Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this...Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this study was to analyze associations between the cervical vertebrae maturation score (CVMS) and skeletal maturation index (SMI). The second objective was to determine the reproducibility of the measurements on lateral cephalograms and hand-wrist radiographs. Materials and Methods—Lateral cephalometric and left hand-wrist radiographs of 92 untreated subjects (44 females and 48 males) aged from 8 to 17 years were obtained from the files of the Columbia University, Division of Orthodontics and measured for growth stage using cervical vertebrae and hand-wrist methods. Results—A high correlation was revealed between the hand-wrist and cervical vertebrae measurements. The Spearman’s rho correlation coefficient was 0.925 and significant at the 0.01 level. The correlation between hand-wrist and age (0.665, p < 0.01) was slightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability was high. When the three categorically modified methods of the Fishman’s 11 skeletal maturation stages in hand and wrist analysis were used to compare with CVMS, methods 2 and 3 were both statistically significantly different according to the Wilcoxon signed ranks test and the Sign test at a significance level of less than 0.05. However, for method 1, the tests showed probability scores of 0.028 and 0.151, respectively, showing no significant difference at the 0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in the 0.01 and 0.05 level in the Signed Test. Conclusions—The Fishman’s hand and wrist skeletal maturation index and Bacetti’s cervical vertebrae maturation stages are both useful tools in evaluating growth stages. Fishman’s hand-wrist method is slightly more accurate.展开更多
The purpose of this study is to remove the shadow of cervical vertebrae from dental panoramic x-ray images with a tomosynthesis method and improve the contrast of details in both the teeth and jaw bones. To measure th...The purpose of this study is to remove the shadow of cervical vertebrae from dental panoramic x-ray images with a tomosynthesis method and improve the contrast of details in both the teeth and jaw bones. To measure the shift-amount at each angular position that was required for reconstruction of panoramic x-ray images of the dental arch, strip images of a calibration phantom were acquired. Then, a shift-amount table was prepared from these images, and the other shift-amount table, which was used to reconstruct a panoramic image of the cervical vertebrae, was prepared by inverting the curve of the shift-amount table upside down. Using these two tables, images focused on the dental arch and cervical vertebrae of a patient were made with the original strip data of the patient. The shadow of the cervical vertebrae appearing on the image focused on the dental arch was removed using the two above-mentioned images and blurring functions defined at two focusing geometries. The validity of the proposed method was evaluated with clinically acquired data of two patients. The shadow of the cervical vertebrae was successfully eliminated, and the contrast of the front teeth and detailed structures of the jaw bones was improved. The results of the experiments showed that our proposed method was significantly effective in removing the shadow of the cervical vertebrae from conventional panoramic x-ray images.展开更多
Objective: To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods: Some functional spinal units were fixed respectively with titanium...Objective: To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods: Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results: As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion: Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.展开更多
<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and ...<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and Methods:</strong> The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. <strong>Results:</strong> Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. <strong>Conclusion: </strong>This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.展开更多
Objective To evaluate the clinical results of sub-mandibular retropharyngeal cervical vertebrahook-plate (RCHP)reconsruction for the treatment of of C2 vertebral body tumors.Methods Nine patents with C2 vertebral body...Objective To evaluate the clinical results of sub-mandibular retropharyngeal cervical vertebrahook-plate (RCHP)reconsruction for the treatment of of C2 vertebral body tumors.Methods Nine patents with C2 vertebral body tumors展开更多
Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods:One hundred and twenty patie...Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years). The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.展开更多
BACKGROUND Symptomatic cervical facet cysts are relatively rare compared to those in the lumbar region.These cysts are usually located in the 7th cervical and 1st thoracic vertebral(C7/T1)area,and surgical excision is...BACKGROUND Symptomatic cervical facet cysts are relatively rare compared to those in the lumbar region.These cysts are usually located in the 7th cervical and 1st thoracic vertebral(C7/T1)area,and surgical excision is performed in most cases.However,facet cysts are associated with degenerative conditions,and elderly patients are often ineligible for surgical procedures.Cervical interlaminar epidural block has been used in patients with cervical radiating symptoms and achieved good results.Therefore,cervical interlaminar epidural block may be the first-choice treatment for symptomatic cervical facet cysts.CASE SUMMARY A 70-year-old man complained of a tingling sensation in the left hand,focused on the 4th and 5th fingers,for 1 year,and posterior neck pain for over 5 mo.The patient’s numeric rating scale(NRS)score was 5/10.The patient was diagnosed with symptomatic cervical facet cyst at the left C7/T1 facet joint.Fluoroscopyguided cervical interlaminar epidural block at the C7/T1 level with 20 mg triamcinolone and 5 mL of 0.5%lidocaine was administered.The patient's symptoms improved immediately after the block,with an NRS score of 3 points.After 3 mo,his left posterior neck pain and tingling along the left 8th cervical dermatome were relieved,with an NRS score of 2.CONCLUSION A cervical interlaminar epidural block is a good alternative for managing symptomatic cervical facet cysts.展开更多
BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case ...BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case of TGCT occurring in the cervical spine.Although the disease is rare,it is essential to consider the possibility of TGCT in axial skeletal lesions.Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARY A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward.Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement.The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine.Puncture biopsy was suggestive of a giant cellrich lesion.The patient had pulmonary tuberculosis,and we first administered anti-tuberculosis treatment.After the preoperative requirements of the antituberculosis treatment were met,we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws.The mass was identified as a TGCT by postoperative immunohistochemical analysis.Recurrence was not detected after 1 year of follow-up.CONCLUSION Spinal TGCTs are often misdiagnosed.The radiological changes are not specific.The ideal treatment comprises complete excision with proper internal fixation,which can significantly reduce postoperative recurrence.展开更多
In order to reduce the magnitude of the force applied to skull for treatment of acute cervical spine dislocation, we developed a method of skeletal traction based on reduction of friction forces under the patient’s h...In order to reduce the magnitude of the force applied to skull for treatment of acute cervical spine dislocation, we developed a method of skeletal traction based on reduction of friction forces under the patient’s head. Traction force was applied to sculls of five patients with cervical fracture-dislocations. A difference in friction interface between the patient’s head and shoulder girdle was created. The traction weight required for the reduction of the vertebral dislocation was significantly lower than an expected minimal traction weight in the commonly used techniques (p = 0.013). The presented method permits an effective and safe reduction of dislocated cervical vertebra by a relatively low traction force.展开更多
Anterior Cervical Discectomy and Fusion (ACDF) currently remains as the gold standard treatment for cervical disc herniation and Degenerative Disc Disease (DDD) refractory to conservative management. Even though anter...Anterior Cervical Discectomy and Fusion (ACDF) currently remains as the gold standard treatment for cervical disc herniation and Degenerative Disc Disease (DDD) refractory to conservative management. Even though anterior cervical fusion provides excellent clinical results, it has been implicated in abnormal kinematic strain on adjacent disc level resulting in symptomatic adjacent segment disease. Anterior cervical disc replacement (ACDR) is an alternative procedure to anterior cervical discectomy and fusion. The aims of cervical disc replacement were to preserve the motion at the index level and to protect the adjacent levels from accelerated symptomatic degeneration. The aim of this systematic review was to evaluate the outcomes of cervical disc replacement published in MEDLINE indexed literature. A literature search was carried out in medical electronic database MEDLINE. Keywords used for the search were Cervical vertebrae, Cervical spine, Neck, Intervertebral disc, Total disc replacement, Arthroplasty, Replacement, Treatment outcome. Two authors reviewed titles and abstracts of all two hundred and thirty six hits. The articles that satisfied the inclusion criteria were critically appraised while remaining articles were discarded. Anterior cervical disc replacement is a relatively new technology in spinal surgery. There are several short and intermediate term follow-up studies to prove the safety and efficacy of ACDR with satisfactory clinical and radiological outcomes. More intermediate to long-term follow-up studies are needed to prove the safety and efficacy of ACDR.展开更多
Background Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticoste...Background Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra. Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID). Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was (3.20±0.75) times and the mean oral dosage of NSAID was (1267±325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P 〈0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted. Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.展开更多
The radiographic measurement of the prevertebral soft tissue of cervical vertebrae was performed in 87 normal adults. According to the results of the measurement, 10 mm and 20 mm were used as the upper limit normal va...The radiographic measurement of the prevertebral soft tissue of cervical vertebrae was performed in 87 normal adults. According to the results of the measurement, 10 mm and 20 mm were used as the upper limit normal values of the retropharyngeal and retrotracheal space respectively. We conclude that although the widened soft tissue space is of diagnostic significance, diagnosis should be made on the basis of analysis of the injury history, clinical manifestation and imaging examination.展开更多
Sexual maturation characteristics,chronologic age,dental,and skeletal development are some of the more commonly used means to identify stages of growth.Hand wrist radiograph and cervical vertebrae maturation index(CVM...Sexual maturation characteristics,chronologic age,dental,and skeletal development are some of the more commonly used means to identify stages of growth.Hand wrist radiograph and cervical vertebrae maturation index(CVMI)are more reliable for skeletal development assessment.This study was conducted to compare the skeletal maturity using the maturational stages of middle phalanx of the third finger(MP3)with cervical vertebrae and then to evaluate the reliability of MP3 as a sole skeletal maturity assessment method.Chronological age group of the 112 subjects was 8-16 years for females and 10-18 years for males were selected for the study.Lateral cephalometry and intra oral peri‑apical radiograph of MP3 of the left hand of each patient were taken.Then,statistically it was correlated which was highly significant.Skeletal maturation of MP3 and cervical vertebrae stages progress with advancing chronological age.Female subjects were advanced on an average of 2 years earlier than male subjects at every stages of growth spurt.These results suggest that MP3 can substitute CVMI for skeletal maturity evaluation to determine optimal treatment time for various orthodontic procedures.The developmental stages of the MP3 could be used as a sole indicator in assessing the skeletal maturity.展开更多
文摘Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this study was to analyze associations between the cervical vertebrae maturation score (CVMS) and skeletal maturation index (SMI). The second objective was to determine the reproducibility of the measurements on lateral cephalograms and hand-wrist radiographs. Materials and Methods—Lateral cephalometric and left hand-wrist radiographs of 92 untreated subjects (44 females and 48 males) aged from 8 to 17 years were obtained from the files of the Columbia University, Division of Orthodontics and measured for growth stage using cervical vertebrae and hand-wrist methods. Results—A high correlation was revealed between the hand-wrist and cervical vertebrae measurements. The Spearman’s rho correlation coefficient was 0.925 and significant at the 0.01 level. The correlation between hand-wrist and age (0.665, p < 0.01) was slightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability was high. When the three categorically modified methods of the Fishman’s 11 skeletal maturation stages in hand and wrist analysis were used to compare with CVMS, methods 2 and 3 were both statistically significantly different according to the Wilcoxon signed ranks test and the Sign test at a significance level of less than 0.05. However, for method 1, the tests showed probability scores of 0.028 and 0.151, respectively, showing no significant difference at the 0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in the 0.01 and 0.05 level in the Signed Test. Conclusions—The Fishman’s hand and wrist skeletal maturation index and Bacetti’s cervical vertebrae maturation stages are both useful tools in evaluating growth stages. Fishman’s hand-wrist method is slightly more accurate.
文摘The purpose of this study is to remove the shadow of cervical vertebrae from dental panoramic x-ray images with a tomosynthesis method and improve the contrast of details in both the teeth and jaw bones. To measure the shift-amount at each angular position that was required for reconstruction of panoramic x-ray images of the dental arch, strip images of a calibration phantom were acquired. Then, a shift-amount table was prepared from these images, and the other shift-amount table, which was used to reconstruct a panoramic image of the cervical vertebrae, was prepared by inverting the curve of the shift-amount table upside down. Using these two tables, images focused on the dental arch and cervical vertebrae of a patient were made with the original strip data of the patient. The shadow of the cervical vertebrae appearing on the image focused on the dental arch was removed using the two above-mentioned images and blurring functions defined at two focusing geometries. The validity of the proposed method was evaluated with clinically acquired data of two patients. The shadow of the cervical vertebrae was successfully eliminated, and the contrast of the front teeth and detailed structures of the jaw bones was improved. The results of the experiments showed that our proposed method was significantly effective in removing the shadow of the cervical vertebrae from conventional panoramic x-ray images.
文摘Objective: To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods: Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results: As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion: Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.
文摘<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and Methods:</strong> The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. <strong>Results:</strong> Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. <strong>Conclusion: </strong>This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.
文摘Objective To evaluate the clinical results of sub-mandibular retropharyngeal cervical vertebrahook-plate (RCHP)reconsruction for the treatment of of C2 vertebral body tumors.Methods Nine patents with C2 vertebral body tumors
文摘Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years). The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.
文摘BACKGROUND Symptomatic cervical facet cysts are relatively rare compared to those in the lumbar region.These cysts are usually located in the 7th cervical and 1st thoracic vertebral(C7/T1)area,and surgical excision is performed in most cases.However,facet cysts are associated with degenerative conditions,and elderly patients are often ineligible for surgical procedures.Cervical interlaminar epidural block has been used in patients with cervical radiating symptoms and achieved good results.Therefore,cervical interlaminar epidural block may be the first-choice treatment for symptomatic cervical facet cysts.CASE SUMMARY A 70-year-old man complained of a tingling sensation in the left hand,focused on the 4th and 5th fingers,for 1 year,and posterior neck pain for over 5 mo.The patient’s numeric rating scale(NRS)score was 5/10.The patient was diagnosed with symptomatic cervical facet cyst at the left C7/T1 facet joint.Fluoroscopyguided cervical interlaminar epidural block at the C7/T1 level with 20 mg triamcinolone and 5 mL of 0.5%lidocaine was administered.The patient's symptoms improved immediately after the block,with an NRS score of 3 points.After 3 mo,his left posterior neck pain and tingling along the left 8th cervical dermatome were relieved,with an NRS score of 2.CONCLUSION A cervical interlaminar epidural block is a good alternative for managing symptomatic cervical facet cysts.
基金Supported by The National Natural Science Foundation of China(General Program),No.81472073the Natural Science Foundation of Hunan Province of China,No.2019JJ40518.
文摘BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case of TGCT occurring in the cervical spine.Although the disease is rare,it is essential to consider the possibility of TGCT in axial skeletal lesions.Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARY A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward.Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement.The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine.Puncture biopsy was suggestive of a giant cellrich lesion.The patient had pulmonary tuberculosis,and we first administered anti-tuberculosis treatment.After the preoperative requirements of the antituberculosis treatment were met,we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws.The mass was identified as a TGCT by postoperative immunohistochemical analysis.Recurrence was not detected after 1 year of follow-up.CONCLUSION Spinal TGCTs are often misdiagnosed.The radiological changes are not specific.The ideal treatment comprises complete excision with proper internal fixation,which can significantly reduce postoperative recurrence.
文摘In order to reduce the magnitude of the force applied to skull for treatment of acute cervical spine dislocation, we developed a method of skeletal traction based on reduction of friction forces under the patient’s head. Traction force was applied to sculls of five patients with cervical fracture-dislocations. A difference in friction interface between the patient’s head and shoulder girdle was created. The traction weight required for the reduction of the vertebral dislocation was significantly lower than an expected minimal traction weight in the commonly used techniques (p = 0.013). The presented method permits an effective and safe reduction of dislocated cervical vertebra by a relatively low traction force.
文摘Anterior Cervical Discectomy and Fusion (ACDF) currently remains as the gold standard treatment for cervical disc herniation and Degenerative Disc Disease (DDD) refractory to conservative management. Even though anterior cervical fusion provides excellent clinical results, it has been implicated in abnormal kinematic strain on adjacent disc level resulting in symptomatic adjacent segment disease. Anterior cervical disc replacement (ACDR) is an alternative procedure to anterior cervical discectomy and fusion. The aims of cervical disc replacement were to preserve the motion at the index level and to protect the adjacent levels from accelerated symptomatic degeneration. The aim of this systematic review was to evaluate the outcomes of cervical disc replacement published in MEDLINE indexed literature. A literature search was carried out in medical electronic database MEDLINE. Keywords used for the search were Cervical vertebrae, Cervical spine, Neck, Intervertebral disc, Total disc replacement, Arthroplasty, Replacement, Treatment outcome. Two authors reviewed titles and abstracts of all two hundred and thirty six hits. The articles that satisfied the inclusion criteria were critically appraised while remaining articles were discarded. Anterior cervical disc replacement is a relatively new technology in spinal surgery. There are several short and intermediate term follow-up studies to prove the safety and efficacy of ACDR with satisfactory clinical and radiological outcomes. More intermediate to long-term follow-up studies are needed to prove the safety and efficacy of ACDR.
文摘Background Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra. Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID). Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was (3.20±0.75) times and the mean oral dosage of NSAID was (1267±325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P 〈0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted. Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.
文摘The radiographic measurement of the prevertebral soft tissue of cervical vertebrae was performed in 87 normal adults. According to the results of the measurement, 10 mm and 20 mm were used as the upper limit normal values of the retropharyngeal and retrotracheal space respectively. We conclude that although the widened soft tissue space is of diagnostic significance, diagnosis should be made on the basis of analysis of the injury history, clinical manifestation and imaging examination.
文摘Sexual maturation characteristics,chronologic age,dental,and skeletal development are some of the more commonly used means to identify stages of growth.Hand wrist radiograph and cervical vertebrae maturation index(CVMI)are more reliable for skeletal development assessment.This study was conducted to compare the skeletal maturity using the maturational stages of middle phalanx of the third finger(MP3)with cervical vertebrae and then to evaluate the reliability of MP3 as a sole skeletal maturity assessment method.Chronological age group of the 112 subjects was 8-16 years for females and 10-18 years for males were selected for the study.Lateral cephalometry and intra oral peri‑apical radiograph of MP3 of the left hand of each patient were taken.Then,statistically it was correlated which was highly significant.Skeletal maturation of MP3 and cervical vertebrae stages progress with advancing chronological age.Female subjects were advanced on an average of 2 years earlier than male subjects at every stages of growth spurt.These results suggest that MP3 can substitute CVMI for skeletal maturity evaluation to determine optimal treatment time for various orthodontic procedures.The developmental stages of the MP3 could be used as a sole indicator in assessing the skeletal maturity.