Journal of Neurosurgery: Spine, Ahead of Print.
OBJECT Endoscopic approaches to the anterior craniocervical junction are increasing in frequency. Choice of oral versus endoscopic endonasal approach to the odontoid often depends on the relationship of the C1–2 complex to the hard palate. However, it is not known how this relevant anatomy changes with age. We hypothesize that there is a dynamic relationship of C-2 and the hard palate, which changes with age, and potentially affects the choice of surgical approach. The aim of this study was to characterize the relationship of C-2 relative to the hard palate with respect to age and sex. METHODS Emergency department billing and trauma records from 2008 to 2014 were reviewed for patients of all ages who underwent cervical or maxillofacial CT as part of a trauma evaluation for closed head injury. Patients who had a CT scan that allowed adequate visualization of the hard palate, opisthion, and upper cervical spine (C-1 and C-2) were included. Patients who had cervical or displaced facial/skull base fractures, a history of rheumatoid arthritis, or craniofacial anomalies were excluded. The distance from McGregor's palatooccipital line to the midpoint of the inferior endplate of C-2 (McL–C2) was measured on midsagittal CT scans. Patients were grouped by decile of age and by sex. A 1-way ANOVA was performed with each respective grouping. RESULTS Ultimately, 483 patients (29% female) were included. The mean age was 46 ± 24 years. The majority of patients studied were in the 2nd through 8th decades of life (85%). Significant variation was found between McL–C2 and decile of age (p < 0.001) and sex (p < 0.001). The mean McL–C2 was 27 mm in the 1st decade of life compared with the population mean of 37 mm. The mean McL–C2 was also noted to be smaller in females (mean difference 4.8 mm, p < 0.0001). Both decile of age (p = 0.0009) and sex (p < 0.0001) were independently correlated with McL–C2 on multivariate analysis. CONCLUSIONS The relationship of C-2 and the hard palate significantly varies with respect to age and sex, descending relative to the hard palate a full centimeter on average in adulthood. These findings may have relevance in determining optimal surgical approaches for addressing pathology involving the anterior craniocervical junction.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OYEKDN
via IFTTT
Αρχειοθήκη ιστολογίου
-
►
2020
(289)
- ► Φεβρουαρίου (28)
-
►
2019
(9071)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3642)
- ► Ιανουαρίου (3200)
-
►
2018
(39872)
- ► Δεκεμβρίου (3318)
- ► Σεπτεμβρίου (3683)
- ► Φεβρουαρίου (2693)
- ► Ιανουαρίου (3198)
-
►
2017
(41099)
- ► Δεκεμβρίου (3127)
- ► Σεπτεμβρίου (2173)
-
►
2016
(13807)
- ► Δεκεμβρίου (700)
- ► Σεπτεμβρίου (600)
- ► Φεβρουαρίου (1350)
- ► Ιανουαρίου (1400)
-
▼
2015
(1500)
-
▼
Δεκεμβρίου
(1450)
-
▼
Δεκ 12
(50)
- Surgical management of bisphosphonate-related oste...
- Results of a Multicenter, Randomized, Double-Maske...
- Pharmacotherapy for Pediatric Generalized Anxiety ...
- Extracellular Toxoplasma gondii tachyzoites metabo...
- CD1a+ and CD83+ Langerhans cells are reduced in lo...
- mTOR pathway protein immunoexpression as a prognos...
- Intrathecal fentanyl abolishes the exaggerated blo...
- Endothelin regulates intermittent hypoxia-induced ...
- Increasing taurine intake and taurine synthesis im...
- Microglia modulate brainstem serotonergic expressi...
- Factors associated with having less than 20 natura...
- The Effect on Sodium/Iodide Symporter and Pendrin ...
- Transient spurious intrathecal immunoglobulin synt...
- Validation of the Chinese version of the FOUR scor...
- IJMS, Vol. 16, Pages 29772-29786: Microtubule-Asso...
- MMP2 and MMP7 at the invasive front of gastric can...
- Carcinosarcoma of the larynx consisting of squamou...
- Head and neck cancers: a clinico-pathological prof...
- The use of intraoperative triggered electromyograp...
- Scoliosis may increase the risk of recurrence of l...
- The role of obesity in the biomechanics and radiol...
- The rise and fall of the craniocervical junction r...
- Preoperative retrolisthesis as a risk factor of po...
- Economic value of treating lumbar disc herniation ...
- Letter to the Editor: Alternative approach in Type...
- Prevalence and type of cervical deformities among ...
- App-assisted external ventricular drain insertion
- Effectiveness of 2-methoxyestradiol in alleviating...
- Neuropsychological outcomes of subtemporal selecti...
- The safety of Pipeline flow diversion in fusiform ...
- Sonographic findings associated with stenosis prog...
- Origin of craniopharyngiomas: implications for gro...
- Identifying preoperative language tracts and predi...
- Dynamic telescopic craniotomy: a cadaveric study o...
- Prospective comparison of sinonasal outcomes after...
- Application of contrast-enhanced T1-weighted MRI-b...
- Treatment of ruptured complex and large/giant rupt...
- A cadaveric microanatomical study of the fascicula...
- EP24.15 as a potential regulator of Kisspeptin wit...
- Research-focused isolation of human islets from do...
- Activation of medulla-projecting perifornical neur...
- Nodal promotes functional luteolysis via downregul...
- Post stroke hemi-dystonia in children: a neglected...
- Salting-out-assisted liquid–liquid extraction as a...
- Downscaling the in vitro test of fungal bioremedia...
- Cervical Cancer Prevention in Malaysia: Knowledge ...
- Local cryosurgery and imiquimod: A successful comb...
- Blistering disease associated with diffuse large B...
- Spontaneous remission of aleukemic cutaneous myelo...
- Kissing tumors of sebaceous carcinoma on the eyeli...
-
▼
Δεκ 12
(50)
-
▼
Δεκεμβρίου
(1450)
Ετικέτες
Σάββατο 12 Δεκεμβρίου 2015
The rise and fall of the craniocervical junction relative to the hard palate: a lifetime story
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου