European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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To describe vertebral artery (VA) course at the C0-C1-C2 complex in patients with congenital bony craniovertebral junction (CVJ) anomalies. ⋯ In occipitalization of the atlas, the VA course is usually abnormal-typically passing through a canal within the C0-C1 fused complex or below the C1 arch. A redundant VA loop is more likely to be seen in os odontoideum and irreducible atlantoaxial dislocation. Careful study of the vertebral artery course with 3D CT angiography is mandatory while contemplating CVJ realignment surgery in congenital anomalies of the CVJ.
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To investigate a unique procedure of joined transoral and retropharyngeal high cervical approach (JTRC) without mandibulectomy for treating upper cervical neoplasm involving both C2 and C3. ⋯ The JTRC approach could provide good surgical exposure for treating disorders involving both upper and lower cervical spine without splitting up the mandible.
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The goal of the study was to describe the lag screw-rod (LSR) technique for the treatment of unstable Hangman's fracture as an attempt to pull C2 vertebral body back to posterior elements easily and immobilize C2 relative to C3 simultaneously. ⋯ The LSR technique is an effective and reliable treatment for unstable Hangman's fractures. The technique has the advantages of pulling back the C2 vertebral body back to posterior elements easily and immobilizing C2 relative to C3 simultaneously.
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We aimed to investigate the clinical performance of the constructs of double-door cervical laminoplasty with suture anchors by examining bony fusion at the hinges and lamina closure. ⋯ The constructs of double-door cervical laminoplasty with suture anchors are stable with a high rate of fusion at the hinges. However, if the procedure is performed at C3, special modifications should be made to avoid lamina closure.
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Ponticulus posticus is a common anatomic variation that can be mistaken for a broad posterior arch during C1 pedicle screw placement. When the atlas lateral mass screws are placed via the posterior arch, injury to the vertebral artery may result. To our knowledge, there are few clinical studies that have analyzed the feasibility of C1 pedicle screw fixation in patients with ponticulus posticus, in clinical practice. ⋯ Three-dimensional CT imaging should be considered prior to C1 pedicle screw fixation in patients with ponticulus posticus, to avoid mistaking the ponticulus posticus for a widened dorsal arch of the atlas. If there is no ponticulus posticus syndrome preoperatively, C1 pedicle screw fixation can be successfully performed without removing the bony anomaly.