How cervical and cervicothoracic scoliosis influence the atlantoaxial joint.

Introduction: Children with cervical or cervicothoracic congenital scoliosis are limited in their ability to compensate for the main curve of the deformity because there are only a few mobile segments in their cervical spine. Over the years, we have frequently observed coronal atlantoaxial dislocation (CAAD) in a lateral direction (from left to right or vice versa) in these patients. It was anticipated that CAAD might compensate for the horizontal position of the head, and it is hypothesized that CAAD depends on the degree of scoliotic deformity.

Surgical treatment for local recurrence of spinal hemangiomas.

Introduction: SH is considered to be the most common benign tumor within the human spine. 1-2% of SH get symptomatic with back pain in most cases. Less often, ingrowth of vessels into the spinal canal is seen.

Melorheostosis of the cervical and cervicothoracic spine: review of the literature and presentation of 3 new cases.

Melorheostosis is a rare dysplastic bone disease that usually affects long bones at the upper or lower limbs. It is rarely seen at the spine and very rarely located at the cervical spine. To the best of our knowledge, there are currently 6 cases of melorheostosis described at the cervical spine.

The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study.

Purpose: Surgical treatment of thoracolumbar A3-fractures usually comprises posterior fixation-in neutral position or distraction-potentially followed by subsequent anterior support. We hypothesized that additional posterior compression in circumferential stabilization may increase stability by locking the facets, and better restore the sagittal profile.

Methods: Burst fractures Type A3 were created in six fresh frozen cadaver spine segments (T12-L2).

[Early intraoperative and postoperative complications of C1-C2 fixation using the Goel-Harms technique : How often? Which? Why?].

Fractures of the axis are among the most frequent spinal injuries. Posterior C1-C2 fixation according to Goel-Harms is an accepted alternative to the more traditional procedures: initial stability has been shown and there is a wide range of indications but there is a paucity of data on possible complications. Such knowledge, however, is essential in order to improve outcomes.

[Neuromuscular scoliosis in patients with central nervous system pathologies].

Neuromuscular scoliosis is due to pathologies within the neuromuscular pathway. These pathologies result in early deformities, usually with ongoing rapid progress. Conservative treatment has only limited value in these individuals, and posterior instrumented surgical correction to the spine is the favored treatment concept for correction and avoidance of progression.

The Feasibility of C1-C2 Screw-rod Fixation in the Children 5 Years of Age and Younger.

Background: Atlantoaxial fixation is technically challenging in younger children. The C1-C2 screw-rod fixation technique is established for adults but limited data about the clinical and radiographical outcome for the treatment of children with 5 years of age or younger is available.

Methods: All files of children who were consecutively treated for spinal disorders were reviewed.

Iatrogenic Intracranial Hypotension after Surgery of Adolescent Idiopathic Scoliosis due to a Misplaced Screw within the Thoracic Thecal Sac.

We present the case of a postoperative intracranial hypotension due to a misplaced intrathecal screw. Although typical symptoms such as orthostatic headache were present immediately after surgery, diagnosis was hidden until 20 years later, resulting in a disastrous clinical course.

[Deep lumbar back pain and neurological sensory deficits in a 56-year-old male patient].

Echinococcus infestations are rare in humans, infestation of bone occurs in less than 1% and a primary spinal infestation is extremely rare. This article reports on a clinical case of lumbar and sacral spinal infestation by Echinococcus multilocularis in a 56-year-old male Caucasian with neurological sensory deficits and deep lumbar back pain. Due to the suspicion of spondylodiscitis a computer tomography-guided biopsy was carried out without success, so that a sample was surgically obtained.

Atlantoaxial Rotatory Dislocation: Delayed Diagnose Will Result in More Invasive Treatment Options.

Purpose:  The atlantoaxial joint represents the most mobile joint complex within the spine, secured by ligaments and capsules. Integrity of the atlantoaxial joint is crucial with respect to the mobility of the head and the upper spine. Atlantoaxial rotatory dislocation is the most common type of injury within this joint in children and is characterized by a typical position of the head (cock robin position).

[Biomechanical compensatory mechanisms of hips and spine : The essentials for spine and hip surgeons].

Spinal alignment changes with age and degeneration. Different compensatory mechanisms of the spine are necessary to preserve spinal balance. The capacity of compensation of the spine decreases with age.

[Diagnostics and treatment of cervical spine trauma in pediatric patients : Recommendations from the Pediatric Spinal Trauma Group].

Background: Severe cervical spine injuries in children under the age of 17 years are rare. Recommendations or even guidelines for the diagnostics and treatment of such injuries in children are currently not available.

Objective: The aim of the study was to formulate recommendations for diagnostics and treatment of injuries of the cervical spine in pediatric patients.

The Effect of Cervicodorsal Hemivertebra Resection on Head Tilt and Trunk Shift in Children With Congenital Scoliosis.

Background: Congenital scoliosis due to hemivertebra of the cervicodorsal spine is a rare disorder. It might be accompanied by impaired cosmetic appearances such as head tilt and trunk shift. Little is known about the effect of correction of the major curve on head tilt and trunk shift in children.

[Harlequin syndrome after scoliosis surgery].

Harlequin syndrome is a rare combination of symptoms, characterized by unilateral facial anhidrosis and paleness on the affected side, becoming obvious by contralateral flushing mainly during sports activity. The syndrome is mostly idiopathic, however it is also described as a complication of thoracic surgery, i.e.

Degenerative Cervical Myelopathy: A 7-Letter Coding System That Supports Decision-Making for the Surgical Approach.

Objective: To validate with a prospective study a decision-supporting coding system for the surgical approach for multilevel degenerative cervical myelopathy.

Methods: Ten cases were presented on an internet platform, including clinical and imaging data. A single-approach (G1), a choice between 2 (G2), or 3 approaches (G3) were options.

[Degenerative cervical spine diseases: fusion vs. total disc replacement : What can be done when?].

Motion preserving surgery within the cervical spine may be performed by special implants, for example, c spine disc prosthesis or total disc replacement (cTDR), or by simple decompression of the cervical nerve roots. However, also fusion surgery may be performed with good results. Here, we summarize indications as well as contraindications for motion preserving techniques and indications for fusion surgery.

Resection of a Hemivertebra Within the Craniocervical Junction.

Study Design: Case report on resection of a hemivertebra at the craniocervical junction.

Objective: To describe technique and result of a hemivertebra resection within the craniocervical junction (axis).

Summary Of Background Data: To our knowledge, this is the first report on a transoral and posterior hemivertebra resection at C2.

C1-C2 Instrumentation According to Harms/Goel in Case of Vertebral Artery below the Arch of C1: A Case Report.

 Case report.  For stabilizing surgery of the atlantoaxial region, a precise evaluation of the course of the vertebral artery (VA) is essential to avoid vessel injury and life threatening complications. In patients with aberrant VA course, an appropriate way for fusion needs to be found.

Sensitivity and specificity of ultrasound in spinal trauma in 29 consecutive patients.

Purpose: Indication for surgery in spine trauma patients depends on the extent of destruction of the spine. Computer-assisted tomography scan (CAT scan) is not suitable to diagnose type B-injuries. Aim of the study was to investigate whether ultrasound is able to detect destruction of the posterior ligament complex (PLC).

Left-right axial rotation within C1-2 after implant removal.

Object: Surgical treatment of atlantoaxial injuries may be performed by a variety of surgical procedures, with each of these having its own specific advantages and disadvantages. To preserve the range of motion within the atlantoaxial joint after surgical treatment, posterior atlantoaxial screw fixation according to the method of Goel and Harms could be beneficial. This technique is not considered to fix the joint permanently if the screws are removed.

[Challenges and characteristics of spondylodiscitis of the cervical spine].

The human cervical spine is a unique structure that differs dramatically from the thoracic and lumbar spine. The main differences concern the topographic anatomy of the spinal cord, anatomy and physiology of the occipito-atlanto-axial joint complex, the close course of the vertebral artery to the cervical spine and the very close relationship of the esophagus, vessels, peripheral and cranial nerves to the spine. To avoid serious complications during surgical treatment of spondylodiscitis within the cervical spine, these aspects must be kept in mind.

Local autograft retrieval from a cervical vertebral body: biomechanical consequences.

Object: To avoid the cost of bone graft substitutes and the morbidity of iliac crest bone graft retrieval, locally harvested vertebral body bone has been used to fill interbody cages. When marginal hypertrophic osteophytes are used, there is little impact on the adjacent vertebrae, but when cancellous bone is removed from the central part of the vertebral body, it is not clear how significantly this procedure weakens the vertebra. The objective of this study was to investigate the immediate mechanical response of the cervical spine after removing bone from the central vertebral body.