The Experts below are selected from a list of 267 Experts worldwide ranked by ideXlab platform

F. Doenz - One of the best experts on this subject based on the ideXlab platform.

J.c. Gerster - One of the best experts on this subject based on the ideXlab platform.

Chen Xian-l - One of the best experts on this subject based on the ideXlab platform.

  • Tactics of surgery treatment for traumatic instability of Atlanto-Axial Joint
    China Journal of Orthopaedics and Traumatology, 2006
    Co-Authors: Chen Xian-l
    Abstract:

    Objective:To Discuss on surgical treatment for traumatic instability of Atlanto-Axial Joint.Methods:Twenty-nine patients with traumatic instability of Atlanto-Axial Joint included 22 male and 7 female,ranging from age 16 to 52 years with an average of 32 years.Among 19 cases with fracture of the odontoid process,there were 16 cases of type Ⅱ fracture of Anderson and 3 cases of fleet type Ⅲ fracture,6 cases of disrupted transverse ligament,1 case of relapse rolling luxation of Atlanto-Axial arthrosis ,1 case of type Ⅰ of Hangman’s fracture accompanying with odontoid fracture,1 case of Atlanto-Axial fracture accompanying with trauma of transverse ligament of Atlanto-Axial,1 case of odontoid fracture accompanying with upper arthrosis fracture of unilateral Atlanto-Axial.Diverse operation treatments were adopted according to the relevant traumatic parts,including 10 cases with fixation by single front screw of dentate protuberance,6 cases with fixation by rear Magerl screw,5 cases with Magerl-Gallie,2 cases with fixtion by Magerl emerging Broooks double Titanium cable,2 cases with fixation by Magerl emerging Apofix board,4 cases with fixation by side nailed board of Atlanto-Axial.Eleven of 19 cases of rear part operation adopted C_1 to C_2 vertebral interbody granule bone transplant,8 cases bone fusion without bone transplant.Results:The patients were followed up for an average of 18 months (range 6 to 60 months).There were no case of serious syndrome such as trauma of artery of vertebra or trauma of spinal cord,neither the case of rupture of internal fixation.There was one case of anaesthetization of hypoglossal after operation which was relieved two weeks later on.Nine of 10 cases of fixation by front screw of dentate protuberance achieved concrescence of bone.There happened flexible of screw in one case of fixation by screw of dentate protuberance,where front cortex of Atlanto-Axial is broken,but bone fusion was finally made by rear fixation of Magerl+Gallie instead of screw of dentate protuberance.Eight cases which were not treated by fusion in 19 cases of rear operation were finally obtain concrescence of fracture.In 6 cases of which internal fixation were brought out and the function of rotary movement of the patients were almost renewed.The rest 11 cases finally obtained fusion.Conclusion:Doctors should prudently select the surgery method on the basis of the traumatic part of the patient,causes of Atlanto-Axial instability and expericence of one’s own.Atlanto-Axial vertebral arc root screw plant system takes dominance to certain extent in aspects of stability of biology mechanics and adaptation.Try best to maintain physiological function of upper neck at expense of little trauma.

Ryo Watanabe - One of the best experts on this subject based on the ideXlab platform.

  • Compression of the Spinal Cord Due to Destructive Spondyloarthropathy of the Atlanto-Axial Joints. A Case Report*
    The Journal of bone and joint surgery. American volume, 1996
    Co-Authors: Yoshihiro Mikawa, Toshio Yamaoka, Ryo Watanabe
    Abstract:

    Destructive spondyloarthropathy was apparently first described by Kuntz et al. in 1984 and has become increasingly recognized in patients who have been managed with long-term hemodialysis. Radiographically evident lesions are located predominantly in the cervical spine. The fifth and sixth and the sixth and seventh cervical intervertebral discs are most frequently involved13. Although destructive spondyloarthropathy affecting the occipitocervical articulation and the cephalad part of the cervical spine has been reported2,5,6,8,12,14, we are not aware of any previous reports of acute compression of the spinal cord attributed to these lesions. We report the case of a patient who had quadriplegia and dyspnea that were due to destructive spondyloarthropathy of the cephalad part of the cervical spine. Immediate reduction of the Atlanto-Axial dislocation and posterior arthrodesis of the Atlanto-Axial Joint resulted in remarkable improvement. A forty-five-year-old woman was admitted to our hospital in June 1994 because of progressive quadriplegia and dyspnea, which had begun twelve hours earlier. A nephrotic syndrome had developed when the patient was forty-two years old. The disease resulted in progressive deterioration of renal function requiring hemodialysis. Beginning in May 1991, the patient had received dialysis three times a week for three years. Pain and arthralgia became apparent for the first time in September 1993. The patient reported having pain in the shoulders, elbows, and thighs. In February 1994, pain developed in the posterior part of the neck and rapidly became severe. The diagnosis was destructive spondyloarthropathy at the level of the fifth and sixth cervical intervertebral disc. On June 30, 1994, the patient's husband raised the cephalad part of her trunk, while she was in bed, in order to alleviate the nuchal pain. The patient suddenly became quadriplegic with shooting pains from the nuchal …

Kenji Takagishi - One of the best experts on this subject based on the ideXlab platform.

  • Atlanto-Axial subluxation after pyogenic spondylitis of the atlanto-occipital Joint.
    European Spine Journal, 2010
    Co-Authors: Kazuhiko Tsunoda, Haku Iizuka, Yasunori Sorimachi, Tsuyoshi Ara, Masahiro Nishinome, Yasuhiko Takechi, Kenji Takagishi
    Abstract:

    This report presents a case of Atlanto-Axial subluxation after treatment of pyogenic spondylitis of the atlanto-occipital Joint. A 60-year-old male had 1-month history of neck pain with fever. Magnetic resonance imaging showed inflammation around the odontoid process. Intravenous antibiotic therapy was administrated immediately. After 6 weeks, CRP had returned almost to normal. After 4 months, laboratory data was still normal, but the patient experienced increasing neck pain. Lateral cervical radiography in the neutral position showed instability between C1 and C2. Computed tomography showed a bony union of the atlanto-occipital Joint and severe destruction of the Atlanto-Axial Joint on the left side. Transarticular screw fixation for the Atlanto-Axial Joint was performed. A lateral cervical radiograph in the neutral position after surgery showed a solid bony union. Neck pain improved following surgery. We speculate that spondylitis of the atlanto-occipital Joint induced a loosening of the transverse ligament and articulation of the Atlanto-Axial Joint. A bony fusion of the atlanto-occipital Joint after antibiotic treatment resolved the pyogenic inflammation concentrated stress to the damaged Atlanto-Axial Joint, resulting in further damage. The Atlanto-Axial instability was finally managed by the insertion of a transarticular screw.

  • Atlanto-Axial Joint of Atlanto-Axial subluxation patients due to rheumatoid arthritis before and after surgery, morphological evaluation using CT reconstruction
    European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2010
    Co-Authors: Yasunori Sorimachi, Haku Iizuka, Tsuyoshi Ara, Masahiro Nishinome, Yoichi Iizuka, Takashi Nakajima, Kenji Takagishi
    Abstract:

    This study investigated the preoperative morphology and postoperative fusion of the Atlanto-Axial Joint (AAJ) in patients with Atlanto-Axial subluxation (AAS) due to rheumatoid arthritis (RA) using computed tomography (CT). Furthermore, we examined the relationship between the preoperative morphology of AAJ and other radiographic results. Thirty patients with AAS due to RA treated by C1–2 transarticular screw fixation (TSF) were reviewed. The morphology of the AAJ was evaluated using sagittal reconstruction views on CT before and 1 year after surgery. Thereafter, the atlanto-dental interval (ADI) value at the neutral and maximal flexion position and Atlanto-Axial angle (AAA) at the neutral position was assessed in preoperative lateral cervical radiographs. The preoperative morphology of the AAJ on CT reconstruction views was graded as follows: Grade 1 showed maintenance of the Joint space, Grade 2 showed the Joint space narrowing and Grade 3 showed the destructive abnormality of subchondral bone. After surgery, the ADI value at the neutral position was assessed in lateral cervical radiographs. Furthermore, the fusion in the AAJ was investigated using CT sagittal reconstruction views taken 1 year after surgery. The preoperative CT image of the AAJ demonstrated Grade 1 in 12 cases (Group A), Grade 2 in 9 cases (Group B) and Grade 3 in 9 cases (Group C). There was no significant difference in age, gender and duration of RA among the three groups. The average ADI value at the flexion position was 11.0 mm in Group A, 12.3 mm in Group B and 12.7 mm in Group C (p > 0.313). The average ADI value at the neutral position before surgery was 4.5 mm in Group A, 7.3 mm in Group B and 11.4 mm in Group C (p   0.144). Fusion in the AAJ 1 year after surgery was demonstrated in 14 cases (46.7%; Group A, 0 case; Group B, 5 cases; Group C, 9 cases). According to the preoperative grading of the AAJ, the postoperative fusion in the AAJ was demonstrated in 0 of 32 Joints (0%) in Grade 1, 7 of 18 Joints (38.9%) in Grade 2 and all of 10 Joints (100%) in Grade 3. In conclusion, this study showed that a destructive abnormality of subchondral bone in the AAJ induced an enlargement of the ADI and anterior inclination of the atlas in patients with AAS due to RA. The current study also showed that fusion in the AAJ was demonstrated in 14 of 30 patients after C1/2 TSF. This was easy to recognize in AAS patients whose Joint destruction extended to the subchondral bone.