Cervical spine

Tumors of the Base of Skull and Cervical Spine. Proton or other charged particle beams are a treatment of choice for skull base and cervieal spine tumors irradiation can be... 

At HCL/MGH in Boston, 621 patients with chordomas and low-grade chondrosarcomas of the skull base and cervical spine were treated with protons between 1975 and January 1998. For skull base tumors, with follow-up ranging from 1 to 254 months (median of 41 months), local recurrence-free survival is significantly better for chondrosarcomas than for chordomas. It is 98% at 5 years and 94% at 10 years for chondrosarcomas and 73% at 5 years and 54% at 10 years for chordomas (Fig. 17) [39]. Overall survival is also significantly better 91% vs. 80% at 5 years and 88% vs. 54% at 10 years, respectively. 

Immobilize cervical spine with an available device. Cervical spine injury is assumed in multiple trauma. 

Cervical Spine and Neck Visualize, palpate, and auscultate the patient s neck. Maintain spine precautions. Surgical assessment is necessary for penetrating neck wounds. Blunt injuries of the neck require frequent reassessment as signs develop late. Spine injuries should be ruled out as soon as possible as the patient is at risk for pressure ulcers from spine immobilization techniques. 

Airway/cervical spine Assess for patency iook for ioose teeth, vomitus, or other obstruction note position of head. Suspect cervicai spine injury with muitipie trauma maintain neutrai aiignment during assessment evaiuate effectiveness of cervicai coiiar, cervicai immobiiization device, or other equipment used to immobiiize the spine. Open cervicai coiiar to evaiuate neck for juguiar vein distention and tracheai deviation. 

Apply C-collar immediately if a cervical spine injury is suspected. 

Most lesions causing Homer s syndrome involve the preganglionic neuron. Patients with such lesions may have an apical lung tumor (Pancoast tumor) or breast malignancy that has spread to the thoracic outlet. The patient may also have a history of surgery or trauma to the neck, chest, or cervical spine. Nonoperative injuries to... 

Tumialan LM, Wippold EJ, Morgan RA (2004) Tortuous vertebral artery injury complicating anterior cervical spinal fusion in a symptomatic rheumatoid cervical spine. Spine 29 E323-E348. 

Prolonged cyclic albendazole treatment (for more than 9 years) was safe and effective in a patient with isolated cervical spine echinococcosis in whom surgery was performed without preoperative antihelminthic therapy because of a delay in diagnosis (7). 

Garcia-Vicuna R, Carvajal I, Ortiz-Garcia A, Lopez-Robledillo JC, Laffon A, Sabando P. Primary solitary echinococcosis in cervical spine. Postsurgical successful outcome after long-term albendazole treatment. Spine 2000 25(4) 520-3. 

A literature review has provided reassurance about the relative safety of spinal manipulation (142). When the serious adverse effects of non-steroidal anti-inflammatory drugs were compared with those of spinal manipulation, both used for neck pain, manipulation emerged as being safer by more than two orders of magnitude. However, these procedures can be associated with serious complications, particularly when they involve the cervical spine (143). 

An authoritative summary of all cases of comphcations of spinal manipulation of the cervical spine published since 1925 has appeared (146). There were 177 cases of severe injury. The most common injuries involved arterial... 

Swedish authors have summarized cases reported to three Swedish insurance companies within 2 years (178). They found 21 cases associated with the cervical spine, six associated with the thoracic spine, 13 with the lumbar spine, and 14 with the sacro-iliac joints. Cervical spinal manipulation had caused damage to the vertebral artery with subsequent paralysis in three cases and disk herniation in three cases. Lumbar spinal manipulation had caused disk herniation in six cases, three of whom suffered severe and persistent problems. 

Di Fabio RP. Manipulation of the cervical spine risks and benefits. Phys Ther 1999 79(l) 50-65. 

Michaeli A. Dizziness testing of the cervical spine can complications of manipulations be prevented Physiother Theory Pract 1991 7 243-50. 

Hufnagel A, Hammers A, Schonle PW, Bohm KD, Leonhardt G. Stroke following chiropractic manipulation of the cervical spine. J Neurol 1999 246(8) 683-8. 

Stevinson C, Honan W, Cooke B, Ernst E. Neurological complications of cervical spine manipulation. J R Soc Med 2001 94(3) 107-10. 

See footnotes in Table 6.5 for the definition of clinical result classifications for acute rheumatic fever, rheumatoid arthritis, and cervical spine-shoulder and lumbar spine syndromes. 

Patients with cervical spine-shoulder syndrome, including shoulder bursitis (frozen shoulder, calcareous tendonitis and Duplay s disease) as well as lumbar spine syndrome, were also successfully treated with Permalon. These patients were generally treated with Permalon infusions as described for patients with RA. However, when these patients suffered from marked impairment of mobility accompanied by severe nocturnal pain, they were given an average of 4-8 infusions (40 to 80 mg of Cu) per day at intervals of... 

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