing the image data sets produced by a transparent imaging plate with both-side reading and to evaluate any possible impact on minimizing the number of additional radiographs and supplementary investigations. Material and Methods: One hundred lateral digital radiographs of the cervical spine were processed with two different methods: processing of each data set using the system-imminent parameters and using the manual model. The difference between the two types of processing is the level of the latitude value. Hard copies of the processed images were judged by five radiologists and three neurosurgeons. The evaluation applied the image criteria score (ICS) without conventional reference images. Results: In 99% of the lateral radiographs of the cervical spine, all vertebral bodies could be completed delineated using the manual mode, but only 76% of the images processed by the system-imminent parameters showed all vertebral bodies. Thus, the manual mode enabled the evaluation of up to two additional more caudal vertebral bodies. The manual mode processing was significantly better concerning object size and processing artifacts. This optimized image processing and the resultant minimization of supplementary investigations was calculated to correspond to a theoretical dose reduction of about 50%. (orig.) [de

Measurement of spinal canal narrowing, interpedicular widening, and vertebral compression in spinal burst fractures: plain radiographs versus multidetector computed tomography

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Bensch, Frank V.; Koivikko, Mika P.; Koskinen, Seppo K.; Kiuru, Martti J.

2009-01-01

To assess the reliability of measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening in burst fractures in radiography compared with multidetector computed tomography (MDCT). Patients who had confirmed acute vertebral burst fractures over an interval of 34 months underwent both MDCT and radiography. Measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening from MDCT and radiography were compared. The 108 patients (30 female, 78 male, aged 16-79 years, mean 39 years) had 121 burst fractures. Eleven patients had multiple fractures, of which seven were not contiguous. Measurements showed a strong positive correlation between radiography and MDCT (Spearman's rank sum test: spinal canal narrowing k = 0.50-0.82, vertebral compression k = 0.55-0.72, and interpedicular widening k = 0.81-0.91, all P 0.25) and for interpedicular widening in the thoracic spine (k = 0.35, P = 0.115). The average difference in measurements between the modalities was 3 mm or fewer. Radiography demonstrates interpedicular widening, spinal canal narrowing and vertebral compression with acceptable precision, with the exception of those of the cervical spine. (orig.)

Does the mesodermal derangement in Chiari Type I malformation extend to the cervical spine? Evidence from an analytical morphometric study on cervical paraspinal muscles.

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Thakar, Sumit; Kurudi Siddappa, Avinash; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

2017-10-01

OBJECTIVE The mesodermal derangement in Chiari Type I malformation (CMI) has been postulated to encompass the cervical spine. The objectives of this study were to assess the cross-sectional areas (CSAs) of cervical paraspinal muscles (PSMs) in patients with CMI without syringomyelia, compare them with those in non-CMI subjects, and evaluate their correlations with various factors. METHODS In this retrospective study, the CSAs of cervical PSMs in 25 patients were calculated on T2-weighted axial MR images and computed as ratios with respect to the corresponding vertebral body areas. These values and the cervical taper ratios were then compared with those of age- and sex-matched non-CMI subjects and analyzed with respect to demographic data and clinicoradiological factors. RESULTS Compared with the non-CMI group, the mean CSA values for the rectus capitis minor and all of the subaxial PSMs were lower in the study group, and those of the deep extensors were significantly lower (p = 0.004). The cervical taper ratio was found to be significantly higher in the study cohort (p = 0.0003). A longer duration of symptoms and a steeper cervical taper ratio were independently associated with lower CSA values for the deep extensors (p = 0.04 and p = 0.03, respectively). The presence of neck pain was associated with a lower CSA value for the deep flexors (p = 0.03). CONCLUSIONS Patients with CMI demonstrate alterations in their cervical paraspinal musculature even in the absence of coexistent syringomyelia. Their deep extensor muscles undergo significant atrophic changes that worsen with the duration of their symptoms. This could be related to a significantly steeper cervical taper ratio that their cervical cords are exposed to. Neck pain in these patients is related to atrophy of their deep flexor muscles. A steeper cervical taper ratio and alterations in the PSMs could be additional indicators for surgery in patients with CMI without syringomyelia.

Blunt cerebrovascular trauma causing vertebral arteryd issection in combination with a laryngeal fracture: a case report

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Krettek Christian

2011-08-01

Full Text Available Abstract Introduction The diagnosis and therapy of blunt cerebrovascular injuries has become a focus since improved imaging technology allows adequate description of the injury. Although it represents a rare injury the long-term complications can be fatal but mostly prevented by adequate treatment. Case presentation A 33-year-old Caucasian man fell down a 7-meter scarp after losing control of his quad bike in a remote area. Since endotracheal intubation was unsuccessfully attempted due to the severe cervical swelling as well as oral bleeding an emergency tracheotomy was performed on scene. He was hemodynamically unstable despite fluid resuscitation and intravenous therapy with vasopressors and was transported by a helicopter to our trauma center. He had a stable fracture of the arch of the seventh cervical vertebra and fractures of the transverse processes of C5-C7 with involvement of the lateral wall of the transverse foramen. An abort of the left vertebral artery signal at the first thoracic vertebrae with massive hemorrhage as well as a laryngeal fracture was also detected. Further imaging showed retrograde filling of the left vertebral artery at C5 distal of the described abort. After stabilization and reconfirmation of intracranial perfusion during the clinical course weaning was started. At the time of discharge, he was aware and was able to move all extremities. Conclusion We report a rare case of a patient with vertebral artery dissection in combination with a laryngeal fracture after blunt trauma. Thorough diagnostic and frequent reassessments are recommended. Most patients can be managed with conservative treatment.

Effectiveness of the cervical vertebral maturation method to predict postpeak circumpubertal growth of craniofacial structures.

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Fudalej, Piotr; Bollen, Anne-Marie

2010-01-01

Our aim was to assess effectiveness of the cervical vertebral maturation (CVM) method to predict circumpubertal craniofacial growth in the postpeak period. The CVM stage was determined in 176 subjects (51 adolescent boys and 125 adolescent girls) on cephalograms taken at the end of treatment (T2; mean ages, 15.75 years [boys] and 15.23 years [girls]) in subjects from the postretention database at the University of Washington in Seattle. Craniofacial growth was evaluated from the following measurements on cephalograms at T2 and end of follow-up (T3) (mean ages, 29.01 years [men] and 28.08 years [women]): condylion to gnathion, condylion to gonion, gonion to gnathion, sella to gnathion, nasion to menton, anterior nasal spine to menton, and sella to gonion. The change of each variable from T2 to T3 was assessed with paired t tests. Parametric (t tests or analysis of variance [ANOVA]) or nonparametric (Mann-Whitney or Kruskal-Wallis) tests were used to detect intergroup differences. One hundred eight subjects (35 boys, 73 girls) demonstrated CVM stage 3, 56 (16 boys, 40 girls) were in CVM stage 4, and 12 (all girls) were in CVM stage 5 at T2. Intrasex comparisons showed that boys in CVM stages 3 and 4 could be differentiated regarding changes of all variables. In the girls, only those in CVM stages 3 and 4 could be differentiated based on the amount of changes of 2 measurements: condylion to gonion and sella to gonion. Intersex comparisons showed that boys in CVM stage 3 had significantly more changes than girls (P <0.01). Boys in CVM stage 4 showed significant differences compared with girls in CVM stage 4 for only 2 variables (sella to gonion and condylion to gonion; P <0.001 and P = 0.012, respectively). The CVM method was modestly effective in determining the amount of postpeak circumpubertal craniofacial growth. Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Computer Based Assessment of Cervical Vertebral Maturation Stages Using Digital Lateral Cephalograms

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Dzemidzic, Vildana; Sokic, Emir; Tiro, Alisa; Nakas, Enita

2015-01-01

Objective: This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. Material and methods: For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no histo...

Vertebral artery variations and osseous anomaly at the C1-2 level diagnosed by 3D CT angiography in normal subjects

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Wakao, Norimitsu; Kamiya, Mitsuhiro [Aichi Medical University, Department of Spine Center, Aichi (Japan); Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan); Takeuchi, Mikinobu; Hirasawa, Atsuhiko; Kawanami, Katsuhisa; Takayasu, Masakazu [Aichi Medical University, Department of Spine Center, Aichi (Japan); Nishimura, Manabu [Aichi Medical University, Department of Radiology, Nagakute, Aichi (Japan); Riew, K.D. [Washington University, Department of Orthopedic Surgery, St. Louis, MO (United States); Imagama, Shiro [Nagoya University, Department of Orthopedic Surgery, Nagoya, Aichi (Japan); Sato, Keiji [Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan)

2014-10-15

The craniovertebral junction is anatomically complicated. Representative vertebral artery (VA) variations include the persistent first intersegmental artery (FIA), fenestration of the VA above and below C1 (FEN), posterior inferior cerebellar artery (PICA) from C1/2, and high-riding VA (HRVA). The ponticulus posticus (PP) is a well-known osseous anomaly at C1. Although those anomalies are frequent in patients with cervical deformity, the prevalence of these in subjects with normal cervical spines is still unknown. The aim of this study is to investigate the variations and prevalence of vascular and osseous anomalies based on three-dimensional computed tomographic (3D CT) angiography in patients without any cervical diseases, such as rheumatoid arthritis, Klippel-Feil syndrome, or Down syndrome. Eligible subjects were patients who underwent 3D CT angiography by the Department of Otorhinolaryngology and Internal Medicine from January 2009 to October 2013 in our institution. The authors defined a HRVA as a C2 pedicle with a maximum diameter of 4 mm or less. Among 480 subjects with a mean age of 63.1 years, 387 patients were eligible. One hundred and eighteen subjects were female, and 269 were male. HRVA was observed in 10.1 % of patients (39 out of 387 cases), FIA in 1.8 % (7 cases), FEN in 1.3 % (5 cases), and PICA in 1.3 % (5 cases). PP was observed in 6.2 % of patients (24 cases). According to past reports, many VA anomalies could be attributed to congenital or acquired conditions (e.g., rheumatoid arthritis). However, VA anomalies appear to exist even in patients without any such cervical diseases. (orig.)

A nomenclature for vertebral fossae in sauropods and other saurischian dinosaurs.

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Jeffrey A Wilson

Full Text Available BACKGROUND: The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs, like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity. Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae, but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. METHODOLOGY/PRINCIPAL FINDINGS: We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses. We standardize the naming process by creating tripartite names from "primary landmarks," which form the zygodiapophyseal table, "secondary landmarks," which orient with respect to that table, and "tertiary landmarks," which further delineate a given fossa. CONCLUSIONS/SIGNIFICANCE: The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental

Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients

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Schicho A

2018-01-01

Full Text Available Andreas Schicho,1 Lukas Luerken,1 Ramona Meier,1 Antonio Ernstberger,2 Christian Stroszczynski,1 Andreas Schreyer,1 Lena-Marie Dendl,1 Stephan Schleder1 1Department of Radiology, 2Department of Trauma Surgery, University Medical Center, Regensburg, Germany Purpose: The aim of this study was to evaluate the true incidence of cervical artery dissections (CeADs in trauma patients with an Injury Severity Score (ISS of ≥16, since head-and-neck computed tomography angiogram (CTA is not a compulsory component of whole-body trauma computed tomography (CT protocols. Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included. Standardized whole-body CT in a 256-detector row scanner included a head-and-neck CTA. Incidence, mortality, patient and trauma characteristics, and concomitant injuries were recorded and analyzed retrospectively in patients with carotid artery dissection (CAD and vertebral artery dissection (VAD. Results: Of the 230 patients included, 6.5% had a CeAD, 5.2% had a CAD, and 1.7% had a VAD. One patient had both CAD and VAD. For both, CAD and VAD, mortality is 25%. One death was caused by fatal cerebral ischemia due to high-grade CAD. A total of 41.6% of the patients with traumatic CAD and 25% of the patients with VAD had neurological sequelae. Conclusion: Mandatory head-and-neck CTA yields higher CeAD incidence than reported before. We highly recommend the compulsory inclusion of a head-and-neck CTA to whole-body CT routines for severely injured patients. Keywords: polytrauma, carotid artery, vertebral artery, dissection, blunt trauma, computed tomography angiogram

Developmental steps of the human cervical spine: parameters for evaluation of skeletal maturation stages.

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dos Santos, Marcos Fabio Henriques; de Lima, Rodrigo Lopes; De-Ary-Pires, Bernardo; Pires-Neto, Mário Ary; de Ary-Pires, Ricardo

2010-06-01

The central objective of this investigation was to focus on the development of the cervical spine observed by lateral cephalometric radiological images of children and adolescents (6-16 years old). A sample of 26 individuals (12 girls and 14 boys) was classified according to stages of cervical spine maturation in two subcategories: group I (initiation phase) and group II (acceleration phase). The morphology of the cervical spine was assessed by lateral cephalometric radiographs obtained in accordance with an innovative method for establishing a standardized head posture. A total of 29 linear variables and 5 angular variables were used to clarify the dimensions of the cervical vertebrae. The results suggest that a few measurements can be used as parameters of vertebral maturation both for males and females. The aforementioned measurements include the inferior depth of C2-C4, the inferior depth of C5, the anterior height of C4-C5, and the posterior height of C5. We propose original morphological parameters that may prove remarkably useful in the determination of bone maturational stages of the cervical spine in children and adolescents.

Primary Ewing's sarcoma of the vertebral column

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Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, Ch2-290 200 First Street, SW, Rochester, 55905, MN (United States); Unni, K.Krishnan [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States); Dekutoski, Mark B. [Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States)

2004-09-01

To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three cases were mixed lytic and sclerotic (6%) and one sclerotic. In the nonsacral spine, the majority of lesions (12/20) involved the posterior elements with extension into the vertebral body. Five cases were centered in the vertebral body with extension into the posterior elements. Two cases were limited to the posterior elements, and one case solely involved the vertebral body. Ala was the most frequently affected site in the sacrum (18/26). Spinal canal invasion was frequent (91%). Detailed clinical information was available in 53 patients. Duration of symptoms ranged from 1 to 30 (mean 7) months. Local pain was the first symptom and seen in all cases. Neurological deficits were present in 21 (40%) cases. All patients received radiation in various dosages; 70% additionally received chemotherapy. Twenty-five patients had surgery, and two patients received bone marrow transplantation. Forty-five patients had follow-up; the five-year disease-free survival probability is 0

Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation.

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María José Fernández-Pérez

Full Text Available The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM in growing and young adult subjects using cone beam computed tomography (CBCT. CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method. Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89 that essential was similar for females (r = 0.88 and males (r = 0.89. CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.

Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation.

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Fernández-Pérez, María José; Alarcón, José Antonio; McNamara, James A; Velasco-Torres, Miguel; Benavides, Erika; Galindo-Moreno, Pablo; Catena, Andrés

2016-01-01

The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.

[A case of medulla oblongata compression by tortuous vertebral arteries presenting with spastic quadriplegia].

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Kamada, Takashi; Tateishi, Takahisa; Yamashita, Tamayo; Nagata, Shinji; Ohyagi, Yasumasa; Kira, Jun-Ichi

2013-01-01

We report a 58-year-old man showing spastic paraparesis due to medulla oblongata compression by tortuous vertebral arteries. He noticed weakness of both legs and gait disturbance at the age of 58 years and his symptoms progressively worsened during the following several months. General physical findings were normal. Blood pressure was normal and there were no signs of arteriosclerosis. Neurological examination on admission revealed lower-limb-dominant spasticity in all four extremities, lower-limb weakness, hyperreflexia in all extremities with positive Wartenberg's, Babinski's and Chaddock's signs, mild hypesthesia and hypopallesthesia in both lower limbs, and spastic gait. Cranial nerves were all normal. Serum was negative for antibodies against human T-cell lymphotropic virus-1 antibody. Nerve conduction and needle electromyographic studies of all four limbs revealed normal findings. Cervical, thoracic and lumbo-sacral magnetic resonance imaging (MRI) findings were all normal. Brain MRI and magnetic resonance angiography demonstrated bilateral tortuous vertebral arteries compressing the medulla oblongata. Neurovascular decompression of the right vertebral artery was performed because compression of the right side was more severe than that of the left side. Post-operative MRI revealed outward translocation of the right vertebral artery and relieved compression of the medulla oblongata on the right side. The patient's symptoms and neurological findings improved gradually after the operation. Bilateral pyramidal tract signs without cranial nerve dysfunction due to compression of the medulla oblongata by tortuous vertebral arteries are extremely rare and clinically indistinguishable from hereditary spastic paraplegia (HSP). Although we did not perform a genetic test for HSP, we consider that the spastic paraparesis and mild lower-limb hypesthesia were caused by compression of the medulla oblongata by bilateral tortuous vertebral arteries based on the post

Vertebrate Embryonic Cleavage Pattern Determination.

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Hasley, Andrew; Chavez, Shawn; Danilchik, Michael; Wühr, Martin; Pelegri, Francisco

2017-01-01

The pattern of the earliest cell divisions in a vertebrate embryo lays the groundwork for later developmental events such as gastrulation, organogenesis, and overall body plan establishment. Understanding these early cleavage patterns and the mechanisms that create them is thus crucial for the study of vertebrate development. This chapter describes the early cleavage stages for species representing ray-finned fish, amphibians, birds, reptiles, mammals, and proto-vertebrate ascidians and summarizes current understanding of the mechanisms that govern these patterns. The nearly universal influence of cell shape on orientation and positioning of spindles and cleavage furrows and the mechanisms that mediate this influence are discussed. We discuss in particular models of aster and spindle centering and orientation in large embryonic blastomeres that rely on asymmetric internal pulling forces generated by the cleavage furrow for the previous cell cycle. Also explored are mechanisms that integrate cell division given the limited supply of cellular building blocks in the egg and several-fold changes of cell size during early development, as well as cytoskeletal specializations specific to early blastomeres including processes leading to blastomere cohesion. Finally, we discuss evolutionary conclusions beginning to emerge from the contemporary analysis of the phylogenetic distributions of cleavage patterns. In sum, this chapter seeks to summarize our current understanding of vertebrate early embryonic cleavage patterns and their control and evolution.

Mechanical implications of pneumatic neck vertebrae in sauropod dinosaurs

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Schwarz-Wings, Daniela; Meyer, Christian A.; Frey, Eberhard; Manz-Steiner, Hans-Rudolf; Schumacher, Ralf

2010-01-01

The pre-sacral vertebrae of most sauropod dinosaurs were surrounded by interconnected, air-filled diverticula, penetrating into the bones and creating an intricate internal cavity system within the vertebrae. Computational finite-element models of two sauropod cervical vertebrae now demonstrate the mechanical reason for vertebral pneumaticity. The analyses show that the structure of the cervical vertebrae leads to an even distribution of all occurring stress fields along the vertebrae, concentrated mainly on their external surface and the vertebral laminae. The regions between vertebral laminae and the interior part of the vertebral body including thin bony struts and septa are mostly unloaded and pneumatic structures are positioned in these regions of minimal stress. The morphology of sauropod cervical vertebrae was influenced by strongly segmented axial neck muscles, which require only small attachment areas on each vertebra, and pneumatic epithelia that are able to resorb bone that is not mechanically loaded. The interaction of these soft tissues with the bony tissue of the vertebrae produced lightweight, air-filled vertebrae in which most stresses were borne by the external cortical bone. Cervical pneumaticity was therefore an important prerequisite for neck enlargement in sauropods. Thus, we expect that vertebral pneumaticity in other parts of the body to have a similar role in enabling gigantism. PMID:19801376

Clinical anatomy and clinical significance of the cervical intervertebral foramen: a review.

Science.gov (United States)

Sioutas, G; Kapetanakis, S

2016-01-01

The aim of this paper is to summarise the knowledge about the anatomy of the cervical intervertebral foramen as a whole. Such reviews are rare in the literature. The intervertebral or neural foramen is the opening between the spinal canal and the extraspinal region. It is located between the vertebral pedicles at all spinal levels. A number of structures pass through the foramen: nerves, vessels and ligaments. We describe the bony borders and dimensions of the foramen, the adjacent ligaments, the arteries and veins passing through or neighbouring it, and the neural components. Many procedures are performed in the area of the cervical intervertebral foramen. Knowledge of the anatomy of the foramen is essential in order to operate to the area and to minimize iatrogenic injuries.

Arteriovenous malformations of the cervical spinal cord

International Nuclear Information System (INIS)

Nagasawa, Shiro; Yoshida, Shinzo; Ishikawa, Masatsune; Yonekawa, Yasuhiro; Handa, Hajime

1984-01-01

Arteriovenous malformation (AVM) of the cervical spinal cord has been known to constitute 5-13% of all spinal AVMs. In contrast to the AVMs located in thoracic or thoraco-lumbar regions, cervical AVM has several characteristic features such as preponderance in younger generation, high incidence of subarachnoid hemorrhage, intramedullary location of the nidus usually fed by the anterior spinal arterial system. We reported three cases of cervical AVMs, which located intramedullary at the levels of C 4 -C 6 , C 1 -C 4 and C 1 -C 2 , respectively. Although selective angiography (vertebral artery, thyrocervical artery, costocervical artery) was essential for the diagnosis of these lesions, computerized tomographic (CT) study with both intrathecal injection of metrizamide and intravenous infusion of contrast material (dynamic and static study) was found to be extremely advantageous in detecting the topography of AVMs in the concerned horizontal planes of the spinal cord. Removal of AVM was given up in one case because of its possible involvement of the anterior spinal artery and central artery shown by CT scan. Removal of AVMs were performed in other two cases. A lateral approach was tried in one case with the AVM located in C 1 -C 2 level, in which CT scan revealed not only an intramedullary but the associated extramedullary AVM in ventrolateral surface of the spinal cord. This operative approach was found to involve less bone removal and markedly reduce spinal cord manipulation necessary to deal with ventrally situated high cervical lesions, compared with a posterior approach with laminectomy. (author)

Treatment and posttreatment effects of mandibular cervical headgear followed by fixed appliances in Class III malocclusion.

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Rey, Diego; Angel, David; Oberti, Giovanni; Baccetti, Tiziano

2008-03-01

In this cephalometric investigation, we compared the treatment and posttreatment effects on patients undergoing an initial phase of mandibular cervical headgear (MCH) therapy followed later by comprehensive edgewise therapy with untreated Class III controls. The treated sample consisted of 21 patients treated consecutively with MCH before the pubertal growth spurt (average age, 10 years 2 months at the beginning of treatment). At the final observation period (average age, 15 years 3 months), all patients were in decelerative growth phases as determined by the cervical vertebral maturation method. Active treatment and posttreatment effects were evaluated in the treated group with nonparametric statistical analysis for paired samples. The treated sample was compared with a nonparametric statistical test for independent samples with 20 untreated Class III subjects who were matched for malocclusion, sex, and stage of cervical vertebral maturation to the treatment group. MCH therapy followed by fixed appliances was shown to be an effective treatment for the correction of skeletal Class III malocclusion at postpubertal observation. The favorable skeletal effects consisted mainly of smaller increases in mandibular length and advancement with respect to the controls, with the final outcome of significant improvements in the sagittal skeletal (+4 mm for the Wits appraisal) and dental (+2.7 mm for overjet, -4.4 mm for molar relationship) parameters. This treatment protocol also induced significant downward rotation of the mandible (2.8 degrees ).

Evolution of neck vertebral shape and neck retraction at the transition to modern turtles: an integrated geometric morphometric approach.

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Werneburg, Ingmar; Wilson, Laura A B; Parr, William C H; Joyce, Walter G

2015-03-01

The unique ability of modern turtles to retract their head and neck into the shell through a side-necked (pleurodiran) or hidden-necked (cryptodiran) motion is thought to have evolved independently in crown turtles. The anatomical changes that led to the vertebral shapes of modern turtles, however, are still poorly understood. Here we present comprehensive geometric morphometric analyses that trace turtle vertebral evolution and reconstruct disparity across phylogeny. Disparity of vertebral shape was high at the dawn of turtle evolution and decreased after the modern groups evolved, reflecting a stabilization of morphotypes that correspond to the two retraction modes. Stem turtles, which had a very simple mode of retraction, the lateral head tuck, show increasing flexibility of the neck through evolution towards a pleurodiran-like morphotype. The latter was the precondition for evolving pleurodiran and cryptodiran vertebrae. There is no correlation between the construction of formed articulations in the cervical centra and neck mobility. An increasing mobility between vertebrae, associated with changes in vertebral shape, resulted in a more advanced ability to retract the neck. In this regard, we hypothesize that the lateral tucking retraction of stem turtles was not only the precondition for pleurodiran but also of cryptodiran retraction. For the former, a kink in the middle third of the neck needed to be acquired, whereas for the latter modification was necessary between the eighth cervical vertebra and first thoracic vertebra. Our paper highlights the utility of 3D shape data, analyzed in a phylogenetic framework, to examine the magnitude and mode of evolutionary modifications to vertebral morphology. By reconstructing and visualizing ancestral anatomical shapes, we provide insight into the anatomical features underlying neck retraction mode, which is a salient component of extant turtle classification. © The Author(s) 2014. Published by Oxford University Press

Optimized cervical spine bone SPET for detection of facet joint injury after whiplash injury

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Cardaci, G T; Bower, G D; Taylor, J [Perth and Perth Pain Management, South Perth, WA (Australia). Mount Medical Centre, Isotope Imaging

1999-04-01

Full text: The most frequent origin for chronic cervical pain in patients with a remote history of whiplash injury is the cervical facet joints. Exact localization of facet joint injury is difficult and currently advocated methods include multiple invasive diagnostic injections. Optimization of {sup 99}Tc{sup m}-HDP cervical SPET (CSPET) to accurately localize facet joint pathology was attempted and the results correlated with clinical localization relying on focal joint tenderness and passive movement methods. Imaging was performed on a dual-headed gamma camera system using an elliptical orbit over 360 deg. The patient's neck was flexed to eliminate the cervical lordosis. Reconstructed CSPET images were reorientated into the long axis of the vertebral bodies. CSPET studies were independently scored by two observers blinded to the clinical and other imaging information and correlated with clinical localization and response to radiofrequency ablation. 54 patients have been studied using this technique in a prospective study. Early patient follow-up data will be presented. CSPET was felt to be clinically useful by pain therapists in targeting treatment.

Optimized cervical spine bone SPET for detection of facet joint injury after whiplash injury

International Nuclear Information System (INIS)

Cardaci, G.T.; Bower, G.D.; Taylor, J.

1999-01-01

Full text: The most frequent origin for chronic cervical pain in patients with a remote history of whiplash injury is the cervical facet joints. Exact localization of facet joint injury is difficult and currently advocated methods include multiple invasive diagnostic injections. Optimization of 99 Tc m -HDP cervical SPET (CSPET) to accurately localize facet joint pathology was attempted and the results correlated with clinical localization relying on focal joint tenderness and passive movement methods. Imaging was performed on a dual-headed gamma camera system using an elliptical orbit over 360 deg. The patient's neck was flexed to eliminate the cervical lordosis. Reconstructed CSPET images were reorientated into the long axis of the vertebral bodies. CSPET studies were independently scored by two observers blinded to the clinical and other imaging information and correlated with clinical localization and response to radiofrequency ablation. 54 patients have been studied using this technique in a prospective study. Early patient follow-up data will be presented. CSPET was felt to be clinically useful by pain therapists in targeting treatment

Posterior cervical spine arthrodesis with laminar screws. A report of two cases

International Nuclear Information System (INIS)

Nakanishi, Kazuo; Tanaka, Masato; Sugimoto, Yoshihisa; Ozaki, Toshifumi

2007-01-01

We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS). When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2). Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion. (author)

Diagnostic reliability of the cervical vertebral maturation method and standing height in the identification of the mandibular growth spurt.

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Perinetti, Giuseppe; Contardo, Luca; Castaldo, Attilio; McNamara, James A; Franchi, Lorenzo

2016-07-01

To evaluate the capability of both cervical vertebral maturation (CVM) stages 3 and 4 (CS3-4 interval) and the peak in standing height to identify the mandibular growth spurt throughout diagnostic reliability analysis. A previous longitudinal data set derived from 24 untreated growing subjects (15 females and nine males,) detailed elsewhere were reanalyzed. Mandibular growth was defined as annual increments in Condylion (Co)-Gnathion (Gn) (total mandibular length) and Co-Gonion Intersection (Goi) (ramus height) and their arithmetic mean (mean mandibular growth [mMG]). Subsequently, individual annual increments in standing height, Co-Gn, Co-Goi, and mMG were arranged according to annual age intervals, with the first and last intervals defined as 7-8 years and 15-16 years, respectively. An analysis was performed to establish the diagnostic reliability of the CS3-4 interval or the peak in standing height in the identification of the maximum individual increments of each Co-Gn, Co-Goi, and mMG measurement at each annual age interval. CS3-4 and standing height peak show similar but variable accuracy across annual age intervals, registering values between 0.61 (standing height peak, Co-Gn) and 0.95 (standing height peak and CS3-4, mMG). Generally, satisfactory diagnostic reliability was seen when the mandibular growth spurt was identified on the basis of the Co-Goi and mMG increments. Both CVM interval CS3-4 and peak in standing height may be used in routine clinical practice to enhance efficiency of treatments requiring identification of the mandibular growth spurt.

Reintroduction of locally extinct vertebrates impacts arid soil fungal communities.

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Clarke, Laurence J; Weyrich, Laura S; Cooper, Alan

2015-06-01

Introduced species have contributed to extinction of native vertebrates in many parts of the world. Changes to vertebrate assemblages are also likely to alter microbial communities through coextinction of some taxa and the introduction of others. Many attempts to restore degraded habitats involve removal of exotic vertebrates (livestock and feral animals) and reintroduction of locally extinct species, but the impact of such reintroductions on microbial communities is largely unknown. We used high-throughput DNA sequencing of the fungal internal transcribed spacer I (ITS1) region to examine whether replacing exotic vertebrates with reintroduced native vertebrates led to changes in soil fungal communities at a reserve in arid central Australia. Soil fungal diversity was significantly different between dune and swale (interdune) habitats. Fungal communities also differed significantly between sites with exotic or reintroduced native vertebrates after controlling for the effect of habitat. Several fungal operational taxonomic units (OTUs) found exclusively inside the reserve were present in scats from reintroduced native vertebrates, providing a direct link between the vertebrate assemblage and soil microbial communities. Our results show that changes to vertebrate assemblages through local extinctions and the invasion of exotic species can alter soil fungal communities. If local extinction of one or several species results in the coextinction of microbial taxa, the full complement of ecological interactions may never be restored. © 2015 John Wiley & Sons Ltd.

Carotid endarterectomy in cervical block anesthesia in patients with occluded contralateral internal carotid artery

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Ilijevski Nenad

2006-01-01

Full Text Available Introduction: The goal of modern carotid surgery is relief of symptoms, stroke prevention, improvement in quality of life, prevention of vascular dementia, and prolongation of lifetime. OBJECTIVE: The objective of this paper was to compare the outcome of carotid endarterectomy in cervical block vs. general anesthesia in patients with occluded contralateral internal carotid artery (ICA. METHOD: One hundred patients (76 male, 24 female, mean age 60.81 years with occluded contralateral ICA were operated from 1997-2000. Neurological symptomatology, deficiency and stroke incidence were preoperatively analyzed in two groups. Duplex-scanning, angiograms and CT-scan confirmed the diagnosis. Risk factors analysis included hypertension, diabetes, lipid metabolism disorders, smoking and history of CAD, CABG and PAOD. Morbidity and mortality were used to compare the outcome of surgery in two groups. RESULTS There was no difference of age, gender and symptomatology between the groups. Paresis, TIA and dysphasia were most frequent. 70%-90% of ICA stenosis was seen in the majority of patients. Hypertension and smoking were dominant risk factors in these two groups. Eversion carotid end arterectomy was the most frequent technique used. In three cases out of nine that were operated under cervical block, the neurological symptoms developed just after clamping, so the intra-luminal shunt was placed. Postoperative morbidity was 12% and mortality was 8%. Conclusion: There was no difference of preoperative parameters, surgical technique and outcome in these two groups. Without other intraoperative monitoring, cervical block anesthesia might be an option in patients with the occlusion of the contralateral ICA. However, prospective studies involving more patients are needed.

A Simple Bone Cyst in Cervical Vertebrae of an Adolescent Patient

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Adriana Bruges Boude

2017-01-01

Full Text Available Introduction. Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. Case Presentation. Incidental Magnetic Resonance Imaging (MRI finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6–12-month follow-up the patient presented no recurrence or symptomatology. Conclusions. Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.

The cervical spine of the American barn owl (Tyto furcata pratincola: I. Anatomy of the vertebrae and regionalization in their S-shaped arrangement.

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Markus Krings

Full Text Available BACKGROUND: Owls possess an extraordinary neck and head mobility. To understand this mobility it is necessary to have an anatomical description of cervical vertebrae with an emphasis on those criteria that are relevant for head positioning. No functional description specific to owls is available. METHODOLOGY/PRINCIPAL FINDINGS: X-ray films and micro-CT scans were recorded from American barn owls (Tyto furcata pratincola and used to obtain three-dimensional head movements and three-dimensional models of the 14 cervical vertebrae (C1-C14. The diameter of the vertebral canal, the zygapophyseal protrusion, the distance between joint centers, and the pitching angle were quantified. Whereas the first two variables are purely osteological characteristics of single vertebrae, the latter two take into account interactions between vertebrae. These variables change in characteristic ways from cranial to caudal. The vertebral canal is wide in the cranial and caudal neck regions, but narrow in the middle, where both the zygapophyseal protrusion and the distance between joint centers are large. Pitching angles are more negative in the cranial and caudal neck regions than in the middle region. Cluster analysis suggested a complex regionalization. Whereas the borders (C1 and C13/C14 formed stable clusters, the other cervical vertebrae were sorted into 4 or 5 additional clusters. The borders of the clusters were influenced by the variables analyzed. CONCLUSIONS/SIGNIFICANCE: A statistical analysis was used to evaluate the regionalization of the cervical spine in the barn owl. While earlier measurements have shown that there appear to be three regions of flexibility of the neck, our indicators suggest 3-7 regions. These many regions allow a high degree of flexibility, potentially facilitating the large head turns that barn owls are able to make. The cervical vertebral series of other species should also be investigated using statistical criteria to further

[Study on the difference of corresponding age at cervical vertebral maturation stages among different skeletal malocclusions].

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Zuo, Changyan; Cong, Chao; Wang, Shihui; Gu, Yan

2015-10-01

To compare the difference of corresponding age at cervical vertebral maturation (CVM) stages among different skeletal malocclusions and provide clinic guideline on optimal treatment timing for skeletal malocclusion. Based on ANB angle, 2 575 cephalograms collected from Department of Orthodontics, Peking University School and Hospital of Stomatology from May, 2006 to November, 2014 were classified into skeletal Class I (ANB 0°~5°, 1 317 subjects), Class II (ANB > 5°, 685 subjects) and Class III (ANB < 0°, 573 subjects) groups. CVM stages were evaluated with the modified version of CVM method. Independent sample t test was performed to analyze the difference of age at different CVM stages among various skeletal groups. Significant gender difference of age was found at CS3 to CS6 for skeletal Class I group (P < 0.05), at CS5 and CS6 for skeletal Class II group (P < 0.05), and at CS3 and CS5 for skeletal Class III group (P < 0.05). At CS3 stage, the average age of male in skeletal Class II and skeletal Class III groups was (11.6 ± 1.5) years old and (10.3 ± 1.9) years old, respectively; the average age of females in those two groups was (11.7 ± 1.3) years old and (9.3 ± 1.5) years old, respectively, and significant difference was found in both comparisons (P < 0.05). Compared average age at CS5 and CS6 between skeletal Class II and skeletal Class III groups [the ages of male was (15.1 ± 1.7) and (16.8 ± 1.6) years old, the ages of male was (14.6 ± 1.2) and (15.7 ± 2.5) years old], significant difference was also found (P < 0.05). Significant gender differences were found when evaluated CVM stage and age in skeletal Class I, II and III groups. Significant differences of age at different CVM stage was noted when skeletal Class II was compared with skeletal Class III groups.

Comparative evaluation between cervical vertebral morphology and hand-wrist morphology for skeletal maturation assessment.

Science.gov (United States)

Grippaudo, C; Garcovich, D; Volpe, G; Lajolo, C

2006-05-01

The aim of the study was to find a correlation between the evaluation of skeletal maturation performed by the study of cervical vertebrae maturation indicators and the evaluation obtained by the hand and wrist maturation indicators. Left hand wrist radiographs and the corresponding lateral cephalograms of 90 patients (48 males and 42 females; aged 6 to 14 years) were paired and a study group of 128 pair of radiographs was obtained, having some patients 2 or more radiographs at different times. Hand and wrist radiographs were evaluated according to the protocol proposed by Grave (scores 0 to 9); corresponding lateral cephalograms were evaluated according to the method reported by Baccetti (scores 1 to 5). Values obtained with the 2 methods were analyzed by Spearman's correlation test. When the values were compared globally in the 2 genders a good correlation was obtained (r=0.795; Pmaturation evaluation by the analysis of cervical vertebrae in laterolateral cephalograms which can substitute the hand and wrist radiograph for the skeletal maturation evaluation in orthodontic diagnosis.

Angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid artery

International Nuclear Information System (INIS)

Na, Dong Gyu; Han, Moon Hee; Chang, Kee Hyun; Han, Gi Seok; Yeon, Kung Mo

1995-01-01

The purpose of this study is to describe the angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of angiographic assessment needed before embolization. We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous malformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n = 5), branches of external carotid artery (n = 2) and common carotid artery (n = 3). Common carotid artery or internal carotid artery (n = 9), vertebral artery (n = 5), ipsilateral external carotid artery (n = 4), contralateral external carotid artery (n = 5), costocervical trunk (n = 2), thyrocervical trunk (n = 2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. The collateral vascular channels were inferolateral trunk of internal carotid artery (n = 8), vertebral artery (n = 5), contralateral external carotid artery (n = 5), ipsilateral external carotid artery (n = 4), deep cervical artery (n = 2) and ascending cervical artery (n = 1). Embolization were performed in 9 cases with operative cannulation (n = 4), embolization via collateral branches of ipsilateral external carotid artery (n = 1), embolization via collateral branches of contralateral external carotid artery (n = 3) and balloon occlusion via direct puncture (n = 1). The collateral channels in cervicofacial vascular lesions with previously ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete angiographic assessment of possible collateral channels is mandatory for the

Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

OpenAIRE

Wagner Cesar Munhoz; Amélia Pasqual Marques; José Tadeu Tesseroli de Siqueira

2004-01-01

Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were...

Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

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Wagner Cesar Munhoz

2004-12-01

Full Text Available Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group and 20 healthy subjects (control group. Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same im ages. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%, but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03. After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.Apesar de a etiofisiopatologia dos distúrbios internos (DI da articulação temporomandibular (ATM ser ainda desconhecida, sugere-se que as posturas de cabeça e corpo estariam associadas a seu desencadeamento, desenvolvimento e sua perpetuação. O objetivo deste estudo foi verificar a relação entre alterações radiográficas de coluna cervical e distúrbios internos da ATM. Este estudo avaliou 30 indivíduos com distúrbios da ATM (grupo teste e 20 saudáveis (grupo controle. Os indiv

The radiographic distinction of degenerative slippage (spondylolisthesis and retrolisthesis) from traumatic slippage of the cervical spine

International Nuclear Information System (INIS)

Lee, C.; Woodring, J.H.; Rogers, L.F.; Kim, K.S.

1986-01-01

In a review of 42 cases of degenerative arthritis of the cervical spine and 22 cases of cervical spine trauma with an observed anterior slip-page (spondylolisthesis) or posterior slippage (retrolisthesis) of the vertebral bodies of 2 mm or more, characteristic features were observed which allowed distinction between degenerative and traumatic slippage of the cervical spine. In degenerative slippage the shape of the articular facets and width of the facet joint space may remain normal; however, in most cases the articular facets become 'ground-down' with narrowing of the facet joint space and the articular facets themselves becoming thinned or ribbon-like. In traumatic slippage the articular facets will either be normally shaped or fractured and the facet joint space will be abnormally widened. Plain radiographs will usually allow this distinction to be made; however, in difficult cases polytomography may be required. (orig.)

Original Research Cervical cancer in southern Malawi: A ...

African Journals Online (AJOL)

by the fact that many cancers may go unrecorded and that ... International Agency for Research on Cancer's (IARC) ... All patients with a new diagnosis of cervical cancer presenting to QECH between ..... A specialist cervical cancer nurse could be appointed to ... Zuma, T., et al., The role of traditional health practitioners in.

Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries

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Rick Hong

2014-07-01

Full Text Available Introduction: We wanted to compare 3 existing emergency medical services (EMS immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based; the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria; and the Hankins’ criteria (immobilization for patients 65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness.To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance. Methods: This was a cross-sectional study of patients ≥18 years transported by EMS post-traumatic mechanism to an inner city emergency department. Demographic and clinical/historical data obtained by physicians were recorded prior to radiologic imaging. Medical record review ascertained cervical spine injuries. Both physicians and EMS were blinded to the objective of the study. Results: Of 498 participants, 58% were male and mean age was 48 years. The following participants would have required cervical spine immobilization based on the respective protocol: PHTLS, 95.4% (95% CI: 93.1-96.9%; Domeier, 68.7% (95% CI: 64.5-72.6%; Hankins, 81.5% (95% CI: 77.9-84.7%. There were 18 cervical spine injuries: 12 vertebral fractures, 2 subluxations/dislocations and 4 spinal cord injuries. Compliance with each of the 3 protocols would have led to appropriate cervical spine immobilization of all injured patients. In practice, 2 injuries were missed when the PHTLS criteria were mis-applied. Conclusion: Although physician-determined presence of cervical spine immobilization criteria cannot be generalized to the findings obtained by EMS personnel, our findings suggest that the mechanism-based PHTLS criteria may result in unnecessary cervical spine immobilization without apparent benefit to injured patients. PHTLS

Pediatric cervical spine in emergency: radiographic features of normal anatomy, variants and pitfalls.

Science.gov (United States)

Adib, Omar; Berthier, Emeline; Loisel, Didier; Aubé, Christophe

2016-12-01

Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult. Such features as hypermobility between C2 and C3, pseudospread of the atlas on the axis, pseudosubluxation, the absence of lordosis, anterior wedging of vertebral bodies, pseudowidening of prevertebral soft tissue and incomplete ossification of synchondrosis can be mistaken for traumatic injuries. The interpretation of a plain radiograph of the pediatric cervical spine following trauma must take into account the age of the child, the location of the injury and the mechanism of trauma. Comprehensive knowledge of the specific anatomy and biomechanics of the childhood spine is essential for the diagnosis of suspected cervical spine injury. With it, the physician can, on one hand, differentiate normal physes or synchondroses from pathological fractures or ligamentous disruptions and, on the other, identify any possible congenital anomalies that may also be mistaken for injury. Thus, in the present work, we discuss normal radiological features of the pediatric cervical spine, variants that may be encountered and pitfalls that must be avoided when interpreting plain radiographs taken in an emergency setting following trauma.

Pediatric cervical spine in emergency: radiographic features of normal anatomy, variants and pitfalls

International Nuclear Information System (INIS)

Adib, Omar; Berthier, Emeline; Loisel, Didier; Aube, Christophe

2016-01-01

Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult. Such features as hypermobility between C2 and C3, pseudospread of the atlas on the axis, pseudosubluxation, the absence of lordosis, anterior wedging of vertebral bodies, pseudowidening of prevertebral soft tissue and incomplete ossification of synchondrosis can be mistaken for traumatic injuries. The interpretation of a plain radiograph of the pediatric cervical spine following trauma must take into account the age of the child, the location of the injury and the mechanism of trauma. Comprehensive knowledge of the specific anatomy and biomechanics of the childhood spine is essential for the diagnosis of suspected cervical spine injury. With it, the physician can, on one hand, differentiate normal physes or synchondroses from pathological fractures or ligamentous disruptions and, on the other, identify any possible congenital anomalies that may also be mistaken for injury. Thus, in the present work, we discuss normal radiological features of the pediatric cervical spine, variants that may be encountered and pitfalls that must be avoided when interpreting plain radiographs taken in an emergency setting following trauma. (orig.)

Pediatric cervical spine in emergency: radiographic features of normal anatomy, variants and pitfalls

Energy Technology Data Exchange (ETDEWEB)

Adib, Omar; Berthier, Emeline; Loisel, Didier; Aube, Christophe [University Hospital of Angers, Department of Radiology, Angers (France)

2016-12-15

Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult. Such features as hypermobility between C2 and C3, pseudospread of the atlas on the axis, pseudosubluxation, the absence of lordosis, anterior wedging of vertebral bodies, pseudowidening of prevertebral soft tissue and incomplete ossification of synchondrosis can be mistaken for traumatic injuries. The interpretation of a plain radiograph of the pediatric cervical spine following trauma must take into account the age of the child, the location of the injury and the mechanism of trauma. Comprehensive knowledge of the specific anatomy and biomechanics of the childhood spine is essential for the diagnosis of suspected cervical spine injury. With it, the physician can, on one hand, differentiate normal physes or synchondroses from pathological fractures or ligamentous disruptions and, on the other, identify any possible congenital anomalies that may also be mistaken for injury. Thus, in the present work, we discuss normal radiological features of the pediatric cervical spine, variants that may be encountered and pitfalls that must be avoided when interpreting plain radiographs taken in an emergency setting following trauma. (orig.)

A methodology to measure cervical vertebral bone maturation in a sample from low-income children.

Science.gov (United States)

Aguiar, Luciana Barreto Vieira; Caldas, Maria de Paula; Haiter Neto, Francisco; Ambrosano, Glaucia Maria Bovi

2013-01-01

This study evaluated the applicability of the regression method for determining vertebral age developed by Caldas et al. (2007) by testing this method in children from low-income families of the rural zone. The sample comprised cephalometric and hand-wrist radiographs of 76 boys and 64 girls aged 7.0 to 14.9 years living in a medium-sized city in the desert region of the northeastern region of Brazil, with an HDI of 0.678. C3 and C4 vertebrae were traced and measured on cephalometric radiographs to estimate the bone age. The average age, average hand-wrist age and average error estimated for girls and boys were, respectively, 10.62 and 10.44 years, 11.28 and 10.57 years, and 1.42 and 1.18 years. Based on these results, the formula proposed by Caldas et al. (2007) was not applicable to the studied population, and new multiple regression models were developed to obtain the children's vertebral bone age accurately.

Delayed vertebral diagnosed L4 pincer vertebral fracture, L2-L3 ruptured vertebral lumbar disc hernia, L5 vertebral wedge fracture - Case report

OpenAIRE

Balasa D; Schiopu M; Tunas A; Baz R; Hancu Anca

2016-01-01

An association between delayed ruptured lumbar disc hernia, L5 vertebral wedge fracture and posttraumaticL4 pincer vertebral fracture (A2.3-AO clasification) at different levels is a very rare entity. We present the case of a 55 years old male who falled down from a bicycle. 2 months later because of intense and permanent vertebral lumbar and radicular L2 and L3 pain (Visual Scal Autologus of Pain7-8/10) the patient came to the hospital. He was diagnosed with pincer vertebral L4 fracture (A2....

Surgeon Reported Outcome Measure for Spine Trauma an International Expert Survey Identifying Parameters Relevant for The Outcome of Subaxial Cervical Spine Injuries

NARCIS (Netherlands)

Sadiqi, Said; Verlaan, Jorrit Jan; Lehr, A. M.; Dvorak, Marcel F.; Kandziora, Frank; Rajasekaran, S.; Schnake, Klaus J.; Vaccaro, Alexander R.; Oner, F. C.

2016-01-01

STUDY DESIGN.: International web-based survey OBJECTIVE.: To identify clinical and radiological parameters that spine surgeons consider most relevant when evaluating clinical and functional outcomes of subaxial cervical spine trauma patients. SUMMARY OF BACKGROUND DATA.: While an outcome instrument

A morphometric investigation on breed-specific features affecting sagittal rotational and lateral bending mobility in the canine cervical spine (c3-c7).

Science.gov (United States)

Breit, S; Künzel, W

2004-08-01

Vertebral and inter-vertebral parameters obtained in large breeds (n = 74), small breeds (n = 35), and Dachshunds (n = 30) were compared to reveal potential differences in the range of motion of the cervical spine between these three groups of breeds. Body size normalized dimensions of vertebral and inter-vertebral parameters and correlations between these indicate large canine breeds to have a tendency towards higher range of motion in sagittal rotation and lateral bending compared with Dachshunds and small breeds. Higher mobility in large breeds is based on significantly (P inter-vertebral discs, wider but shorter cranial and caudal articular surfaces, larger differences in width between caudal and cranial joining facets (compared with Dachshunds from C3/4 to C6/7, compared with small breeds from C4/5 to C5/6), and larger differences in length between caudal and cranial joining facets. Large differences in width between caudal and cranial joining facets were associated with small distances between the most medial (C3/4 to C6/7) and lateral (C3/4 to C5/6) aspects of the articular surfaces as well as with small differences in length between caudal and cranial joining facets (C3/4 to C5/6). This suggests that from C3/4 to C5/6 a higher range of motion in lateral bending is coupled to a lower range of motion in sagittal rotation. The present findings contribute also to explain the higher incidence of degenerative lesions of the cervical spine in large dogs.

Lateral cervical puncture for cervical myelography

International Nuclear Information System (INIS)

Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

1985-01-01

Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

Lateral cervical puncture for cervical myelography

Energy Technology Data Exchange (ETDEWEB)

Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

1985-12-15

Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media.

Relationship between screw sagittal angle and stress on endplate of adjacent segments after anterior cervical corpectomy and fusion with internal fixation: a Chinese finite element study.

Science.gov (United States)

Zhang, Yu; Tang, Yibo; Shen, Hongxing

2017-12-01

In order to reduce the incidence of adjacent segment disease (ASD), the current study was designed to establish Chinese finite element models of normal 3rd~7th cervical vertebrae (C3-C7) and anterior cervical corpectomy and fusion (ACCF) with internal fixation , and analyze the influence of screw sagittal angle (SSA) on stress on endplate of adjacent cervical segments. Mimics 8.1 and Abaqus/CAE 6.10 softwares were adopted to establish finite element models. For C4 superior endplate and C6 inferior endplate, their anterior areas had the maximum stress in anteflexion position, and their posterior areas had the maximum stress in posterior extension position. As SSA increased, the stress reduced. With an increase of 10° in SSA, the stress on anterior areas of C4 superior endplate and C6 inferior endplate reduced by 12.67% and 7.99% in anteflexion position, respectively. With an increase of 10° in SSA, the stress on posterior areas of C4 superior endplate and C6 inferior endplate reduced by 9.68% and 10.22% in posterior extension position, respectively. The current study established Chinese finite element models of normal C3-C7 and ACCF with internal fixation , and demonstrated that as SSA increased, the stress on endplate of adjacent cervical segments decreased. In clinical surgery, increased SSA is able to play important role in protecting the adjacent cervical segments and reducing the incidence of ASD.

Staphylococcal endogenous endophthalmitis in association with pyogenic vertebral osteomyelitis.

Science.gov (United States)

Steeples, L R; Jones, N P

2016-01-01

PURPOSE To describe pyogenic vertebral osteomyelitis as a rare infection associated with endogenous endophthalmitis.METHODS A retrospective review of three patients with endogenous endophthalmitis and sepsis due to underlying Staphylococcal vertebral osteomyelitis presenting during a 21-month time period. The ophthalmic and systemic features and management and outcomes are presented.RESULTS One patient developed unilateral endophthalmitis with cervical spine osteomyelitis, Staphylococcus aureus being isolated from blood cultures. The second presented with bilateral endophthalmitis with disseminated Methicillin-resistant S. aureus (MRSA) infection, with thoracic and lumbar discitis and para-spinal abscesses. MRSA was cultured from vitreous, blood, and synovial fluid. Both patients received prolonged courses of intravenous antibiotics. Intravitreal antibiotic therapy was used in the second patient. Excellent visual and systemic outcomes were achieved in both cases with no ocular complications. The third patient developed lumbar osteomyelitis following spinal surgery and presented with disseminated S. aureus sepsis including unilateral endogenous endophthalmitis. Despite systemic antibiotics and intensive care the patient died.CONCLUSIONS Endogenous endophthalmitis should be suspected in septic patients developing eye symptoms. Endogenous endophthalmitis with staphylococcal bone infection is a rare but serious condition. Osteomyelitis should be considered as an infective source in any such patient reporting bone pain or reduced spinal mobility. Prompt investigation and treatment can achieve favourable visual and systemic outcomes.

An experimental study of percutaneous laser nucleotomy of the intervertebral cervical disc

International Nuclear Information System (INIS)

Wang Yiqing; Wang Zhimin; Guo Weiping; Zhang Hongxin; Guan Yan; Li Wenxian; Ni Daihui

2002-01-01

Objective: To study the effectiveness and safety of laser nucleotomy of the intervertebral cervical disc. Methods: The experimental study was performed in 10 dogs, and each dog was treated with laser nucleolysis in C3-4 and C4-5. The laser energy was turned on in 1.0-second pulses with 1.0 second (C3-4) and 5.0 second (C4-5) pause interval, and the total energy was up to 1000 joules. The temperatures were measured at the place between the posterior longitudinal ligament and the dura and at the vertebral foramen by using a tip type thermometer. Chronic histologic changes were observed by light microscopy at 2-4 weeks after laser irradiation. Results: The temperatures at the place between the posterior longitudinal ligament and the dura and at the vertebral Forman did not exceed 40 degree C when the pause interval was 5 second. Two dogs were euthanized immediately after treatment, and the oval-shaped cavity was observed on the macroscopic view in the nucleus. The cavity measured between 5 mm and 6 mm in long axis and between 2 mm and 4 mm in short. 4 weeks after the laser irradiation, the nucleus pulposus was replaced by cartilaginous cells and fibrous tissues. Conclusion: The laser nucleotomy of the intervertebral cervical disc is effective and feasible at the suitable condition

The Vertebral Column, Ribs, and Sternum of the African Giant Rat (Cricetomys gambianus Waterhouse)

Science.gov (United States)

Olude, Matthew Ayokunle; Mustapha, Oluwaseun Ahmed; Ogunbunmi, Temitope Kehinde; Olopade, James Olukayode

2013-01-01

Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00 ± 41.91 gm and body length of 67.20 ± 0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31–36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm) and the lowest at the caudal sacral bones (2 mm). The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation. PMID:24288518

The Vertebral Column, Ribs, and Sternum of the African Giant Rat (Cricetomys gambianus Waterhouse

Directory of Open Access Journals (Sweden)

Matthew Ayokunle Olude

2013-01-01

Full Text Available Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00±41.91 gm and body length of 67.20±0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31–36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm and the lowest at the caudal sacral bones (2 mm. The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation.

The deformation behavior of the cervical spine segment

Science.gov (United States)

Kolmakova, T. V.; Rikun, Yu. A.

2017-09-01

The paper describes the model of the cervical spine segment (C3-C4) and the calculation results of its deformation behavior at flexion. The segment model was built based on the experimental literature data taking into account the presence of the cortical and cancellous bone tissue of vertebral bodies. Degenerative changes of the intervertebral disk (IVD) were simulated through a reduction of the disc height and an increase of Young's modulus. The construction of the geometric model of the cervical spine segment and the calculations of the stress-strain state were carried out in the ANSYS software complex. The calculation results show that the biggest protrusion of the IVD in bending direction of segment is observed when IVD height is reduced. The disc protrusion is reduced with an increase of Young's modulus. The largest protrusion in the direction of flexion of the segment is the intervertebral disk with height of 4.3 mm and elastic modulus of 2.5 MPa. The results of the study can be useful to specialists in the field of biomechanics, medical materials science and prosthetics.

Cervical vertebral maturation as a biologic indicator of skeletal maturity.

Science.gov (United States)

Santiago, Rodrigo César; de Miranda Costa, Luiz Felipe; Vitral, Robert Willer Farinazzo; Fraga, Marcelo Reis; Bolognese, Ana Maria; Maia, Lucianne Cople

2012-11-01

To identify and review the literature regarding the reliability of cervical vertebrae maturation (CVM) staging to predict the pubertal spurt. The selection criteria included cross-sectional and longitudinal descriptive studies in humans that evaluated qualitatively or quantitatively the accuracy and reproducibility of the CVM method on lateral cephalometric radiographs, as well as the correlation with a standard method established by hand-wrist radiographs. The searches retrieved 343 unique citations. Twenty-three studies met the inclusion criteria. Six articles had moderate to high scores, while 17 of 23 had low scores. Analysis also showed a moderate to high statistically significant correlation between CVM and hand-wrist maturation methods. There was a moderate to high reproducibility of the CVM method, and only one specific study investigated the accuracy of the CVM index in detecting peak pubertal growth. This systematic review has shown that the studies on CVM method for radiographic assessment of skeletal maturation stages suffer from serious methodological failures. Better-designed studies with adequate accuracy, reproducibility, and correlation analysis, including studies with appropriate sensitivity-specificity analysis, should be performed.

A study on clinical findings about vertebral disease diagnosed with MRI

Energy Technology Data Exchange (ETDEWEB)

Kim, Ham-Gyum [Ansan College, Seoul (Korea, Republic of)

2006-09-15

In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%.

A study on clinical findings about vertebral disease diagnosed with MRI

International Nuclear Information System (INIS)

Kim, Ham-Gyum

2006-01-01

In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

The investment case for cervical cancer elimination.

Science.gov (United States)

Tsu, Vivien Davis; Ginsburg, Ophira

2017-07-01

We already know what causes cervical cancer, how to prevent it, and how to treat it, even in resource-constrained settings. Inequitable access to human papillomavirus vaccine for girls and screening and precancer treatment for women in low- and middle-income countries is unacceptable on ethical, social, and financial grounds. The burden of cervical cancer falls on the poor and extends beyond the narrow bounds of the family, affecting national economic development and community life, as family resources are drained and poverty tightens its grip. Proven solutions are available and the priorities for the next few years are clear, as shown by the papers in this Supplement. Sustained political commitment and strategic investments in cervical cancer prevention can not only save millions of lives over the next 10 years, but can also pave the way for the broader fight against all cancers. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Chondromyxoid Fibroma of Two Cervical Vertebrae with Involvement of Surrounding Soft Tissue: Radiologic Diagnostic Dilemma

International Nuclear Information System (INIS)

Taghipour Zahir, Shokouh; Sefidrokh Sharahjin, Naser; Sadlu Parizi, Farzad; Rahmani, Koorosh

2015-01-01

Chondromyxoid fibroma is a rare benign cartilaginous neoplasm that mostly affects the metaphyseal region of the long bones. The tibia, small tubular bones of the foot, the distal femur and pelvis are common locations, but involvement of the vertebral bones, especially the cervical vertebra, is very rare. Radiographic features show typical characteristics and this tumor often presents as a lobulated, eccentric radiolucent lesion with no periosteal reaction. In addition, geographic bone destruction is seen in all cases. We present an adult female with a one-year history of neck pain, and ultrasound findings that suggest a right paravertebral muscular lesion due to inflammatory or neoplastic origins. The histopathological studies confirmed that the biopsied specimen was a chondromyxoid fibroma of the cervical vertebrae laminae and spinous processes (C3 and C4) with abutting soft tissue. Despite the unusual location and soft tissue presentation, a chondromyxoid fibroma should be considered in the differential diagnosis of a cervical bone lesion

The value of MR and other methods in evaluation of cervical spondylosis; Wartosc badania MR i innych metod obrazowania w ocenie stopnia zaawansowania spondylozy szyjnej

Energy Technology Data Exchange (ETDEWEB)

Konopka, M.; Rejniak, I.; Kluczewska, E.; Baron, J.; Collie, D. [Pracownia Rezonansu Magnetycznego, Instytut Pediatrii w Budowie, Katowice (Poland) and Zaklad Diagnostyki Obrazowej, Centrum Medyczne Ksztalcenia Podyplomowego, Centralny Szpital Kliniczny, Warsaw-Miedzylesie (Poland) and Western General Hospital, Edinburgh (United Kingdom)

1995-12-31

38 patients with clinical symptoms of myelopathy, radiculopathy and neck pain have undergone X-ray and MR examinations in order to estimate spinal canal and degenerative changes of cervical vertebral column. The correlation between degree of degenerative changes and myelopathy or radiculopathy or neck pain was established on MR. In patients with myelopathy advanced degeneration changes (2. and 3. degree) were observed more often than in radiculopathy and neck pain. Disorders of mobility and cervical spine instability were found in 50%. Focal changes with high signal on T2 images in cervical cord were found in 2 cases. (author) 17 refs, 4 figs , 7 tabs

Straightened cervical lordosis causes stress concentration: a finite element model study

Energy Technology Data Exchange (ETDEWEB)

Wei, Wei; Shi, Shiyuan; Fei, Jun; Wang, Yifan; Chen, Chunyue [Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, (China); Liao, Shenhui [School of Information Science and Engineering, Central South University, Changsha, Hunan (China)

2013-03-15

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

Straightened cervical lordosis causes stress concentration: a finite element model study

International Nuclear Information System (INIS)

Wei, Wei; Shi, Shiyuan; Fei, Jun; Wang, Yifan; Chen, Chunyue; Liao, Shenhui

2013-01-01

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

Timing Embryo Segmentation: Dynamics and Regulatory Mechanisms of the Vertebrate Segmentation Clock

Science.gov (United States)

Resende, Tatiana P.; Andrade, Raquel P.; Palmeirim, Isabel

2014-01-01

All vertebrate species present a segmented body, easily observed in the vertebrate column and its associated components, which provides a high degree of motility to the adult body and efficient protection of the internal organs. The sequential formation of the segmented precursors of the vertebral column during embryonic development, the somites, is governed by an oscillating genetic network, the somitogenesis molecular clock. Herein, we provide an overview of the molecular clock operating during somite formation and its underlying molecular regulatory mechanisms. Human congenital vertebral malformations have been associated with perturbations in these oscillatory mechanisms. Thus, a better comprehension of the molecular mechanisms regulating somite formation is required in order to fully understand the origin of human skeletal malformations. PMID:24895605

CT-guided percutaneous vertebroplasty combined with 125I-seed implantation for metastatic vertebral carcinoma involving the spinal canal: analysis of 23 cases

International Nuclear Information System (INIS)

Xie Xiaoxi; Lu Yinxiang; Ji Yong; Wang Xiaowei; Zhang Guodong

2014-01-01

Objective: To evaluate the safety and efficacy of CT-guided percutaneous vertebroplasty (PVP) combined with 125 I-seed implantation for the treatment of metastatic vertebral carcinoma involving the spinal canal. Methods: A total of 28 involved vertebrae were detected in 23 patients with metastatic vertebral carcinoma. Each patient had 1-2 diseased vertebrae. The lesions included cervical vertebra (n=4), thoracic vertebra (n=13) and lumbar vertebra (n=11). Destroyed posterior vertebral wall was seen in all involved vertebrae. Thirteen vertebrae found in 12 patients showed involvement of the epidural space. According to treatment planning system (TPS) CT-guided implantation of 125 I seeds was carried out first for cervical lesions, which was followed by PVP. For the thoracic and lumbar lesions, unilateral or bilateral puncturing with several particle needles was employed to implant the 125 I seeds, then, PVP with bone cement injection was performed. The complications and the clinical efficacy were analyzed. Results: Successful operation was obtained in all patients. The number of implanted 125 I seeds ranged from 4 to 30 per vertebra, and the volume of injected bone cement was 1-6 ml per vertebra. After the operation the pain relief rate was 86.9% (n=20). The incidence of bone cement leakage was 17.8% (5/28). One patient had radicular pain caused by neuropore leakage, which was relieved after medication. No serious complications, such as spinal cord injury or radiation myelitis, occurred. Conclusion: CT-guided PVP combined with 125 I-seed implantation is effective and safe for the treatment of metastatic vertebral carcinoma involving the spinal canal. This therapy can effectively relieve the pain and control the deterioration of tumor, besides, the incidence of bone cement leakage is very low. (authors)

Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

Energy Technology Data Exchange (ETDEWEB)

Huwart, Laurent, E-mail: huwart.laurent@wanadoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Foti, Pauline, E-mail: pfoti@hotmail.fr [Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Andreani, Olivier, E-mail: andreani.olivier@gmail.com [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Hauger, Olivier, E-mail: olivier.hauger@chubordeaux.fr [Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux (France); Cervantes, Elodie, E-mail: elodie.cervantes@live.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Brunner, Philippe, E-mail: pbrunner@chpg.mc [Department of Radiology, Hôpital Princesse Grasse de Monaco (Monaco); Boileau, Pascal, E-mail: boileau.p@chu-nice.fr [Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France)

2014-01-15

Objective: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P < 0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P < 0.001). Conclusion: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.

Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

International Nuclear Information System (INIS)

Huwart, Laurent; Foti, Pauline; Andreani, Olivier; Hauger, Olivier; Cervantes, Elodie; Brunner, Philippe; Boileau, Pascal; Amoretti, Nicolas

2014-01-01

Objective: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P < 0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P < 0.001). Conclusion: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty

Are upright lateral cervical radiographs in the obtunded trauma patient useful? A retrospective study

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Bolles Gene

2007-02-01

Full Text Available Abstract Background The best method for radiographic "clearance" of the cervical spine in obtunded patients prior to removal of cervical immobilization devices remains debated. Dynamic radiographs or MRI are thought to demonstrate unstable injuries, but can be expensive and cumbersome to obtain. An upright lateral cervical radiograph (ULCR was performed in selected patients to investigate whether this study could provide this same information, to enable removal of cervical immobilization devices in the multiple trauma patient. Methods We retrospectively reviewed our experience with ULCR in 683 blunt trauma victims who presented over a 3-year period, with either a Glasgow Coma Score Results ULCR was performed in 163 patients. Seven patients had studies interpreted to be abnormal, of which six were also abnormal, by either CT or MRI. The seventh patient's only abnormality was soft tissue swelling; MRI was otherwise normal. Six patients had ULCR interpreted as normal, but had abnormalities on either CT or MRI. None of the missed injuries required surgical stabilization, although one had a vertebral artery injury demonstrated on subsequent angiography. ULCR had an apparent sensitivity of 45.5% and specificity of 71.4%. Conclusion ULCR are inferior to both CT and MRI in the detection of cervical injury in patients with normal plain radiographs. We therefore cannot recommend the use of ULCR in the obtunded trauma patient.

V. Terrestrial vertebrates

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Dean Pearson; Deborah Finch

2011-01-01

Within the Interior West, terrestrial vertebrates do not represent a large number of invasive species relative to invasive weeds, aquatic vertebrates, and invertebrates. However, several invasive terrestrial vertebrate species do cause substantial economic and ecological damage in the U.S. and in this region (Pimental 2000, 2007; Bergman and others 2002; Finch and...

The BD Onclarity HPV assay on SurePath collected samples meets the International Guidelines for Human Papillomavirus Test Requirements for Cervical Screening

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Ejegod, Ditte; Bottari, Fabio; Pedersen, Helle

2016-01-01

This study describes a validation of the BD Onclarity HPV (Onclarity) assay using the international guidelines for HPV test requirements for cervical cancer screening of women 30 years and above using Danish SurePath screening samples. The clinical specificity (0.90, 95% CI: 0.88-0.91) and sensit......This study describes a validation of the BD Onclarity HPV (Onclarity) assay using the international guidelines for HPV test requirements for cervical cancer screening of women 30 years and above using Danish SurePath screening samples. The clinical specificity (0.90, 95% CI: 0.......88-0.91) and sensitivity (0.97, 95% CI: 0.87-1.0) of the Onclarity assay were shown to be non-inferior to the reference assay (specificity 0.90, 95% CI: 0.88-0.92, sensitivity 0.98, 95% CI: 0.91-1.0). The intra-laboratory reproducibility of Onclarity was 97% with a lower confidence bound of 96% (kappa value: 0...

Ultrasonographic Features of Tuberculous Cervical Lymphadenitis

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Chen-Han Chou

2014-09-01

Full Text Available Making an accurate diagnosis of tuberculous cervical lymphadenitis (TCL has been a problem to clinicians because it is a versatile masquerader and is often confused with lymphomas or cervical metastases. Ultrasound (US has advantages over other examination modalities in that it is noninvasive, inexpensive, time-saving, and able to guide procedures such as fine-needle aspiration and core-needle biopsy. It is increasingly being recognized as a primary tool for the evaluation of cervical lymph nodes. In this article, we present six cases with microscopically and/or pathologically confirmed TCL and illustrate the US features. A literature review was also conducted. The key US features of TCL include hypoechogenecity, strong internal echoes, echogenic thin layers, nodal matting, soft tissue changes, and displaced hilar vascularity. US is a reliable and effective tool in assessing cervical lymphadenopathies. When TCL is suspected under US, US-guided procedures such as fine-needle aspiration or core-needle biopsy can be conducted concomitantly to obtain the microscopic or pathological proof.

The biogeography of threatened insular iguanas and opportunities for invasive vertebrate management

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Tershy, Bernie R.; Newton, Kelly M.; Spatz, Dena R.; Swinnerton, Kirsty; Iverson, John B.; Fisher, Robert N.; Harlow, Peter S.; Holmes, Nick D.; Croll, Donald A.; Iverson, J.B.; Grant, T. D.; Knapp, C. R.; Pasachnik, S. A.

2016-01-01

Iguanas are a particularly threatened group of reptiles, with 61% of species at risk of extinction. Primary threats to iguanas include habitat loss, direct and indirect impacts by invasive vertebrates, overexploitation, and human disturbance. As conspicuous, charismatic vertebrates, iguanas also represent excellent flagships for biodiversity conservation. To assist planning for invasive vertebrate management and thus benefit threatened iguana recovery, we identified all islands with known extant or extirpated populations of Critically Endangered and Endangered insular iguana taxa as recognized by the International Union for Conservation of Nature (IUCN) Red List of Threatened Species. For each island, we determined total area, sovereignty, the presence of invasive alien vertebrates, and human population. For the 23 taxa of threatened insular iguanas we identified 230 populations, of which iguanas were extant on 185 islands and extirpated from 45 islands. Twenty-one iguana taxa (91% of all threatened insular iguana taxa) occurred on at least one island with invasive vertebrates present; 16 taxa had 100% of their population(s) on islands with invasive vertebrates present. Rodents, cats, ungulates, and dogs were the most common invasive vertebrates. We discuss biosecurity, eradication, and control of invasive vertebrates to benefit iguana recovery: (1) on islands already free of invasive vertebrates; (2) on islands with high iguana endemicity; and (3) for species and subspecies with small total populations occurring across multiple small islands. Our analyses provide an important first step toward understanding how invasive vertebrate management can be planned effectively to benefit threatened insular iguanas.

A review of clinical and radiological aspects of rheumatoid arthritis of head joints

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Schilling, F.

1987-01-01

The most important inflammations--rheumatic joint diseases of the vertebral column--are chronic polyarthritis (rheumatoid arthritis) with involvement of cervical vertebral and atlanto-axial dislocation and ankylosing spondylitis (Bechterew's disease) resp. the seronegative spondylarthritis. A decisive and important difference between both forms of disease is found in the region of the cervical part of the vertebral column. In case of a spondylarthritis (ASp.) the ankylopoietica type includes the cervical vertebrae but the chronic polyarthritis (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA and ASp.) of cervical involvement is about 30%. The authors present an account of the underlying disease process. A description of rheumatoid cervical arthritis is given. The destructive and dislocating arthritis of the cranio-cervical function (arthritis of the head and neck joints) is described

Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in Tertiary Care Hospitals in Karachi, Pakistan.

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Syed Faizan Ali

Full Text Available BACKGROUND AND OBJECTIVE: Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan. METHODS AND DESIGN: A cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied as no definitive data was available regarding the number of registered interns and nurses at each center. RESULTS: Of all the interviews conducted, 1.8% did not know cervical cancer as a disease. Only 23.3% of the respondents were aware that cervical cancer is the most common cause of gynecological cancers and 26% knew it is second in rank in mortality. Seventy-eight percent were aware that infection is the most common cause of cervical cancer, of these 62% said that virus is the cause and 61% of the respondents knew that the virus is Human Papilloma Virus (HPV. Majority recognized that it is sexually transmitted but only a minority (41% knew that it can be detected by PCR. Only 26% of the study population was aware of one or more risk factors. Thirty seven percent recognized Pap smear as a screening test. In total only 37 out of 400 respondents were aware of the HPV vaccine. CONCLUSION: This study serves to highlight that the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer. Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about this disease.

Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in Tertiary Care Hospitals in Karachi, Pakistan.

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Ali, Syed Faizan; Ayub, Samia; Manzoor, Nauman Fazal; Azim, Sidra; Afif, Muneeza; Akhtar, Nida; Jafery, Wassi Ali; Tahir, Imran; Farid-Ul-Hasnian, Syed; Uddin, Najam

2010-06-10

Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan. A cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied as no definitive data was available regarding the number of registered interns and nurses at each center. Of all the interviews conducted, 1.8% did not know cervical cancer as a disease. Only 23.3% of the respondents were aware that cervical cancer is the most common cause of gynecological cancers and 26% knew it is second in rank in mortality. Seventy-eight percent were aware that infection is the most common cause of cervical cancer, of these 62% said that virus is the cause and 61% of the respondents knew that the virus is Human Papilloma Virus (HPV). Majority recognized that it is sexually transmitted but only a minority (41%) knew that it can be detected by PCR. Only 26% of the study population was aware of one or more risk factors. Thirty seven percent recognized Pap smear as a screening test. In total only 37 out of 400 respondents were aware of the HPV vaccine. This study serves to highlight that the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer. Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about this disease.

CT study of vertebral metastasis: re-realization of the diagnostic role of the vertebral pedicle sign

International Nuclear Information System (INIS)

Meng Quanfei; Jiang Bo; Chen Yingming; Zhang Chaohui

2000-01-01

Objective: To investigate the essence of the vertebral pedicle sign of vertebral metastasis on plain film, and to explore the useful CT signs for the diagnosis and differential diagnosis of this tumor. Methods: The CT scans of the spine obtained in 48 patients with vertebral metastases, 19 patients with vertebral tuberculosis, and 11 with vertebral myeloma, were analyzed. The CT findings were correlated with the abnormalities seen on plain films in 34 of the 48 patients (66 vertebrae involved) with vertebral metastasis. Results: 66 vertebrae were involved in the group of metastasis. Of the 28 vertebrae whose vertebral body were completely destroyed, 15 were seen bilateral pedicles destruction; Of the 22 vertebrae with lateral destruction of the body, 16 were noticed unilateral pedicle destruction which located posterior to the involved side of the body. Of the 62 micro-metastatic foci, 56 were scattered in the vertebral body. In the 19 para-spinal soft-tissue masses of vertebral tuberculosis, 5 were noticed calcifications and 12 with postcontrast rings enhancement. The rates of vertebral pedicle destruction of vertebral metastasis and myeloma were not statistically different (X 2 = 0.03, P > 0.50). The locations of destruction of vertebral body in vertebral metastasis and myeloma had no statistical difference (X 2 = 3.52, P > 0.10), but they differed from that in tuberculosis (X 2 = 39.32, P < 0.001). The distribution of lesions within the vertebrae of metastasis and tuberculosis was similar, but was quite different from myeloma. Conclusion: The vertebral metastasis initially occurs in the vertebral body. The vertebral pedicle sign on plain film of vertebral metastasis is the outcome of the posterior invasion of the tumor in the vertebral body, which is of no differential significance for vertebral metastasis and myeloma. Para-spinal soft tissue mass, location of destruction of vertebral body, and the distribution of lesions within the vertebrae may help

Dynamic function MR of the cervical vertebral column. Dynamische Funktions-MRT der Halswirbelsaeule

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Naegele, M.; Woell, B.; Reiser, M. (Radiologische Universitaetsklinik, Bonn (Germany)); Koch, W. (Orthopaedische Universitaetsklinik, Bonn (Germany)); Kaden, B. (Neurochirurgische Universitaetsklinik, Bonn (Germany))

1992-09-01

To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T[sub 1] and T[sub 2][sup *] weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations. (orig.).

Functional MR imaging of the cervical spine in patients with rheumatoid arthritis

International Nuclear Information System (INIS)

Allmann, K.H.; Uhl, M.; Uhrmeister, P.; Neumann, K.; Langer, M.; Kempis, J. von

1998-01-01

Purpose: To evaluate functional MR imaging in patients with rheumatoid arthritis (RA) involving the cervical spine. Material and Methods: We used a device that allows MR examination to be made of the cervical spine in infinitely variable degrees of flexion and extension. Dynamic functional MR imaging was performed on 25 patients with RA. Results: Functional MR imaging was able to show the degree of vertebral instability of the occipito-atlantal or atlanto-axial level as well as the subaxial level. By performing functional MR imaging, we were able to demonstrate the extent of synovial tissue around the dens, and the impingement and displacement of the spinal cord during flexion and extension. The basilar impression, the cord impingement into the foramen magnum, the cord compression, the slipping of vertebrae, and the angulation of the cord were all much more evident in functional than in static MR imaging. Conclusion: Functional MR imaging provided additional information in patients with RA, and is valuable in patients who have a normal MR study in the neutral position and yet have signs of a neurological deficit. Functional MR imaging is important in the planning of stabilizing operations of the cervical spine. (orig.)

Fast and accurate semi-automated segmentation method of spinal cord MR images at 3T applied to the construction of a cervical spinal cord template.

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Mohamed-Mounir El Mendili

Full Text Available To design a fast and accurate semi-automated segmentation method for spinal cord 3T MR images and to construct a template of the cervical spinal cord.A semi-automated double threshold-based method (DTbM was proposed enabling both cross-sectional and volumetric measures from 3D T2-weighted turbo spin echo MR scans of the spinal cord at 3T. Eighty-two healthy subjects, 10 patients with amyotrophic lateral sclerosis, 10 with spinal muscular atrophy and 10 with spinal cord injuries were studied. DTbM was compared with active surface method (ASM, threshold-based method (TbM and manual outlining (ground truth. Accuracy of segmentations was scored visually by a radiologist in cervical and thoracic cord regions. Accuracy was also quantified at the cervical and thoracic levels as well as at C2 vertebral level. To construct a cervical template from healthy subjects' images (n=59, a standardization pipeline was designed leading to well-centered straight spinal cord images and accurate probability tissue map.Visual scoring showed better performance for DTbM than for ASM. Mean Dice similarity coefficient (DSC was 95.71% for DTbM and 90.78% for ASM at the cervical level and 94.27% for DTbM and 89.93% for ASM at the thoracic level. Finally, at C2 vertebral level, mean DSC was 97.98% for DTbM compared with 98.02% for TbM and 96.76% for ASM. DTbM showed similar accuracy compared with TbM, but with the advantage of limited manual interaction.A semi-automated segmentation method with limited manual intervention was introduced and validated on 3T images, enabling the construction of a cervical spinal cord template.

Fast and accurate semi-automated segmentation method of spinal cord MR images at 3T applied to the construction of a cervical spinal cord template.

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El Mendili, Mohamed-Mounir; Chen, Raphaël; Tiret, Brice; Villard, Noémie; Trunet, Stéphanie; Pélégrini-Issac, Mélanie; Lehéricy, Stéphane; Pradat, Pierre-François; Benali, Habib

2015-01-01

To design a fast and accurate semi-automated segmentation method for spinal cord 3T MR images and to construct a template of the cervical spinal cord. A semi-automated double threshold-based method (DTbM) was proposed enabling both cross-sectional and volumetric measures from 3D T2-weighted turbo spin echo MR scans of the spinal cord at 3T. Eighty-two healthy subjects, 10 patients with amyotrophic lateral sclerosis, 10 with spinal muscular atrophy and 10 with spinal cord injuries were studied. DTbM was compared with active surface method (ASM), threshold-based method (TbM) and manual outlining (ground truth). Accuracy of segmentations was scored visually by a radiologist in cervical and thoracic cord regions. Accuracy was also quantified at the cervical and thoracic levels as well as at C2 vertebral level. To construct a cervical template from healthy subjects' images (n=59), a standardization pipeline was designed leading to well-centered straight spinal cord images and accurate probability tissue map. Visual scoring showed better performance for DTbM than for ASM. Mean Dice similarity coefficient (DSC) was 95.71% for DTbM and 90.78% for ASM at the cervical level and 94.27% for DTbM and 89.93% for ASM at the thoracic level. Finally, at C2 vertebral level, mean DSC was 97.98% for DTbM compared with 98.02% for TbM and 96.76% for ASM. DTbM showed similar accuracy compared with TbM, but with the advantage of limited manual interaction. A semi-automated segmentation method with limited manual intervention was introduced and validated on 3T images, enabling the construction of a cervical spinal cord template.

Vertebral osteomyelitis without disc involvement

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Kamani, I.; Syed, I.; Saifuddin, A. E-mail: asaifuddin@aol.com; Green, R.; MacSweeney, F

2004-10-01

Vertebral osteomyelitis is most commonly due to pyogenic or granulomatous infection and typically results in the combined involvement of the intervertebral disc and adjacent vertebral bodies. Non-infective causes include the related conditions of chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. Occasionally, these conditions may present purely within the vertebral body, resulting in various combinations of vertebral marrow oedema and sclerosis, destructive lesions of the vertebral body and pathological vertebral collapse, thus mimicking neoplastic disease. This review illustrates the imaging features of vertebral osteomyelitis without disc involvement, with emphasis on magnetic resonance imaging (MRI) findings.

Ovarian and cervical cancer awareness: development of two validated measurement tools.

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Simon, Alice E; Wardle, Jane; Grimmett, Chloe; Power, Emily; Corker, Elizabeth; Menon, Usha; Matheson, Lauren; Waller, Jo

2012-07-01

The aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures). Potentially relevant items were extracted from the literature and generated by experts. Four validation studies were carried out to establish reliability and validity. Women aged 21-67 years (n=146) and ovarian and cervical cancer experts (n=32) were included in the studies. Internal reliability was assessed psychometrically. Test-retest reliability was assessed over a 1-week interval. To establish construct validity, Cancer Awareness Measure (CAM) scores of cancer experts were compared with equally well-educated comparison groups. Sensitivity to change was tested by randomly assigning participants to read either a leaflet giving information about ovarian/cervical cancer or a leaflet with control information, and then completing the ovarian/cervical CAM. Internal reliability (Cronbach's α=0.88 for the ovarian CAM and α=0.84 for the cervical CAM) and test-retest reliability (r=0.84 and r=0.77 for the ovarian and cervical CAMs, respectively) were both high. Validity was demonstrated with cancer experts achieving higher scores than controls [ovarian CAM: t(36)= -5.6, pcancer leaflet scored higher than those who received a control leaflet [ovarian CAM: t(49)=7.5, pcancer awareness in the general population.

Eukaryotic tRNAs fingerprint invertebrates vis-à-vis vertebrates.

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Mitra, Sanga; Das, Pijush; Samadder, Arpa; Das, Smarajit; Betai, Rupal; Chakrabarti, Jayprokas

2015-01-01

During translation, aminoacyl-tRNA synthetases recognize the identities of the tRNAs to charge them with their respective amino acids. The conserved identities of 58,244 eukaryotic tRNAs of 24 invertebrates and 45 vertebrates in genomic tRNA database were analyzed and their novel features extracted. The internal promoter sequences, namely, A-Box and B-Box, were investigated and evidence gathered that the intervention of optional nucleotides at 17a and 17b correlated with the optimal length of the A-Box. The presence of canonical transcription terminator sequences at the immediate vicinity of tRNA genes was ventured. Even though non-canonical introns had been reported in red alga, green alga, and nucleomorph so far, fairly motivating evidence of their existence emerged in tRNA genes of other eukaryotes. Non-canonical introns were seen to interfere with the internal promoters in two cases, questioning their transcription fidelity. In a first of its kind, phylogenetic constructs based on tRNA molecules delineated and built the trees of the vast and diverse invertebrates and vertebrates. Finally, two tRNA models representing the invertebrates and the vertebrates were drawn, by isolating the dominant consensus in the positional fluctuations of nucleotide compositions.

Innovative approaches to cervical cancer screening for sex trade workers: an international scoping review.

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Thulien, Naomi S

2014-03-01

Female sex trade workers are among those at highest risk for developing and dying of cervical cancer, and yet many-particularly the most marginalized-are less likely than other women to be screened. This review summarizes global findings on innovative approaches to cervical cancer screening for female sex trade workers, highlights current gaps in the delivery of cervical cancer screening for female sex trade workers globally, and suggests areas for future research and policy development. A scoping review of peer-reviewed publications and grey literature was conducted. Medline (OVID), PubMed, EMBASE, and SCOPUS were searched for relevant studies written in English. There were no limitations placed on dates. Grey literature was identified by hand searching and through discussion with health care providers and community outreach workers currently working with sex trade workers. Twenty-five articles were deemed suitable for review. Articles detailing innovative ways for female sex trade workers to access cervical cancer screening were included. Articles about screening for sexually transmitted infections were also included if the findings could be generalized to screening for cervical cancer. Articles limited to exploring risk factors, knowledge, awareness, education, prevalence, and incidence of cervical cancer among sex trade workers were excluded from the review. Successful screening initiatives identified in the studies reviewed had unconventional hours of operation, understood the difference between street-based and venue-based sex trade workers, and/or used peers for outreach. Two significant gaps in health care service delivery were highlighted in this review: the limited use of unorthodox hours and the nearly exclusive practice of providing sexually transmitted infection screening for female sex trade workers without cervical cancer screening. In addition, although street-based (as opposed to venue-based) sex trade workers are likely at higher risk for

An interesting case report of vertebral artery dissection following polytrauma

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Vikas Acharya

2016-01-01

Conclusion: Our report displays select images related to this case report and emphasizes the consideration of routine imaging in head and neck traumatic injuries to diagnose internal carotid and/or vertebral artery dissections much earlier.

Comparison of measurement results between cervical pedicle specimens and CT images

International Nuclear Information System (INIS)

Zhang Guangjian; Li Hua; Liu Haiyan; Gao Zhenping

2011-01-01

Objective: To compare the difference between the measurement results of the cervical pedicle specimens and CT image, and provide the basis for clinical cervical screw internal fixation operation. Methods: Twenty-seven Chinese adult cadaver cervical specimens including C3 to C7 vertebrae were measured by a digital calipers and CT image, containing pedicle height (PH, PH'), pedicle width(PW, PW'), total pedicle length (TL, TL') and two pedicle lengths(PL1, PL2; PL1', PL2'). The results of specimens and CT image were compared. Results: Different cervical vertebra in the same side of specimens or CT images, PW (PW'): C3, C4< C5, C6 (P<0.05), C5, C6< C7 (P<0.01); PH (PH'): there were no significant differences; TL, PL1, PL2 (TL', PL1', PL2'): there were no marked differences. In the same cervical vertebra of the specimens or CT images, PW (PW')< PH (PH') (P<0.01), PL1 (PL1') < PL2 (PL2') (P<0.01). Conclusion: The results of measurement by CT images are not markedly different from that of specimens. CT image measurement is available before cervical screw internal fixation operation. (authors)

Cervical spine injuries in suicidal hanging without a long-drop--patterns and possible underlying mechanisms of injury: an autopsy study.

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Nikolić, Slobodan; Zivković, Vladimir

2014-06-01

The incidence of cervical spine injuries in suicidal hangings with a short-drop has been reported to be extremely low or non-existent. The aim of this study was to determine the frequency and pattern of cervical spine injuries in suicidal hanging. A retrospective autopsy study was performed and short-drop suicidal hanging cases with documented cervical spine injuries were identified. This group was further analyzed with regard to the gender and age of the deceased, the position of the ligature knot, the presence of hyoid-laryngeal fractures, and the level of cervical spine injury. Cervical spine injuries were present in 25 of the 766 cases, with an average age of 71.9 ± 10.7 years (range 39-88 years). In 16 of these 25 cases, the ligature knot was in the anterior position. The most common pattern of cervical spine injury included partial or complete disruption of the anterior longitudinal ligament and widening of the lower cervical spine disk spaces, associated with absence of hyoid-laryngeal fractures. Cervical spine injuries are not commonly found in short-drop suicidal hanging, occurring in only 3.3 % of all observed cases. Cervical spine injury may be occurring in 80 % of subjects aged 66.5 years and above. The most common pattern of cervical spine injury included anterior longitudinal ligament disruption of the lower cervical spine, disk space widening, and no vertebral body displacement. These injuries were mainly associated with an anterior knot position, and may be a consequence of loop pressure to the posterior neck and cervical spine hyperextension.

A eficácia da terapia manual em indivíduos cefaleicos portadores e não-portadores de degeneração cervical: análise de seis casos The effectiveness of manual therapy in indiv iduals with headaches, with and without cervical degeneration: analysis of six cases