• 제목/요약/키워드: Cervical computed tomography

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The Inaccuracy of Surface Landmarks for the Anterior Approach to the Cervical Spine in Southern Chinese Patients

  • Ko, Tin Sui;Tse, Michael Siu Hei;Wong, Kam Kwong;Wong, Wing Cheung
    • Asian Spine Journal
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    • 제12권6호
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    • pp.1123-1126
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    • 2018
  • Study Design: Observational study. Purpose: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.

Cervical Spine Malformations Associated With a 5q34-5q35.2 Micro-interstitial Deletion: A Case Report

  • Lee, Heewon;Kim, Joon Sung;Lim, Seong Hoon;Sul, Bomi;Hong, Bo Young
    • Annals of Rehabilitation Medicine
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    • 제42권6호
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    • pp.884-887
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    • 2018
  • We report a female proband carrying a de novo 5q34-q35.2 deletion breakpoint, and review the unique skeletal phenotype and possible genotype related to this mutation. The patient presented with a persistent head tilt and limited head rotation. Non-contrast-enhanced three-dimensional computed tomography of the cervical spine revealed several malformations including a bone cleft in the right pars interarticularis, a bone defect in both C5 lamina and the transverse foramen at C2-C3, agenesis of the right articular process of C5, bony fusion of C4-C5, and subluxation of the craniocervical joints. Several deformities of the cervical spine seen in this patient have not been associated with the 5q deletion. A review of 5q-related mutations suggests that abnormalities associated with MSX2 gene might cause cervical spine abnormalities.

폐암의 경추 전이로 인한 경추통 환자 1예 (Neoplasm Metastasis of Cervical Vertebrae Found in Lung Neoplasm Patient Suffering Neck Pain: A Case Report)

  • 김민우;이지원;조동찬;고연석
    • 한방재활의학과학회지
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    • 제31권3호
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    • pp.133-139
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    • 2021
  • The purpose of this study is to report a case in which neoplasm metastases of cervical vertebrae were found in lung cancer patient during inpatient treatment for neck pain. Pain assessment and physical examination including numeral rating scale, range of motion of neck, Spurling's test, cervical compression test were performed. As a result, C-spine series X-ray was taken under the judgement it is not a simple neck pain. Bone metastases were suspected as X-ray showed loss of C7 left pedicle, indistinct C7 left transverse process and indistinct C4 upper margin. Magnetic resonance imaging and computed tomography were taken as further examination, and metastases of C4, C6, C7 were confirmed. The patient was transferred for professional treatment. In conclusion, this study shows the importance of appropriate diagnostic evaluation such as pain assessment and physical examination, and the need for diagnostic imaging in the treatment of patients with neoplasm history.

Complex Acupuncture Treatment for Cervical Ossification of Posterior Longitudinal Ligament: Case Report of Two Patients

  • Jae Hyung Kim;Ga Young Choi;Sang Ha Woo;Jung Hee Lee;Hyun Jong Lee;Jae Soo Kim
    • Journal of Acupuncture Research
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    • 제40권3호
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    • pp.265-271
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    • 2023
  • Ossification of the posterior longitudinal ligament (OPLL) is a disease that narrows the spinal canal, causing neurological symptoms. To date, there have been several reports on traditional Korean medicine treatments for OPLL; however, there is no study on complex acupuncture treatment. Herein, we report 2 cases of cervical OPLL involving cervical pain, upper limb radiating pain, and hypoesthesia. The patients were diagnosed using C-spine computed tomography and did not receive any treatment at any other hospital. The patients were treated with acupuncture treatments, including electroacupuncture, pharmacopuncture, and acupotomy, at Daegu Korean Medicine Hospital at Daegu Haany University. The results were assessed using the visual analog scale, neck disability index, and Japanese Orthopedic Association scores, and the results indicated an improvement in the symptoms. Thus, this study demonstrated that complex acupuncture treatment may be helpful for treating cervical OPLL and improving the quality of life.

두경부 편평세포암종의 경부 전이에 대한 F-18 FDG PET의 진단적 유용성 (Diagnostic Usefulness of FDG-PET in Cervical Metastasis of Squamous Cell Carcinoma of the Head and Neck)

  • 김찬종;김재승;강우석;남순열;최승호;김상윤
    • 대한두경부종양학회지
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    • 제19권2호
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    • pp.142-147
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    • 2003
  • Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

Comparison of Morphological Characteristics of the Subaxial Cervical Spine between Athetoid Cerebral Palsy and Normal Control

  • Kim, Jun Young;Kwon, Jae Yeol;Kim, Moon Seok;Lee, Jeong Jae;Kim, Il Sup;Hong, Jae Taek
    • Journal of Korean Neurosurgical Society
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    • 제61권2호
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    • pp.243-250
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    • 2018
  • Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. Results : LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. Conclusion : LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.

Automatic Segmentation of Vertebral Arteries in Head and Neck CT Angiography Images

  • Lee, Min Jin;Hong, Helen
    • Journal of International Society for Simulation Surgery
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    • 제2권2호
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    • pp.67-70
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    • 2015
  • We propose an automatic vessel segmentation method of vertebral arteries in CT angiography using combined circular and cylindrical model fitting. First, to generate multi-segmented volumes, whole volume is automatically divided into four segments by anatomical properties of bone structures along z-axis of head and neck. To define an optimal volume circumscribing vertebral arteries, anterior-posterior bounding and side boundaries are defined as initial extracted vessel region. Second, the initial vessel candidates are tracked using circular model fitting. Since boundaries of the vertebral arteries are ambiguous in case the arteries pass through the transverse foramen in the cervical vertebra, the circle model is extended along z-axis to cylinder model for considering additional vessel information of neighboring slices. Finally, the boundaries of the vertebral arteries are detected using graph-cut optimization. From the experiments, the proposed method provides accurate results without bone artifacts and eroded vessels in the cervical vertebra.

Metastatic thyroid C-cell carcinoma in a beagle dog

  • Lee, So-Ra;Lee, Mi-Kyoung;Youp, Kyoung-A;Lee, Ah-Ra;Won, Sung-Jun;Kim, Myung-Chul;Kim, So-Yeon;Kim, Yongbaek
    • 대한수의학회지
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    • 제53권3호
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    • pp.189-192
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    • 2013
  • An adult beagle dog was presented with a cervical mass detected by palpation and computed tomography. Fine needle aspirates revealed numerous epithelial cells with plasmacytoid appearance and frequent naked nuclei. Histologically, the mass consists of multiple packets of neoplastic cells and extensive areas of necrosis and fibrosis. Neoplastic cells were also found in submandibular lymph nodes. Immunohistochemistry showed that neoplastic cells were positive for calcitonin and negative for thyroglobulin. Based on these findings, the cervical mass was diagnosed as thyroid C-cell carcinoma. Almost one year after the surgical excision, the dog remains healthy without any symptom of recurrence or metastasis.

Pain Management with Extracorporeal Shockwave Treatment in Multiple Level Clay-shoveler's Fracture in a Novice Golfer: A Case Report

  • Seongho Woo;Kwangohk Jun;Hyoshin Eo;KooWon Mo;Sunyoung Joo;Donghwi Park;Chung Reen Kim
    • The Journal of Korean Physical Therapy
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    • 제35권6호
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    • pp.163-166
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    • 2023
  • A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

Alveolar bone thickness around maxillary central incisors of different inclination assessed with cone-beam computed tomography

  • Tian, Yu-lou;Liu, Fang;Sun, Hong-jing;Lv, Pin;Cao, Yu-ming;Yu, Mo;Yue, Yang
    • 대한치과교정학회지
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    • 제45권5호
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    • pp.245-252
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    • 2015
  • Objective: To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). Methods: Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. Results: The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. Conclusions: Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.