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Advances in surgical treatment for atlantoaxial instability focusing on rheumatoid arthritis: Analysis of a series of 67 patients.
Int J Rheum Dis
October 2023
Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Article Synopsis
- An estimated 88% of rheumatoid arthritis (RA) patients deal with cervical spine issues, specifically atlantoaxial instability (AAI), which can complicate surgical procedures.
- This study reviewed 20 years of surgeries on 67 AAI patients, employing advanced techniques like fluoroscopy, surgical navigation, and augmented reality to enhance surgical accuracy.
- The findings suggest that using CT-based image-guided surgery and augmented reality can significantly improve the outcomes of C1-C2 surgeries, especially for RA patients facing technical challenges.
Unilateral facet fixation as a salvage procedure: Report of two cases with cervical primary bone tumors with extensive bone destruction.
J Craniovertebr Junction Spine
June 2023
K. J. Somaiya Medical College, Hospital and Research Center, Mumbai, Maharashtra, India.
We describe cases of two patients with primary cervical bone tumors that resulted in extensive destruction of bones of the region. In the first patient, the tumor and its growth resulted in the destruction of C3-C5 vertebral bodies and the unilateral destruction of facets and pedicles. In the second case, there was focal destruction of the body and odontoid process and unilateral pedicle and facet of C2.
View Article and Find Full Text PDFPredictors factors of atlanto-axial subluxation in Tunisian patients with rheumatoid arthritis.
Musculoskeletal Care
September 2023
Department of Rheumatology, Kassab Institute of Orthopaedics, La Mannouba, Tunisia.
Background: The aim of this study was to describe clinical and imaging features of atlantoaxial subluxation (AAS) and the associated risk factors in patients with rheumatoid arthritis (RA).
Methods: We conducted a retrospective and comparative study including 51 RA patients with AAS and 51 RA patients without AAS. Atlantoaxial subluxation was defined by the presence of an anterior C1C2 diastasis on the cervical spine radiograph in hyperflexion and/or an anterior, posterior, lateral or rotatory C1C2 dislocation on MRI with/without inflammatory signal.
Surgical management of Grisel syndrome in the adult patient: illustrative case.
J Neurosurg Case Lessons
March 2022
Article Synopsis
- - Grisel syndrome is an infectious condition that affects the cervical spine, leading to instability, primarily seen in children, but this case highlights a rare occurrence in an adult where the right atlantoaxial facet joint was destroyed, causing misalignment of the head and neck.
- - The infection led to serious complications, including a contusion of the cervical spinal cord due to the brainstem being compressed against a fixed point, resulting in the patient experiencing neck twisting (torticollis) and weakness in the left arm.
- - Treatment involved a surgical procedure to realign the cervical spine under anesthesia, followed by a fusion operation using various surgical techniques to stabilize the severely unstable junction between the skull and cervical spine, emphasizing important surgical strategies
An Unusual Chordoma of the Odontoid Process: A Case Report and Literature Review.
J Am Acad Orthop Surg Glob Res Rev
May 2022
From the Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
The aim of this study is to present a rare case of chordoma in the odontoid process in which the tumor involved the odontoid process and compressed the spinal cord at the craniocervical junction. We report on the effectiveness and successful outcome of anterior microscopic tumor resection combined with posterior occipitocervical fixation and review the current standard treatment. A 39-year-old man presented with sudden dyspnea and quadriparesis caused by an unknown tumor compression at C2.
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