Surgical management of atlantoaxial nonunions.


:Sixteen patients referred for atlantoaxial fixation failures were treated surgically with revision procedures during the past decade. Of these 16 patients, atlantoaxial instability occurred because of rheumatoid arthritis in five, as odontoideum in seven, transverse ligament disruption in two, and odontoid fracture nonunion in two. The 16 individuals (10 men, six women; mean age 43.7 years; age range 20-77 years) had undergone a total of 20 C1-2 internal fixation procedures that failed. Surgical strategies for definitive revision of the nonunions in these 16 subjects included 10 rigid internal fixations with transarticular screws, three revised C1-2 fixations with autogenous bone struts and wire or cables, and three extended fixations with occipitocervical instrumentation. Autogenous grafts were used in all revisions. A postoperative halo brace was used in five individuals with osteoporotic bone; all patients wore a restrictive postoperative cervical orthosis. Postoperatively, 15 patients (94%) had a stable construct (mean follow up 35 months; range 12-79 months), which included 13 osseous unions and two stable fibrous unions. One patient had nonunion; he fractured his anterior C1-2 transarticular screws 2 years postoperatively. He had occipital radicular pain without myelopathy but refused further surgery. Atlantoaxial pseudarthroses were effectively treated by addressing the pathological, biomechanical, and technical reasons for failed fusion. Successful fusion after reoperation was improved by using autologous bone grafts, adequately controlling atlantoaxial motion (with rigid transarticular screws internally or externally with a halo vest), compressing the bone grafts between the arches of C-1 and C-2 with wire cables, meticulously preparing the fusion bed, and by optimizing the pharmacological and clinical parameters to promote bone healing.


J Neurosurg


Journal of neurosurgery


Dickman CA,Sonntag VK




Has Abstract


1995-08-01 00:00:00












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    abstract::The roles of hemoglobin (Hb) in the pathogenesis of cerebral vasospasm remain a matter of discussion. Hemoglobin is known to be released from extravasated red blood cells in a variety of pathological conditions, including subarachnoid hemorrhage. These conditions are often accompanied by infiltration of inflammatory c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Suzuki S,Takenaka K,Kassell NF,Lee KS

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    journal_title:Journal of neurosurgery

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    authors: Steinbok P,Mahaley MS Jr,U R,Varia MA,Lipper S,Mahaley J,Dalzell JG,Bigner DD

    更新日期:1980-07-01 00:00:00

  • The 1-piece transbasal approach: operative technique and anatomical study.

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    journal_title:Journal of neurosurgery

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    authors: Effendi ST,Rao VY,Momin EN,Cruz-Navarro J,Duckworth EA

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    pub_type: 杂志文章


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  • Bone morphogenetic protein-2 application by a poly(D,L-lactide)-coated interbody cage: in vivo results of a new carrier for growth factors.

    abstract:OBJECT:Growth factors such as bone morphogenetic protein-2 (BMP-2) have been proven to promote spine fusion and to overcome the disadvantages of an autologous bone graft. The optimum method to deliver such growth factors remains a matter of discussion. The purpose of this study was to determine the safety and efficacy ...

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    authors: Kandziora F,Bail H,Schmidmaier G,Schollmeier G,Scholz M,Knispel C,Hiller T,Pflugmacher R,Mittlmeier T,Raschke M,Haas NP

    更新日期:2002-07-01 00:00:00

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    abstract::Myelomeningoceles are routinely diagnosed prenatally by using ultrasonography. Because the level of the neural defect has been shown to correlate with functional and cognitive outcome in infants with myelomeningocele, it is of prognostic importance to identify the level prenatally. The authors report on a case in whic...

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    更新日期:2005-03-01 00:00:00

  • Reduced local recurrence of a single brain metastasis through microscopic total resection.

    abstract:OBJECT:The goal of this study was to evaluate the therapeutic impact of the resection of metastatic brain tumor cells infiltrating adjacent brain parenchyma. METHODS:Between July 2001 and February 2007, 94 patients (67 males and 27 females, with a mean age of 55.0 +/-12.0 years) underwent resection of a single brain m...

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    pub_type: 杂志文章


    authors: Yoo H,Kim YZ,Nam BH,Shin SH,Yang HS,Lee JS,Zo JI,Lee SH

    更新日期:2009-04-01 00:00:00

  • Intraoperative subcortical stimulation mapping for hemispherical perirolandic gliomas located within or adjacent to the descending motor pathways: evaluation of morbidity and assessment of functional outcome in 294 patients.

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    journal_title:Journal of neurosurgery

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  • Symptoms of pituitary apoplexy rapidly reversed with bromocriptine. Case report.

    abstract::Macroprolactinomas rarely present with apoplexy. The authors describe a patient with a macroprolactinoma who presented with apoplexy and rapid progression of a third nerve palsy. The patient was managed expectantly with bromocriptine, and within 48 hours, the patient's third nerve palsy had completely resolved. The au...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Brisman MH,Katz G,Post KD

    更新日期:1996-12-01 00:00:00

  • Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study.

    abstract:OBJECT:The goal of this paper was to investigate a possible relationship between the consumption of low-dose aspirin (LDA) and traumatic intracranial hemorrhage in an attempt to determine whether older patients receiving prophylactic LDA require special treatment following an incidence of mild-to-moderate head trauma. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Spektor S,Agus S,Merkin V,Constantini S

    更新日期:2003-10-01 00:00:00

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    journal_title:Journal of neurosurgery

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    authors: Kristof RA,Aliashkevich AF,Schuster M,Meyer B,Urbach H,Schramm J

    更新日期:2002-10-01 00:00:00

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    abstract:OBJECT:Age-related macular degeneration (AMD) is the leading cause of severe vision loss in people older than age 65 years in the western world. The visual acuity loss usually results from the ingrowth of new vessels from the choroid capillaries, so called choroidal neovascularization (CNV). The aim of this pilot study...

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    pub_type: 杂志文章


    authors: Haas A,Papaefthymiou G,Langmann G,Schröttner O,Feigl B,Leber KA,Hanselmayer R,Pendl G

    更新日期:2000-12-01 00:00:00

  • Radiographic absence of the posterior communicating arteries and the prediction of cognitive dysfunction after carotid endarterectomy.

    abstract:OBJECT:Approximately 25% of patients exhibit cognitive dysfunction 24 hours after carotid endarterectomy (CEA). One of the purported mechanisms of early cognitive dysfunction (eCD) is hypoperfusion due to inadequate collateral circulation during cross-clamping of the carotid artery. The authors assessed whether poor co...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sussman ES,Kellner CP,Mergeche JL,Bruce SS,McDowell MM,Heyer EJ,Connolly ES

    更新日期:2014-09-01 00:00:00

  • Chronic subdural hematoma: evaluation of the clinical significance of postoperative drainage volume.

    abstract:OBJECT:A wide variation in postoperative drainage volumes is observed during treatment of chronic subdural hematoma (CSDH) with twist-drill or burr-hole craniostomy and closed-system drainage. In this study the authors investigate the causes of the variation, the clinical significance thereof, and its influence on trea...

    journal_title:Journal of neurosurgery

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    abstract::The translabyrinthine route or an extension of it was used to remove 150 acoustic nerve tumors. The mortality was 2% and the morbidity low. Preservation of the facial nerve was achieved in 100% of the small and 80% of the medium-sized tumors, but in only 20% of the large growths. The complications encountered are disc...

    journal_title:Journal of neurosurgery

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    authors: King TT,Morrison AW

    更新日期:1980-02-01 00:00:00

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    journal_title:Journal of neurosurgery

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    authors: Hasegawa T,Kida Y,Kobayashi T,Yoshimoto M,Mori Y,Yoshida J

    更新日期:2005-01-01 00:00:00

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    abstract:OBJECT:Physicians are often solicited by patients or colleagues for clinical recommendations they would make for themselves if faced by a clinical situation. The act of making a recommendation can alter the clinical course being taken. The authors sought to understand this dynamic across different neurosurgical scenari...

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    authors: Tanweer O,Wilson TA,Kalhorn SP,Golfinos JG,Huang PP,Kondziolka D

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    abstract::OBJECTIVE Stereotactic radiosurgery (SRS) with or without whole-brain radiotherapy can be used to achieve local control (> 90%) for small brain metastases after resection. However, many brain metastases are unsuitable for SRS because of their size or previous treatment, and whole-brain radiotherapy is associated with ...

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    authors: Raleigh DR,Seymour ZA,Tomlin B,Theodosopoulos PV,Berger MS,Aghi MK,Geneser SE,Krishnamurthy D,Fogh SE,Sneed PK,McDermott MW

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    abstract::In this paper the authors describe two patients with recurrent hemiparesis and limb shaking that gradually progressed to hemichorea. Cerebral angiography confirmed severe unilateral internal carotid artery stenosis (95%) contralateral to the hemichorea. The cerebral blood flow, assessed using N-isopropyl-p-(iodine-123...

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    authors: Morigaki R,Uno M,Suzue A,Nagahiro S

    更新日期:2006-07-01 00:00:00

  • Salvage retreatment after failure of radiosurgery in patients with arteriovenous malformations.

    abstract:OBJECT:The goal of this study was to evaluate the outcomes of patients who underwent repeated radiosurgery to treat a residual intracranial arteriovenous malformation (AVM) after an initial radiosurgical treatment failure. METHODS:The authors reviewed the cases of 52 patients who underwent repeated radiosurgery for re...

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    authors: Foote KD,Friedman WA,Ellis TL,Bova FJ,Buatti JM,Meeks SL

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    abstract::The goals in the management of patients with vestibular schwannomas have changed drastically over the past few decades, with preservation of useful hearing representing the newest challenge. The true incidence of preserved useful hearing, however, has become clouded by a lack of uniformity in reporting results. The au...

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    authors: Tabaddor K,LaMorgese J

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    abstract:OBJECT:The goal of this study was to elucidate the genotype-phenotype relationship in syndromic craniosynostoses by analyzing the mutations of the fibroblast growth factor receptor (FGFR) gene and its clinical manifestations in patients, particularly those in atypical cases. METHODS:Twenty patients with craniosynostos...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ito S,Sekido K,Kanno H,Sato H,Tanaka M,Yamaguchi K,Yamamoto I

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hales JR,Yeo JD,Stabback S,Fawcett AA,Kearns R

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hao S,Hong CS,Feng J,Yang C,Chittiboina P,Zhang J,Zhuang Z

    更新日期:2016-06-01 00:00:00

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Yokota M,Tani E,Maeda Y,Morimura T,Kakudo K,Uematsu K

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Taylor JC,Choudhury AR

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Pollock BE,Lunsford LD,Flickinger JC,Clyde BL,Kondziolka D

    更新日期:1998-12-01 00:00:00