• Title/Summary/Keyword: Cervical vertebra

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Comparative Analysis of Three Different Cervical Lateral Mass Screw Fixation Techniques by Complications and Bicortical Purchase : Cadaveric Study

  • Baek, Jin-Wook;Park, Dong-Mook;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.193-198
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    • 2010
  • Objective : The purpose of this study is to compare the incidence of possible complications of cervical lateral screw fixation and the achievements of bicortical purchase using the Roy-Camille, Magerl and the modified methods. Methods : Six fresh-frozen cervical spine segments were harvested. The Roy-Camille technique was applied to C3 and C4, and the Magerl technique was applied to C5, C6, and C7 of one side of each cadaver. The modified technique was applied to the other side of each cadaver. The nerve root injury, violation of the facet joint, vertebral artery injury, and the bicortication were examined at each screwing level. Results : No vertebral artery injury was observed in any of the three methods. One nerve root injury was observed in each cervical spine segment using the Roy-Camille method (8.3%), the Magerl method (5.6%), and the modified method (3.3%). Facet joint injuries were observed in two cervical spinal segments using the Roy-Camille method (16.7%) and three with the Magerl method (16.7%), while five facet joint violations occurred when using the modified method (16.7%). Bicortical purchases were achieved on ten cervical spinal segments with the Roy-Camille method (83.3%) and Magerl method (55.6%), while twenty bicortical purchases were achieved in the modified method (66.7%). Conclusion : The advantages of the modified method are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known methods. This modified method can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

A Case of Airway Obstruction due to Retropharyngeal hematoma (기도폐쇄를 유발한 인두후 혈종 1예)

  • 박영학;전범조;조주은;최혁기
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.96-100
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    • 2003
  • Retrophayngeal hematomas frequently develop in patients who had cervical vertebra fracture. The hematoma develops in the space between buccopharyngeal fascia and prevertebral fascia. But it rarely causes severe airway obstruction. We recently treated a patient who had dyspnea and dysphagia due to a retropharyngeal hematoma without any significant trauma history. First, tracheostomy was performed to maintain the airway. Then, incision and drainage was done under suspension laryngoscope. This case shows the fact that a retropharyngeal hematoma can result in severe airway obstruction even after a minor trauma.

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The Immediate Effect of Maitland Cervical Spine Mobilization on Tone and Stiffness of Upper Limb Muscles in Chronic Stroke Patients (메이틀랜드 목뼈 가동술이 만성 뇌졸중 환자의 팔 긴장도 및 뻣뻣함에 미치는 즉각적인 영향)

  • Park, Shin-jun
    • Physical Therapy Korea
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    • v.25 no.2
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    • pp.13-21
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    • 2018
  • Background: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group ($n_1=10$), a placebo group ($n_2=10$), and a control group ($n_3=10$). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton(R)PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone.

Anterior Approach Following Intraoperative Reduction for Cervical Facet Fracture and Dislocation

  • Kim, Seul Gi;Park, Seon Joo;Wang, Hui Sun;Ju, Chang Il;Lee, Sung Myung;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.202-209
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    • 2020
  • Objective : The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation. Methods : Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period. Results : The cohort comprised 15 men and eight women with a mean age of 57 years (from 24 to 81). All patients were operated on within the first 8 hours following the injury. After gentle manual reduction or closed reduction with Gardner-Wells traction, under general anesthesia monitored by somatosensory-evoked potentials, all operations were successfully completed using the anterior approach alone except in two patients, who had a risk of over-distraction. In them, a satisfactory gentle manual reduction or closed reduction was not possible, and required open posterior reduction of the locked facets followed by anterior cervical discectomy and fusion. In one patient, screw retropulsion was observed in 1 month after surgery. There were no reduction-related complications or neurological aggravations after surgery. All patients showed evidence of stability at the instrumented level at the final follow-up (mean follow-up, 12 months). Conclusion : Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction.

Giant Ventral Midline Schwannoma of Cervical Spine : Agonies and Nuances

  • Mahore, Amit;Chagla, Aadil;Goel, Atul
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.454-457
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    • 2010
  • Pure ventral midline giant schwannoma is an extremely rare entity. Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated giant pan cervical extramedullary schwannoma in an 18-year-old male patient with compressive myelopathy and sphincter involvement is presented. Spinal MR imaging showed a midline ventrally situated extramedullary tumor with severe spinal cord compression extending from clivus to C7 vertebra. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. Post operative MR imaging showed no evidence of the tumor. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed.

Morphometrical Study of Uncinate Processes and Vertebral Body of Cervical Spine

  • Lee, Tae-Hoon;Kim, Sang-Jin;Chung, In-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.247-252
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    • 2012
  • Objective : The anatomical knowledge is the most important and has a direct link with success of operation in cervical spine surgery. The authors measured various cervical parameters in cadaveric dry bones and compared with previous reported results. Methods : We made 255 dry bones age from 19 to 72 years (mean, 42.3 years) that were obtained from 51 subjects in 100 subjects who donated their bodies. All measurements from C3-C7 levels were made using digital vernier calipers, standard goniometer, and self-made fix tool for two different cervical axes (canal and disc setting). We classified into 4 groups (uncinate process, vertebral body, lamina, and pedicle) and measured independently by two neurosurgeons for 28 parameters. Results : We analyzed 23970 measurements by mean value and standard deviations. In comparing with previous literatures, there are some different results. The mean values for uncinate process (UP) width ranged from 5.5 mm at C4 and 5 to 6.3 mm at C3 and C7 in men. Also, in women, the mean values for UP width ranged from 5.5 mm at C5 to 6.3 mm at C7. C7 was widest and C5 was most narrow than other levels. The antero-posterior length of UP tended to increase gradually from C3 to C6. The tip way, tip distance, and base distance of UP also showed increasing pattern from C3 to C7. Conclusion : These measurements can provide the spinal surgeons with a starting point to address bony architectures surrounding targeted soft tissues for safeguard against unintended damages during cervical operation.

Cervical Lymph Node Metastases of Tonsillar Squamous Cell Carcinoma in a Shih-tzu (시츄견에서 경부 림프절로 전이된 편도 편평세포암종)

  • Jung, Dong-In;Lee, Kyung-Woo;Park, Ki-Tae;Wang, Ji-Hwan;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.154-158
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    • 2011
  • A 8-year-old female Shih-tzu dog (weighting 4.5 kg) with history of both hindlimb lameness and cervical mass was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, ataxia, kyphosis, back pain and cervical mass were identified. Marked periosteal new bone formation of the fourth lumbar vertebra and soft tissue opacity mass of cervical region were observed in survey radiographs. Transverse computed tomography (CT) scan obtained at the lumbar and cervical lesions shown a well defined multilobulated bony mass and partially destructive lytic lesions the fourth lumbar vertebral body and a enlarged retropharyngeal lymph node with heterogeneous contrast enhancement and moderately enhancing left tonsillar mass. Neoplastic squamous epithelium which have developed vessel and lymphocyte infiltration in surrounding tissue were confirmed based on histopathologic examination. Based on the diagnostic findings the dog was diagnosed as a cervical lymph node metastases of tonsillar squamous cell carcinoma.

Effect of Shoulder stabilization exercise and McKenzie Exercise on Forward Head Posture (거북목을 가진 사람에게 메켄지 폄운동과 어깨안정화운동이 앞쪽머리자세에 미치는 영향)

  • Lee, Jun-cheol
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.227-235
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    • 2019
  • The purpose of this study was to investigate the effects of cervical vertebral height and shoulder stabilization on anterior head posture in people with turtle neck. The subjects of this study consisted of normal and healthy people with 30 turtle necks. Subjects were randomly assigned to shoulder stabilization exercise and cervical vertebrae exercise (30 men, 15 men and 15 women, height: $168.67{\pm}6.51$, $22.33{\pm}8.27$, $65.03{\pm}11.98$, and $28.66{\pm}1.91$), In the experimental group, shoulder stabilization exercise and cervical spine exercise were performed for 4 weeks. Deep neck flexor, leavator scapular, upper trapezius, rhomboid, and lower trapezius showed significant differences in shoulder stabilization and cervical vertebrae before and after the experiment. As a result, the CVA value decreased significantly and the muscle activity value increased significantly when exercise and Mckenzie program were applied. These results show that exercise and Mckenzie programs have a positive effect on turtle neck improvement.

Repetitive Dorsiflexion Exercises in Ankles have Effects on the Active Range of Flexion and Extension Motion through Lumbar, Cervical Spine and Ankle, Wrist Joints (족관절의 반복적 배측굴곡 운동이 요.경추와 족.수관절의 능동 굴신 가동범위에 미치는 영향)

  • Moon, Sang-Eun;An, Sung-Jun;Jung, Dong-Sub
    • Journal of Korean Physical Therapy Science
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    • v.15 no.4
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    • pp.27-34
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    • 2008
  • Background: This study was designed to analyze Repetitive dorsiflexion exercises in ankles have effects on the active range of flexion and extension motion through lumbar, cervical spine and ankle, wrist joints. Methods: 30 female college students in their twenties who frequently wear high heels participated the number of the experimental group was 15 persons and the number of the control group was 15 persons. They did exercise at the physical therapy room in M college, from the 8th of March to the 11th of April 2007. The experimental group had used the model of dorsiflexion repetitive exercise three times per week, for 4 weeks, but the control group did not exercise at all. In the sagittal plane active ROM of the these spine and joints were measured before and after the experiment using a digital goniometer. The results of two groups were compared and analyzed using paired T-test. Results: The active range of flexion and extension motion of the vertebra(especially lumbar flexion) and distal joints were significantly different in exercise group(p<.05). Conclusion: The model of repetitive dorsiflexion exercise of the ankle joint had positive effects on improving the active range of flexion and extension motion of the lumbar vertebra and distal joints of limbs. The results suggest that the repetitive dorsiflexion exercise is useful and also effective therapy for improving motion in women usually wearing high-heel.

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A Case of Recurrent Papillary Thyroid Carcinoma with Adrenal Metastasis (재발 유두 갑상선암의 부신전이 1예)

  • Kim, Chang-Woo;Yun, Ji-Sup;Lee, Yong-Sang;Nam, Kee-Hyun;Chung, Woong-Youn;Hong, Soon-Won;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.50-53
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    • 2007
  • Adrenal metastasis from papillary thyroid carcinoma is extremely rare. We present herein a patient with adrenal metastases from recurrent papillary carcinoma of the thyroid. A 54 year-old woman had received a total thyroidectomy and postoperative radioactive iodine therapy for locally advanced papillary thyroid carcinoma. One year after initial surgery, distant metastases to multiple organs including right cervical lymph nodes, left upper lung, left 2nd and 3rd ribs, 2nd thoracic vertebra and left adrenal gland were found by 18-FDG-PET-CT whole body scan. She underwent right modified neck dissection, partial resection of left 2nd and 3rd ribs, posterior arch of 2nd thoracic vertebra, left upper lobectomy of lung, and left adrenalectomy. On histologic examination, metastases to the left adrenal gland and cervical lymph nodes were papillary thyroid carcinomas, while other metastatic sites turned out to be anaplastic thyroid carcinomas. Despite aggressive surgery and postoperative adjuvant therapy, her general clinical conditions were getting worse day by day due to regrowing of the anaplastic thyroid carcinomas. To our knowledge, this is the first case reported in Korea.