Osteomyelitis of the atlas in an infant

A case of osteomyelitis of the atlas in an infant is presented. Its unusual nature and aspects of cervical osteomyelitis are discussed. Received: 21 June 1996     

Craniocervical bone pneumatisation

We report a case of extensive craniocervical bone pneumatisation presenting after minor trauma. The patient had neurological signs and initial radiographs showed multiple lucencies in the skull base and the atlas vertebra. CT established the true nature of this rare condition.     

Fractures of the arches of the atlas: A Study of their causation

Summary The autopsy findings in 32 accidental deaths which showed fracture(s) of the arches of the atlas have been correlated to reconstructions of the course of events in the accidents.Flexion of the head causing fracture(s) of the neural arch or odontoid process of the axis also resulted in fracture(s) of the posterior arch due to downward traction. Extension of the head causing fracture of the odontoid process of the axis gave rise to fractures of the posterior arch due to pressure from below. Tilting of the head caused marginal fractures of the anterior arch due to oblique traction. Tilting of the head also caused fracture(s) of the anterior and/or posterior arch due to transverse extension of the atlas ring and/or superior dislocation of one lateral mass in relation to the other. Oblique flexion or extension of the head resulted in similar fractures. Flexion of the head with some rotation combined with compression of the neck can cause the anterior margin of one upper joint surface of the axis to act as a wedge separating the anterior arch of the atlas from below. Extension of the head with some rotation combined with compression of the neck can lead to a fracture running through one lateral mass due to its tilting-dislocation in posterior direction.It is striking that there was no fracture of the atlas which could be ascribed to a simple and symmetric compression of the neck (classical Jefferson's fracture).     

Habent sua fata libelli

There is often more to a book than the subject matter addressed by its author. Taking B?rensprung and Hebra's desktop volume as an example, this article shows how books can tell us more about the history of medicine than might be apparent at first sight. Eingegangen am 29. Juli 1993/Angenommen am 20. August 1993     

术中双壁定位椎弓根螺钉内固定治疗齿状突骨折

目的：探讨术中双壁定位寰枢椎椎弓根螺钉内固定治疗齿状突骨折的临床疗效。方法：自2006年6月至2010年9月采用双壁定位寰枢椎椎弓根螺钉固定治疗12例齿状突骨折,其中男8例,女4例,年龄18～62岁,平均37.9岁。按Anderson分类：Ⅱ型10例,Ⅲ型2例。新鲜骨折脱位9例,陈旧性骨折脱位3例。所有患者均有不同程度的颈枕部疼痛,颈部僵硬、活动受限。9例伴有脊髓损伤症状和体征,按美国脊髓损伤协会（ASIA）分级标准：C级4例,D级5例。术中经寰椎下壁、内壁,枢椎上壁、内壁定位后行寰枢椎椎弓根螺钉内固定治疗。结果：12例患者术中无椎动脉、脊髓及神经根损伤发生。术后随访6～24个月,平均14个月。X线和CT扫描显示所有寰枢椎椎弓根螺钉位置良好,植骨融合,无螺钉断裂、松动。所有患者枕颈部疼痛症状明显缓解。9例伴有神经损伤者按ASIA分级：C级1例,D级2例,E级6例。结论：术中双壁定位操作简单,寰枢椎椎弓根螺钉进钉点和进钉角度准确,可安全置入椎弓根镙钉并能获得满意的疗效。     

寰椎椎弓根显露置钉法的临床应用

目的 探讨寰椎椎弓根显露置钉法(pedicle exposure method,PEM)的手术可操作性和临床疗效.方法 对46例寰枢椎脱位患者应用经寰椎椎弓根螺钉内固定技术治疗.患者术前均行X线、CT和MRI等影像学检查,寰椎后弓(椎弓根)高度为2.5～4.0 mm,平均3.1 mm;术中在直视下行C1,2置钉,复位固...     

新型寰枢椎内固定系统的生物力学评价

目的 评价一种新型寰枢椎内固定系统的生物力学性能.方法 选取12头猪颈椎标本制作寰枢椎不稳模型,采用该新型内固定系统进行固定,测量三维运动范围,并与寰枢椎椎弓根钉棒系统进行比较.结果 新型寰枢椎内固定系统的特点是设计新颖、操作简单、使用安全;生物力学实验结果表明其在旋转、屈伸及侧弯状态的活动度与寰枢椎椎弓根钉棒差异无统...     

前路经皮三钉固定治疗老年寰枢椎联合骨折

 目的 探讨经皮内固定技术治疗老年(特别是合并颅脑损伤)患者急性寰枢椎联合骨折的方法及其疗效。方法 2006年 3月至 2011年 2月, 共 7例老年急性寰枢椎联合骨折患者。男 6例, 女 1例;年龄 64~84岁, 平均 72.4岁。寰椎骨折: Jefferson骨折 2例, 前弓骨折 2例, 前后弓两处骨折 2例, 前后弓骨折+侧块骨折 1例。枢椎齿状突骨折: Anderson域型骨折 6例, 浅芋型骨折 1例。颅脑损伤 5例, 均合并不同程度意识朦胧、谵妄或昏迷。对所有患者均在”C冶型臂X线机监视下行经皮前路枢椎齿状突和两侧寰枢关节螺钉内固定术治疗, 并分析其治疗效果。结果 手术时间 36~78 min, 平均 56 min。同时行植骨术的患者出血 20~50 ml, 未行植骨术者无明显出血。 7例患者均获得满意治疗效果, 螺钉位置正确。无神经根、脊髓、椎动脉和食管损伤等并发症发生。全组病例平均随访 10.7个月, 无脱钉、弯钉及断钉发生, 枢椎齿状突骨折均骨性愈合, 无寰枢关节不稳。结论 对于老年特别是合并颅脑损伤患者的急性寰枢椎联合骨折, 经皮前路三钉固定技术是一种简单、安全和有效的方法, 有利于对患者临床护理和早期功能训练, 减少并发症的发生。     

小鼠经寰枢椎蛛网膜下腔置管法的建立

目的介绍一种新型小鼠蛛网膜下腔置管法,并与传统的Wu方法相比较,为脊髓水平的药物生理研究及疼痛治疗提供更有效方法。方法选择40只24-28 g雄性昆明小鼠,随机分为Wu组和寰枢椎（AA）组,分别从腰5-6椎间隙、寰枢椎间隙置管至蛛网膜下腔。模型建立后,观察各组小鼠置管后死亡率、肢体瘫痪率,并测定其缩足反应阈值（50%PWT）、甩尾反应潜伏期（TF）和吗啡作用。对比两组是否有差异。结果置管后Wu组和AA组在死亡率无差异的情况下,AA组的肢体瘫痪率明显低于Wu组;术后7 d内,AA组大鼠的50%PWT值和TF值与术前基础值相比最为接近;吗啡镇痛及耐受实验说明此新方法可以进行小鼠长期给药。结论小鼠经寰枢椎蛛网膜下腔置管方法具有瘫痪率低、恢复快、术后并发症少等优点,是一种新型有效的小鼠鞘内置管法。