Safety and efficacy of the new modified technique for c2 nerve root resection in 3d fluoroscopy navigated instrumentation in the cranio-cervical junction.

Purpose: Instrumentation of the C1 vertebra requires either mobilization or transection of the C2 nerve root. This study investigates clinical and radiological outcomes and incidences of C2 neuropathic pain after posterior instrumented fusion in the cranio-cervical junction with or without division of the C2 nerve roots.

Methods: This retrospective study compared two cohorts of patients who underwent instrumented fusion in the cranio-cervical junction.

Transtubular image-guided surgery for spinal intradural lesions: techniques, results, and complications in a consecutive series of 60 patients.

Objective: The authors previously described the image merge tailored access resection (IMTAR) technique for resection of spinal intradural lesions (SIDLs). The authors reported their updated experience with the IMTAR technique and compared surgical results between patients who underwent operations with 2D or 3D fluoroscopic guidance.

Methods: The authors reviewed 60 patients who underwent SIDL resection with transtubular techniques over a 14-year period.

Using Smartphones for Clinical Assessment in Cervical Spondylotic Myelopathy a Feasibility Study.

Degenerative cervical myelopathy (DCM) is characterized by a progressive deterioration in spinal cord function. Its evaluation requires subjective clinical examination with wide interobserver variability. Objective quantification of spinal cord function remains imprecise, even though validated myelopathy-grading scales have emerged and are now widely used.

Transtubular Anterior Cervical Foraminotomy for the Treatment of Compressive Cervical Radiculopathy: Surgical Results and Complications in a Consecutive Series of Cases.

Study Design: This was a retrospective review of patients with compressive cervical radiculopathy treated with a minimally invasive anterior cervical foraminotomy (ACF).

Purpose: This study aimed to evaluate the results and complication rates of ACF in a consecutive series of patients and to report our clinical results of ACF as a minimally invasive technique in a series of 45 consecutive patients treated for compressive cervical radiculopathy.

Overview Of Literature: ACF is a motion-sparing procedure and an alternative to anterior cervical discectomy and fusion (ACDF) and posterior cervical foraminotomy for direct nerve root decompression in patients with compressive cervical radiculopathy.

Minimally invasive anterior foraminotomy for cervical radiculopathy: how I do it.

Background: The standard treatment for cervical radiculopathy is anterior discectomy and fusion. The authors describe a minimally invasive anterior cervical foraminotomy as a surgical option for direct nerve root decompression in cervical radiculopathy.

Method: Through a modified Smith-Robinson approach, the prevertebral fascia is mobilized laterally, displacing the sympathetic chain with it.

Multilevel Pedicular Osteotomies for En Bloc Resection of a Primary Ewing Sarcoma of the Subaxial Cervical Spine with Pedicle Screw Reconstruction.

Background: Primary Ewing sarcoma of the mobile spine is a rare disease. Its management requires careful surgical planning, because radical, margin-free excision is directly correlated with prognosis. Extensive bone removal in the cervical spine can lead to instability and cause postoperative iatrogenic cervical deformity.

Surgical planning for cervical deformity based on a 3D model.

The treatment of fixed cervical deformity is complex, but the principles guiding its correction remain the same as in deformity of other spinal regions, with the goal of deformity correction that results in a solid fusion with adequate decompression of the neural elements. In these challenging cases, osteotomies are necessary to mobilize the rigid spine and to obtain the desired correction, but they can be associated with increased risk of complications. Therefore, careful preoperative planning and a complete understanding of the anatomic variations allow patient-tailored approaches with and case specific techniques for the optimal and safe treatment of a variety of complex cervical deformities.

Biomechanical Assessment of Stabilization of Simulated Type II Odontoid Fracture with Case Study.

Study Design: Researchers created a proper type II dens fracture (DF) and quantified a novel current posterior fixation technique with spacers at C1-C2. A clinical case study supplements this biomechanical analysis.

Purpose: Researchers explored their hypothesis that spacers combined with posterior instrumentation (PI) reduce range of motion significantly, possibly leading to better fusion outcomes.

Bilateral C-1 lateral mass reconstruction following radical resection of a giant osteoblastoma of the atlas: case report.

Osteoblastoma is a rare, benign, osteoid-producing, and slow-growing primary bone tumor, typically arising in long bones or in the spine, with a slight male predominance. This report describes the surgical treatment of a giant C-1 (atlantal) osteoblastoma diagnosed in a young male patient with neurofibromatosis Type 1. The authors describe the clinical presentation, the surgical procedure for complete excision and stabilization, and results as of the 1-year follow-up.

Duplicated filum terminale in non-split cord malformations: An underrecognized cause for treatment failure in tethered cord syndrome.

Context: Anatomical variations of the filum terminale (FT) have been described in association with split cord malformations (SCM) but they appear to be a rare finding in its absence. We report the first case in literature of a duplicated FT in a patient presenting with tethered cord syndrome (TCS) without any radiological evidence of SCM.

Findings: A 47-year-old man presented with invalidating back pain radiating to both legs.

Image Merge Tailored Access Resection (IMTAR) of Spinal Intradural Tumors. Technical Report of 13 Cases.

Objective: Standard translaminar approaches for intradural extramedullary (IDEM) tumors require extensive soft tissue dissection and partial facet removal. Ventral lesions may necessitate wider bone resection with subsequent possible spinal instability. Any manipulation of an already compromised spinal cord may lead to neurological injury.

Single stage transforaminal retrojugular tumor resection: The spinal keyhole for dumbbell tumors in the cervical spine.

Background: Dumbbell tumors are defined as having an intradural and extradural component with an intermediate component within an expanded neural foramen. Complete resection of these lesions in the subaxial cervical spine is a challenge, and it has been achieved through a combined posterior/anterior or anterolateral approach. This study describes a single stage transforaminal retrojugular (TFR) approach for dumbbell tumors resection in the cervical spine.

Occipitoaxial spinal interarticular stabilization with vertebral artery preservation for atlantal lateral mass failure.

The treatment of craniocervical instability caused by diverse conditions remains challenging. Different techniques have been described to stabilize the craniocervical junction. The authors present 2 cases in which tumoral destruction of the C-1 lateral mass caused craniocervical instability.

Delayed presentation of deep penetrating trauma to the subaxial cervical spine.

Purpose: To present a rare case of deep penetrating neck trauma in which a retained foreign body in the cervical spine (a broken knife blade) resulted in delayed radicular injury. We describe the surgical management using a retrojugular approach.

Case Report: Our patient sustained a stab wound to the supraclavicular triangle from a small pocketknife.

A statistical shape model of the human second cervical vertebra.

Purpose: Statistical shape and appearance models play an important role in reducing the segmentation processing time of a vertebra and in improving results for 3D model development. Here, we describe the different steps in generating a statistical shape model (SSM) of the second cervical vertebra (C2) and provide the shape model for general use by the scientific community. The main difficulties in its construction are the morphological complexity of the C2 and its variability in the population.

[Inter-hospital CHUV-HUG medical consensus of back pain management. Its application in care pathways within CHUV of Lausanne].

Back pain is a considerable economical burden in industrialised countries. Its management varies widely across countries, including Switzerland. Thus, the University Hospital and University of Lausanne (CHUV) recently improved intern processes of back pain care.

Markerless endoscopic registration and referencing.

Accurate patient registration and referencing is a key element in navigated surgery. Unfortunately all existing methods are either invasive or very time consuming. We propose a fully non-invasive optical approach using a tracked monocular endoscope to reconstruct the surgical scene in 3D using photogrammetric methods.

Pituitary apoplexy precipitating diabetes insipidus.

Objective: To describe a case of pituitary apoplexy complicated by diabetes insipidus and to review management of patients with pituitary apoplexy and water excretion disturbances associated with transsphenoidal surgery.

Methods: We describe clinical, laboratory, and radiologic findings in a patient with pituitary apoplexy and central diabetes insipidus.

Results: A 74-year-old woman presented with severe headache and sudden loss of vision for 12 hours, accompanied by thirst and frequent urination.