JuniperPublishers_Head Neck & Spine Surgery

  Journal of Head Neck & Spine Surgery Juniper Publishers Author By:  Mudit Mehrotra Abstract Intra operative reduction of dislocated C1-C2 joints involves joint manipulation and varying degrees of distraction, compression and extension components. This holds good in cases of congenital Atlanto-axial dislocation (AAD) with Basilar invagination (BI). In cases of traumatic AAD associated with fracture of C1-C2 vertebrae, the joints may be hypermobile and grossly unstable because of the injured osseous-ligamentous complex. Distraction in these cases can cause traction on the brain stem or cervical cord, as well as over reduction of the C1-C2 joints leading to spinal canal compromise. We report a case of traumatic AAD (translation / rotatory/ lateral tilt) with fractures of C1-C2 vertebrae. While performing intra operative reduction, there was over reduction of C1-C2 joints. The management and available literature is discussed. Keywords:  Traumatic; Atlanto-axial dislocat...

  Journal of Head Neck & Spine Surgery Juniper Publishers Author By:  Abhishek Chaturbedi Abstract Background:  The efficacy of Dexamethasone as a method of conservative management for CSDH to avoid surgery remains inconclusive even after “Dex-CSDH” randomized controlled trial as almost all patients underwent an initial operation to remove the hematoma. Current study aims to determine the efficacy and safety of Dexamethasone alone therapy in comparison with the surgical drain of CSDH. Methods:  A multicenter, prospective study on mild to moderately symptomatic adult patients with CSDH were performed from January 2019 to December 2020. The patients were enrolled in a 1:1 ratio to receive a 3-weeks tapering course of oral Dexamethasone, starting at 4 mg thrice daily, or surgical drain of CSDH. The patient was assigned to a particular therapy based on their preference. The primary outcome was functional outcome in each group at 6 months determined by mRS, and cure r...

  Journal of Head Neck & Spine Surgery Juniper Publishers Author By:  Lorenzo Viviani Abstract Development in osteointegration and bone-implant interface led through the years to different prosthetic procedures, varying from tilted implant to zygomatic or pterygoid implant. Though feasibility of these prosthetic rehabilitations is to be determined for each patient. Here we suggest a paradigm shift in subperiosteal implant technique, where rigid fixation, load bearing concept, virtual planning and digital engineering are mandatory. A clinical case is reported in order to better explain and help understand the technique. Keywords:  Subperiosteal implants; Alternative implantology; Juxtabone implants; Bone atrophy; Atrophic maxilla Introduction The success of an implant-prosthetic oral rehabilitation relies on multiple factors: an optimal and firm bone tissues support, dental implant device features, peri-implant soft tissues favorable conditions and a proper prosthetic ...

  Journal of Head Neck & Spine Surgery Juniper Publishers Author by:  Kartik Sonawane Abstract Spine surgery is associated with multiple postoperative complications, ranging from simple nausea and vomiting to devastating complications leading to postoperative morbidity or mortality. The postoperative neurological impairment, especially in the neurologically intact patient, is a dreadful event that makes it difficult for the surgeon to perform technically challenging or high-risk spine surgeries. Preoperative or intraoperative factors that can influence the postoperative neurological status include nature and the severity of the pathology, comorbid conditions of the patient, preexisting neurological symptoms, multiple levels involved, complex surgery or instrumentation, surgical blood loss, neurological monitoring, hemodynamic parameters, polypharmacy, and total duration of the surgery. In addition to several known contributing factors (fixation failure, epidural hematoma, ...