-
Turkish Journal of Medical Sciences 2023Craniocervical junction (CCJ) can be involved in inflammatory arthritis. We aimed to define types of CCJ involvement in rheumatoid arthritis (RA), spondyloarthritis...
BACKGROUND/AIM
Craniocervical junction (CCJ) can be involved in inflammatory arthritis. We aimed to define types of CCJ involvement in rheumatoid arthritis (RA), spondyloarthritis (SpA), and psoriatic arthritis (PsA) and compare them with patients without inflammatory arthritides.
MATERIALS AND METHODS
In this retrospective analysis, cervical CT or MRIs of patients with RA, SpA, or PsA, taken for any reason between 2010 and 2020, according to ICD-10 codes, were scanned. Demographic data of the patients were recorded. CCJ involvements (atlantoaxial, vertical, or subaxial subluxation, odontoid process involvement) were reevaluated by an experienced radiologist. The control group consisted of consecutive patients without inflammatory arthritis.
RESULTS
Exactly 459 patients (204 RA, 200 SpA, and 55 PsA) and 78 patients in the control group were included in the study. CCJ involvement was detected in 101 (49.5%) RA, 53 (26.5%) SpA, 10 (18.2%) PsA, and 4 patients (5.1%) in the control group (p < 0.001). The odontoid process was one of the main targets, especially in RA patients (69 (33.8%)), which was significantly higher than in the SpA, PsA, and control groups. Although vertical subluxation (VS) was numerically higher in the RA and SpA groups compared to the control group, VS-related brainstem compression was relatively uncommon: 6 (2.9%) in RA, 1 (0.5%) in AS, and none in the PsA and control groups.
CONCLUSION
CCJ involvement can often be detected in patients with inflammatory arthritis, especially in RA and SpA patients. The odontoid process is the main target of inflammation.
Topics: Humans; Female; Male; Middle Aged; Retrospective Studies; Arthritis, Rheumatoid; Adult; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Spondylarthritis; Aged; Arthritis, Psoriatic; Atlanto-Axial Joint; Cervical Vertebrae; Odontoid Process
PubMed: 38813511
DOI: 10.55730/1300-0144.5740 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... May 2024To investigate the imaging characteristics of cervical kyphosis and spinal cord compression in cervical spondylotic myelopathy (CSM) with cervical kyphosis and the...
OBJECTIVE
To investigate the imaging characteristics of cervical kyphosis and spinal cord compression in cervical spondylotic myelopathy (CSM) with cervical kyphosis and the influence on effectiveness.
METHODS
The clinical data of 36 patients with single-segment CSM with cervical kyphosis who were admitted between January 2020 and December 2022 and met the selection criteria were retrospectively analyzed. The patients were divided into 3 groups according to the positional relationship between the kyphosis focal on cervical spine X-ray film and the spinal cord compression point on MRI: the same group (group A, 20 cases, both points were in the same position), the adjacent group (group B, 10 cases, both points were located adjacent to each other), and the separated group (group C, 6 cases, both points were located >1 vertebra away from each other). There was no significant difference between groups ( >0.05) in baseline data such as gender, age, body mass index, lesion segment, disease duration, and preoperative C angle, C sagittal vertical axis (C SVA), C slope (C S), kyphotic Cobb angle, fusion segment height, and Japanese Orthopedic Association (JOA) score. The patients underwent single-segment anterior cervical discectomy with fusion (ACDF). The occurrence of postoperative complications was recorded; preoperatively and at last follow-up, the patients' neurological function was evaluated using the JOA score, and the sagittal parameters (C angle, C SVA, C S, kyphotic Cobb angle, and height of the fused segments) were measured on cervical spine X-ray films and MRI and the correction rate of the cervical kyphosis was calculated; the correlation between changes in cervical sagittal parameters before and after operation and the JOA score improvement rate was analyzed using Pearson correlation analysis.
RESULTS
In 36 patients, only 1 case of dysphagia occurred in group A, and the dysphagia symptoms disappeared at 3 days after operation, and the remaining patients had no surgery-related complications during the hospitalization. All patients were followed up 12-42 months, with a mean of 20.1 months; the difference in follow-up time between the groups was not significant ( >0.05). At last follow-up, all the imaging indicators and JOA scores of patients in the 3 groups were significantly improved when compared with preoperative ones ( <0.05). The correction rate of cervical kyphosis in group A was significantly better than that in group C, and the improvement rate of JOA score was significantly better than that in groups B and C, all showing significant differences ( <0.05), and there was no significant difference between the other groups ( >0.05). The correlation analysis showed that the improvement rate of JOA score was negatively correlated with C angle and kyphotic Cobb angle at last follow-up ( =-0.424, =0.010; =-0.573, <0.001), and positively correlated with the C S and correction rate of cervical kyphosis at last follow-up ( =0.336, =0.045; =0.587, <0.001), and no correlation with the remaining indicators ( >0.05).
CONCLUSION
There are three main positional relationships between the cervical kyphosis focal and the spinal cord compression point on imaging, and they have different impacts on the effectiveness and sagittal parameters after ACDF, and those with the same position cervical kyphosis focal and spinal cord compression point have the best improvement in effectiveness and sagittal parameters.
Topics: Humans; Cervical Vertebrae; Kyphosis; Spondylosis; Spinal Cord Compression; Magnetic Resonance Imaging; Spinal Fusion; Treatment Outcome; Spinal Cord Diseases; Decompression, Surgical; Retrospective Studies; Male; Female; Middle Aged
PubMed: 38752239
DOI: 10.7507/1002-1892.202402018 -
Journal of Craniovertebral Junction &... 2024To study the clinicoradiological features and treatment outcomes of atlantoaxial dislocation (AAD) in Down syndrome.
AIMS
To study the clinicoradiological features and treatment outcomes of atlantoaxial dislocation (AAD) in Down syndrome.
SETTINGS AND DESIGN
Retrospective case series.
SUBJECTS AND METHODS
A retrospective chart and radiology review of 9 Down syndrome patients with AAD managed at our center from 2007 to 2018.
STATISTICAL ANALYSIS USED
Chi-squared/Fisher's exact test.
RESULTS
There were 4 males and 5 females (n = 9). The median age was 14 years (interquartile range [IQR]: 7-15.5). 77.7% (7/9) of patients had severe spasticity (Nurick Grades 4 and 5). The median duration of symptoms was 9 months (IQR: 5-39). The AAD was reducible in all (n = 9) cases. Eight (88.8%) patients had os odontoideum. The mean atlantodental interval (ADI) was 8.5 mm (±2.9). T2W cord hyperintensity was seen in 66.6% (6/9). Posterior C1-2 transarticular fixation was done in 8 and occipitocervical fusion in 1 patient. Follow-up of more than 6 months (7-57 months) was available in 8/9 (88.9%) patients. There was a significant improvement in spasticity (n = 8, mean Nurick Grade 1.7 (±1.1), = 0.003). Follow-up radiographs (n = 8) showed good reduction and fusion. A preoperative bedbound patient with poor respiratory reserve expired at 10 months following surgery. There were no other complications.
CONCLUSIONS
Posterior surgical approach for AAD in Down syndrome resulted in good alignment and fusion, with excellent clinical improvement. Patients with elevated PCO are poor surgical candidates and require home ventilation facility.
PubMed: 38644917
DOI: 10.4103/jcvjs.jcvjs_171_23 -
Journal of Craniovertebral Junction &... 2024This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a...
This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a posterior transpedicular approach with the use of preoperative contrast-enhanced scans to highlight the course of the vertebral artery. The technique is presented through two exemplification cases: a pediatric patient with osteoblastoma and secondary aneurysmal bone cyst and one adult patient with melanoma metastasis. This case highlights the potential of the CT-guided posterolateral/transpedicular approach for performing safe and effective biopsies in the body and dens of C2, even in pediatric patients.
PubMed: 38644913
DOI: 10.4103/jcvjs.jcvjs_183_23 -
Journal of Orthopaedic Surgery and... Apr 2024Contiguous two-segment cervical disc arthroplasty (CDA) is safe and effective, while post-operative radiographic change is poorly understood. We aimed to clarify the...
BACKGROUND
Contiguous two-segment cervical disc arthroplasty (CDA) is safe and effective, while post-operative radiographic change is poorly understood. We aimed to clarify the morphological change of the three vertebral bodies operated on.
METHODS
Patients admitted between 2015 and 2020 underwent contiguous two-level Prestige LP CDA were included. The follow-up was divided into immediate post-operation (≤ 1 week), early (≤ 6 months), and last follow-up (≥ 12 months). Clinical outcomes were measured by Japanese Orthopedic Association (JOA) score, visual analogue score (VAS), and neck disability index (NDI). Radiographic parameters on lateral radiographs included sagittal area, anterior-posterior diameters (superior, inferior endplate length, and waist length), and anterior and posterior heights. Sagittal parameters included disc angle, Cobb angle, range of motion, T1 slope, and C2-C7 sagittal vertical axis. Heterotopic ossification (HO) and anterior bone loss (ABL) were recorded.
RESULTS
78 patients were included. Clinical outcomes significantly improved. Of the three operation-related vertebrae, only middle vertebra decreased significantly in sagittal area at early follow-up. The four endplates that directly meet implants experienced significant early loss in length. Sagittal parameters were kept within an acceptable range. Both segments had a higher class of HO at last follow-up. More ABL happened to middle vertebra. The incidence and degree of ABL were higher for the endplates on middle vertebra only at early follow-up.
CONCLUSION
Our findings indicated that after contiguous two-segment CDA, middle vertebra had a distinguishing morphological changing pattern that could be due to ABL, which deserves careful consideration before and during surgery.
Topics: Humans; Arthroplasty; Spine; Orthopedics; Vertebral Body; Bone Diseases, Metabolic
PubMed: 38610023
DOI: 10.1186/s13018-024-04663-6 -
Indian Pediatrics May 2024
Topics: Humans; Atlanto-Axial Joint; Joint Dislocations; Odontoid Process; Pruritus
PubMed: 38554007
DOI: No ID Found -
Swiss Journal of Palaeontology 2024is a baenid turtle from the Late Cretaceous Hell Creek Formation of the United States of America known from cranial, shell, and other postcranial material. Baenid...
Updated cranial and mandibular description of the Late Cretaceous (Maastrichtian) baenid turtle based on micro-computed tomography scans and new information on the holotype-shell association.
UNLABELLED
is a baenid turtle from the Late Cretaceous Hell Creek Formation of the United States of America known from cranial, shell, and other postcranial material. Baenid turtles are taxonomically diverse and common fossil elements within Late Cretaceous through Eocene faunas. Detailed anatomical knowledge is critical to understanding the systematics and morphological evolution of the group. This is particularly important as baenids represent an important group of continental vertebrates that survived the mass extinction event associated with the Cretaceous/Paleogene boundary. High-resolution micro-computed tomography scanning of the holotype skull reveals additional anatomical details for the already well-known . This includes the revision of some anatomical statements from the original description, but also detailed knowledge on internal anatomical features of the braincase and the description of a well-preserved axis (cervical vertebra 2). Our new detailed description and previous work on the shell and postcrania make one of the best-described, nearly complete baenid turtles, which are often only known from either isolated shell or cranial material. A revised phylogenetic analysis confirms the position of as a derived baenid (Eubaeninae) more closely related to than to .
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s13358-023-00301-6.
PubMed: 38274637
DOI: 10.1186/s13358-023-00301-6