Download PDF by Douglas L. Brockmeyer: Advanced Pediatric Craniocervical Surgery

By Douglas L. Brockmeyer

ISBN-10: 3131320818

ISBN-13: 9783131320810

This article offers cutting-edge suggestions for surgical procedure of the
craniovertebral junction and cervical backbone. It offers concise reasons of
the underlying ideas of every procedure and insights into the original concerns
in pediatric surgical procedure. With this entire source, you'll achieve the forged
foundation in surgical ideas essential to make severe medical judgements as
well because the technical wisdom and self belief to hold them out.

Highlights include:

  • targeted causes illuminating the hyperlinks among
    embryology and common and irregular improvement of the craniovertebral junction
    and cervical backbone
  • In-depth dialogue of the problems and methods
    concerned about either atlantoaxial and occipitocervical surgical procedure in little ones
  • a complete bankruptcy dedicated to coping with craniocervical
    stipulations of sufferers with Down Syndrome
  • An exam of demanding accidents of the
    craniocervical junction in teenagers
  • greater than a hundred step by step illustrations demonstrating
    key surgical thoughts

This comfortably obtainable textual content can be a precious asset in
the library of physicians dealing with and treating craniocervical stipulations, from
the such a lot skilled pediatric neurosurgeon to citizens within the early levels in their careers.

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Additional resources for Advanced Pediatric Craniocervical Surgery

Example text

21 These structures are the odontoid process and the transverse ligament. They provide the majority of stability at the C1–C2 joint, and their integrity is critical. The transverse ligament is a thick horizontal band of the cruciate ligament that attaches to the inner aspect of the C1 ring, and straps hold the dens against the anterior arch of C1. It is the pivotal stabilizer against horizontal translation of the dens into the spinal canal. 22 The strength of the transverse ligament is clinically illustrated by the occurrence of dens fractures in adults and synchondrosis failure in young children while the ligament itself remains intact.

Many Figure 2–4 Radiographic assessment of stability. This panel schematically shows the various distances and ratios used to assess plain radiographs for evidence of instability. ADI, atlantodental interval; BAI, basion–axial interval; B, basion;C, posterior arch of atlas; O, opisthion; A, anterior arch of atlas; C2, base of C2; C2L, C2 lamina. 57 Additional radiographic criteria have been devised to infer instability at the craniocervical junction. It is important to recognize that once the major stabilizing structures between the occiput and C2 are disrupted in the O–C2 complex and the critical threshold for instability is reached, various displacements between the occiput and C1, between C1 and C2, as well as between the occiput and C2 can be seen.

48 Abnormal fusion of adjacent ossification centers at the CVJ may produce several well-known malformations. Within the atlas or axis, a failure of anterior and posterior ossification centers to fuse properly will produce characteristic defects involving the predictable sites of normal fusion—anterolaterally and at the posterior midline. A failure of midline fusion between the paired odontoid ossification centers results in a bifid odontoid process. In an analogous manner, a failure of fusion between the ossiculum terminale (fourth cervical sclerotome) and the odontoid process (first cervical sclerotome) results in ossiculum terminale (or os avis); in some cases the ossiculum terminale fuses instead with the distal clivus.

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Advanced Pediatric Craniocervical Surgery by Douglas L. Brockmeyer


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