Advanced Pediatric Craniocervical Surgery by Douglas L. Brockmeyer

By Douglas L. Brockmeyer

This article provides state of the art ideas for surgical procedure of the
craniovertebral junction and cervical backbone. It offers concise reasons of
the underlying rules of every method and insights into the original concerns
in pediatric surgical procedure. With this whole source, you are going to achieve the cast
foundation in surgical recommendations essential to make severe scientific judgements as
well because the technical wisdom and self belief to hold them out.

Highlights include:

  • specified causes illuminating the hyperlinks among
    embryology and general and irregular improvement of the craniovertebral junction
    and cervical backbone
  • In-depth dialogue of the problems and methods
    focused on either atlantoaxial and occipitocervical surgical procedure in young ones
  • a whole bankruptcy dedicated to coping with craniocervical
    stipulations of sufferers with Down Syndrome
  • An exam of disturbing accidents of the
    craniocervical junction in kids
  • greater than a hundred step by step illustrations demonstrating
    key surgical suggestions

This quite simply available textual content should 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

Sample text

Acta Orthop Scand 1981;52:331–338 34. McMaster MJ. Congenital scoliosis. In: Weinstein SL, ed. The Pediatric Spine: Principles and Practice. New York: Raven; 1994:227–244 25 26 Advanced Pediatric Craniocervical Surgery 35. Tori JA, Dickson JH. Association of congenital anomalies of the spine and kidneys. Clin Orthop 1980;148:259–262 36. Bavinck JN, Weaver DD. Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil, and Mobius anomalies. Am J Med Genet 1986;23:903–918 37.

23 The apical, cruciate, and alar ligaments are also derived from the fourth occipital sclerotome. Figure 1–8 Development of the craniovertebral junction from the fourth occipital (C” O”) and first three cervical (C1,C2,C3). For details, see text. (Reprinted with permission from Parke WW. Development of the spine. In: Herkowitz HN, Garfin SR, Balderston RA, Eismont FJ, Bell GR, Wiesel SW, eds. Rothman-Simeone sclerotomes, The Spine. 4th ed. ) 13 14 Advanced Pediatric Craniocervical Surgery The axis is derived from the fourth occipital sclerotome (somite 4) and the first and second cervical sclerotomes (somites 5 and 6).

The superior surface slopes downward and forward. This shape is conducive to the flexion–extension motion that occurs at this joint. In the adult, the total range of flexion and extension is 60 to 75 degrees. The greatest motion of flexion and extension is at the O–C1 junction (13 degrees), and the next greatest is between C5 and C7. Dynamic radiographs in children show that the upper cervical segments in infants and children are hypermobile in flexion. 14–16 The predilection for C2 and C3 forward displacement occurs because the joint is more mobile in children given that the articular facets of C2 and C3 lie in a relatively horizontal plane allowing for forward displacement.

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