Kranioservikal Bileşke Travmalarında Tanı Yöntemleri

Year 2016, Volume: 25 Issue: 3, 335 - 350, 30.09.2016

Zübeyde Seçme Özkaya Ahmet Aslan

https://doi.org/10.17827/aktd.248422

Cited By: 2

Abstract

Kraniyoservikal bileşke baş ve boyun hareketlerinin yapıldığı, omurganın en hareketli bölümüdür. Fazla hareketli olması nedeniyle yaralanmalara en açık bölgedir. Bu bölgenin travmalarının tanısı özel yaklaşım gerektirir. Yan servikal grafi ile tek başına %85’e yakın tanı konulabilir. Bununla birlikte yaralanmaları gözden kaçırma oranı %10-48 arasında değişmektedir. Bu nedenle tanıda radyografilerin yanında daha duyarlı olan bilgisayarlı tomografi ve manyetik rezonans görüntülemeden de faydalanılmalıdır. Bu derlemeyi yazmaktaki amaç üst servikal bölge yaralanmalarını daha iyi anlamamızı sağlayacak ipuçlarını sunabilmek ve akut ya da kronik süreçte oluşan patolojilerde tanıya yardımcı yöntemler konusunda aydınlatıcı bilgiler verebilmektir.

Keywords

Kranioservikal bileşke, üst servikal omurga, travma, radyolojik, tanı yöntemleri

Diagnostic Methods for Craniocervical Junction Traumas

Abstract

Craniocervical junction is the most mobile part of the spine that helps head and neck movement. It is most vulnerable part to injury because of its feature of high mobility. The diagnosis of trauma in this area requires a special approach. With lateral cervical radiographs can lead to diagnosis alone in 85% of cases. However, injury could be overlooked 10-48% of cases. Therefore more sensitive diagnostic like computed tomography and magnetic resonance imaging are needed in addition to plain radiography.The purpose of this review paper is to offer clues that will allow us to better understand methods used to assist diagnosis in acute or chronic pathological processes of upper cervical spine injuries.

Keywords

Craniocervical Junction, upper cervical spine, trauma, radiological, diagnostic methods

References

• Singh A, Tetreault L, Kalsi-Ryan S, Nouri A, Fehlings MG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014;6:309-31.
• Bellabarba C, Mirza SK, Chapman JR. Injuries of the craniocervical junction. in Rockwood & Green's Fractures Adults. 6th ed (Eds RW Bucholz, JD Heckman, CM Court-Brown):1544-85. Philadelphia, Lippincott Williams and Wilkins, 2006.
• Özkaya ZS. Kranioservikal bileşke travmalarının etiyolojisi ve tanı yöntemlerinin incelenmesi (Tıpta uzmanlık tezi). İzmir, T.C. Sağlık Bakanlığı Atatürk Eğitim ve Araştırma Hastanesi, 2006.
• Kırcelli A, Cansever T, Yılmaz C. Geriatrik hastalarda üst servikal bölge travmaları. Turk Neurosurg. 2015;25:216-26.
• Bransford RJ, Alton TB, Patel AR, Bellabarba C. Upper cervical spine trauma. J Am Acad Orthop Surg. 2014;22:718-29.
• Dalbayrak S, Yaman O. Erişkin üst servikal travma yönetimi. Turk Neurosurg. 2015;25:201-15.
• Syre P, Petrov D, Malhotra NR. Management of upper cervical spine injuries: a review. J Neurosurg Sci. 2013;57:219-40.
• Swartz EE, Floyd RT, Cendoma M. Cervical spine functional anatomy and the biomechanics of injury due to compressive loading. J Athl Train. 2005;40:155-61.
• Cusick JF, Yoganandan N. Biomechanics of the cervical spine 4: major injuries. Clin Biomech. 2002;17:1-20.
• Hadley MN, Walters BC, Grabb PA, Oyesiku NM, Przybylski GJ, Resnick DK et al. . Guidelines for the management of acute cervical spine and spinal cord injuries. Clin Neurosurg. 2002;49:407-98.
• Walters BC, Hadley MN, Hurlbert RJ, Aarabi B, Dhall SS, Gelb DE et al. Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 2013;60(Suppl 1):82-91.
• Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of atlanto-occipital and atlantoaxial traumatic injuries: what the radiologist needs to know. Radiographics. 2015;35:2121-34.
• Van Goethem JWM, Maes M, Özsarlak Ö, Van Den Hauwe L, Parisel PM. Imaging in spinal trauma. Eur Radiol. 2005;15:582-90.
• İş M, Şafak AA. Servikal omurga yaralanmalarında tanı görüntüleme yöntemleri. Düzce Tıp Fakültesi Dergisi. 2005;1:35-42.
• Kitiş S, Güzey FK, Çevik S. Çocuklarda üst servikal bölge ve kraniyovertebral bileşke yaralanmaları Turk Neurosurg. 2015;25:177-88.
• Graber MA, Kathol M. Cervical spine radiographs in the trauma patient. Am Fam Physician. 1999;59:331-42.
• Kontautas E1, Ambrozaitis KV, Spakauskas B, Smailys A. [Upper cervical spine injuries and their diagnostic features]. Medicina (Kaunas). 2005;41:802-9.
• Obenauer S, Herold T, Fischer U, Fadjasch G, Koebke J et al. The evaluation of experimentally induced injuries to the upper cervical spine with a digital X-ray technic, computed tomography and magnetic resonance. Rofo. 1999;171:473–9.
• Rojas CA1, Bertozzi JC, Martinez CR, Whitlow J. Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. 2007;28:1819-23.
• Dullerud R, Gjertsen O, Server A. Magnetic resonance imaging of ligaments and membranes in the craniocervical junction in whiplash-associated injury and in healthy control subjects. Acta Radiol. 2010;51:207-12.
• Roy AK, Miller BA, Holland CM, Fountain AJ Jr, Pradilla G, Ahmad FU. Magnetic resonance imaging of traumatic injury to the craniovertebral junction: a case-based review. Neurosurg Focus. 2015;38:E3.
• Bertalanffy D, Seeger W. The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery. 1991;29:815-21.
• Topuz AK, Şimşek H. Kraniovertebral bileşke anomalilerinin tanı yöntemleri ve tedavi algoritması. Turk Neurosurg. 2013;23:150-57.
• Menezes AH, Vangilder JC. Transoral-transpharyngeal approach to the anterior craniocervical junction. J Neurosurg. 1988;69:895-902.
• Young WF, Rosenwasser RH, Geth C, Jallo J. Diagnosis and management ol occipital condyle fractures. Neurosurgery. 1994;34:257-61.
• Anderson LD, D'Alanzo RI. Fractures of the odontoid process of the axis. J Bone Joint Surg.1974:56A;1663-74.
• Bozboğa M, Ünal F, Hepgil K, İzgi N: Turantan I, Türker K: Fractures of the occipital condyl. Spine.1992; 17:1119-21.
• Sharma BS, Mahagan RK, Bhaitia S, Khosla UK. Collet Sicard Syndrome afier closed head injury. Clin Neurol Neurosurg. 1994;96:197-98.
• Ahuja A, Glasauer FE, Alker GJ, Klein DM. Radiology in survivors of traumatic atlantooccipital dislocation. Surg Neurol. 1994;41:112-18.
• Chandra S, Yerramani V. Injuries of the craniovertebral junction and upper cervical spine. In Textbook of Neurosurgery (Eds R Ramammurthi, NP Tandon):567-78. New Delhi, Jaypee Brothers 2012.
• Hadley MN, Dickman CA, Browner CM, Sonntag VKH. Acute traumatic atlas fractures: management and long term outcome. Neurosurgery. 1988;23:31-5.
• Steel HH. Anatomical and mechanical considerations ol the atlanto-axial articulations. J Bone Joint Surg. 1968;50A:481-2.
• Dickman CA, Sonnag VKH. Surgical techniques lor the stabilization ol the carvical stabilization. In: Operative Neurosurgical Technigues. Indications, Methods, and Results, 3rd ed. (Eds HH Schmidek, WH Sweet):1849-73. Philadelphia, W. B Saunders 1995.
• Hadley MN, Browner CM, Liu SS, Sanntaq UK. New subtype of acute odontoid fractures (type IlA). Neurosurgery. 1988;22:67-71.
• Hadley MN, Diclanan CA, Browner CM. Acute axis fractures: a review of 229 cases. J. Neurosurg. 1989;71:642-47.
• Levine AM, Edward CC: Traumatic lesions of occipito atlanto axial rotatory deformity. Semin Spine Surg. 1991;3:33-8.
• Traynelis VC, Marano GD, Dunker RO, Kaufman HH: Traumatic atlanto-occipital dislocation: case report. J Neurosurg. 1986;65:863-70.
• Madhavan P, Monk J, Wilson-MacDonald J, et al. Instability due to unrecognised fracture- subluxations after apparently isolated injuries of the cervical spine. J Bone Joint Surg Br. 2001;83:486-90.
• Effendi B, Roy D, Cornish B, Dussault RG, Laurin CA: Fracture of the ring of the axis. A classification based on the analysis of 131 cases. J Bone Joint Surg. 1981;63:319-27.
• Özkaya SÇ, Özkaya S, Aslan A. Investigate the etiology and diagnosis methods of the craniocervical junction trauma. XIth International Turkish Spine Congress. 29 April-3 May 2015,Çeşme, İzmir/Turkey [Poster Present].
• Burney RE, Maio RF, Maynard F, Karunas R. Incidence, characteristics, and outcome of spinal cord injury at trauma centers in North America.Arch Surg. 1993;128:596-9.
• Correspondence Address / Yazışma Adresi Ahmet Aslan
• Afyonkarahisar Devlet Hastanesi,
• Ortopedi ve Travmatoloji Kliniği,
• Afyonkarahisar, Turkey
• e-mail: [e-mail]
• Geliş tarihi/ Received: 07.12.2015
• Kabul tarihi/Accepted: 11.01.2016