Gauthier Laustsen (talkepoch9)

29 mm (left insertion 4.28 mm, right insertion 4.31 mm, range 3.02-5.62 mm). Despite the highest size in a female and the lowest in a male, the male population showed larger bone stock (mean of 4.71 mm left connection 4.70 mm, right connection 4.71 mm) than the female one (mean of 4.29 mm left 4.28 mm, right 4.31 mm). Overall, we found 59.5% insertions higher than 4 mm and 86.9% arch connections bigger than 3.5 mm. CONCLUSION The anatomical situation allows inserting at least a 3.5mm diameter screw in a vast majority of cases. The posterior arch attachment point thus seems to be a suitable anatomical target for instrumentation of C1 lateral mass. Nevertheless, individual presurgical planning and intraoperative spinal navigation should be implemented, as well.INTRODUCTION Purpose of the study is to evaluate a possible influence of subdural drainage duration and burr hole quantity on a relapse of a unilateral chronic subdural haematoma (CHSH). METHODS Sixty - five patients who underwent evacuation of unilateral CHSH via 1 or 2 burr holes and subdural drainage during a period from January 2014 to December 2018 were retrospectively analyzed. click here Duration of the subdural drainage and the number of burr holes used were assessed in relation to an incidence of CHSH recurrence. According to the subdural drainage duration, we divided the patient cohort into two subgroups with the subdural drainage duration of 1-3 days and 4-5 days. We also evaluated a possible influence of the subdural drainage duration on risk of postoperative infection. RESULTS An overall incidence of CHSH recurrence was 18.5%. In 45 patients treated by means of a single burr hole the haematoma recurrence was observed in 10 patients (22.2%), in 22 patients with two burr holes recurrence occurred in 2 of them (9.1%). The difference was however, not statistically significant (p=0.3214). We did not observe any significant influence of age, gender and subdural drainage duration on the incidence of CHSH recurrence. The duration of subdural drainage had not significant impact on postoperative infection rate (p=0.0950). CONCLUSION The number of burr holes used does not affect the rate of unilateral CHSH recurrence. Similarly the duration of subdural drainage affects neither the unilateral CHSH recurrence rate nor the incidence of postoperative infection.INTRODUCTION Atlanto-occipital dissociation (AOD) is a rare and unstable injury of the craniocervical junction, associated with very high morbidity and mortality. The most common cause of this injury is high energy trauma with hyperextension of the cranium, such as car accidents. Due to specific anatomical predispositions, children and young adults are the frequently affected populations. Improving pre-hospital and early emergency care has resulted in a higher sensitivity of AOD diagnosis. METHODS A retrospective analysis of all patients with cervical spine trauma, treated at the Masaryk Hospital Trauma Center between 2008 and 2018, identified 7 patients with AOD. The cohort consisted of 5 males and 2 females, with a mean age of 19,6 years and with the age range 9 to 35 years. All cases occurred as a result of a car accident. RESULTS All patients in the cohort had findings of a highly unstable C0-C1 injury on their CT scans on admission. Four patients died early, while undergoing CPR in the emergency department. Two patients were in severe neurological states, with lesions of the upper cervical spinal cord and medulla oblongata on MRI. These patients were treated with external halo fixation and died within 3 days of the trauma. Only one patient with a new progressive neurological deficit was successfully treated using acute occipitocervical stabilization and fusion. CONCLUSION The increasing incidence of AOD requires an early diagnosis, which minimizes the risk of successive clinical deterioration. The diagnostic met