• Title/Summary/Keyword: Cervical plate

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Management of Unilateral Facet Dislocation of the Cervical Spine

  • Baek, Geum-Seong;Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.295-300
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    • 2007
  • Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

PCB Instrumentation with Lubboe Bone in Anterior Cervical Interbody Fusion (PCB 기구와 이종골을 이용한 경추체간 전방 유합술)

  • Park, Jeong Hyun;Oh, Seong Hoon;Yi, Hyeong Joong;Kim, Ju Heon;Kim, Young Soo;Ko, Yong;Kim, Kwang Myung;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1284-1290
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    • 2001
  • Objective : PCB cervical instrument is a newly introduced fusion device which comprises cervical plate, cage (spacer) and screw system. It is developed to enhance fusion rate and stability, as well as to reduce complications related to hardware failure. We investigated the efficacy of clinical and radiological results of PCB instrument and Lubboc bone. Methods : From August, 1998 to October, 1999, authors performed 54 cases of anterior cervical interbody fusion with PCB instrument and Lubboc bone. Retrospective analysis was undertaken based on clinical and radiological findings. Clinical improvement was evaluated according to Odom's criteria. Cervical plain films and tomography were taken every 2 months to evaluate the degree of interbody fusion and disc height changes. Results : Bone fusion was observed in 36 cases(90%) over 6 months after operation, and during which time there was no significant interval change. There were 3 cases of hardware dislodgement. Disc height was increased significantly and preserved in all cases. Clinical outcome over good degree was seen more than 94% of patients. Conclusion : Longer follow-up period and comparative studies to similar instrument appear to be necessary, but this instrumentation system has shown high fusion rate and fewer adverse effects in our series. We believe this system might be indicated for the treatment of cervical trauma and degenerative disease in selective cases.

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Comparative Study on Biomechanical Behavior of Various Cervical Stand-Alone Cage Designs (경추용 일체형 추간체 유합 보형재의 디자인 변화에 따른 생체역학적 효과 비교 연구)

  • Park, Kwang Min;Jung, Tae Gon;Jeong, Seung Jo;Lee, Sung Jae
    • Journal of the Korean Society for Precision Engineering
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    • v.33 no.11
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    • pp.943-950
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    • 2016
  • The purpose of this study was to evaluate and compare by finite element analysis the biomechanical performance, in terms of cervical stand-alone cage screw insert angle (Type 3 - 5: 2 Screws) and screw arrangement (Type 6 and 7: 3 Screws / Type 8 and 9: 4 Screws), and the range of motion (ROM) of traditional anterior cervical discectomy of a fusion device (Type 1: Cage / Type 2: Cage + ACP). Our study suggests that the biomechanical behavior of a postoperative cervical spine could indeed be influenced by design features, such as screw angle and number of screws. In particular, ROM and the risk of subsidence were more sensitive during extension about type 5 (Insert Angle $20^{\circ}$). Our study also suggested that the number of screw asymmetries between up and down for type 6 and 7 could result in differences in the risk of screw fracture manifesting in different clinical aspects.

Changes of the Electromyographic Activity by Head Posture and Cervical Spine Shape (두부자세와 경추형태에 따른 근활성의 변화에 관한 연구)

  • Ho-Chun Hwang;Kyung-Soo Han;Chan Jung
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.393-405
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    • 1996
  • This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.

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Tumor Surpressor Gene Therany, and Natural Product with Vectors[Aoenouirus, Aoenn associated virus] in Human Papilloma virus (HPV[Human papilloma virus]유래 바이러스 벡터[Adenovirus, Adeno associated virus]를 이용한 암 억제유전자치료법과 자연산물에서의 암 억제 효과)

  • 천병수;노민석;유종수;김준명
    • KSBB Journal
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    • v.16 no.6
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    • pp.579-591
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    • 2001
  • The cell growth inhibitor effect of cervical cancer cells was investigated by liposome mediated transfection (pRcCMVp53/lipofectin) and by transfection using adenovirus (AdCMVp57). The papilloma virus cancer cell lines we used in this study were HPV16 positive, having inhibiter gene, wild p53 gene, CaSki, SiHa, HPV18 positive HeLa, HeLaS3 and HPV negative C33A, HT3. LacZ gene of E.coli was used as the marker gene for the transfection efficiency. The effect on the inhibition of tumor cell growth was measured by cell count and cell viability though ELISA analysis and MTT assay. The inhibition of tumor cell growth was confirmed by measuring each assay for six days, comparing with the normal control cell growth. The cell growth of cervical cancer calls by transfection was significantly reduced and showed tittle differences among the cell lines. To eliminate the potential problem of Ad(adenovirus) contamination during rAAV production, rAAV can be produced by a triple transfection of vector plasmic, packaging plasmid, and adenovirus helper plasmid. To examine the helper functions of Ad plasmids on the production of rAAV vector, we carried out cotransfection of three plasmids, AAV vector, packaging construct, and Ad helper plasmids. The optimized transfection condition for calcium phosphate method is 25ug of total DNA per 10-cm-diameter plate of 293 cell. We found that rAAV yields peaked at 48hr after Ad infection. The titer of rAAV was measured by the dot blot analysis to measure the number of particles/ml based on the quantification of viral DNA. Recent1y, Kombucha(fungi) was identified as a very potent antileukefic agent. In the present study, effect of natural toxin(plankton) and Kombucha is PSP(GTXI-3, neoSTX), on various MTT assay cervical cancer cell line. Toxin(GTX 1-3, neoSTX) also inhibited the proliferation in primary cervical cancer calls in a dose-dependent toxin concentration. These results showed that toxin was very potent in inhibiting the proliferation of cervical cancer calls in vitro. Toxins and Kombuoha exhibited a dose dependent inhibition of cellular proliferation in cancer cell line.

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Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

  • Kang, Jung Hoon;Im, Soo-Bin;Yang, Sang-Mi;Chung, Moonyoung;Jeong, Je Hoon;Kim, Bum-Tae;Hwang, Sun-Chul;Shin, Dong-Seong;Park, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.671-680
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    • 2019
  • Objective : We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL). Methods : Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom's criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months. Results : In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom's criteria or between the single-level and two-level corpectomy groups. Conclusion : The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.

Posterior Cervical Fixation with Nitinol Shape Memory Loop in the Anterior-Posterior Combined Approach for the Patients with Three Column Injury of the Cervical Spine: Preliminary Report

  • Yu, Dong-Kun;Heo, Dong-Hwa;Cho, Sung-Min;Choi, Jong-Hun;Sheen, Seung-Hun;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.303-307
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    • 2008
  • Objective: The authors reviewed clinical and radiological outcomes in patients with three column injury of the cervical spine who had undergone posterior cervical fixation using Nitinol shape memory alloy loop in the anterior-posterior combined approach. Materials: Nine patients were surgically treated with anterior cervical fusion using an iliac bone graft and dynamic plate-screw system, and the posterior cervical fixation using Nitinol shape memory loop ($Davydov^{TM}$) at the same time. A retrospective review was performed. Clinical outcomes were assessed using the Frankel grading method. We reviewed the radiological parameters such as bony fusion rate, height of iliac bone graft strut, graft subsidence, cervical lordotic angle, and instrument related complication. Results: Single-level fusion was performed in five patients, and two-level fusion in four. Solid bone fusion was presented in all cases after surgery. The mean height of graft strut was significantly decreased from $20.46{\pm}9.97mm$ at immediate postoperative state to $18.87{\pm}8.60mm$ at the final follow-up period (p<0.05). The mean cervical lordotic angle decreased from $13.83{\pm}11.84^{\circ}$ to $11.37{\pm}6.03^{\circ}$ at the immediate postoperative state but then, increased to $24.39{\pm}9.83^{\circ}$ at the final follow-up period (p<0.05). There were no instrument related complications. Conclusion: We suggest that the posterior cervical fixation using Nitinol shape memory alloy loop may be a simple and useful method, and be one of treatment options in anterior-posterior combined approach for the patients with the three column injury of the cervical spine.

Cervical spine reconstruction after total vertebrectomy using customized three-dimensional-printed implants in dogs

  • Ji-Won Jeon;Kyu-Won Kang;Woo-Keyoung Kim;Sook Yang;Byung-Jae Kang
    • Journal of Veterinary Science
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    • v.25 no.1
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    • pp.2.1-2.14
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    • 2024
  • Background: Sufficient surgical resection is necessary for effective tumor control, but is usually limited for vertebral tumors, especially in the cervical spine in small animal neurosurgery. Objective: To evaluate the primary stability and safety of customized three-dimensional (3D)-printed implants for cervical spine reconstruction after total vertebrectomy. Methods: Customized guides and implants were designed based on computed tomography (CT) imaging of five beagle cadavers and were 3D-printed. They were used to reconstruct C5 after total vertebrectomy. Postoperative CT images were obtained to evaluate the safety and accuracy of screw positioning. After harvesting 10 vertebral specimens (C3-C7) from intact (group A) and implanted spines (group B), implant stability was analyzed using a 4-point bending test comparing with groups A and C (reconstituted with plate and pins/polymethylmethacrylate after testing in Group A). Results: All customized implants were applied without gross neurovascular damage. In addition, 90% of the screws were in a safe area, with 7.5% in grade 1 (< 1.3 mm) and 2.5% in grade 2 (> 1.3 mm). The mean entry point and angular deviations were 0.81 ± 0.43 mm and 6.50 ± 5.11°, respectively. Groups B and C significantly decreased the range of motion (ROM) in C3-C7 compared with intact spines (p = 0.033, and 0.018). Both groups reduced overall ROM and neutral zone in C4-C6, but only group B showed significance (p = 0.005, and 0.027). Conclusion: Customized 3D-printed implants could safely and accurately replace a cervical vertebra in dog cadavers while providing primary stability.

Mesenchymal Chondrosarcoma of the Cervical Spine - Case Report - (경추부에 발생한 간엽성 연골육종 - 증 례 보 고 -)

  • Kwon, O Hyun;Kim, Jung Deuk;Park, Sang June;Kim, Eui Joong;Yoon, Sung Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1336-1339
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    • 2001
  • Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.

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Comparison of treatment effects between the modified C-palatal plate and cervical pull headgear for total arch distalization in adults

  • Park, Chong Ook;Sa'aed, Noor Laith;Bayome, Mohamed;Park, Jae Hyun;Kook, Yoon-Ah;Park, Young-Seok;Han, Seong Ho
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.375-383
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    • 2017
  • Objective: The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear. Methods: The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, $24.7{\pm}7.7years$) and 22 who received treatment with cervical pull headgear (age, $23.0{\pm}7.7years$). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups. Results: The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and $3.9^{\circ}$ in the MCPP group, and 2.3 mm, 0.6 mm, and $8.6^{\circ}$ in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups. Conclusions: The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.