Management of craniocervical junction dislocation
| العنوان: | Management of craniocervical junction dislocation |
|---|---|
| المؤلفون: | J. P. Chirossel, J. G. Passagia, E. Gay, O. Palombi |
| المصدر: | Child's Nervous System. 16:697-701 |
| بيانات النشر: | Springer Science and Business Media LLC, 2000. |
| سنة النشر: | 2000 |
| مصطلحات موضوعية: | Decompression, medicine.medical_treatment, Joint Dislocations, Basilar invagination, Platybasia, Humans, Medicine, Internal fixation, Cervical Atlas, Child, Hydromyelia, Axis, Cervical Vertebra, Chiari malformation, business.industry, General Medicine, Aplasia, Anatomy, Prognosis, medicine.disease, Hypoplasia, Arnold-Chiari Malformation, Spinal Fusion, Occipital Bone, Pediatrics, Perinatology and Child Health, Neurology (clinical), business |
| الوصف: | The discovery of a craniocervical junction malformation requires management in three steps: (1) The patterns must be recognized using tomographic measurements (Chamberlain’s line, Wackenheim’s line). Dynamic flexion–extension studies are necessary to assess stability or instability. Stable patterns range from platybasia to basilar invagination, with gradual deformation, and are frequently associated with Chiari malformation. Unstable patterns characterized by odontoid instability are the equivalent of an odontoid fracture. The origin is malformative (hypoplasia, aplasia of the dens, os odontoidum), but the last may be difficult to distinguish from an old odontoid fracture. They are found in many syndromes (Down, Morquio, etc.). Unstable atlanto- axial patterns with atlas assimilation are hardly reducible; they evolve toward progressive instability. (2) The neurological consequences must be defined from the clinical features of the spinal cord and the cranial nerves. Both static and dynamic MRI scans must be performed; in this way identification of the neural abnormalities (hydromyelia, Chiari, etc.) and of the osseous compression is possible. (3) The most appropriate operative procedure must be selected: stable platybasia with a nervous compression by Chiari is cured only by posterior decompression; odontoid instability is cured by reduction and posterior fixation, using hooks and autologous bone grafts on the posterior arches of C–1 and C–2. Sometimes a transarticular screw fixation of C1–2 is necessary if there is a defect on the C–1 posterior arch. Craniocervical dislocations with assimilation of the atlas require posterior occipito-vertebral bony fixation with grafts and external halo immobilization or internal fixation with hooks or screws, with anterior transoral decompression in a second step. |
| تدمد: | 1433-0350 0256-7040 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fa862b7f4c7fc97a3e3fbbc607bb4d85 https://doi.org/10.1007/s003810000324 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....fa862b7f4c7fc97a3e3fbbc607bb4d85 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14330350 02567040 |
|---|