Lateral Retropharyngeal Approach to the Upper Cervical Spine: Long-term Follow-up

Study Design: Retrospective. Objectives: To present rarely reported complex fractures of the upper cervical spine (C1-C2) and discuss the clinical results of the posterior temporary C1-2 pedicle screws fixation for C1-C2 stabilization. Methods: A total of 19 patients were included in the study (18 males and 1 female). Their age ranged from 23 to 66 years (mean age of 39.6 years). The patients were diagnosed with complex fractures of the atlas and the axis of the upper cervical spine and underwent posterior temporary C1-2 pedicle screws fixation. The patients underwent a serial postoperative clinical examination at approximately 3, 6, 9 months, and annually thereafter. The neck disability index (NDI) and the range of neck rotary motion were used to evaluate the postoperative clinical efficacy of the patients. Results: The average operation time and blood loss were 110 ± 25 min and 50 ± 12 ml, respectively. The mean follow-up was 38 ± 11 months (range 22 to 60 months). The neck rotary motion before removal, immediately after removal, and the last follow-up were 68.7 ± 7.1°, 115.1 ± 11.7°, and 149.3 ± 8.9° ( P < 0.01). The NDI scores before and after the operation were 42.7 ± 4.3, 11.1 ± 4.0 ( P < 0.01), and the NDI score 2 days after the internal fixation was removed was 7.3 ± 2.9, which was better than immediately after the operation ( P < 0.01), and 2 years after the internal fixation was removed. The NDI score was 2.0 ± 0.8, which was significantly better than 2 days after the internal fixation was taken out ( P < 0.001). Conclusions: Posterior temporary screw fixation is a good alternative surgical treatment for unstable C1-C2 complex fractures.

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Long-term follow-up of the progression of ossification of the posterior longitudinal ligament

Journal of Neurosurgery Spine ◽

10.3171/2010.1.spine09452 ◽

2010 ◽

Vol 12 (5) ◽

pp. 577-579 ◽

Cited By ~ 17

Author(s):

Motoaki Murakami ◽

Atsushi Seichi ◽

Hirotaka Chikuda ◽

Katsushi Takeshita ◽

Kozo Nakamura ◽

...

Keyword(s):

Cervical Spine ◽

Mixed Type ◽

Posterior Longitudinal Ligament ◽

Maturation Process ◽

Initial Stage ◽

Initial Symptoms ◽

Long Term Follow Up

The authors report the case of a man with cervical ossification of the posterior longitudinal ligament (OPLL) who was observed for more than 26 years. Initial symptoms consisted of subtle numbness of the hands, and initial radiography showed small, segmental-type OPLL in the cervical spine. Lateral radiography of the cervical spine was performed every few years. Ossification accelerated for about 4 years during the follow-up. Segmental-type OPLL developed into mixed-type extensive OPLL. This case shows an accelerating maturation process of OPLL over the course of a few years. Segmental-type OPLL appears to represent an initial stage of extensive OPLL.

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Atlantal fracture with transverse ligament disruption in a child

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.4.peds0973 ◽

2009 ◽

Vol 4 (3) ◽

pp. 196-198 ◽

Cited By ~ 2

Author(s):

Marcelo D. Vilela ◽

Eric C. Peterson

Keyword(s):

Cervical Spine ◽

Surgical Treatment ◽

Upper Cervical Spine ◽

Transverse Ligament ◽

Jefferson Fracture ◽

Fractures In Children ◽

Upper Cervical ◽

Almost All ◽

Ligament Disruption

Even though fractures in children with immature spines occur predominantly in the upper cervical spine, isolated C-1 fractures are relatively rare. The fractures in almost all cases reported to date were considered stable due to the presence of the intact transverse ligament. The authors report the case of a young child who sustained a Jefferson fracture and in whom MR imaging revealed disruption of the transverse ligament. Although surgical treatment has been suggested as the treatment of choice for children with unstable atlantoaxial injuries, external immobilization alone allowed a full recovery in the patient with no evidence of instability at follow-up.

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Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.5.4.313 ◽

2006 ◽

Vol 5 (4) ◽

pp. 313-319 ◽

Cited By ~ 35

Author(s):

Hideki Sudo ◽

Manabu Ito ◽

Kuniyoshi Abumi ◽

Yoshihisa Kotani ◽

Tatsuto Takeuchi ◽

...

Keyword(s):

Cervical Spine ◽

Spinal Fusion ◽

Posterior Instrumentation ◽

Survival Rates ◽

Spinal Instability ◽

Initial Surgery ◽

Long Term Follow Up ◽

Spine Disorders

Object As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. Methods Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. Conclusions Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.

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Long-Term Follow-Up After Interbody Fusion of the Cervical Spine

Journal of Spinal Disorders ◽

10.1097/00024720-200404000-00001 ◽

2004 ◽

Vol 17 (2) ◽

pp. 79-85 ◽

Cited By ~ 312

Author(s):

Jan Goffin ◽

Eric Geusens ◽

Nicolaas Vantomme ◽

Els Quintens ◽

Yannic Waerzeggers ◽

...

Keyword(s):

Cervical Spine ◽

Interbody Fusion ◽

Long Term Follow Up

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Long-term Follow-up of Myelopathy due to Ossification of the Posterior Longitudinal Ligament（OPLL） and Spondylosis of the Cervical Spine

Spinal Surgery ◽

10.2531/spinalsurg.9.1 ◽

1995 ◽

Vol 9 (0) ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Chikao Nagashima ◽

Hidehiko Yoshizawa

Keyword(s):

Cervical Spine ◽

Posterior Longitudinal Ligament ◽

Long Term Follow Up

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Upper Cervical Spine Fracture-Dislocation in Patients With Ankylosing Spondylitis: Application of Halo Vest Before and During Posterior Surgery

10.21203/rs.3.rs-557216/v1 ◽

2021 ◽

Author(s):

Haisong Yang ◽

Yuling Sun ◽

Liang Wang ◽

Chunyan Gao ◽

Fengbin Yu ◽

...

Keyword(s):

Cervical Spine ◽

Ankylosing Spondylitis ◽

Spine Fracture ◽

Fracture Dislocation ◽

Cervical Spine Fracture ◽

Upper Cervical Spine ◽

Halo Vest ◽

Posterior Surgery ◽

Upper Cervical

Abstract Background It is a challenge to reduce and immobilize the broken “bamboo spine”, especially for the upper cervical spine, in patients with ankylosing spondylitis (AS) before and during posterior surgery. Methods We retrospectively analyzed the case histories, operations, neurologic outcomes, follow-up data, and imaging records of 17 patients with AS and upper cervical spine fracture-dislocation who underwent surgical treatment in three clinical spine center from 2010 to 2019. A halo vest was used to reduce and immobilize fractured spinal column ends. The neurological injury was evaluated using the American Spinal Injury Association (ASIA) impairment scale score and Japanese Orthopaedic Association (JOA) score before and after operation. Complications and time of bone fusion were recorded. Results Fourteen patients achieved closed anatomical reduction after halo vest application. No displacement in fracture ends and loss of reduction occurred after prone position. No patient presented with secondary neurological deterioration. All patients was performed posterior surgery. The surgery improved the ASIA grade in all patients (P < 0.001). The mean JOA score also increased significantly at last follow-up compared to preoperation (14.5 ± 2.3 vs. 9.2 ± 2.4, P < 0.01). No severe complication and death occurred. All patients reached solid bony fusion at 12-month follow-up. Conclusions Use of a halo vest before and during the operation is safe and effective in patients with AS who develop upper cervical spine fracture-dislocation. This technique makes positioning, awake nasoendotracheal intubation, nursing, and the operation more convenient. It can also provide satisfactory reduction and rigid immobilization and prevent secondary neurologic deterioration. .

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