Skip to main content
Erschienen in: Child's Nervous System 10/2008

01.10.2008 | Special Annual Issue

Anatomy and biomechanics of normal craniovertebral junction (a) and biomechanics of stabilization (b)

verfasst von: Arnold H. Menezes, Vincent C. Traynelis

Erschienen in: Child's Nervous System | Ausgabe 10/2008

Einloggen, um Zugang zu erhalten

Abstract

Introduction

A knowledge of the bony configuration, ligamentous attachments, joint articulations, vascular supply, muscle function, and lymphatic drainage as well as the kinetic anatomy of the craniocervical junction is necessary to understand the etiology of abnormalities in this area and their treatment.

Results and discussion

The craniovertebral junction (CVJ) is the most mobile of the upper cervical spine especially in children. It is uniquely adapted for stability and motion. The bony anatomy and the normal biomechanics of the CVJ in children are presented and subsequently the biomechanics of complex stabilization. Our review of more than 600 children who required stabilization is presented.
Literatur
1.
Zurück zum Zitat Aufdermaur M (1974) Spinal injuries in juveniles: necropsy findings in twelve cases. J Bone Joint Surg 56B:513–519 Aufdermaur M (1974) Spinal injuries in juveniles: necropsy findings in twelve cases. J Bone Joint Surg 56B:513–519
2.
Zurück zum Zitat Bailey DK (1952) The normal cervical spine in infants and children. Radiology 59:712–719PubMed Bailey DK (1952) The normal cervical spine in infants and children. Radiology 59:712–719PubMed
3.
Zurück zum Zitat Bhatnagar M, Sponseller PD, Carroll C IV, Tolo VT (1991) Pediatric atlantoaxial instability presenting as cerebral and cerebellar infarcts. J Pediatr Orthop 11:103–107PubMed Bhatnagar M, Sponseller PD, Carroll C IV, Tolo VT (1991) Pediatric atlantoaxial instability presenting as cerebral and cerebellar infarcts. J Pediatr Orthop 11:103–107PubMed
4.
Zurück zum Zitat Blaw ME, Langer LO (1969) Spinal cord compression in Morquio–Brailsford’s syndrome. J Pediatr 74:593–600PubMedCrossRef Blaw ME, Langer LO (1969) Spinal cord compression in Morquio–Brailsford’s syndrome. J Pediatr 74:593–600PubMedCrossRef
5.
Zurück zum Zitat Bonadio W (1993) Cervical spine trauma in children: Part 1. General concepts, normal anatomy, radiographic evaluation. Am J Emerg Med 11:158–165PubMedCrossRef Bonadio W (1993) Cervical spine trauma in children: Part 1. General concepts, normal anatomy, radiographic evaluation. Am J Emerg Med 11:158–165PubMedCrossRef
6.
Zurück zum Zitat Bonadio W (1993) Cervical spine trauma in children: Part 2. Mechanisms and manifestations of injury, therapeutic considerations. Am J Emerg Med 11:256–278PubMedCrossRef Bonadio W (1993) Cervical spine trauma in children: Part 2. Mechanisms and manifestations of injury, therapeutic considerations. Am J Emerg Med 11:256–278PubMedCrossRef
7.
Zurück zum Zitat Brasch JC (1958) Cunningham’s manual of practical anatomy. Oxford University Press, London, pp 258–295 Brasch JC (1958) Cunningham’s manual of practical anatomy. Oxford University Press, London, pp 258–295
8.
Zurück zum Zitat Calvy TM, Segall HD, Gilles FH, Bird CR, Zee CS, Ahmadi J, Biddle R (1987) CT anatomy of the craniovertebral junction in infants and children. Am J Neuroradiol 8(3):489–494PubMed Calvy TM, Segall HD, Gilles FH, Bird CR, Zee CS, Ahmadi J, Biddle R (1987) CT anatomy of the craniovertebral junction in infants and children. Am J Neuroradiol 8(3):489–494PubMed
9.
Zurück zum Zitat Dickman CA, Crawford NR, Tominaga T, Brantley AG, Coons S, Sonntag VK (1994) Morphology and kinematics of the baboon upper cervical spine. A model of the atlantoaxial complex. Spine 19(22):2518–2523PubMed Dickman CA, Crawford NR, Tominaga T, Brantley AG, Coons S, Sonntag VK (1994) Morphology and kinematics of the baboon upper cervical spine. A model of the atlantoaxial complex. Spine 19(22):2518–2523PubMed
10.
Zurück zum Zitat Dickman CA, Lekovic GP (2005) Biomechanical considerations for stabilization of the craniovertebral junction. Clin Neurosurg 52:205–213PubMed Dickman CA, Lekovic GP (2005) Biomechanical considerations for stabilization of the craniovertebral junction. Clin Neurosurg 52:205–213PubMed
11.
Zurück zum Zitat Fielding JW, Cochron GB, Lawsing JR III, Hohl M (1974) Tears of the transverse ligament of the atlas. A clinical and biomechanical study. J Bone Joint Surg (Am) 56:1683–1691 Fielding JW, Cochron GB, Lawsing JR III, Hohl M (1974) Tears of the transverse ligament of the atlas. A clinical and biomechanical study. J Bone Joint Surg (Am) 56:1683–1691
12.
Zurück zum Zitat Fielding JW, Griffin PP (1974) Os odontoideum: An acquired lesion. J Bone Jt Surg Am 56:187–190 Fielding JW, Griffin PP (1974) Os odontoideum: An acquired lesion. J Bone Jt Surg Am 56:187–190
13.
Zurück zum Zitat Gaskill SJ, Marlin AE (1990) Custom fitted thermoplastic Minerva jackets in the treatment of cervical spine instability in preschool age children. Pediatr Neurosurg 16:35–39PubMedCrossRef Gaskill SJ, Marlin AE (1990) Custom fitted thermoplastic Minerva jackets in the treatment of cervical spine instability in preschool age children. Pediatr Neurosurg 16:35–39PubMedCrossRef
14.
Zurück zum Zitat Gilles RH, Bina M, Sotrel A (1979) Infantile atlanto-occipital instability: The potential danger of extreme extension. Am J Disabled Child 133:30–37 Gilles RH, Bina M, Sotrel A (1979) Infantile atlanto-occipital instability: The potential danger of extreme extension. Am J Disabled Child 133:30–37
15.
Zurück zum Zitat Gladstone J, Erickson-Powell W (1914–1915) Manifestation of occipital vertebra and fusion of atlas with occipital bone. J Anat Physiol 49:190–199 Gladstone J, Erickson-Powell W (1914–1915) Manifestation of occipital vertebra and fusion of atlas with occipital bone. J Anat Physiol 49:190–199
16.
Zurück zum Zitat Glasauer FE, Cares HL (1973) Biomechanical features of traumatic paraplegia in infancy. J Trauma 13:166–170PubMed Glasauer FE, Cares HL (1973) Biomechanical features of traumatic paraplegia in infancy. J Trauma 13:166–170PubMed
17.
Zurück zum Zitat Godersky JC, Menezes AH (1989) Optimal management for children with spinal cord injury. Contemp Neurosurg 11:1–6 Godersky JC, Menezes AH (1989) Optimal management for children with spinal cord injury. Contemp Neurosurg 11:1–6
18.
Zurück zum Zitat Goel VK, Clark CR, Gallaes K, Liu YK (1988) Movement–rotation relationships of the ligamentous occipito-atlanto-axial complex. J Biomech 21(8):678CrossRef Goel VK, Clark CR, Gallaes K, Liu YK (1988) Movement–rotation relationships of the ligamentous occipito-atlanto-axial complex. J Biomech 21(8):678CrossRef
19.
Zurück zum Zitat Grisel P (1930) Enucleation des l’atlas et torticollis nasopharyngien. Presse Med 38:50 Grisel P (1930) Enucleation des l’atlas et torticollis nasopharyngien. Presse Med 38:50
20.
Zurück zum Zitat Grob D, Crisco JJ III, Panjabi MM, Wang P, Dvorak J (1992) Biomechanical evaluation of four different posterior atlantoaxial fixation techniques. Spine 17(5):480–490PubMedCrossRef Grob D, Crisco JJ III, Panjabi MM, Wang P, Dvorak J (1992) Biomechanical evaluation of four different posterior atlantoaxial fixation techniques. Spine 17(5):480–490PubMedCrossRef
21.
Zurück zum Zitat Hadley MN, Rauzzino MJ (1996) Pediatric spinal cord injuries. In: Menezes AH, Sonntag VKH (eds) Principles of spinal surgery. McGraw-Hill, New York, pp 817–840 Hadley MN, Rauzzino MJ (1996) Pediatric spinal cord injuries. In: Menezes AH, Sonntag VKH (eds) Principles of spinal surgery. McGraw-Hill, New York, pp 817–840
22.
Zurück zum Zitat Hanley EN Jr, Harvell JC Jr (1992) Immediate postoperative stability of the atlantoaxial articulation: A biomechanical study comparing simple midline wiring, and the Gallie and Brooks procedures. J Spinal Disord 5(3):306–310PubMed Hanley EN Jr, Harvell JC Jr (1992) Immediate postoperative stability of the atlantoaxial articulation: A biomechanical study comparing simple midline wiring, and the Gallie and Brooks procedures. J Spinal Disord 5(3):306–310PubMed
23.
Zurück zum Zitat Hanson PB, Montesano PX, Sharkey NA, Rauschning W (1991) Anatomic and biomechanical assessment of transarticular screw fixation for atlantoaxial instability. Spine 16(10):1141–1145PubMedCrossRef Hanson PB, Montesano PX, Sharkey NA, Rauschning W (1991) Anatomic and biomechanical assessment of transarticular screw fixation for atlantoaxial instability. Spine 16(10):1141–1145PubMedCrossRef
24.
Zurück zum Zitat Hawkins RJ, Fielding JW, Thompson WJ (1976) Os odontoideum. Congenital or acquired. J Bone Jt Surg Am 58:413 Hawkins RJ, Fielding JW, Thompson WJ (1976) Os odontoideum. Congenital or acquired. J Bone Jt Surg Am 58:413
25.
Zurück zum Zitat Jirout J (1973) Changes in the atlas-axis relations on lateral flexion of the head and neck. Neuroradiology 6:215PubMedCrossRef Jirout J (1973) Changes in the atlas-axis relations on lateral flexion of the head and neck. Neuroradiology 6:215PubMedCrossRef
26.
Zurück zum Zitat Johnson MH, Smoker WR (1994) Lesions of the craniovertebral junction. Neuroimag Clin North Am 4(3):599–617 Johnson MH, Smoker WR (1994) Lesions of the craniovertebral junction. Neuroimag Clin North Am 4(3):599–617
27.
Zurück zum Zitat Krakenes J, Kaale BR, Rorvik J, Gilhus NE (2001) MRI assessment of normal ligamentous structures in the craniovertebral junction. Neuroradiology 43:1089–1097PubMedCrossRef Krakenes J, Kaale BR, Rorvik J, Gilhus NE (2001) MRI assessment of normal ligamentous structures in the craniovertebral junction. Neuroradiology 43:1089–1097PubMedCrossRef
28.
Zurück zum Zitat Krakenes J, Kaale BR, Moen G, Nordli H, Gilhaus NE, Rorvik J (2003) MRI of the tectorial and posterior atlanto-occipital membranes in the late stage of whiplash injury. Neuroradiology 45(9):585–591PubMedCrossRef Krakenes J, Kaale BR, Moen G, Nordli H, Gilhaus NE, Rorvik J (2003) MRI of the tectorial and posterior atlanto-occipital membranes in the late stage of whiplash injury. Neuroradiology 45(9):585–591PubMedCrossRef
29.
Zurück zum Zitat Lufkin T, Mark M, Hart CP, Dollé P, LeMeur M, Chambron P (1992) Homeotic transformation of the occipital bones of the skull by ectopic expression of a homeobox gene. Nature 359:835–841PubMedCrossRef Lufkin T, Mark M, Hart CP, Dollé P, LeMeur M, Chambron P (1992) Homeotic transformation of the occipital bones of the skull by ectopic expression of a homeobox gene. Nature 359:835–841PubMedCrossRef
30.
Zurück zum Zitat Mandabach M, Ruge JR, Hahn YS, McLone DG (1993) Pediatric axis fractures: Early HALO immobilization, management and outcome. Pediatr Neurosurg 19:225–232PubMedCrossRef Mandabach M, Ruge JR, Hahn YS, McLone DG (1993) Pediatric axis fractures: Early HALO immobilization, management and outcome. Pediatr Neurosurg 19:225–232PubMedCrossRef
31.
Zurück zum Zitat Menezes AH (1988) Os odontoideum-pathogenesis, dynamics and management. In: Marlin AE (ed) Concepts in pediatric neurosurgery. Karger, Switzerland, pp 133–145 Menezes AH (1988) Os odontoideum-pathogenesis, dynamics and management. In: Marlin AE (ed) Concepts in pediatric neurosurgery. Karger, Switzerland, pp 133–145
32.
Zurück zum Zitat Menezes AH, Muhonen M (1990) Management of occipitocervical instability. In: Cooper P (ed) Management of posttraumatic spinal instability. AANS, Park Ridge, IL, pp 65–76 Menezes AH, Muhonen M (1990) Management of occipitocervical instability. In: Cooper P (ed) Management of posttraumatic spinal instability. AANS, Park Ridge, IL, pp 65–76
33.
Zurück zum Zitat Menezes AH (1995) Congenital and acquired abnormalities of the craniovertebral junction (Children and Adults). In: Youmans J (ed) Neurological surgery, 4th edn. Saunders, Philadelphia, pp 1035–1089 Menezes AH (1995) Congenital and acquired abnormalities of the craniovertebral junction (Children and Adults). In: Youmans J (ed) Neurological surgery, 4th edn. Saunders, Philadelphia, pp 1035–1089
34.
Zurück zum Zitat Menezes AH (2003) Developmental abnormalities of the craniocervical junction. In: Winn RH (ed) Youmans neurological surgery. Saunders, Orlando, pp 3331–3345 Menezes AH (2003) Developmental abnormalities of the craniocervical junction. In: Winn RH (ed) Youmans neurological surgery. Saunders, Orlando, pp 3331–3345
35.
Zurück zum Zitat Mitchie I, Clark M (1968) Neurological syndromes associated with cervical and craniocervical anomalies. Arch Neurol 18:241 Mitchie I, Clark M (1968) Neurological syndromes associated with cervical and craniocervical anomalies. Arch Neurol 18:241
36.
Zurück zum Zitat Mubarack SJ, Camp JF, Vuletich RF, Wenger DR, Garfin SR (1989) Halo application in the infant. J Pediatr Orthop 9:612–615 Mubarack SJ, Camp JF, Vuletich RF, Wenger DR, Garfin SR (1989) Halo application in the infant. J Pediatr Orthop 9:612–615
37.
Zurück zum Zitat Osenbach RK, Menezes AH (1989) Spinal cord injury without radiographic abnormality in children. Pediatr Neurosci 15:168–175PubMedCrossRef Osenbach RK, Menezes AH (1989) Spinal cord injury without radiographic abnormality in children. Pediatr Neurosci 15:168–175PubMedCrossRef
38.
Zurück zum Zitat Osenbach RK, Menezes AH (1992) Pediatric spinal cord and vertebral column injury. Neurosurgery 30:385–390PubMed Osenbach RK, Menezes AH (1992) Pediatric spinal cord and vertebral column injury. Neurosurgery 30:385–390PubMed
39.
Zurück zum Zitat Panjabi MM, Dvorák J, Duranceau J, Yamamoto I, Gerber M, Rauschning W, Bueff HV (1988) Three-dimensional movements of the upper cervical spine. Spine 13(7):726–730PubMedCrossRef Panjabi MM, Dvorák J, Duranceau J, Yamamoto I, Gerber M, Rauschning W, Bueff HV (1988) Three-dimensional movements of the upper cervical spine. Spine 13(7):726–730PubMedCrossRef
40.
Zurück zum Zitat Panjabi MM, Dvorák J, Crisco JJ III, Oda T, Wang P, Grob D (1991) Flexion, extension and lateral bending of the upper cervical spine in response to alar ligament transactions. J Spinal Disord 4(2):157–167PubMedCrossRef Panjabi MM, Dvorák J, Crisco JJ III, Oda T, Wang P, Grob D (1991) Flexion, extension and lateral bending of the upper cervical spine in response to alar ligament transactions. J Spinal Disord 4(2):157–167PubMedCrossRef
41.
Zurück zum Zitat Pappas CT, Rekate HL (1988) Role of magnetic resonance imaging and three-dimensional computerized tomography in craniovertebral junction anomalies. Pediatr Neurosci 14(1):18–22PubMedCrossRef Pappas CT, Rekate HL (1988) Role of magnetic resonance imaging and three-dimensional computerized tomography in craniovertebral junction anomalies. Pediatr Neurosci 14(1):18–22PubMedCrossRef
42.
Zurück zum Zitat Parke WW (1978) The vascular relations of the upper cervical vertebrae. Orthop Clin North Am 9(4):879–889PubMed Parke WW (1978) The vascular relations of the upper cervical vertebrae. Orthop Clin North Am 9(4):879–889PubMed
43.
Zurück zum Zitat Parke WW, Rothman RH, Brown MD (1984) The pharyngovertebral veins. An anatomical rationale for Grisel’s syndrome. J Bone Jt Surg Am 66:568 Parke WW, Rothman RH, Brown MD (1984) The pharyngovertebral veins. An anatomical rationale for Grisel’s syndrome. J Bone Jt Surg Am 66:568
44.
Zurück zum Zitat Penning L (1981) Prevertebral hematoma in cervical spine injuries. Am J Roentgenol 136:553–557 Penning L (1981) Prevertebral hematoma in cervical spine injuries. Am J Roentgenol 136:553–557
45.
Zurück zum Zitat Puttlitz CM, Goel VK, Clark CR, Traynelis VC, Scifert JL, Grosland NM (2000) Biomechanical rationale for the pathology of rheumatoid arthritis in the craniovertebral junction. Spine 25(13):1607–1616PubMedCrossRef Puttlitz CM, Goel VK, Clark CR, Traynelis VC, Scifert JL, Grosland NM (2000) Biomechanical rationale for the pathology of rheumatoid arthritis in the craniovertebral junction. Spine 25(13):1607–1616PubMedCrossRef
46.
Zurück zum Zitat Puttlitz CM, Goel VK, Traynelis VC, Clark CR (2001) A finite element investigation of upper cervical instrumentation. Spine 26(22):2449–2455PubMedCrossRef Puttlitz CM, Goel VK, Traynelis VC, Clark CR (2001) A finite element investigation of upper cervical instrumentation. Spine 26(22):2449–2455PubMedCrossRef
47.
Zurück zum Zitat Puttlitz CM, Melcher RP, Kleinstueck FS, Harms J, Bradford DS, Lotz JC (2004) Stability analysis of craniovertebral junction fixation techniques. J Bone Jt Surg Am 86:561–568 Puttlitz CM, Melcher RP, Kleinstueck FS, Harms J, Bradford DS, Lotz JC (2004) Stability analysis of craniovertebral junction fixation techniques. J Bone Jt Surg Am 86:561–568
49.
Zurück zum Zitat Ruge JR, Sinson GP, McLone DM, Cerullo LJ (1988) Pediatric spinal injury: the very young. J Neurosurg 68:25–30PubMed Ruge JR, Sinson GP, McLone DM, Cerullo LJ (1988) Pediatric spinal injury: the very young. J Neurosurg 68:25–30PubMed
50.
Zurück zum Zitat Schiff DCM, Parke WW (1972) The arterial supply of the odontoid process (dens). Anat Rec 172:399–400 Schiff DCM, Parke WW (1972) The arterial supply of the odontoid process (dens). Anat Rec 172:399–400
51.
Zurück zum Zitat Selecki BR (1969) The effects of rotation of the atlas on the axis: Experimental work. Med J Aust 1:1012PubMed Selecki BR (1969) The effects of rotation of the atlas on the axis: Experimental work. Med J Aust 1:1012PubMed
52.
Zurück zum Zitat Smoker WR, Keyes WD, Dunn VD, Menezes AH (1986) MRI versus conventional Radiologic examinations in the evaluation of the craniovertebral and cervicomedullary junction. Radiographics 6(6):953–994PubMed Smoker WR, Keyes WD, Dunn VD, Menezes AH (1986) MRI versus conventional Radiologic examinations in the evaluation of the craniovertebral and cervicomedullary junction. Radiographics 6(6):953–994PubMed
53.
Zurück zum Zitat Stevens JM, Chong WK, Barber C, Kendall BE, Crockard HA (1994) A new appraisal of abnormalities of the odontoid process associated with atlantoaxial subluxation and neurological disability. Brain 117(Pt 1):133–148PubMedCrossRef Stevens JM, Chong WK, Barber C, Kendall BE, Crockard HA (1994) A new appraisal of abnormalities of the odontoid process associated with atlantoaxial subluxation and neurological disability. Brain 117(Pt 1):133–148PubMedCrossRef
54.
55.
Zurück zum Zitat VanGilder JC, Menezes AH, Dolan K (1987) The craniovertebral junction and its abnormalities. Futura, New York, pp 1–255 VanGilder JC, Menezes AH, Dolan K (1987) The craniovertebral junction and its abnormalities. Futura, New York, pp 1–255
56.
Zurück zum Zitat VonTorklus D, Gehle W (1972) The upper cervical spine: Regional anatomy, pathology and traumatology. In: Verlag GT (ed) Systemic radiological atlas and textbook. Grune & Stratton, New York, pp 1–99 VonTorklus D, Gehle W (1972) The upper cervical spine: Regional anatomy, pathology and traumatology. In: Verlag GT (ed) Systemic radiological atlas and textbook. Grune & Stratton, New York, pp 1–99
57.
Zurück zum Zitat Werne S (1957) The craniovertebral joints. Acta Orthop Scand 23(Suppl):150 Werne S (1957) The craniovertebral joints. Acta Orthop Scand 23(Suppl):150
58.
Zurück zum Zitat Werne S (1957) Studies in spontaneous atlas dislocation. The craniovertebral joints. Acta Orthop Scand 23(Suppl):11–83 Werne S (1957) Studies in spontaneous atlas dislocation. The craniovertebral joints. Acta Orthop Scand 23(Suppl):11–83
59.
Zurück zum Zitat White AA III, Panjabi MM (1978) The clinical biomechanics of the occipitoatlantoaxial complex. Orthop Clin North Am 9(4):867–878PubMed White AA III, Panjabi MM (1978) The clinical biomechanics of the occipitoatlantoaxial complex. Orthop Clin North Am 9(4):867–878PubMed
60.
Zurück zum Zitat Yuksel M, Heiserman JE, Sonntag VKH (2006) Magnetic resonance imaging of the craniocervical junction at 3-T: Observation of the accessory atlantoaxial ligaments. Neurosurgery 59:888–893PubMedCrossRef Yuksel M, Heiserman JE, Sonntag VKH (2006) Magnetic resonance imaging of the craniocervical junction at 3-T: Observation of the accessory atlantoaxial ligaments. Neurosurgery 59:888–893PubMedCrossRef
61.
Zurück zum Zitat Gallie WF (1939) Fractures and dislocations of the cervical spine. Am J Surg 46:495CrossRef Gallie WF (1939) Fractures and dislocations of the cervical spine. Am J Surg 46:495CrossRef
62.
Zurück zum Zitat Brooks AL, Jenkins EB (1978) Atlanto-axial arthrodesis by the wedge compression method. J Bone Jt Surg 60A:279 Brooks AL, Jenkins EB (1978) Atlanto-axial arthrodesis by the wedge compression method. J Bone Jt Surg 60A:279
63.
Zurück zum Zitat Papadopoulos SM, Dickman CA, Sonntag VK (1991) Atlantoaxial stabilization in rheumatoid arthritis. J Neurosurg 74:1PubMedCrossRef Papadopoulos SM, Dickman CA, Sonntag VK (1991) Atlantoaxial stabilization in rheumatoid arthritis. J Neurosurg 74:1PubMedCrossRef
64.
Zurück zum Zitat Hanley EN, Harvell JC (1992) Immediate postoperative stability of atlantoaxial articulation: a biomechanical study comparing simple midline wiring and the Gallie and Brooks procedures. J Spinal Disord 5:306PubMed Hanley EN, Harvell JC (1992) Immediate postoperative stability of atlantoaxial articulation: a biomechanical study comparing simple midline wiring and the Gallie and Brooks procedures. J Spinal Disord 5:306PubMed
65.
Zurück zum Zitat Grob D, Crisco JJ, Panjabi MM (1992) Biomechanical evaluation of four different atlantoaxial fixation techniques. Spine 17:480PubMedCrossRef Grob D, Crisco JJ, Panjabi MM (1992) Biomechanical evaluation of four different atlantoaxial fixation techniques. Spine 17:480PubMedCrossRef
66.
Zurück zum Zitat Menezes AH, Ryken TC (1994) Instrumentation of the craniocervical region. In: Benzel EC (ed) Spinal instrumentation (AANS Neurosurgical Topics). Williams and Wilkins, Baltimore, p 47 Menezes AH, Ryken TC (1994) Instrumentation of the craniocervical region. In: Benzel EC (ed) Spinal instrumentation (AANS Neurosurgical Topics). Williams and Wilkins, Baltimore, p 47
67.
Zurück zum Zitat Hanson PB, Montesano PX, Sharkey NA, Rauschning W (1991) Anatomic and biomechanical assessment of transarticular screw fixation for atlantoaxial instability. Spine 16:1141PubMedCrossRef Hanson PB, Montesano PX, Sharkey NA, Rauschning W (1991) Anatomic and biomechanical assessment of transarticular screw fixation for atlantoaxial instability. Spine 16:1141PubMedCrossRef
68.
Zurück zum Zitat Dickman CA, Crawford NR, Paramore CG (1996) Biomechanical characteristics of C1–C2 cable fixations. J Neurosurg 85:316–322PubMed Dickman CA, Crawford NR, Paramore CG (1996) Biomechanical characteristics of C1–C2 cable fixations. J Neurosurg 85:316–322PubMed
69.
Zurück zum Zitat Puttlitz CM, Goel VK, Traynelis VC, Clark CR (2001) A finite element investigation of upper cervical instrumentation. Spine 26(22):2449–2455PubMedCrossRef Puttlitz CM, Goel VK, Traynelis VC, Clark CR (2001) A finite element investigation of upper cervical instrumentation. Spine 26(22):2449–2455PubMedCrossRef
70.
Zurück zum Zitat Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J Bradford DS (2002) Biomechanical testing of posterior atlantoaxial fixation techniques. Spine 27:2435–2440PubMedCrossRef Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J Bradford DS (2002) Biomechanical testing of posterior atlantoaxial fixation techniques. Spine 27:2435–2440PubMedCrossRef
71.
Zurück zum Zitat Gorek J, Acaroglu E, Berven S, Yousef A, Puttlitz CM (2005) Constructs incorporating intralaminar C2 screws provide rigid stability for atlantoaxial fixation. Spine 30:1513–1518PubMedCrossRef Gorek J, Acaroglu E, Berven S, Yousef A, Puttlitz CM (2005) Constructs incorporating intralaminar C2 screws provide rigid stability for atlantoaxial fixation. Spine 30:1513–1518PubMedCrossRef
72.
Zurück zum Zitat Oda I, Abumi K, Sell LC, Haggerty CJ, Cunningham BW, McAfee PC (1999) Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine 24:2377–2382PubMedCrossRef Oda I, Abumi K, Sell LC, Haggerty CJ, Cunningham BW, McAfee PC (1999) Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine 24:2377–2382PubMedCrossRef
73.
Zurück zum Zitat Hurlbert RJ, Crawford NR, Choi WG, Dickman CA (1999) A biomechanical evaluation of occipitocervical instrumentation: screw compared with wire fixation. J Neurosurg 90:84–90PubMed Hurlbert RJ, Crawford NR, Choi WG, Dickman CA (1999) A biomechanical evaluation of occipitocervical instrumentation: screw compared with wire fixation. J Neurosurg 90:84–90PubMed
74.
Zurück zum Zitat Sutterlin CE, Bianchi JR, Kunz DN, Zdeblick TA, Johnson WM, Rapoff AJ (2001) Biomechanical evaluation of occipitocervical fixation devices. J Spinal Dis 14:185–192CrossRef Sutterlin CE, Bianchi JR, Kunz DN, Zdeblick TA, Johnson WM, Rapoff AJ (2001) Biomechanical evaluation of occipitocervical fixation devices. J Spinal Dis 14:185–192CrossRef
75.
Zurück zum Zitat Currier BL, Papagelopoulos PJ, Neale PG, Andreshak JL, Hokari Y, Berglund LJ, Larson DR, Fisher DR, An K (2003) Biomechanical evaluation of new posterior occipitocervical instrumentation system. Clin Orthop Rel Res 411:103–115CrossRef Currier BL, Papagelopoulos PJ, Neale PG, Andreshak JL, Hokari Y, Berglund LJ, Larson DR, Fisher DR, An K (2003) Biomechanical evaluation of new posterior occipitocervical instrumentation system. Clin Orthop Rel Res 411:103–115CrossRef
76.
Zurück zum Zitat Stock GH, Vaccaro AR, Brown AK, Anderson PA (2006) Contemporary posterior occipital fixation. J Bone Jt Surg Am 88:1642–1649 Stock GH, Vaccaro AR, Brown AK, Anderson PA (2006) Contemporary posterior occipital fixation. J Bone Jt Surg Am 88:1642–1649
77.
Zurück zum Zitat Doherty BJ, Heggeness MH, Esses SI (1993) A biomechanical study of odontoid fractures and fracture fixation. Spine 18:178PubMedCrossRef Doherty BJ, Heggeness MH, Esses SI (1993) A biomechanical study of odontoid fractures and fracture fixation. Spine 18:178PubMedCrossRef
78.
Zurück zum Zitat Sasso BC, Heggeness MH, Doherty BJ (1992) Biomechanics of odontoid fracture fixation: a comparison of one and two screw technique. Cervical Spine Research Society Abstracts, p 61 Sasso BC, Heggeness MH, Doherty BJ (1992) Biomechanics of odontoid fracture fixation: a comparison of one and two screw technique. Cervical Spine Research Society Abstracts, p 61
79.
Zurück zum Zitat Montesano PX, Anderson PA, Schlehr F, Thalgott JS, Lowrey G (1991) Odontoid fractures treated by anterior odontoid screw fixation. Spine 16:S33PubMedCrossRef Montesano PX, Anderson PA, Schlehr F, Thalgott JS, Lowrey G (1991) Odontoid fractures treated by anterior odontoid screw fixation. Spine 16:S33PubMedCrossRef
Metadaten
Titel
Anatomy and biomechanics of normal craniovertebral junction (a) and biomechanics of stabilization (b)
verfasst von
Arnold H. Menezes
Vincent C. Traynelis
Publikationsdatum
01.10.2008
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 10/2008
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-008-0606-8

Weitere Artikel der Ausgabe 10/2008

Child's Nervous System 10/2008 Zur Ausgabe

Special Annual Issue

Decision making

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.