Introduction: Motion preserving techniques in C1 ring fractures are increasingly used especially in young patients. Therefore, lateral mass screws are inserted in the first vertebra and connected by a rod. The purpose of this study was to determine safe zones regarding the vertebral arteries and the medulla oblongata for optimal lateral mass screw positioning when fusing the C1-ring.
Materials And Methods: Images of the cervical spine of 50 patients (64-line CT scanner) were evaluated and virtual screws were positioned in both lateral masses of the first vertebra using 3D-reconstructions of CT scans. The length of the screws, the insertion angles in two planes, the distance to the vertebral artery, and the spinal canal was investigated. Descriptive statistics was used and gender-dependent differences were calculated using student t-test. A diameter of 4 mm was chosen for the screws.
Results: The mean screw length was 30.0 ± 2.3 mm on the right and 30.1 ± 2.1 mm on the left side. The arithmetic mean for the transverse angle was 16.4 ± 5.6° on the right and 15.6 ± 6.3° on the left, the sagittal angle averaged 8.3 ± 3.8° on the right, and 11.0 ± 4.9° on the left side. The mean distance between screw and spinal canal has been determined on the right with 2.4 ± 0.7 mm and 2.2 ± 0.6 mm on the left side. The distance from the C1 lateral mass screw to the vertebral artery was on average 7.1 ± 1.5 mm on the right side (significant correlation with gender, p value: 0.03) and 7.4 ± 1.4 mm on the left side.
Conclusions: Screws should be positioned with a slightly converging angle of 16° and a slightly ascending angle of 10°. Due to the required high precision technique intraoperatively multiplanar 2 D or 3 D imaging is recommended to avoid harm to the vertebral artery or the spinal canal.
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http://dx.doi.org/10.1007/s00402-017-2678-y | DOI Listing |
AME Case Rep
November 2024
Department of Oncology Surgery, Qinghai University Affiliated Hospital, Xining, China.
Background: Occult papillary thyroid carcinoma (PTC) refers to the PTC accidentally found due to its occult lesions. Classic, as the most common subtype of PTC, is usually considered to have a low degree of malignancy and a favorable prognosis. Currently, the American Thyroid Association Management Guidelines adopted active surveillance (AS) as an alternative to immediate surgery in some low-risk PTC patients with less than 1 cm in diameter.
View Article and Find Full Text PDFRes Vet Sci
January 2025
Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy.
A Roman goose (Anser anser domesticus) was presented with a large mass on the left lateral side of the neck with a smaller satellite mass on the right. Utilizing radiography, blood tests, and histological and immunohistochemical investigations, a diagnosis of cutaneous T-cell lymphoma associated with hypercalcemia of malignancy was established. The involvement of oncogenic viruses was ruled out through PCR and RT-PCRs.
View Article and Find Full Text PDFClin Nutr ESPEN
January 2025
Professor of Department of Physical Education, São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente (SP), Brazil.
Objective: To analyze the relationship between body fat, motor skills, and physical fitness in children and adolescents.
Methods: 216 children and adolescents (143 males and 73 females, aged 5-15 years) from a social project composed this study. Body mass and height were measured to calculate the body mass index (BMI).
Int J Surg Case Rep
January 2025
Oral and Maxillofacial surgery Unit, Department of Dental and Maxillofacial Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Introduction: Pleomorphic adenoma, the most common benign salivary gland tumor, typically occurs in the parotid region but can also arise in minor salivary glands. Its occurrence in the lateral tongue is infrequent, making this case the first reported from Ethiopia and the second in English literature.
Case Presentation: We present an 11-year-old girl who underwent an excisional biopsy for a tongue swelling lasting 2 years.
Fertil Steril
January 2025
Department of Gynaecology, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia.
Objective: To study and address the diagnostic, management, and classification challenges of unilocular myometrial cystic lesions adjacent to a normal uterine cavity.
Design: Describe 23 further cases, and undertake a systematic review using Medline, PubMed and Ovid for similar lesions.
Subjects: 23 cases of accessory uterine cavities presenting to pediatric and adolescent gynecologists in Australia and New Zealand.
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