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Non-Traumatic Atlanto-Axial Dislocation

Report of Case with Recovery after Quadriplegia

Leonard A. Titrud, C. A. McKinlay, Walter E. Camp and Hewitt B. Hannah

They emphasized the avoidance of excessive rotation and manipulation of a child's head during surgical drainage of cervical infections since the relaxed anesthetic muscles may not protect against vertebral dislocation. These same authors 9 reported in 1942 a 5-year follow-up of a 12-year-old boy who had an unreduced spontaneous atlanto-axial dislocation. Their suggestion was that although occasionally spontaneous reduction and normal calcification may occur, some of the persisting spinal deformities in older persons may have arisen as in their described case. Martin

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Glen O. Cross, James R. Reavis and William W. Saunders

preceded or followed the herniations. Examinations reported prove the absence of meningocele but do not prove the absence of bone defects. Even in our patient one can postulate that a marked spinal deformity had existed since birth. Final decompensation with destruction of an intervertebral disc, increased kyphoscoliosis and development of radicular pain followed an adequate injury by a period consistent with the course of traumatic arthritis. Meningocele formation may have been incidental. Sengpiel et al. 5 have suggested that an unusually extended attachment of the

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Burton L. Wise and Jacob J. Foster

present, but no actual urinary incontinence or retention. While in the U. S. Army from 1942 to 1946, the patient served in Africa, China and India, but did not contract any illness. Examination. The patient was a thin, short Chinese male. No spinal deformities were noted, and there was a full range of motion of the back without pain, tenderness or muscle spasm. Rectal sphincter tone was good. On the right side, the quadriceps reflex was slightly hyperactive and the Achilles reflex was absent. Left quadriceps and Achilles reflexes were normal. Abdominal reflexes

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W. Eugene Stern and Paul H. Crandall

anatomy in relation to certain spinal deformities. Spec. Rep. Ser. med. Res. Coun., Lond. , No. 161 , 1931 , 79 pp . Beadle , O. A. The intervertebral discs. Observations on their normal and morbid anatomy in relation to certain spinal deformities. Spec. Rep. Ser. med. Res. Coun., Lond., No. 161 , 1931, 79 pp. 4. Begg , A. C. Nuclear herniations of the intervertebral disc. Their radiological manifestations and significance. J. Bone Jt. Surg. , 1954 , 36-B , 180 – 193 . Begg , A. C. Nuclear herniations of the

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William J. German

, has obvious points of special interest to neurosurgeons. Among these are ruptured intervertebral discs, spinal deformities and compression of the cord, neuronal degeneration, vascular lesions including aneurysms and delayed wound healing. 23 Less obvious is the fact that experimental lathyrism is a model of chemically induced disease, a tool for the study of some of the basic processes of disease. The excellent article by Menzies and Mills 28 on the pathology of osteolathyrism indicated that the fundamental pathological process in the bones and aorta was an

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Ernest Sachs Jr., John R. Dyke and Garry deN. Hough III

Paraplegia caused by kyphoscoliosis is quite rare other than in those cases in which it is secondary to tuberculosis of the spine. In this presentation we plan to refer only to those cases of paraplegia resulting from severe kyphoscoliosis not caused by tuberculous granuloma. Scoliosis itself is a common deformity of the spine but seldom results in neurological disturbance. Some 150 patients with scoliosis without primary neurologic disease have been treated at the Springfield Unit of the Shriners Hospitals. Although many have had severe spinal deformity, no

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Leslie E. Geiger

. Armstrong , J. R. Lumbar disc lesions Pathogenesis and treatment of low back pain and sciatica. Edinburgh & London : E. & S. Livingstone Ltd . 1952 , viii , 228 pp. Armstrong , J. R. Lumbar disc lesions. Pathogenesis and treatment of low back pain and sciatica. Edinburgh & London: E. & S. Livingstone Ltd . 1952, viii, 228 pp. 2. Beadle , O. A. The intravertebral discs. Observations on their normal and morbid anatomy in relation to certain spinal deformities. Spec. Rep. Ser. Med. Res. Court., Lond., No. 161

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Ralph B. Cloward

anterior angulation resulted in a permanent spinal deformity. In 3 patients the deformity was extreme, resulting either in marked angulation ( Fig. 1B ) or what appeared to be severe encroachment of the lower vertebral body upon the spinal canal. From the appearance of the roentgenogram, serious impairment of function of the spine and/or the spinal cord might be expected because of the change in the weight-bearing angle of the vertebral column. However, each of these 5 patients is entirely symptom-free as far as his neck is concerned and the deformity of the cervical

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Harvey Cushing

can examples of acromegaly without gross changes in the pituitary body be excluded in a general consideration of acromegaly. Case 9 . [Dr. Mooser's case.] Acute painful obesity sparing extremities. Cutaneous pigmentation. Spinal deformity from osteoporosis. Duration three years. Autopsy: osteomalacia with multiple fractures; cardiac hypertrophy; atheromatous vessels; contracted kidneys; acute pancreatic necrosis; testicular atrophy. Pituitary body large but said to be normal . Clinical history . The patient, aged 27 (born in 1890), the eldest of eleven children

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Robert H. Wilkins

scholarly work with numerous and extensive foot-notes….” 17 In his various writings, Hippocrates dealt with several subjects of neurosurgical interest. Among other things, he discussed epilepsy, 2, 16, 18–20, 25, 29–31 the coexistence of spinal deformity with pulmonary tubercles, 11 and the functional effects of compression of the spinal cord. 20 He devised a method of reducing vertebral dislocations, 20 and mentioned trephining as a cure for blindness without evident ocular disease. 3 He also described permanent and transient facial paralyses, sciatica, the