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William Beecher Scoville

by lateral myelograms and by spinal fluid dynamics with the neck both flexed and extended. 16, 19 The sometimes dire results in trauma to the neck in older persons may well be ascribable to cervical hyperextension 1, 3, 5, 25 and kinking of the ligamenta flava against a vulnerable and compressed spinal cord. Transitory subluxation is probably a rare occurrence. DISCUSSION The writer takes tentative issue with certain of these observations, especially their surgical implications, but concurs in the need of lateral roentgen-ray films of the bone and

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Collin S. MacCarty, David C. Dahlin, John B. Doyle Jr., Paul R. Lipscomb and David G. Pugh

. The expansion, or widening, of the bone is often a striking feature and is evident even when great collapse of the vertebral body is present. Similar involvement often is seen in the laminae. When the spinous process is the site of the lesion, it often is greatly expanded and in some respects resembles a large egg, since the margin of the tumor ( Fig. 1 ) consists of an extremely fine shell of bone. As the result of the collapse of the vertebral body and involvement of the neural arch, concomitant subluxation of the vertebra often occurs, and a gibbus may be present

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H. Verbiest

. Roentgenograms showed a tear-drop compression fracture of the C5 vertebral body with slight posterior displacement of its inferior margin into the spinal canal, narrowed intervertebral diskal space between C5 and C6, and subluxation of articular processes C4–C5 ( Fig. 2A ). He was treated with skull traction for 5 days and subsequently a Minerva collar. Fig. 2. Case 2 . (A) August 1959, taken after injury, showing “tear-drop” compression fracture of C5 body and slight displacement of its posterior inferior margin into spinal canal, narrowed disk C4–C5, and subluxation

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Charles G. Drake

myelopathy is based upon evidence that the vertebral artery may be compressed by cervical subluxation at the atlanto-occipital and atlantoaxial junctions as well as below, particularly where unco-vertebral lipping narrows the canal of the vertebral artery. The secondary relative insufficiency in the anterior spinal and anterior sulcal arteries produces the central softening. As the leg area of the corticospinal tracts, the posterior columns and the lateral spinothalamic tracts lie more peripherally and are nourished by the arteriae coronae (branches of the posterior spinal

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William L. Stoops and Robert B. King

persons showed straightening of the normal cervical lordosis, in some cases extending to kyphosis. Subluxation of one cervical vertebra upon another was noted in 5 persons. Congenital anomalies of the cervical spine were demonstrated radiographically in 4 patients; a fifth patient had a cervical rib on the side opposite her radicular symptoms. Films of the cervical spine of 1 patient were normal in all regards. This patient was found at operation to have an extrusion of soft disc on the right at C4–C5 and a bony ridge on the right at C5–C6, narrowing that foramen and

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Bennett M. Stein, Norman E. Leeds, Juan M. Taveras and J. Lawrence Pool

subsequent deformities from vertebral luxation may thus be avoided.” In only 1 case in which a number of negative exploratory laminectomies had been carried out before removal of the tumor, did the problem of instability of the cervical spine with subluxation occur. In 1 case marked cervical kyphosis was noted postoperatively, but without clinical manifestation. Follow-Up Results Of the original 25 cases we were able to obtain follow-up information about 23. Seven of the patients died. Of this group 2 had not undergone operation; 1 of these died from a

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Robert B. King and William L. Stoops

narrowed, and there was slight posterior subluxation of C5 on C6. Myelography revealed ventral transverse defects in the contrast material at the C4–5 and C5–6 interspaces which were exaggerated by cervical flexion. A large dorsal defect was demonstrated at C4–5. A small lateral defect was present on the right at C4–5. The protein in the cerebrospinal fluid was 39 mg. per cent. There was no block of spinal fluid during flexion or extension of the cervical spine. Operation . A wide laminectomy of C6, C5 and C4 was performed. The dural tube moved posteriorly after

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Spontaneous Dislocation of the Atlas

Report of a Case Simulating Syringomyelia with a Discussion of Etiology and Methods of Treatment

Paul Skok, John Kapp and Charles E. Troland

. Obstet. , 1961, 113: 757–762. 6. Jackson , H. The diagnosis of minimal atlanto-axial subluxation. Brit. J. Radiol. , 1950 , n.s. 23 : 672 – 674 . Jackson , H. The diagnosis of minimal atlanto-axial subluxation. Brit. J. Radiol. , 1950, n.s. 23: 672–674. 7. Jacobson , G. , and Bleecker , H. H. Pseudosubluxation of the axis in children. Amer. J. Roentgenol. , 1959 , 82 : 472 – 481 . Jacobson , G., and Bleecker , H. H. Pseudosubluxation of the axis in children. Amer. J

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Richard C. Schneider, Kenneth E. Livingston, A. J. E. Cave and Gilbert Hamilton

and right side of the body. Although comatose he responded to painful stimuli with slight movement of his left extremities. The pupils were equal and there was bilateral internal strabismus and a continuous rotatory nystagmus. He was areflexic. Roentgenograms of the cervical spine showed bilateral avulsion of the pedicles of the 2nd cervical vertebra with subluxation of the 2nd vertebral body on the 3rd. Slight compression fracture of the 3rd cervical vertebra was noted and there was marked retropharyngeal swelling ( Fig. 2 ). Crutchfield skeletal traction was

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Louis Bakay and Eugene V. Leslie

artery. A clinicopathological study. Brain , 1956 , 79 : 319 – 331 . Hutchinson , E. C., and Yates , P. O. The cervical portion of the vertebral artery. A clinicopathological study. Brain , 1956, 79: 319–331. 13. Kovács , A. Subluxation and deformation of the cervical apophyseal joints. A contribution to the aetiology of headache. Acta radiol., Stockh. , 1955 , 43 : 1 – 16 . Kovács , A. Subluxation and deformation of the cervical apophyseal joints. A contribution to the aetiology of headache. Acta radiol., Stockh