Problems and Clinical Course after Operation of Spinal Cord Tumor at Upper Cervical Spine

Abstract For the past 20 years, the transoral approach to the upper cervical spine has been utilized for odontoid fractures, the removal of an abnormal odontoid process, decompression of basilar impression, and biopsy or resection of nasopharyngeal or metastatic tumors. The effectiveness and safety of this procedure is well documented. Use of the surgical microscope adds to the efficiency and safety of the procedure. We are reporting a case of fusion of the odontoid base to the anterior arch of the atlas. To our knowledge, this entity has not been described previously. The spinal cord was protected by an initial posterior fusion of C-1, C-2, followed in 10 days by a tracheostomy and the transoral removal of the anterior C-1 arch and the abnormal dens. Because the medical history did not reveal a source of trauma, it is supposed that the patient had malunion of the odontoid process to C-2, with subsequent migration and fusion of the dens to the C-1 arch.

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Headache Caused by a Spinal Cord Stimulator in the Upper Cervical Spine

Headache The Journal of Head and Face Pain ◽

10.1046/j.1526-4610.2000.040008689.x ◽

2000 ◽

Vol 40 (8) ◽

pp. 689-691 ◽

Cited By ~ 9

Author(s):

Thomas N. Ward ◽

Morris Levin

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Upper Cervical Spine ◽

Spinal Cord Stimulator ◽

Upper Cervical

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Concussion with primary impact to the chest and the potential role of neck tension

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000362 ◽

2018 ◽

Vol 4 (1) ◽

pp. e000362 ◽

Cited By ~ 3

Author(s):

Ron Jadischke ◽

David C Viano ◽

Joe McCarthy ◽

Albert I King

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Cervical Spinal Cord ◽

Tensile Force ◽

Impact Testing ◽

American Football ◽

Upper Cervical Spine ◽

Upper Cervical ◽

Primary Impact

ObjectivesMost biomechanical research on brain injury focuses on direct blows to the head. There are a few older studies that indicate craniocervical stretch could be a factor in concussion by causing strain in the upper spinal cord and brainstem. The objectives of this study are to assess the biomechanical response and estimate the strain in the upper cervical spine and brainstem from primary impact to the chest in American football.MethodsImpact testing was conducted to the chest of a stationary unhelmeted and helmeted anthropomorphic test device (ATD) as well as the laboratory reconstruction of two NFL game collisions resulting in concussion. A finite element (FE) study was also conducted to estimate the elongation of the cervical spine under tensile and flexion loading conditions.ResultsThe helmeted ATD had a 40% (t=9.84, p<0.001) increase in neck tensile force and an 8% (t=7.267, p<0.001) increase in neck flexion angle when compared with an unhelmeted ATD. The case studies indicated that the neck tension in the injured players exceeded tolerable levels from volunteer studies. The neck tension was combined with flexion of the head relative to the torso. The FE analysis, combined with a spinal cord coupling ratio, estimated that the strain along the axis of the upper cervical spinal cord and brainstem was 10%–20% for the combined flexion and tension loading in the two cases presented.ConclusionStrain in the upper spinal cord and brainstem from neck tension is a factor in concussion.

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Combined Transoral and Median Labiomandibular Glossotomy Approach to the Upper Cervical Spine

Neurosurgery ◽

10.1227/00006123-198106000-00006 ◽

1981 ◽

Vol 8 (6) ◽

pp. 672-674 ◽

Cited By ~ 47

Author(s):

Ehud Arbit ◽

Russel H. Patterson

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Surgical Treatment ◽

Surgical Approach ◽

Cervical Spinal Cord ◽

Transoral Approach ◽

Direct Approach ◽

Upper Cervical Spine ◽

Functional Loss ◽

Upper Cervical

abstract A surgical approach to the clivus and anterior spine from C-1 to the upper part of C-5 is described. It is a direct approach that provides a wider and longer exposure than does the transoral approach. Despite the seemingly radical incision, the cosmetic deformity and functional loss are minimal. This approach is useful for the surgical treatment of a variety of processes that are situated ventral to the upper cervical spinal cord and the cervicomedullary junction.

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A CASE OF SUCCESSFUL TREATMENT FOR SEVERE PENETRATING SPINAL CORD TRAUMA IN THE UPPER CERVICAL SPINE

Hirurgiâ pozvonočnika ◽

10.14531/ss2005.1.125-127 ◽

2005 ◽

pp. 125-127

Author(s):

Sergey Anatolyevich Matuzov ◽

Sergey Anatolyevich Rozhansky ◽

Vladimir Aleksandrovich Sizonenko

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Successful Treatment ◽

Upper Cervical Spine ◽

Spinal Cord Trauma ◽

Upper Cervical

Clinical, intraoperative and paraclinical description of a case of successful surgery for severe open penetrating spinal cord trauma in the upper cervical spine is reported.

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Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine

PeerJ ◽

10.7717/peerj.9716 ◽

2020 ◽

Vol 8 ◽

pp. e9716

Author(s):

Rob Sillevis ◽

Russell Hogg

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Cadaver Study ◽

Cervicogenic Headache ◽

Passive Movement ◽

Cervical Region ◽

Upper Cervical Spine ◽

Posterior Aspect ◽

Upper Cervical ◽

Nuchal Ligament

Background The upper cervical region is a complex anatomical structure. Myodural bridges between posterior suboccipital muscles and the dura might be important explaining conditions associated with the upper cervical spine dysfunction such as cervicogenic headache. This cadaver study explored the upper cervical spine and evaluated the myodural bridges along with position of spinal cord in response to passive motion of upper cervical spine. Methods A total of seven adult cadavers were used in this exploratory study. The suboccipital muscles and nuchal ligament were exposed. Connections between the Rectus Capitis Posterior major/minor and the Obliquus Capitis minor, the nuchal ligament, posterior aspect of the cervical spine, flavum ligament and the dura were explored and confirmed with histology. The position of the spinal cord was evaluated with passive motions of the upper cervical spine. Outcomes In all cadavers connective tissues attaching the Rectus Capitis Posterior Major to the posterior atlanto-occipital membrane were identified. In the sagittal dissection we observed connection between the nuchal ligament and the dura. Histology revealed that the connection is collagenous in nature. The spinal cord moves within the spinal canal during passive movement. Discussion The presence of tissue connections between ligament, bone and muscles in the suboccipital region was confirmed. The nuchal ligament was continuous with the menigiovertebral ligament and the dura. Passive upper cervical motion results in spinal cord motion within the canal and possible tensioning of nerve and ligamentous connections.

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