Severe dysphagia after a posterior cervical spine fusion at the C1-C3 level and its improvement after correction surgery for malalignment: a case report.

BACKGROUND: The development of dysphagia and trismus following posterior C1-C3 fusion is rare compared to occipitocervical fusion, and there are very few reports in the literature. CASE PRESENTATION: A 75-year-old Thai man who had an extradural tumor at the C1/C2 level developed severe dysphagia and trismus immediately after tumor resection and C1-C3 fusion. During the surgery for malalignment correction, the C1-C2 screws were re-aligned into an increased lordotic position. The symptoms resolved immediately post-surgery. CONCLUSIONS: Short upper cervical fusion can produce trismus and dysphagia in a relatively flexed position. Preoperative planning should be individualized based on the patient's resting neutral alignment to prevent complications.

Subpial Schwannoma of the Cervical Spinal Cord: A Case Report and Its Intraoperative Finding Supporting a Theory of the Pathogenesis of an Intramedullary Schwannoma.

Because of its tumor origin from nerve sheath cells (the Schwann cells), the pathogenesis of an extraordinary rare intramedullary schwannoma, which should not have any Schwann's cells in nature, is controversial and still in debate. We report a case of a 63-year-old man diagnosed with a cervical cord intramedullary schwannoma with an interesting intraoperative finding that could support one of the theories on its genesis.

Success Rate of Simple Coil Embolization in Wide-Neck Aneurysm with Aneurysmal Shoulder.

BACKGROUND AND OBJECTIVE: Wide-necked intracranial aneurysm (WIA) is one of the challenging diseases for neuro-interventionist to treat by simple coiling technique. The purpose of this study is to identify the morphology associated with successful simple coil embolization in wide neck aneurysm patients. MATERIALS AND METHODS: Between January 2002 and August 2018, 102 patients with total 115 ruptured or unruptured WIA which received endovascular treatment were retrospective reviewed. Data were analyzed including demographics, aneurysm morphology, endovascular technique, angiographic outcome, complication, regrowth, and retreatment rate. RESULTS: The mean age of patients was 61.6 years with female predominant (72.5%). Ruptured WIA was diagnosed in 71 patients (61.7%). Majority of aneurysms were located in an anterior circulation which were 74 cases (64.3%), mainly paraclinoid aneurysm (30/115). Endovascular treatment was successful in 113 cases (98.3%) which can be mainly divided into simple coil embolization 50 cases (43.5%), balloon-assisted coil embolization 26 cases (22.6%), and stent-assisted coil embolization 32 cases (27.8%). Complete, subtotal, and incomplete occlusion of WIA was achieved in 32 cases (27.8%), 62 cases (53.9%), and 18 cases (15.7%), respectively. There was 9.6% complication occurred. Regrowth and retreatment were found 20% and 15.7%, respectively. CONCLUSION: WIA with two-sided aneurysmal shoulder or neck width <3.6 mm. are significantly associated with successful coil embolization using simple coiling technique.